VA announces final community care regulations under MISSION Act


shadow

Today the U.S. Department of Veterans Affairs (VA) announced the publication in the Federal Register of two final regulations as part of its new Veterans Community Care Program under the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018.

Signed into law on June 6, 2018, the MISSION Act strengthens VA’s ability to deliver trusted, easy to access, high quality care at VA facilities, virtually through telehealth, and in Veterans’ communities. The law makes several improvements to VA care that begin on June 6, 2019.

“President Trump promised to give Veterans greater choice. We are honoring that promise by making sure Veterans have access to timely, high-quality care, whether from our VA facilities or our community providers,” said VA Secretary Robert Wilkie.

A key component of the MISSION Act is a new urgent care benefit that provides eligible Veterans with greater choice and access to timely, high-quality care. With urgent care, Veterans have a new option for care for the treatment of minor injuries and illnesses, such as colds, sore throats and minor skin infections. The benefit is offered in addition to the opportunity to receive care from a VA provider, as VA also offers same-day services.

VA also published the final regulation for the Veterans Community Care Program governing how eligible Veterans receive necessary hospital care, medical services, and extended care services from non-VA entities or providers in the community. The new Veterans Community Care Program replaces the Veterans Choice Program, which expires June 6, 2019.

VA previously published an interim final rule for Veterans Care Agreements (VCA) on May 14, 2019. VA may use VCAs to order care when that care is not otherwise feasibly available through VA’s contracted network. VCAs are intended to be used in limited situations. VA will purchase most community care for Veterans through its contracted network as part of its strong partnerships with third party administrators. Currently, these administrators are TriWest Healthcare Alliance and Optum Public.

VA is implementing improvements to its community care program as required by the VA MISSION Act. Veterans can find detailed information on urgent care eligibility, community care eligibility and MISSION Act implementation at www.missionact.va.gov

Author

Media Relations

The Office of Media Relations serves as the interface with news media representatives from newspapers and electronic media for the Department. OMR arranges interviews, provides press releases and answers media queries.

Comments

  1. Joseph Kennette MacPherson    

    Wow, look at all these Veterans explaining just how ineffective, confusing, and absurdly ridiculous it is just to apply for this program. It is disgraceful that our government and nation treat these people this way. Every U.S. military veteran should be able to walk into any hospital, clinic, or medical facility in the world and receive healthcare paid fully by our country that we served honorably.

  2. Joseph Kennette MacPherson    

    I am an 80% service-connected disabled veteran. I live in Thailand, and received a benefits letter from the Foreign Medical Program that reduces my earned benefits from full healthcare to just what is listed as service-connected. Now that veterans in the U.S. are able to use community-care options instead of VA hospitals far away ( I am very familar, having lived in Bend Oregon and required to travel 164 miles one way to Portland for care when i lived there), the earned benefits for Veterans living abroad has been reduced. I applaud the MISSION Act, but i also want Veterans overseas to have the same rights as Veterans living within the U.S. There is no reason why our healthcare shouldn’t be the same, especially considering healthcare anywhere outside of the U.S. is LESS EXPENSIVE. Why shouldn’t we get our full benefits? I would like to hear a reasonable answer to this question.

  3. Name is Mudd    

    OMG! I am totally thunderstruck with this “new & improved” Mission Act stuff. Ha! 100% SC Total&Perm. 40 mile w/ Choice. VCP saved my life after VA deemed all chronic pain patients as addicts and left us out on the streets to withdraw from years on opioids. Felt to me that VA hoped we’d all disappear so they could confirm that more than 50%+ of vets were now off “the drugs”. (Thank CDC for grouping all chronic pain patients with heroin addicts.) Having used Choice and local doctors for the past 2 years, I currently do not have a single clue as to where to turn for continued care.
    These highlighted quotes from some of the dozens of documents outlining new program:
    “Veterans should contact their local VA facility to determine if they are still eligible for community care.”
    “Veterans who were eligible for community care under VCP should speak to their VA care team or a VA staff member at their local VA medical facility about their eligibility for community care after June 6, 2019”.
    “Certain Veterans that were eligible under VCP based on distance may still be eligible to receive community care after June 6, 2019, under the “grandfather” eligibility criterion established under the MISSION Act.”
    “A final determination on your eligibility for community care will continue to depend on your specific care needs, circumstances and whether or not the care is available through the VA AND other factors.”
    MISSION details basically say to contact my “VA Heath Care Team” to get permission to use local doctors. “Call your local VA for permission”. Who to call is never really clarified! How to do this when I haven’t been forced to travel 2 hours each way to VA for past 2 years? Furthermore, why would the small community care clinics bother trying to jump through Mission’s hoops when they barely got paid for my care thru Choice?
    After researching and making notes about this new & improved program for hours in regards to my own continued care; it’s all just clear as mud! Seriously? What are the chances I won’t need any ongoing continuity of care before 2020 while “they” work out all the bugs?

