State Senator Crowder – District 35 -The VA and What Needs to be Fixed.

District 35 State Senator Larry Crowder

I met with the in Denver on the issue of health care and walked away with a conclusion that the system is broken, but can be fixed.

“The Department of Veterans Affairs (VA) announced, it will determine eligibility for the Veterans Choice Program (VCP) based on the distance between a Veteran’s residence and the nearest VA medical facility using driving distance rather than straight-line distance. Under the VCP, Veterans who live more than 40 miles from a VA medical facility or are unable to get a VA appointment within 30 days of a medically necessary or preferred date may obtain approved care within their community.

This change nearly doubles the number of eligible Veterans. Letters from VA will be sent to newly eligible Veterans notifying them of their eligibility for the VCP under this expansion.”

There are basic problems with this: first, The health care provider will wait up to a year for re-imbursment for treating a veteran. Second, finding a provider is very difficult due to the first problem. Third, Health Net, which is the government run contractual entity who oversees this program for the VA, claims that billing from the provider to Health Net takes an excessive amount of time. Health Net’s claim is that since the provider takes an excessive amount of time to forward records and billing that they cannot re-imburse until this is complete. Contacting them is very difficult, and they, are not inclusive to the needs of the veteran.

An example of this is, currently the San Luis Valley is designated a hardship, due to winter driving conditions and mountain passes that have to traversed to get to a VA hospital or clinic at front range providers. The problem is that there are no designated private providers to see them in the San Luis Valley.

Solution- guaranty payment to the health care provider of no more than 60 days upon completion of medical service to the veteran.

• guarantee from the provider that veteran records and billing will be submitted to the Health Net(insurer) promptly within 30 days of medical service to the veteran.
• Health Net needs to clean up its operation on how they perform as a contractor and health care insurer. If they cannot, then it is time for them to step aside and let some other entity take this on.

  If this relatively simple task can be accomplished then the influx of veterans into our VA hospital and front range VA clinics will be reduced and appointments such as we have seen in Colorado Springs and other areas of the country will be avoided. Due to the excessive distances from southern Colorado to the front range VA clinics and hospital, if used properly can benefit not only the veteran but the provider.

  The Choice Card program will work, but not under the current methods utilized. A change is needed, and it is up to the current VA administration to come up with solutions.

  Colorado State Senator Larry Crowder
  Veteran and in the VA Health care system