The firestorm over the VA Veterans Health Administration scandal had been steadily building until it finally boiled over into the national media spotlight at the end of April this year. In the following months it was learned that dozens of veterans had died while waiting for medical care, around 1,700 veterans needing medical attention were at risk of either dying or not receiving care, and that more than 120,000 veterans were still waiting for – or never received – an appointment. Several investigations were launched into the VA’s healthcare operations, including ones by the White House and the FBI. Ultimately the Secretary of Veterans Affairs resigned amid talk of coverups, persecuted whistle-blowers, falsifications of documents, and warped incentive pay.
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There were several outcomes as a result of the scandal, including notable pieces of legislation and increased funding for both the VA and for further investigations. One of the significant acts passed by Congress was the Veterans’ Access to Care through Choice, Accountability, and Transparency Act of 2014. This act expands the options of healthcare coverage and access for veterans, and will also influence the workloads of medical billing and coding professionals.
Changes Will Affect Medical Billing and Coding Professionals
Passed on August 7th, this act allows for several changes that will affect billing and coding professionals. Among these provisions are:
Veterans who cannot be scheduled for an appointment in a reasonable amount of time will be allowed to obtain treatment from private, non-profit, and not-for-profit healthcare providers
Veterans who live more than 40 miles away from a VA healthcare facility will be allowed to obtain treatment from private, non-profit, and not-for-profit healthcare providers
This means an untold number of veterans will be receiving medical treatment and services from non-VA healthcare providers. The Congressional Budget Office estimates that reimbursing non-VA healthcare providers for the services veterans will obtain will cost approximately $35 billion over the next decade. That potentially means medical billing and coding professionals who work in these private, non-profit, and not-for-profit healthcare facilities – hospitals, physicians’ clinics, emergency rooms, and specialist practices to name a few – will be working with an estimated $35 billion-worth of additional medical bills and medical codes. That breaks down to an extra $3.5 billion in services every year.
Already one week after this act became law, and just over three months after the Veterans Health Administration scandal hit the front pages, the Department of Veterans Affairs reports that referrals to doctors outside the VA system are steadily on the rise. During this period the head of the VA has stated that more than 837,500 veterans have received referrals for care from private physicians, a number representing a 25-percent rise from the same time last year.
Whether or not this boost of veterans to the healthcare system outside the VA will be permanent is another issue. Also contained in recent legislation addressing the VA scandal was billions of dollars of additional funding to hire more VA doctors, nurses, and other healthcare providers, build more VA clinics and hospitals, and arrange for additional mobile VA healthcare centers. As the infrastructure of the Veterans Health Administration catches up with demand and veterans regain confidence in the VA’s healthcare system, the surge in services experienced by medical billing and coding professionals outside the VA system will likely fade.