Audit: VA Mishandles Non-VA Healthcare Payments

54

Non-VA Healthcare Doctor

Benjamin KrauseA recent audit shows VA is giving non-VA healthcare providers the same runaround when they try to get paid that VA gives veterans trying to get their benefits.

The Government Accountability Office (GAO) conducted the audit, which shows VA is only processing two-thirds of non-VA payments to healthcare providers on time. GAO believes the data from VA is likely inaccurate meaning the processing mishandling is more prevalent than reported.

RELATED: Preliminary Observations On VHA Processing Delays

Veteran are not shocked by the report given that many veterans are unable to receive non-VA care because local providers refuse to accept Veterans Choice or Fee Basis. The reason cited by providers is that VA is impossible to deal with when it comes to getting paid.

NON-VA HEALTHCARE AUDIT

The GAO acknowledged this problem:

“Without significantly improving the timeliness of its payments and addressing community providers’ concerns about the administrative burden of obtaining VHA payments and the agency’s lack of responsiveness when they inquire about unpaid claims, VHA will risk losing the cooperation of these providers as it attempts to transition to a future care delivery model that would heavily rely on them to deliver care to veterans.”

The audit confirmed that “almost all providers” said the administrative burden for seeking payment for healthcare was bogged down by red tape:

“Almost all providers described the administrative burden of submitting claims and medical documentation to VHA, which the providers say they often must do repeatedly before receiving payments… In addition, community providers experienced issues with VHA’s claims processing locations not responding when the providers contacted them by telephone to follow up on claims or to obtain information.”

It is interesting that most fixes proposed by VA always require fixes for the fixes. They can never seem to get the process right the first time or the second time. When VA sees a problem, they use bulky bureaucratic committees to study problems and propose fixes that are neither timely nor effective.

How long before VA ineptitude and corruption turns Americans against veterans? Is that the plan all along? Does creating a bloated system harms that veterans also result in an erosion of sentiment and support in the long run?

AFGE NON-VA HEALTHCARE SOLUTION

Reports indicate the AFGE union has a proposed fix. They want to reverse Veterans Choice since the program has yet to work correctly after one year of implementation. But by that measure, should VA reverse itself since the agency has yet to work right after 80 years?

Source: http://www.mcall.com/news/local/watchdog/mc-veterans-healthcare-va-late-payments-watchdog-20160227-column.html

Stay informed on VA news, scandals and benefits. Get our daily newsletter via email.

17343

DisabledVeterans.org

Get our free daily newsletter.

54 COMMENTS

  1. “Audit” the VA!

    Could the “AFGE” (maybe) have something here? “Reverse Choice?”
    I don’t think McDonald will do that. Why? Where can McDonald and Gibson and all the other pukes go to steal taxpayer’s monies?

    I say, like Ben suggested in the last paragraph, get rid of the VA. Let veterans use outside healthcare. Use veterans for making appointments and assuring payments are made “ON TIME!” No civilian personnel, who have never served in the military, need apply!

    Or, let the military take over VA. Then make all employees come under the UCMJ. And, again, civilians who have never served need apply for any position! If anyone gets caught with their hands in the till. JAIL TIME!
    Have audits, periodically, to insure everything is above board!

      • This is tragic that this should be happening in our country. How do these individuals at the VA justify their behavior.

    • I’m going to add;
      NO PERSON WHO HAS NOT SERVED TIME IN A WAR ZONE NEED APPLY FOR ANY POSITION!
      That will get rid of a lot of pussies.

      • Some may not agree with this but I also think it should ONLY be prior ENLISTED, not the likes of West Point Robots, as we would have the exact same problem all over again…that’s just MY take on things. Enlisted are used to doing WORK, what we do NOT NEED is a bunch of worthless management types (prior Officers) taking the place of the greedy Civilian Management…it would be a vicious circle all over.

        I say this because I have seen time and time again former Officers get involved with Politics and in NO TIME it’s revealed they are polluting the waters.

        Then again, look at what happened in Virginia over weekend. An ex-military, Pentagon Security man shot those -3- cops, and the -1- fatally. So I guess crazy comes in all flavors.

