Oregon’s U.S. Sens. Jeff Merkley and Ron Wyden this past week urged Department of Veterans Affairs Secretary Robert Wilkie not to repeat past mistakes when it comes to veterans receiving care outside the VA.

The VA switched to a new community care program, based on the provisions of the Mission Act, in June. The VA has said its goal is to make it easier for veterans to receive care outside the VA when they need to, and for those who provide that care to receive timely payments for their services.

Like its predecessor, the Choice Act, the Mission Act allows veterans to receive outside care and have the VA pay for that care if the drive or the wait for VA care would be too long.

However, some veterans fear the problems with Choice, including a complicated bureaucracy that made it challenging for providers to receive timely payments, will continue under Mission.

Others are concerned that increasing the privatization of services will harm the VA programs by depriving them of funding.

In their letter to Wilkie, Wyden and Merkley said that they are seeking assurances that the mistakes of the previous program will not be repeated.

“We believe strongly that veterans should spend their time getting good health care rather than driving to it, especially in states like Oregon where many veterans living in rural areas are underserved,” they wrote.

The Oregon senators also implored Wilkie not to allow community care to come at the expense of the VA’s core functions.

News-Review senior staff writer Carisa Cegavske can be reached at ccegavske@nrtoday.com or by phone at 541-957-4213.

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Carisa Cegavske is the senior reporter for The News-Review. She can be reached at ccegavske@nrtoday.com or 541-957-4213. Follow her on Twitter @carisa_cegavske

(5) comments

chicagomike

Due to my and other Veterans experiences with VA medical care there are gaps in the system/medical records and appropriate screenings are often not offered to Veterans. I've had to make the request for some of these medical tests and many Veterans are unaware of these routine medical screenings or that they should ask for them. I am suggesting that the following notice be posted in all Roseburg VA clinics: The Roseburg VA is committed to providing quality health care to it’s Veterans. We offer the following medical screening services to our Veterans. Please inquire with your Primary Care Provider to see if you would benefit from the following screenings: 1. Carotid Artery (Plaque) Screening Ultrasound scan of the carotid arteries that screens for buildup of fatty plaque - a leading cause of strokes. 2. Heart Rhythm Screening (Atrial Fibrillation) A quick and easy test using EKG electrodes placed on the arms and Legs to identify the presence or absence of an irregular heartbeat. 3. Abdominal Aortic Aneurysm Screening Ultrasound screening for an abdominal aneurysm (enlargement) That could lead to a ruptured aorta. 4. Peripheral Arterial Disease Screening Evaluates for peripheral artery disease (PAD) in the lower extremities, Which increases the risk of heart disease. 5. Osteoporosis Risk Assessment Ultrasound screens the shin bone for bone mass density. Osteoporosis Is painless and silent in its early stages. 6. Colorectal Cancer Screening Colorectal cancer screening is an important part of routine healthcare. Colorectal cancer can often be prevented and usually does not cause symptoms until the disease is advanced.

chicagomike

The letter below was emailed to Senator Merkley as well as being published on Disabledveterans.org and a shorter version was published as a letter to the editor in the Curry Costal pilot new paper last May This over and wrongful billing still continues, BCBS insurance replied that it relies on the integrity of the VA to not bill them for service connected conditions and to reimburse them when they do. With regards to the exorbitant over billing of of my health insurance, BCBS states that these costs are absorbed by employer and enrollee contributions. And that they don't monitor a providers profit margins. Ever wonder why your insurance premiums are so high? This is one way for Roseburg Director Allen to hold down costs for Veterans health care. Dear Senator Merkley, After receiving two very thick envelopes of statements of benefits from my BC/BS insurance company this week, I realized that the Roseburg VA has fraudulently billed and overbilled Bluecross/Blueshield Insurance for treatment of service connected conditions. As you are aware, treatment for veterans service-connected conditions should not be billed to veterans private insurance companies. The VA routinely bills my insurance for treatment of my service-connected conditions and what I recently discovered is that the VA has been overbilling my insurance for a significant profit when my insurance should have never received a bill in the first place. Here are just a few examples: For treatment I received on 3/27/18, the Roseburg VA billed my BC/BS insurance on 3/30/19 the amount of $705.56. The provider originally billed the VA for these services in the amount of $243.38. The Roseburg VA paid the provider $107.56 and the provider wrote off $135.82. On 4/7/19, BC/BS reimbursed the Roseburg VA $319.48 for a VA profit of $211.92. This treatment was for service-connected conditions. For treatment I received on 4/10/18, The Roseburg VA billed my BC/BS insurance on 3/30/19 the amount of $231.70. This provider originally billed the Roseburg VA for this treatment $184.70. The Roseburg VA paid the provider $63.96 and the provider wrote off $120.74. On 4/7/19 BC/BS reimbursed the VA $195.79 for a VA ​profit of $131.83. This treatment was for service connected conditions. For treatment I received on 9/27/18, the Roseburg VA billed my BC/BS insurance on 4/2/19 the amount of $439.32. The provider originally billed the Roseburg VA for these services in the amount of $346.56. The Roseburg VA paid the provider $105.79 and the provider wrote off $240.77. On 4/14/2019 the Roseburg VA was reimbursed by BC/BS $414.09 for a VA profit of $308.30. This treatment was for service connected conditions. For treatment I received on 12/18/18, the Roseburg VA billed my BC/BS insurance on 4/6/19 the amount of $1,1001.68. The provider of this treatment originally billed the VA for these services in the amount of $492.00. The Roseburg VA paid the provider $168.12. The provider wrote off $322.88. On 4/14/19 BC/BS reimbursed the Roseburg VA in the amount of $621.45 for a VA profit of $453.33. This treatment was for service connected conditions. Senator Merkley, These are just 4 examples of this VA insurance fraud I can give at least 28 more just from one provider. There are a lot more examples. This is systemic and this affects everyone, the medical providers who have to write off what the VA does not pay, the insurance companies who should not be billed in the first place for service connected conditions but are then billed for hundreds of dollars more than what the VA paid for these services. This results in higher insurance/Medicare premiums for everyone and the VA profits substantially from this fraud. Is there anything you can do to stop this? Sincerely, Michael Berns

