[House Hearing, 118 Congress]
[From the U.S. Government Publishing Office]
THE VA BENEFICIARY TRAVEL SELF-SERVICE.
SYSTEM: MISSION ACCOMPLISHED?
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HEARING
BEFORE THE
SUBCOMMITTEE ON TECHNOLOGY
MODERNIZATION
OF THE
COMMITTEE ON VETERANS' AFFAIRS
U.S. HOUSE OF REPRESENTATIVES
ONE HUNDRED EIGHTEENTH CONGRESS
SECOND SESSION
__________
TUESDAY, JUNE 11, 2024
__________
Serial No. 118-66
__________
Printed for the use of the Committee on Veterans' Affairs
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available via http://govinfo.gov
__________
U.S. GOVERNMENT PUBLISHING OFFICE
56-196 WASHINGTON : 2025
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COMMITTEE ON VETERANS' AFFAIRS
MIKE BOST, Illinois, Chairman
AUMUA AMATA COLEMAN RADEWAGEN, MARK TAKANO, California, Ranking
American Samoa, Vice-Chairwoman Member
JACK BERGMAN, Michigan JULIA BROWNLEY, California
NANCY MACE, South Carolina MIKE LEVIN, California
MATTHEW M. ROSENDALE, SR., Montana CHRIS PAPPAS, New Hampshire
MARIANNETTE MILLER-MEEKS, Iowa FRANK J. MRVAN, Indiana
GREGORY F. MURPHY, North Carolina SHEILA CHERFILUS-MCCORMICK,
C. SCOTT FRANKLIN, Florida Florida
DERRICK VAN ORDEN, Wisconsin CHRISTOPHER R. DELUZIO,
MORGAN LUTTRELL, Texas Pennsylvania
JUAN CISCOMANI, Arizona MORGAN MCGARVEY, Kentucky
ELIJAH CRANE, Arizona DELIA C. RAMIREZ, Illinois
KEITH SELF, Texas GREG LANDSMAN, Ohio
JENNIFER A. KIGGANS, Virginia NIKKI BUDZINSKI, Illinois
Jon Clark, Staff Director
Matt Reel, Democratic Staff Director
SUBCOMMITTEE ON TECHNOLOGY MODERNIZATION
MATTHEW M. ROSENDALE, SR., Montana, Chairman
NANCY MACE, South Carolina SHEILA CHERFILUS-MCCORMICK,
KEITH SELF, Texas Florida, Ranking Member
GREG LANDSMAN, Ohio
Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public
hearing records of the Committee on Veterans' Affairs are also
published in electronic form. The printed hearing record remains the
official version. Because electronic submissions are used to prepare
both printed and electronic versions of the hearing record, the process
of converting between various electronic formats may introduce
unintentional errors or omissions. Such occurrences are inherent in the
current publication process and should diminish as the process is
further refined.
C O N T E N T S
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TUESDAY, JUNE 11, 2024
Page
OPENING STATEMENTS
The Honorable Matthew M. Rosendale, Sr., Chairman................ 1
The Honorable Sheila Cherfilus-McCormick, Ranking Member......... 3
WITNESSES
Panel 1
Mr. Ryan Heiman, Deputy Executive Director for Members Services,
Veterans Health Administration, U.S. Department of Veterans
Affairs........................................................ 4
Accompanied by:
Mr. Benjamin Williams, Veterans Transportation Program
Director, Veterans Health Administration, U.S. Department
of Veterans Affairs
Ms. Carrie Lee, Deputy Chief Information Officer, Office of
Information and Technology , U.S. Department of Veterans
Affairs
Mr. Jon Retzer, Assistant National Legislative Director, Disabled
American Veterans.............................................. 6
APPENDIX
Prepared Statements Of Witnesses
Mr. Ryan Heiman Prepared Statement............................... 31
Mr. Jon Retzer Prepared Statement................................ 36
THE VA BENEFICIARY TRAVEL SELF-SERVICE
SYSTEM: MISSION ACCOMPLISHED?
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TUESDAY, JUNE 11, 2024
Subcommittee on Technology Modernization,
Committee on Veterans' Affairs,
U.S. House of Representatives,
Washington, DC.
The subcommittee met, pursuant to notice, at 4:30 p.m., in
room 360, Cannon House Office Building, Hon. Matt Rosendale
(chairman of the subcommittee) presiding.
Present: Representatives Rosendale, Self, Cherfilus-
McCormick, and Landsman.
Also present: Representatives Miller-Meeks, and Hageman.
OPENING STATEMENT OF MATTHEW M. ROSENDALE, CHAIRMAN
Mr. Rosendale. Good afternoon. The subcommittee will come
to order. Before we proceed, I ask unanimous consent that Dr.
Miller-Meeks and Representative Hageman be permitted to
participate in this hearing. Without objection, so ordered.
I want to welcome our witnesses from the U.S. Department of
Veterans Affairs (VA) and the Disabled American Veterans (DAV).
Today, we are going to discuss the Beneficiary Travel Service
System
[sic], or BTS3. This effort began in 2019 to automate
veterans' travel reimbursements and eliminate improper payments
using a new web-based system. I am sure the idea made perfect
sense and looked good on paper, but in reality, VA blindsided
millions of veterans with a complicated and confusing new
process. Training was minimal and user testing was limited to a
small group of VA employees.
Without warning, the Department deactivated and then
removed the popular Vet-Link kiosk from most of its facilities.
Veterans have been successfully using the kiosk for years, but
veterans struggle with the new website and they continue to
struggle with it today.
I am proud to represent one of the most rural districts in
this country. Montana veterans travel long distances to receive
the healthcare they have earned. I routinely hear from my
constituents about the frustrations with the new systems and
the struggles to get reimbursed on time, if at all. As a result
of these problems, most veterans are relying on the paper
travel reimbursement form and a huge claims backlog developed
that took several years to work down.
We have seen this movie time and time again, unfortunately.
The VA undertakes an ambitious Information Technology (IT)
modernization project to revamp a business process, but it
fails because it is not developed with the user in mind.
Veterans who rely on the system to manage their health or
finances are the ones that get hurt. In this particular
situation BTS3 caused confusion and frustration for veterans
across America who count on receiving travel reimbursements
when their VA medical appointments are not available close to
home, which, based on the $2 billion a year expense associated
with this program, is quite often; maybe another opportunity to
expand local care healthcare delivery. That is an argument for
another day.
This project has been a glaring example of poor planning,
misunderstanding of veterans' needs, and general dysfunction.
According to the Office of Inspector General's report, the
system is a long way from meeting any of its goals. The
contract was signed 8 years ago, but as of last year, only 34
percent of travel reimbursement claims were being submitted
electronically. Eight years. That is far below the goal of 80
percent. The project was supposed to simplify the entire travel
reimbursement process by auto adjudicating 90 percent of the
claims, but as of last year, the system was only able to auto
adjudicate about 40 percent.
Veterans submit about 6 million travel reimbursement claims
every year. A majority of those claims have to be keyed into
the BTS3 system manually. Worse, the software is completely
unable to auto adjudicate travel reimbursements for community
care, so 100 percent of those claims have to be manually
reviewed. More than 4 years after the system was rolled out,
the VA still does not have a good solution for that. VA
actually had to add about 140 more employees to process the
travel claims manually.
The project's budget started at $11 million, which is
modest compared to Oracle or the supply chain modernization,
but I understand now that it has doubled. The budget does not
seem to include all the additional expense from the extra
staffing and reworking, and it surely does not account for all
the veterans' frustration and wasted time. I expect clear
answers from our witnesses about the path forward.
Despite several years of software updates, the BTS3 system
is still too difficult to log into, too slow to load, and too
confusing to navigate. We learned that the VA is planning to
fold it into VA.gov soon. Given the difficulties that other
parts of the VA.gov have experienced recently, that
consolidation needs to be handled very carefully. Now that the
VA has shown that the kiosks can be integrated with BTS3, we
need to see an orderly plan to reintroduce the kiosk where the
veterans want them.
Most of all, we need to know that any further changes to
this system and the travel reimbursement process will be tested
by real veterans and clearly communicated before anything gets
pushed out. We cannot allow another VA IT project, even a
relatively small project, to escape scrutiny while it burns
through taxpayers' dollars and undermines veterans' care.
Once again, I want to thank our witnesses for joining us
today. With that, I will yield to Ranking Member Cherfilus-
McCormick for your opening statement.
OPENING STATEMENT OF SHEILA CHERFILUS-MCCORMICK, RANKING MEMBER
Ms. Cherfilus-McCormick. Thank you, Mr. Chairman, and I
would like to say thank you to our witnesses for being here
today.
Over the year, VA has taken on many programs that seek to
make healthcare access at VA more equitable for all veterans.
Today's topic, the Beneficiary Travel Service Systems--Self-
Service System, BTS3, is one of those efforts to help relieve
veterans' expenses incurred while traveling to approved
healthcare appointments.
In Fiscal Year 2021, Veterans Health Administration (VHA)
reimbursed over $1.3 billion in travel expenses to veterans.
That is $1.3 billion worth of mileage compensation, tolls,
parking, and in some cases, airfare and specialized
transportation costs. Reimbursing these costs is important to
building trust with veterans and not inflicting financial
hardships while veterans utilize the healthcare they have
rightfully earned.
Historically, veterans have relied on a paper-based process
that required VA personnel to manually enter the data into VA's
legacy electronic healthcare records, Veterans Health
Information Systems and Technology Architecture (VistA). VA has
been trying to replace that system for the past 5 years, but
that is a conversation for another year, another day.
BTS3 is an attempt to modernize VA's legacy beneficiary
travel program by adding additional electronic functionalities,
like electronic submission, automated adjudication, and
improper payment detection. These features aim to decrease
administrative efforts, erroneous payments, and processing
times. However, a May 2023 report from VA's Office of Inspector
General found that the new system was not meeting any of its
four established goals regarding auto adjudication, system
usage, manual overrides, or self-service utilization.
