GAO just published its report following an audit into the Veterans Choice Program and how well that program has reduced wait times affecting veterans’ timely access to needed or required health care. That report did not look good for veterans in need.

The audit found veterans frequently waited between 51 to 64 days for appointments with private sector doctors under the program. The lengthy approval and appointment set-up process can take as long as 70 days.

VA Wait Time Problem 2

DOWNLOAD: GAO Veterans Choice Program Report

Let’s remember the Veterans Choice Program was created in 2014 to resolve longer than allowed wait times beyond 30 days. So, instead of making sure veterans get to doctors quicker, the agency created a new layer of bureaucracy with additional needs for funding into the billions while not providing appointments within the timeframe sought.

Why bother? It is not much of a choice if you cannot get to the doctor in a timely fashion.

The 102-page GAO report published Monday of an audit of the Veterans Choice Program administration from April 2016 to May 2018. However, it seems to limit the actual appointment data to 2016 in its discussions meaning the facts as they sit now may be better or worse.

Right now, President Donald Trump has cleared the deck of many “Obama Holdovers” sited as being the reason why reforms were not coming quickly enough to the agency. Now that the deck is cleared, will Trump’s team be able to expedite these appointments to finally fulfill what Congress intended four years ago?

It should. Congress just passed the VA Mission ACT to provide expansion of resources including funding for the initiative likely incorporating deficits addressed in the GAO report into a plan to address longstanding bureaucratic wrangling.

Map Of Third Party Administrators (TPA)

 

If you have experienced problems with wait times related to Veterans Choice, please let us know which TPA is responsible using the above GAO map: 1) TriWest or 2) Health Net. This image explains how the TPA referral process works.

If you have been reading this website for a while, you know I’ve written a time or two about both companies listed above. Here are a couple excerpts:

Health Net “Miserable”

Senators have called on VA to intervene after Veterans Choice Program vendor Health Net failed to reform its practices to improve performance.

Centene subsidiary Health Net Federal Services is responsible for processing payments to community health care providers but severe delays have harmed the program. Eleven senators sent a letter to Secretary David Shulkin demanding VA take action last week saying they were “fed up” with how the company is managing its program.

“Our home state providers deserve better than the miserable customer service provided to them by Health Net, which appears to be devoting even less attention to the Choice Program as its expiration nears,” the senators wrote.

“Moving forward, we expect VA to take immediate action to address our concerns so that the provider experience is improved,” they added.

The company was recently admonished by the Office of Personnel Management’s Office of Inspector General for not cooperating with investigators. The company refused to comply with requests to audit its IT systems.

TriWest Benched By VA (2016)

TriWest will no longer schedule veterans for non-VA care as part of the government contractor’s duties in the Veterans Choice Program. The move will result in VA employees again making appointments for Alaska veterans for non-VA appointments.

Veterans nationwide have complained about problems making appointments through TriWest. Alaska veterans will now be able to enjoy interfacing with VA employees again due to persistent failures that have led to numerous medical specialists outside VA refusing to care for veterans.

Hopefully, these issued have been resolved since the above-linked publications. Below is a GAO graphic explaining the process TPAs follow when securing medical appointments and how it may contribute to wait times.

No Wheels For You

Rather than reinvent the wheel here, the following in italics is what GAO found. I also took screenshots from the report that, if you are visual like me, help explain where the delays may be coming from within the bowels of the most corrupt agency in the government.

GAO Findings – Veterans Choice Program

Through the Veterans Choice Program (Choice Program), eligible veterans may receive care from community providers when it is not readily accessible at Veterans’ Health Administration (VHA) medical facilities. The Department of Veterans Affairs (VA) uses two contractors—or third party administrators (TPA)—to schedule most veterans’ Choice Program appointments after receiving referrals from VA medical centers (VAMC). GAO found that veterans who are referred to the Choice Program for routine care because services are not available at VA in a timely manner could potentially wait up to 70 calendar days for care if VAMCs and the TPAs take the maximum amount of time VA allows to complete its appointment scheduling process. This is not consistent with the statutory requirement that veterans receive Choice Program care within 30 days of their clinically indicated date (when available), which is the soonest date that it would be appropriate for the veteran to receive care, according to a VHA clinician. Without designing appointment scheduling processes that are consistent with this requirement, VA lacks assurance that veterans will receive Choice Program care in a timely manner. 

GAO and VHA found that selected veterans experienced lengthy actual wait times for appointments in 2016, after manually reviewing separate samples of Choice Program authorizations. For example, when GAO analyzed 55 routine care authorizations that were created between January and April of 2016, it found that the process took at least 64 calendar days, on average. When VHA analyzed about 5,000 authorizations created between July and September of 2016, it took an average of 51 calendar days for veterans to receive care.