chicagomike

The below ad was published in the May 25, 2019 Curry Costal Pilot newspaper. Dear Senators Merkley and Wyden and Congressmen Walden and DeFazio, Currently the Department of Veterans Affairs (VA) does not perform lung cancer screening for veterans exposed to Agent Orange, Asbestos, Burn pits or other known respiratory carcinogens that occurred during their service to our country. It is only after a veteran gets lung cancer that veterans exposures are presumed to have caused the lung cancer and VA benefits can be applied. The purpose of running this advertisement in our local paper is to create public awareness of this situation and request your assistance to apply pressure on the VA to offer low dose CT lung cancer screening to veterans who are at a higher risk of getting lung cancers based on their military exposures. By the time lung cancer is detected, it is often in the later stages of the disease. Low dose CT lung cancer screening can be utilized to detect lung cancer in the early stages when it is treatable. We are asking for your assistance to take whatever measures necessary and help save veterans lives. Sincerely, Vietnam Veterans of America. Chapter 757, Brookings Oregon “Never again will one generation of veterans abandon another”

chicagomike

Our senators and congressman need to do more with regards to the multitude of systemic problems at the Roseberg VA. I have brought many of these problems to the attention of Senator Merkley's Veterans reps who have made inquiries with no response from the VA as of yet. Most veterans are not aware of the various tests/screenings that are available but not being performed unless they know to ask for them as they are not advertised at the Roseburg VA. there are other systemic problems as well in Radiology, prescription drugs, failure to provide/offer Lung cancer screening, annual colorectal cancer screening, Abdominal Aorta Aneurysm (AAA) screening, Carotid Artery (plaque) screening (a leading cause of strokes), Peripheral Artery Disease (PAD) screening (PAD increases the risk of heart disease), Heart Rhythm Screening (Atrial Fibrillation) and Osteoporosis Risk Assessment (osteoporosis is painless and silent in its early stages). Unlike the services offered to Veterans who suffered Military Sexual Trauma, the Roseburg VA does not advertise these most basic non invasive screenings and Roseburg VA doctors have consistently/systemically failed to provide these services to all Veterans who would benefit from these screenings. this is not my opinion but a provable fact! It is well know that these screenings save lives and I have long advocated that the availability of these services posted in all Roseburg VA clinics. AQUATHERAPY- Any Veteran with back, Hip/joint problems -Arthritis should request this from their VA provider, this low impact therapy combined with the 94 degree water temperature (evidenced based) is extremely helpful and I urge Veterans that would benefit from this therapy to ask their VA provider to request this. I was receiving this therapy for pain management and maintenance so that I could maintain my current level of function. The Physical Therapist in Roseburg who has never seen or examined me denied that this therapy continue even though my VA PCP and my boots on ground physical therapist have requested that aqua therapy continue. Senator Merkley has yet to receive a response from the Roseburg VA. ROSEBURG VA RADIOLOGY- DON'T HAVE AN MRI PERFORMED AT THE ROSEBURG VA! The OIG previously cited the Roseburg radiology for problems with not being able to ensure the quality of imaging or radiologist reports. I've had 3+ hours of meeting's/phone call with Chief Radiologist Dr. Wang. We compared Roseburg's images with those obtained outside the VA and Dr. Wang admits that the non VA images performed on newer equipment are better, that he wants a new MRI machine and even invited me to the ribbon cutting ceremony if my efforts to replace Roseburg's outdated piece of junk were successful. Dave Whitmer even promised in an email and at 2 consecutive town halls in Brookings to make the high tech high cost replacement for a new MRI. at his last town hall in Brookings he back pedaled stating that the outdated piece of junk was now "State of the art for its generation". Arthritis disappears from Roseburg VA's MRIs, torn tendons, ligaments, nerve root encroachment and stenosis are not shown. technicians are not trained to recognize artifact motion when it occurs during an MRI (due to Roseburg's small bore and flexible coil) and repeat that section of the MRI which have failed to recognize conditions that require surgery. Mercy's outpatient MRI is a newer 3T wide bore machine that produces high quality images. Mercy's inpatient MRI is an older small bore GE Machine like Roseberg VA's but Mercy employees have informed that 7 months ago Mercy invested 3/4 of a million dollars to refurbish this machine. I addressed Radiology problems with Director Allen at the June 4th town hall in Brookings and he promised to investigate. When I spoke with him on June 25th he informed the Associate Director Ryan Baker was investigating. Non VA radiology images (even when the VA pays for these studies) and reports are not entered into the Veterans Radiology records for comparison. I've requested that a complete audit of the Roseburg VA Radiology Department be performed including a comparison of the non VA radiology studies images and reports to Roseburg VA's. Senator Merkley's office informs the have made the inquiry. No response yet from the VA. there are so many more problems with industry standard protocols that are not being followed than I can write about here. ORTHOPEDIC Docs at the Roseburg VA continue to inject cortisone into Veterans with shoulder and knee problems that require surgery. Due to the screwed up medical records system these docs are unaware of how many injections of cortisone a veteran has had or that there is a limit of no more than three or four of these injections per year. I can write more as the systemic problems are numerous. gotta go for now. Mike

CitizenJoe

Every thing Trump touches, dies. I love my VA, and mourn for its demise.

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