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VA watchdog says bureaucratic bungling bogged private care program

By TOM ROEDER | The Gazette (Colorado Springs, Colo.) (Tribune News Service) | Published: February 1, 2017

Bureaucratic bungling at the Department of Veterans Affairs undermined a program designed to cut health care wait times for veterans, the agency's inspector general reported Tuesday.

The Choice program, an insurance option implemented in 2014 to send veterans to civilian doctors, was bogged down by paperwork, scheduling problems and a small network of doctors. While Congress approved $10 billion to send veterans to private doctors outside the VA system, the agency has only spent $306 million on actual care for veterans, with another $206 million paid for administrative costs to implement the troubled program, the report found.

The low use of the program was because VA bosses had built a program that was "cumbersome and time-consuming" for veterans in need, the inspector general said.

"We recommended the undersecretary for health streamline procedures for accessing care, develop accurate forecasts of demand for care in the community, reduce providers' administrative burdens, ensure veterans are not liable for authorized care, and ensure provider payments are made in a timely manner," the agency watchdog said in its 45-page report.

Congress this year will decide the future of the Choice program, which was brought as a temporary measure in 2014 to roll back long waits for care at VA clinics. Of 1.2 million veterans deemed eligible to use the Choice program to get faster care, just 13 percent used it, the report found.

Republicans who lead the House and Senate VA panels have alleged the agency purposefully sabotaged the Choice program in order to keep money for veteran care in VA coffers.

Colorado Springs Republican U.S. Rep. Doug Lamborn said Tuesday that he's pushing a measure to tighten discipline for VA employees that he said could help fix the Choice program.

"Accountability is a really serious issue, especially when we see what's happened with Choice," Lamborn said. "When you have a bureaucracy that us entrenched and unresponsive, you have to have the tools to deal with them appropriately." Lamborn's H.R. 611 would allow the VA secretary to fire problem employees. It would also cut retirement benefits for VA workers convicted of felonies and kill a system of bonuses for top VA brass. It reprises an accountability bill that passed the House last year but died in the Senate.

VA issued a statement defending its implementation of the Choice program.

"VA is moving in the right direction, towards an integrated healthcare network that improves veterans' healthcare experience by delivering the best of VA and the community," the agency said.

While waits for VA care in Colorado Springs have improved in recent weeks, a January report showed that more than 20 percent of Pikes Peak region veterans were waiting more than a month for care here, with nearly 1,000 veterans here waiting more than three months.

Chris Garcia said she's been happy with the care her Korean War veteran husband Genaro has received at VA's Floyd Lindstrom Clinic on Fillmore Street. But getting cataract surgery for the 86-year-old under the Choice program has been a different story.

"It's been a disaster," she said Tuesday.

Genaro Garcia, an Army artilleryman in Korea, has waited since October to get a cataract fixed under Choice. Chris Garcia said she's spent hours on the phone working to untangle the Choice insurance to cover the surgery, but with little luck. She's been told the procedure has been approved four times, only to have it denied at the doctor's office.

"It's been one heck of a nightmare," she said.

Lamborn said Congress hopes to clean up some of the Choice program mess when it's reauthorized this year.

"I don't think the existing system has the ability to fully meet the needs of veterans the way it is supposed to," Lamborn said.

But technical fixes to the program won't help until VA's workers can be held accountable for poor care and managers carve into the bureaucracy, he said.

"I see some slight improvement," Lamborn said of VA care in Colorado Springs. "They brought in some better personnel, but the system is so tied up in red tape, that the system itself has to be changed."

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©2017 The Gazette (Colorado Springs, Colo.)

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