GAO also found that VHA cannot systematically monitor the timeliness of veterans’ access to Choice Program care because it lacks complete, reliable data to do so. The data limitations GAO identified include:

  • A lack of data on the timeliness of referring and opting veterans in to the program. GAO found that the data VHA uses to monitor the timeliness of Choice Program appointments do not capture the time it takes VAMCs to prepare veterans’ referrals and send them to the TPAs, nor do they capture the time spent by the TPAs in accepting VAMCs’ referrals and opting veterans in to the Choice Program. VHA has implemented an interim solution to monitor overall wait times that relies on VAMC staff consistently and accurately entering unique identification numbers on VHA clinicians’ requests for care and on Choice Program referrals, a process that is prone to error.
  • Inaccuracy of clinically indicated dates. GAO found that clinically indicated dates (which are used to measure the timeliness of care) are sometimes changed by VAMC staff before they send Choice Program referrals to the TPAs, which could mask veterans’ true wait times. GAO found that VAMC staff entered later clinically indicated dates on referrals for about 23 percent of the 196 authorizations it reviewed. It is unclear if VAMC staff mistakenly entered incorrect dates manually, or if they inappropriately entered later dates when the VAMC was delayed in contacting the veteran, compiling relevant clinical information, and sending the referral to the TPA.
  • Unreliable data on the timeliness of urgent care. GAO found that VAMCs and TPAs do not always categorize Choice Program referrals and authorizations in accordance with the contractual definition for urgent care. According to the contracts, a referral is to be marked as “urgent,” and an appointment is to take place within 2 days of the TPA accepting it, when a VHA clinician has determined that the needed care is (1) essential to evaluate and stabilize the veteran’s condition, and (2) if delayed would likely result in unacceptable morbidity or pain. GAO reviewed a sample of 53 urgent care authorizations and determined that about 28 percent of the authorizations were originally marked as routine care authorizations but were changed to urgent by VAMC or TPA staff, in an effort to administratively expedite appointment scheduling.

Without complete, reliable data, VHA cannot determine whether the Choice Program has helped to achieve the goal of alleviating veterans’ wait times for care.  

GAO found that numerous factors adversely affected veterans’ access to care through the Choice Program. These factors include: (1) administrative burden caused by complexities of referral and appointment scheduling processes, (2) poor communication between VHA and its VAMCs, and (3) inadequacies in the networks of community providers established by the TPAs, including an insufficient number, mix, or geographic distribution of community providers. VA and VHA have taken numerous actions throughout the Choice Program’s operation that were intended to help address these factors, though not all access factors have been fully resolved. For example, to help address administrative burden and improve the process of coordinating veterans’ Choice Program care, VA established a secure e-mail system and a mechanism for TPAs and community providers to remotely access veterans’ VA electronic health records. However, these mechanisms only facilitate a one-way transfer of necessary information. They do not provide a means by which VAMCs or veterans can view the TPAs’ step-by-step progress in scheduling appointments or electronically receive medical documentation associated with Choice Program appointments. 

While the Choice Program will soon end, VA anticipates that veterans will continue to receive community care under a similar program that VA plans to implement, which will consolidate the Choice Program and other VA community care programs. Incorporating lessons learned from the Choice Program into the implementation and administration of the new program could help VHA avoid similar challenges.

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36 COMMENTS

  1. Sometimes you just want to beat a healthcare CEO so bad his shitbag employees go OW

    Oh and first…again 😉

  2. Petulant Assholes R’ US:

    “[…Meet the new boss
    Same as the old boss.]”- The Who, “Won’t Get Fooled Again”

    • Hahahaha…there is no way that they can fool us again but they just give us another layer of bureaucracy…

  3. I would come under “Health Net”. That is, IF I were allowed to use it!
    My PCP informed me, a few months ago, it was “…a good thing…” I had NOT been able to use the “Choice Program”! Because, the odds are the civilian physicians involved, would more than likely, “…would NOT have been paid!” Leaving me with a bill. Which would have been turned over to a collection agency!
    Kinda makes one wonder, “Where the Hell is all the taxpayers monies going?”

    Back around 2005 or ’06, a dentist informed me the “…administration had taken over the appointments scheduling.” He was very upset over this issue! He even stated “…other physicians were considering quiting!”
    His main complaint was; “If physicians made the appointments, there would be less delays…” in appointment times!
    Whether or not that’s true, could be debated!

    It seems like, since outside agencies, (Tri-West and Health Net), have taken over the “appointments scheduling” and “billing processing”, the [taxpayers] monies have been squandered away!
    It also appears there is no accountability or transparency within these two agencies!
    In closing, Why not just shut down VA and put veterans on the Social Security Healthcare or Champva? Both seem to have better healthcare systems!

    • @Crazy elf- Speaking of Vets and Dentists:

      Monday. I had a return visit to Aspen Dental, where I have paid out of pocket for new dentures after final 7 teeth extracted…and not by theVA, but Aspen Dental. I return today for final appointment.

      Monday while there first thing in morning there were TWO OTHER VETERANS there…like me, paying out of pocket.
      Why?
      The VA told the one Vietnam Era Veteran whom half of his face was swollen outward from extreme abscesses that he would not be seen in Dayton VA Dental until March of 2019…he was afraid to go to emergency room because Medicare NEVER EVER pays for anything dental unless you pay quite a bit extra for a supplemental plan, so he had been trying to wait this out and Aspen Dental did what the VA failed this Vet…they firstly placed him on antibiotics that he’s NOT ALLERGIC TO…rat bastards!

      The other Vet was like me…he was scared shitless of receiving yet another mass mailing from the Dayton VA Dental Clinic of warning to get tested for HIV/HEP, you name it, because of asshole idiotic VA Dentists either going from one bloody mouth to another with same dental tools OR not sterilizing the equipment at all…so better get tested…

      What are the odds that -3- of us Veterans were paying OUT OF POCKET, even though all three of us 100% Svc. Connected, are at a consumer dental place because the VA is so shitty and afraid it would cause even worse problems?

      Aspen Dental told me they see A LOT of Veterans …..paying out of pocket and NOT CHOICE…nope, paying from our benefits $$.

