AHA says lack of prompt VA payment hinders access to care

A lack of prompt payment by the Department of Veterans Affairs (VA) and its contractors “hinders access to care for veterans who need non-VA services and undermines the viability of non-VA hospitals and the essential services they provide to their communities,” an AHA witness June 3 told the House Veterans Affairs Committee’s health panel.

Testifying at a House Veterans Affairs’ health subcommittee hearing on the “VA’s ability to promptly pay non-VA providers,” Vince Leist, president and CEO of North Arkansas Regional Medical Center (NARMC) in Harrison, Ark., expressed concern about how the VA processes claims and detailed how many hospitals, including NARMC, have not been paid by the VA for claims that go back more than three years.

In his testimony, Leist noted hospitals’ longstanding collaboration with the VA to care for veterans through the Veterans Choice Program, the Patient-Centered Community Care program, direct contracting with the VA, and by “serving the urgent health care needs of our veterans as they arise when there isn’t a contract with VA in place.” And he commended the VA health system for its “extraordinary work under difficult circumstances for a growing and complex patient population.”

But he expressed frustration with the VA’s inability to move claims for payment through its bureaucracy. Since 2011, NARMC has 215 claims totaling more than $750,000 that have not been paid by the VA, he said. Attempts to resolve these claims have resulted in “long periods on hold to speak to VA service personnel, limitations on the number of cases to be discussed per phone call and lost medical records,” Leist told the subcommittee. 

While there is a small VA health clinic “down the street from the hospital” in Harrison, Leist said the nearest VA hospital is 70 miles away and the nearest non-VA hospital 60 miles away. NARMC regularly treats patients seen at the VA clinic who are too sick to travel to the VA or other hospitals, he said.

“While we are very dedicated to serving the veterans in our community, and we accept each and every one who walks through our doors, we have decided against contracting with the VA due to slow or no payment for claims and the bureaucracy involved with getting claims through the payment process,” he told the subcommittee.    

Leist offered a number of recommendations that he said could help ensure prompt payment by the VA, including paying claims within 30 days of the receipt of a proper claim, making interest payments to hospitals when claims are not paid in 30 days and requiring the VA to develop a metric to measure effectiveness in its claims processing.

“We want to continue to provide essential health care services to our communities, including our veterans,” Leist testified. “But we will not be able to do so without the proper resources, including prompt payment from the VA.”