VA launches new health care options under MISSION Act


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The U.S. Department of Veterans Affairs (VA) launched its new and improved Veterans Community Care Program on June 6, 2019, implementing portions of the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (MISSION Act), which both ends the Veterans Choice Program and establishes a new Veterans Community Care Program.

The MISSION Act will strengthen the nationwide VA Health Care System by empowering Veterans with more health care options.

“The changes not only improve our ability to provide the health care Veterans need, but also when and where they need it,” said VA Secretary Robert Wilkie. “It will also put Veterans at the center of their care and offer options, including expanded telehealth and urgent care, so they can find the balance in the system that is right for them.”

Under the new Veterans Community Care Program, Veterans can work with their VA health care provider or other VA staff to see if they are eligible to receive community care based on new criteria. Eligibility for community care does not require a Veteran to receive that care in the community; Veterans can still choose to have VA provide their care. Veterans may elect to receive care in the community if they meet any of the following six eligibility criteria:

  1. A Veteran needs a service not available at any VA medical facility.
  2. A Veteran lives in a U.S. state or territory without a full-service VA medical facility. Specifically, this would apply to Veterans living in Alaska, Hawaii, New Hampshire and the U.S. territories of Guam, American Samoa, the Northern Mariana Islands and the U.S. Virgin Islands.
  3. A Veteran qualifies under the “grandfather” provision related to distance eligibility under the Veterans Choice Program.
  4. VA cannot furnish care within certain designated access standards. The specific access standards are described below:
  • Drive time to a specific VA medical facility
  • Thirty-minute average drive time for primary care, mental health and noninstitutional extended care services.
  • Sixty-minute average drive time for specialty care.

Note: Drive times are calculated using geomapping software.

  • Appointment wait time at a specific VA medical facility
  • Twenty days from the date of request for primary care, mental health care and noninstitutional extended care services, unless the Veteran agrees to a later date in consultation with his or her VA health care provider.
  • Twenty-eight days for specialty care from the date of request, unless the Veteran agrees to a later date in consultation with his or her VA health care provider.
  1. The Veteran and the referring clinician agree it is in the best medical interest of the Veteran to receive community care based on defined factors.
  2. VA has determined that a VA medical service line is not providing care in a manner that complies with VA’s standards for quality based on specific conditions.

In preparation for this landmark initiative, senior VA leaders will visit more than 30 VA hospitals across the country to provide in-person support for the rollout.

The VA MISSION Act:

  • Strengthens VA’s ability to recruit and retain clinicians.
  • Authorizes “Anywhere to Anywhere” telehealth across state lines.
  • Empowers Veterans with increased access to community care.
  • Establishes a new urgent care benefit that eligible Veterans can access through VA’s network of urgent care providers in the community.

VA serves approximately 9 million enrolled Veterans at 1,255 health care facilities around the country every year.

For more information, visit www.missionact.va.gov.

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Comments

  1. Eldon E. Lackey    

    been waiting since May 24 for a new c-pap machine hows that for service LOL except it is not funny when you cant breath at night when your machine quits for no reason, VA response oh we are running a little behind, you think. Try to find someone to help update your disability claims good luck with that. Fractured vertebra in my back 1970, knees getting so bad walking is very hard most of the time.Diabetes from agent orange, and more things they wont tell us from this chemical. So yes this new program is nothing new except a different name. Hell the illegals get better care most of the time what a shame we are treated like second class citizens!!!!!!!!

  2. Eldon E. Lackey    

    same old lies over and over nothing ever changes just a new name.

  3. Wilbur l Bass    

    The mission Act doesn’t help us it made things worse, I no longer desire to be treated by the VA but what options do I really have zero, this sucks.

  4. Sheila Wilson    

    The CBOC in Lynchburg VA is a joke, except for one clinic – mental health. The only clinic you can reach (if you have their extension) is the mental health clinic.
    You can never speak to an actual human being when calling the CBOC. There was even a young man working behind the desk that was “moved to the back because of always being rude and then had the audacity to cuss at a veteran and yelled at him. The veteran was having none of it. And a yelling argument started. It was time for me to go home.

