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Veterans like myself were thrilled at the news we can all use non-VA urgent care centers when needing urgent care, but is there a hitch?

One of the newest expansions following the VA Mission Act’s passage is the urgent care provision. Veterans actively enrolled in the VA health care system can now seek local urgent care when needing non-preventative care.

Or, at least that is what we were told, at first.

New Urgent Care Details

However, new details are slowing dripping out that the urgent care provision of the Mission Act may have a lot of the problems veterans experienced with emergency room visits outside the VA system.

Some of you may recall I had my own run-in with the non-VA emergency room denial program ‘er payment program. For years, VA was wrongly refusing to pay for emergency room visits touting some obscure “prudent layperson” standard.

RELATED: VA Spins Non-VA Care Story

Basically, if a prudent layperson would not go to the emergency room when experiencing chest pains, then a VA adjudicator would refuse the bill to the tune of thousands or tens of thousands of dollars.

Ouch!

Prudent Layperson

The point is that when a person is in distress, perhaps using a “prudent layperson” standard is inappropriate to begin with. No matter, VA used it as the basis for denying veterans billions – – yes billions with a “b” – – in emergency room visits, sticking sick veterans with the bill.

RELATED: VA Mishandles Non-VA Healthcare Payments

Now, with the urgent care non-VA system rolling out, can we expect a brighter future or will bean counters strangle the benefit?

I think the answer we all hear in our heads like a canary in the coal mine is a faint “you betcha.”

What I have understood is the urgent care program will use similar or the same adjudication system that hammered us when seeking emergency room care.

RELATED: Bad Faith Insurance Denials Of Non-VA Emergency Care

Whenever a VA adjudicator decides a prudent layperson would not think a condition required urgent care, then I’d bet you can expect a denial in the mail. While most urgent care visits are a lot less than emergency room visits, one can assume a ton of veterans may get caught up in the confusion.

Other Red Tape

There will also be a few other red tape related issues like making sure the urgent care you pick happens to be within VA’s network. If you make an error when picking the facility, you will have to pay for the visit out of pocket.

Aside from the red tape, once the program gets ironed out, I think veterans will enjoy the benefit. It may be a tough road until we get there, though.

Breakdown Of Payments

Veterans using the civilian urgent care option may need to make a co-payment depending on what VA Priority Group they belong to. VA apparently will approve three free visits per year, but I am not sure how that works or who decides the cap.

  • Priority Groups 1-5. This group will have three free visits per year. All visits after that require a co-payment of $30.
  • Priority Group 6. If the visit is linked to combat and chemical exposures like Agency Orange, the first three visits are free. Subsequent visits are $30. If not related to the condition, co-payment is required for all visits. If the visit is not related to these conditions, the co-payment is $30 per visit, for all visits.
  • Priority Groups 7-8. Co-payment is $30 per visit.

Flu shots will apparently be free for any veteran eligible under the program.

Prescriptions

The program currently suggests using the VA network pharmacy if you receive a prescription from the urgent care center. If you use an out-of-network pharmacy, you’ll need to pay full price and seek reimbursement from VA later.

Prescriptions for conditions VA considers routine or maintenance drugs, those will still need to be filled by VA. This last one concerns me a bit since I can think of a ton of scenarios where the pills might be urgently required for a routine condition – – but where VA refuses to reimburse under this provision.

Here are some details about the copay situation: https://www.va.gov/COMMUNITYCARE/revenue_ops/copays.asp.

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60 Comments

  1. Off Topic

    -THE FAR REARCHING ARM OF THE VA PR MACHINE~

    Radio show came on this morning, asking for Vets to call in about transitioning out of military life then into civilian, and then working with VA. They wanted Vets to call in to offer hints.

    And this was the first time listening to this station but its near Philadelphia. WMGK radio.

    I told the interviewer that I’m in the process of filing complaint against VA employees, that I’m an Investigative Research Biologist (throw my own plug), and that I was able to train my own service dogs in the past.

    I said what ever you want to talk about then let me know. The radio jock then told me about a poll where the VA came in last in trust.

    So I said do you want a few areas of where new Vets going into.the VA needs to know? The radio.jock turns it into asking me to.donate to something for VAMC.

    I wasn’t in donate mode.

    So I called the radio show back, and left a message for John, that if he would like to inform new Vets about the VAMC, that Inhave a wealth of information.

    I’m beginning to think this is all a set-up, as I’m trying to finish a complaint against the VA Nurse Practitioner & a Clinical Pharmacologist.

    Now those two above, they made a wicked team for treatment & care.

    • Have a look at the VA’s advertising and public relation package in print, on the air and TV media. Millions go into that. Most is paid to relatives and friends of VA administrators that are in the loop. That is just the way thing get done in those circles. Same in the Pentagon procurement system. Blood is thicker than, but you know the rest. In the Michigan area we have billboards all over the highways advertising for the VA. Radio and TV adds galore. Only thing missing are services to and for military men and women.

