Overview

In August 2017, the President signed the VA Choice and Quality Employment Act of 2017 which authorized $2.1 billion in additional funds for the Veterans Choice Program (VCP). The law reflects the ongoing commitment of VA and Congress to make sure Veterans get the right care, at the right time, from the right provider.

The new funds represent a short-term, temporary funding solution for VCP that will enable VA to increase the number of appointments scheduled and ensure payments are made to community providers.

Impact to Veterans

The new funding helps ensure VCP-eligible Veterans continue to have access to care in their communities.

Impacts to Community Providers

The new funding helps ensure that community providers are able to continue to provide care to VCP-eligible Veterans and receive payment for authorized VCP care.

Impacts to VA Medical Facilities

The new funding will allow VA medical facilities to refer Veterans to VCP to the maximum extent possible. In addition to referring those Veterans eligible for VCP based on distance (residing more than 40 miles from the closest VA medical facility with a full-time primary care provider), wait times (30 days from the clinically indicated date), or other criteria (such as special criteria for residents of Alaska, Hawaii and New Hampshire), VA medical facilities may use the “Choice First” business process to refer Veterans to community providers when services are unavailable. VA medical facilities may also use traditional community care when services are unavailable. This local flexibility is important to ensure Veterans get the care they need and that VCP and traditional community care funds are used in the most optimal manner.

Next Steps

VA will continue to work with stakeholders to secure funding for VCP for the remainder of FY2018 and to establish a single, consolidated community care program that is simple to understand, easy to administer, and meets the needs of Veterans and their families, community providers, and VA staff. This includes combining existing accounts for VA community care into one account or ensuring flexibility between accounts.

Frequently Asked Questions

1. Has VA changed how Veterans are referred to VCP?

There are no changes on how Veterans are deemed eligible for VCP and are subsequently referred to a VCP community provider.

2. How are VA medical facilities specifically authorized to use VCP funds?

VA will continue to refer eligible Veterans to VCP. This includes those Veterans eligible for VCP based on distance (residing more than 40 miles from the closest VA medical facility with a full-time primary care provider), wait times (30 days from the clinically indicated date), service unavailable at the VA facility (“Choice First” business process), or other criteria (such as special criteria for residents of Alaska, Hawaii and New Hampshire). VA will continue the utilization of VCP for all eligible Unusual or Excessive Burden (UEXB) VCP Veterans. This includes all provisions of this section of the Veterans Access, Choice, and Accountability Act of 2014.

3. Are VA medical facilities allowed to refer Veterans to community providers using provider agreements?

VA will continue to use Provider Agreements for VCP-eligible Veterans when services are not available on the VCP contracts, authorizations are returned from the contractors (including Category of Care Withholds), and to provide care as appropriate.

4. Why were additional funds needed for VCP?

VCP was originally established as a temporary program in 2014 to quickly expand access to care for Veterans. The program is set to expire when the original $10 billion dollars is exhausted. Because VA has separate accounts for VCP and its traditional community care programs, and cannot transfer funds between accounts, additional funds were needed to continue VCP. This accounting structure creates barriers to VA using community care funds in the most optimized way.

5. What is VA’s plan for addressing community care funding issues and its overall approach for improving VA community care?

VA continues to work with Congress to address funding for VA community care, including VCP, and to combine VA’s community care programs into a single, modern, consolidated community care program that is easy to understand, simple to administer, and meets the needs of Veterans and their families, community providers, and VA staff

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From the Federal VA August 2017 Extension of Veterans Choice Program Funding Fact Sheet.

More about the Veterans Choice Program: VA Veterans Choice Program