Choosing a preferred VA treatment facility

[cannoncocker]

My question is who determines your choice for preferred VA treatment facility (your primary VA treatment facility)?

I have been treated at a single VA Treatment facility in NC since 2006. I have property in NC and FL. I have been using my FL residence until the residential construction is completed on the NC property. Prior to this I rented in NC. 

My primary provider transferred so I was assigned a new physician a couple of months ago. It was going fine until his screening nurse noticed I had a temp address in FL. At that point she asked if that was temporary. I explained as above. The treatment stopped and right quick.

I was told by her my treatment was restricted to: "urgent/emergencies".

I had assumed this was merely a mask to push me off an opioid prescription (since 2008). I acquiesced that point but they continued their unilateral and abrupt virtual refusal to continue my treatment there.

Is their refusal to continue my treatment at my designated preferred VA facility in fact within the scope of the nurse's/provider's authority?

 

I won't bother with what that means to tell a person to tough luck, see ya, after receiving an opioid prescription for a SC disability (reconciled by Neurology consult).

PS: if this is the incorrect forum please move.

Edited July 7, 2016 by cannoncocker
PS

[Vync]

13 minutes ago, cannoncocker said:

My question is who determines your choice for preferred VA treatment facility (your primary VA treatment facility)?

I have been treated at a single VA Treatment facility in NC since 2006. I have property in NC and FL. I have been using my FL residence until the residential construction is completed on the NC property. Prior to this I rented in NC. 

My primary provider transferred so I was assigned a new physician a couple of months ago. It was going fine until his screening nurse noticed I had a temp address in FL. At that point she asked if that was temporary. I explained as above. The treatment stopped and right quick.

I was told by her my treatment was restricted to: "urgent/emergencies".

I had assumed this was merely a mask to push me off an opioid prescription (since 2008). I acquiesced that point but they continued their unilateral and abrupt virtual refusal to continue my treatment there.

Is their refusal to continue my treatment at my designated preferred VA facility in fact within the scope of the nurse's/provider's authority?

 

I won't bother with what that means to tell a person to tough luck, see ya, after receiving an opioid prescription for a SC disability (reconciled by Neurology consult).

PS: if this is the incorrect forum please move.

So much for the VA's Patient's Bill of Rights. They just threw that right out the window.

Your primary VA treating facility should be determined by your primary residential zip code, but your treatment should be available at any VA clinic or hospital. Yeah, you might need to register in their district, but they are not supposed to leave you without care.

Here's my interpretation about opiate treatment. It works very well for some people. The VA has taken a lot of heat about veteran suicide, so the VA blames opiates for it. Recent military operations resulted in IED injuries caused the amount of opiate prescriptions to increase. DEA guidelines changed regarding opiate use. The VA unfairly looks at any veteran who every used opiates as an addict. The VA is using all of these as justification to get veterans off of any type of long-term opioid pain treatment. Unless it is absolutely necessary, i.e. cancer, postsurgical, etc... Instead of weaning veterans off of it, many are just dropped cold turkey. From what I heard a few months back, the VA was going to be even more aggressive in this once the internal directives filtered down to the worker bees. And the process in getting someone to re-approve use is just more red tape. Primary care will refer you to a specialist. The specialist will refer you back to primary care. Both will say it's "not their job" to prescribe it. Requesting a new doc will result in more of the same. And running this up the chain through the patient advocate, chief of staff, or facility director might get you the typical "we can't force our physicians to write prescriptions" result. If you do end up getting a VA doc to prescribe opiates, they will likely hit you up with a opiate pain contract which says if you get them at a non-VA facility, they VA will cut you off forever.

So where does the VA leave us veterans?
- Mental health clinic to help us learn to cope
- Physical therapy
- Pain clinic (pain blocks, facet injections, TENS unit, alpha-stim unit, etc...)
- Non-VA specialists like chiropractors and acupuncture
- Surgery
- Some veterans live in medical marijuana-legal states

This might have been a more extensive than what you expected, but I wanted to give you a heads of on what you might expect in the future.