Since the release of the report, VHA has taken steps to
address these failures. Recent data has shown improvements
across these key matrix, like auto adjudication, payment
timeliness, and improper payment rates. For example, in Fiscal
Year 2021, BTS3 faced nearly 14 percent improper payment rates,
and only 20 percent of the claims were auto adjudicated. In
Fiscal Year 2023, over 40 percent of the claims were auto
adjudicated and improper payments were actually down to under 7
percent. While these matrices still do not meet the set goals
established by the Veterans Transportation Office, I am glad to
see that the VA is growth in this area.
However, despite these promising improvements, I remain
concerned on several fronts. In our pre-brief hearing last
week, we learned that in January, 8 years after the contract
was awarded, Office of Information and Technology (OIT) began
discussing the need for a governance structure within the BTS3
program. I am fairly concerned that if a solid governance
structure had been in place from the very beginning, it would
not have taken 8 years to deploy this product.
It seems that we hear the same issue every time we talk
about a VA IT modernization effort: poor requirement
development, poor change management, poor governance
structures, millions of dollars spent on programs that does not
meet VA's needs. It is long past the point where we must have a
conversation about why the VA cannot learn from its past
mistakes. Veterans, VA employees, and the American taxpayers
deserve better than this.
Further, I remain concerned about the future of this
project in light of the nearly 50 percent cuts to the VA's IT
modernization budget. When we pit modernization efforts against
each other for funding, it is not just the infrastructure or VA
employees that face challenges. It is a disservice to veterans
as well.
Finally, I have concerns since I joined this subcommittee
about some of the other choices that the VA has made. While
modernization is necessary, we cannot leave out our less tech
savvy or our lower income veterans behind. There are many who
do not have access to smartphones, laptops, or even home
Internet. Because of this, VA's decision to remove the kiosks
and limit the paper filing of claims has caused undue stress on
some of our most vulnerable veterans. I look forward to
continuing to work with VA as they deploy further strategies to
engage both veterans and VA employees with technology and
improve data collection for both VA and the community care
providers to ensure timely and correct reimbursements to
veterans.
I would be remiss if I did not mention the importance of
Veterans Health Administration (VSO) partners here as well. Our
VSOs often play a key role in facilitating veterans'
interaction with VA healthcare and benefits. I look forward to
hearing from DAV today and how they and their members feel BTS3
rollout has been going.
Thank you, Mr. Chairman. I yield back.
Mr. Rosendale. Thank you, Ranking Member Cherfilus-
McCormick. I will now introduce the witnesses on our first and
only panel today.
First, from the Department of Veterans Affairs, we have Mr.
Ryan Heiman. Heman? Heman. Heiman. Okay. Mr. Ryan Heiman, the
Deputy Executive Director for Member Services in the Veterans
Health Administration. We also have Mr. Benjamin Williams, the
Director of the Veterans Transportation Program. We have Ms.
Carrie Lee, the Deputy Chief Information Officer for Product
Engineering. Finally, we have Mr. John Retzer, Assistant
National Legislative Director for Disabled American Veterans.
I ask the witnesses to please stand and raise your right
hand.
[Witnesses sworn.]
Mr. Rosendale. Please let the record show that each one has
responded in the affirmative. Thank you very much.
Mr. Heiman, you are now recognized for 5 minutes to deliver
your opening statement on behalf of the VA.
STATEMENT OF RYAN HEIMAN
Mr. Heiman. Chairman Rosendale, Ranking Member Cherfilus-
McCormick, and members of the subcommittee, thank you for this
opportunity to appear before you today to discuss VA's
Beneficiary Travel Self-Service System, or BTS3. I am joined
today by Ms. Carrie Lee, Deputy Chief Information Officer, and
Mr. Ben Williams, Director of the Veterans Transportation
Program.
The Beneficiary Travel program is crucial for eligible
Veterans providing essential travel reimbursement and
transportation services to ensure access to necessary health
care. It addresses the financial and logistical challenges of
travel for medical care by reimbursing eligible Veterans for
expenses. The program enhances access to medical appointments
and reduces their financial stress.
With the introduction of BTS3, VA transformed the travel
claim process, providing Veterans the ability to submit claims
online 24/7/365 and improving the agency's ability to pay
eligible Veterans correctly. The BT System underwent phased
implementation with testing in July 2020 and national
deployment from September to December 2020.
During the transition, claims processing time increased due
to manually scanning paper claims. To manage frontline
challenges with the adoption of a new system and during the
COVID-19 pandemic, VA extended the legacy system alongside
BTS3, delaying this full implementation but allowing for user
experience enhancements. During the same time, VA imposed a 10-
day inventory goal in March 2021 to improve efficiency and
visibility of open BT claims.
VA closely monitored critical performance indicators and
redesigned the BTS3 rules engine to improve efficiency. By
December 2023, the BT system became the exclusive solution,
offering self-service options, automated rules engines, and
internal controls to ensure proper payment.
VA has made significant improvements to the BT system in
response to the 2023 OIG report. The report identified four key
areas that had not been met, including auto adjudication rate,
veteran feedback, legacy system decommissioning, and the
reconciliation of duplicate payments. All but one of the OIG
recommendations have been remediated and closed out. The
remaining recommendation related to auto adjudication was
launched this past month.
Stakeholder feedback has been crucial in identifying areas
for improvement within the BT system. Since October 2023, VA
has received over 11,000 veteran surveys, with the most desired
improvements being claims automation and process
simplification. Eighty percent of those survey respondents have
been identified as over the age of 50. Recent improvements
instituted as a direct result of this feedback has shown 17
percent increase in ease and simplicity of use, as well as a 16
percent increase in overall satisfaction.
Instituting a veteran-centric approach, VA is continuing to
enhance the system's design, functionality, and user experience
through fiscal years 2024 and 2025. Two of these planned
enhancements include the expansion of the system's text-
initiated claim submission process and integration of the
travel claim feature to the VA health and benefits mobile
application. The veteran facing experience of the BT system
will also be transitioned to VA.gov platform over the next 18
months, providing seamless integration with other digital
health solutions.
Chairman Rosendale and Ranking Member Cherfilus-McCormick,
thank you once more for the opportunity to speak with you
today. VA remains deeply committed to expanding self-service
options and streamlining the BT reimbursement process to
enhance the overall healthcare experience for veterans. We
value your ongoing engagement as we embrace our shared
responsibility to better serve those who have served. My
colleagues and I are prepared to answer questions that you may
have. Thank you.
[The Prepared Statement Of Ryan Heiman Appears In The
Appendix]
Mr. Rosendale. Thank you, Mr. Heiman. The written record--
written statement of Mr. Heiman will be entered into the
hearing record.
Mr. Retzer, you are now recognized for 5 minutes to deliver
your opening statement on behalf of DAV.
STATEMENT OF JON RETZER
Mr. Retzer. Thank you. Chairman Rosendale, Ranking Member
Cherfilus-McCormick, and members of the subcommittee, DAV is
pleased to offer our perspectives on the VA Beneficiary Travel
Self-Service System.
VA launched a web-based system in September 2016 to
automate travel reimbursement claims, reduce costs, and
mitigate payment errors. In November 2020, VA transitioned from
the travel reimbursement kiosk machines at VA medical
facilities to the self-service system, computer-based program
nationwide. According to the May 21, 2023, Office of Inspector
General report, the program office took almost 5 months after
the system launched to provide veterans and veteran service
organizations training on entering claims in the self-service
system.
VA only sought feedback from a small group of veterans who
worked in the program office during the system development,
which excluded both veterans and veterans service
organizations. Many veterans have expressed disappointment in
the new system and noted that the current enhancements are not
user-friendly, lengthy in time, and delay timely travel
reimbursement. Currently, veterans who have a VA.gov or My
HealtheVet account must go to two logins to two sites, four
screen changes just to begin the new travel reimbursement
process. We appreciate VA is trying to address the issues to
streamline these processes with the one site, one password
access. However, it is important to address the system delays,
multiple screen changes that add to lag times, and the need for
verification when appointments are not at the VA medical
centers.
However, Chairman Rosendale, not all veterans appreciate
the self-service system. Veterans want the option to file their
reimbursement claims at the medical facilities. Although we
appreciate the innovation of mobile tech's features for
reimbursement, it has presented challenges, in some locations
due to lack of staffing knowledge or facilities not being
enrolled in the new process.
To enhance the self-service portal usage, it is recommended
that the Veterans Health Administration engage in outreach to
veterans and the veterans service organizations, actively seek
feedback, and assess the need for system changes based on the
feedback they receive. Veterans have shared with the DAV
recommended changes should include the return of the kiosks at
all medical facilities, onsite computer access for filing
beneficiary travel claims for those who have access, and direct
assistance at the front desk for submitting reimbursement
claims during check-in and check-out for appointments. DAV
recommends all VA facilities should improve their signage and
communication of their resources to assist veterans to onsite
computers that can access self-service system or other facility
resources to file their claims.
As VA considers improvement to the self-service system, we
remind VA that there are veterans who lack access to personal
computers, laptops, tablets, smartphones, and adequate
bandwidth. Also, many veterans lack familiarity or comfort with
online web-based technology. DAV recommends the Department
improves onsite real-time services by integrating necessary
data and banking information from the Veterans Benefits
Administration to the Veterans Health Administration.
Additionally, deploying digital signature pads and onsite
ID verification technology can expand and enable the medical
facility staff to use internal access to the self-service
system in filing digital reimbursement claims for veterans who
have difficulty filing through the web-based program and
eliminates the paper claims form process which delays timely
receipt of the reimbursements.