      Fuck Off, VA! You suck in SO many ways it’s absolutely not fixable without a total reset.

      • I had my teeth taken out because of dry mouth due to the medications I have to take. They kept breaking off. I am lucky I guess because I have Tricare Dental and AARP Dental and they covered some of the $15,000 for getting my teeth out and my new dentures. I had implant put in the bottom and will have to wait to get implants for the top until next year when the insurance can help pay for them. Sucks, but I tried VA Dental because I am 100% and was not impressed. I had some dentist that was still in training and wanted to go wild on my mouth. Needless to say, the $1500 I pay a year for my dental policy sometimes comes in handy. Wish the VA would just outsource the dental and focus on the medical side. I had an abscess one time and went to the VA medical Center and had to argue with the doctor to get anti-biotics. She said I had to pay for my care because it was dental and they didn’t have a dentist on call. I said I was a 100% Disabled Veteran and don’t have to pay for dental or for medical. What a moron…the anti-biotics worked by the way…

    • Amen to your statements. When medical attention delayed causes death that is conspiracy to commit murder.
      Get rid of the VA and let us go to private physicians, whom we can approve of or not.
      Ben for VA Secretary

    • Crazy Elf: I was under Health Net in 2016 when I was referred to outside Neurosurgeon. Needless to say, after having an 8 inch Titanium Plate and 9 screws implanted in my cervical spine, due to large chance of being paralyzed due to numerous issues. Anyway, Va or HealthNet or someone reused to pay the bill for $104,000 because it was stated that the provider did not file the paperwork correctly. They sued me, charged to my Medicare, who paid $1,200. Now they are suing me for the rest. Collection agency says, in a threatening manner that they are going to report it to Credit Bureaus. Oh well. I told them I had NOTHING and really did not care about a bad credit report. And do you think anyone give a rats ass. NO! So, why go to non va referral when you will still get screwed, one way or another.

  4. Here’s the article out on 5 Jun 2018 concerning this very issue!
    Titled;

    “Vets May Wait Longer to See Private Doctor Than a VA Provider: Report”

    From: “Military.com”
    Dated; 5 Jun 2018
    By “Richard Sisk”

    “The Veterans Choice Program for private health care is in such bad shape that the bill backed by President Donald Trump to fix it will be difficult to implement even if done right, according to the nonpartisan Government Accountability Office.”

    “The Choice program was aimed at reducing wait times through increased access to private health care, but the GAO’s performance audit conducted from April 2016 through May 2018 found that, in many cases, veterans would have been better off making appointments at VA facilities.”

    “Timeliness of appointments is an essential component of quality health care,” the report released Monday said, but poor management and bookkeeping under the Choice program can result in veterans waiting up to 70 days to see a private doctor.”

    “In 2016, the average wait for a private appointment was 51 days, the GAO said, although the VA eligibility rules made private care an option when the veteran had to wait 30 days to see a VA doctor.”

    “Delays in care have been shown to negatively affect patients’ morbidity, mortality, and quality of life,” the report said, and the “VA lacks assurance that veterans are receiving care from community providers in a timely manner.”

    “At a White House ceremony Wednesday, Trump is expected to sign the VA Mission Act, which provides $4.2 billion to overhaul and expand the Choice program for private care while consolidating its seven existing care options into one.”

    “The GAO report warned that staff shortages, bureaucratic roadblocks and poor communication between the VA and private doctors under the existing Choice program make a quick fix unlikely.”

    “To the extent that these factors persist under the consolidated community care program that VA plans to establish, they will continue to adversely affect veterans’ access to care,” the GAO said.”

    “Citing the problems with Choice detailed in the report, the GAO said, “Ignoring these lessons learned and the challenges that have arisen under the Choice Program as [VA officials] design the future consolidated program would only increase VA’s risk for not being able to ensure that all veterans will receive timely access to care in the community.”

    “VA PLEDGES ACTION TO CORRECT PROBLEMS”

    “The blizzard of acronyms used by the GAO in its report, and by the VA in its response, illustrates the difficulty the individual veteran has in navigating the system.”

    “The GAO called for better coordination among the VA’s Veterans Health Administration (VHA), the VA medical centers (VACMs), the VHA’s Office of Community Care (OCC), third-party administrators (TPAs), the Computerized Patient Record Systems (CPRS), the Community Care Network (CCN) and private doctors themselves, who often complain of late payments.”

    “In its response to the GAO report, the VA concurred with four of the five recommendations for improving the transition from the Choice program to the VA Mission Act but disagreed with the GAO on urgent care.”

    “The GAO found that “VAMCs and TPAs do not always categorize Choice Program referrals and authorizations in accordance with the contractual definition for urgent care.”

    “The GAO said that a referral to private care is to be marked “urgent” when a VHA doctor determined that it was essential and “if delayed would likely result in unacceptable morbidity or pain.” However, the GAO found that some referrals originally marked as routine were changed to urgent to speed up the slow appointment process.”

    “Even that conclusion was difficult to reach because of the VA’s lack of reliable records and data, the GAO said. “Without complete, reliable data, VHA cannot determine whether the Choice Program has helped to achieve the goal of alleviating veterans’ wait times for care,” the GAO said.”

    “In its response to the report, the VA said that the GAO’s recommendation on urgent care “is no longer needed because VHA has resolved the issue with the new CCN (Community Care Network) contract.”

    “Under the new contract, VHA staff will have responsibility for scheduling community care appointments with providers, as opposed to the old system in which administrators routed referrals to the TPAs (third-party administrators), the VA said.”

