That explanation doesn't seem accurate. Medicare determines the acceptable/allowable fees for the services, pays its share and forwards the claim to TFL for the remainder. Seems like two government entities working on the same event. Why can't the VA be part of that?
I suspect there isn't that much additional cost for you to use private offices because they only get paid what Medicare allows anyway. When you figure all the fixed costs to run the VA system into it, it probably comes out close.
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