Chairman Rosendale, although we appreciate that VA is
working to improve these issues in benefits travel
reimbursement program, simply addressing the self-service
innovations for veterans is not enough. The VA travel mileage
reimbursement rate has not kept up with the rising gas prices
and the cost of auto maintenance and insurance. As a result,
these expenses can hinder access to care for some veterans.
Currently, veterans' mileage reimbursement rate is at 41.5
cents per mile compared to the Government Services
Administration rate for government employees currently at 67
cents per mile.
In conclusion, we urge the Secretary to exercise his full
authority and align mileage reimbursement rates for veterans
with government employee rates, while also ensuring subsequent
changes stay in line with changes of the Government Service
Administration rates in the future.
Chairman Rosendale, this concludes my testimony and I am
pleased to answer questions you or members of the subcommittee
may have.
[The Prepared Statement Of Jon Retzer Appears In The
Appendix]
Mr. Rosendale. Thank you very much, Mr. Retzer. The written
statement of Mr. Retzer will be entered into the hearing
record.
We will now proceed to questioning and I will recognize
myself for 5 minutes to kick this off.
Mr. Williams, is the BTS3 system working as it ought per
the contract requirements?
Mr. Williams. Thank you, Chairman, for the question. I will
get this started and then I will pass to Ms. Lee as it is an
OIT-managed contract for the design and sustainment of the
system.
Mr. Rosendale. Could you bring your microphone just a bit
closer to your mouth, please?
Mr. Williams. Yes, sir. Better?
Mr. Rosendale. A little bit.
Mr. Williams. I will speak up. How about that?
Mr. Rosendale. Thank you.
Mr. Williams. Yes, sir. The system is working as designed
currently and I do not have issues and I feel that the----
Mr. Rosendale. You say it is acting as per the contract
requirements?
Mr. Williams. It is operating as designed from the VHA
perspective.
Mr. Rosendale. Is it acting as per the contract
requirements?
Mr. Williams. I will have to defer to Ms. Lee for that, to
answer that question.
Mr. Rosendale. Thank you.
Ms. Lee. Yes, the system is acting as required by the
contract. The system was developed based on the requirements
that the government gave to the contractor.
Mr. Rosendale. The contract requirements allow for 40
percent of these claims to be adjudicated. The goal that you
set is 80 percent and the contract literally allows for only 40
percent of this to be done? If that is the case, then we have
got a serious procurement problem here. Is that the case? The
contract allows for a complete inefficiency, ineffectiveness?
Ms. Lee. I will need to take that for the record because I
do not know the details of the exact contract.
Mr. Rosendale. Well, then please do not comment, okay, when
I ask, is it functioning as per the contract requirements if
you do not know what the contract requirements are. I do not
know is acceptable, but find the answer out for me, please.
Ms. Lee. Will do.
Mr. Rosendale. Thank you very much. Mr. Williams, how much
has the VA spent on this project, including the contract and
any other costs to date?
Mr. Williams. Sir, I will defer to Ms. Lee on that as well.
Mr. Rosendale. Ms. Lee, go ahead.
Ms. Lee. To date, the estimated amount spent is $36
million.
Mr. Rosendale. Excuse me?
Ms. Lee. Thirty-six million dollars from the time of the
projects.
Mr. Rosendale. Okay, $36 million. Does that include all the
extra staffing, the 140 staff that have been placed on as well?
Ms. Lee. That includes--that is the cost for the IT system.
I would have to pass to my VHA cohorts for the VHA costs
associated.
Mr. Rosendale. Okay. We have got $36 million for the
software program itself, where that does not--am I assuming
that does not include the additional expense for the 140 extra
staff?
Mr. Heiman. That is correct.
Mr. Rosendale. Okay. We originally were supposed to be at
$11 million, correct?
Mr. Heiman. That is correct.
Mr. Rosendale. Okay. Quick math, a four function
calculator. You are already three times what the original cost
was estimated to be, and it is only doing 40 percent of what it
was supposed to, correct?
Mr. Heiman. For the automation portion, yes. For the
record, I would also add that one of the really great benefits
has been the associated improper payments that 5 years ago was
at 25 percent.
Mr. Rosendale. I see that. As a matter of fact, I was
looking at those numbers, and while it is at--in 2019, it was
18.79 percent. In 2021, it was almost 14 percent. Now we have
got it down to 6.83 percent. That sounds like a really great
achievement. The problem is, in 2021, it was $123 million, and
in 2023, that 6.8 percent translates into $120 million. Do not
stretch your arm patting yourself on the back, okay? You saved
$3 million. Percentages are very attractive, but dollars are
what this committee is concerned with.
Before I go into anything else, I am going to go ahead and
yield 5 minutes to Ranking Member Cherfilus-McCormick so she
can begin her questioning.
Ms. Cherfilus-McCormick. Thank you, Mr. Chairman. Mr.
Heiman, in our May hearing on the IT budget, VA witnesses noted
that they felt that the budget request was sufficient to keep
all its IT modernization efforts moving forward at the same
pace. How does the VA plan to manage the upkeep and
implementation of the new BTS3 technology and ensure that VA
has--VHA staff are prepared to effectively address challenges
in the claims process?
Mr. Heiman. Ranking Member Cherfilus-McCormick, thank you
for that question. For the first part, I will say that we have
a very strong partnership with OIT, and we feel very confident.
I will let Ms. Lee speak to that portion for our out-year plan.
As it relates to maintaining the claims volume, really
important work is being done. I mentioned it as part of our OIG
recommendation that they gave to us to improve automation.
We are approximately at 46 percent, as the Chair had
referenced. We deployed that release May 30th. Most recently,
over the course of the last 10 days, we have seen that auto-
adjudication rate raise as high as 70, 80 percent. We are
really excited. We are continuing to monitor that, of course,
but that is a very large workload that is being processed by
the system as it was designed. Ms. Lee.
Ms. Cherfilus-McCormick. What did you change?
Mr. Heiman. I am sorry. What did we change as for the
release?
Ms. Cherfilus-McCormick. Mm-hmm.
Mr. Heiman. Yes, so what the release was in association
with the rules engine and how a Veteran's claim essentially
bounces against different requirements that we have in order to
be able to process that effectively and eventually pay that
claim. Those improvements, as we have learned more about the
system and have been able to build additional capability in, is
what has made that improvement to the automation.
Ms. Cherfilus-McCormick. Did you lower the requirements?
Mr. Heiman. No. Lowering the requirements? I think we had
very strict, very, very strict requirements and the intent,
again, originally because of OIG's recommendation many years
ago, was in part because of the paper claim challenges and
those volumes that was difficult to track. The system itself
has been able to be improved, I would say. Truth be told, you
can look no further than our improper rates that are holding as
we continue to make these updates.
Ms. Cherfilus-McCormick. Do you think that BTS3 has enough
funding to address the issues with latency and the login
struggles that we have heard about by veterans?
Mr. Heiman. Yes. To your first question, I will ask Ms. Lee
to talk about 24 and 25, and then also cover any latency.
Ms. Lee. Yes. As part of our The Sergeant First Class Heath
Robinson Honoring our Promise to Address Comprehensive Toxics
(PACT) Act efforts, and thank you for the PACT Act, we are
modernizing the BTS3 system and using the Toxic Exposure Fund
(TEF) funding to help with those modernization efforts. As you
know, our current congressional budget is--we are making
tradeoffs, and since we have the PACT Act authority, we are
able to use that TEF funding to be able to make additional
improvements where our base budget does not have enough
funding.
Ms. Cherfilus-McCormick. Now, this is questions for Mr.
Heiman, Mr. Reid's [sic] testimony, we heard about many
challenges that the veterans are facing in accessing BTS3 and
technology in general. I was glad to hear that the veterans had
an option to utilize different modalities for submitting travel
reimbursements. With an increased focus on BTS3 and the kiosks
usage, how does VA plan to continue bridging the digital
divide?
Mr. Heiman. Yes, absolutely. I will touch on probably a
couple topics here, but we have recently integrated also with
My HealtheVet. A lot of veterans like My HealtheVet, they use
it for various different reasons to interact with their
healthcare experience. BTS3 is also now integrated with My
HealtheVet, so they can log directly from their My HealtheVet
account.
As you mentioned, kiosks have been mentioned a few times,
and we know they are or had been popular. While my office does
not own the properties of the kiosks necessarily, we have
pressed forward to integrate with the kiosks that do exist out
there. In fact, there is 38 VA Medical Centers that----
Ms. Cherfilus-McCormick. I only have 16 or 15 seconds left.
Mr. Heiman. Sure.
Ms. Cherfilus-McCormick. I just have a real quick question.
Are there any methodologies that you are evaluating?
Mr. Heiman. Yes. We have, through the digital health
office, we have a multidisciplinary team, OIT's included in it,
Veterans Experience Office. We are looking at what we would
call on-premise devices and how those may be best used in
veterans' healthcare, how they can interact with those.
Ms. Cherfilus-McCormick. Thank you. I yield back.
Mr. Rosendale. Thank you very much.
I now recognize Representative Self for 5 minutes of
questioning.
Mr. Self. Thank you, Mr. Chairman.
Much of what we deal with on this committee is, frankly,
leadership decisions. Mr. Williams, how long have you been in
your position?
Mr. Williams. Thank you for the question. I started with
the Veteran Transportation Program in March 2019.
Mr. Self. Okay, very good. I am curious about your decision
to go exclusive in December 2023, I think it was. Why did you
make that decision with the lack of--why did not you do a soft
opening? Why did you make that decision with a lack of testing
that you did?
Mr. Williams. Sir, for clarity, we did operate both
processing systems, so the legacy processing tool in VistA, as
well as BTS3. We operated those simultaneously from 2021 or,
sorry, from the inception of BTS3 until December 2023. We felt
that that was a very smart move by leadership to be able to
leave the legacy system open, which some facilities and some
staff prefer to process in, especially during the COVID
pandemic, and some of the administrative staffing challenges
that all businesses had during that time.
