I-Team: Fix Meant To Improve Veterans' Access To Medical Care Is Broken

BOSTON (CBS) - After a national wait time scandal, it was supposed to be a program that helped veterans get access to faster, more convenient medical care.

However, the I-Team discovered the Veterans Choice program implemented at the Department of Veterans Affairs (VA) is fraught with issues. Some of the problems include a confusing appointment process, health care providers not getting paid, and veterans being harassed by bill collectors.

Treatment approved, then denied

When Stephen DuLong needs to see a doctor, he usually makes the trip from his home in Onset, Mass. up to a VA facility in Boston.

But last summer, the Navy veteran learned it would be two months before he could see a specialist. It was longer than he could afford to wait.

"I was in pain and needed to see someone soon," DuLong told the I-Team.

DuLong learned he was a candidate for the new Veterans Choice program, which was created in late 2014. If veterans live 40 miles from the closest VA facility, or face a wait at least 30 days for an appointment, the program allows them to see a private physician.

DuLong navigated the tedious application process and eventually received an approval letter to see a specialist in Fall River.

However, after the appointment, DuLong received a surprise in his mailbox: a letter from the VA, rejecting the claim for his treatment.

Incredulous, DuLong filed an appeal and included the initial approval letter he received. His treatment was denied again.

"It was totally unthinkable," he recalled. "The VA is authorizing this on one hand and now turning around and rejecting it on the other hand."

The next thing to arrive in the Navy veteran's mailbox? A bill from the private physician for $1,625. On a fixed-income, it was an amount DuLong had no chance of paying.

That is when he contacted the I-Team.

Congressional leaders react, propose changes

"This story that you just told me is outrageous. And yet, it's not surprising," said Rep. Seth Moulton.

The Massachusetts Congressman, a Marine veteran who still receives his medical care at the VA, said it is an issue he takes personally.

"The bottom line is the VA as a system needs to be dramatically reformed," Moulton said.

Moulton and other Congressional leaders have recently filed a flurry of proposals to make changes to the beleaguered Veterans Choice program. They will eventually be worked into a VA reform package.

New Hampshire Senator Kelly Ayotte has heard plenty about the problems because many of her constituents live farther away from the nearest full-service VA facility and have tried to access the program.

Ayotte wants veterans to be able to make appointments directly with private providers instead of contacting the government's third-party contractor.

"The fix needs a fix," Ayotte said. "Frustration is not the right word. It's unconscionable. It's appalling."

Fellow New Hampshire Senator Jeanne Shaheen echoed those sentiments.

Earlier this year, Shaheen introduced a bill to streamline and simplify the billing process for reimbursing private providers. That is the issue that has resulted in some veterans receiving calls from bill collectors because of the delayed payments.

"Bureaucracy at the VA continues to prevent the program from living up to its full potential," Shaheen said.

VA leader apologizes for confusion

Vincent Ng, the director of the VA Boston Healthcare System, agrees the program added another layer of bureaucracy when it hurriedly took shape in the of the national scandal.

"The intention of the program is a very good one," he told the I-Team.

The VA director is optimistic some of the proposed legislation will help eliminate the problems with Veterans Choice and cut through some of the existing red tape.

Ng said DuLong's case highlighted an internal communication problem with the billing process. Even though the Boston VA approved his treatment, the private provider inadvertently sent the claim to the VA facility in Providence.

The third-party billing contractor in Providence had no record of DuLong's appointment, so the claim was repeatedly rejected. Ng said the systems will now be able to access records in other locations, which will hopefully avoid similar dilemmas.

"I'd like to apologize to Mr. DuLong for the confusion," Ng said. "We made improvements for the system, which will help other veterans. So we thank him for that."

DuLong is relieved he no longer has to worry about the expensive medical bill. But for now, he has no plans to give Veterans Choice another chance.

"It's not worth the headache. Or the panic," he said.

Ryan Kath can be reached at rkath@cbs.com. You can follow him on Twitter or connect on Facebook.