  4. Donovan Wright    

    I’m located in Panama City Florida and I deal with that VA clinic I’ve been bleeding easily for years and I’ve been diagnosed so many times with different things for doctor and Pensacola Florida to sit down with five different reports and say he don’t know what’s going on there was no test just giving me all different types of drugs to try then I had to be rushed to surgery and a doctor said I barely made it in Biloxi Mississippi then when I go back to the doctor up here dr. Hardin he gives me adult diapers and tells me to have a nice day.. they outside source me the doctor said that I needed surgery I faxed the paperwork to VA over a month ago of roughly around a month-and-a-half ago yesterday they confirmed the number that it was sent to which their office the fax went through they said they never got it there reply was oh well I’ve been in and out of the emergency room passing blood clots everything else there is no care nothing for the the veterans around..then the specialist at the outside source me to stated the medication for my stomach was not working that the stomach acid is still damaging me inside and VA still hasn’t did anything about it and they won’t rate me for my gastro acid reflux disease that I was diagnosed with and o3 and Balboa medical hospital in California because they said that they don’t need to honor it

  5. Leon Chitman Sr    

    I am a disabled veteran rated 100% and I’ve been going to the VA dentist at Ft. Roots in NLR for over a year now and the only thing I’ve had done are x-rays, cleannings and a root canal. I was going to a local dentist prior to going to the VA and I was told that I needed crowns and replacement of a bridge that was loose. I still haven’t been able to get this work done yet. In fact, I was sent an appointment for October 2019 to come back to the dentist. It shouldn’t take a year to get a bridge or a crown done at any dentist office period.

    Leon Chitman Sr
    USA DAV Army (Ret.)

  6. Daniel McKinney    

    Our daughter (veteran) was denied treatment at all the immediate and urgent care facilities in Tumwater, Olympia and Lacey, Washington on Jan he 7, 2019. They claim no knowledge of the VA Mission Act and are not contracted with them to provide any medical service to veterans. Same old story with politicians claiming how they are helping veteran and they just create a bureaucratic nightmare that does work any better than the last program. I’m so sick of people talking about helping veterans and nothing really changes.

  7. Luna    

    Oh look more malpractice doctors or doctors that have no clue what they are doing. How about firing the ones you have and stop covering the situation. That’s great that the mission act is covering more area but you basically hiring contract doctors that see Us Veterans as dollar bills on their pay check. Granted yes there are doctors that do care but that is only 5% of the 95% doctors and workers of the VA.

  8. Jasinto Garcia    

    How does this act affect veterans that receive and use Medicare? What happened to Tricare/Tricare for Life?

    1. Johnnie Martin    

      It has no effect on either. If you have Medicare and TFL, you have no copayments. All 100% of your bill is covered and paid.

  9. Rick    

    Terry,
    I agree with you. These new programs are usually done in favor of the VA and not necessarily the Veteran. Paying a co-pay or for prescriptions until reimbursement is a nightmare waiting to happen for most vets.
    Rick

  10. Rick    

    In just my brief reading of this new plan, I find it confusing as hell. I’m a law student and I don’t see if I qualify or where I can go for urgent care. Is Med Express covered? It seems the onus is on the Veterans back in that if they go to one of these alternative facilities they may end up paying for services rendered and then just hope and pray that the VA will properly and timely pay the provider. I think it stinks. Fortunately, my VA clinic is fairly local but If I need urgent care I have to travel over 50 miles to the nearest VA hospital. I don’t think the VA is actually carrying out the Presidents wishes when they leave the responsibility on the veteran. Why couldn’t they just give us a card like regular insurance instead of half a program that favors the VA and makes it all the more confusing for Veterans?

    1. JP Sullivan    

      Rick, you have wrapped up 100% my opinions based on the terms of this new NON-VA care provided by other qualified Hospitals and Surgeons. What is still rotten to the core is the VA Hospitals and their primary Doctors who to this day still refuse to perform or have performed SURGERY. The VA for Men is located at Long Beach, CA and I have been refused needed surgery now for 3 & 1/2 years. Inguinal Hernia. Yes, it will take pics of the body….but refuse surgery to correct. The only hope for Vets like me is NON-VA Surgery. Currently that means Medicare and 20% my Costs.

  11. Colonel Todd D. Stong    

    This VA email of 06 Jun 19 about the VA Mission Act is massively confusing. I have no idea what I must do to comply with whatever is new. The mindset of the author of these 1000s of words is a1000 miles distant from the mindset of a veteran. This is the most terribly written message I have seen in my life. I am a 30 year service vet, rank colonel O6, PhD in engineering, I write over 1000 pages a year myself. What a total waste of money. There appear to be “new terms” all over the writing. Do we have to fill out this new application form or are we who have been in a past VA progam OK? The new application form is so dense in the call for ancient data I I do not know where I can find 10 or more items. Surely this is ALL in current VA computers. .

