Our Archives 2010 - 1998

Dear Kerrville Times Editor,
As a Veteran, I read with interest Victoria Aldrich’s article on the South Texas Veterans Health Care System (STVHCS) Veterans Town Hall in the November 6, 2015 edition of your paper. While Ms. Aldrich’s article accurately portrays the STVHCS briefing on the Veterans CHOICE Program, it lacks a historical context and identification of the remaining problems that limit Veteran’s use of the program.
Last year, in the wake of the Veterans Administration (VA) appointment scandal that led to the resignation of the VA Secretary, Congress passed the Veterans Access, Choice, and Accountability Act of 2014 that commissioned the Veterans Choice Program. Congress gave the VA a short 3-month timeline to stand up the program and make it operational. The Choice program was to provide Veterans critical non-VA care options if a Veteran could not be seen by the VA, in a timely manner or, who lived more than 40 miles from the nearest VA medical facility. The program was only open to Veterans enrolled in VA health care as of August 1, 2014.
There were several problems with the new Choice Program. The 40-mile rule was measured “as the crow flies and not by road distance traveled. If the VA medical facility within the 40-mile limit was unable to provide the required medical service, the Veteran could not use the Choice Program and was required to travel long distances to another VA medical facility. In some geographic regions (especially in rural areas), there were limited numbers of non-VA providers signed up to provide care. Veterans who signed up for VA health care after August 1, 2014, were not eligible for the program. Choice had priority over existing non-VA care programs and did not cover all medical services. Complicated, confusing, with gaps, may be an appropriate description of the program.
On May 22, 2015, Public Law 114-19 (the Construction Authorization and Choice Improvement Act) changed the 40-mile rule to reflect driving distance. It did not address any of the other above issues with the Choice Program.
Finally, on July 31, 2015, Congress passed, and the President signed Public Law 114-41 (Surface Transportation and Veterans Health Care Choice Improvement Act of 2015). This law directed the Secretary of the VA to develop a plan to establish a new, single program named the “Veterans Choice Program” to furnish hospital care and medical services to all Veterans enrolled in VA health care no matter what date they enrolled. It makes almost $3.4 billion dollars available to the VA to pay for non-VA health care provided to Veterans between May 1 and October 30, 2015. Additionally, it expands the number of non-VA providers permitted to participate in the Choice Program and eliminates the 60-day limit on follow-up care.
What the latest Congressional change does not do is fix the two issues that most limit Veterans use of the CHOICE Program. It does not eliminate the 40-mile rule and it does nothing to allow Veterans to choose any health care provider that will accept Medicare rates. This is especially important in rural areas where providers are limited and distances Veterans must travel for healthcare are greater.
The VA is implementing the new law in steps. To read Public Law 114-41 in its entirety, go to https://www.congress.gov/bill/114th-congress/house-bill/3236/text/pl . For the latest information on Choice eligibility, call 866-606-8198 or visit http://www.va.gov/opa/choiceact/ . The web page has a link you can click to see which doctors are participating in your area. If you have questions or require more information, call your County Veterans Service Officer.

Dennis Birchall
Bandera County Veteran Service OfficerMary T. "Terry" Garza
Kerrville VA Hospital Advocate
830 792-2472



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