VA Montana meeting

Sen. Jon Tester, second from right in dark jacket, meets on June 6 with national and Montana VA leaders at Fort Harrison.

Last week the U.S. Senate unanimously approved legislation that ensures disability and health care benefits for Vietnam veterans who were exposed to Agent Orange while serving aboard U.S. Navy ships. Why is this legislation necessary now, four decades after the last U.S. troops returned from that war?

Because the law covering illnesses caused by that toxic defoliant covers veterans who served on land, but doesn't specifically require the VA to cover veterans who were exposed aboard ships in Vietnam waters.

The Blue Water Navy Vietnam Veterans Act passed the U.S. House on May 14 without dissent. It will be on President Donald Trump's desk shortly. He should sign this long overdue bill into law.

"It rights a wrong perpetrated by a government that ignored them for far too long," said U.S. Sen. Jon Tester, who championed the bill as the ranking minority member of the Senate Veterans Affairs Committee. He heard from Montana U.S. Navy veterans who are among tens of thousands suffering from effects of Agent Orange.

“Our Vietnam vets who served both on land and sea deserve equal care for their bravery in defense of our country,” said U.S. Sen. Steve Daines, who was visiting Billings when the Senate passed the bill on a voice vote. 

The Blue Water Navy Vietnam Veterans Act is the latest in a continuing series of bills aimed at ensuring U.S. veterans receive the benefits they deserve.

On June 6, the MISSION Act of 2018 was launched. It "will enable VA to consolidate the department’s community care efforts into a single, simple-to-use program that will empower veterans with the ability to choose the health care providers they trust," Robert Wilkie, secretary of Veterans Affairs, wrote in an opinion last month for Fox News.

The MISSION Act drew strong support from major veterans groups. It replaces the Veterans Choice Act that fell short of its goals to streamline and expedite quality care for all veterans in urban and rural communities. A major problem with Veterans Choice was the failure of the private contractor to make timely appointments for veterans who needed care outside the VA system. The contractor, Health Net, also frustrated community health care providers with very slow reimbursement for the care they provided veterans.

Health Net has been replaced by Triwest, which has contracted with a network of Montana community health providers. When veterans need care that isn't available close enough or fast enough from a VA facility (under one of six new criteria), VA staff can refer the veteran to a community provider for care. The veteran decides whether he or she wants community care or VA care.

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The MISSION Act adds a new benefit: Urgent Care. This is designed for veterans who need immediate care for non-life-threatening problems, such as flu-like symptoms or a sprained ankle. Triwest is responsible for adding urgent care clinics to its network. Veterans already enrolled with VA health care, who have been served at a VA facility within the previous 24 months, can walk into an urgent care facility — in the network — without a VA referral. The first three urgent care visits in a year are at no charges to the veteran. 

The MISSION Act is a work in progress. Triwest has a temporary contract until a new third party administrator is selected. That selection has been delayed because of a protest filed before the contract was awarded. The protest has been investigated and dismissed and the contractor could be chosen in a couple of months.

The long-term benefits of the MISSION Act could be tremendous for Montana. Our state VA facilities are continually struggling to recruit and retain highly skilled health care professionals. 

The new law:

  • Improves incentives for doctors and other professionals to work at rural, tribal and underserved VA facilities.
  • Increases VA reimbursement for educational debt.

The MISSION Act also will expand eligibility for caregiver support services to veterans regardless of when they served. The caregiver support changes haven't yet been finalized.

The mission of making the new law work for all veterans has just begun. According to a spokesman for VA Montana, Triwest has 8,000 Montana providers in its community care network (counting every doctor, therapist and facility individually). But as of last week, the MISSION Act website didn't yet list any community provider for the Urgent Care benefit within 100 miles of Billings.

The uncertainty over this region's third party administrator contract must be resolved as soon as possible, so that Montana community providers, including urgent care clinics, can contract to serve veterans into next year and beyond.

VA must ensure that there is no interruption in ongoing services as the department works to improve veterans benefits with the Mission Act.

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