    “In the transition from Choice to the VA Mission Act, the VA will also set up a new referral and authorizations system that will be called “Health Share Referral Manager (HSRM).”

    “The VA said that HSRM will “measure the time it takes to review and accept consults, prepare referrals and schedule veterans community appointments.”

    “THE VA IN FLUX”

    “The VA Mission Act has been estimated to cost as much as $55 billion over five years. Sen. Johnny Isakson, R-Georgia, chairman of the Senate Veterans Affairs Committee, has said that funding sources have yet to be identified, but he was confident they would be found.”

    “When Trump signs the bill Wednesday as one of the major achievements of his administration, he will not have a VA secretary looking over his shoulder.”

    “Robert Wilkie, who had been the Pentagon’s undersecretary for personnel and readiness, was named acting secretary after Trump ousted former VA Secretary Dr. David Shulkin in March.”

    “However, Wilkie stepped down as acting secretary last week to get around a law that made it questionable whether an acting secretary could succeed to the permanent post.”

    “Trump has said that he intends to nominate Wilkie to the permanent job, but the Senate has yet to set a date for his confirmation hearing. In the meantime, Peter O’Rourke, who had been the VA chief of staff, has become acting secretary temporarily.”

    “Its major proponents have acknowledged that the VA Mission Act and the overhaul of Choice will be difficult to implement.”

    “At a panel discussion last month sponsored by the Concerned Veterans for America, which lobbied hard for the expansion of private care, Rep. Phil Roe, R-Tennessee, chairman of the House Veterans Affairs Committee, said that putting the VA Mission Act into effect will sorely test the VA.”

    “Let me tell you, it is a painful thing to do,” Roe said. “This is a massive undertaking. It could be very disruptive to the VA. It’s humongous.”

    Jon Dewitt14 minutes ago I use the VA system and have no problems getting into see the Doctor ..my wife uses the privet system and it takes up to six weeks to see him or use emergency room…both can be a problem at times..

    3424963740 minutes ago I can see my PCP usually the next day. Not that it matters. She refers it to the specialist. I have been waiting for an annual eye exam since May 11, and nobody has still contacted Tri-West for an outside eye doctor. The Phoenix VA hospital has one eye doctor for about 75,000 veterans in the Phoenix area. Backup? You better believe it. In the meantime I used my medicare benefits and went and saw an eye doctor the next day.

    359277617 hours ago This claim here is a rare exception but in general, private care is MUCH more efficient and expedient…

    3676000310 hours ago Throw the whole Shebang out. Give each Vet $4000 a year and tell them to buy their own insurance. Save a lotta money.

    Robert Harrison11 hours ago Government efficency. /s

    © 2018 Military Advantage
    AdChoices

    • The “comments section” starts AFTER the word “humongous”, with “commenter” “Jon Dewitt”, in the article!

      Does anyone else see whats occurring. It looks like VA, with this GAO report, is trying to make it where vets are FORCED to use the VHA healthcare!

      • Did notice that on the GAO report but have been reading that the VA is trying to force all of our private providers to turn over our medical records. That is to grow the VA’s data base on all Veterans.

        I guess it most raise the value of the Data Base with more Veterans health records recorded.

        Given most Veterans do not receive any kind of Health Care Service through the VA health care system. They should not be allowed to have our medical records especially with the way they keep selling them to every Tom, Dick, and ass-clown that wants them.

        Not to mention their clear inability to protect our data from hackers.

  5. I had to file an SF-95 for $2,150.00 because Health Net didn’t pay the bill. Have to wait 4 more months to file in U S District Court to recover. And it took almost 90 days to get the Health Net Choice “authorization”. But there wasn’t any available PTSD treatment in Cheyenne.

  6. Same problem as the VA, too many patients, not enough resources. When you throw in the fact that they need to make profit to exist, all-in-all the Choice program was doomed from it’s inception.

    Same thing will happen to medicare if sufficient resources are not dedicated to handle the load.

    The solution is NOT to gut the VA and dump those patients on Medicare, the solution is to make more resources available and clean up the VA’s vast bunch of fat cats that are sucking the system dry.

  7. I quit using the VA a few years back, the doctor I was to see was only interested in giving me pills and not actually treating me for my symptoms, I’m glad that I had commercial health insurance while I was employed and it’s paid for now my regular doctor can refer me to specialist if needed, I realize that not all veterans have that choice

  8. Reducing wait times, What a joke, It took 7 months for them to find me a neurologist and it was through Health net….
    “veterans frequently waited between 51 to 64 days for appointments” I think even those numbers are skewed.

  9. I just received a bill from the VA & my private insurance. In 2014 I opted in the VA healthcare system because Obamacare sent my private insurance, ‘thru my wives work’ deductible to over $5,000.00, not counting premiums, making care unaffordable, plus 2014 was the last year I was able to work, due to my health/service connected disabilities.
    All my care blood work, mri’s, xrays, were ran thru my wives insurance, discounted, and what was not paid by insurance, I was billed. This bill is the first bill I have ever seen where the VA and private insurance has left me owing money. I’m a 70% disabled, according to VA math.
    Veterans choice failed me due to heath net here in Colorado, and I was forced back into VA care. I waited over 2 months for a knee brace measurement, and 3 months to see an orthopedic doctor and a neurologist in Denver, my appointment is the 1st week of July.
    I hired a disability attorney, I’m sick of this shit. I’ve battled the VA for more than a decade, been unable to work for half that time due to illness from exposure to nerve agents, from our own damn weapons.
    No wonder the suicide rate is 23 veterans a day now. Shit care, and then they bill you, make you wait, and fight a broken system. At least now i’m lawyerd up.
    You just can’t make this shit up

  10. It is no secret that one of the primary reasons for the failure of the Veterans Choice Program is the slow walking done by VA employees. Both in getting Veterans enrollment paper work started and correctly done in a timely manor and then shelving the paperwork for a period of time a Veteran is approved, before starting to set up an authorization for an appointment.

