Rep. Jeff Miller Outlines Failures Of Veterans Choice Program

Chairman of the House Committee on Veterans Affairs Jeff Miller led the push to create the Veterans Choice program, and cooperated with his ideological opposite, Sen. Bernie Sanders, to get it passed. The Florida Republican has been among the VA's leading critics, especially for what he considers mismanagement of the choice program and a reluctance to fire bad VA staff.

ROBERT SIEGEL, HOST:

NPR has reported that the Veterans Choice program which was supposed to clear up the backlog of veterans waiting for care has failed in its purpose. We've heard it called a new layer of bureaucracy. Delays in treatment are still common. In fact, more vets are waiting for care this year than last. And delays in reimbursement for health care providers are also common.

Representative Jeff Miller is chairman of the House Committee on Veterans' Affairs. He's a Florida Republican, and he's one of the original sponsors of Veterans Choice. And he joins us from Capitol Hill. Welcome to the program.

JEFF MILLER: Thank you, Robert. It's good to be with you.

SIEGEL: Veterans Choice was supposed to make it easier for vets facing long waits to go outside the VA's system to private doctors. In a nutshell, what's gone wrong?

MILLER: Well, the things that veterans are experiencing today unfortunately are much like the things that we experienced and discovered back in 2014. And that is the inability for the department to be able to decide when a veteran actually is waiting to see a physician, not being transparent with their numbers.

And the other thing that is causing problems for the program is the reimbursement rate. That's one of the things that we discussed a lot and a lot of the providers said was very, very important - was that they get a timely reimbursement.

SIEGEL: But why is that not happening? What's your understanding of why it's not happening?

MILLER: It makes makes absolutely no sense to me. If they authorize something to be done, it's being done with a contract provider. There's absolutely no reason that there should be a delay past 30 days with getting the payment.

SIEGEL: But Congressman, our reporters also found that the 90-day deadline that Congress imposed at the beginning to create a provider network was just beyond what the VA could handle. And did the law ask for too much too soon?

MILLER: Well, I mean, it - we're two years now into the law, and if they haven't been able to fix it by now, if we'd give them 120 days to set it up, they still would be squawking and saying that there were problems. There was a crisis. Everybody knew there was a crisis. And you know, quote the 90 started when the president signed the bill into law, but VA was well on notice of what the language was and what they were going to need to do.

I mean, look; the Department of Veterans' Affairs - if you asked them to set up an ice cream stand, they'd forget to go out and buy the freezer. No program that's been rolled out by the department in recent years has come without flaws and without problems.

SIEGEL: Well, given your - well, you sound mystified by why things haven't worked better. Can you describe something that if the VA had the authority to fire at will, something that you and others have spoken about? Forgetting about the 90 days they're deeply into, is there some prescription for fixing it all that you can sum up briefly for the veterans?

MILLER: Part of the problem is the bureaucracy is so large, and it's very difficult for anybody. And we've said this from the very beginning - that it doesn't matter who the secretary is. When you have 350,000 people, it's very difficult to move the agency in a different direction.

SIEGEL: If the bureaucracy is so big and unwieldy, how do you fix that? What would you ideally see done at the secretary's office?

MILLER: Well, I think you need to look at the efficiency with which the agency does the job that they're supposed to do. There's over 20,000 schedulers right now that work at the Department of Veterans Affairs. You would think that there wouldn't be any problems scheduling veterans time to see a physician, but for some reason, we've got problems out there just in that one area.

SIEGEL: Ten billion dollars put into Veterans Choice, and there are now more vets waiting for care than before. What do you do now? What's next? What happens?

MILLER: We continue to work with the department, with the secretary, with the veterans service organizations that are out there. I believe that many folks now accept the fact that Choice is going to be here. I think it's going to take some time. I mean, nobody expected this to be resolved overnight. You can go back and check the transcripts of most of the interviews, and nobody thought that it was going to be resolved immediately.

SIEGEL: Thanks to Representative Jeff Miller, Republican of Florida, chairman of the House Committee on Veterans' Affairs.

Copyright © 2016 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.