A recent extension and reform of the Veterans Choice Program could allow for better access to care for veterans diagnosed with rare cancers such as mesothelioma.
President Donald Trump signed the Veterans Choice Program Extension and Improvement Act (S.544) into law on April 18.
The bill amends the Veterans Access, Choice, and Accountability Act of 2014, eliminating the Aug. 7, 2017, expiration date and allowing the program to operate until the remaining $950 million in the Veterans Choice Fund is expended.
Under the new law, military veterans can continue receiving health care in the private sector when care isn’t easily available from a Veterans Affairs Department (VA) provider. The VA will cover copays and deductibles directly for veterans seeking private care, rather than reimbursing them for paying up front.
Veterans account for 30 percent of mesothelioma cases in the U.S. each year. There are roughly 22 million veterans in the U.S. today and only 1,700 VA medical facilities — a vast majority of which don’t offer the services or specialists needed to properly treat mesothelioma.
“This bill will extend and improve the Veterans Choice Program so that more veterans can see the doctor of their choice…and don’t have to wait and travel long distances for VA care,” Trump said after signing the bill. “This new law is a good start, but there is still much work to do.”
The Veterans Choice Program was created in 2014 after complaints emerged that numerous VA health care facilities falsified data about appointment and referral wait times for veterans.
It gave veterans access to non-VA health care if a VA facility was at least 40 miles away from their home or if a veteran could not be accommodated within 30 days. However, the original program didn’t specify distinctions of whether a VA facility could adequately meet a veteran’s needs.
Mesothelioma cancer centers and specialists are few and far between. Specialized treatment facilities in the VA network are scarce.
Doctors diagnose about 3,000 cases of mesothelioma each year. Roughly 900 of those are veterans were exposed to toxic asbestos during service.
Because mesothelioma represents only a small fraction of all cancers, it is highly recommended that patients seek a specialist who understands the intricacies of the rare cancer. Mesothelioma is aggressive and difficult to treat. Finding a doctor with experience can have a significant impact on a patient’s life expectancy.
In his speech following the signing of the new bill, Trump noted how some veterans have to travel five or eight hours — sometimes on a weekly basis — to receive covered health care.
With top VA treatment centers for the disease located in Boston and Los Angeles, travel demands can be even greater for veterans with mesothelioma. Time is also a vital factor because early diagnosis and treatment can make all the difference.
Long wait times have been a major concern for the VA in recent years.
During his administration, former President Barack Obama pledged to cut down on around 600,000 pending claims. More than 370,000 remain, including disability compensation and pension claims.
But the VA’s claims backlog that might be most troubling. Currently, more than 94,000 claims are awaiting a rating decision. This can be detrimental to veterans diagnosed with cancer and other serious conditions that require prompt treatment.
Aaron Munz, Director of the Veterans Department at The Mesothelioma Center, said the new bill may make it easier for veterans to receive care from a top mesothelioma specialist.
“The VA is not the best medical treatment option for many veterans diagnosed with mesothelioma,” Munz said. “Many would prefer to receive treatment closer to home.”
Under the act, the VA will cover all approved expenses for service connected disabilities. However, Munz noted many veterans diagnosed with mesothelioma are not approved yet when they need to begin treatment.
“In these cases they may be able to file for reimbursement from the VA for expenses accrued for treatment for a condition that is later determined to be service connected,” Munz said. “Expenses for mesothelioma treatment can be reimbursed if they occurred after the initial disability claim is received by the VA.”
Veterans can work with their local service office and VA medical center to assess what treatment costs may be eligible for reimbursement once the VA approves the disability rating.
Unfortunately, many veterans diagnosed with mesothelioma do not have the luxury of waiting for the VA to approve their service-related disability compensation claim.
“Their primary concern is connecting with a team of doctors who will give them the best chance of fighting the disease,” Munz said. “In these cases, the Veterans Choice Program may make it easier to have some of the costs paid for by the VA depending on the veteran’s priority group for VA health benefits and disability rating.”
In order to receive Veterans Choice benefits, a veteran must first be approved by the VA and have a Choice Card.
A week after the Veterans Choice Improvement Act became law, Trump signed an executive order creating an accountability and whistleblower protection office at the VA.
The new office will help identify “barriers” that make it difficult to fire or reassign employees deemed unfit to serve veterans in the VA. It also aims to protect whistleblowers from retaliation.
“We’ve imposed new standards of accountability and transparency, including a new website that publishes wait times at every VA hospital,” Trump said. “This executive order makes it clear that we will never, ever tolerate substandard care for our great veterans. With the creation of this office, we are sending a strong message: Those who fail our veterans will be held, for the first time, accountable.”
The head of the new office will report to VA Secretary David Shuklin.
Shuklin called the signing of the new Veterans Choice bill “a great day to celebrate not only what veterans have contributed to the country, but how we’re making things better for them.”
In a White House briefing, Shuklin said Trump’s executive order asks the VA to do everything it can internally, but the creation of the new office isn’t enough to get the job done. Help from Congress is needed to pass strong accountability legislation to remove problematic employees once they are identified by the new department.
“We’re also calling on the Senate to pass legislation to give the Secretary the authority he needs to ensure all VA employees are held accountable for how they treat our veterans,” Trump said. “Our veterans have secured this nation with their blood, sweat and tears, and we will not let them down.”