VA plans overhaul of Veterans Choice program

The Department of Veterans Affairs has prepared a bill that would overhaul its Choice program. 

The VA announced that it has submitted the Veterans Coordinated Access & Rewarding Experiences (CARE) Act to both the House and Senate Veterans Affairs committees. The bill would eliminate the current wait time and distance requirements under the Choice program, which limits participation to veterans who face a 30-day wait for an appointment at a VA hospital or who live 40 miles or more from a VA facility. 

Instead, veterans would be able to seek care outside of the VA if they face a wait that is longer than a "clinically acceptable period." 

The changes would create options for veterans to use walk-in clinics for nonemergency needs and would place veterans and their physicians "at the center" of decisions on where to receive care, according to the VA. 

"We want veterans to work with their VA physicians to make informed decisions that are best for their clinical needs, whether in the VA or in the community, and this bill does just that, while strengthening VA choices at the same time," VA Secretary David Shulkin said in the announcement. 

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The Veterans Choice program was created in 2014 following a nationwide scandal that revealed thousands of veterans faced monthslong waits for care at VA facilities. The Senate approved $2.1 billion in emergency funding in August to keep the program going, but the VA revealed it may need additional funds before the end of the year. 

In addition to the changes to the Choice program, the CARE Act would include proposals for tools that could assist in training and retaining staff at VA facilities, solutions to improve financial management for the Community Care program and elements that would better allow the VA to partner with other federal agencies, according to the announcement. 

Sen. Johnny Isakson, R-Ga., chairman of that chambers' Veterans Affairs committee, said in a statement that the bill is "very thoughtful and balanced." The committee's ranking Democrat, Sen. Jon Tester of Montana, said the CARE Act is a "good starting point" and considers months of bipartisan discussion in its provisions. 

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But veterans groups are not completely convinced. Dan Caldwell, policy director for Concerned Veterans for America, said in a statement emailed to FierceHealthcare that the bill contains "some positive reforms" but there is "room for improvement." 

"One important modification that we believe should be made is that a veteran should be able to choose a primary care physician inside or outside of the Veterans Health Administration within the integrated care network," Caldwell said. "This reform would be an important step towards fulfilling President Trump’s promise to increase health care choice for our veterans." 

Meanwhile, Shulkin may be eyeing an exit from the VA amid the reform process. He has interviewed for the vacant secretary post at the Department of Health and Human Affairs and is likely a leading candidate for the job, alongside Centers for Medicare & Medicaid Services Administrator Seema Verma.