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VA Ann Arbor Healthcare System

 

Veterans Access, Choice and Accountability Act

Veterans Access, Choice, and Accountability Act of 2014

The new Choice Program will provide many Veterans the option to receive non-VA healthcare rather than waiting for a VA appointment or travelling to a VA facility.

Thursday, December 4, 2014

Veterans Access, Choice, and Accountability Act of 2014

Title I: Choice Program and Health Care Collaboration

On August 7, 2014, President Obama signed into law the Veterans Access, Choice, and Accountability Act of 2014 (Public Law 113-146) (“VACAA”). Technical revisions to VACAA were made on September 26, 2014, when the President signed into law the Department of Veterans Affairs Expiring Authorities Act of 2014 (Public Law 113-175). The Department of Veterans Affairs’ (VA) goal continues to be to provide timely, high-quality health care for Veterans.

Section 101 of VACAA requires VA to establish a temporary program (“the Choice Program”) to improve Veterans’ access to health care by allowing eligible Veterans to use eligible health care providers outside of the VA system (non-VA care). Sections 102 and 103 of VACAA are also discussed below.

Background

In order to improve VA’s ability to deliver high-quality health care to Veterans, section 101 of the VACAA requires VA to expand the options for eligible Veterans to elect to use non-VA health care for a period of up to three years, based either on the distance a Veteran lives from a VA facility, or if he or she is experiencing wait-times beyond the 30 day standard . This is referred to as the Choice Program. Veterans who meet certain eligibility requirements will be able to elect to receive care from eligible non-VA entities and providers through the Program. VA must enter into agreements with eligible non-VA health care entities and providers for them to participate in the Program. Prior to VACAA being passed, VA had mechanisms in place to purchase non-VA care, which are still available to VA. VACAA will enhance VA’s non-VA care options.

Choice Fund and Choice Program

VACAA includes a $10 billion fund from which VA must pay for non-VA care furnished as part of the Choice Program. VA will provide a Choice Card to all Veterans who were enrolled in the VA health care system as of August 1, 2014, and to recently discharged combat Veterans. Eligibility criteria are discussed in greater detail below.

Eligibility

A Veteran must have been enrolled in VA health care on or before August 1, 2014, or be eligible to enroll as a recently discharged combat Veteran within 5 years of separation. Additionally, a Veteran must also meet at least one of the following criteria.

a) The Veteran is told by his/her local VA medical facility that he/she will need to wait more than 30 days from his/her preferred date or the date medically determined by his/her physician.

b) The Veteran’s current residence is more than 40 miles from the closest VA health care facility.

c) The Veteran resides in a location other than Guam, American Samoa, or the Republic of the Philippines and needs to travel by plane or boat to the VA medical facility closest to his/her home.

d) The Veteran faces a geographic challenge, such as extensive distances around water or other geologic formations, such as mountains, that presents a significant travel hardship.

Cost Sharing

If an eligible Veteran has another health-care plan, VA will be secondarily responsible for costs associated with non-service connected care and services furnished to eligible Veterans through the Choice Program and primarily responsible for service connected care.

Medical Records

When a Veteran receives care from an eligible non-VA health care entity or provider, the entity or provider must submit to VA a copy of any medical record information related to the care and services provided. This information will be included in the Veteran’s medical record maintained by the Department.

Indian Health Service and Native Hawaiian Health Care Systems

VA will work with the Indian Health Service (IHS) to ensure that certain medical facilities operated by an Indian tribe or tribal organization are aware of the opportunity to negotiate reimbursement agreements with VA. This is in accordance with section 102(a) of VACAA.

VA will enter into contracts or agreements with certain Native Hawaiian Health Care Systems (NHHCS) for reimbursement of direct care services provided to eligible Veterans. This is in accordance with section 103 of VACAA.

Implementation

VA submitted a report to Congress the week of October 6 redefining the wait-time goals of the Veterans Health Administration (VHA). The report establishes the wait-time goal as being within 30 days from the date requested by the Veteran for the appointment, as long as that date is clinically appropriate.

VA hosted an Industry Day at the VA’s Denver, Colorado Acquisitions and Logistics Center to seek input from the private sector on how best to provide administrative support in the process of issuing Veteran Choice Cards. VA recognizes that partnership with the private sector to implement this new law will be important.

As of October 2014, VA has streamlined how we pay for hospital care, medical services, and other health care furnished through non-VA providers. This marks a significant change in the way VA conducts business as required by VACAA.

Frequently Asked Questions

What is the Veterans Choice Act?

On August 7, 2014, President Obama signed into law the Veterans Choice Act which helps some Veterans get health care in their local community.

Do Veterans have to be enrolled in the VA Health Care System to Get Choice?

Yes. Veterans must be enrolled as of August 1 2014 or they must be a Combat Veteran within five years of leaving the military.

Which Veterans Who are Enrolled Can Get VA Choice Benefits?

Veterans who live more than 40 miles from their nearest VA VA health care facility including community based outpatient clinics (CBOC)

OR

Veterans who have to wait more than 30 days for care from their preferred visit date (when they want to be seen) or the date their provider feels is medically needed.

Will Veterans Get a Choice Card?

Yes. VA began mailing cards today (November 4th) to Veterans living more than 40 miles from a VA facility began receiving cards today.

This will be followed shortly thereafter by Veterans waiting more than 30 days for appointments.

Finally, all other Veterans enrolled for VA health care who may be eligible in the future will be mailed cards between December and January 2015.

How Can Veterans Get Help With Questions on VA Choice?

Visit our internet site at www.va.gov/opa/choiceact 

OR

Call the National Choice Helpline at Toll Free at 1-866-606-8198.

For further questions about the Choice Program, please contact VA Ann Arbor Healthcare System’s Choice Champions Group at (vhaannchoicechampions@va.gov).

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