Putting Families First: Strengthening CHAMPVA for Survivors and Dependents
2025-12-10
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Source: Congress.gov
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This oversight hearing of the Subcommittee on Health will now come to order. The chair may declare a recess at any point. That was when we were anticipating votes. I'd like to welcome all the members and the witnesses to today's hearing. Many here today have likely heard that the VA has taken significant steps to improve the civilian health and medical program of the Department of Veterans Affairs, CHAMPVA. CHAMPVA is a program to provide earned benefits for veterans' families whenever the veteran has qualifying service-connected disabilities or death. A veteran's spouse or child can access a range of covered health services through CHAMPVA, inpatient and outpatient care, prescription drugs, mental health services, skilled nursing care, and others. CHAMPVA is a way that we honor our commitment to serving the veterans and their families who are injured in the line of duty. Sometimes, circumstances require that family members forego a full-time job with health insurance benefits so they can care for their veteran full-time instead. These caregivers consider CHAMPVA a lifeline. Decades ago, Congress created CHAMPVA to close a gap left by TRICARE. CHAMPVA, when it works, is a huge relief for veterans and their families. Affordability is on everyone's mind, and that is especially true for veteran families with serious medical needs. Fortunately, the VA has recently taken steps to ensure CHAMPVA works. I'm pleased that the Trump administration is pulling out all the stops to bring down the cost of living by putting families first. Just before Thanksgiving, Secretary Collins announced the elimination of CHAMPVA application backlog. That's over 60,000 more families who can now access caregiver health care benefits at the VA. The subcommittee appreciates the VA's work to modernize CHAMPVA. Online applications and claims should have been available a long time ago, but if we continue to hold the VA accountable, veterans and their families will see greater results. As a case in point, I'm particularly pleased that the VA is in the process of developing a CHAMPVA provider directory.
This is after an abundance of feedback from members of Congress to the VA about the difficulty that beneficiaries have even finding someone who will accept CHAMPVA. The committee has been diligent in exploring solutions for a provider directory. I want to thank my friend and colleague, Oversight Committee Chairwoman Jen Kiggins, for her leadership on this issue as she recently wrote a letter and introduced legislation to create this system for veterans and their families. Needless to say, we'll continue to exercise oversight to ensure that the CHAMPVA directory is fully implemented. Modernization like this and CHAMPVA's ongoing efforts enhances the convenience of using the CHAMPVA program. And now, VA can process applications and claims faster than they have in the past. I'm encouraged that the VA is now aiming to process 100% of electronic claims within 30 days. It should be noted that in the past, their stretch goal was to process 90% of electronic claims in that time. However, there are still obstacles and opportunities for this program. Navigating VA bureaucracy is never easy. I have heard that certain obstacles remain in CHAMPVA, and I expect our witnesses to highlight these issues today. Foremost, this subcommittee will do its part so that the VA can process 100% of all claims within 30 days, not only the electronic ones. Paper claims still take too long to process. I know delays are inherent and manual processing is tedious, but I look forward to working with the VA to speed up paper processing as well. Second, there is limited transparency for status updates on applications or claims requests. Spouses and children want to know what's going on with their application. Caregivers and providers want to know whether their claims will be accepted or denied. Whenever they hear radio silence from the VA, they lose trust in the VA. This subcommittee spoke with one large healthcare provider who shared that the VA assigned a direct representative to address their claims questions, but the direct representative was too overwhelmed to ever timely resolve the provider's questions.
The provider would have to wait months just to get questions answered. And speaking as a veteran and a provider, I want to ensure this provider's experience is a thing of the past. There must be a better way to get information for families and providers so they know exactly what their benefits are ahead of time. Third, the VA could resolve claims faster if it improved its ability to cross-reference a spouse or a child's health insurance and whether that person reached his or her deductible. Because CHAMPVA can function as either a primary or a secondary payer, providers must properly bill either the program or somebody else's health insurance first. Unfortunately, this coordination frequently breaks down and providers lose time filing the claim only for the VA to require a different form. It's also important to know in real time whether a spouse or child has reached the deductible. Right now, real-time knowledge is unavailable to claims processors.
D
Dr. Maria Llorente
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