  2. The military contracts out Tricare billing for active duty dependents and retired military. Why doesn’t VA use the same contractor, no VA employees………….. Seems like a simple solution to me………..

    • Simple answer? It makes too much sense. More complicated answer…Because there’s no way for the current powers that be to make money off of it…

    • The ONLY time the VA is extremely quick with ANY KIND of payment data is: 1) If the VA thinks YOU OWE them any amount, even from 8 years ago, and 2) VA Employee Performance Bonuses and related not-so-civil-service-salary-boosting-relocation expenses, again, for VA Employees, and finally 3) When the VA bills your Medicare or Private Insurance….even without asking the Veteran.

      So, not very Vet-Centric when it comes to payments. I know of -1- Veteran that had approx. 9 years of Compensation Back Pay and when he was awarded his 100%, and NO appointed VA Fiduciary, the VA required him to accept his hefty back pay amount in -4- equal installments. I do not recall over what time-frame he was completely paid by the VA *but* I can tell you this happened early last Summer 2015 when the VA supposedly had a serious “shortfall in ca$h”, and my buddy was worried he was going to get screwed but he was indeed paid full amount, but without any reason they decided to give him “installments”. I told him at the time something did not smell right but after all those years he was finally glad to get his Service Connection shored-up.

      Now, perhaps this is standard when a Veteran has such a large back-pay amount but guarantee the VA would NOT do that to their own employees. I have a strong feeling it was not up and up…but then again, out of cash before Summer last year…what wll 2016 bring? Is the Choice Cookie Jar almost consumed already?

      • My first question to them would be if they were going to pay interest on the amount not paid. At some point, Uncle requires interest to be paid on outstanding debt. I believe they have the same obligation, but one has to demand it.

    • HealthNet, who administers Choice, also has contracts for administering Tricare. Along with contracts for Medicare and Medicaid.
      The more I find about Healthnet, the more I get the sense that consolidation is happening prior to going to single payer.
      Then we can all have the same misery. Except for elites and our betters who have exempted themselves.

    • To add to my response Hondo, if you do a search using Healthnet, the first 3 responses are to the company web site, their Wikipedia site, and then links to financial news on Healthnet.

      Which makes me wonder…how many politicians or other government insiders are invested in HealthNet?

      How many are watching their stock price increase regardless of how bad the economy is? While ignoring veterans?

  3. And this is news to you? We Vets already knew this. Heck the stupid Vets Choice card is proof of that. It has VA all over it, yet when you call to activate the person on the other end clearly says that they are NOT affiliated with the VA in any way. And the info says you have to call in 5 days before you can use it. Now does that mean IF I have a PTSD panic attack and its bad, that I have to call in 5 days BEFORE the attack so I can be assured that the VA will pay for it and I wont have to drive 50 miles to the closest VA center for treatment? Or if I have a nerve attack because of my CRPS disease that I need to call in 5 days BEFORE the attack or the VA wont pay for it? Thats what the info on the card says.

    So again I say, that I am surprised that you didnt know what we Vets have always known…The VA’s ONLY good point is that they screw up 98% of the time. I have two feet…and they sent me shoes because of my ankle braces. Now the reason I mentioned having two feet is the stupid morons sent me SEVEN PAIR of shoes. What the bloody heck am I? A Veteran Centipede?

  4. Veterans who reads do not surrender if you believe that Veterans Healthcare need to be improved called your Congressman or Congresswoman and Spread the word even you have to advertise in your local newspaper. ……SEMPER FI

  5. I noticed waning public sentiment against veterans a very long time ago. I can only suppose that it will continue to get worse though. Civilians have an open hostility for any group who are being abused. Hell, look at how the Indians were treated a long time ago! The civilian politicians don’t give a damn about vets. Don’t think for one second I’m going to believe anybody now running for POTUS is going to change anything for the betterment of veterans! It’s just no way that will ever happen. I’m old now. I’m not much smarter but I’m a hell of a lot wiser now, if that means anything. It sure as hell doesn’t change anything though, does it?!…..We are doomed!

