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GAO: Vets' health care costs a 'high risk' for taxpayers

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Published February 11, 2015

Feb. 11, 2015: Veterans Affairs Secretary Robert McDonald testifies on Capitol Hill in Washington.

Veterans' health care is a "high risk" budget issue that threatens to cost taxpayers tens of billions of dollars unless longstanding problems are addressed, government auditors warned Wednesday.

The nonpartisan Government Accountability Office said health care costs at the Department of Veterans Affairs have nearly tripled since 2002 -- to more than $59 billion a year -- as a result of the Iraq and Afghanistan wars and the aging of Vietnam-era veterans.

Costs are likely to continue to rise as the VA responds to "serious and longstanding problems with veterans' access to care," the GAO said.

The report praised a new law overhauling the VA in the wake of a scandal over long wait times for veterans seeking care. But it said officials must ensure that veterans obtain needed care, whether from the VA or from outside providers authorized under the 2014 law.

"While timely and cost-effective access to needed health care services is essential, it also is imperative that VA ensures the quality and safety of the services it provides," the report said.

The GAO report, issued every other year, identified 32 "high risk" areas that could cause significant budget problems due to waste, fraud, mismanagement or structural flaws. The list includes Medicare and Medicaid, as well as a host of Pentagon and nuclear security programs and the national flood insurance program, among others.

In 2013, the GAO added climate change to the high-risk list.

The GAO report is the latest in a series of reports and investigations highlighting problems at the VA, which has been under intense scrutiny since a whistleblower reported last year that dozens of veterans died while awaiting treatment at the Phoenix VA hospital, and that appointment records were manipulated to hide the delays.

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GAO: Vets' health care costs a 'high risk' for taxpayers

Health care issues still a hot topic in the legislature

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Note: This is the entire story; the overflow fromthefront page is missing in our printed edition.

Medicaid expansion is dead, but that doesnt mean looking out for the uninsured in Wyoming and the hospitals that serve them isnt foremost in the minds of legislators.

Representative Elaine Harvey

The week began in the House of Representatives with the second reading of the supplemental budget and numerous amendments. With the deadline past for introducing new bills, representatives are adding amendments to the budget as a last resort.

Everyone is kind of scrambling, trying to do things through the budget, explained Rep. Elaine Harvey of Lovell. People are trying to correct things through the budget.

We are looking at other ways to deal with health care costs. One of them is Senator Petersons bill that deals with the hospital end of things, but I also have an amendment in the works that could also provide some relief.

Harvey said she is submitting an amendment for consideration on the third reading of the budget, which is expected to take place on Thursday. The amendment would offer reimbursement to hospitals for uncompensated care. The amendment takes $4 million from an $8 million building project at the University of Wyoming. The $4 million would be funneled to community health centers and rural health clinics, compensating them for some of the uncompensated care they provide to the uninsured.

Community health centers operate in underserved areas and serve the needs of a wide variety of clients from the indigent to the fully insured. She said these clinics typically provide a wide array of services, even dental care in some cases, and are typically bigger and more comprehensive in services than rural health clinics.

In contrast, rural health clinics, such as North Big Horn Hospital, are typically located in smaller communities, offering limited services. They are spread throughout the state, which allows people in adjacent communities to drive a reasonable distance to the clinic for care.

Both types of clinics offer services on a sliding fee scale. The proposed amendment would allocate funds to reimburse the clinics for a portion of the uncompensated care they provide through the sliding scale method of billing. Harvey said the amendment would allow the clinics to bill the State Dept. of Health for reimbursement for uncompensated care. It differs from Medicaid expansion in that the money comes from the state instead of the federal government.

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Health care issues still a hot topic in the legislature

Health care options expanding in east and south Hillsborough

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BRANDON As construction crews hammer away on new houses in Hillsborough Countys fastest-growing area, those moving in are going to need more than a few restaurants and service stations. Theyll need health services.

An $11 million medical office building going up at Kings Avenue and Oakfield Drive in Brandon, anchored by Florida Cancer Specialists & Research Institute, is one of several recent projects in eastern and southern Hillsborough County related to the medical fields. The new construction is directly tied to the expanding customer base.

Brandon Regional Hospital is adding on and BayCare Health System just built a new hospital in Riverview that opened at the beginning of the year. A new partnership between Tampa General Hospital and Florida Hospital called West Florida Health plans to begin construction on a Falkenburg Road clinic later this year.

The new 38,400 square-foot Brandon Medical Pavilion is scheduled to open as soon as November and the developer is still seeking tenants for its second floor.

The 3.27-acre plot the former site of Lifestyles Fitness is just blocks from Brandon Regional Hospital.

We work with health care providers and this is an area a lot of groups are interested in, with so much growth in Brandon and to the south. But it doesnt have a lot of high quality medical office space, said Andrew Boggini, principal for developer Optimal Outcomes LLC.

