WASHINGTON — As their stack of unpaid bills continues to grow, Veterans Affairs officials are promising a host of reforms in coming months to more quickly pay community providers for care they deliver to veterans.
The new moves, announced Wednesday, include creating new “rapid response teams” to settle the largest outstanding bills within 90 days and awarding at least four new contracts this year to provide faster payments in the future.
In a statement, VA Secretary David Shulkin called the reforms “vital to the health of our network of providers” and to veterans’ health.
“Our outside providers are an essential part of our network, and we need to improve our system of payments for their services,” he said.
The issue of community provider payments has taken on extra importance in recent months as administration officials have expanded their emphasis on health care options outside the Veterans Health Administration.
Along with resolving issues of eligibility and access to medical appointments for those community care programs, lawmakers and VA officials have pushed for streamlining the payment system for those private-sector visits, following complaints from their financial departments about the current process.
Some offices taking in veterans as patients have seen unpaid bills swell into the tens of thousands of dollars, with no clear payment date.
As part of the reforms announced Wednesday, department officials next week will start publicly posting some of the highest debt totals, to make public how much is owed. Those claims will be the first to be settled, they vowed.
Currently, Health Net Federal Services and TriWest Healthcare work as third-party administrators for those payments. Both have promised to cooperate with the new initiatives, but could see some of their business taken away with the new contracts.
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VA officials are setting a new goal of processing 90 percent of “clean” claims within 30 days by this spring. Doing that will require new workload goals for third-party administrators in coming months and multiple IT improvements in the next six months to streamline the claims submission process.
The changes announced Wednesday were billed by officials as “sustainable fixes” for the department, but VA leadership is also continuing to push lawmakers for legislative changes to address the issue.
Several measures pending in the House and Senate include the community provider payments issue along with plans to consolidate multiple veterans community care programs into a single, broader outside care offering.
Roughly one-third of VA medical appointments take place at doctors’ offices and hospitals outside the VHA system.
President Donald Trump and Shulkin have suggested expanding that even further, to give veterans more flexibility in their health care. But critics have warned that those moves could undermine the existing VA health system, by pushing patients and funding into medical centers less equipped to handle veteran-specific medical issues.
Leo covers Congress, Veterans Affairs and the White House for Military Times. He has covered Washington, D.C. since 2004, focusing on military personnel and veterans policies. His work has earned numerous honors, including a 2009 Polk award, a 2010 National Headliner Award, the IAVA Leadership in Journalism award and the VFW News Media award.