      • UhOhhh, before I’d let DAV speak for me, I’d go to a Church and pray!
        Have you ever been on the following website, called ;
        “DAVREFORM dot org”
        It’s full of what DAV doesn’t do for veterans! Google it. Then come back on here and get more of lowdown on that worthless veterans organization.

  6. First choice program appointment done today.filled out their paperwork.

    One part on payments.if Medicare does not pay.your responsible for the payments.

    I wrote.I’m 100 percent disabled veteran and I will not be responsible for any payments.if VA does not pay !

    Seen a doctor md.he stated he’s leaving and your provider will be a nurse !

    This office us directly a cross the hall from the VA ! Anyone think these medical people.know the VA employees and how many think.the VA employees will contact my new treatment team about my care at the VA?

    This is a rural community !

    Think I should change providers or stay and test the water’s.to see if the VA employees.try something to bad mouth me to the new providers !

    Any veteran should be able to apply for VA jobs ! Should not be punished for not being in a war zone !

    Enlisted are on call to be sent into a conflict or war zone 24 _ 7. Active duty are all over the world and could and are attacked by unsavory people.

    In other words active military are target’s anywhere ! And they do get hurt !

    Speaking about officers. I agree just because they were officers.that should not automatically qualify them for management positions!

    Some work for congressmen and they Do jobs a pfc could do and they dont get more respect from the VA.just because they say I’m a retired officer.

  7. Thanks for reporting this Ben. I believe this is just an audit by the GAO, and not the full blown investigation starting this spring that a number congressmen and senators have requested. That should be eye-opening.
    Today is Day 54 of waiting on Choice to contact my neurosurgery clinic for an appointment. I was told again this morning they were sending my info to the authorization team, and they would be expediting it.
    I spoke with another veteran I work with, and she said Choice approved her appointments with her Acupuncturist without her even calling them, and that they back-dated a referral to cover an appointment she already had. She said she doesn’t understand why Choice can approve her appointment for an Acupuncturist in a couple weeks, but cannot do anything on my appointment in almost 2 months. I had to contact Choice to get a Choice card. She had to contact them to get hers, still does not have it, but already has appointments approved.
    She did say her provider refuses to accept any new Choice patients since she has provided appointments to others, and has not been paid for any of them. I have a congressman and Senator Gardner inquiring. I contacted Senator Bennets office in Denver last week, no response. I called his DC office this morning, and they claim his Denver office is working her way through my request…whatever that is. I left a voice mail with her asking to be called to inform them of my Choice experience and to request help. I figured his office would be interested since he seemed concerned in the media regarding the ongoing Colorado Springs VA wait scandal. Looks like his concern may only be visible to the media.

  8. Because of an ugly malpractice incident with VA, I have complete “fee for services” care from VA. It is a HUGE problem finding providers who are willing to get entangled with trying to bill VA. My Chiropractor and Psychologist/therapist have both said they would rather treat me for free than try to bill VA.

  9. More information on HealthNet from their Form 10-K filed with the Securities and Exchange Commission.
    They were awarded a Patient Centered Community Care contract by VA in Setember 2013.
    This contract covered 37 states, DC, Peurto Rico and the Virgin Islands. It states they provide veterans to coordinated, timely access to care through a comprehensive network of non-VA providers, which is a lie.
    The contract was for a base period of performance ending September 30 2014, and has 4 1 year optional extensions. The VA awarded the first 1 year extension on September 23, 2014 regardless of veterans complaints.
    This contract was for the initial Veterans Choice 40 mile, 30 day plan. In August 2014 the VA expanded their contract to include VACAA passed by Congress and covering other veterans like me who could not get care at their VA regardless of meeting the 40 mile, 30 day rule.
    It also states HealthNet operates “a call center” to assist veterans with determining eligibility, and to help educate us on VACAA.
    That section ends with reporting revenues of $24.7 million, and a warning on how risk factors could impact those revenues.
    Further in, it described which states are covered under their Tricare contract, and that they administer contracts from the VA to manage CBOCs in one state.
    61% of their revenues come from state, local or federal government’s.
    There is an interesting section on them being under various state and federal audits, but not much detail, and only in how it may affect their common stock price.
    There is also an interesting section on litigation (being sued by many), but again, in how it might impact their stock price.
    Another section mentions negative publicity possibly affecting their business. Well, not as far as the VA is concerned.

