Department of Veterans Affairs Addresses Payment Backlog
WASHINGTON, D.C. (February 12, 2020)—The Department of Veterans Affairs (VA) faced sharp questioning during a Senate committee hearing on Feb. 5 from skeptical Senators about a growing backlog of unpaid providers caring for elderly and disabled veterans.
The Senate Veteran’s Affairs Committee hearing, VA Mission Act: Update on the Implementation of the Community Care Network, focused on the implementation of the VA Mission Act and its impact on veterans and health care providers, as carried out by the department and its contracted administrators.
Senators on the committee received testimony from two separate panels, the first composed of representatives from the VA, while the second panel was made up of representatives of the administrative contractors for the VA, as well as the Disabled American Veterans, an organization providing assistance to disable veterans.
Committee Ranking Member Jon Tester (D-Montana) questioned why providers were not being paid promptly for services they provide to veterans. The VA responded that they too were frustrated with the delays in payments, and that they are “working to get it right.”
The VA has conceded a backlog of 2.5 million unpaid claims from community care providers, and 3.4 million overall.
Senator Mike Rounds (R-South Dakota) challenged the VA’s assertion that implementation of the VA Mission Act has been a success so far, particularly with payments to providers in the community care network. Specifically, Senator Rounds mentioned providers in his home state with $5 million to $6 million in unpaid bills, and expressed concern for small providers as well. He then questioned the VA on the specifics of the delays and what corrective steps are in place. The VA responded with three steps they are taking to remedy the issue:
- Auto adjudication;
- Change the rules on claim audits to do them less frequently; and
- Enhance contracts for outside companies to pay bills.
The VA stated they plan to have all these remedies in place within 90 days of the hearing.
In response to a question from Senator Marsha Blackburn (R-Tennessee), the VA claimed it will clear the current backlog of unpaid claims by the end of the fiscal year, with a goal of having future claims processed within 30 days.
In their opening testimony, witnesses from the VA described the implementation of the VA Mission Act as a “continued success” and that they are now in a “phase of proactive refinement and enhancement.” At the time of the hearing, the VA reports placing over 3.6 million referrals to community care providers and authorizing over 3.85 million episodes of care. In addition, the VA reported they are currently updating their information technology systems, which when complete, will speed and make more efficient the process of eligibility determinations, authorizations, claims submission, and payment, among other optimizations.
On Wednesday, Feb. 12 the House of Representatives Veterans Affairs Committee will hold a similar hearing, led by the Oversight and Investigations subcommittee. The National Association for Home Care and Hospice President Bill Dombi will testify at that hearing. He will be joined by representatives from the VA, Optum, and TriWest, as well as two veterans and first responders.
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