    My dad has a 90% hearing loss and can’t reach anyone; because he can’t hear all the ridiculous numbers to push for this and that just to get a recording to leave a message.

    The VA in Salem is great except the Nuerology department. The clerks are great, but since Dr. Harpo retired you get someone telling you, “you walk in and you’re asked; at a scheduled appointment, “what can I do for you today?” I don’t know, you’re the doctor, you scheduled this appointment for me to come back, how about reading your notes. Good grief!
    The dental program has been falling short over the years, but thank goodness they outsourced me to an outside dentist.

  5. Dwight A Nemeth    

    It seems that this ‘mission act’ was created to help veterans healthcare, NOT the veteran. I’ve lost my provider under the ‘choice’ program and have to go back to waiting for weeks to get an appointment and then hours of sitting in the waiting room to see the provider. What the hell was wrong with the ‘choice’ program?????????????

  6. Kevin Baird    

    Why does this blog require censorship. Tried to post and says “awaiting moderation

    1. Kevin Baird    

      Boycott this conference call. Let the President and the Congress and ask them why does Congress have better healthcare than Veterans? That is not right.

      The 2020 election is come WE DO NOT HAVE TO RE-ELECT THESE PEOPLE. They work for US and WE DO NOT WORK FOR THEM. They need to be told that.

  7. Kevin Baird    

    The geomapping is probably rigged in favor of the VA. Time will tell

  8. LEONARD CROCKEN    

    I got skin cancer and had to travel approx. 90 miles each way for 10 days to East Orange,NJ to be treated with radiation for 10 treatments.I’am 100% disabled vet and have had to travel all theses years since around 1977 long distances to get treatment from the VA.for my service connected problems.The VA worked with me for I have new cancer now on my face, the VA hospital used the Mission Act to help me out by sending me to a outside community clinic only 20 miles from my home in South Jersey to treat my face with radiation treatments.I’ll always be 100% disabled but at least my travel and care just became a little easier thanks to the Mission Act.

  9. LEONARD CROCKEN    

    I got skin cancer and had to travel approx. 90 miles each way for 10 days to East Orange,NJ to be treated with radiation for 10 treatments.I’am 100% disabled vet and have had to travel all theses years since around 1977 long distances to get treatment from the VA.for my service connected problems.The VA worked with me for I have new cancer now on my face, the VA hospital used the Mission Act to help me out by sending me to a outside community clinic only 20 miles from my home in South Jersey to treat my face with radiation treatments.I’ll always be 100% disabled but at least my travel and care just became a little easier thanks to the Mission Act.

  10. Pete Perez    

    My V.A. Dental Care began when I was 60. Now,I am 74. My Dental Implants were agreed to, about 5 years ag,o by the “Michael E. DeBakey V.A. Medical Center’s Dentists.” They have only, so far, implanted only 3 Implants. They need to Implant ,at least, a total of 6 Implants. They have Not yet begun to Implant the other three Implants that need to be Implanted. It is difficult for me to chew my food with only one side of my mouth.
    *Pete Perez-(Donnelly), age 74, Diabetic & Disabled War-Vet with Skin Cancer and Prostate Cancer*Houston, Texas*

  11. Lloyd Scher    

    The Mission Act is another waste of time for Veterans back forth 3

  12. Tonya Wright    

    Michael Rogala, the VA currently only provides dental care in a few instances.
    1. You must be 100% service connected (with any disability) to be eligible.
    2. If you are less then 100% SC, then some of your rating must be related to dental. Ex: You were injured in some way while on active duty. Maybe a tooth was knocked out.
    3. You are diabetic and an infected tooth would cause more health problems, so your provider refers you to dental if you have an infected tooth.
    4. You did not receive a dental exam before you were discharged from service.