As we continued to move forward and the system started to
pick up pace as it pertains to usability, and we were able to
address some of the staff as well as some of the concerns from
Veterans about the system, in addition to the Inspector
General's (IG) recommendation to decommission the legacy tool,
that is when the agency made the determination that it was time
to go exclusively on the processing side to BTS3.
Mr. Self. Well, several of you have mentioned the age, the
lack of technology skills, if you will, with the veteran
population. Do you stand by that decision to go exclusive,
knowing the issues that the population had?
Mr. Williams. I do. I think it was very important to
mitigate some of the risks of duplicating payments, as well as
to ensure that across the enterprise, we were able to take
advantage of the internal controls that the system provides. I
do think it was the right decision.
Again, from a processing modality perspective, it does
provide us the ability to ensure we are making proper payments
to Veterans. When you look at the entire population of claims
across the enterprise, we are making 83 percent of those
payments for those claims within 10 days. 90 percent of those
claims are being paid within 20 days.
Mr. Self. Yes, I do not have time to ask the next question.
Obviously, the concern here is with rural districts. You have
got some members here. Just consider, did you do any
consideration for rural districts? I do not represent--well, I
do, but not as rural as some of the members.
You started off requiring 62 individual rules all be
perfect. Walk me through how you have loosened those rules,
very quickly.
Mr. Williams. We did a rules engine redesign to smartly, I
will say, compartmentalize and----
Mr. Self. Did you prioritize the rules?
Mr. Williams. Yes.
Mr. Self. All 62?
Mr. Williams. Yes.
Mr. Self. Okay. There is an old adage in business: price,
speed, and quality, you only get two. Mr. Heiman, which two did
you prioritize at the beginning and which two do you prioritize
today? Price, speed, and quality, you only get two.
Mr. Heiman. Yep. I think we chose quality and price, and I
think we are starting to feel the effects of speed and quality
as of lately.
Mr. Self. Yes, I would disagree with your original
prioritization. I think you prioritize speed and sacrificed
quality, but that is arguable.
Mr. Heiman, you heard Mr. Retzer's solutions. How much
would they cost? Ballpark.
Mr. Heiman. I would have to defer that to Ms. Lee. I am not
sure on some of the technologies that he was----
Mr. Self. I think I will submit that question for the
record, because I would like to--you can obviously get his
testimony. I would kind of like to see a ballpark of his
solutions.
With that, Mr. Chairman, I yield back. Thank you.
Mr. Rosendale. Thank you very much.
I will now recognize Representative Landsman.
Mr. Landsman. Thank you, Mr. Chair. I want to talk a little
bit about performance measures and the kiosk.
I am from Cincinnati and Hamilton County. We have had
issues with transportation and getting veterans where they need
to be. Of course, you know, their ability to get reimbursed,
and reimbursed quickly is a part of that.
The contract, you all started the process, as I understand,
in 2016. Full implementation, maybe 7 years later, in 2023. I
do not know if that is normal or slow, but that does seem like
a long period of time, but maybe that is how long it takes. You
know, did tests. The 23--did you say 23 or 30? How much did you
say, Ms. Lee? I know it did not include staffing, but the cost
itself.
Ms. Lee. Thirty-six million.
Mr. Landsman. Thirty-six.
Ms. Lee. That is from 2016 until present.
Mr. Landsman. Yes, $36 million, again, do not know if that
is, you know, based on the scope, a good number. What I did see
that was very alarming, was the time it is taking. Before, my
understanding was that items would get processed in a couple
minutes, and now it is anywhere between 7 and 12 minutes to get
processed. I am not sure if that is true or not. I am curious,
and this gets at the chair's question about performance
measures. Obviously, I would love to know the contract-related
performance measures, but does BTS3 have performance measures?
What are those performance measures? What are the most
important ones in terms of getting better at ensuring that
veterans get reimbursed in a timely manner, A, B, I know that
kiosks is not your department, Mr. Heiman, but I would just ask
that we get some additional kiosks. How do we request kiosks?
You know, not to be selfish here, but I am wondering how we get
more kiosks. We can do the performance measures first, and then
see if I cannot get us a kiosk.
Mr. Heiman. Yes. Thank you, Representative Landsman. I
think I got most of it, but if not, you are welcome to follow
up, too.
We definitely have performance metrics. Quite frankly, your
area of Cincinnati is doing quite well under a 10-day
processing time, on average, which is great. I would say that
that is true of, really, the entire landscape of VA, across all
of VA Medical Centers. We are, again, paying, as I think Ben
referenced earlier, to the tune of 80 percent of all claims
within 10 days. When you look at the 20-day mark, it is over 90
percent that we are able to pay within that 20 days.
We have many metrics. Obviously, the auto adjudication we
have talked about, we also look at Veteran utilization in that
space. We have many metrics and are happy to share that with
the committee as well.
To the cost----
Mr. Landsman. Just because I want to make sure it is on the
record, I would love that to be submitted to each of the
members, all of the performance measures. Thank you.
Mr. Heiman. Yep. Then to the cost, I understand that there
was some concerns about $36 million, but to the tune of
improper payments, we are saving $90 million projected a year.
The math on that certainly does add up for us.
Then, as per kiosks----
Mr. Landsman. Yes.
Mr. Heiman [continuing]. great question. Popular topic.
Again, we are looking at on-premise devices. I will say the
current--currently we have 38 facilities. There are 754 kiosks
out there, okay, so we do have kiosks. They are not at every VA
medical center. We definitely hear that from congressional
members, from our partners in DAV and otherwise. We have a team
that is assessing what that will look like in the future and
how we make sure the veterans have devices in their hands that
they can interact with their healthcare.
Mr. Landsman. I suspect others will feel the same. What is
the process about, you know, in terms of engaging you all and
getting additional kiosks? It is a very popular tool.
Mr. Heiman. I do not know the formal process. I think you
certainly can request for the record, I guess, that we give you
what we have on the roadmap. We are planning to provide some
recommendations to VHA leadership as well.
Mr. Landsman. I think in addition to the recommendations, I
will request, you know, as many as we can for our district and
our veterans.
Thank you. I yield back.
Mr. Rosendale. Thank you, Representative Landsman.
Mr. Heiman, I mean, that is great. We are hearing about how
great and wonderful this system is working. Again, 4 years
later, 45 percent of travel reimbursement claims are submitted
electronically in BTS3, 45 percent. Only 52 percent of claims
are adjudicated automatically without manual review. While the
veterans are getting their compensation back, I have to think
that that is due in part to 140 extra employees there to help
our veterans through the system. Mr. Williams, is the plan to
keep paying the contractor? I mean, we are $36 million into an
$11 million contract. Okay? Is the plan to continue to keep
paying the contractor until they get it right? We are 4 years
into it and it is not right.
Mr. Williams. Sir, I will have to direct that to Ms. Lee.
Ms. Lee. The contractor work is guided by VA employees and
so we will continue to work with a contractor to make
improvements. It is the VA employees that are providing the
requirements and so they are building toward those
requirements----
Mr. Rosendale. Okay. I am gonna need----
Ms. Lee [continuing]. on our roadmap.
Mr. Rosendale. Okay. I am going to need, and whoever gets
that, whether it is staff or whether it is Ms. Lee, I need a
copy of this contract. Okay? I need a copy of the Matrix
because I want to be able to see why in the world we have yet
another vendor who is getting enriched to the tune of millions
of dollars while they are not delivering the system that we are
supposed to have.
Mr. Williams, BTS3 was created in part to process more
travel claims with fewer people through automation. According
to the OIG report, VA had to hire 148 employees to manually
process the claims and deal with the backlog created by BTS3's
failed auto adjudication. What are those 148 employees doing
today?
Mr. Williams. Sir, they are currently processing the paper
claims that are----
Mr. Rosendale. Okay. They are inputting this stuff
manually.
Mr. Williams. Yes, sir.
Mr. Rosendale. How much money has the VA spent to hire
employees to compensate for the system's failings? Does
anybody--can anybody give me that?
Mr. Heiman. We can get the cost of those team members that
we are----
Mr. Rosendale. Okay. We want to get that 148, what the cost
associated with them, both their current, when they started, so
that we can see exactly what the system is because, clearly,
the $36 million is not covering what the true expense
associated with this is.
Mr. Williams, would not it be better to place those
employees in the medical centers to directly assist the
veterans with their travel reimbursements as Mr. Retzer
actually recommended?
Mr. Williams. Yes, sir, Chair, we agree with that. We are
working with the facility leadership to ensure that we free up
as many resources.
Mr. Rosendale. My question is, are we going to place these
employees actually in the centers or are we going to bring
another round of employees, leave the 148 at whatever
facilities they are at now for inputting all this information,
and then bring another round of employees to place them out
into the facilities themselves?
Mr. Williams. No, sir, we are not bringing in another round
of folks to do this.
Mr. Rosendale. We are looking at dispersing these 148
individuals out into the facilities?
Mr. Williams. They are at the facilities currently, sir.
Mr. Rosendale. Okay. I would like to see the list of--I do
not need names, but I want to see the list of the facilities
that have these extra people that are dedicated toward
exclusively helping our veterans get this travel program
reimbursement back. I want to see where they are located, how
many there are, and so that we can see what facilities are
still lacking and do not have that. Would not it be more
economical to keep the kiosk based on all these numbers? Mr.
Heiman, Mr. Williams, whoever would like to.
Mr. Heiman. Yes. I will say that the legacy kiosks prior to
our integration just spit out a piece of paper for somebody to
process in an office. Now it is integrated. The kiosks that
exist today, we have integrated to where that information they
are putting in the kiosk goes directly to BTSSS. 5 years ago
that was not the case.