[cannoncocker]

thank you Vync. I knew it was basically a fool's errand to butt my head against the wall on the prescription so i gave them that one. the kiss off part is a bit on the harsh side but i expect no less.

so they kinda can restrict me to emergency/urgent care since my actual current address is FL until the home on my NC property is completed. It's not a major gig but I did want to know precisely how heavy handed they are. still, I own residential property in NC but whatever.

[Vync]

4 hours ago, cannoncocker said:

thank you Vync. I knew it was basically a fool's errand to butt my head against the wall on the prescription so i gave them that one. the kiss off part is a bit on the harsh side but i expect no less.

so they kinda can restrict me to emergency/urgent care since my actual current address is FL until the home on my NC property is completed. It's not a major gig but I did want to know precisely how heavy handed they are. still, I own residential property in NC but whatever.

Don't settle for that. You're SC and deserve equal medical treatment across all regions without being restricted to emergency/urgent care in one area. Yeah, you might have to register in that region, but who cares - you're a SC veteran. Don't let them make up excuses to limit your type of care regardless where you are.

Although I am in Alabama, a couple of years back I had to seek emergency care in Florida, which is in a different VA region. There was no VAMC within range, so I was treated at an Orlando hospital. When it came time for the bills to arrive, the VA denied everything because I was not "registered" in their region. Well, I "registered" and it took almost a year for the VA to cough up and cover the bills. I was told that if I planned to travel to or through another VA region, they advised I "register" because anything can go wrong and they wanted to ensure I received medical treatment when I needed medical treatment. I have not had an opportunity to see if their plan worked, but I hope I don't get the runaround either.

[cannoncocker]

Vync, we/I am lucky you are active on this forum. I appreciate your willingness to share your knowledge and experience.

It's pointless to me to pushback, aside from on principle that after 8 years of a prescription for a sc condition they throw me under the bus (is that reasonable to flip the switch and expect anyone to just be over that?). Not that they care but no way can I register, schedule an appointment, then get on some step down plan without months of cold turkey. 

I'll re-register in FL. I live outside 40 miles to the nearest va care facility but the choice option the last I checked is useless, i.e. they couldn't tell me what doctors were eligible nor tell me if I would be reimbursed until after the appointment. let me know how that is helpful because that eludes me. I really only intend to use any va facility as a medical emergency last resort anyway.

That run around you got is precisely what I wish to avoid. I'm glad you ultimately beat them down but it's a toss up how that could have gone. You wuz lucky.

Edited July 8, 2016 by cannoncocker
too much info

[Vync]

I appreciate the friendly feedback. I just lurk around here from time to time to help out.

You are correct. The VA handled this badly. Up until the VA changed their policies to match the DEA policies, they would often tell veterans go ahead and request a refill as soon as your medication arrived. In those instances, veterans were at least one month ahead of the expiration. This cold turkey approach is a serious problem for some veterans.

I agree with you about the choice program, or as I more appropriately call it, the "lack of" choice program. Supposedly, you are supposed to be able to find an eligible provider at this link: http://www.va.gov/opa/apps/locator/

If you have doc you wish to see, try to look them up. If they are not listed, you can ask them to see if they are interested in getting listed by going to that link and clicking "for providers". It says they must accept Medicare, which is a real turn off for many providers.

[Chuck75]

10 hours ago, Vync said:

I appreciate the friendly feedback. I just lurk around here from time to time to help out.

You are correct. The VA handled this badly. Up until the VA changed their policies to match the DEA policies, they would often tell veterans go ahead and request a refill as soon as your medication arrived. In those instances, veterans were at least one month ahead of the expiration. This cold turkey approach is a serious problem for some veterans.

I agree with you about the choice program, or as I more appropriately call it, the "lack of" choice program. Supposedly, you are supposed to be able to find an eligible provider at this link: http://www.va.gov/opa/apps/locator/

If you have doc you wish to see, try to look them up. If they are not listed, you can ask them to see if they are interested in getting listed by going to that link and clicking "for providers". It says they must accept Medicare, which is a real turn off for many providers.

The real problem with ""choice" from the provider's side is getting paid. The VA is failing to do so in any sort of reasonable manner.