Veteran’s Choice Program

Derived from the Veterans Access, Choice and Accountability Act of 2014 (VACAA) that was signed into public law by President Obama August 7, 2014 to created the Veteran’s Choice Program Implemented November 5, Background

 Ensure quality, timely care for all Veterans  Expand the availability of care and medical services for eligible Veterans through agreements 3 Goals of Veteran’s Choice Program

 Wait-list  40-mile  Unusual or excessive burden  Choice-First 4 Tiers of Veteran’s Choice Program

 To be eligible for Veteran’s Choice Program Wait-List, the Veteran must meet the following criteria: 1) Enrolled for VA healthcare 2) VA appointment scheduled with a wait-time of >30 calendar days  How is wait-time calculated? Appointment date is subtracted from the date the VA Provider wants the Veteran to receive care. Example. Dr. Smith refers Mr. Burroughs to the neurology clinic for evaluation of headaches. Dr. Smith requests Mr. Burroughs be seen September 2, The neurology clinic is unable to offer an appointment to Mr. Burroughs until October 16, Appointment date (October 16, 2016) is subtracted from the VA Provider’s date he want the Veteran’s to receive care (September 2, 2016). Mr. Burroughs’ wait-time is 44 days. 5 Wait-list Overview

 Community Care staff retrieves a list of all Veteran’s with a wait-time of >30 days daily  Calls are made to all Veterans listed (unless otherwise specified by the clinic) to discuss options for wait-list  If the Veteran Opts-in, the veteran’s information is forwarded to Health Net (HN) for scheduling. The VA appointment remains scheduled at the medical center until HN schedules in the community. The VA appointment Is only cancelled when an appointment in the community is secured.  If the Veteran Opts-out, the Veteran keeps his or her scheduled appointment. 6 Wait-list Overview continued

 To be eligible for Veteran’s Choice Program 40 mile, the Veteran must meet the following criteria: 1) Enrolled for VA healthcare 2) Reside >40 miles from the nearest VA facility with at least one full time physician on staff  Veteran initiated  Veteran contacts Veterans Choice Program to request care  No documents from VA forms or documents required 7 40-mile Overview

 To be eligible for Veteran’s Choice Program 40 mile, the Veteran must meet the following criteria: 1) Enrolled for VA healthcare 2) Face an unusual or excessive burden in traveling to the closest VA medical facility based on geographic challenges, environmental factors, or a medical condition  VA Provider must document in the Veteran’s medical record explaining the need for unusual/excessive burden  Veteran contacts Veterans Choice Program to request care  No documents from VA forms or documents required 8 Unusual / Excessive Burden Overview

 Dental  Home health  Home maker  Prosthetics 9 Exclusions

 The Choice Card does not replace the identification card Veterans already use to access other VA benefits.  If Veterans did not receive or have misplaced their Choice Card, they can call to find out if they are eligible for the program. 10 Veterans Choice Cards

Physicians in the community contract directly with the VA to provide services to the Veteran. The Veteran MUST opt-in to Choice and then the consult is sent to HealthNet or TriWest to obtain an appointment for the Veteran. The consult is returned back to the VA within 2-5 days depending on the urgency of the consult due to the inability of HealthNet/TriWest to schedule the appointment. 11 Provider Agreements

VA schedules the appointment with the physician through a Provider Agreement. The physician receives payment from the VA using Choice dollars. 12 Provider Agreements (cont)

 Assures Veterans that comprehensive health care services will be available when they are needed  Health care benefits are completely portable throughout the entire VA system  Once a Veteran enrolls in the VA health care system, they remain enrolled 13 Benefits of VA Health Care Enrollment

If you or a Veteran have a question about the Choice Program, there are a number of places where you can get more information!  Direct Veterans to wherewww.va.gov/opa/choiceact they can use the “Live Chat” feature to get answers to their specific questions  Have Veterans call the Choice Program Call Center at  Contact Fee department at extension How to Answer Veterans’ Questions

15 Questions