The delay in payments has been a persistent problem for a number of providers in Maine, including Eastern Maine Healthcare System
Washington, D.C. - At a Senate Appropriations Subcommittee hearing today on increasing veterans’ access to health care, U.S. Senator Susan Collins, a senior member of the Appropriations Committee, urged the Department of Veterans Affairs (VA) to accelerate the payments it owes to providers. The VA purchases health care services from non-VA community providers to help veterans receive timely and accessible care, yet delays in processing claims have been a persistent problem. In a May 2016 report, the Government Accountability office found that the Veterans Health Administration (VHA) only processed 66 percent of claims within 30 days.
During the hearing, Senator Collins pointed out to Dr. Baligh Yehia, the VHA Deputy Under Secretary for Health for Community Care, that these delays create a serious issue for providers in Maine, from rural providers to larger networks like Eastern Maine Healthcare Systems (EMHS).
“[The prompt payment of VA claims] continues to be a problem not only in my state but others as well. For smaller, rural providers, it really means the difference between whether they are going to keep practicing or not,” said Senator Collins. “But it’s not just our smaller providers that have experienced a problem. The Eastern Maine Medical Center, as you know, has been working with our office and with [the VHA], to try to resolve a huge backlog of some 2,000 claims…My worry is that we really need prompt payment in order for the Choice program to work well.”
Senator Collins asked Dr. Yehia, “[W]hat can be done to speed along the process of resolving disputed claims and to pay those that aren’t disputed more rapidly so that providers are not stuck?”
“Making sure that we are good partners for community providers is critical, because we will never be able to build a high preforming network that we want if we are not good business partners to community providers,” Dr. Yehia responded. “I’ve had personal phone calls with the CEO of [EMHS] and all their facilities, and it’s been great to work with them…We still have a ways to go, but I feel like we are making good progress there.”
Dr. Yehia attributed part of the challenge with processing claims in a timely manner to the existence of multiple programs, each with different rules and authorities. He requested assistance in streamlining the VHA’s efforts so that the community care program is easy to use for both veterans and health care administrators.
“I am certainly happy to work with you, and I appreciate the efforts you are making,” Senator Collins told Dr. Yehia. “I hope they continue.”