  12. Daymond Cox    

    So, I see several requests for help here, is anyone from the VA listening and taking action?
    After seeing them repeatedly deny my Dad’s compensation, having worked in the “systems” as a reservist and having several issues identified after I retired, some recognized by the VA and others, the more painful/restrictive, denied: my thought is it is all about show, denied til you die.
    I respect our President, but this is just one effort, so much more to do.
    We should be thankful that we have anything, but not “settle” for substandard care (care is multidimensional, not just physical Dr visits and medications to appease us).

    Do I expect slower response on my current pending claims, yes, after posting this.

  13. Troy E Hagan    

    This is great that we get leave comment. I just don’t believe anyone reads them, and if they do, nothing gets done. The “Choice” program is not a choice, it’s a “PICK” program. You have to pick a doctor on a VA list that you have no access to. You pick one, VA says no, and then tell you over the phone they’ll pick one for you. And then the Doctor you choose doesn’t get payed in a timely manner and drops the Choice program. So much wrong with it.

  14. John D` McNamara    

    Choice Program had its problems but when they weren’t able to fix them, VA introduced a new program. Any care for Veterans is better than the ’70’s. Big on promises?

  15. Kenneth P Conrad    

    It is June 6th and I cannot find any information if any of the urgent care providers in my area have been approved for payment by the VA. It seems that nothing has changed with the VA, Wonderful benefits, but veterans cant access them.

  16. Alan Greenberg    

    I hope it works better than the Choice program! 3 years ago I had called my Local VA Clinic in Daytona Beach Florida because I had an earache (Which is a chronic condition in my VA Records). They said I couldn’t be seen for 1 month and told me to use my “Choice card” and go to Halifax hospital for care, so I did. I was examined at that (Private) hospital and was given a prescription (Cipro) to be filled at a local pharmacy. One moth later I received a bill from that private hospital so I called them and they said the VA refused to pay! I went to the VA Daytona clinic and told them what had happened and that I had called the clinic and the clinic told me to go there. The person I talked to said that a phone call doesn’t authorize payment and that I should have come in person to that clinic, so I was stuck with the Bill!
    In April of this year (2019) I called the VA clinic and asked to see a Doctor because I was I was ill with a headache, earache, body aches and a sore throat, they told me I had to wait until my scheduled appoint (Over 1 month), to be seen. The pain was so bad that I went to an Urgent care clinic and was given medication for Sinusitis.
    This has to be the WORST VA Facility (In 35 years) that I ever had to deal with, it should be CLOSED PERMANENTLY!!!!

  17. Clyde T Miller    

    I have always had excellent service and care from the VA in Augusta, GA. I think this will ad to the great service. Thanks to the President and the director.

  18. Clyde T Miller    

    I have not finished reading all the information, but what I have read so far looks good. I hope it is as easy as it appears to be. Thanks to our President for helping to get this in place. I have always had great service from the Augusta VA in Georgia, and this service should be a wonderful addition to meet our needs.

    1. Terry Roger Epling    

      All on the surface sounded good at first! Now reading more I understand that with this new Mission Act, Any medical service you get if it in not connected to a specific service connected disability then you are charged a hefty Co-Pay for that service. This will put many Vets now unable to pay for their part of serious ailments such as cancer surgery or heart surgery if not directly a resulted from a service related disability. Their part of this cost will make access impossible.

  19. michael e. statham    

    mike statham,, I am excited about what I have read about va missions act. thank you all for your help in this. i do not understand how to find out if a vet qualifies these services. it seems a little veague.

    I would also like to know why some vets have to pay for va treatment and others do not? we all served our country the same , because i have a job and pay my taxes i am not being treated the same as a vet who does not have to pay.

    I live 85 miles from the Atl va and it takes about 2 hours to travel, and if i have an emergency it is not practical to come that far. does that mean i do or dont qualify for missions act?

  20. James L Dillon    

    I have an appointent on June 10 that TriWest set up do i still use the choice act card

    1. Ken Davidson    

      James, I also have appointments set up by Tri-West for the next 90 days and was told to go ahead with them as usual. My Doctor is also aware of the change and would inform me if there was a problem about them getting paid. Thanks for serving and wishing you a great life. Ken

  21. Eddie m JONES    

    Will TriWest be involved in this change?
    Who will be the company in charge of insurance?

