Letter to Secretary McDonald - Fix Choice Card Payments Process for NH Health Care Providers

Letter

Dear Secretary McDonald:

I write to urge you to make changes to the Veterans Choice Card program to improve its implementation and better serve New Hampshire veterans. Too many veterans and healthcare providers across our state continue to encounter substantial problems participating in the program due to the failure to receive payments for services rendered in a timely manner. Because of the excessive burden Department of Veterans Affairs (VA) requirements are placing on providers striving to care for veterans, I urge you to immediately revise payments processing conditions to achieve prompt payment.

I have joined with Senator Jeanne Shaheen on multiple occasions to write to you with our concerns about the implementation of the Choice program, including the issue of prompt payments. Additionally, Senator Shaheen and I have hosted several forums at which veterans, VA, Health Net, and providers have been able to discuss the Choice program. A common frustration has been the difficulty in participatng in the program-for veterans seeking care, for providers wanting to offer care, and for providers seeking reimbursement for the care that they have provided to our veterans.

While the Choice Card office in the Manchester VAMC appears to have improved VA customer-facing resources brought to bear on the first two problems, the issue of payments has reached a critical level. Providers participating in the program-such as PainCare, a Somersworth pain management clinic-are leaving the Choice program because they are not being paid. The burden of participating is too high, with providers noting tens of thousands of dollars of unpaid invoices dating back months.

Although VA has an interest in receiving veterans' medical records following the provision of private care through the Choice program, the requirements in the contract with third party administrators are resulting in a significant percentage-more than half in New Hampshire-of provider claims going unpaid.

This is unacceptable. The Choice program was created to expand options for veterans by allowing eligible individuals to seek care in their own communities with private providers. VA's bureaucratic barriers too often impose unsustainable overhead costs, and beyond-industry-standard medical documentation requirements are demanding resources that should be devoted to caring for our veterans.

Given the ongoing harm to the operation of the Choice program in its service to our veterans, I request that you revise the payments processing requirements to accomplish prompt payment as required by the creating statute, the Veterans Access, Choice, and Accountability Act of 2014. This law does not require the payments process VA chose to pursue. As such, the revision of those requirements-accomplished through a contract revision with the third party administrators-is within the authority of the agency. For example, such a modification could include authorizing payment in advance of receiving medical documentation from the provider, and streamlining the medical documentation reporting requirements to comport with industry standards.

I urge your immediate attention to this issue. Absent prompt reforms, the value of the Choice program will erode as providers flee from bureaucracy-inflicted losses. Without fixing the payments process, the Choice program will not function as Congress intended and our veterans will pay the price of that failure.

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