Veterans Access, Choice and Accountability Act of 2014 (VACAA) The Choice Program and the Choice Card. June 17, 2015
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1 Veterans Access, Choice and Accountability Act of 2014 (VACAA) The Choice Program and the Choice Card June 17, 2015
2 Key Points of VA Health Care Enrollment Veterans generally must be enrolled to receive VA Health Care Enrollment assures Veterans that comprehensive health care services will be available when they are needed All enrolled Veterans receive VA s comprehensive Medical Benefits Package which includes preventive, primary and specialty care, diagnostic, inpatient and outpatient care services Health care benefits are completely portable throughout the entire VA system Once a Veteran enrolls in the VA health care system, he or she will remain enrolled To be eligible for the Choice Program, a Veteran must have been enrolled by August 1, 2014 or be a newly enrolled combat Veteran 1
3 Veterans Access, Choice and Accountability Act of 2014 (VACAA) The Choice Program and the Choice Card Launched the Veterans Choice Program on November 5, 2014 in accordance with the timeframe established under Public Law signed by President Obama on August 7, 2014 Allows VA to expand the availability of hospital care and medical services for eligible Veterans through agreements with eligible non VA entities and providers through section 101 of the Act. Includes Veterans who are: On a wait list of 30 or more days from the clinically indicated date (CID) for the service (date that the provider has specified for the Veteran to be seen) or patient preferred date if no CID provided Reside more than 40 miles from the closest VA medical facility (or more than 20 miles from White River Junction, VT if a resident of New Hampshire) Meet certain other residence based requirements On November 5, 2014, an interim final rule was published in the Federal Register that provides the authority to begin implementation of section 101 of the Act Addressing comments in final rulemaking 2
4 Veterans Access, Choice and Accountability Act of 2014 (VACAA) The Choice Program and the Choice Card On April 24, 2015 VA published an interim final regulation changing mileage calculation from straight line to driving distance (fastest route). Changes the special provision for New Hampshire residents who live more than 20 miles from White River Junction, VT to driving distance Doubles the estimated number of Veterans eligible for Choice based on residence in driving miles to the closest VA medical facility All newly eligible Veterans received a letter informing them of their eligibility on April 25, 2015 On May 22, 2015, Public Law (HR 2496), the Construction Authorization and Choice Improvement Act, was signed into law Updates the Veterans Access, Choice and Accountability Act of 2014 by enhancing the language surrounding the unusual and excessive burden for travel to a VA medical facility. Expands the eligibility for certain Veterans to use the Choice Act based on challenges in traveling to a VA medical facility. Includes four provisions that describe the unusual and excessive burden (sections aa through dd ) 3
5 Veterans Access, Choice and Accountability Act of 2014 (VACAA) The Choice Program and the Choice Card Implementing the first three provisions (sections aa through cc ) of the enhanced eligibility (aa) Geographical challenges (bb) Environmental factors such as: Roads that are not accessible to the general public, such as a road through a military base or restricted area Traffic, or Hazardous weather conditions (cc) A medical condition that impacts the ability to travel by the route(s) that are 40 miles or less (e.g. Veteran cannot travel over rough roads. ) Determination of medical condition requires clinical provider determination/documentation (dd) Remaining provision requires additional discussion and will be implemented at a later time 4
6 Contractors for Choice VA signed contracts with two companies, Health Net and TriWest, to help VA administer the Choice program Contractors will manage the Choice Program card distribution, call center, Veteran counseling, provider management, appointment management, reporting and billing Pre authorizes all Veteran care Coordinates other health insurance (OHI) information with provider and responsible to provide Explanation of Benefit (EOB) to VA for payment Providers are either part of the contractor s PC3 network or Choice network meeting the requirements of the Choice Act Choice network allows entities that do not want to contract but meet requirements of the Act to provide care under the Choice Program Contractors provide list of approved providers to Veteran to choose 5
7 Eligible Choice Providers Non VA entities and providers who enter into an agreement with VA to furnish care, and must be participating in the Medicare program, be a Federally qualified health center, or be a part of the Department of Defense or the Indian Health Service Maintain at least the same or similar credentials and licenses as VA providers, and must submit information verifying compliance with this requirement annually Be accessible to the Veteran be able to provide timely care, have the necessary qualifications to furnish the care, and be within a reasonable distance of the Veteran's residence Agree to accept rates as outlined in the Act 6
8 Choice Card Production/Distribution Contractors provide : Instructional letter for how to use card will accompany card Phased distribution Nov 4 th 6 th : Cards were mailed to Veterans who live more than 40 miles from VA facility Nov 17 th 20 th : Cards were mailed to Veterans who are waiting for an appointment more than 30 days from their clinically indicated date Dec 1 st Jan 31 st : Cards were mailed to all other Veterans enrolled as of Aug 1,
9 Copayments and Secondary Payers VA Copayments Regulation eliminates VA copayment at time of service and allows it to be charged to the Veteran after care provided and coordination of benefits processed Other Health Insurance (OHI) Cost Shares/Copayments/Deductibles Requires Veterans with OHI to provide information if selecting Choice Program Declining to provide OHI results in loss of this benefit OHI cost shares will be due by the Veteran to the provider or the OHI VA does not have authority to interfere with health plan requirements May shift up front costs to Veterans with OHI VA can only reimburse Veteran up to the Medicare rate minus the cost of care provided If the total of the cost of care plus the cost shares exceed the Medicare rate, Veteran may be left owing some portion of cost share Care for service connection or those without OHI will not incur additional expense 8
10 Additional Choice Program Resources and Information: VACAA web site (Internet external): For more information on how to become a Choice provider: /index.asp HealthNet TriWEST Contractor phone number
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This publication has been developed by the U.S. Department of Labor, Employee Benefits Security Administration (EBSA). To view this and other EBSA publications, visit the agency s Website at dol.gov/ebsa.