  2. Yea RIGHT, the VA is going to pay emergency room visits that veterans use! Really, well, I have some beautiful ocean front property (in Arizona) for sale! Of course, it’s all on the contingency of California falling into the Pacific Ocean!
    FACT:
    I just got screwed for almost $4,000 (out of pocket) because the VA refused to pay my “emt transport”, “emergency room visit” and a “3 & 1/2 day civilian hospital stay” – EVEN THOUGH the VHA doctor. my PCP, ordered it to occur!
    My “Medicare” picked up 80% above what I paid! That would have totaled around $22,000 to $24,000! Leaving me with the rest. I even was forced to pay the “emt transport” bill ($720 for a 5 mile ride) to the nearest civilian hospital. The nearest VHA hospital w/emergency room (Lake Nona, Fl.) is over 65 miles one way, with multiple toll booths!
    After I paid my portion. The VA said they were NOT required to reimburse me. They claim, since I had paid it, there’s a VA directive stating I should have waited.
    My response to that ASSHOLE was, “Wait for what? That the bill goes into collections, ruining my perfect credit? Like thousands of other vets the VA screwed over?
    #fucktheva
    #fuckthevha
    #fucktheafge

    • Hey Elf, My VAMC sent me to Augusta Univ. Med. Center Augusta, Ga. for spine surgery. Had a Titanium plate and several screws put in my Cervical Spine. The hosp. billed the VA for services rendered at an amount in excess of $104,000. Well, VA never paid. Said the hosp. filled paperwork wrong. Now I had NOTHING to do with setting this up. Choice/ Fee Basis, set the whole thing up. Now the hospital is suing me. On credit report as “Collection”. Lawyer calling with threats. The hospital did bill my Medicare for $1,200 and were paid about $400. I told the hosp. and their lawyer I would NEVER pay them. Also, my Senator just happens to be Johnny Isakson. Several communications with him. NOTHING! So I know how you feel.

      • you are right never pay it. if they made the arrangements and everything is signed in triplicate in govt dealings. talk to an attorney who is blood thirsty and let him handle it. he will get the creditors off your back and someone is guilty in the end. BUT NOT YOU

      • Careful about failure to pay heath care bills especially around my location or Indiana which is found under corruption in the encyclopedia.

        There is debtors prison here. I spent the weekend in jail for not making payments waiting on SSD. Lawyer and judge laughed and said I could find a way. Come Friday wired up with multiple TENS units I was put in a holding cell treated like crap and denied med help or a hospital run later the next day. Monday went back in front of the judge and played the game again, same threats. I asked isn’t it illegal to be put in jail for non payment of medical bills and refused health care. They both said no and it’s not debtors prison or over medical bills. It was over “violation of court orders.” More “semantics.” Anyone care? NO.

        Bankruptcy here, pure hell. Vet disability is not “exempt from bankruptcies” even though we had documents from the state and DC claiming it is. Not here. Many here had to go chap 13 not 7 and the attorney making more money and vets here making nonsensical payments back with more rules and regs to follow. Plus the first thing that happens here is insurance companies dropping your insurance, property and vehicle if any. Then having the balls to tell people that it’s because poor people, veterans, bankruptcy clients are more apt to become criminals and do things like torching property and houses to collect, or commit some kind of fraud. I asked if they would put that in print and allow me to record such statements while at my home. They said no then changed their stories over the phone later. But still got my coverage dropped along with others. That is the short side of it all amongst more crap and corruption. No way to get around the corruption and shysters here, none. While the shame and fear tactics work well to keep things quiet along with lying two-faced corrupt media. Again, no leverage or hope at all. Period.

  3. I have to concur with “Crazy Elf” on this not that it matter or make a difference. Vets have no leverage against the VA and have to go with what is given them. I just had a talk with the Wyoming VA clinic director regarding my experiences and wishing to understand why I have been waiting for years for medical services. I was promised that she will look into it and get answers. Does that mean I will get resolution? I won’t hold my breath. I love to meet some of the vets that speak so highly of the service they receive and what matter of Rx they required. If all they wanted were Advil, than I can understand that.

    • “sunvale”,
      I can just about guarantee you, the veterans who get or got to use the “Choice Program” were probably employed by the VA or in government service in some manner!
      The ones who used “Choice”, but had to fight to get their bills paid, were people who ARE attorneys (like Ben) OR could retain an attorney!

      I can see the writing on the wall. You wait, it won’t take long for another scam/scandal to emerge!

    • “Should Veterans Be Wary Of New Urgent Care Expansion?”

      Should be wary of everything.

      Sunvale, that’s is the big trick of it all. We have zero leverage or easy helps when it comes to government’s, any health care providers, or the VA. While they keep pushing new ideas/plans on people without fixing the old problems all while playing musical chairs up there with the same cliques and agendas. With way too many so-called professionals, well established and self protective professional groups complete with their supporters and fancy law firms and PR groups, LEOs, war departments, unions/associations, medical boards, politics, lobbyist, big Pharma, United Nation’s agendas, media scum, to the AMA and insurance companies, contractors, cowardly VAOs all having their hands and agendas in our health care full circle. Depending on location we have far more enemies and uncaring folks out here than friendlies. Got plenty of proof of that but no-one cares much and it’s censor censor censor, totally ignore or attacks. Plus the medical predators and profiteering not giving a real damn about our health or many issues. Throw in all the fear that so many have or to dare make a peep about any VA or medical care issues they have the perfect storm to ruin us at will and keep many totally silent.

