Hawaii veterans say Virginia’s red tape is getting in the way of health care access

Roxanne Bruhn was relieved when she was referred to a female therapist to help her with the trauma she experienced in the military.

The 66-year-old Air Force veteran sees the Veterans Affairs Community Care Network therapist regularly. However, she said her doctor told her those services may stop because the therapists were not paid on time by the VA.

“It’s really going to hurt me to have to go back and have the same problems at the VA,” Brun said Wednesday during a panel event, noting that she went through a lengthy process to file her claim with the agency in the first place .

Brune’s story was one of many complaints aired by military veterans who attended the public hearing hosted by U.S. Sen. Maisie Hirono to learn about health care, homelessness and other issues.

Left to right: David McIntyre of TriWest Healthcare Alliance; Ronald Hahn, director of the Hawaii Veterans Service; Roxanne Brun, retired Air Force member; and Hawaii Disability Legal Services founder Diane Haar discussed the concerns of military veterans. Cassie Ordonio/Civil Beat/2022

Hawaii has a shortage of doctors and mental health professionals, which has delayed access to health care for many communities.

Veterans and health care advocates who attended the hearing expressed concern that the loss of medical providers could be detrimental to veterans who experienced trauma and other health problems during their service. In Hawaii, problems with the VA’s payment system have raised concerns that some doctors may stop accepting veterans as patients.

In August, President Joe Biden signed legislation called the PACT ACT, which provides benefits to veterans who have been injured or become ill after being exposed to toxins while serving in the military without having to prove it. The new law will help increase access to care for veterans.

Diane Haar, founder of Hawaii Disability Legal Services, a local law firm that assists veterans in the state, said she spoke with several medical providers in Hawaii and concluded that “we are still in danger of losing medical providers.”

Haar said doctors have told her they are considering not admitting any more veterans.

Those who treat veterans for two or more years receive overpayment notices from the VA, which can be a problem for medical providers who are “one-stop shops” trying to contact veterans to discuss the payment problem. But veterans who live on neighboring islands may have poor reception, making it difficult to connect and fix the problem immediately.

“All the time they (medical providers) spend on this is money they’re not getting paid for, it’s time they can’t spend treating patients, and it’s money they don’t have,” Haar said. “So it really makes them question whether they’re going to pay for VA patients.”

TriWest Healthcare Alliance President and CEO David McIntyre said the company will work with the VA to resolve these issues.

TriWest, an Arizona-based insurance company that administers health benefits under the VA, has approximately 5,600 providers in Hawaii, 40 percent of whom are solo practitioners, according to McIntyre.

He said TriWest has taken steps to increase staffing and improve training to help with claims in Hawaii and the Pacific.

“The staff who bill for the providers, in the cases, need basic training to make sure that the claims submitted are done correctly,” McIntyre said.

McIntyre said many providers in the state did not file their claims electronically, which delayed payments. Suppliers who are paid electronically will receive payment in less than five days, he added.

Hawaii has more than 97,000 veterans, according to the U.S. Census Bureau.

Veterans Affairs Secretary Dennis McDonough, who attended the hearing, said the agency is working to improve, including expanding telehealth capabilities and hiring more staff.

“We believe we need to hire 45,000 nurses over the next three years,” McDonagh said. “July was the first month this calendar year that we hired more nurses than we lost to retirement or leaving to go to other health systems.”

Brune said she would like the VA to look at the “thought process” when talking to veterans.

“Every time I think of the VA, I think they’re going to say no,” she said. “I think they’re going to put so many hurdles for me to overcome to get treatment and to be seen.”

That seems to be the prevailing thought when you talk to any veteran who has to go through the VA system is that they’re going to give me a hard time,” she added. “Hopefully that will change.”

Civil Beat health coverage is powered by the Atherton Family FoundationSwain Family Fund of the Hawaii Community Foundation, Cook Foundation and Unity Health Council.

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