Tester Presses VA to Protect CHAMPVA Beneficiaries’ Access to Health Care

Senator calls on VA to ensure children, spouses, and caregivers of veterans enrolled in the CHAMPVA program do not experience disruptions in care due to changes in how the program reimburses its providers

Senate Veterans’ Affairs Committee Chairman Jon Tester is calling on the Department of Veterans Affairs (VA) to ensure children, spouses, and caregivers of veterans who receive health care through the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) do not experience disruptions in care due to the program’s transition to reimbursing CHAMPVA providers through electronic funds transfer.

“I write today to express my concern with the high number of Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) providers who have been placed on ‘payment hold’ status due to not enrolling in electronic funds transfer (EFT),” Tester wrote to VA Secretary McDonough. “Approximately 76,000 CHAMPVA providers, nearly half of whom are actively providing care to CHAMPVA beneficiaries, are on payment hold. The Department of Veterans Affairs (VA) must take further action to ensure these providers are aware of the requirement to enroll in EFT, so that CHAMPVA beneficiaries do not experience disruptions in care.”

The CHAMPVA program provides health care to children and spouses of certain veterans, including those who were rated by VA as permanently or totally disabled for a service-connected disability, those who died from a VA-rated service-connected disability or who were rated permanently and totally disabled from a service-connected disability at the time of death, or those who died in the line of duty. Some caregivers who are approved for VA’s Program of Comprehensive Assistance for Family Caregivers are also eligible for CHAMPVA benefits. There are more than 706,000 CHAMPVA enrollees nationwide, including more than 3,500 CHAMPVA enrollees in Montana.

The Senator continued, “Though I understand VA has been conducting outreach to some of these affected providers, it is clear there is an enormous amount of work to be done until all active CHAMPVA providers are enrolled in EFT. I strongly encourage the Department to dedicate all resources necessary to ensure CHAMPVA providers enroll in EFT, thereby preventing CHAMPVA beneficiaries from experiencing any disruptions in their access to health care.”

Tester requested VA describe its efforts to conduct outreach to CHAMPVA providers on payment hold, especially in rural areas, and to describe the barriers preventing CHAMPVA providers from enrolling in EFT. He also called on the Department to describe the impact this payment hold status of many CHAMPVA providers is having on beneficiaries’ access to care.

A staunch advocate of bolstering CHAMPVA beneficiaries’ access to earned care, Tester has long pushed for legislation to allow children of disabled veterans who receive health care under CHAMPVA to remain eligible for the program until they are 26 years old, and is fighting for VA to allow CHAMPVA applications and medical claims documentation to be submitted electronically in his Making Community Care Work for Veterans Act.

Read the Senator’s full letter HERE.