Companies Managing VA’s Choice Program Suspected of Financial Fraud

The Veterans Administration Choice Program, run by two companies who are managing the program, are under investigation for allegedly over-billing the U.S. government by the tune of tens of millions of dollars.

Yes, the same program that was designed to help veterans who lived too far or their appointments were more than 30 days out.

The two companies, TriWest Healthcare Alliance and Health Net Federal Services are under contract to facilitate private healthcare services for military families and veterans as part of the VA’s new Veterans Choice program, which was created in 2014 after Congress passed the Veterans Access, Choice and Accountability Act.

Task and Purpose reported:

The bill allocated $10 billion to give veterans a private medical option, but has cost taxpayers upward of $12 billion to date, according to The Republic. An audit launched by the VA Office of Inspector General after anonymous comments on the employer review website Glassdoor.com found that some of that money has vanished into corporate coffers.

The inspector general recently reported to Congress that the two companies have collected at least $89 million more than what they were supposed to. At least must be emphasized, as the audit is still ongoing (the inspector general’s office says it should be completed by the end of the year). TriWest is also being investigated by a federal grand jury for possible wire fraud and misuse of government funds.

Companies Managing VA’s Choice Program Suspected of Financial Fraud
Veterans Choice program

“This was a senseless waste of resources that could have been better spent on veterans’ health care,” Republican Rep. Phil Roe, chairman of the House Committee on Veterans’ Affairs, wrote to VA Secretary David Shulkin in September, according to The Republic. “I am disappointed in the department’s continued lack of urgency to prevent these extensive over-payments.”

TriWest and Health Net have overseen the VA Choice program since it was launched in 2014 to help alleviate tremendous strain on the VA. Mounting backlogs had resulted in infamously — and occasionally deadly — long wait times for veterans seeking treatment at its facilities. In some cases, veterans had to wait months to see a provider.

Now, if the VA can’t schedule an appointment for a veteran within a month, or if a veteran lives more than 40 miles from one of its clinics, they can access a network of private clinicians and hospitals managed by TriWest and Health Net.

At least, that’s how it’s supposed to work.

Task and Purpose found the story about TriWest Healthcare Alliance and Health Net Federal Services at the Arizona Republic.

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I can tell you from this veteran, it has had its problems from bills not being paid, which is also a common complaint from many veterans using the program and then their credit gets hit because of TriWest and Health Net not doing their job.

As an unnamed veterans’ wife stated the other day, “My husband is a disabled Veteran, he has a Pace Maker that has to be monitored, and sees his heart Dr. twice a year. He has been on the choice program for 2 going on 3 years. Every year he goes through hoops to be approved and it always runs out before he is approved.”

“Finally after more time Choice said that he was approved but they had to contact his provider to get all the information of his appointments, and for him to call back in seven days. So here it is six months later and he calls back today, and was told by a supervisor that it has been kicked back to the VA for a new approval she admitted that because they (choice) did not contact his Dr. in a timely matter to get his appointments, that now the process has to start all over again… this is ridiculous!!! Shame, Shame, Shame on them for not doing their job, and putting it back on the Veteran who also has PTSD.”

The Choice Act program was supposed to assist us veterans but as you can see, if these two companies are allegedly over-billing the U.S. government, then what will veterans do?

Help a USAF Veteran who has had no income in 3 months in need by clicking here.

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Fmr. Sgt, USAF Intelligence, NSA/DOD; Studied Cryptology at Community College of the Air Force

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