      Choice Cards. Ads on TV about that too, back when, and bragging about we vets getting “excellent care,” all big lies and propaganda. First we were told to use it to telling us to find our own outside health providers like with acupuncturist or chiropractors, etc. But would not pay for second opinions and such. Then told by outside care givers that they won’t accept the card nor the VA’s low pay scales for their costs or wants for higher charges. Then told not to use the card at all. Then told in our selected group NOT to EVER use civilian care for anything including emergencies, heart attacks, vehicle crashes, even with “two broken legs,” etc. We were told “to drive the hundreds of miles to Roudebush VA hospital and use their ER.” Yeah right the idiot scum bags. Totally insane stuff but no-one wanted to investigate or report on that either. And other vets clammed up about that and other insane “orders” from the local VA or some agency. While some others kept claiming great use using their card. Go figure. Like others mention there is NO accountability with VA or medical care issues, abuse, neglect, any form of misconduct.

      They gonna force some test subject vets to use anti-depressants and Gabapentin for chronic pain issues to use the new expansion too???! Like with suicide rates and reasons we will never know. And lets not forget there are those out in civvy world that want nothing to do with vets or those with multiple health issues or especially those with pain issues. Repeating their mantra; ‘there are too many issues you’re dealing with and the VA is better suited for your care.’ Plus playing their games of being passed around to others in their “associated” MDs and clinics for more predatory practices, redundancy for profit.

      Let’s not forget our situations and locations are different. The warnings and threats about what would happen to us for leaving the VA came true. For some of us finding decent civvy care is near impossible due to the long arm of the VA, politics, “associations” and the controllers we were warned about having total control over our care in Indiana being in part medical teaching universities and medical groups owning or in control over state-wide hospitals and clinics. Having all that “influence.” Till some heads roll from the top down and in the unions with all those associations and their thuggery nothing much will change. Change may help some but not all or certain targeted vets on their poop-on and kill lists. Things sound nice or looks good on paper or sounds good in board rooms but not in practice and not for all.

      • Reminds me of my exact same story!

        I Went to “St. John Macomb.” at 11 mile and John R., in Michigan. Emergency room about six months ago for Stomach aches that would not go away after three days.

        Male nurse was offended when I told him I was retired, and had Medicare. he had two racist 19 y.o. security guards apologize as they are smiling ear to ear, and strapping me down to the bed for no reason. I Was not belligerent or anything!

        I just asked the Female Doctor about National Geographic Magazine Febuary 2015. Unlocking the secrets of TBI.

        Thinking. Thank god I have medicare now, and can get some truthful answers about TBI outside of the corrupt VA! Specifically, where the article states: “The blasts lifted my stomach upwards, and put them back down.”

        So, they had Mr. high water tight pants, and fancy shoes come in with his rainbow socks and clip board showing me his civilian war face! Only to tell me, Since I was A combat vet. I needed to go for a “Mental Evaluation.” yet, again! For the Fourth time!

        Once, after the SOC. “We just want to monitor you! You have been through alot.”

        A Second time, after the Divorce from The German Nurse at corrupt Henry Ford in Detroit. They did not like me because, I would not remodel one of her coworkers houses for free! “Slingers!” At A Michigan Tailgate! redoubtably! She came home and said: “I would rather spend more time with my friends then you!.”

        Third lock up, was Mental evaluation ( Locked up on B-2 North) Detroit VA after hazed at the SSA. Dirtbags pushed me, and making Vietnam war slogans. All orchestrated by a recruiter peacetime vet. Sorrority sister yelling at me in front of everybody. Yet, I have to get locked up!

        An odd hazing in back of A book store, by A couple of older vets… Who made it perfectly clear that since I voluntarily joined. I brought this condition on myself! “You did this to yourself!” Mmmmrrrrrr One of their sons was A local detective. okay, time to move!

        Then, right before the “Mission act” came out. they had the odassidy to send me an invite to some St. Matthews college to become a doctor. on some island East of Puerto Rico. Then, some perminate doc bullshit in San Diego. I e-mailed the Detroit VA doc, no thank you!

        Then, right before I crushed my smart phone. An Annual Doctor convention in Chicago. Then, A Nurse convention in Nashville!

        Point being. We as vets have been black balled and cant go anywhere for proper treatment! Why, because they are all in the same socialist network! Party Together, as A collective group of:…..wait for it…..”Slingers!”

        I moved out of state.. Not much better here in Indiana either from what I can gather!

      • always remeber YOU are your best health care advocate. you should always do much of the legwork in researching current treatments for your problems. always remember you get 15 minutes and make the best of them by being prepared with questions ahead of time. know what YOU want addressed not the practitioner be it dr. arnp, p.a. etc. ALWAYS make sure you use that time wisely and do not let anyone not address YOUR concerns not the va.’s time frame. people must always understand what you are facing with any healthcare concern. educate and have good questions that are relevant to your concerns . the smarter you are the better care you will get. TRUST ME.

      • Leon, I learned that a long time ago. Did all the leg work I could and in person. Along with the research traditional or homeopathy, etc. I also know when not to engage people or when feeling too rough around edges and thin skinned on that day.

        I carried my trusty composition writing books around for each clinic at the VA and one for civvy care and collected all the paper work and things like blood test in them too along with any ‘contracts signed.’ Had my questions in hand, notes from others doing some testing, their comments, etc. And it’s also what my first PCP told me to do since I was dealing with so many issues. One problem is they’d, some would ask to see the tablet and not read it at all just tossing it aside and doing their thing on the fly. So that didn’t work well all the time either.

        The one thick one I had for the CBOC events and games was tossed in a ‘biohazard waste can’ when I left the room for attempts at an X-ray and blood testing, urine screen. The one who did it was with another patient and the other gal said she must have thought you all were finished and was just worn out looking trash left behind. A total loss and too juicy and didn’t care to mess with it anymore. So I lost that and had my EVet secure messages totally deleted around the same time and I am not wondering why. With all female staff with their attitudes and other goings on I wasn’t about to argue with them or raise some hell to get flagged over. Due to the many warnings about getting flagged for various reasons or for ‘not being compliant.’