    There may be other instances, but these are the ones I know of after almost a decade of working for the VA.
    Dental is very expensive and it is rationed.

  13. Harlan Melvin Tilton    

    My audiologist and ENT doctors at VAOPC in Martinez, Ca have determined that I should have a Cochlea implant. The nearest VA facility that can do it or even do the prior surgery CT scan and most likely any follow up appointments is more than 50 miles from home and is more than an hours drive time due to the heavy traffic between Antioch, Ca. and San Francisco VA hospital. I am 100% disaailiy rated and am 72 years old.

    Since I also have medical coverage through my retirement plan with Kaiser Permanente (KP) and have the “senior citizen” medicare coverage as a separate insurance can I utilize them rather than VA do the surgery and related procedues/appointments
    .
    Would I need prior approval from VA under the Veterans Choice Program or Mission Act?

    Since it is a second health plan would KP bill VA for any part of their services or would VA even enter into it at all?

  14. Rodney J LaChapelle Jr    

    Yes, once again in a failed attempt to help veterans, the Red Tape has become Redder!!! They use drive time distance by geomapping, What a joke!!. No consideration about actual driving time. Once I get off I-87, I have to contend with numerous speed limits, traffic lights and traffic. Did they geomap that!!! Urgent care is another joke!! I have a civilian urgent care less than 5 miles from my house but it is not in the network. That means to get free urgent care I have to drive almost 30 miles to an approved network provider. Thanks but no thanks!! We are the veterans but we can’t just go anywhere for care yet those who never served have a lot better choices. Go figure.

  15. Greg Marsh, Disabeled VET    

    These folks need to write their congresspeople.

    1. Lloyd Scher    

      I spent a week meeting with my Congressional members from NC and I got no help from Senator Tilis or Senator Burr’s Office I never saw such a runaround as I did when talking to these people. It has been one year exactly since I met with their offices along with my Congressman’s Office and nothing has happened the VA has not paid the bills authorized by the VA from 2016.

      I have been paying the bills because the VA hasn’t. I had to jump up and down to meet with the Administrator of the Salisbury facility. It was the suggestion of the Senators offices and even after telling them I was referred by the Senators to meet with the administrator I still got calls telling me they can talk to me on his behalf I told them I will only talk with the Administrator it took another 3 phone calls of people calling on his behalf. I finally got to the point where I just asked them are you the Administrator, if they said no I thanked them for the call and told them I will only speak with him and hung up.

      The advocates never called me back and I never heard from them and had no idea just what they do and each time I tired to talk with someone about getting the authorized bills paid they would tell me talk with the Advocate. I had better luck talking to my wall.

      Finally after months of waiting I finally got a meeting with him. I await his review but again I will not hold my breath.

  16. WILLIAM TRAIL    

    Here’s my Navy Vietnam veteran’s story. I’m posting it only because I think it highlights another side to all of these sad stories.

    I worry about my familial cancer situation; dad had bladder cancer just before he died in 2004, older brother died couple years ago @ 72 from leukemia (I’m 71), youngest sibling (sister) died 9 years ago of ovarian cancer.

    VA bloodwork indicated blood in my urine several times in 2 years however VA did not offer or suggest anything.

    After couple weeks this last time in September 2018 I drove the 50+ one way miles from my home in Macon, GA to Carl Vinson VA Hospital, Dublin, GA and waited to be seen by my “Blue Team” nurse… the actual doctor is never there. I’ve only seen/met him once in three years.

    I requested a complete urological study. They scheduled me for kidney ultrasound there at the VA in Dublin – another 100-mile plus round trip weeks later.

    Well I did not ever hear anything – no result in the promised one week… even after a month. Doctor was supposed to call – what doctor. Aren’t any.

    So I drove the round trip 100+ miles for a third time and asked for a copy of the scan result. They did give me a copy as well as “burned” a DVD copy of the actual imaging scans for me.