Mr. Rosendale. Mr. Williams, how do you measure the
veterans dissatisfaction and the cost imposed on them by BTS3
and the lapses when they do not receive their funds on time?
Mr. Williams. Sir, I do not think that we can specifically
measure that. I can tell you that through work that we have
done since implementing the system and getting veteran feedback
as well as partnership, my team, our team met with Mr. Retzer a
month or so ago and we are attending all eight of the VSO
conventions this year, that continued partnership, listening to
the VSOs, working with them on a regular basis, as well as
taking the feedback directly from veterans to make--to use to
prioritize the changes to the system.
Mr. Rosendale. I would include Mr. Retzer in those
conversations because he seems to have his hand on the pulse.
Mr. Williams. Yes, sir.
Mr. Rosendale. With that, Ranking Member Cherfilus-
McCormick, I yield you.
Ms. Cherfilus-McCormick. Thank you, Mr. Chairman. I wanted
to go back, Mr. Heiman, to the conversation about the kiosk
replacement. What role does the VSOs or veterans have in the
decision-making?
Mr. Heiman. Associated with kiosks? I apologize. I think
that--I think we have a strong partnership with many of the
VSOs. I would say that probably along the decision-making
process, I am not sure that there is an active requirement
there, but.
Ms. Cherfilus-McCormick. Do they play no role? I am trying
to figure out because they have--the veterans are trying to
access, they prefer the kiosks. The VSOs have also been in the
process. Their partnership in it, does it have any role in any
decisions that are being made?
Mr. Heiman. Absolutely. Yes, absolutely.
Ms. Cherfilus-McCormick. What is that role?
Mr. Heiman. Similar to, as Mr. Williams had mentioned, we
met, I think beginning of May. Previous to that, we had met
with Mr. Retzer, I believe in February. That continual--those
listening sessions and being able to understand because, you
know, for example, DAV has a tremendous reach into communities
across this country for veterans, and certainly we take note of
that. Many of their recommendations are things that we are
working in partnership with.
Ms. Cherfilus-McCormick. Mr. Retzer, what should that role
be?
Mr. Retzer. Thank you for that question. I think one thing,
it is true just this year, however, it is a little late. You
know, we would have preferred it upfront before the development
happened that they engaged us so that we could express the
needs of our veterans, but they have engaged since February and
we have met two to three times already. We proposed some ideas
with regards to improving the system.
One of the things that is really challenging is, and this
gives light to what, you know, the committee is looking for,
our veterans really want this. Like DAV, we have over a million
members. This is one of our resolutions we voted on in August
of last year, that the BTS system must be improved. It shows
you that this is really important to them. At a cost of what it
may be for them to make it, we need to make sure that VA
understands they should not have replaced the system in full.
They should have kept things that were working in place for our
veterans.
They need to be reminded that our veterans are aging. That
is another barrier that is happening. As our veteran population
ages, technology is not comfortable for them. They want to be
able to have VA do the customer experience, the veterans
experience for them. We are going to work and continue to work
with the VA to help them.
We do wish to be more involved in rule-basing, because one
of the things that we are hearing about the rule base is when
we know most of our veterans are just getting mileage
reimbursement. That mileage reimbursement is about point A to
point B and back to point A, home to facility and back home.
They may alter that choice, so the automated decision process
has then been kicked out if there is some extenuating
circumstance that you are not using the primary direction that
was set up in the system. That should not be, that is a
barrier. They need to remove barriers like that out of the
system. They need to look at their algorithm. The best way they
are going to get those algorithms is by talking to Veteran
Service Organizations and veterans.
Ms. Cherfilus-McCormick. Mr. Heiman, how is the VA
measuring utilization rates with their kiosks? How is the VA
using the data to bolster kiosk usage as it reintegrates these
technologies back into the VA, MCs, and other VA facilities?
Mr. Heiman. Yes. Thank you, Ranking Member. The utilization
rates for the kiosks now that we have BTS3 integration is able
to be tracked. That is one of the good things about the
integration. We can tell what percentage of claims are being
entered through the 38 sites that have kiosks of those 754
kiosks that exist out there. It ranges across those sites that
do have those, but that is something that certainly we can get
if you have interest in a particular area.
Ms. Cherfilus-McCormick. This is for Mr. Retzer. One of the
barriers toward enrollment that OIG identified was issues with
access to VA, which in some cases led to veterans not signing
up for our utilization--or utilizing these benefits. Can you
share more about how these barriers impact veterans' usage of
BTS3?
Mr. Retzer. Yes. Barriers that exist are digital divide
barriers upfront. That is one of the issues that we have. Like
I said in my testimony, in the written and oral, they are
challenged, but one with access to technology and its
bandwidth.
I was just in Iowa this past weekend talking to our members
out there who are in rural and also in metropolitans. They are
not satisfied with the BTS3 and the way it has functioned
because of these barriers. They are also challenged with the
technological requirements that require them to have accounts.
ID.me, they spoke about how they are not appreciative of how
ID.me is restrictive and how confusing it is even to set up an
account. Also, that the fact is that the system is in two
worlds.
We appreciate the fact that VA is working on improving it,
but they need to have a solution now for our veterans because
they cant wait for their reimbursements. We need to ensure that
technology and legacy processes are working together seamlessly
for all of our veterans, rather than thinking a one-size-fit-
all concept.
Ms. Cherfilus-McCormick. Thank you, I yield back.
Mr. Rosendale. Representative Self, I recognize you for 5
minutes of questioning.
Mr. Self. Thank you Mr. Chairman. I have been listening to
this conversation about paper, kiosks, BTS3. In your own
testimony, Mr. Heiman, you gave us a chart. For all of the talk
about kiosks, a very small percentage of claims are put in
through the kiosk and that might be the number. More
importantly to me is you list the 23 Veterans Integrated
Service Networks (VISN) and only 9 of the 23, 9 of the 23,
still use more paper than BTS3. In fact, two, four, six, no,
eight. Only 8 of the 23 is primarily BTS3. How do you explain
that? You have only got--I am trying to figure out how you are
managing these three because you have only got--you have added
140-odd employees to help with paper, and yet you say they are
integrated from the kiosk, and yet BTS3 does not have a
majority of the submissions even yet.
Somebody explained to me, I mean, your percentages look
like you are making improvement. This chart that you gave us
does not suggest that. Mr. Williams or Mr. Heiman, either one
of you.
Mr. Heiman. I will let Mr. Williams. I want to start with
in that particular chart, the kiosk figure that you see at the
top there, those percentages, in fact, are BTS3. We broke those
out so that we could identify how different sites are using
them. That is also why you see some that do not have them
because it is not--the kiosks are not in every VISN, in every
medical center.
Mr. Self. Do the 140 employees, do they go to the kiosk to
help? Where do they work? I know you have got them spread out.
I cannot figure this chart out.
Mr. Heiman. Yes, the 140 do work across the country. More
or less, I would call that more of a Tiger Team. They are in
place permanently and they are working claims from all over the
country, anywhere where there might be challenges with
processing time or adoption of the BTS system. There is also
staff turnover. These are frontline team members, GS----
Mr. Self. Okay. What is your plan to cut down on paper? I
assume you have a plan to cut down on paper because BTS3 still
has a minority of the VISNs input their claims through your
automated system.
Mr. Heiman. Yes.
Mr. Self. This is claims submitted. We are not talking
about adjudication, we are talking about submitted. It looks to
me like the system is still in its infancy.
Mr. Heiman. Yes. One of the things that I will let Mr.
Williams speak to, and it is something that I think we spoke
with Mr. Retzer many times, and that is associated with an
outreach and communications plan. Ben, if you do not mind
touching on that real briefly.
Mr. Williams. Sure. You are correct. I will say 5 years
ago, 100 percent of our claims were paper, so. While we have
seen, I will say across some VISNs more than others, adoption,
high levels of adoption, we felt strongly with OIT that we
needed to adjust the Veteran portal where Veterans log in to
submit their claims. That, as was mentioned earlier, is
migrating to VA.gov in a simplified claim submission process.
As Ms. Lee mentioned, that will bring--be a unified platform
where Veterans can manage their profiles, their individual
claims.
Mr. Self. Wait a minute, Mr. Williams. In Mr. Heiman's
testimony, it says, as you were just mentioning, transitioning
the veteran facing user experience in BTS3 into VA.gov over the
next 18 months, ``providing tighter integration with other
digital health features, such as managing appointments.'' It
sounds to me like you are adding complexity to it rather than
simplifying it over the next 18 months. Which is correct?
Mr. Williams. We are not adding complexity to BTS3.
Mr. Self. You are adding----
Mr. Williams. Sorry, just to clarify, we are adding the
Veteran portal portion where Veterans submit their claims. We
are adding that as a modality on the VA.gov platform.
Mr. Self. I am out of time, but I fail to see how making
more changes to a system that looks to me to be in its infancy
is going to make things better.
With that, I yield back.
Mr. Rosendale. Thank you very much, Representative Self,
and I agree.
You are spot on time, Representative Hageman. Can you dive
right in? We will give you an extra 15 seconds or so here to
get yourself organized. How is that?
Okay. I yield you 5 minutes for your questioning.
Ms. Hageman. Thank you so much.
Mr. Rosendale. Thank you for joining us.
Ms. Hageman. Well, Mr. Chairman, I greatly appreciate the
subcommittee for allowing me to join today's hearing to discuss
this critical issue that continues to affect our veterans in
both Wyoming and across the country.
Decisions made here in Washington, DC, by our bureaucratic
agencies have the most profound impact on the livelihood of
millions of Americans, and a one-size-fits-all approach is
hardly ever a viable solution. While I ultimately believe
fundamental reform is desperately needed in the realm of agency
decision-making, until then, proper notice, communication, and
outreach, along with providing an accessible and timely
mechanism for soliciting feedback, must always remain a core
responsibility for each and every one of our Federal agencies.