Weve maximized the site, putting every bit of square footage in that we could and there will be more than adequate parking, something that some other medical offices in Brandon lack, he said.

Boggini said there are no county or state economic incentives tied to the project, but it is expected to result in at least a handful of new permanent jobs for the area.

Florida Cancer Specialists plans to hire eight new employees, in addition to a radiation oncologist, said Brad Prechtl, CEO of the 31-year-old Florida-based company.

Prechtls company, which has 90 locations throughout Florida, has been in Brandon for a decade already, but has outgrown its space on Parsons Avenue. At the new building, it will occupy all of the first floor and will continue to offer traditional oncology treatment, hematology services and research and will add radiation therapy.

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Health care options expanding in east and south Hillsborough

VA doesn't release 140 vet health care probe findings

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WASHINGTON (Tribune News Service) The Department of Veterans Affairs' chief watchdog has not publicly released the findings of 140 health care investigations since 2006, potentially leaving dangerous problems to fester without proper oversight, a USA TODAY analysis of VA documents found.

It is impossible to know how many of the investigations uncovered serious problems without seeing the reports, but all concerned VA medical care provided to veterans or complaints of clinical misconduct.

The VA inspector general declined to provide the reports, say what's in them or why the contents were kept from the public.

"We have not analyzed these reports and therefore cannot offer a specific description of the kinds of reasons," spokeswoman Catherine Gromek said.

She advised requesting the reports under the Freedom of Information Act. USA TODAY submitted a request in January for 23 reports. Joanne Moffett, a special assistant to the inspector general, said Friday officials are "working diligently" to fulfill the request.

Moffett said in general, reports may not be released if allegations are unsubstantiated and disclosing them could damage someone's reputation, when there is a pending lawsuit or when subjects of investigations are no longer working at the VA.

Officials from the inspector general's office did review 26 reports withheld from the public since January 2014 and found less than half -- 46% -- involved unsubstantiated allegations. They said in 42% of the cases, inspectors determined VA officials had already addressed their concerns so a public report was unnecessary. One was the subject of a pending lawsuit.

That's not good enough for Marv Simcakoski, whose son, Jason, a 35-year-old Marine veteran, died of an overdose five months after a report that raised "serious concerns" about "unusually high" opiate-prescription rates at the VA medical center in Tomah, Wis., was completed but kept secret from the public.

He believes there's a "good possibility" his son might be alive if the report had been released. Jason died as an inpatient days after doctors agreed to add another opiate to the 14 medications he was prescribed.

"When something is kept secret, it makes me wonder what else are they hiding?" he said. "If something doesn't get done, there could be other veterans that end up losing their lives."

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VA doesn't release 140 vet health care probe findings

Congressional auditors: VA health care is high-risk

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The Department of Veterans Affairs' vast health network beset by a scandal last year over delayed care has been listed as a high-risk federal program by congressional auditors for the first time.

The report by the watchdog Government Accountability Office, which is issued every two years, includes a broad indictment of the $55.5 billion VA program, one of the nation's largest health care systems. USA TODAY obtained the VA section of the report, scheduled for release Wednesday.

The number of aging or disabled veterans treated by the VA has grown to 8.9 million from 6.8 million in 2002, and Congress has increased funding by 85% during that time.

Yet problems with poor health care, delayed doctor appointments and leadership accountability and oversight persist, according to the report. The GAO said it keeps issuing audits identifying problems eight just last year but more than 100 areas of mismanagement remain unresolved, according to the report.

VA spokesman James Hutton, in a response, said the department is committed to becoming a "model agency" and example for other government programs to emulate.

"In many ways, (the VA health care system) is on the cutting edge of the industry. In other areas, we realize we need to make significant improvements," Hutton said.

Federal agencies or programs are chosen for the high-risk list by the GAO based on such factors as health or safety, delivery of services and incidents of injury or loss of life.

"These risks to the timeliness, cost-effectiveness, quality and safety of veterans' health care, along with persistent weaknesses we have identified in recent years, raises serious concerns about VA's management and oversight of its health care system," the report said. "VA health care is a high-risk area."

The VA became enveloped in scandal last year over allegations that veterans had died waiting for care at a hospital in Phoenix.

The agency's Inspector General office, which launched a probe into the allegations, found that delays contributed to the deaths of VA patients. However, inspectors concluded that delays may have contributed to the deaths of some veterans and that the falsifying of appointment records by VA staffers to hide delays is a systemic problem within the VA health care system.

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Congressional auditors: VA health care is high-risk

Health care coverage gaps to hit local hospitals

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ORLANDO, Fla. -

In just months, tens of thousands of central Floridians will lose their health care coverage. They fall into a gap -- uncovered by Medicaid and making too much for significant stipends afforded by the Affordable Care Act.

[WEB EXTRA: Read the proposed bill ]

"God forbid I get some kind of illness or whatever that I wont be able to get the health care that I need, said 31-year-old Charlene Caines.