    There Legal Proceedings section is also interesting.

    Maybe the VA and Congress should actually read HealthNets financial documents. At least those who do not have a personal interest in their stock price.

    It’s a 202 page report available on their web site.

  10. I am still waiting for my approved and authorized MRI which was done on July 11, 2015 (almost eight months now) to be paid. I have received bills from the facility that done the procedure. This place has told me that they wish they did not have to deal with the Choice program as it is so terrible.
    I have been told by the Indy VAMC that it will be taken care of and if I receive anything else from the facility to contact the Indy VAMC. I am sure they Indy VAMC is waiting for the other facility to get tired of the BS and just right it off.
    It is such a shame as this place was so much better than any VAMC appointment I have ever had. The people here seemed to care about the patients and took their time with me. There was no rush and they made sure I did not have any other questions before I left.
    I am sure I will be receiving another bill from them soon. They have told me that I will not have to pay as they have the authorization and approval from the Choice Program and the Indy VAMC has told them this will be taken care of. There billing Dept. kicks out these as part of their system.
    f8f

      • Thanks,
        I have been busy. I finally was able to move out of the transitional housing and I now have an apartment of my own. It feels great to have moved above being homeless. It is a huge accomplishment and goal for me. Now I can concentrate more on the worthless Indy VAMC.
        f8f

    • @f8f-

      Really great news for you!!! There is nothing like your own space and privacy. Let us know if there’s anything we can help you out with. Seriously!!

      • namnibor,
        Thanks but I am doing OK. It is great to be able to pay for things and not have to worry if it is going to take your last dollar.
        It is taking a little getting use to not having to sign in and out when I leave, getting called every night to make sure I am in, have to have a mandatory weekly meeting with my case worker, worrying if my place and/or myself is going to be searched, have to abide by a curfew, have a drug test, having to do a weekly chore, among other things.
        Thanks to all.
        f8f

      • F8f, it’s easy for me to say, but try ignore the BS as something you have to get through on your way to better things.
        Imagine how different this country would be if the same thing happened with public housing.

  11. Hell, I gave up trying to use “Choice” about 8 or 9 months ago.
    I was disapproved, then approved, then disapproved and approved over and over!
    Then all the negative articles started coming out.
    Especially over veterans being charged for proceedures “Choice” SHOULD HAVE PAID FOR! Ruining their credit. Ruining their lives.

    Now, we on here speculate VA, or others, monitor this site!
    I sure hope so. Because they need to know their cushy jobs, and six figure pay is about to end. The next President (Mr. Trump) isn’t going to put up with their damn lies.

  12. Folks, this is a bit off-topic but something that is truly bothering me. This weekend in my metro area of Columbus, OH, a recently discharged veteran went outside a bar in The Short North to use his phone and three thuglets beat the crap out of him for simply being “white”, and is indeed being investigated as a “Hate Crime”. The thugs did not even take his phone, wallet, or even his Apple Watch…they were there to beat him up and they did not care that he was an Afghanistan War Marine Veteran…”””http://abc6onyourside.com/news/local/marine-corps-veteran-says-he-became-target-of-hate-crime”””

    There was some talk on here today about negative sentiment towards military and vets…well, here’s a prime example. This just tears me up because I too, when I lived in a rather unsavory part of Columbus, back when I had to use Public Assistance for -3- years to keep from being homeless while waiting on both SSDI and the VA. Mine happened at a bank’s drive-up ATM after hours…but none of the savages beat me up in this case, and am sure I have a few guardian angels because those two were going to try to force me to drive them to a non-disclosed location, rob me, carjack, and probably leave me for dead….I did not allow the two thuglets to do that.

    The notion that just because someone or people WANT what YOU HAVE…just BECAUSE it’s easier than working for it, DOES NOT COMPUTE with me.

    This Marine is so physically marred he has to have facial reconstruction surgery. Tears me up.
    Off-Topic rant over. Sorry if I offended anyone with this. The level of disrespect in his Country astounds me.

