VA attempting faster payments to private-sector medical providers who care for vets
By NIKKI WENTLING | STARS AND STRIPES Published: January 5, 2018
WASHINGTON – The amount of money that the Department of Veterans Affairs owes private-sector medical providers will be made public now – one of several moves the agency announced this week in an attempt to hold itself accountable for faster reimbursements to outside doctors that treat VA patients.
The largest debt totals will posted on the agency’s website starting next week and updated each month with information about how quickly payments are made, VA Secretary David Shulkin announced in a statement released Wednesday.
“It is vital to the health of our network of providers that we provide payment in a timely and consistent fashion,” Shulkin said. “Our outside providers are an essential part of our network and we need to improve our system of payments for their services.”
The VA has been slow to pay private-sector health care providers, according to government watchdogs. The issue has plagued the VA since 2014, when the agency put more dependence on the private sector to care for veterans who faced long wait times at VA facilities.
The number of VA medical appointments made in the private sector has increased since Congress created the Veterans Choice Program that year, allowing veterans to go into the community for treatment if they live more than 40 miles from a VA facility or can’t get an appointment at the VA within 30 days.
In December, Shulkin said the VA authorized 6.1 million appointments in the private sector in 2017 – a 64 percent increase from the 3.7 million in 2016.
The Government Accountability Office named the VA health care system a “high risk” area of government in 2017. In its explanation, the GAO wrote the agency needed to ensure timely payments to community providers, among other things.
In a letter to Shulkin during the summer, 40 House lawmakers criticized the slow reimbursements for hurting veterans’ credit reports. Thousands of veterans who use the Choice program have complained their medical bills are sent to debt collectors when a timely payment is not made, according to the letter.
Health Net Federal Services and TriWest work as third-party administrators to pay claims from private-sector doctors, and the federal Prompt Payment Act requires the bills to be paid within 30 days. According to a report on Dec. 21 from the VA inspector general, Health Net took an average of 47 days to pay providers and TriWest took 39 days.
Of the 2 million payments made through the claims system between November 2014 and September 2016, 224,000 – or 12 percent -- contained errors, the report stated.
Besides posting the debt totals the VA website, Shulkin said the VA would work to improve the administrators’ performance and award four new contracts this year to provide faster payments.
He also announced new “rapid response teams” that will work with private providers to pay back the largest debts within 90 days. The agency will also make technology improvements in the first six months of 2018 that should speed up payments in the long term, Shulkin said.
Rep. Phil Roe, R-Tenn., chairman of the House Committee on Veterans’ Affairs, said the changes announced this week are overdue.
“VA’s issues with timely payments have been well-documented and have gone unaddressed for far too long,” Roe said. “I applaud Secretary Shulkin’s actions this week to ensure providers are paid in a timely and efficient manner to ensure veterans in the community are receiving the best quality care where and when they need it most.”