Sen. Jon Tester, D-Mont., the top Democrat on the Senate Veterans Affairs Committee and a cosponsor of the MISSION Act, said he has “grown increasingly concerned” about the law since it sailed through Congress last year.

Sen. Jon Tester, D-Mont., the top Democrat on the Senate Veterans Affairs Committee and a cosponsor of the MISSION Act, said he has “grown increasingly concerned” about the law since it sailed through Congress last year. Alex Brandon/AP

Lawmakers Worry New VA Private Care Program Could Be a ‘Train Wreck’

Members task Veterans Affairs secretary with avoiding familiar trappings in implementing the new law.

Lawmakers from both parties cautioned the Veterans Affairs Department to tread carefully in enacting a law President Trump signed last year to give more veterans access to private sector health care, suggesting the current trajectory could sabotage the entire program.

VA is actively seeking to address potential pitfalls through its negotiations with potential contractors that will make up the “community care network,” Secretary Robert Wilkie told a joint, bicameral congressional committee on Wednesday. Criticisms came from an array of sources, most of whom voted to approve the MISSION Act last year.

Sen. Jon Tester, D-Mont., the top Democrat on the Senate Veterans Affairs Committee and a cosponsor of the MISSION Act, said he has “grown increasingly concerned” about the law since it sailed through Congress last year. He accused VA of going down a “different road” than it was just six months ago with regard to its implementation. He suggested VA is now considering a complete outsourcing of certain procedures and appointments, as well as giving veterans carte blanche to pursue private care outside of VA based on “arbitrary” wait times or distance from a VA facility. One of the main tenets of the new law was to move away from such metrics for determining eligibility for outside care, Tester said.

Wilkie said the department, in conjunction with the White House, is in the process of determining its “designated access standards,” or the criteria it will use to decide which veterans have access to the private sector through the MISSION Act. Trump is planning to unveil those criteria in his State of the Union address, lawmakers said at the hearing. Wilkie committed only to briefing lawmakers on the criteria as soon as the president approves them. He conceded that veterans are “not chomping at the bit” to increase their access to private care and are generally happy with VA services. He noted that the use of community care has actually dipped slightly in recent years and very few veterans eligible to have 100 percent of their private sector medical costs paid for by VA choose to pursue that path.

The MISSION Act provides veterans with access to private sector care when the services they are seeking are not offered at VA, there is no full-service medical facility in their state, they previously were eligible for outside care under the Veterans Choice Program or VA cannot meet its own standards of care in providing care to an individual veteran. It also allows a veteran and doctor to mutually agree that private care was in the patient's “best medical interest.” It no longer requires veterans to live more 40 miles from a VA facility to get private care.

The law will soon sunset and replace the Choice Program, which Congress established after the 2014 scandal involving department employees manipulating patient data to hide long wait times. The existing program is set to expire in June, one year from the date Trump signed the MISSION Act into law.

Rep. Phil Roe, the House VA Chairman and the MISSION Act’s main shepherd in the lower chamber, said he did not want to repeat the “fiasco” of the 2014 law’s rollout. Tester said the onus was now on Wilkie to ensure such a fate does not befall the new measure, which consolidates existing community care programs.

“We passed it with the best of intentions but it could be a train wreck too,” Tester said told Wilkie. “It’s in your lap.”

Lawmakers repeatedly pointed a recent report that found the Choice Program was riddled by unusually large overhead costs and overcharging by the contractors tasked with implementing it. Wilkie admitted the costs were a problem, saying VA was “taken advantage of” due to a rushed time frame associated with 2014 law and decisions were made before his tenure.

“VA had to move as rapidly as possible and there was not that time for reflection that you would usually have for an issue like this,” Wilkie said.

He sought to assuage concerns by saying the MISSION Act addressed the problems created by the 2014 law. Ongoing negotiations will ensure new contracts reduce overhead costs, he said, though lawmakers noted one of the contractors, TriWest, is still operating on the existing contract.

Rep. Jim Banks, R-Ind., suggested VA may be sending good money after bad.

“It seems like we've been pouring money into a leaky bucket or a clogged-up pipe,” Rep. Jim Banks, R-Ind., said.

The secretary said VA expects three of the four regions of community networks to have all the contracts in place by the end of February 2019, with contracts for the fourth region established the following month. The program is set to “go live” in June.

Wilkie also took the opportunity to praise the VA workforce.

“This may come as a surprise to some in the press that a conservative Republican would say this: I am incredibly proud to be part of the best workforce in the federal government,” the secretary said.

X
This website uses cookies to enhance user experience and to analyze performance and traffic on our website. We also share information about your use of our site with our social media, advertising and analytics partners. Learn More / Do Not Sell My Personal Information
Accept Cookies
X
Cookie Preferences Cookie List

Do Not Sell My Personal Information

When you visit our website, we store cookies on your browser to collect information. The information collected might relate to you, your preferences or your device, and is mostly used to make the site work as you expect it to and to provide a more personalized web experience. However, you can choose not to allow certain types of cookies, which may impact your experience of the site and the services we are able to offer. Click on the different category headings to find out more and change our default settings according to your preference. You cannot opt-out of our First Party Strictly Necessary Cookies as they are deployed in order to ensure the proper functioning of our website (such as prompting the cookie banner and remembering your settings, to log into your account, to redirect you when you log out, etc.). For more information about the First and Third Party Cookies used please follow this link.

Allow All Cookies

Manage Consent Preferences

Strictly Necessary Cookies - Always Active

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data, Targeting & Social Media Cookies

Under the California Consumer Privacy Act, you have the right to opt-out of the sale of your personal information to third parties. These cookies collect information for analytics and to personalize your experience with targeted ads. You may exercise your right to opt out of the sale of personal information by using this toggle switch. If you opt out we will not be able to offer you personalised ads and will not hand over your personal information to any third parties. Additionally, you may contact our legal department for further clarification about your rights as a California consumer by using this Exercise My Rights link

If you have enabled privacy controls on your browser (such as a plugin), we have to take that as a valid request to opt-out. Therefore we would not be able to track your activity through the web. This may affect our ability to personalize ads according to your preferences.

Targeting cookies may be set through our site by our advertising partners. They may be used by those companies to build a profile of your interests and show you relevant adverts on other sites. They do not store directly personal information, but are based on uniquely identifying your browser and internet device. If you do not allow these cookies, you will experience less targeted advertising.

Social media cookies are set by a range of social media services that we have added to the site to enable you to share our content with your friends and networks. They are capable of tracking your browser across other sites and building up a profile of your interests. This may impact the content and messages you see on other websites you visit. If you do not allow these cookies you may not be able to use or see these sharing tools.

If you want to opt out of all of our lead reports and lists, please submit a privacy request at our Do Not Sell page.

Save Settings
Cookie Preferences Cookie List

Cookie List

A cookie is a small piece of data (text file) that a website – when visited by a user – asks your browser to store on your device in order to remember information about you, such as your language preference or login information. Those cookies are set by us and called first-party cookies. We also use third-party cookies – which are cookies from a domain different than the domain of the website you are visiting – for our advertising and marketing efforts. More specifically, we use cookies and other tracking technologies for the following purposes:

Strictly Necessary Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Functional Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Performance Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Social Media Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Targeting Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.