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Shaheen Calls on VA to Address Health Care Provider Payment Backlog

(Washington, DC) – U.S. Senator Jeanne Shaheen (D-NH) sent a letter last night to Department of Veterans Affairs (VA) Secretary Robert Wilkie requesting that the Department explain its delay in addressing the backlog of payment claims to health care providers in the community. In her letter, Shaheen called on the Secretary to dedicate the resources necessary to expeditiously reduce and eliminate the backlog of claims, and to give clarity to health care providers with unpaid claims. The unpaid claims largely originated under the Veterans Choice Program, which has since been replaced by a new community care network established by the VA MISSION Act. 

“My office has heard from numerous health care providers in New Hampshire who have yet to receive payment on claims in the tens of thousands of dollars,” wrote Senator Shaheen. “We are more than willing to assist these providers and have worked with them to identify the claims for the VA and pursue expedited payment. However, providers should not be forced to seek assistance simply to receive what is rightly owed to them for services rendered to veterans.” 

“Delays in payment undermine provider confidence in the Community Care Network (CCN) and threaten efforts to build a strong network, which will be necessary for the community care model established in the VA MISSION Act to succeed. If providers can’t trust that they will be paid in a timely manner, then ultimately it is our veterans who suffer as these providers drop out of the network and veterans receive fewer options for care. Unfortunately, I have heard from community providers who have made the difficult choice to stop seeing veterans covered by the VA because they can no longer wait to receive compensation. As you know, most of these providers appreciate the opportunity to deliver care to the veterans who have served our nation and are willing to assume responsibilities that are not inherent in the more traditional delivery of care. Many of them are also small businesses who depend on timely payments for services to keep their business running. At the very least, we must ensure that these providers are confident that when they see a veteran they will be paid.”

“Not only has this backlog resulted in unpaid claims, but it has created confusion among providers during a time of transition to the new CCN where clarity and consistency is critical to building a robust network. It is often unclear to providers who contact my office as to whether claims are delayed due to administrative backlog or errors in their submissions. Providers are also struggling to discern the difference between claims still pending with the VA and claims that will be paid out by Optum under the new CCN. For these reasons, I urge you to increase provider outreach to ensure that those with unpaid claims understand the reasons for delay and are able to quickly remedy any omissions or mistakes in their claim submissions.”

In 2018, Senator Shaheen worked to include a provision in the VA MISSION Act – which was signed into law – ensuring every veteran in New Hampshire has access to care in the community. This was a top priority for Shaheen as New Hampshire does not have a full-service VA medical facility. Under the previous VA community care program, Senator Shaheen introduced the Veterans Choice Card Prompt Payment Act to expedite payment to providers who serve veterans.

The full text of the letter is available here.