How I Predicted this New VA Joke

The date was June 15, 2014 and here was my entry:

In almost a parody upon itself, the AAFP News put out this headline for its article on the VA mess:

Family Physicians ‘Stand Ready to Assist’ Nation’s Veterans

In other words, family docs, we are sending the veterans your way. Like it or not. The AAFP offered our services so be a good sport about it and do it. The government will thank you some day. Not.

The AAFP outlined five proposals that could address the immediate primary care physician shortage:

• Allow family physicians working outside the agency to treat eligible veterans.
• Permit prescriptions written by civilian family physicians to be filled at VA pharmacies.
• Allow civilian family physicians to order diagnostic tests at VA facilities.
• Permit FPs outside the system to make referrals to subspecialists and other health care professionals working in VA facilities.
• Enable civilian FPs to provide care for eligible veterans in accordance with the protections provided by the Federal Tort Claims Act.

Listen, we all want to help patients. We all feel patriotic to our country and want to help the veterans. I get that. I also get that veterans are not easy patients and have a ton of problems. There also is a NATIONAL primary care shortage for the same reason there is a VA primary care shortage. That reason being MONEY. So before the AMA offered us up so casually they should have asked for some real concessions. More pay. No nurses leading ACOs. More overall tort reform. And a ton of others things. Instead, they threw us under the bus again. Thanks, guys, should be lots of fun.

So why do I bring this up 8 months later?  Well, this is from the AAFP website:

VA Payments for Physicians in New Program Fall Short of Expectations

• The Veterans Access, Choice and Accountability Act was signed into law in August with the intent of expanding health care access for veterans, but the AAFP is concerned that restrictive payment policies included in the interim final rule implementing provisions of the act could limit physician participation.
• Currently, the VA contracts with only two third-party administrators (TPAs) to handle the Veterans Choice Program established by the law, and payments these TPAs are offering physicians are much lower than anticipated. The Academy’s letter urges the VA to at least meet Medicare rates.
• “Many family physicians are reporting that these TPAs, if they’ve even yet bothered to approach the practice about participating in the Veterans Choice Program, are then offering reimbursement rates that are 30 percent less than the Medicare physician payment rate,” the AAFP letter reads.
• Finally, under current rules, physician practices participating in the Veterans Choice Program are prohibited from collecting co-payments from veterans at the time of service. Practices can bill patients only after the VA processes claims, a policy the AAFP opposes.

When will the AAFP ever learn?  They offered up our services and got bitch slapped again.  It’s laughable. And I called it from the beginning.

That being said, I will see any Veteran that comes my way.  I won’t even bill the government.   It just costs him or her $75 a month. That solves this whole mess.