    After reading what looked to like a questionable result I realized I needed help and asked that I be referred to a urologist which meant a civilian doctor because VA Dublin GA has no urologist.

    That process of Community Care approval took about three weeks. However the request was granted.

    The civilian urologist did a full workup including an abdominal CT scan which “accidentally” showed a mass on my right rear hip just below the belt line. No urological issues however… good news there.

    So the civilian urologist immediately referred me to a local surgeon. I Googled & Yelp’ed the surgeon and unfortunately found almost nothing on him or about him so I began asking all my friends who might me a good alternative. The same surgeon’s name continued to surface.

    I used Secure Messaging to request the change away from VA’s recommended “mystery surgeon” to the other more prominent and better known (probably more expensive) surgeon.

    In the meantime a fast initial appointment with this new surgeon became available so I went ahead.

    He ordered an immediate CT-guided biopsy and discovered a soft tissue sarcoma cancer tumor about the size, he said, of a “large chicken breast”.

    He fast tracked me for surgery to remove the tumor June 10 just a few days ago.

    I continued to call and use Secure Messaging to try to find out if this was going to be covered.

    IMMEDIATELY – before the end of the old Community Care program on June 6 (on June 5th) I got a call from VA Dublin and was informed that VA was going to pay for everything even though the program was morphing into this new incantation… including any required followup radiation or chemo or meds.

    So I had the cancer tumor removal surgery on Monday June 10.

    The pathology lab quickly confirmed June 13 “clear margins” and I have a followup appointment in another week with the surgeon.

    Even though it took seven or eight months from the time I started making noise and demanding help I just have to say that – all in all – I think VA came through for me as best as they could. Thanks to the fact that my Dublin, GA VA permitted me to go to a civilian urologist where my cancer was accidentally discovered I believe my overall health is remarkably improved as are my chances for a longer and healthier life.

    Also: I don’t know any of the details about the Veteran who committed suicide in the parking lot of my Dublin VA hospital late last year. It was a horrible tragedy and my heart goes out to that family.

    But maybe my story proves that things are better there… and improving.

    We do, however, definitely, need several full time doctors. As I mentioned I met my “doctor” once – 3 years ago – when I first started going to VA Dublin, GA. That was it. Only nurses or PA’s ever since. I honestly don’t think that doctor really even works there. They just say his name every now and then to keep his memory alive!

    Still, in all, THANK YOU to Carl Vinson VA, Dublin, GA, for the help you have given me with my cancer.

  17. Gilbert A. Lerma    

    I have been using the VA, hospital and out patient clinic for a number of years and have no complaints.

    1. Tonya Wright    

      As a disabled veteran, VA patient, and former VA employee, I can certainly attest to the fact that the VA is always short on doctors. After 9 years of working closely with and scheduling for these doctors, here is what I have learned:

      1. The doctors are frustrated with all the red tape they have to go through to get their patients the care they need. Everyone complains about the wait time it takes to see a specialist—wake up people! Government healthcare is rationed healthcare. Welcome to Socialized Medicine.

      2. When VA doctors leave, they talk to their network of colleagues and friends about all the problems they encountered. No one else wants to tangle with the VA.

      3. Most of the VA docs and staff that we do have are overworked and emotionally/physically exhausted. I have known them to stay at work hours after a clinic closes, without compensation.

      That being said, I have also worked with some of the most compassionate providers I’ve ever known in my 25 years of healthcare work. I encourage everyone who reads this to smile at the clerks and treat them with respect ( most of them are veterans too). Some are worthless and lazy–many are very hardworking. Show kindness and appreciation to the staff–that will get you further than you can imagine. Believe me, I know some staff that I wouldn’t trust to care for my dog but the good ones are out there.

  18. Kenneth Goldstein    

    How is this going to help a 100% Permanent and totally disabled veteran that lives in the Philippines. The FMP doesn’t allow for all my medicine to be covered or the same services I normally would have. The VA clinic is extremely limited in their services other than service connection and my travel time exceeds 2 hrs to Manila and 4+ hours to Guam. What is this going to do for me and other veterans in the same situation.

