A program designed to help veterans get medical care more quickly and closer to their homes “remains deeply flawed” and immediate changes are needed, Maine’s congressional delegation said in a letter sent to the secretary of Veterans Affairs on Friday.

In the strongly worded letter to Robert McDonald, the delegation said that Maine veterans often have been unable to contact a company that was hired to streamline the appointment process and help resolve health care payment issues for veterans.

And even when the veterans are able to get through to the company, Health Net Federal Services, the representatives often are in offices thousands of miles away and “lack understanding of Maine’s geography” that’s needed to help make the appointments at places that are easier to reach, said the letter from Sens. Angus King and Susan Collins, and Reps. Chellie Pingree and Bruce Poliquin.

The delegation urged the VA to work with Health Net to hire Maine workers to help make the appointments for veterans and take care of payment issues under the Veterans Choice Program, which was created two years ago after reports about long waits for appointments, often in VA medical facilities far from veterans’ homes, stirred outrage.

A report turned over to the delegation a week ago said that the program designed to fix the flaws isn’t working as intended. According to the report, from the VA Maine Healthcare System, fewer than half of the veterans who applied for care under the program have received appointments since July.

The letter said the problems in the program are “entirely unacceptable and must be addressed.”

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In addition to hiring Maine workers for Health Net, the delegation said the VA needs to continue to give VA medical centers in Maine the flexibility to use non-VA community care programs for veterans, and continue and expand a separate program to provide access to health care close to veterans’ homes.

“Veterans should not be forced to endure reduced quality of services as Health Net and the VA work to improve the Choice Program,” the letter said. The delegation also invited David Shulkin, who is the VA’s under-secretary of health, to visit Maine, review the program and talk about next steps.

A call late Friday afternoon to the VA for comment on the letter wasn’t returned.

The Choice Program was intended to reduce wait times for appointments and allow the VA to buy health care services from private providers when the VA was unable to provide those services because of geographic inaccessibility or in emergencies. Veterans were supposed to be allowed to use a private doctor if they lived 40 miles or more from a VA hospital or if they had been waiting 30 days or more for care.

But the VA Health Administration Office of the Inspector General found that the private companies hired to run the program, including Health Net in New England, got poor marks from veterans and private providers alike. Many health care providers complained about payment processing and the bureaucratic processes followed by the care administrators.

A representative from Health Net told the delegation’s staff last week that just one person is responsible for setting up and overseeing the provider networks under the Choice Program for all of New England.

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Adria Horn, the director of the Maine Bureau of Veterans Service, said she told the delegation staff that it was “impossible” to think that one person, with no staff, could set up and manage the networks and resolve payment issues.

Veterans have said they face long waits when they try to get through to Health Net. Their calls are sent to a call center in Florida, where 130 people work. But the center was intended to be staffed by 500, the company said.

Appointments that were supposed to be made within five days instead took an average of 15 days to set up, according to the inspector general’s report, and many veterans have received notices that their bills weren’t being paid.

Gary Lawyerson, a retired Marine from Waldoboro who chairs the Maine Veterans Coordinating Committee, said last week that the Choice Program was rushed into existence and implementation has been “substandard.”

 


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