Dep. Sec. Gibson: VA works to expand Choice Program eligibility

Eligibility criteria for 40 miles calculation would change to driving distance


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We’ve heard what Veterans are saying about the Veterans Choice Program and the current method of determining eligibility based on how the 40-mile distance is calculated. We are going to change that.

The mileage is currently calculated as the straight-line distance between a Veteran’s residence and nearest VA medical facility. In the near future, it will be calculated as the driving distance between the two. This change will roughly double the number of Veterans eligible to use the Veterans Choice Program using the 40-mile criteria.

VA is working quickly to implement this new benefit for Veterans and appreciates the constructive feedback from Veterans, VSOs and partners. In this instance, VA listened and researched ways to expand the program. We found that VA has the authority to expand the program by changing how the distance determination is calculated, which better serves Veterans.

VA Deputy Secretary Sloan GibsonWe will be notifying Veterans who will be eligible under the revised mileage calculations to let them know of the change. The change will take place after we publish a new interim final rule. It will take a few weeks to accomplish this, but we are working to ensure it happens in a coordinated fashion as soon as we can.

VA looks forward to continued collaboration as we work to ensure the Veterans Choice Program is a success in expanding access to care. Since it went into effect on Nov. 5, 2014, more than 45,000 medical appointments have been scheduled through the Veterans Choice Program, and 45,990 Veterans have requested to receive care using Choice as of March 17.

Many members of Congress have come forward since November asking VA to expand the law that they passed. Still, many Veterans tell us that they’d like to stay with VA for their health care needs. At VA, we are looking at the decisions we make asking ourselves one question, “what is best for the Veterans we serve?” As I’ve said, VA wants to make sure Veterans are able to get high quality care where they choose to receive it.

We are fully committed to effectively implementing VACAA and the Choice Program and we’ve seen that the program is not working for Veterans the way it should. For example, the law is clear that eligibility must be based on the distance from the Veteran’s residence to any VA medical facility, even if that facility does not offer the specific medical service the Veteran requires for that particular visit. VA is working with Congress, VSOs and Veterans like you to make changes to the law so that it works for all Veterans. We will be also working with them to make sure the funding is in place for the appropriate expansion of the program.

The Choice Program is one component in VA’s efforts to increase access, under VACAA. VA has been increasing staffing, enhancing collaboration with partners such as Indian Health Service, and extended the Project Arch Pilot and the AL/TBI Pilot. VA looks forward to the continued support of our partners as we continue to streamline and make improvements to this new program.

More information about the Veterans Choice Program can be found on va.gov.


VA Deputy Secretary Sloan GibsonSloan D. Gibson was nominated by President Obama to serve as the Deputy Secretary of Veterans Affairs, and he was confirmed by the Senate on February 11, 2014. Mr. Gibson also served as Acting Secretary of the Department of Veterans Affairs from May 30 to July 30, 2014. Read his full biography on va.gov.

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Sloan D. Gibson

Comments

  1. Eric    

    Just a note to maybe help another vet who needs non-VA emergency care. Please note this is not a VA problem. Rather, it seems to be a problem with the law itself. I use a VAMC for 100% of my healthcare. I learned an important but hard $125.00 lesson about emergency medical care. I was being transported by ambulance to the VAMC’s ER. In route, rig crew was told VAMC was on a full diversion – no available beds – and I had to be taken somewhere else. They took me to my local hospital’s ER. VAMC will pay for the outside emergency care – but are only allowed to if a claim is submitted within 72 hours of discharge and you don’t have health insurance. I have health insurance and I thought I had 90 days to file. VAMC can’t pay anything because of the way the law is written. My copay was $125.00, and I thank God I had insurance to meet the emergent need. I just wish I’d have known how this program works. Now, we budget for any emergency medical care I might need. I live too far from VAMC for quick emergency care I live 38.5 miles away (mapquest), which takes over 45 minutes to drive. Staff at VAMC said there wasn’t a day that goes by that someone feels disenfranchised over this. She tries to explain (very kindly, I might add) that it is the way the law itself is written. But, I think most people probably still blame her because she’s the messenger. That lady needs a high-five and a giant hug for the great amount of patience and compassion she has in dealing with us when we aren’t happy. I’m going to have to put her on my Christmas card list this year.

  2. Lyle werner    

    Have the choice card. It’s not working one bit here in Charleston /myrtle Beach SC. Can’t get apps scheduled. No one calls you back. Doctor can’t cut through red tape I guess. Need help so much. Much pain.

  3. Erick    

    Unfortunately vendors have to be approved by the VA Fee Basis Vendorizibg. Plus the vendor must accept the low amounts the VA reimburses for the care rendered via the VA Fee Schedule all based on CPT and ICD9 codes. To be approved required actions by the vendors. If the vendors owe money on student loans they may be not the exclusionary list. Medicare or Medicare fraud. Bad debts. Etc the vendor may not be approved. Many vendors want nothing to do with the VA which is a great number because of low payments and paperwork bureaucracy.

  4. Jessie    

    We live 33.6 miles from our closet clinic but it is a 52 min drive down winding dirt roads and narrow highways. While I deal with a great deal of pain.

    It should be based on the average travel TIME, not distance. They are capable of figuring this out, many applications can do it. I’m sure there are people who live more than 40 minutes away from our local VA can get there in under 30 minutes, they don’t have mountains and other obstacles to contend with.

  5. John R Stadler    

    You are deleting all of my FB comments/complaints. I have violated no protocol, you are denying me my voice!