  22. Ralph C Muhammad    

    Concerned on how veterans are treated when it comes to housing…many are homeless and many of us can’t qualify because VA allows private vendors which means a Vet has to have a credit score of 662..this is insane when we already have earned housing benefits.. This criteria should be waved and VA should make it that we get what we have our lives and our sacfice to protect this country.but who is protecting us…Homeless..can’t qualify..living in substandard housing..renting to own..paying high rent for low value..but we always hear”thank you for your service”…what about servicing us ALL…

  23. Ja Nicole Carvalho    

    I am looking forward to improvements. However I’m still not clear on how to get new Prescriptions from my Community care Doctor. So far it has been difficult, at best. Also, it has not been clear on how to get authorization if I am grandfathered in. I had been using choice now for 3 or more years. A phone number has not been published on who to call at my VA Center. I do use Telehealth for my Mental Health doctor which is pretty awesome. Thank you for listening to President Trump.

  24. David E. Beeler    

    Thank you VA and President Trump for the Mission Act. Access to urgent care is a very big deal for veterans.

  25. Cardin, Richard Bruce    

    How does this system handle prescriptions, if a veteran seeks services, from a community care. ” With urgent care, Veterans have a new option for care for the treatment of minor injuries and illnesses, such as colds, sore throats and minor skin infections. The benefit is offered in addition to the opportunity to receive care from a VA provider, as VA also offers same-day services.”

    It is my understanding, that currently Prescriptions must be written by a primary care physician, or a walk in clinician or physician. Will the contracted providers have the authority to write prescriptions to be dispensed at, say, a local pharmacy or Walmart? And, In the case of a 100% disabled person, will they have the authority to charge the VA for the coast of said medications?

  26. Rhonda Jean Kelley    

    I am a 100% disabled wheelchair veteran. I am to weak to leave my home and traveling causes me great stress. My health has been declining since 2014. When I last saw my Dr. and for the past year I have told him (a gynecologist) that I have SEVERE abdominal pain. He said my CT SCAN 6 months ago showed a enlarged hernia in my abdominal area. It is so painful now I am terrified to move. I am normally in bed 20 plus hours a day. I am unable to care for myself. But I take a shower once a week.
    I fear that the hernia will break and kill me. I don’t know what to do. The pain is to much.
    PLEASE HELP ME.

    1. Linda Fredrick    

      You need to get to an er not urgent care asap. If its that painful it could be strangulated. Call. for help if you cant get there alone.

  27. Barbara chrestensen    

    Where information on free audio books for vet and family?

  28. Tom Reynolds    

    I wonder if Congress and the Heads of the VA would consider having to travel over 100 miles just to get an X-Ray as having Great Health Care?

  29. Michael Aprile    

    I lived in far eastern TN and received great full care from The Mountain Home VA in Johnson City for years, but I just moved to Clarksville TN where I have family. Clarksville has a very decent VA clinic but when I tried to check in there, the desk clerk said that ‘they were down five doctors and I had to go somewhere else.’ Naturally, I was dismayed and did not want to go somewhere else. Why can’t the VA in Clarksville TN get more doctors instead of turning local enrolled Veterans away?
    Sincerely
    Michael Aprile
    Veteran USAF

  30. Bernard Duff    

    I’m curious to know if either dental or optical care is included in community care. I have been in treatment for oral cancer and require frequent deem cleaning of my teeth. In the past, I was using Veteran’s Choice, or something similar to get this done closer to my home. I currently have to travel over an hour to get to either the dental, or eye clinics and both clinics have an extremely long backlog of appointments.

  31. Pete Perez    

    Please, See my Previous Dental Comments.

  32. Pete Perez    

    I asked for Dental Implants in 2005 from “Michael E.DeBakey V.A.Medical Center.” I was 60 in 2005.
    They only agreed to give me Crowns in 2005. All my Crowns eventually broke off.
    It was 4 to 5years ago my “V.A.M.C.”Dentists finally agreed to give me Implants.

    They have only given me three Implants, in my upper Gums. I need four more Implants in my upper Gums.
    They are taking too long. I am 74 years old now in 2019.
    Can you please ask my Dentists to finish my other 4 Upper Implants by July 2019??

  33. David Rubin Barbour    

    How do I apply for this program

  34. Lyman Jordan    

    Care In The Community should be aborted.

  35. Vernon Cole    

    Should have kept the Choice program and gotten rid of Tri West. If Tri West is involved this is going to fail and just cause more confusion.

  36. Vernon Cole    

    Should have kept the Choice program and gotten rid of Tried West. If Tri West is involved this is going to fail and just cause more confusion.

  37. Doyle Burrows    

    Hopefully staffing workers will be a little better trained than those staffing TriWest. They about drove us crazy this last year…….Some didn’t even know how to pull up the veterans information, or else were too unconcerned.

    Service was good after the authorizations were completed. Happy with community service. Thank you Mr. President for keeping your promises.

Comments are closed.