  19. Phillp C Thomas    

    is there a provision in the Mission Act which provides for emergency care for a veteran and what are the conditions.

  20. Michael Rogala    

    Why does the VA not offer dental care? I was told it had to be service related, does that mean your teeth had to be knocked out by a gun butt?

  21. Steven S. Palmer    

    I am under care with the VA, Oregon. I asked for a primary care near my home and was put on a waiting list 2013 for a new clinic that opened 20 miles from me, and this was in 2013/2014 they opened the new clinic. They only let me go to the clinic or hospital that are located 150 mile round trips. They told me I don’t have to renew my request for the new clinic. I have been waiting sine it opened in Salem Oregon 2014. I have pancreas and liver disease, and it is very difficult to travel hundreds of miles. There is no one that can help. I tried so many times. My doctor is retiring in a couple months at the clinic they have me going to 150 miles round trip. Communication is horrible with the va, especially Oregon, I lived in San Diego VA for six months as an in patient after a failed pancreas operation. Each VA treats vets differently, and the VA says we are suppose to have a team to help us, no word on any teams. Please, help me fix these problems.

  22. Michael Godwin    

    I tried to use the new Mission Act, and still got bogged down in the Telephone transfer bounce-around that has been pretty regular in the VA System. I had a Physciatry Appointment scheduled for late July, and needed it pretty much immediately, so I finally got to the right person inside the VA that could set up the referral, except for the fact that they couldn’t actually set it up; all they could do it s cancel my previous appointments and send a request for another department to call me back and discuss if I could (or actually needed to be referred) to care outside of the VA, under the Mission Act. They could not give me a time frame, but said it could take a few weeks for them to get in touch with me. If that happens, I’ll be running into a tight schedule to get a new outside the VA Appointment, and if they decide I can’t be referred (for whatever reason), I’ll be in a much more difficult position because I’ll have to reschedule the original VA Appointments, which could be 1.5 to 2 or more months out from the original appointments. I’m just wondering if this new way of doing the old VA Choice Program will be any more of an improvement.

  23. Thomas W Carey    

    Yes I am also a 100% p&t service-connected DAV with multiple medical problems.
    And have been involved with the VA Choice program since 2014. And have been trying to get somebody’s attention to correct these major problems.
    That’s Senators, Congressmen, Veteran’s oversight Committee in Washington DC. EVEN Mark Takano president of the VA Etc. I have sent many letters and correspondences to all of them. And IAM still waiting for replies! Don’t forget the VFW American Legion and the DAV associations also.
    That means I see 4 different specialists. A primary care doctor who takes your vitals and tells you to go see a specialists. Me I see a cardiologist, pulmonologist, gastrologist and a urologist. Which all of them have diagnosed me with serious medical problems. And are mostly connected to cardiac/ lung problems.
    Since 2014 I’m was on Choice program that changed to Health Net and now it’s called the Community Care Missions Act.
    All’s they did was change the name and make it more difficult to get authorizations for every single needs your out-of-network Doctors have to do. TO diagnose your problems to and keep you healthy . Unnecessary time that you’re out of network doctors don’t have, getting authorizations, communicating with the VA to get their money!
    It’s what they don’t tell you. IS that you have to go through the VA to get authorizations for everything not only to get your doctor of your choice. BUT to get your medications your Diagnostics testings Etc.
    And if your out-of-network doctor refuses the protocol from the VA you don’t get the best doctor available, for the best possible Health Care you deserve. (Bottom line the VA is in charge of Who You See)
    So now it seems like the Veteran’s has to do all the legwork in trying to keep track of their medical needs. THAT the doctors and the VA are supposed to be doing. TO try and get their health benefits and authorizations straightened it out. “THAT THEY DESERVE” by calling all these different VA Community Care numbers AND different departments (that are subject to change at any given time) trying to find which VA department to call for each specialist to find out what’s happening.
    The bottom line is your spouse, if your 100% p&t service-connected gets a CHAMPVA card RUN by the DOD and gets taken care of 100% with no questions asked. It’s like AN INSURANCE CARD.
    To save time and money. Why not give the 100% service-connected vets (THAT QUALIFY) with multiple medical problems a similar card? Those questions and complaints have been talked about for years. BUT nothing has been applied yet, (they spend more money trying to save money)…. Instead of having the VETERANS go through all the unnecessary problems because of lack of communication between the out-of-network doctors and the VA running the Veteran’s vital Health needs?
    So basically all they did was change the name and everything Still Remains the Same. Just more confusing now.
    And good luck going to an out-of-state or another VA hospital or clinic. Because your Medical records haven’t been stored in one convenience data server Yet.
    They’re still working on it for the last year or so or more…
    They’re still talking about it, so good luck on your medical needs!
    Bottom line is the “Veterans voices” need to be heard!
    And that’s not by just calling your Senator or Congressman to get your voice heard which you’re just talking to a receptionist and goes into the circular file.
    There’s a reason why all these Secretaries of the VA and other people are getting fired or retiring. Resigning is proper Etc.

