After passing both houses of Congress with overwhelming support, legislation designed to increase medical access for military veterans who are struggling to obtain basic health care at U.S. Department of Veterans Affairs (VA) facilities now awaits President Obama's signature. According to an Aug. 4 White House press briefing(www.whitehouse.gov), Obama is scheduled to sign the bill Aug. 7 at Fort Belvoir, Va.
The Veterans Access, Choice and Accountability Act outlines several measures intended to improve access and reduce the long waiting periods that many veterans have endured when trying to meet with a physician. In addition to providing financial support to hire more physicians, the bill makes it easier for veterans to see physicians outside VA facilities, including community-based family physicians.
"The AAFP supports the Veterans Access, Choice and Accountability Act passed by Congress and encourages the President to promptly sign it into law," said AAFP President Reid Blackwelder, M.D., of Kingsport, Tenn., in an Aug. 1 statement. "In the wake of the VA scandal, the AAFP was the first physician organization to make specific recommendations to President Obama and congressional leaders about how they could leverage America's civilian family physicians to ensure timely access to primary care services for veterans."
Currently, if a veteran chooses to visit a physician outside the VA network, he or she must use other insurance or pay for the visit out of pocket. Under the legislation, family physicians who participate in Medicare will be eligible to sign agreements with the VA to offer care for veterans.
- New legislation passed by both houses of Congress would enable veterans who cannot get an appointment with a physician at a U.S. Department of Veteran Affairs (VA) facility within 30 days to see a physician who is not affiliated with the VA.
- Under the legislation, family physicians would be able to sign provider agreements with the VA to care for veterans.
- The legislation also would provide funding to hire more physicians at VA facilities.
Eligible veterans who cannot get an appointment at a VA facility within 30 days of their request for one can obtain care outside the VA system and still receive full coverage. In addition, veterans who live more than 40 miles from the nearest VA health clinic will be able to go to a facility not affiliated with the VA. To facilitate this expanded access, veterans will receive a benefit card called a "Veteran's Choice Card."
Payment rates for care provided outside VA facilities have yet to be determined but will be no higher than Medicare rates unless the services are provided in highly rural locations.
The legislation includes $10 billion to pay for care provided at non-VA facilities, plus $5 billion to enable the VA to hire more doctors, nurses and other health care professionals. Also included in the bill is a provision to add as many as 1,500 new graduate medical education residency positions with an emphasis on primary care and mental health.
The House and Senate moved quickly to introduce the legislation after media reports surfaced earlier this year that veterans were unable to schedule appointments or faced long wait times to see a physician at a VA facility. Of particular concern was the fact that primary care visits at VA facilities have risen dramatically in recent years, but the number of full-time primary care physicians has increased only slightly.
An internal investigation(www.scribd.com) ordered by (then) VA Secretary Eric Shinseki found that 57,000 veterans nationwide waited more than 90 days for an appointment, and 64,000 others requested medical care but never made it onto a VA waiting list.
In June, the AAFP sent a letter(3 page PDF) to Committee on Veterans' Affairs leaders in both the House and Senate, asking legislators to move quickly to address gaps in care at VA facilities.
"Th(e) shortage of VA primary care physicians is frequently cited as the principal reason so many veterans are facing lengthy delays -- in some cases over 100 days -- securing an appointment with the VA," the letter reads.
The AAFP also outlined detailed recommendations in a letter to the president(2 page PDF) that listed steps to facilitate care for veterans who need to consult a physician.
Specifically, the Academy urged the president to
- allow civilian family physicians to provide primary care services to eligible veterans,
- allow prescriptions prescribed by civilian family physicians to be filled at VA pharmacies,
- allow civilian family physicians to order diagnostic tests at VA facilities,
- allow civilian family physicians to refer patients to specialist physicians and other health care providers at VA facilities, and
- allow civilian family physicians to provide care to eligible veterans under the protections of the Federal Tort Claims Act.
"We believe these five actions would be beneficial to veterans and the VA health care system," said AAFP Board Chair Jeff Cain, M.D., of Denver, in the letter.
"The AAFP stands ready to assist in the development of these or any other beneficial policies," Cain concluded. "Additionally, we are prepared to use our available resources to communicate such policy changes to our members and encourage them to assist their nation by providing care to eligible veterans."
Related AAFP News Coverage
Letter to President, Congressional Leaders
Family Physicians 'Stand Ready to Assist' Nation's Veterans