According to the May 2023 OIG report entitled ``Goals Not
Met for Implementation of the Beneficiary Travel Self-Service
System,'' one of the key findings was that, quote, ``During
system development, the Veterans Transportation Program only
solicited feedback from a narrow group of veterans who worked
with the program office, excluding both veterans not employed
by VA and veteran service organizations,'' end quote. While I
understand the VA has taken steps to address this oversight, it
is clear that the failures identified in the report have
continued to inhibit the system's overall success.
Mr. Williams, would you agree that it is a foundational
responsibility for the VA to conduct overreach and solicit
feedback from our Nation's veterans, veteran service
organizations, and other relevant stakeholders prior to
implementing large-scale operational changes?
Mr. Williams. Yes, ma'am.
Ms. Hageman. Could you elaborate on why the Veterans
Transportation Program Office did not properly solicit feedback
when the new system was in the development stage versus after
the system was implemented on a national scale?
Mr. Williams. I cannot say. It was prior to joining the
program for myself, but it is a commitment of ours currently
and has been. We have been working on vastly improving since
2021. There has been substantial increases, both on the IT side
as well as on the VHA side of the house, to collect feedback
from Veterans.
Ms. Hageman. Well, the program continues to fail our
veterans, and I know that from just visiting with one at a
reception that I was that, but also in learning and talking
with our veterans in the State of Wyoming. Would not you agree
that in order to mitigate errors and guarantee the most
successful outcomes, the proper input and feedback from those
being affected should be completed beforehand?
Mr. Williams. Yes, ma'am.
Ms. Hageman. The same OIG report also found that, quote,
``The program office did not provide training to veterans on
how to enter claims in the new system until almost 5 months
after the system launched,'' end quote. Mr. Williams, can you
explain why the Veterans Transportation Program Office did not
provide proper training to veterans on how to submit claims
into the new system until almost 5 months after it was rolled
out?
Mr. Williams. Yes, ma'am. The intent and as with a lot of
applications currently, there is on screen, on screen help. The
strategy at the time and the decision at that point was to
allow the onscreen help to be the guide for veterans.
Ms. Hageman. Do you think that that is going to be adequate
for our older veterans?
Mr. Williams. No, ma'am, it is not.
Ms. Hageman. Do you have knowledge of the particular
background or number of veterans who missed out on
reimbursements due to training not being available until well
after the rollout of the new system?
Mr. Williams. No, ma'am, I do not.
Ms. Hageman. Can you get that information to us?
Mr. Williams. We will do our best to be able to isolate
that in terms of Veterans who may have been submitting prior to
the rollout and who did not following.
Ms. Hageman. Is your office following up with veterans who
are having trouble with the program and making sure that they
are receiving the benefits to which they are entitled?
Mr. Williams. We do have a help desk that we track and we--
or, sorry that we resolve questions that veterans have on how
to submit claims and ensure that and follow through to
resolution on that. In terms of, as we mentioned earlier, prior
to your arrival, we are establishing a multi-prong approach to
collect and get feedback from veterans as well as resolve their
issues that they, if they continue to have them.
Ms. Hageman. Well, I would like to quickly focus my
discussion about the reimbursement kiosks from VA medical
centers. My home State of Wyoming holds over 40,000 veterans
and is one of the most rural in the Nation. It is not uncommon
for veterans across my State to travel significant distances to
reach a VA facility. Accessibility to reliable Internet is a
also a luxury that is simply not always present. Mileage
reimbursement kiosks provided all veterans, including those who
did not have the best Internet connectivity or lacked
familiarity with the online applications, with an easily
accessible option for submitting their claims upon arriving at
a VA facility. Unfortunately, these kiosks were removed from
the VA medical centers in my home State.
Mr. Heiman, how were the veterans in Wyoming consulted
prior to this decision?
Mr. Heiman. Thank you, Representative Hageman. I am not
sure that they were contacted to that degree.
Ms. Hageman. Thank you. We need to do better.
With that, I yield back.
Mr. Rosendale. Thank you very much, and thank you again for
joining us today.
Ms. Lee, we have got a goal, your internal goal is at 90
percent for the auto adjudication rate, and yet we are still
sitting at this 40 percent. Does the VA understand why the auto
adjudication rate is so low? Can you pinpoint what is causing
this?
Ms. Lee. We did a thorough review of the rules associated
with auto adjudication, which was completed in February 2024,
and made changes to the rules engine to make it more efficient
and to auto adjudicate more claims without manual intervention.
That was rolled out on May 30, and I think it was either Mr.
Williams----
Mr. Rosendale. Is it the system or is it the people that
are using, or for that matter, not using the system? Have we
identified the problem is what I am getting at.
Ms. Lee. With auto adjudication, it follows a certain set
of rules, and it was the rules----
Mr. Rosendale. This is the 62 rules that we were just
talking about.
Ms. Lee. Yes, yes.
Mr. Rosendale. Okay.
Ms. Lee. We just redesigned that, which was deployed on May
30th.
Mr. Rosendale. I can tell you, if I was working on a
software program, and I am not completely technically
illiterate, and I had to go through 62 steps in order to try
and figure out what my compensation was going to be, just to
get from point A to point B, you would have lost me at about
question number 6, I can tell you. Then the next call would
have been to the VA, to one of these 148 other facilitators, I
think we should probably call them, to help us figure out why
in the H this is such a cumbersome process to get me reimbursed
for my travel, to get my healthcare.
I understand what you just walked through, quite frankly, a
convoluted statement about how you are going to fix it. I
understand VA decided to loosen the system rules because auto
adjudication rate was so low and so few veterans were receiving
their travel reimbursements in a timely fashion. Which system
rules did you decide to loosen and what was the process used to
select those rules that were loosened and how did you loosen
them?
It is a three-part question. Which rules did you loosen?
How did you make that determination about prioritizing which
ones were going to be loosened? What do you mean by loosen
them?
Ms. Lee. I will pass this on to Ben because it was the
program office. He was the one who defined what the rules
should be.
Mr. Williams. Thank you, sir. We will provide you the list
of the rules that were changed. I do not have them off the top
of my head.
Mr. Rosendale. Do you have the criteria that you used that
you could discuss and say what was the process in selection?
Mr. Williams. As we looked at the rules, frankly, we were
looking at what, I will say, what portion of claims, the
largest portion of claims, that we could impact safely. As you
look at one of the main goals of the reason to implement the
rules engine was to establish controls around paying eligible
veterans the correct amount. Right? So when----
Mr. Rosendale. Sixty-two part question. When I am going
from here to my home and back to get healthcare, I just--I will
be honest with you, I cannot even fathom anybody going through
that.
I just had a note brought to me that the 2021 VA study of
veteran population, the average age is 61. I am 64. Okay?
Ninety percent male, 36.2 percent Vietnam era, 30.4 percent
post 9-11. That means we are somewhere in the 36 percent-plus.
Thirty is post--so we have got at least 50 percent of the
population that is Vietnam era or older. Fifty percent is
Vietnam era or older, based on my information here.
Do you truly believe that they are going to sit down in
front of their computer, if they have one, and go through a 62-
step process to figure out how they can get reimbursed for
going to seek their healthcare?
Mr. Heiman. Yes. Thank you.
Mr. Rosendale. You do? Yes? You just said yes?
Mr. Heiman. Thank you for the question. What I would say is
that the complexity, some of it is in the law, and, quite
frankly, veteran eligibility is one of those factors of the 62
that we have to check every single time, right. There also has
to be a trip that is completed, and there has to be the
completion of the appointment. Those are the three basic areas
of those rules that touch on.
Mr. Rosendale. Why do we have 62 parts then that we are
going through, instead of those three questions saying, did you
go there? Doctor signs a slip. We know that it is 420 miles
round-trip from in Montana, from your home to the doctor's
office.
My time has expired. I am gonna yield to Ranking Member
Cherfilus-McCormick.
Ms. Cherfilus-McCormick. Thank you, Mr. Chairman.
Mr. Heiman, during the pre-hearing briefing, my staff heard
that the VA has taken steps to automate the processing of
travel claims for approved community care appointments. How
different is the process through BTS3 for community care
appointments versus VA healthcare appointments? Are there any
snags that often occur in this process?
Mr. Heiman. Yes. Thank you for the question, Ranking
Member.
The difference in the layman terms for myself, who is not
all that technically savvy, but the main difference is really
the fact that we in VA do not have access to every single one
of the community providers that are out there. There is many,
probably thousands, if not more. That is one of the biggest
challenges, is not being able to quantify if that appointment
actually happened or if it was canceled or what actually
happened.
Ms. Cherfilus-McCormick. What are the main snags that occur
in that process?
Mr. Heiman. The main snag for a Veteran, I guess, would be
that the fact that if they are getting community care. It is a
little bit challenging for our team to quantify if that care
actually occurred.
Ms. Cherfilus-McCormick. Mr. Heiman, my next question is,
we appreciate the VA being proactive during the development of
BTS3 to create goals to measure success. This is not something
that we have seen VA do well often. However, without
enforcement mechanisms, these goals are just goals and not
effective assessment tools. I understand that the VA has taken
steps in moving the needle closer to these goal matrices. How
does the VA plan to ensure that these goals are met and are
creating better outcomes for veterans?
Mr. Heiman. Yes, thank you for the question, Ranking
Member. The 10-day inventory that we created back in March 2021
did help, quite frankly. There were many--there was inventories
all over the place in VA, and by setting that goal, it really
did help many of our VA medical centers and the beneficiary
travel staff that exist on the front lines to focus in on that.
As we also referenced earlier, we put together a claims
processing team that would support those areas that may have
been down one or two processors as they are trying to recruit
additional, as well as any areas that required additional
training, we can kind of help fill in that gap.
