U.S. Sens. Merkley and Wyden pen letter expressing concern over VA MISSION Act roll-out

In a July 9 letter, Oregon’s U.S. Senators Jeff Merkley and Ron Wyden wrote to U.S. Department of Veteran Affairs Secretary Robert Wilkie to express concerns over the implementation of the VA MISSION Act. The letter specifically points to the roll-out of the new Veterans Community Care Program as a cause of concern. 


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In 2018, Congress passed the VA MISSION Act of 2018, creating additional avenues outside of the VA for veterans to receive health care. A portion of the law — the Veterans Community Care Program — went into effect at the beginning of June and will allow veterans to work with the VA to determine if they are able to receive community-based care based on new criteria. 

Previously, veterans were able to receive community care through the Veterans Choice Program (VCP), but the MISSION Act was passed in an effort to address problems within that program. 

A recent Government Accountability Office (GAO) report identified three key problems with the VCP: complex referral and appointment scheduling, incomplete data on the timeliness of veterans’ access to care, and a lack of timely payments to community providers. 

Merkley and Wyden write that their offices were contacted by veterans who expressed frustration with the program, noting that about one-third of the complaints that their offices received on VA health care were related to the VCP. 

In their letter, the two senators warn against making the same mistakes that were made with the Choice Program.

As the VA moves to implement that law, we are concerned that officials may not learn from past mistakes.  For example, we fear that the VA and third-party administrators may continue to withhold information about billing practices and procedures from community health providers, as often happened under Choice.  We are also concerned that TriWest remains a third-party administrator for the Veterans Community Care Program, despite a large number of complaints about its performance under Choice. And we have heard from some staff that the VA has been slow to share guidance and information about the Community Care Program launch, which echoes what we heard about the Choice Program roll out.”

The senators posed a list of questions to be answered by Secretary Wilkie by the end of this month:

  • What problems did the VA identify from its experience with the Choice Program, and what is the VA doing to ensure those same problems do not arise again under the VA MISSION Act?
  • When did the VA first provide information and guidance on the new law to VA Health Care Systems in Oregon and Idaho? 
  • What steps has the VA taken to ensure community providers understand billing practices and procedures under the VA MISSION Act?
  • What steps has the VA taken to ensure community providers will receive timely payments under the new law?
  • When will the VA establish contracts with community providers under the Community Care Network and provide lists of in-network providers to veterans?

The senators conclude their letter by emphasizing that the new community-based program should be supplemental to the care offered at VA hospitals and clinics, and not a replacement. 

“VA facilities in our state and across the nation have decades of experience serving veterans and offer unmatched specialty care and services; even so special interests continue their relentless push to outsource or privatize aspects of veterans care.  We implore you to implement the VA MISSION Act based on the principle that community care must never come at the expense of VA’s core functions.”