5/1/2017
Veterans Choice Program Law Changes
On April19, 2017, President Trump signed a law that removes the Aug. 7, 2017, expiration date and allows VA to utilize funding dedicated to the Veterans Choice Program until it is exhausted. The VCP is a critical program that increases access to care for Veterans by authorizing millions of appointments for Veterans in the community. There were three changes made to the VCP:
Change 1 – Removal of Expiration Date: The law removes the Aug. 7, 2017, expiration date for the VCP. The VCP will continue until the original $10 billion is spent. Based on current estimates, funds for the VCP will last through January 2018, but could shift to fall 2017 if more Veterans use the program.
Impact to Veterans: Veterans eligible for the VCP will continue receiving care from providers in the community.
Impact to community providers: Community providers can continue delivery care to Veterans.
Change 2 – Primary Coordinator of Benefits: VA is now the Primary Coordinator of Benefits for services provided to Veterans under the VCP. This common sense change VA requested from Congress more closely aligns the VCP with the other community care programs.
Impact to Veterans: Before this law change, some Veterans were required to pay the cost-shares/co-pays associated with their private health insurance. Now, those Veterans will not have to pay the cost-shares/co-pays to their private, health-insurance carrier.
Impact to community providers: Originally, some community providers had to bill the Veterans’ private health insurance and the VCP. With the law change, community providers will now only have to bill the VCP.
Change 3 – Information Sharing: Previously, VA had a restriction different from other health-care providers regarding the exchange of health information. This law removes these restrictions and ensures that community providers have access to appropriate health information for Veterans, and brings VA in line with other health-care providers and federal standards related to the exchange of health information. We emphasize that this does not create an exception to, or weaken in any manner, the protections of the Health Insurance Portability and Accountability Act (HIPAA).
Impact to Veterans: Veterans will experience improved continuity and quality of care because community providers will have appropriate access to necessary medical records.
Impact to community providers: Community providers will now have access to all appropriate health information for Veterans.
Has eligibility for the Veterans Choice Program (VCP) changed? No. The law did not change eligibility for the VCP. Please refer to the VCP website for information regarding eligibility here: https://www.va.gov/opa/choiceact/
Did the law make the Veterans Choice Program permanent?
No. The law allows VA to use the remaining funds available for the VCP. VA has partnered with Congress to work though remaining legislative needs to build a single, community care program.
Do Veterans still have to provide VA their private health insurance information?
Yes. The Choice law requires Veterans to provide VA with their private health insurance information in order to use the program. The new law means that Veterans will no longer be responsible for cost-shares/co-pays associated with their private health insurance. It also means community providers will no longer have to bill a Veteran’s private health insurance and the VCP; they will only have to bill the VCP.
Does the information-sharing provision in the law put my health information at risk?
No. This law does not put any health insurance information at risk. Previously, VA had restrictions different from other health-care providers regarding the exchange of Veterans’ health information. This law removes those restrictions and ensures that community providers have access to appropriate health information for Veterans, and brings VA in line with other health providers and federal standards related to the exchange of health information.
Did the law provide VA the authority it needs to reform the Veterans Choice Program?
This law makes meaningful improvements for the VCP, but more needs to be done. The law is a bridge to allow VA time to partner with Congress and all of its stakeholders to create one community care program that is simple to administer, easy to understand and meets the needs of Veterans and their families, community providers and VA staff.