        Same thing about with my new PCP MD after leaving the VA. Just tossed my tablet aside and went on with the their game and why they couldn’t do what they were trained to do but had to pass patients along to others in their ‘associations.’ He said the nurse coming in would take the notes and such then put them in my record and in their computer files. Ha. didn’t happen. And they are the same ones that have refused to give me copies of the records and did not put any of the discussion or info in my files for the next MD visit. And he didn’t seem to mind that all that info was missing in the computer and paper work. Just been one thing after another plus the uncaring attitudes to the obvious activist crap and retaliation games.

  4. www DisabledVeterans org is a site that I try to visit daily. If I don’t comment but I’ll always share.

    Keep spreading the news because we can’t afford to loose, ANYMORE!!!

    I have to concur that the VA ISN’T GOING TO CHANGE UNTIL;

    – other models of large medical providers, with large front, middle & back ends need to be specifically monitored & managed to deternine what works and what doesn’t. You do this every day.

    If VA isn’t measured against some model, we can forget about ANY strong inpacting changes inside the VA. It WILL NOT MATTER . . .

    It’ll not matter how much money or operational changes this defunct Agency changes or adds to.

    VA ISN’T MEASURED PROPERLY INTERNALLY, AND THATS UP.AND DOWN ITS JANKING CHAIN OF . . . I’d rather not say.

    • They don’t have to do what is RIGHT. Their is NO Accountability for Fucking Up.

  5. I agree with Elf on this one and call foul! I was informed that I had to have a complete knee replacement on my left knee and the VA could not do it as the closest orthopedic doctor in the VA system was over 3.5 hours away. So they sent me to see a local orthopedic surgeon/neurologist and even sent them the complete authorization to have the knee replaced. Then it went to hell in a handbasket. I got a very shocked notification that my private insurance was billed for the 65,000 for the knee replacement. The problem is I am a 100% perm and total service connected veteran and the VA is required by federal law as well as VA regulations to pay for the cost of the treatment on my service connected injuries 100% including any PT that is required afterword. Remember I stated the cost of the replacement was 65,000. The VA paid a grand total of $1.45 and I even received a bill from the hospital for over 12,000.00! I contacted the VA and the Hospital and told them that they had damn well better get this corrected as if this effected my credit rating in any way, I would sue the piss out of both of them. So far I have not heard back. So again I am crying FOUL on this as I have to now have my right knee replaced and to make it worse there is a growth on my right knee cap. The doctors dont know what it is and have told me to just hold on till after July 9th and they will remove the whole knee including the growth and the knee cap. lets just hope the VA actually pays for this as they have already authorized the treatment.

  6. 2 years ago I collapsed bringing an empty garbage can up to the house. I live 110 miles from a VA emergency room so I went to a local hospital. They found I was in AFIB and lungs were filling. They gave me Lasix and I went home. At that time the VA in Minneapolis was moving billing to St. Cloud, MN who was hiring an outside company to take it over. As one of the St. Cloud guys told me on the phone – Do they really think we are training these outsiders properly so I can be unemployed in a few weeks. For the x-rays of my chest someone decided that if I went home the same day it could not be a real emergency. I have dealt with collection agencies and even a lawyer threatening to sue me. I wished them luck.

  7. It seems that the VA plants Gotchas like landmines to confuse and many times deny. I believe I looked up one of the Urgent Care networks, and found less than encouraging information. That is you will probably not see a doctor, but will probably see a nurse practitioner or if lucky a physician’s assistant. Also that the reviews of these medical chains was less than stellar. The VA is running a substandard medical system despite all the glowing reports they publish. I asked my doctor today if they provide a lead blood test, as I am concerned about all my silver amalgams giving me too much lead exposure. The doctor said they don’t provide such a test. At one time a VA doctor asked if I wanted a flu shot on my visit. Luckily the nurse was laughing when she told me that the flu season is already over and next year they will have a new concoction. I also asked for the blood test, I forget what you call it to determine body inflammation. My brother’s doctor gives him the test on each visit as he is also a senior citizen. The VA doctor said that they don’t give this test. I could go on and on about these incidents. That is why my opinion isn’t completely positive about the quality of the VA healthcare. My final thought is that veterans should do their homework on what the VA is recommending to them and participate in the final decision as to what needs to be prescribed.

    • THATS PART OF YOUR RESPONSIBILITY TO UNDERSTAND WHAT YOU WANT. all blood testing has a name and if you are that concerned then research it online and know what typo ask for by name. and actual information. r u taking this silver concoction for some reason? if so if it concerns you do not take it. you are always your best healthcare advocate when you are concerned and doing the research makes you a smarter patient but everything you read needs to be from factual sources. lots of disinformation out there .

  8. Like I’ve said many a times, I rely on www DisabledVeterans org ‘s weekday articles. I always start my day by reading articles about DisabledVeterns.

    Strange to where I’ve personally came across Veterans that are now, and when complained about internal matters when working for VA, that party was targeted and believed to be watched by VA, along with other possible VA actiins that made the Veteran to be intimidated.

    Another Veteran living in Boston, is hesitant to say anything against VA because he rely’s on a monthly VA check to survive each month. Remenber the lastest glitch in benefit payments?