Cainescan't get health care coverage. She works and goes to school but falls into the "no coverage" gap.

"She's in the gap. She's too low to qualify for subsidy through the market place or too high and doesn't qualify for the current Medicaid programs,"said Larri Thatcher, of Orange County Legal Aid Bar Association.

For example, a single parent with one child falls into the gap of no coverage if he or she makes between $5,436 a year to $15,730 a year.

More than 50,000 Orange County residents fall into this area.

"In the last month alone we have seen 37 people that have come to legal aid for some other reason, but while here have told us they do not currently have health care coverage,"Thatcher said.

Without Medicaid expansion, 1 million Floridians will continue to go without coverage.

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Health care coverage gaps to hit local hospitals

Supreme Court’s Obamacare Decision: What’s At Stake? | NBC Nightly News – Video

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Supreme Court #39;s Obamacare Decision: What #39;s At Stake? | NBC Nightly News
The Justices #39; decision on Obamacare subsidies would affect millions of Americans who receive them to help pay for health care. Subscribe to NBC News: http://nbcnews.to/SubscribeToNBC ...

By: NBC News

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Supreme Court's Obamacare Decision: What's At Stake? | NBC Nightly News - Video

Kingston hospital front-line staff take in international education thanks to BMO – Video

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Kingston hospital front-line staff take in international education thanks to BMO
Four deserving care providers from Kingston #39;s university hospitals are brushing up on world-leading techniques thanks to a special endowment fund established by BMO. Recipients of the first...

By: UHKFdn

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Kingston hospital front-line staff take in international education thanks to BMO - Video

Health care ministries rely on community to share costs

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Richard and Jaime Wilson didn't have health insurance when the second of their three children was born in 2011, so the couple had to come up with $13,000 in cash to cover the delivery.

But several months later, when the couple had moved to Pittsburgh from North Carolina, checks from people across the country started arriving in the mail.

Accompanying the checks, which eventually added up to $13,000, were letters and cards letting the Wilsons know they were in the donors' prayers.

It was no miracle, but religion and faith played a part.

The Wilsons, who are both 37 and live in McKees Rocks, belong to Samaritan Healthcare Ministries, a Peoria, Ill.-based Christian organization in which members agree to contribute toward each other's medical bills.

Health care sharing ministries are an organized way of passing the hat after church, said James Lansberry, executive vice president of Samaritan. With about 140,000 members, Samaritan is among the largest of such groups in the country.

Christian sharing ministries are experiencing a spike in membership as people look for alternatives to government-mandated health insurance under the federal Affordable Care Act, which was passed in 2010.

There are three national ministries that have about 425,000 members, said Joel Noble, vice president of the Alliance of Health Care Sharing Ministries, a Washington, Ill.-based advocacy group.

Small church-based ministries add another 25,000 members, bringing total membership this year to about 450,000, he said. That's more than double the 200,000 total ministry members in 2013.

Health law exemption

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Health care ministries rely on community to share costs

Utah lawmakers get premium state health care while debating what to give the poor

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Utah legislators, as part-time state workers, are eligible for a package of benefits that includes the health insurance offered to other state employees, including highway patrol officers, motor vehicles clerks and wildlife resource officers.

Under legislation tweaked several times over the years, retired lawmakers also are eligible for medical coverage, depending on when they retire and how many years they have served in the Legislature. Lawmakers who were elected before 2012 and have served 10 years or more can have 100 percent of their health insurance costs covered by taxpayers for life.

The House and Senate denied The Salt Lake Tribune's open-records requests for documents explaining members' insurance benefits and declined to say how many and which lawmakers participate.

The state's Public Employees Health Program declined to provide an exact number or the names of lawmakers who participate, citing the federal health care privacy act, HIPAA.

PEHP did say, however, that year in and year out, more than 90 percent of the 104 lawmakers take one of the insurance plans offered to state employees. And it provided information about the plans.

As soon as they take office, legislators qualify for the same three plans as other state employees, including all permanent full-timers and some part-timers who work at least 20 hours a week.

The plans are called Traditional, STAR and Utah Basic Plus, and each has two tiers distinguished by which network of doctors and hospitals the employee wants to use. STAR and the high-deductible Utah Basic Plus offer tiers that require no monthly premium payments from employees.

Of the state's 23,300 employees, 18,900 take one of the plans.

And whichever route lawmakers choose Healthy Utah, which would cover 89,000 Utahns; or Utah Cares, which proposes to expand coverage to half that number their own insurance is pretty deluxe, said Sen. Luz Escamilla, D-Salt Lake City.

"It is shameful for all of us who have the best health care coverage in the state, which is PEHP, to talk about people who do not have coverage and think that's OK," she said when the Senate was debating a Medicaid expansion bill.

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Utah lawmakers get premium state health care while debating what to give the poor


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