June 04, 2018

Weekly Column: Holding Veterans Services Administrator--Health Net--Accountable

Guest column submitted by U.S. Senator Mike Crapo

“We are fed up.  In our view, the Department of Veterans Affairs’ (VA) management of the Health Net contract has been a failure.  While Health Net is the administrator of the Veterans Choice Program in our states, VA is ultimately accountable for Health Net’s poor performance.”  In March, I joined ten fellow senators in calling on the VA to address ongoing concerns with Health Net’s poor performance in administering the Veterans Choice Program (Choice program).  The VA promptly responded that Health Net’s contract to administer the Choice program will end in September 2018. 

The creation of the Choice program stemmed from delays for appointments and treatment at Veterans Health Administration facilities.  The Choice program was intended to ease some of the burden experienced by veterans facing extremely long waits or considerable geographical barriers to accessing care at the VA; however, some veterans still face significant bureaucratic hurdles to use this program.  Health Net’s misadministration of the program in eastern Idaho and other areas has severely worsened the problem.  My colleagues and I urged the VA to address the problems providers have faced in dealing with Health Net that include significant delays in repayment for services provided to veterans; lengthy call center hold times; unanswered requests for assistance; and having to resubmit lost paperwork multiple times. 

With the discontinuation of Health Net’s contract, the VA has advised, “Veterans can expect closer coordination between VA and their community provider.”  Further, the end of the VA’s contract with Health Net will not affect the VA’s contract with TriWest Healthcare Alliance, which administers the western region of the Choice program and Patient-Centered Community Care networks.  With the ongoing, invaluable input of Idaho’s veterans community and those who serve them, I will continue to press to ensure veterans have timely access to quality services they so greatly deserve.   

Last May, I introduced S. 1279, the Veterans Health Administration Reform Act of 2017, to improve access to local care for veterans to better meet their individual needs.  The legislation I introduced, and co-sponsored by fellow Idaho Senator Jim Risch, would combine the Choice program and the many other programs through which veterans can receive “non-VA care” into a single program centered on the unique medical needs and circumstances of each veteran.  The new, streamlined program would enable the VA to better partner with providers in the community when it is in the best interest of veterans, enhancing accountability and direct communication between the agency and local providers.  The legislation would also require the VA to ensure payment to providers in a timely fashion and educate veterans on how the new program works and interacts with their other health care options.  I included these provisions after hearing stories directly from Idaho veterans struggling to access health care through the Choice program and medical providers waiting extended periods of time for payment from Third Party Administrators of the Choice program, like Health Net.

A number of Senators, including those on the Senate Committee on Veterans’ Affairs under the leadership of Chairman Johnny Isakson (R-Georgia), introduced legislation dealing with this important topic.  Provisions and ideas from my measure, based on the experience of Idahoans, made it into the Committee’s product.  These provisions are also included in legislation recently passed by both the Senate and House.  I will continue to support legislative solutions to address shortcomings of the Choice program and improve oversight to ensure Idaho veterans receive accessible, quality health care. 

I greatly value the ongoing input from Idaho veterans, their families and friends, as I work with my colleagues in Congress and the Administration to improve veterans programs. 

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