The Department of Veterans Affairs (VA) is amending its medical regulations to implement its authority to furnish necessary care to covered individuals through certain agreements. Section 102 of the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (the MISSION Act) authorizes VA to enter into agreements to furnish required care and services when such care and services are not feasibly available to certain individuals through a VA facility, a contract, or a sharing agreement. This interim final rule establishes the parameters of those agreements, to include: Establishing a certification process for providers who will furnish such care or services; establishing a methodology by which rates will be calculated for payment of care or services under an agreement; and establishing an administrative process for adjudicating disputes arising under or related to such agreements, including those pertaining to claims for payment for care or services provided under an agreement.
Although the veterans community care agreement rule was issued on an interim final basis due to a statutory deadline for implementation, VA is soliciting comments to identify concerns of stakeholders.
- The text of this rule and additional information are available here.
- Comments on this rule are due by July 15, 2019 and can be submitted here.
This interim final rule is one of several rules implementing community care provisions of the MISSION Act. Links to rules governing the Veterans Care Program itself and its urgent care provisions are provided below. Comments are no longer accepted on these rules, but they provide context for the interim final rule on community care agreements, on which comments are now being accepted.
- The text of a related final rule implementing the Veterans Care Program is here.
- The text of a related final rule implementing urgent care provisions is here.
- Advocacy contact: Joseph Sobota