    _______

    Dam, it looks like little Davie Cox got such a butt whooping by Trump with those Executive Orders. That he started crying and ran back to his hood to find some other union gang members to back him up. He even found some that don’t even have a dog in this fight to back him.

    See:

    “Motion to Intervene by Proposed Plaintiff in Intervention American Federation of State, County and Municipal Employees, AFL-CIO (AFSCME)”
    “https://www.bloomberglaw.com/public/desktop/document/AMERICAN_FEDERATION_OF_GOVERNMENT_EMPLOYEES_AFLCIO_v_TRUMP_et_al_/2?1528201403”

    “NATIONAL TREASURY EMPLOYEES UNION vs DONALD J. TRUMP, COMPLAINT FOR DECLARATORY AND INJUNCTIVE RELIEF”
    “https://www.bloomberglaw.com/public/desktop/document/National_Treasure_Employees_Union_v_Trump_et_al_Docket_No_118cv00?1528133995”

    As a taxpayer can we sue these union gangs for wasting taxpayer’s money to defend against these frivolous court filings?

    As it stands right now it appears that all Government employees who are in a union are totally against the American Tax-Payer. Not only the Federal Employees but now even the State, County and Municipal Employees are against us. Let’s fire them all and start over!

    • Oh, I forgot to add the obvious on these unreasonable wait times.

      These long wait times recorded are for Veterans that did get approved and were seen.

      It doesn’t include the time it took for the Veterans that gave up and went elsewhere because they really needed medical care. The numbers also don’t include the number of Veterans that were improperly denied care through the Veterans Choice Program and never seen by a physician at all.

      I would be willing to bet that there were more than three times the number of Veterans denied care or who went else where than there were Veterans who were eventually received health care through the program.

  11. “https://www.apnews.com/604e68f172cb4a50848f1b92512e86dc/Trustees-report-warns-Medicare-finances-worsening”

    There are many issues that are not being mentioned in their ‘improvements’ or ‘implementation.’

    Decreasing wait times to rush vets though like cattle does not mean they will receive quality care or what they may believe is quality care. Many are fooled. You get stuck in the revolving doors of PCPs or incompetent PCP care you are screwed. Meet with PCPs that can’t move their eyes from a pc screen or their watch, going by their ‘orders’ from the top not giving a damn what’s in our files or never reading them?

    The big money and circus of having to do countless test all over again since one clinic or doctor always seem to repeat the same crap… ‘we need to do our own testing and findings.’ Besides, not many MDs in the civvy world don’t seemingly care to read through the interspersed methods of health care files VA styled others have to waste time on filtering through it all.

    Health care professionals not believing what we say or report after years of testing and knowing what may work for us. No, they tell you how you are feeling, how much pain you’re in, etc., even if it is backed up by years of medical files and remarks.

    Costs of meds. Medicare may not cover what is needed or been used for years. One inhaler I use that is not covered by supplemental insurance is three hundred bucks, no discounts at all. Just like some other things like steroids, eye drops, etc. Out of pocket, hit the limit on Medicare no coverage, etc. But they sure as hell will cover SSRIs and Gabapentin or meds we’ve been told to never use due to liver damage and on it goes.

    Have multiple issues? More than once I have simply been told I should go back to the VA for care since they are better equipped and capable of dealing with such issues. WTF?

    Contractors, like dental in some places are not under the 40 mile rule and vets MUST travel to see them since the VA will not pay to see some local dentist. Travel or do without. Just how many types of care falls under this I don’t know. Just what I have dealt with.

    Getting civilian care may not be that easy depending on locations or concerns. Or if you’ve left the VA under hostile conditions that are continued on under civvy care and any damages done by the VA are dismissed and covered-up due to “professional courtesies” or not wanting to get involved in such matters or conflicts.

    Being a ‘new’ patient many physicians and clinics are not taking on ‘new’ patients especially those with multiple chronic pain issues. Many I am trying locally don’t have the courtesy or professionalism to return calls to not checking out why my med records are not being sent out in timely fashion by some VA protecting far left winger controlled hospital staff acting as bad if not worse than the VA staff did. Using the same tactics/excuses, phony evil smiles.

    Civvy world MDs not accepting the price/lowered amounts the VA or gov is willing to pay for their services. By “Choice Card” or referrals. Or to find some specialist finally then be told by the VA to bicker over costs with some local MD, or they are training their own so forget it, like acupuncture or Chiro, then be told those trained have left the VA. And more issues.

    The claimed: Severe shortages of MDs or health care workers. Why is that? Or why have so many I had left this area or got tired of local games or state board nonsense and demands? So bad losing records from the youthful years and not knowing where they are at. Then led to believe we have to see foreigners, more, that have little comprehension or handle on English. Or need a nurse standing by to translate what would/should be simple communications. No, gotta endure someone like attempting to communicate with while quickly sounding like ‘Supercalifragilisticexpialidocious’ with a mouth full of crackers spraying us. Specialties and training… unknown. Or saying we should be happy to sit in chronic pain clinics for six hours to get what we need. If you hurt bad enough. Another… WTF? I hurt bad enough but can’t do those long ethical hours long waits, and can’t sit in common seating to play their games so what do some mean by hurting bad enough? New American styled health care.

