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Upton urges VA to expand veteran access to private-sector medical care

Area veterans facing difficulties should contact Upton’s constituent service offices for assistance

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WASHINGTON, DC, June 4, 2014 | Lynn Turner / Nick Culp (269-385-0039 / 202-225-3761) | comments
"My office has been in regular contact with veterans, Veterans Service Officers, and VA staff in Michigan to ensure our veterans are receiving the care they have earned and deserve. If you are a veteran and are concerned about the care you’re receiving, please contact my office."
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Following the resignation of Department of Veterans Affairs Secretary Eric Shinseki in wake of a scandal at the VA medical facility in Phoenix, Congressman Fred Upton has joined a bipartisan group of House Members in sending a letter to the VA, urging the Department to immediately expand fee-basis care to any veteran awaiting medical care in the VA health system.

“The current VA health system is broken and incentivizes bad bookkeeping instead of individual patient care,” said Upton. “By expanding access to medical services in the private sector, we can ensure our veterans receive timely access to quality care, while also easing the VA backlog until more thorough reforms can be made. These men and women bravely fought for our nation; it’s time to return the favor.”

Fee-basis care, in which the VA pays for veterans to see private-sector medical providers, is something that the VA currently does to help address capacity shortfalls. While the VA health system is overburdened, many veterans are still denied access to fee-basis care as the outsourced care is paid for by each individual VA health facility, creating an incentive for those facilities to deny veterans’ requests and keep them locked in the VA health system. To address this issue, the joint letter asks Acting VA Secretary Sloan Gibson to “establish a budget mechanism outside of the existing model to ensure that the local and regional VA healthcare managers have no incentive to deny veterans access to fee-basis care.”

Southwest Michigan veterans having difficulties with their benefits or in seeking medical care are encouraged to contact Upton’s constituent service offices in Kalamazoo (269-385-0039) and St. Joseph/Benton Harbor (269-982-1986) for immediate assistance.

“My office has been in regular contact with veterans, Veterans Service Officers, and VA staff in Michigan to ensure our veterans are receiving the care they have earned and deserve.  If you are a veteran and are concerned about the care you’re receiving, please contact my office.  As Congress continues to examine the VA and the how veterans are best served, I will continue to listen to veterans in Michigan for their input.”

Since last week’s release of the VA Inspector General report on the problems at the VA facility in Phoenix, Upton’s office has been in contact with the VA medical facility in Battle Creek as well as the veteran service offices in each county in his district.

The full text of the letter to Acting VA Secretary Gibson immediately follows. Click here to view the original letter online:

Dear Acting Secretary Gibson:

We are deeply concerned by recent reports of secret waiting lists at Veterans Affairs (VA) medical clinics across the country. While the investigations remain open, the first priority of the VA and Congress should be to make sure that all our veterans receive the medical care that they need in a prompt and timely fashion. We know of at least 1,700 veterans in the Phoenix region alone stuck on secret waiting lists.  The VA-OIG's recent admission that this is a systemic problem that exists throughout the VA healthcare system means that there are likely thousands more across our country who are unacceptably being denied the timely care they need and deserve.

In testimony to the House Veterans Affairs Committee, both on April 9, 2014, and again on May 28, 2014, Dr. Lynch, the VA’s Assistant Deputy Under Secretary for Health for Operations and Management, confirmed that the VA currently has the authority and funds to pay for veterans to go see private-sector medical providers. There is absolutely no reason that veterans should be waiting months for care at VA medical facilities when the VA has a system in place for them to immediately see private-sector doctors. While Dr. Lynch testified to the House Veterans Affairs Committee that the 1,700 veterans in Phoenix would be offered immediate access to private doctors, we believe that the VA should take the next logical step. It should provide this disaster relief for veterans across the country and make fee-basis care immediately available for any veteran who has been waiting too long for care. However, the VA must remain the guarantor and coordinator of care for all enrolled veterans. Veterans should never be expected to coordinate their own care or be held responsible for record sharing when receiving care outside of the VA.

Fee-basis care can and should be used to provide medical care to veterans when the VA health system is overburdened. Unfortunately, one of the reasons that many veterans are denied access to fee-basis care is that the costs of this outsourced care is covered out of the budget of each individual VA health facility. Local and regional VA managers are incentivized to deny veterans’ requests for fee-basis care and keep them locked in the VA health system, even if that leads to longer wait times for care. Therefore, in addition to directing immediate and wide-spread access to fee-basis care for waiting veterans, we also ask you to immediately establish a budget mechanism outside of the existing model to ensure that the local and regional VA healthcare managers have no incentive to deny veterans access to fee-basis care. Creating a new funding mechanism for fee-basis care, independent of local VA facilities, will both ensure that veterans on waiting lists receive private sector medical care quickly if they so choose, and will fundamentally change the incentive structure that has led, at least in part, to these atrocious secret waiting lists.

We urge you to immediately take action to increase all veterans’ ability to access fee-basis care when the VA's capacity does not allow them to provide the timely care that our veterans need.

Sincerely,

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