Comment on AO47-Direct Final Rule-Kuder, Charles D.

‘RIN 2900–AO46—Authorization for Non-VA Medical Services.’’ 38 CFR Part 17 AGENCY: Department of Veterans Affairs. ACTION: Proposed rule. I believe that "Fee Paid" services should be looked at beyond the cost factors. Will fee paid services better serve the veteran? In general, I believe that the VA has been too restrictive on the use of fee paid services for multiple reasons, mainly due to the way the cost is accounted for. I also don't believe that the VA should be duplicating medical services readily available by well qualified providers. Many veterans are forced by current VA practices to utilize local medical services, even though the services are in theory available from the VA at other than a "local" VA facility. Timely care can be a major factor, and the VA is known not to be fully capable in this facet of care. I also believe that veteran's expenses in utilizing "medicare" should be offset by VA reimbursement.