New Health Care Options for Veterans? Read Carefully

Health Editor’s Note:  I see some big holes in this MISSION ACT that do not serve the Veteran.  Probably the one that really jumps off the page, is “the veteran can only receive health care “outside” the VA system if the VA does not offer that type of treatment, care, etc.” That would be number one on the list of eligibility requirements. There can be a  very, very large difference in the value, quality of care that the VA offers/performs and what can be received on the outside. For instance, there can be incalculable difference in physical therapy, physical therapists, treatments used, and equipment available.

This is a first hand experience….VA has physical therapist who did not get up from her chair, performed a “dry needle” (acupuncture?) treatment that caused 100% more pain than was present in beginning of the office visit, plus no actual treatment given and quite obviously no improvement.  Outside the VA system, physical therapist (we found on our own), with an ungodly understanding of how the human body works, bones, muscles, tendons, ligaments, and how to manipulate these items to achieve lasting treatment and utter improvement in condition was enlisted and knew how to offer exercises, treatments, etc. to make most of the skeletal muscle/nerve issue go away. 

The physical therapy was ordered by the Care Choice (which is how going to be gone) approved orthopedist/pain management and rehabilitation doctor (who never received payment from the VA but did bill us, which was his right.)  Physical Therapy charges were never reimbursed by the VA.

Care Choice was okayed because the VA could not make an appointment for pain management for several weeks. So, bottom line, the Pain Management and Rehabilitation doctor outside the VA, but okayed by the VA, was just fine, but his fees, the x-rays he ordered, the physical therapy he ordered were never paid for by the VA. I might also add, that “why the appointment for pain management when the physical reason for the pain was not going to be addressed by a neurologist, neurosurgeon, orthopedist”, but sent all the way to pain management without stopping to find out what the physical reason was for the pain in the first place. Thus, I do not see much of a chance that the new health care options under the MISSION Act being a move in the right direction for the veterans’ health issues, I am sorry for this and deeply irritated and angry at the maltreatment our veterans receive at the hands of the VA…..Carol 

VA launches new health care options under MISSION Act

by Office of Public and Intergovernmental Affairs

The U.S. Department of Veterans Affairs (VA) launched its new and improved Veterans Community Care Program on June 6, 2019, implementing portions of the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (MISSION Act), which both ends the Veterans Choice Program and establishes a new Veterans Community Care Program.

The MISSION Act will strengthen the nationwide VA Health Care System by empowering Veterans with more health care options.

“The changes not only improve our ability to provide the health care Veterans need, but also when and where they need it,” said VA Secretary Robert Wilkie. “It will also put Veterans at the center of their care and offer options, including expanded telehealth and urgent care, so they can find the balance in the system that is right for them.”

Under the new Veterans Community Care Program, Veterans can work with their VA health care provider or other VA staff to see if they are eligible to receive community care based on new criteria. For more information, you might want to check out Why Medicare advantage plans are bad. It is a wonderful resource on this topic.

Eligibility for community care does not require a Veteran to receive that care in the community; Veterans can still choose to have VA provide their care. Veterans may elect to receive care in the community if they meet any of the following six eligibility criteria:

1. A Veteran needs a service not available at any VA medical facility.
2. A Veteran lives in a U.S. state or territory without a full-service VA medical facility. Specifically, this would apply to Veterans living in Alaska, Hawaii, New Hampshire and the U.S. territories of Guam, American Samoa, the Northern Mariana Islands and the U.S. Virgin Islands.
3. A Veteran qualifies under the “grandfather” provision related to distance eligibility under the Veterans Choice Program.
4. VA cannot furnish care within certain designated access standards. The specific access standards are described below:

• Drive time to a specific VA medical facility

• Thirty-minute average drive time for primary care, mental health and noninstitutional extended care services.
• Sixty-minute average drive time for specialty care.

Note: Drive times are calculated using geomapping software.

• Appointment wait time at a specific VA medical facility

• Twenty days from the date of request for primary care, mental health care and noninstitutional extended care services, unless the Veteran agrees to a later date in consultation with his or her VA health care provider.
• Twenty-eight days for specialty care from the date of request, unless the Veteran agrees to a later date in consultation with his or her VA health care provider.

5. The Veteran and the referring clinician agree it is in the best medical interest of the Veteran to receive community care based on defined factors.
6. VA has determined that a VA medical service line is not providing care in a manner that complies with VA’s standards for quality based on specific conditions.

In preparation for this landmark initiative, senior VA leaders will visit more than 30 VA hospitals across the country to provide in-person support for the rollout.

The VA MISSION Act:

• Strengthens VA’s ability to recruit and retain clinicians.
• Authorizes “Anywhere to Anywhere” telehealth across state lines.
• Empowers Veterans with increased access to community care.
• Establishes a new urgent care benefit that eligible Veterans can access through VA’s network of urgent care providers in the community.

VA serves approximately 9 million enrolled Veterans at 1,255 health care facilities around the country every year.

For more information, visit www.missionact.va.gov.

For more information:

• VA news release – April 22, 2019: https://www.blogs.va.gov/VAntage/59215/vas-improvements-veteran-community-care-mission-act-track-june-6-implementation/
• VA VAntage Point Blog – April 1, 2019: New eligibility criteria a major improvement over existing rules
• VA VAntage Point Blog – March 19, 2019: VA MISSION Act: What is the latest on community care? How VA is transforming Veteran community care under the VA MISSION Act of 2018 and what to expect.
• VA VAntage Point Blog – Feb. 11, 2019:  MISSION ACT 101: How the law will improve VA’s ability to deliver health care to Veterans

Carol Duff, MSN, BA, RN

Carol graduated from Riverside White Cross School of Nursing in Columbus, Ohio and received her diploma as a registered nurse. She attended Bowling Green State University where she received a Bachelor of Arts Degree in History and Literature. She attended the University of Toledo, College of Nursing, and received a Master’s of Nursing Science Degree as an Educator.

She has traveled extensively, is a photographer, and writes on medical issues. Carol has three children RJ, Katherine, and Stephen – one daughter-in-law; Katie – two granddaughters; Isabella Marianna and Zoe Olivia – and one grandson, Alexander Paul. She also shares her life with her husband Gordon Duff, many cats, and two rescues.

• Carol’s Archives 2009-2013