The United States Department of Veterans Affairs (VA) announced its proposed access standards for community care and urgent care provisions that will take effect in June and guide when veterans can seek healthcare under the VA’s Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018.
There are six eligibility criteria for community care:
· Services unavailable
· Residence in a state without a full-service VA medical facility
· 40-mile legacy/grandfathered from the Veterans Choice Program
· Access standards
· Best medical interest
· Needing care from a VA medical service line that the VA determines is not providing care that complies with its standards for quality
The VA is proposing new access standards that will become effective when the final regulations are published, which is expected to occur in June, to ensure veterans have greater choice in receiving care. Eligibility criteria and the final standards as follows were based on the VA’s analysis of best practices in government and in the private sector and tailored to the needs of veterans.
· Access standards will be based on average drive time and appointment wait times.
· For primary care, mental health, and non-institutional extended care services, the VA is proposing a 30-minute average drive time standard.
· For specialty care, the VA is proposing a 60-minute average drive time standard.
· The VA is proposing appointment wait-time standards of 20 days for primary care, mental health care, and non-institutional extended care services, and 28 days for specialty care from the date of request, with certain exceptions.
Eligible veterans who cannot access care within those standards would be able to choose between eligible community providers and care at a VA medical facility.
Eligible veterans will have access to urgent (walk-in) care that gives them the choice to receive certain services when and where they need it. To access this new benefit, veterans will select a provider in VA’s community care network and may be charged a copayment.
In its announcement, the VA encouraged the public to comment on the proposed access standards and urgent care benefit during the public comment period once these proposed regulations (RIN 2900-AQ46 and RIN 2900-AQ47, respectively) publish in the Federal Register.