    • @namnibor
      There was an article out late last week over the same kind of B/S.
      It happened in Washington D.C to a young (white) vet. I’m not sure which “branch” he served in!
      While he was eating inside a McDonald’s a few (black) pukes, around 5 or so, approached him and asked, not to politely, if he believed in “Black Lives Matters”!
      According to the article, he basically said nothing. He just wanted to eat in peace. Yet, they continued to harrass him!
      As he left, they attacked from behind. Real brave people, huh. They put him on the ground and continued the assault.
      I’m not sure if they were all caught. But I do remember a couple were male and one female were caught. Because of the security camera.
      Brave people we got roaming the streets. One day this kind of “thuglet” will meet up with someone who “carries”! They won’t like the outcome!

      ———————————————-

      Here’s an article I got through Military dot com.
      Title;

      “Decades Later, Agent Orange Catches Up with Vietnam Veterans”

      by Don Wilkens
      28 Feb. 2016

      According to the article, some veterans are receiving compensations from it.
      There’s even mention, I believe, of the VFW & DAV in the article.

      • Crazy elf, he was a decorated Marine vet who was in the Hell House firefight in Fallujah. If you recall, there is a picture of two guys helping a third guy out of a building. That third guy was rather bloody because he had been shot several times. The wounded Marine was a Sergeant Major, and the guy on his right was the Marine attacked in DC.
        There was actually a second attack on a Marine in DC that same night. The second guy was also attacked from behind, and left for dead between 2 cars. Another guy and his son driving by found him and called police. They have no idea who did it. The family of that second guy couldn’t find him, and his twin brother finally tracked him down in a local hospital with a skull fracture.
        Until authorities stop treating these as minor attacks, and every reaction to something involving a black as a serious hate crime worthy of a DOJ investigation, these attacks will continue. In fact, the knock out game crap came about from the “Polar bear” hunting…where blacks would try knock out a white person with one punch.
        Then there is the story of the 3 SUNY girls claiming they were attacked by about a dozen white people, only for their story to fall apart when security video showed they started the fight, and it was nowhere near like what they claimed. There was even news video of them holding a rally and crying for the cameras describing the attack…that never happened.

      • Listen.all races are being robbed.killed not just whites. We are veterans and picking one race is just wrong !

        I don’t care what color people are.criminals are criminals. Why do some of you keep saying white people.

        If this site wants only KKK members.then it’s time the FBI gets involved !

        Enough is enough.hate is hate and should have no place on this site.your supposed to be Americans and like it or not this country is made of many nationalities and colors.

        And you will never change it.so live with it !

      • I don’t disagree James, but not stating facts involving who the perps were just hides them, and lowers awareness of those who might be attacked.
        If I was aware of a bank robbery and the police left out the facts that it was committed by a 3 legged midget driving a Porsche because they don’t want to offend short people just does not help narrow the field of who to be alert for.
        Back in the 80s I was stationed in Ft. Belvoir, and me and some buddies would go into DC on the weekends, see the sights and go back on the 10pm bus. Some nights the bus might run until midnight. We walked a lot of miles at night to catch buses. I would not go anywhere in DC now at night, or in many other cities. In fact, there are many places I wouldn’t go in daylight now.
        I know this topic upsets you, but leaving out facts would be similar to the VA ignoring facts about a veteran.

      • It does bother me and for good reason. Back in the 70s me and a few buddies when out in our civilian clothes. In Germany and a white person (German). Remember our father’s fought against in ww1 and two.well this guy still hated Americans and I got shot point blank in the head !

        I have a funny feeling you think.just maybe you were behind the gun. If you were.I would not be here!

        Too bad. I’m here and I’m going to stay here and keep my oath to defend this country against foreign and domestic.

        You decide. The cause is for all veterans and Americans seeking justice from people that try to raise road blocks from really being United.

        We can not let injustice happen where ever it raises it’s ugly head. If we do.were no better than the VA employees taking advantage of Veterans as a whole !

        We all bleed red don’t we.

      • @James and to anyone else who misread my comment as being racist!
        I was only trying to show what had happened and by whom. As 91Veteran pointed out.