    So what does it take to VALIDATE that VA is operating on fair grounds with Veterans.

    Seems like the VA’s sub-contractors and themselves have it better with consistancy in receiving VA services directly or indirectly from outside associations, being paid in some form or way, with monies from VA’s massive and unmonitored budget.

    • Windguy,
      On your “pharmacy” question. It’s better to have them filled by an outside pharmaceutical business. I sometimes get mine from Publix! They know how to help keep the cost down!

  9. Off Topic: I have a question for those of you more knowledgeable about the VA Pharmacy and prescriptions. Will a VA doc give me a scrip for an outside pharmacy to fill. It’s only $8 per month again (as opposed to once being free, then not, then free – long story), but it adds up. One scrip in particular, that isn’t in the VA formulary I could use a little more of, and I can get a 90 day supply for $5 on the outside. Odd industry those drug maker/dealers. Anyway, anyone have any experience? Then again, I’ll need a doctor to prescribe, and once again, we don’t have any docs at our CBOC.

  10. I’ve been using TriWest for some treatments not available in the VA Puget Sound healthcare facility in Seattle. The 40 mile issue is complicated by some of the worst traffic conditions in the U$.

    The single most effective treatment for my PTSDisabilities has been Transcranial Magnetic Stimulation. It has kept me out of the pit of deep depression exacerbated by our Tweeter-In-Chief, Hair Gropin’Fuhrer Drumpf. Mission Act seems more like a clever way to privatize the VA.

    The other treatment is acupuncture. Ever wonder why us Auld Pharts are so grumpy? Pain, creaky joints etc. I think this is another treatment that should be available.

    I’m using both of these now. They were authorized by the VA before the Mission Act went into effect. I’ve not dared to question their availability to me under it.

    If they are not then I will be looking for the modern equivalent of MASH’s “Black Mariah,” fentanyl.

    • Donald,
      To be honest, I’d rather see the VHA section of the VA go far away.
      My reasons are long and I can back them up with many sources!
      Right now “…the VA spends $25 million taxpayers monies for public relations!” Basically, Mr. Cashour, who’s in charge of public relations has lied to Congress AND the American People for some time. Ben had a blog on that some time ago. Right now, the Veterans Committee wants Cashour to testify as to WHY there’s two sets of appointment books!
      2.) These “Choices” vets were supposed to use has been a failure since its inception. You may not be aware of something which was reported, concerning that issue: Seems Obama’s administration took that money and gave it to the illegal immigrants AND the Muslims he was transplanting here! And that’s a fact!

      3.) To say President Trump is souly responsible for crap being perpetrated by VA employees IS rediculous.
      If you had visited this, and other vet-centric websites, you’d know the upper echelon of the VA breaks the laws constantly. We’ve seen it numerous times!
      You’ll have to dig hard to say President Trump is to blame for anything. He’s up against some of the most ruthless assholes in government service.
      As a matter of fact, the VA – along with its corrupt afge union – are the most corrupt government agencies in the United States!

  11. “[…I think the answer we all hear in our heads like a canary in the coal mine is a faint “you betcha.”…]”

    Except it’s a perpetual circular flight pattern of VA Crows, and we Veterans are the canaries in the VA’s minds.

  12. Scenario- -**what if**
    “Prudent Layperson” has chronic diarrhea to where not only is dehydration a factor, but the “Prudent Laypersons” prolapse projected to point of the VA’s recommend cure of buying three-legged pants, would it be prudent to go to urgent care or would a budget-conscious “Prudent Layperson” just pull themselves up by their prolapse bootstraps and wait for the VA to wait for”PL” to die?

  13. I checked with my local VAMC (Northport, NY); nothing contracted for community care or urgent care. I checked with VISN 2; still nothing in either category. I checked with VACO; same story. Then, I checked with OPTUM Private Sector Solutions (United Health Care); they denied having any contracts in VISN 2 at all. It is my understanding that VACO signed a $54 Billion contract with OPTUM to run this dog and pony show. Waazzzup?

  14. I checked with my local VAMC (Northport, NY); nothing contracted for community care or urgent care.
    I checked with VISN 2; still nothing in either category.
    I checked with VACO; same story.
    Then, I checked with OPTUM Private Sector Solutions (United Health Care); they denied having any contracts in VISN 2 at all.
    It is my understanding that VACO signed a $54 Billion contract with OPTUM to run this dog and pony show.
    Waazzzup?

  15. Please don’t call them Bean Counters. Call them what they really are.

    Thief’s and plain criminals. Why the hell are these type of employees, not being arrested and put in jail for abuse of their power and their own mistakes that the veterans have to pay for.

    Scamming of the veterans and the American people. Pass laws to hold employees accountable through our justice department.

  16. I’m going to be posting lots of articles from *”military.com”* today.
    This is the first one;
    *”https://www.military.com/benefits/veterans-health-care/va-urgent-care-benefit-how-to.html”*

    • This is number two:
      *”https://www.military.com/daily-news/2019/06/07/inspector-general-finds-va-overcharged-disabled-vets-home-loans.html”*

    • Number three:
      *”https://www.military.com/daily-news/2019/06/10/va-hospitals-ban-all-tobacco-use-vaping.html”*

    • Number four:
      *”https://www.military.com/daily-news/2019/06/05/vets-denied-va-home-loans-if-they-work-cannabis.html”*

    • Number five;
      *”https://www.military.com/daily-news/2019/06/06/justice-department-wont-appeal-agent-orange-ruling-benefiting-blue-water-navy-vets.html”*

      This will keep y’all busy for awhile!