Those things were not visible previously in a paper
environment. We did not know those things. BTS3 is helping us
to manage the overall program.
Ms. Cherfilus-McCormick. Mr. Retzer, as VA takes steps to
pilot more integrated technology with BTS3, like the smartphone
check-in system or the consolidated mail payment tool, what
role can VSOs play in easing veterans into changes with
existing systems?
Mr. Retzer. I think the role that we can play for VA is to
give them the veterans' experience from a user standpoint. We
could tell them what works, what does not work, what are the
barriers that we have to be able to get to or not to be able to
get to the VA benefits that we are trying to obtain.
I mean, I can even provide them my own experience of what
it was like to try to use BTS3 with regards to this system.
Even though I am a metropolitan person, but I have fiber
optics, I was able to share with them that with the one gig
system, I still got timed out. Fifteen minutes later, I was
timed out. As an advocate, we can also provide the veterans'
experience from our veterans who are coming to us, our national
service officers. This is something that has been challenging
us for years.
I was out in the field for--I am with DAV for 21 years, and
14 of those 21 years was advocating for our veterans. Back in
2003, when I started, this was a problem. I actually went to
the cashier window. I had the kiosk. When those two were in
place, we were good. We were getting our benefits. When we went
with technology and we did not have the other resources, that
is where VSOs can help them, is to tell them, pause, stop, take
a moment, let us keep what is working running, and as we move
forward, let us figure this out.
One of the challenges that they have with community care,
interoperability. This is the same challenge and this is
something that we are waiting for VA to get their electronic
health record system modernized so we have that
interoperability to be able to do the scheduling components.
Then we can get the reimbursement verification, or we can help
them to think about from the Veterans Healthcare Administration
how we do business with the Veterans Benefits Administration
dealing with the old concepts of fully developed claims, direct
claims access or submissions. We have SCP, stakeholders
enterprise portal. They should leverage using us because we
have the experience and we have been testers for them behind
the VA firewall, also.
Ms. Cherfilus-McCormick. Thank you. I yield back.
Mr. Rosendale. Representative Self, would you like to have
another round?
Mr. Self. Absolutely, Chairman. Thank you.
I will be honest with you, I came into this hearing
thinking that you had made great progress because of your
percentages. I am less convinced now.
Once again, and I make this statement often, the VA comes
to us and tells us about all the inputs, the new systems, the
new hires, the new organizational structure, the new something.
In this case it is another new shiny IT system. It looks to me
like you have failed to take into account age of the veterans,
access to an automated system, the rural aspects of this, and,
frankly, what I see is not a complete buy-in to the community
care system as a whole. I understand you do not have full
visibility on that, but, Mr. Heiman, you said something like,
you have got more knowledge. That is an input. What about the
veterans? What about the veterans getting proper payments on
time?
This system, once again, is in the infancy. After all this
time and all this money, I do not see how it is going to be
cheaper and better because supposedly when you do something it
should be cheaper and better. I just do not see how you are
going to do that with the system in its infancy until you take
into account these four issues that I have laid out for you
here. I do not think you have taken them into account.
Once again, I just encourage the VA to think about the
veterans. How are you going to make things better for the
veterans rather than just rolling out a new shiny system.
With that, Mr. Chairman, I yield back.
Mr. Rosendale. Thank you, Representative Self.
Ms. Lee, is BTS3 capable of auto adjudicating a travel
claim for a community care appointment?
Ms. Lee. Not at this time.
Mr. Rosendale. Why is that?
Ms. Lee. I will pass that to Mr. Williams.
Mr. Rosendale. The system was in development for several
years before it was implemented, and, as you know, community
care is a core part of the VA healthcare. Why is this not taken
care of, especially, again, for the rural states like Wyoming?
Representative Hageman was just here, Montana, where a lot of
the times the veterans have to utilize community care.
Mr. Williams. The reason we cannot auto adjudicate a
mileage--say, a simple mileage claim to a community care
appointment is we do not have a way to verify the appointment
occurred from a data perspective. We are working--we do have an
integrated project team with the Office of Integrated Veteran
Care, which runs our community care program, to obtain that
data. We expect to be able to test that data point in advance
of the medical claim coming. We expect to be able to test that
this fall and be able to begin auto adjudicating community care
claims within BTS3.
Mr. Rosendale. We are 4 years into the program, community
care has been around the whole time, and we are just now
getting around to, hopefully, this fall, introducing the system
so that the people that utilize community care can get their
reimbursements.
Ms. Lee, as you prepare to put BTS3 on VA.gov, how is the
veteran's experience going to change and what risk are you
preparing for?
Ms. Lee. As we add VA.gov capability to the system, there
is a couple things that change. First off is they will be able
to view their claims with all their other claims, so they can
see the status of their claims just alongside with all their
other claims. They are also able to look at their appointments
and be able to submit claims based on those appointments in the
system instead of just at the time of service.
Mr. Rosendale. How is it going to work easier? Okay. If we
have a system that independently is not functioning properly
yet, and now we are going to link it to VA.gov, which is not
functioning properly yet, like two bads are gonna make a good?
I am sorry, but I just--I do not understand how this is going
to help the situation.
What are you gonna resolve by putting that on VA.gov and
how are you not going to exasperate the problems that they are
already having?
Ms. Lee. One of the things that will change in VA.gov is
they will only have one login. As he mentioned earlier, right
now, if you log into VA.gov, then you have to log into another
system when you access BTS3. That will solve some of the
issues.
In addition, we are gonna have, or we do have, end-to-end
claims claims process visibility. We can see as claims are
submitted, we can see throughout the entire process until it is
adjudicated that it made it through the process.
Mr. Rosendale. With my limited, again, knowledge about how
this all works, are you going to be able to auto populate? Once
you place this information in VA.gov, is it going to start auto
populating all the way down through the different areas so that
the veteran will not have to continue to create this new
information?
Ms. Lee. It will take the information submitted by the
veteran through our claims ingest Application Programming
Interface (API) and get it to the BTS3 backend system to be
adjudicated.
Mr. Rosendale. Okay. I still have a little bit of time
here. I am still very concerned that the VA has struggled to
implement this relatively small IT project. Your counterparts
in Electronic Health Record Modernization (EHRM) program keep
telling me how they are going to turn this effort around and I
am very skeptical. EHRM is 1,000 times bigger than BTS3, and it
certainly has racked up the bill to go along with it.
What did the VA get wrong during the development and
initial implementation of this project? I think I am going to
ask you, Mr. Retzer, that question, because I believe I will
get a more unbiased answer.
Mr. Retzer. I think what they got wrong was they did not
start with us, the veterans. They should have been with us from
the beginning of this. They should have been hearing us about
our challenges right when they did shut off the kiosk, that we
did not have alternative methods. They should have reached out
to the veterans Service organizations because we do have the
experience of what their challenges are behind the VA firewall
and outside the VA firewall. They should have contacted us for
ideas and even with their algorithm to determine are we
creating too much restrictions, so we would have been able to
help them navigate this.
Mr. Rosendale. Thank you. Thank you very much, Mr. Retzer.
Representative Cherfilus-McCormick, you still have a
question, correct?
Ms. Cherfilus-McCormick. Yes.
Mr. Rosendale. Go ahead.
Ms. Cherfilus-McCormick. Mr. Heiman, one of the challenges
we have heard today is that the VA has not been the best
manager, the messenger, or trainer of the implementation for
the tools. What is the VA doing to improve their communications
with staff, patients, and VSOs?
Mr. Heiman. Yes, thank you for the question, Ranking
Member. We are developing a multi-prong communications and
outreach that we expect to launch in the coming months. That is
number one.
Number two, I think as these system enhancements find
themselves, we do believe that the uptake of interest in
actually using the system will increase as well. Those two
things I think I would offer to answer.
Ms. Cherfilus-McCormick. Mr. Heiman, I am glad to hear
about many of the upcoming technology improvements that the VA
is implementing to make BTS3 more accessible. However, I am
concerned that the VA is attempting to add new features without
addressing foundational issues in the first version of the
self-service tool, like login errors and network latency. How
will the VA's migration to VA.gov as the portal impact
veterans' experience with BTS3?
Mr. Heiman. Yes, thank you for the question. We are taking
very--have very close eyes on any sorts of integrations. One of
the key ones I had mentioned is My HealtheVet that we have
gotten feedback that is appreciated and is helpful. Many
Veterans use that tool already to renew prescriptions and check
on appointments and all of these types of things. That type of
mentality exists with the future of VA.gov that Ms. Lee was
describing, to where they really truly do have a one-stop shop
where they can interact with both their health and their
benefits interactions.
Ms. Cherfilus-McCormick. Thank you. I yield back.
Mr. Rosendale. Thank you, Ranking Member. I now recognize
Representative Self.
Mr. Self. Ms. Lee, you said that they would have better
visibility of all of their claims. It has been demonstrated to
me by my veterans that there is a list of documents, PDFs under
their claim when you go into their account. Yet the PDFs are
not live links, and when you copy the link, it will not take
you there because when you copy the link, you are outside the
system. I question whether or not they are going to have any
more visibility in their total claim universe with this system
because it has been demonstrated to me the PDF's are not live
links. They do not have today total visibility of their claim.
Their claims that they currently have. I yield back.
Mr. Rosendale. Thank you, Representative Self.
I now recognize Ranking Member Cherfilus-McCormick for her
closing statements.
Ms. Cherfilus-McCormick. Thank you, Mr. Chairman.
I appreciate the testimony and answers from our witnesses
this afternoon. While VA's travel reimbursement program has
connected many veterans to their rightfully earned healthcare,
it is clear that BTS3 has faced challenges since its inception.
Improvements and refinements to the auto adjudication process,
improvement payments and improper payments, and veteran
utilization are critical to both the success of this
modernization effort and to providing exceptional care for
veterans.