    Then the bouncing around of some vets from the tan states and blue? Why is that or is it known of? I don’t know but happened or happening discussing issues with others. Pity I am not a credentialed lone wolf journalist with privileges and the body to do run around and report on things.

    Plus the fact that those of us who have left the VA, forced out, became an enemy of the countless, there is no returning, too much damage done, and began a series of issues that will never be or can be rectified or fixed in our lifetime. There needs to be some drastic changes with big Pharma, and all health care today. And to hell with all the stock-holders and elite in DC.

  12. Because of the wait time with the VA for a right wrist problem, I was ‘referred’ to tri-west. My first impression when I called to make the appointment was not good!! The lady on the other end of the phone’s first question was ‘do you have any other insurance’, I said that I was on Medicare. She said ‘no, I mean real insurance’. After about 4-5 minutes of stupid questions and condescending conversation, I got an appointment for 5 weeks in the future. I objected, telling her that the VA sent me to yall to get a quicker appointment. Long story short, I called the Dallas VAMC patient advocate and got an appointment with a VA doc in 10 days. My question was, why did it take me bitchin and griping to get what I should’ve gotten in the first place.

    There has been a lot of ink used on this blog used to bemoan the low level grunts that we interact with at the VA, but the truth of the matter is that they only do what their managers mandate them to do!! ie, they, the managers, solve their wait time problem by sending you to tri-west who has their own wait time problem. We concentrate on ‘cleaning house’ at the very top of the VA hierarchy and at the low level union member, while second line management and middle management get off Scott free. Middle management could play havoc with even the most well intentioned executive, after all it is middle management that has the most fiefdoms to protect.
    The solution is to do an investigation like what was done in the military. Start with the troop, or platoon that screwed up, then keep going UP (not down) the chain of command until you find out the “WHY” the screw up occurred. After that revelation then go back to the top of the command structure that encouraged the screw up to occur.

    Breaking up the fiefdoms will go a long way to getting the VA to fulfill their mission.

  13. cj ¯¯̿̿¯̿̿’̿̿̿̿̿̿̿’̿̿’̿̿̿̿̿’̿̿̿)͇̿̿)̿̿̿̿ ‘̿̿̿̿̿̿\̵͇̿̿\=(•̪̀●́)=o/̵͇̿̿/’̿̿ ̿ ̿̿

    This is nothing but the AFGE, playing games, NOT wanting Veterans to use outside care, and thereby making their precious union job, obsolete, so what do they do? they create obnoxious wait times, and then don’t pay private practice Dr’s. That will make Veterans come back to the VA NO HEALTHWEDON’TCARE SYSTEM.

    SHUT THE ENTIRE MESS DOWN, AND REMOVE THE AFGE LEACHES.

    NO Veterans Admin= Taxpayer savings
    NO AFGE= Taxpayers savings
    NO VA Property= Taxpayers savings
    Have SS take over all claims = Efficiency and ACCOUNTABILITY
    Issue Veterans SSDI, and Medicare Cards=Taxpayers savings and great Healthcare
    Veterans using private healthcare= NO Imported know nothing, do nothing, Dr’s, and mad scientists using Veterans as the latest greatest experiment.

    Go ahead you AFGE UNION FUCKS, point out the downside.

    ______________$$$$$$$
    _____________$$$$$$$$$
    ____________$$$$$$$$$$$
    ____________$$$$$$$$$$$
    ____________$$$$$$$$$$$
    _____________$$$$$$$$$
    _____$$$$$$_____$$$$$$$$$$
    ____$$$$$$$$__$$$$$$_____$$$
    ___$$$$$$$$$$$$$$$$_________$
    ___$$$$$$$$$$$$$$$$______$__$
    ___$$$$$$$$$$$$$$$$_____$$$_$
    ___$$$$$$$$$$$__________$$$_$_____$$
    ____$$$$$$$$$____________$$_$$$$_$$$$
    ______$$$__$$__$$$______________$$$$
    ___________$$____$_______________$
    ____________$$____$______________$
    _____________$$___$$$__________$$
    _______________$$$_$$$$$$_$$$$$
    ________________$$____$$_$$$$$
    _______________$$$$$___$$$$$$$$$$
    _______________$$$$$$$$$$$$$$$$$$$$
    _______________$$_$$$$$$$$$$$$$$__$$
    _______________$$__$$$$$$$$$$$___$_$
    ______________$$$__$___$$$______$$$$
    ______________$$$_$__________$$_$$$$
    ______________$$$$$_________$$$$_$_$
    _______________$$$$__________$$$__$$
    _____$$$$_________$________________$
    ___$$$___$$______$$$_____________$$
    __$___$$__$$_____$__$$$_____$$__$$
    _$$____$___$_______$$$$$$$$$$$$$
    _$_____$____$_____$$$$$$__$$$$$$$$

    Hi! I am your VA Dr Mickey, Thank you for your service.

    • cj ¯¯̿̿¯̿̿’̿̿̿̿̿̿̿’̿̿’̿̿̿̿̿’̿̿̿)͇̿̿)̿̿̿̿ ‘̿̿̿̿̿̿\̵͇̿̿\=(•̪̀●́)=o/̵͇̿̿/’̿̿ ̿ ̿̿

      .