    • One of the interesting things about the search tool mentioned in the article is that when I type in my zip code, it only returns VA facility information.

      If (under certain circumstances) we are authorized civilian medical care for Urgent situations, should not the search tool be returning a list of civilian providers?

      For myself, anything less than a broken bone, sudden eye injury, etc. does not qualify as an “urgent” situation.

  17. Received msg of denial of payment for emergency. Denail was for incident in 2016.
    Almost 4 years ago.
    I fear it will be necessary to fight back soon to avoid being killed by the v.a. i survived
    Vietnam and 3 traumatic brain injuries and broken neck at c5. Let see if i can survive our real enemy, the veterans administration!

  18. I wish our Urgent Care bitch boards were read by VA leadership. The VA would learn a lot from the experince of Veterans and from the front line personnel, and how the whole VA process measures up.in being effective.

    Even with Urgent Care, I don’t think the VA listens well to their employees. Slack management breeds destructful clicks that have negative energy to anyone one in contact with the VA.

    Now I’m going to smoke some good Sativa Cannabis; the brain thought enhancer. Yeah right, how well is that working out for for you?

    Sometimes the when it happens its Urgent Care or Urgebmnt Cade is being worked on.

  19. Urgent Care is desparatemy.needed due to VA experimenting on dogs in their cold and damp laboratories.

  20. i have received denial for ER visit from VA. It was an inappropriate denial determination. The language being used by the VA is sounding very much like private health insurance. That is unfortunate as private health insurance industry is out to make money. Why the VA has picked up private health insurance language and policies I wonder about as private health insurance is more interested in how not to pay for services.

  21. THIS is a major symptom of what is wrong systematically across the nation with the VA:

    “https://www.dailypress.com/news/military/dp-nws-veterans-administration-labor-talks-20190607-story.html”

    Note the sign the man is holding in the photo. These slugs should be grateful they have such a nice cushy job to begin with. One of the things they are bitching about is the proposed reduction of “official time,” the part of the workday union members set aside to deal with local grievances, prepare for negotiations or other activities.

    Balderdash! They get a lunch hour, they have their evenings, and they have telephones and computers in their homes. They do not need to be paid for their union activity at work. Every minute devoted to “official time” during the VA workday is time spent denying veterans what they need.

    Fire them all.

    • Jim,
      I read that article. These reprobates really are assholes. I liked the comment by Elliott, who said the new union deal, quote: “…is setting up the VA for failure!”
      My question is, how can it be “setting up a failure” when the VA is already a failure?

      Oh, btw, scrolling down I noticed another article you might want to read!
      *”https://www.dailypress.com/news/military/dp-nws-military-update-0128-story.html”*

      • Well, if her statement were translated into proper english, it would read “The new union deal is tipping the scales at the VA (slightly) in favor of the veterans we are supposed to be serving. And we darn sure do not like that”.

        Or something very close to it . . .

  22. Check this out. It is actually a continuation on today’s blog:
    *”https://www.dailypress.com/news/military/dp-nws-military-update-0128-story.html”*
    Lawsuits abound against VA for civilian healthcare not paid for by VA!

  23. . . . And some veterans humor (intentional or not) was included in Ben’s article today. To wit:

    “Priority Group 6. If the visit is linked to combat and chemical exposures like Agency Orange, the first three visits are free. Subsequent visits are $30. If not related to the condition, co-payment is required for all visits. If the visit is not related to these conditions, the co-payment is $30 per visit, for all visits.”

    Agency Orange. I love that little typo, as it so BRILLIANTLY captures the ‘National Overall Performance Service Rating” of the VA with respect to veterans.

    Agency Orange, indeed !!!

  24. It is a step up. At least it will be “urgent care” charges instead of ER charges. As a “prudent lay person” I went to urgent care with a yeast infection when I couldn’t get to the VA because of the lack of a driver or other means. Should have gone to the ER. They would have paid the ER bill at that time but weren’t paying urgent care.

  25. Oh My – After reading everyone’s comments – I’m scaarrred, eeeek – I hope the VAHCS improves with these changes, but I am a lil worried about these changes making things worse. All in all, meaning after a near death experience and five years of my life gone, the VAHCS has been good to me. Most of the time the healthcare professionals are courteous and genuine about their care for the veteran. It’s the few “bad apples” that take advantage and rotten the whole system. Fingers crossed and hope that these “bad apples” will be disposed of accordingly and the VAHCS will be the”New and Improved”! I believe it is possible.

    Peace Out

    • TLC,
      As long as there’s a union, the VA will continue to be a failure. Count your blessings your receiving proper healthcare. Because, I can guarantee you – the majority of veterans are NOT!

  26. Privatize Veterans and care for the families of active duty military 100%. ANY requirement for veterans and families to go to VA facilities distorts the market and restricts their “liberty” to live where they want to. It also distorts the distribution of medical staff (doctors, nurses, etc.) because they need to live near those types of facilities.

    If veterans want to live in Montana, then they shouldn’t have to live near a VA facility or drive hours to get to one. They should be able to get care as close to their home as possible.

    Simply let insurance companies develop plans for veterans and the families of active duty military and then either subsidize or outright pay for the plans on behalf of the insured.