        As far as any government law enforcement agencies investigating these types of crimes as “hate crimes”. Good luck with that!
        Loretta Lynch, Head of the DOJ, has already shown her “true colors”! By NOT investigating hate crimes against anyone except for those of a “certain color” by a “certain color”!
        Even the President has caused more divisiveness between the races, this is FACT! This has been reported by more than just the liberal news sources! So deal with it!

        Every day we see and hear where there are muliple KILLINGS. SENSELESS KILLINGS and robberies perpetrated by (you fill in the blank)!

        When I was in the Army, then Navy, we didn’t see “color”! In the army we were all “Green”! In the Navy, “Battleship Grey”! We knew how to “deal with problem children!”

        The biggest problem I see today is this:
        These “thugs” and “thuglets”, no matter what color, have NEVER belonged to anything or served their country. Why? Because they are true cowards. They have no loyalty, pride or commitment to OR for anything. And that includes their blood “FAMILY!
        Their “families” are the punkass drug dealing parasites that take whatever they can by mob rule! A couple or more punks attacking one person from behind is cowardly.

        Like I said. One day these punks are going to run across someone who is legally allowed to carry, and it won’t be pleasant!

        The next time I put “FACTS” on here. It will be to enlighten, not divide!
        Knowledge is power!
        That’s all I’ve got to say about this damn subject!

      • Actually, I am more open-minded and tolerant of quite a bit in this life than what some may wish to paint me here by my simply stating the facts and outrage of what indeed has been happening across our USA to our fellow Veterans. Whether they are green, polka-dot, stripes of any color in this life. However, I refuse to stick my head in the sand and not at least putting the warning out there of heightened vigilance when out and about and others stated similar happenings around USA…there’s a reason, there seems to be a trend.
        Again, was not my intention to upset anyone. Only alerting Vets.

    • A criminal is a criminal no matter what and they need to pay ! Even VA employees who are hurting veterans everyday !

      Problem.Even when their turned in and the proof is there.they cover it up.

      No justice

  13. Dear Mr. Krause:

    As I previously stated, not only do we have to solicit human help, which, as I see does not help much, seeing that our own leaders seem to have fallen into the rut by tolerating the lawlessness, not only in our country, but throughout the world by doing nothing to but help instead condoning his type of behavior all over the world, and I do not mean by going to war with any other country, but by peacefully fight this outlawry anywhere by peaceful, but effective measures such as embargoes, and boycotts, and last but not least prayer which is the most effective; I can vouch for this since I experienced the efficacy of prayer from my own life experience; there were many instances of this during my life, not only during my military duty but my civilian life.

    So please do not forget prayer as the most efficacious means if you are serious and devout in your petitioning and do not neglect to thank GOD He will most certainly help.

    Try it, give Him at least one hour,of petitioning and thanksgiving and you would be surprised what you can accomplish, as I previously set forth the, ” The Battle of Lepanto,”
    I suggest google it in your computer if you have one if not get a friend or family member.

    Your for GOD and Country
    Frank P. Calderon

  14. The people will be the judge and they hear you loud and clear. ! You have a second agenda using this site to provide your propaganda!

    Go ahead with that agenda. People are not stupid and will defend themselves and their family from people who wish them harm !

    Have another ? hick up

  15. HATE IS THE MIND KILLER, FEAR IS THE SOUL KILLER. THERE ARE PEOPLE OF ALL RACE,S,S THAT HAVE KILLED THERE MIND,S AND SOUK,S AND USE RACE TO DO THOSE TYPE OF THINGS. FOR THEY HAVE SEARED THERE MINDS TO EVIL. MAN KIND HAS LEARNED NOTHING AND DOOM TO TO REPEAT IT.

    • New news article on firing of employees. You can post to Facebook your thoughts.

      I expressed the concerns of many veterans as to why VA employees that were fired not made public, since they are not VA employees anymore.

      Veterans have been harmed by some of these employees and should know if those employees are still working and if the veterans must still worry.

      Also mentioned how the va is using the disruptive committee as a way to punish veterans for their so called disruptive behavior.

      That this illegal disruptive committee is taking away any right’s the civilian population have, such as their Human, civil and constitutional right’s to a fair trial.

      Your turn to speak out to the ? !

Comments are closed.