  14. Well let me be the only person to say I like TriWest.
    I see the va doc and he sends in a referral for a VA doc to my knee.
    No knee surgeons so the Choice nurse calls me and asked if I want to go choice , I say yes. Timeline to this point 3- 5 days.
    Triwest calls me and starts scheduling. timeline for the call 2-3 days.
    Tri West calls me with an appointment and asks if it will work. Timeline usually a week
    I go to the appointment. Usually in a week.
    Total time 3.5 weeks versus suffering until the VA hires a knee doc. (currently no knee docs to be hired this year)
    Now the VA radiologist and my PCP and Ortho doc all missed 2 tears in the meniscus on the MRI and CAT scans. Civi doc saw them scoped and repaired and sent me out the door. 95% pain free 3 months after surgery.
    Or in pain taking massive doses of morphine wait for maybe next year.

  15. I genuinely thought the continued use of wait lists within the VA was common knowledge. Per this post, I can see that I was wrong when considering the Veterans Choice Program (VCP) as a secondary source for waiting lists. When I gained employment with the VA in 2015, we were strongly discouraged from using the word “waitlist.” It reminded me of the scene in Monty Python and the Holy Grail regarding the Knights Who Say Ni (pronounced “nee”). It had been common practice to use waiting lists prior to the 2014 Veterans Health Administration (VHA) scandal. As was the case when King Arthur took the Knights a shrubbery and they declared that use of the word “Ni” would no longer be permitted, because the new phrase would be “Ekke Ekke Ekke Ekke Ptang Zoo Boing,” the term “waitlist” was abolished and language used as a synonym of waitlist was then employed (i.e., primary and secondary schedule, appointment, etc.). Worse yet, the VCP ultimately served as a waitlist program of its own.

    The Veterans’ Access to Care through Choice, Accountability, and Transparency Act of 2014 resulted in the VCP, championed to the public as having been the remedy for the existence of waiting lists. For those of us who actually used the VCP, however, it was no different than uttering one nonsensical phrase (“Ni”) or another (“Ekke Ekke Ekke Ekke Ptang Zoo Boing”). I learned this lesson from firsthand experience when trying to receive an MRI in 2015.

    In May 2015, VHA personnel told me I’d need an MRI and scheduled an appointment for July 2015. Falling outside the 30-day window of care, I qualified for the VCP. In June 2015, I was contacted by Choice personnel to schedule an appointment with a non-VA, Choice-approved provider. Throughout June, I would maintain contact with five different Choice employees. Some of them clearly hadn’t communicated with one another and didn’t annotate information regarding my medical needs. Each seemed uniquely confused when speaking with me. As well, I was informed that an MRI would be ordered only for a portion of the concerned area to be imaged, not the entire sector needing to be assessed. Finally in late June 2015, I spoke with the private sector provider who set my appointment. I then was contacted by two additional VCP personnel to finalize the details of my pending visit (for those who are counting, that makes seven different Choice personnel who I’d been in contact with).

    As a then-employee of the VA, I attended training in regards to the VCP in late June and learned how other veterans had reported similar difficulties when attempting to utilize the Program. The saying “misery loves company” alludes to the element of psychology called “universality,” which essentially means people find comfort in knowing we aren’t the only ones to endure a certain type of suffering. This was my case when hearing about how other veterans had also experienced difficulty accessing the Choice resource.

    I was again contacted by an eighth Choice employee who assured that my appointment was set. Not long after, I was contacted by the private provider who informed me that my appointment was canceled, because the individual scheduled to perform the MRI wasn’t licensed and would be unable to sign off on a report of treatment. By that time, July rolled around. (Keep in mind that my reason for using the VCP was because the VA couldn’t see me within 30 days.) By mid-July I contacted the VHA and asked if my original appointment with the VHA could be preserved, because the Choice option took too long. I was promptly informed that once the VCP process was initiated veterans lost their VHA appointment slots.

    I again made contact with VCP personnel (number nine) who again scheduled an MRI. Towards the end of July 2015, thirteen days after my originally-scheduled VHA MRI, I was able to receive an MRI in the private sector via the VCP. Despite being 100% service-connected and irrespective of the fact that the MRI related to one of my service disabilities, for almost a year after the MRI was conducted I continued receiving bills from the private provider for the MRI. VCP personnel assured me that I didn’t have to pay and that I could ignore the monthly reminders. Ultimately, the VHA paid the provider.

    Though not the most troubling Choice story ever, my tale was frustrating enough for me to gain emic understanding in regards to what the veterans I served as a VA employee also endured. Concerning my Choice narrative, “it” took place within the TriWest Healthcare Alliance. (For those familiar with the tale of Monty Python’s King Arthur, you surely know that saying “it” causes the significant pain to the Knights.) Ekke Ekke Ekke Ekke Ptang Zoo Boing!!

  16. It’s always “We didn’t get the info sent from the VA yet.” says Healthnet. Call the VA and it’s “Healthnet hasn’t sent the info to us yet, so we can send our info to them” It is possibly the most frustrating thing I’ve had to deal with as far as trying to get something done. I try to start two months early to renew it, but, then it’s “Well you have to see a VA DR. to get it renewed again. (But they can’t get me in in less than 30 days) So then I have to start the whole thing all over again. Or they say “You still have two months left, call us 30 days out from when it ends” and then it takes two to three months after I call them back. The thing I hate the most is how people in the VA are always trying to keep me in the VA system (We can squeeze you in here, but still like 33 days till appt.) and the constant reminders about ‘how expensive’ the Choice program is, like it’s coming out of their own pockets. I’m usually frazzled after spending so much time on the phone doing all the leg work that the VA and Healthnet should be doing, after hearing “We didn’t get the info yet” for the hundredth time….