    • BC49,
      I don’t have faith in insurance companies either. Being forced to be a hard liner pessimist I have lost faith in about everything American and in most humans.

      There are too many real and problematic issues to deal with or be concerned over. So I see no easy fixes especially in states and communities like mine. Dealing with VA issues or improvements are not, will not, help fix other issues at hand or the many in the civilian health care worker clubs, unions, and associations.

      The claims of shortages of medical care people and nurses. So they bring in foreigners with visas to work such care or professional positions since those at the top figure Americans are too stupid. With those too that are not there (in med care) because they care or qualified to do so, or can speak English well enough. There are perks, scholarships, no need to be basically good to get into the health care working arenas for the prestige and powers. Just be connected, willing or wanting to teach others what they’ve learned, or have the right names. And seems most of them could care less about our American rights, culture, or individual needs or proper care. Or they use those with special advantages to work/train to appease some groups and not about being well trained or well intentioned health care workers. All the complaints/discussions being buried by the media of patient abuse and neglect in hospitals and nursing homes is proof of that. So is the movements disallowing cameras, pics, and filming in hospitals, nursing homes, etc.

      All these clowns passing “Acts” are not taking in the considerations of the difficulty in finding outside care or problems in all states and corrupted communities. There is no end to the real issues at hand.
      1. Not wanting patients with chronic pain issues.
      1-A. Not wanting to hear about or see patients other MDs have already screwed up or mis-diagnosed.
      2. Not taking new patients.
      3. Possible “new patient fees.” Cash, out of pocket. Heard that one yet?
      4. More possible goofy contracts to sign like agreements to allow some clinic or MD to sue you for not following all their “orders” or to help fill the wallets of their associates that have already been seen or more physical therapy and such that does no good at all and tried many times before. But that too is sue worthy.
      4-A. Contracts stating you will not sue medical providers or staff over issues as malpractice, mistakes, etc. And not wanting to know staff’s real names instead of nick names, etc. Due to staff security and clinic rules.
      5. Spending months to years trying to navigate phone books and false advertisements to the long list of MDs long gone or moved. Hospitals will not guarantee up to date referal lists either so you have to play that game as well. And play the hopefully they’ll call back game after leaving messages. After days long wait games till they come back to work in-office, when ever they return or care to work. Online searches are just as bad and useless in my area.
      6. More long waiting room times as bad or worse than the VA. Six hours or more to get into a pain clinic then play their games too.
      7. About the two week wait periods (if lucky) while they run your pharmacy use records, get possible VA records, run the criminal to bankruptcy and insurance checks, etc.
      8. The claimed newer VA CBOCs being installed or built but not in more rural areas where it’s needed but again in more metropolitan areas leaving some same old issues ignored. But they want 5G and more telehealth crap for the long distance drivers or more rural areas instead. Then claim to need more tax dollars or revenue to get more high tech, 5G and more, into rural areas. Then claiming most needs can be met with IT, Google or Apple health care tech or algorithms & AI, or booths wanted in Walmart to check vitals or detect some issue going on to helping those with PTSD via cell phones or pcs.
      9. Then on to the dealing with the many union activist, SJWs, all those in the cover-up and protect games…ie … from the top down, sorority sistas, frat’s brahs, societies, cliques, the deep seated all protective nepotism types, all those with connected families in every state agency out there and in media or health care to functioning in medical schools with some being X-VA staff and workers with chips on their shoulders or axes to grind/politics with veterans. Then on to the hate on “baby boomer” youngsters in health care or their activism being number one not people’s proper health care. On it goes.

      Come on. How many other communities, oral surgeons and dentist, health care people will refuse to do simple X-rays on a broke and shattered jaw from the VA with zero support or concerns from anyone, any agency. A major hospital get by with withholding medical files to move along to other care givers, or refuse to release files they got from the VA? No HIPPA laws, no Disability Act protections, no human rights or civil rights protections, no Constitutional rights protected to be had but plenty of threats and harassment, along with others to be enforced or investigated all denied and covered up or excused?

      Let’s get real while living in the matrix of semantics and playing lab rats or models while suffering for new “Acts” or plans to be implemented or tried. That is how it is in Indiana and few really give a damn.

  27. www DisabledVeterans org ‘s weekday article tremendously helps me to reach understandable conclusions. Here’s one;

    The VA Urgent Care, regular PCP Care, and other Specility Care VA departments, can & will be a frustrating process for MOST VETERANS entering in the VA system for the first time, the Vet already in the system, or the Veteran that’s just stuck with sub-standard VA care. A far stretch from Precision Medicine.as proclaimed by VA in the past.

    Where are the observing teams that watches over changes, and then makes suggestions for changes. To tweak up what was started up.

    More issues will be coming down the pike, because the VA can’t properly monitor, manage, and treat its current 21st. Century Veteran load. This is straightforward.

  28. Well if I can ever figure out how to get elected I’ll try to get veterans a lifetime medical card after bootcamp and change the laws were veterans that serve dont have to pay back there times served to count as retirement. Our veterans population will be cut in half and are 1 percent of the population going to half percent.

  29. ~Off Topic BUT of Urgent Caring~

    All this while Federal & State Gov’ts and of course Wall Street are running a $4 – $5 Trillion ($$$) mismanaged losses or legal theft of such amounts of cash.

    As I scan my life, I’m believing that almost everyday, that there needs urgent caring of just everyday life of things for all of us.

    My personal urgent care is that I still believe that the VA is a threat in trying to obtain optimal health using the services from an Agency that always promotes precisision health.

