Thursday, March 5, 2015

Choice Card confusion frustrates veterans, Congress

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Air Force veteran Mark Gendron lives just a few miles from a psychiatrist who can help treat his post-traumatic stress disorder.
But Veterans Affairs Department officials won't pay for the treatment.
"So I'm paying for it myself," the 55-year-old Minnesota resident said. "I don't understand why I have to. They sent me a card that was supposed to let me go see any doctor. But VA won't let me use it."
Gendron is one of tens of thousands of veterans left scratching their heads about the VA's new Choice Card program, designed to give veterans in remote areas or facing long wait times a chance to easily turn to private care providers.
The closest available VA psychiatrist Gendron can visit is 70 miles away in St. Cloud, an unbearable burden for the retired vet who is also his disabled son's primary caregiver. Private care options are supposed to be open to any veterans who live more than 40 miles from a VA facility.
But VA officials say Gendron doesn't qualify for the private care options, because there is a VA clinic just 12 miles from his home. It doesn't have the personnel or services he needs, but it's enough to disqualify him from the program.
"I just want to get the care I need," he said. "I shouldn't have to deal with this."
Lawmakers and veterans groups have been dismayed with the implementation of the new Choice Card system so far, complaining that program officials seem more focused on keeping individuals out of the program than getting it running. VA officials note that Congress — not the department — set the eligibility rules and needs to make fixes if gaps are emerging.
A survey this week by the Veterans of Foreign Wars found 80 percent of individuals who thought they qualified for the outside care options were rejected by VA, a figure the group calls call unsettlingly high.
"This program is intended to be the solution to last year's nationwide crisis in care and confidence," VFW National Commander John Stroud said in a statement. "[We] will not let it fail."
VA officials have received more than 500,000 inquiries into the program since cards went out last fall, but only about 30,000 have been able to receive private care appointments through the program, and only a small fraction of those veterans live far enough from VA facilities to qualify.
Last week, 41 senators petitioned the department to relax its interpretation of the 40-mile rule, taking service availability into account instead of just geography. Sen. Johnny Isakson, R-Ga., chairman of the Senate Veterans' Affairs Committee, said he and his colleagues will take up legislative fixes to the problem in coming weeks.
VA Secretary Bob McDonald said his department is looking into fixes too, and said he'll come back to Congress with a "reinterpretation" of the 40-mile rule in the near future.
But he also lamented that, despite his promises to reform VA into a more customer-focused organization, "I'm kind of a prisoner of the system."
McDonald has asked for flexibility to shift Choice Card funds to other accounts if needed, noting that planners still have questionable estimates about veterans' interest in and use of the program.
Critics have called that an attempt to undermine the still-new offering, rather than investing time into making sure it works. VA officials have said they have numerous tools to send veterans to outside care if needed, but integrating all of them together will take time.
Veterans denied the Choice Card program can request a "geographic burden" exception if they think the 40-mile rule is being applied unfairly. But fewer than 50 veterans have done so, prompting department officials to ask if patients and administrators are aware of the option.
And while the fight over the program rages in Washington, D.C., veterans like Gendron are left waiting for a fix.
The Minnesota veteran said he already has an overdue bill of about $1,500 for outside VA medical services, a debt that will only grow with his new out-of-pocket psychiatry expenses.
"There's a problem with what they're doing," he said. "I don't understand why I'm left suffering here, and that's what really bothers me."

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