We have highlighted today's BTS3 is an important tool,
especially for our rural veterans, who represent almost a
quarter of all veterans in the United States. Accessing medical
services in rural America poses significant challenges for
veterans who may have to drive hours and seek lodging in order
to attend their VA appointments.
I am glad to see that the VA seems to be taking steps in
the right direction. However, it is time for the VA to hold its
operational offices to the goals they have set. Our veterans,
caregivers, and survivors deserve as much.
Thank you, Mr. Chairman. I yield back.
Mr. Rosendale. Thank you, Ranking Member Cherfilus-
McCormick.
Four years after its launch, the BTS3 system is still
missing its mark. The plan was not well thought out, and I am
concerned that its managers at the VA still do not have a clear
picture of the future in their vision. Another commercial off-
the-shelf IT system has collided with the complexity of the VA.
No one thought about basic requirements, like how to confirm
that veterans attended their community care appointments. Once
again, we are left to spend millions of dollars re-engineering
a system that does not work. If the VA cannot execute a
relatively small project like this, why should anyone on this
dais feel confident when VA executives come up here to pitch
their next multibillion dollar scheme?
I want to ensure the veterans that we will be closely
monitoring this system and insisting that the VA extensively
test any new software before rolling it out.
I ask unanimous consent that all members have 5 legislative
days to revise and extend their remarks and include any
extraneous material. Without objection, so ordered, and this
hearing is adjourned.
[Whereupon, at 5:58 p.m., the subcommittee was adjourned.]
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A P P E N D I X
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Prepared Statements of Witnesses
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Prepared Statement of Ryan Heiman
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Prepared Statement of Jon Retzer
Chairman Rosendale, Ranking Member Cherfilus-McCormick and Members
of the Subcommittee:
Thank you for inviting DAV (Disabled American Veterans) to testify
at today's oversight hearing of the Technology Modernization
Subcommittee on the Department of Veterans Affairs (VA) Beneficiary
Travel Self-Service System (BTSSS).
DAV, a congressionally chartered non-profit veterans service
organization (VSO), is comprised of over one million wartime service-
disabled veterans. Our single purpose is to empower veterans to lead
high-quality lives with respect and dignity. DAV is pleased to provide
our perspectives on the BTSSS being discussed today by the
Subcommittee.
Transportation Programs
DAV is involved in the VA's network of transportation and due to
the selflessness of DAV volunteer drivers, we provide free
transportation to and from VA health care facilities to veterans who
may not otherwise have access to the vital medical care and services
they need. The DAV Transportation Network is the largest program of its
kind for veterans in the Nation and provides thousands of rides to
veterans each year to ensure they receive the care they need. However,
there are still gaps in VA's transportation services for veterans that
require attention and solutions.
VA understands the importance of improving access to health care
services for ill and injured veterans, and the need to address the
unique transportation obstacles many veterans face. VA provides
transportation grants for highly rural communities, rides through the
Veterans Transportation Service, and beneficiary travel benefits to
help defray travel costs that veterans incur to overcome access
barriers to care.
The Veterans Transportation Service, with a focus on veterans
living in rural and remote areas, offers secure and dependable
transportation to and from VA health care facilities and authorized
non-VA health care appointments. Eligible veterans can receive these
services at little or no cost through this critical program. To
reimburse veterans and caregivers for travel expenses to and from
approved health care appointments, the Veterans Health Administration
(VHA) established the Beneficiary Travel Reimbursement Program.
Beneficiary travel benefits include round-trip transportation from the
veteran's home to the medical center, mileage reimbursement, or special
mode transport. Transportation at government expense may be available
to beneficiaries traveling to or from VA facilities, or other places of
examination, treatment, or care.
VA offers two types of travel benefits under the Beneficiary Travel
Program: general health care travel and special mode transportation.
Veterans may be eligible for one or both if they have a service-
connected rating of 30 percent or more; are traveling for treatment of
a service-connected condition; receive a VA pension or income does not
exceed the maximum annual VA pension; are traveling for a scheduled
compensation or pension exam; have a vision impairment or spinal cord
injury or disorder; have double or multiple amputations; or are
enrolled in the VA Rehabilitation Program.
VA Beneficiary Travel Self-Service System
To streamline and improve oversight of the program, reduce fraud,
and expedite reimbursement, VA rolled out a program created in
September 2016 that allows veterans to submit their travel
reimbursement claims online. BTSSS, a web-based system, was intended to
automate the travel reimbursement claims process, reduce long-term
costs, and decrease the risk of improper payments.
In November 2020, the VA transitioned from travel reimbursement
kiosk machines at VA medical facilities to the BTSSS computer-based
program nationwide. Veterans were required to use the new travel
reimbursement website, leading to over six million beneficiary travel
claims being submitted between February 2021 and July 2022. Despite the
new program and the hope for a more streamlined process, the changes
failed to meet intended goals, resulting in veterans experiencing slow
claims processing.
Office of Inspector General Report
The May 21, 2023 Office of Inspector General (OIG) report (21-
03598-92) stated that despite making certain improvements since system
rollout, VHA needs to do more to ensure successful implementation of
BTSSS and complete the transition away from the legacy Veterans Health
Information System Technology Architecture (VistA) system. The Veterans
Transportation Program (VTP) office deemed auto-adjudication and self-
service portal usage as key critical goals. These two goals were deemed
critical to ensure success of the program as they would result in
spending less time on claims, either to review or to manually input
data, which will result in faster claim processing and ultimately help
decrease staffing levels.
The OIG attributes the Department's goal of veteran utilization of
the new system falling far short because of the lack of solicitation of
feedback from veterans and veterans service organizations (VSOs) prior
to implementation. The program office did not offer training to
veterans or VSOs on how to enter claims in BTSSS until nearly 5 months
after system launch. While rolling out the system, veterans encountered
difficulties in creating user accounts and lacked the training on how
to use the new system to enter their travel claims.
High veteran portal usage is critical to the new system's success
because it eliminates the need for travel staff to manually input
claims, ultimately contributing to faster claims processing. However,
during system development, VTP only solicited feedback from a narrow
group of veterans who worked within the program office--excluding both
veterans not employed by VA and VSOs. Better communication and earlier
veteran involvement would have helped ensure that veterans were
provided and received the training they needed to use the self-service
portal and ultimately adopt the new system.
Veterans Experience
The mission has definitely not yet been accomplished. Since the
program's implementation, veterans report they continue to struggle
with getting reimbursed because of challenges accessing and using
BTSSS, insufficient resources and/or lack of staff or facility
assistance. For veterans that have a VA.gov account, it takes two log-
ins for two sites and four screen changes simply to create a new travel
reimbursement claim. Despite the ability of veterans to access the
scheduled medical appointments that are within, and outside of the 30-
day period associated with their claim, they find that the experience
is not user-friendly or seamless because of system delays, multiple
screen changes, and the need for verification when the appointment is
not at a VA Medical Center.
Veterans want options to file their reimbursement claims more
seamlessly and timely while they are engaged in their actual medical
appointment. While they appreciate the mobile text feature to start the
reimbursement process, this has also been a challenge at certain
locations because of lack of staffing knowledge or facilities not being
enrolled in the new process. To increase self-service portal usage, we
recommend VHA conduct outreach to veteran and VSO users, solicit
feedback, and consider whether system changes are needed based on the
comments and recommendations received.
Additional interaction with veterans and VSOs would provide VA with
ideas on how to improve technical issues in BTSSS and better understand
the need for alternative options to filing travel reimbursement claims.
For example, the need for kiosks at medical facilities, assistance with
on-site computer access to file a beneficiary travel claim, and/or
direct assistance on how to submit reimbursement claims from the front
desk when checking in and out for appointments. VA needs to ensure
staff are trained and available to assist veterans onsite. All
facilities need to provide better signage and communication to assist
veterans in accessing onsite computers that can access BTSSS or other
facility resources.
The VA can and should do more to assist veterans with filing
beneficiary travel claims. Despite implementing a self-service
beneficiary travel system, not all veterans have access to personal
computers, laptops, tablets, smartphones, or adequate bandwidth at
home. Many veterans are not familiar with or do not feel confident in
using online web-based technology. The Department has the resources to
enhance onsite real-time services by integrating needed data and
banking information from VBA to VHA and expanding technology through
the use of signature pads and ID verification onsite to filing digital
reimbursement claims on direct contact.
Travel Reimbursement Rates
We appreciate that VA is proactively working to improve the
veterans' experience by improving self-service through BTSSS; however,
that does not fully meet the needs of the veterans who are entitled to
travel reimbursement benefits. In 2010, Congress passed legislation
that set the mileage reimbursement rate at a minimum of 41.5 cents per
mile, which was the rate Federal employees were being reimbursed for
work-related travel. The law gave the VA Secretary the authority to
adjust rates in the future based on the mileage rate for Federal
employees using private vehicles for official business, as determined
by the GSA Administrator.
The VA travel mileage reimbursement rate has not kept up with the
rising gas prices and costs of auto maintenance and insurance. While
the GSA rate has increased over time to 67 cents per mile for
government employees, the mileage reimbursement rate for veterans has
remained at 41.5 cents and is well overdue for an increase. Associated
travel costs have increased significantly since the enactment of this
law. Unfortunately, with gas prices continuing to rise, the current
mileage rates for veterans' beneficiary travel do not always cover the
actual expenses for gas and the associated costs of using a personal
vehicle; as such, these expenses may serve as a barrier to care.
We strongly recommend the Secretary exercise his full authority,
under the law, to adjust mileage reimbursement rates for veterans to 67
cents--in alignment with the current rate for government employees and
keep on pace with GSA rates into the future.
Mr. Chairman, this concludes my testimony on behalf of DAV. I am
pleased to answer questions you or members of the Subcommittee may
have.
[all]