Veteran’s wife fights for his health care

Jim Moreno
Jim Moreno

Unlike the days when he manned a .50 caliber machine gun on a U.S. Navy assault boat during the Vietnam War, 67-year-old Jim Moreno is moving a bit gingerly of late.

The U.S. Department of Veterans Affairs replaced Jim’s hip in March 2015. According to his wife, Jill, about a week later, the hip replacement just broke.

Photo courtesy Jim Moreno
Photo courtesy Jim Moreno

“He wasn’t jumping, running, doing anything. It just fell apart. He fell to the ground,” Jill explained.  Jim endured two more corrective surgeries.

Jim endured two more corrective surgeries. “After that he was in constant pain,” Jill told 8 On Your Side. The V.A. Determined spinal stenosis was causing the

The VA Determined spinal stenosis was causing the pain and referred Jim to the Veterans Choice program for outside treatment. According to its website, Health Net assists the VA in making sure veterans receive timely access to the high-quality medical care they need.

In a series of reports, 8 On Your Side has documented problems with veterans getting the timely help they need from the Veterans Choice program. In addition, doctors have not been paid.

Health Net lined up a mid-December doctor’s appointment for Jim. Once they were there, the Morenos learned Health Net hadn’t sent the necessary authorization so they couldn’t see the doctor.

Meanwhile, Jim’s agonizing pain continued. “It was bad and it looked to me like he was aging in front of my eyes,” Jill said.

When he finally got in to see a doctor, the office scheduled a procedure, which was later canceled because Health Net did not submit the authorization.

“My husband went ballistic. He literally went ballistic,” Jill added.

Jill Moreno
Jill Moreno

She spent the entire next week on the phone, all day every day, pleading with Health Net.

The Morenos still hadn’t received authorization the day before the second scheduled procedure so Jill put it all on her credit card.

Health Net issued a media statement that said in part, “Developing a new program like Veterans Choice requires a high degree of coordination and Health Net is working closely with Congress, the Department of Veterans Affairs, health care providers, and others to provide veterans with the appropriate, coordinated and convenient care they have earned for their service to our grateful nation. By late 2015, Health Net was scheduling 34,000 medical appointments and fielding more than 230,000 phone calls monthly in support of the Veterans Choice program. As we rapidly expand our operations and services to meet the demand of veterans, there may be situations where a veteran does not get care as expeditiously as we would like. For that, we apologize.”

“They’re spinning their wheels. They’re wasting peoples’ time and they’re wasting taxpayers money,” Jill said.

Jim finally underwent the spinal injection he needed. It has helped with the pain level.

Jill said they finally received the authorization they needed from Health Net, two weeks after Jim’s procedure had taken place. The Morenos say they’ve had it and will not use the Veterans Choice program again.

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