  17. This was posted about an hour or so ago. From: “Live On-Air News” (17:27 min long)
    Dated: 6/6/18
    Titled;
    “President Trump Signs VA Mission Act 6/6/18”

    “http://youtu.be/T6llGtKN5lo”

    What you don’t see in the crowd is ALL the VSO’s in their “little funny cunt caps” applauding!

    • For some reason, it says NOT found when I copied the http site.
      You might have to google the title!
      Sorry!

  18. From the first time that I saw my VA “doctor” (he’s actually. NP), it took me 9 months to have back surgery.
    All of this “prompt” service was courtesy of Tri-West.
    But walking isn’t considered too important.

  19. I used the Choice program several times. At first it was fast, and the appointments were made in days. After about the first year, that changed. The biggest logjam that the Choice program had was getting the authorizations to Healthnet. I would call them, and Healthnet would not have anything on the wire for weeks, then the last time, a month had gone by.

    The cronies at VA designed their system bureaucracy to make the Choice time as bad as they could. There was no way to contact the VA department responsible for processing these referrals. They were the black hole that was responsible to nobody. This was the UNION protecting their jobs. Why else would people invested in Veterans Health Care impede that care?

    Go figure.

  20. I used the VCP through Health Net for Agent orange caused Prostate cancer treatment. Someone who worked for the VA said the VCP was created only to make the VA look good or not as bad. Most Health net workers could not make it the fast food business.
    At one point 7 faxed requests from my Oncologist were “lost”. There was no backup plan, just keep faxing to the same number. Supervisiors had no authority or ability. I have a log of the 28 phone calls I made to Health net. The local VA Patient Advocate said I could not call them directly. I said too late times 28. She called the same number and routinley waited 1 hour, and still got no action.

    Even though the VA admitted Agent orange caused my prostate cancer, they still billed me $50 for every visit and treatment. I finally reached a supervisior in billing who said the co pay was correct and that she had been doing he job “a long time”. My reply was thet she had been doing it wrong for a long time. The co pays disappeared.

    • Is this service connected? What percentage? If is it, report this to your Congresscritter. If it is not, go to Hadit.com and put in a claim to get it SC.
      SC conditions are covered at 100%.

  21. Does not matter what program VA is in charge of, will be. Messed up.

    Ben, someone needs to do a follow-up story on the veteran’s and whistleblowers accountability office Trump set up to hold employees accountable and not to help the VA to continue harming these veteran’s.

    I had a employee named Jennifer and her supervisor without a single piece of evidence from me.

    Send of an e-mail to VISN 19, for action on my allegations that one VA manager falsely accused me of disruptive behavior and punished me for 5 years and VISN 19 covering up the false allegations.

    Not one piece of paper. Then Jennifer told me VISN 19, told her my case was closed.

    The new whistleblowers and veteran’s accountability office is not to help the VA to continue harming veteran’s.

    Per Jennifer who works out of her home in California, she stated that she was a Triage manager.

    When they receive complaints from veteran’s they send the inquiry (right back), to the very people harming to answer and whatever the VA says, goes.

    Jennifer and her supervisor are not following their own regulations and speaking to her. If other employees from the whistleblowers and veteran’s accountability office are doing the same thing, more veteran’s are going to be harmed.

    They are not or even know the regulations. They are to gather all the evidence or information and make a recommendation to the Secretary of veteran’s affairs and they have to decide if the employee is to be fired.

    The Secretary of veteran’s affairs, must then report to the veteran’s committee and tell them why the employee was not fired.

    These must be former VA employees. Here is what she said. I did what I was told to do, we are just a Triage and make no decisions.

    I told Jennifer, really !, well you did make a decision, when you sent an email with out any of the 150 page’s of evidence, I have accumulated since 2004.

    This is bull shit. I told Jennifer, how can anyone make a Serious and proper decision without reviewing any of the evidence.

    Very smug. She works out of California. She received not a single piece of evidence from me and still e-mailed VISN 19 and that what they are doing with each veteran who sends in a complaint.

    They are getting paid to send an email and that’s all. What a scam !

    • cj ¯¯̿̿¯̿̿’̿̿̿̿̿̿̿’̿̿’̿̿̿̿̿’̿̿̿)͇̿̿)̿̿̿̿ ‘̿̿̿̿̿̿\̵͇̿̿\=(•̪̀●́)=o/̵͇̿̿/’̿̿ ̿ ̿̿

      James, I think the WH Veterans Hotline is about the same. You call, make a legit complaint, the VA doesn’t do shit, says they took care of the matter, and the WH Hotline says, oh okay. Veteran is still fucked, and even more so, because they now know you called the WH Veterans Hotline. Isn’t that special?

      Way to go President Trump, you formed a Veterans Hotline, staphed with VA AFGE workers…………..hats off, what a novelty….yeahhhhhhhhhhh thats the ticket..

  22. Not only a new layer of bureaucracy, but one which has to make a profit.
    Just a reason to back up another backhoe and a couple more dump trucks to the huge pile of taxpayer money that is the VA

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