Jun 03 2014
Bill provides veterans choice and flexibility in medical care, increases accountability and transparency at the VA
Washington, DC – U.S. Senators John McCain (R-AZ), Tom Coburn (R-OK), Richard Burr (R-NC), and Jeff Flake (R-AZ) today introduced the Veterans Choice Act to address the most pressing issues raised by the continuing VA scandal by providing veterans with greater choice and flexibility in health care providers and increasing accountability and transparency at the U.S. Department of Veterans Affairs (VA). According to the VA Inspector General (IG) report issued last week, 42 VA medical facilities across the nation are now under investigation, and delays in care and manipulation of records are “systemic throughout” the VA, including waiting times in Phoenix averaging 115 days for initial primary care – more than four times the previously reported average of 24 days. Most disturbing, the IG found that some 1,700 veterans waiting for primary care appointments were never placed on the Phoenix VA’s electronic wait list, and according to the report, “these veterans continue to be at risk of being forgotten or lost in Phoenix HCS’s convoluted scheduling process.”
“As I’ve long argued, we must provide for veterans without timely access to VA facilities the option of using high-quality health care providers near their homes, rather than rely on a system which is too often riddled with dysfunction,” said Senator John McCain. “This legislation increases veterans’ flexibility to get the care they’ve earned, while bringing much-needed accountability and transparency to create a VA worthy of the heroes it serves.”
“It is wrong to ask our soldiers to fight for freedom abroad only to deny it to them here at home,” said Dr. Tom Coburn. “We should allow veterans to go to the doctor, and health care facility, of their choice rather than allowing politicians and bureaucrats to decide where they can receive health care. In America, every hospital should be a veterans' hospital. Our bill makes that possible.”
“It’s clear with the evidence we now have that veterans had a lack of access to needed care, even in the past few years when VA carried over money,” said Senator Richard Burr. “This is a cultural problem with deep roots in VA, and money will not solve cultural problems. In fact, it could prove to only reinforce that culture. The legislation we are introducing today will address these problems head on by getting veterans the appointments they need from the doctor of their choice, providing the transparency needed to do an apples-to-apples comparison with non-VA hospitals, and start reforming the system and changing the culture to ensure no veteran ever again dies while waiting for the care they need.”
“While the national scandal involving scheduling irregularities in VA facilities around the country deserves swift attention, and those responsible need to be held accountable, we cannot take our focus off the fact that there are still veterans awaiting care,” said Senator Jeff Flake. “Instead of lengthy wait times or secret lists, this legislation provides much-needed flexibility for veterans to get the care they need in a timely fashion.”
The Veterans Choice Act provides veterans with more choice and flexibility, while bringing much-needed accountability and transparency to VA operations. This legislation will provide:
CHOICE: Provide veterans’ flexibility and choice in medical providers:
- All veterans enrolled for care at VA will receive a Choice Card to allow them to receive care from a non-VA provider
- If VA cannot schedule an appointment for a veteran within their wait time performance metrics or the veteran resides more than 40 miles from any VA medical center (VAMC) or Community Based Outpatient Clinic (CBOC), then the veteran can exercise their choice to receive care from the doctor or provider of their choice
- Requires VA to abide by the Department of Treasury’s Prompt Pay rule; to contract using Medicare prices; and any co-pay a veteran would pay goes to the VA
- Authorized for two years following VA’s implementation of the program
TRANSPARENCY: Increase transparency in VA operations:
- Directs VA to publish on each VA medical center (VAMC) website the current wait time for an appointment, current wait-time goals, and to improve their “Our Providers” link to include where a provider completed their residency and whether the provider is in residency.
- Directs VA to establish a publicly-available database of patient safety, quality of care, and outcome measures.
- Directs VA to report to the Department of Health and Human Services the same patient quality and outcome information as other non-VA hospitals.
- Directs Veterans Health Administration to provide veterans with the credentials of a provider prior to surgery.
CHANGE: Tighten accountability on VA operations:
- Provides the VA Secretary the authority to demote or fire Senior Executive Service employees based on performance. (Includes the VA Management Accountability Act H.R. 4031/S. 2013, passed by 390-33 in the House of Representatives)
- Removes scheduling and wait time metrics/goals as factors to determine performance monetary awards or bonuses.
- Directs VA to establish policy outlining penalties and procedures for employees knowingly falsify data on wait times and quality measures, including civil penalties, unpaid suspensions, or termination.
- Directs VA to modify performance plans of the directors of VA medical centers (VAMC) and Veterans Integrated Service Networks (VISN) to ensure they are be based on overall quality of care that veterans receive.
- Directs VA to consider reviews from the Joint Commission; the Commission on Accreditation of Rehabilitation Facilities; IG Combined Assessment Program reviews, CBOC reviews, and Healthcare Inspections; and the number and outcomes of administrative investigation boards, root cause analysis, and peer reviews in assessing the performance of VAMC and VISN directors.