  24. Robert W YORK    

    I have been receiving community based care from a non-va pulmonologist in the city closest to my home for about 3 years now. This has been covered by the Choice program in the past. I recently had an emergency that hospitalized me for 3 days that is related to my pulmonary issues (spontaneous pneumothorax). The attending pulmonologist ordered a follow-up with my regular pulmonary care physician but the authorization (under the Choice program) will expire prior to my follow-up. Currently I cant find any instructions on how to continue the care needed under the Missions Act.

    Any place I can go or anything I can do to facilitate my treatment and follow-up? Or am I just screwed like Mr. Ross?

  25. Alfonso Granata    

    I live in Illinois. Trying to fine a provider under the VA policy in my area. Can’t find any thing on the va web site. Looking for a provider in the LaSalle, Illinois area? Shouldn’t their be a list!

    1. Tom Wallace    

      Every VA Hospital should have a Care Coordinator now that will assist you. Call the nearest VA Hospital operator to you and request to be connected to that to that number. If that office has not been established yet, request to be connected to the patient Advocate office. That office will probably be busy and follow the message to the LETTER!
      Call two or three times a day 0800 thru 1600 Mon thru Fri and leave the same message each time. Be persistent and polite. You will recieve assistance.

  26. Jon    

    I have had to go to the local hospital…40 miles away for twice for emergency situation . Ruptured appendix and pancreatitis. Never had to pay for anything…

  27. Luther Palmer    

    Sounds like my situation. Guess we’re both screwed.

  28. Raymond D.Ross, Jr.    

    The Problem I have is that I Don’t want to Drive to West Haven VA Hospital which is 56 Miles from my House. I have a VA Outpatient Clinic about 10 Miles or less and that Cancelled out the Choice Program. My Primary Doctor is at the Outpatient Clinic, the Only thing they do at the Clinic is Physical Exams, Medication Renewals and Pneumonia Shots. Everything Else happens at West Haven VA. If I have a problem I have to go to the Emergency Room at the Local Hospital and then I’m stuck paying Co-Pays for the Hospital and Doctors. How is the new system going to Help Me? Am I able to see Doctors on the Outside? I’m 72, and don’t want to Drive on I-95 for an Hour in traffic for a 10 minute appointment. Please Give Me Good News, or Am I Screwed. I’m Permanent and Total. Thank You for your response.

    1. Phillp C Thomas    

      I am in the same situation. I have an Emergency room (i.e. hospital) close to my home and a VA outpatient clinic even closer. However, if I need emergency care due to my health, I am unsure what the rules are governing my care in those situations. The main VA medical facility is over 30 miles away.

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