  6. Ronald P Johnston    

    I do live withen 40 miles of a VA, however they do not do the surgery that I need. I have to travel 218 miles to milwauke. they require 3 trips befor surgery. how can this be right? also I have not even recived my choise card yet..I have called at least 5 times asking for it, each time being told they will mail it out this started in sept, O by the way it is knee surgery I need.

  7. Patricia Stover Hobbs    

    I am glad they are changing this, but I would prefer they calculated from the clinic you attend. I am between three locations and one is in a different state as I am close to a state line. I go to the one that is the most comfortable for me, not necessarily the one closest. There is only a couple miles difference so that would not be much.

  8. Michael Hawyard    

    Much needed! Now if they get the second change we have been advocating for, which is measuring the distance to the closest VA facility that can provide the needed service, not just the closest facility.

  9. Stuart cottrill    

    We should also not be disqualified for having a clinic that cannot do anything but still offers 2 trips to the regional hospital a day. We should be able to schedule any appointment We need with a doctor using this program.

  10. David Fleming    

    Could’nt get me eye glasses, Couldn’t help me .

  11. John Buono    

    Excellent. Now, if only I can get you guys to pay the providers in a timely manner, so that I stop getting sent to collections for bills on pre-approved care received by civilian providers, that would be great…

  12. Christopher Karr    

    i am a veteran and It would be better if it was based on how close you are to a VA hospital not a medical facility cause clinics count as a medical facility and clinics can’t do anything pertitant to your health just basic exams and lab work. I am being ignored by my dr’s and can’t get proper health care even from the VA. I am 90% service connected and I get treated like I don’t exist.

  13. Joseph Campana    

    While this change is a good thing.
    What about considering a VA local clinic as a facility, which has restricted hours during the week, no coverage on weekends and insufficient staffing at any time.
    What this does is exclude using the choice program.
    Any clinic in the VA system should not be counted as part of the required mileage, at all, as the clinics can’t care for the Veterans except for minor problems.

    1. Megan Moloney    

      Joseph,

      That’s one of the things VA hopes to work on with Congress about the law. As Deputy Secretary Gibson points out in the blog above, we’ve seen that the program is not working for Veterans the way it should. The law is clear that eligibility must be based on the distance from the Veteran’s residence to any VA medical facility, even if that facility does not offer the specific medical service the Veteran requires for that particular visit. We are working with Congress, VSOs and Veterans like you to make changes to the law so that it works for all Veterans.

  14. Manya Walters    

    If a veteran has other insurance they should be able to go to private doctors with the va paying co pay.without 40 mile rules. Personally I get ill every time I enter the building.

  15. John G Gonzales Jr    

    Still doesn’t work, got a letter to call and set up veterans choice. After 1/2hr on the phone they say oh yea you qualify based on mileage, someone will contact you well three months later nothing zero zip nada. Thanks for nothing?

  16. John M. Borho, Jr.    

    I’ve tried time and again to get approved for the CHOICE program only to be told over and over again it’s not going to happen! I live in excess of 40 miles to any VA facility and most are at least 120 miles, yet that doesn’t qualify me; also I’m told have I been denied an appointment in the last thirty days, if not I can’t be approved. Guess if I get any serious illnesses I should just lay down and die since I can’t be approved for CHOICE or I can go to a private facility and be forced to pay all their fees!! I am under the impression there is some 10 Billion dollars allocated for this program and as of yet I have not found one Veteran that has been approved for this program!! Yep, just keep the money locked up and put away so you can make the general public believe you are actually attempting to help Veterans!

  17. M Robles    

    This is a first step but the other obstacle is level of care. It’s 40 miles to an Outpatient Facility which fine for check-ups, glasses and hearing aids but they weren’t even able to remove an ear wax build up. That had to be done at the nearest Health center which is 89 miles away. Now that my husband has been diagnosed with Non-Hodgkins Lymphoma we face many, many trips over the next 6-9 months to the Healthcenter and are not eligible for travel expenses or overnight lodging.

  18. Michael moore    

    It’s a great program if you don’t get prescribed medications. If you do you have to pay for them at full price and the program tells you to go to the VA,to get them filled but the VA does not fill them. So what’s the point….. you see a dr. He or she tell you what you need but you still can’t get it…..

  19. R Carreon    

    Not sure where this is working but I went to my Dr and showed him the VA Card and you think I was showing them the Ebola Virus. They wanted nothing to do with it. We live 137 miles from the VA Hospital so I guess we’re done for.
    sorry it’s not working here. Called the VA and well, that was a joke getting them to understand that nobody wanted to have anything to do with the Choices Card.

    1. Megan Moloney    

      The Choice Program will still need to schedule the appointment for you — start with the toll free number on our website at http://www.va.gov/opa/choiceact/how_to_get_started.asp and they should be able to help get you scheduled.

  20. Charles Lee Cherry    

    Well- Now we are talking- THIS is (more) fair It isn’t my fault there is not a shorter way to drive over the mountains. Regardless, you are still paying mileage for what I do drive, anyway. Thanks for listening and taking action.

    1. DannyG    

      To all of those who doubt Secretary McDonald.I hope this causes you to take a moment to reconsider your opinions. He can’t change everything, & can change nothing in the blink of an eye, but this shows that under his watch, the VETERANS Administration is listening & changing to better serve the veterans! Thank you, Secretary McDonald.

      Now if someone could (honestly) explain why they hold out $6 of our travel pay, I know, up to $20. a month, it might not be so irritating. Do they take that from the politicians & VAMC “executives’ ” travel pay?

      1. DannyG    

        Thank you to everyone at the VETERANS Administration that is truly working to make things better for the veterans. Secretary McDonald may be in charge, but we know it is a group effort! After all, without the bottom of the totem pole, the top would tumble!!!
        THANK YOU!!

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