Tester Directs VA to Address Dismal Implementation of VA MISSION Act: ‘find a way to reduce red tape’

At hearing, Ranking Member presses TriWest for answers regarding dental network adequacy and payment rates affecting Montana veterans and providers

(U.S. Senate) – Following numerous delays, false starts, and failures with the Department of Veterans Affairs (VA) MISSION Act, Ranking Member Jon Tester led a Senate Veterans’ Affairs Committee hearing today to address dismal implementation of the Veterans Community Care Program and Caregivers expansion—highlighting low dental network rates impacting Montana veterans and a problematic start to the expansion of the Caregivers Program to pre-911 veterans.

At the hearing, Tester admonished VA for its overly-bureaucratic internal process for getting veterans scheduled for care in the community. According to data provided by VA, veterans wait nearly 22 days for VA to cut through its own red tape before a veteran is scheduled for care with a private sector provider.

“Veterans shouldn’t have to wait for VA to navigate a bureaucratic process before their appointments are scheduled,” Tester said at the hearing. “Then veterans wait an average of 20 days for their appointments after they have been scheduled. That dog doesn’t hunt. If VA was here I would tell them to find a way to reduce that red tape—the Administration needs to explain how it plans to bring down the number of days it takes internally to get veterans to the point where they get scheduled for care in the community. In the last year there has not been much improvement in this timeline.”

The VA MISSION Act—Tester's bipartisan law streamlining VA's seven community care programs into one Veterans Community Care Program and expanding the Caregivers Program to pre-9/11 veterans—required VA to certify a new information technology system for the Caregivers Program in October 2018, prior to implementing the expansion. Since then, there have been a series of ensuing setbacks and problems as VA has worked to develop this information technology system. VA declined to participate in today’s hearing and answer critical questions on the law’s implementation.

Tester also raised concerns with TriWest Health Alliance regarding an uptick in concerns from veterans and providers regarding low dental network rates, impacting a veterans’ ability to see a preferred dental provider in Montana.

“Access to a preferred dental provider is a concern I hear consistently in the state,” Tester addressed David McIntyre, President and CEO of TriWest Health Alliance. “My state staff tells me that calls and emails from veterans concerned that their regular dental provider is not in the TriWest Network have eclipsed those about eligibility for dental care through VA. The chief concern appears to be that dentists believe the network rates are too low…are rates in Montana the same that you pay in more urban areas where there might be more general dentists and specialists? Under what circumstances would you pay more than the current rates?”

“It’s been a little more complicated than we originally expected,” McIntyre replied. “The reason for that in part is there is no fee schedule that’s national for dental service for the VA…and what we were asked by VA to do in the dental space is to attempt to put together a network that reflected market rates in those environments… In some cases, the market rate that they’re paying for dental services is different than what the VA was paying historically and that’s where part of the [problems] occurred, and we and VA are collaborating market by market to make sure that we are able to make appropriate adjustments and complete the network.”

Tester continued, “So do you feel at this point in time that the rates have not been a limiting factor on you building that network?”

“I think that it’s been a bit of a challenge but it’s one that we and VA are working through to attempt to respond to the local conditions in the market to make sure that we can build a sufficient network that the veterans need to be able to rely on,” McIntyre answered.

Tester’s opening statement as prepared for delivery can be found HERE.