    I’m just having an urgentlessly and caringlessly thought about the VA overall.

    You as a Vet need to urgently care for what’s on your records, so that you’re not able to recall your VA medical.history.

    If you run on emotions and touchy wouchy feelings, then you need more VA urgent care.

    • Should be- so that you’re able to recall you’re VA medical history and not to be stomped.

  30. 06/12/2019

    Dear Benjamin Krause,

    ANutterVet, “the VA can’t properly monitor, manage, and treat its current 21st. Century Veteran load” that is correct, and considering the evidence we can go back to the beginning of time with our U.S. Veterans/Americans.

    The U.S. Veterans/Americans have been defrauded.

    The VA officials must come clean along with the three Branches of Power and their Bankers; the past five years [150 Hospitals/VA/Congress/DOD/HHS] is enough evidence to convict most senators who have been around for a long time like Sanders, Pelosi, Biden—Trump’s impeachment attempts is just a cover for this monster of a fraud and the embezzlement of the American Taxpayer.

    What should Trump campaign on—- you guessed it!

    Will Beto O’Rouke explain to Americans how the VA lost all the cash and delivered more of the same fraudulent care to our Veterans; I doubt it.

    Will Elisabeth Warren go after the VA; I doubt it —she is still waiting on William Nutter, Jr. case [two years].

    The Senators in Arizona are tight lipped, apparently.

    Sincerely,

    Don Karg

  31. I had a procedure done on 3-14 2014 at a U.H., this was outsourced by the V.A., I was called by someone, and they stated, we have found something strange in your stomach, were going to send you some medicine, 2 years later I took my greatnephew to this facility for his procedure, I decided to get a copy of my procedure that was done on 3-14 2014, I was very shocked what was found, and I was not told,In fact there report, was so detailed, and was nothing like what the V.A. notes stated, They rewrote the hold procedure to there liking, and never gave me a Treatment Plan, and denied that I had these conditions, so in short, I think the Veteran should have these out side providers finding in there medical records at the V.A. intact as it was done originally, also a copy of there procedures should be given to the veteran, as it’s completed, just like getting a receipt when you by something at Wal-Mart. Please don’t change or rewrite the Veterans history.

  32. I was saddened to hear of the complaints on this post and am always saddened when I hear the vet him or herself talking. I am almost 80 and for the most part the VA has done a fair to decent or good job, but had I stayed with one of them in west central PA I would surely be dead now. I don’t know who is getting the money but audits should be done routinely and published. It’s like Pelosi and her ilk, the longer these administrators and doctors are in place the better they are at hiding hidden VA income. I never knew being a US Senator would put me on the gravy train forever. Too bad as I could really use the income now.

    Yes, Pres Trump should address this issue. However, no one has ever called me to determine what the outcome has been on any procedure or statement of misogynist male doctors I have been concerned about. Nobody has asked me to examine my record to determine if anyone wrote a statement that is blatantly untrue. It may be we have a population too large for anyone in power to see any benefit of keeping older people alive. The consequence is we die by attrition. I doubt Trump ever gets an honest comment from his minions or from those in Power.

    Frankly I think the whole governmental and non-governmental medical and medical insurance consortium should be examined and overhauled. What is happening now is disgusting…but maybe better than euthanasia because we are ill and 60,70, and 80+ years old. The audit should include patient perceptions but only providing the patient’s identity will be protected. Might get some honest answers that way.

    One last comment, I wonder about the “tier system” of care. When I was in the Navy I married one of my instructors. I had been in boot camp and schools for a year at that point. However, he and I both looked forward to my having a career in the Navy–he was about 10 years older than I so his career was well launched. Within 3 months after our marriage I was pregnant. We were delighted and knew the 6 weeks necessary to recoup after delivery wouldn’t be too onerous and I would soon be back at school. As soon as Navy command at Navy Memphis heard I was pregnant It told me I had be discharged, “honorably” it is true and sign a waiver I would return to the Navy if I had a spontaneous abortion. We were devastated. My Husband was a good man, a wonderful instructor and an honorable being. It didn’t matter. So I was honorably discharged and spent the next 7 years being a Mom and good partner to my then retired Navy partner. So now, long after his death and being in my 80’s I found out I qualified for VA care. I think it might have been easier to have died outrightly.
    The VA has been such a merry-go-round of abysmal and excellent care I worry now when I get a new PCP. I never know when the administration at the VAMC I go to will decide that my tier of care will be outsourced to local clinics. I have secondary progressive MS, RA, Sjogren’s and possibly another autoimmune disease. My local clinics and Class C hospitals haven’t a clue but the VAMC I do go to does understand that good care involves not only VA docs but outside doctors. I don’t diss this VAMC.
    I am so glad to know of this site. Maybe there will be some way I can help get it all straightened out. LOL

  33. I went to the Missoula, Montana CBOC to be treated for a sinus infection. They called me in, took my blood pressure and temp.. I was told that they couldn’t treat me, but I could go downtown to an Urgent Care clinic. They charged my insurance $135.00 for a visit. Why have a clinic for vets if they won’t treat you on an outpatient basis?

  34. That is your privatized VA everyone on this board is calling for. A contract CBOC or a contract Choice. The CBOC got theirs and sent you to their contract referral the Choice program insurance co. Wake up guys.. Our choice is fix the VA or the privatized version. Neither is working. And without one working we have nothing and that is probably the goal of Congress.

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