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AAMC Responds to VA Request for Information Regarding Health Care Access Standards

August 3, 2018

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PRESS CONTACTS
Christa Wagner, Senior Legislative Analyst
Kate Ogden, Physician Payment & Quality Specialist

The AAMC July 30 submitted comments to a Department of Veteran’s Affairs (VA) request for information regarding health care access standards as the VA begins to develop regulations for its new community care program.

The VA sought stakeholder feedback as it begins to develop regulations for the reworked community care programs under the VA MISSION Act (P.L. 115-182), which was signed into law in May [see Washington Highlights, May 4]. The AAMC comment letter encourages the VA to continue partnering with academic medical centers and their physicians, as they have unique expertise in providing highly specialized care and treating some of the most complex and vulnerable patients.

The AAMC recommends that the VA reduce the complexity of administrative burden on providers to ensure continued participation by providers and align administrative practices with industry best practices when developing policies. The AAMC further encourages the VA to consult with providers (specifically the large AMCs and faculty practice plans) on systems they currently use for scheduling patients, submitting claims, and for documenting and submitting prescriptions [see Washington Highlights, May 4].

The AAMC letter also recommends that the VA work closely with third-party administrators and insurers when developing network and adequacy standards to ensure that they take into account veteran health status, population, and location regions.

In conversations with member institutions, the AAMC found many teaching hospitals had experienced challenges with the referral and prior authorization process instituted by the VA, sharing concerns about the time it may take for a veteran to be seen for a secondary test or appointment. The AAMC encourages the VA to consider new methods to address this problem, suggesting a broader prior authorization or referral to address the whole episode of care instead of a single appointment, or working with providers to establish standards of care for use within the VA community care system. With these modification, the AAMC also encourages the VA to retain the role of case manager for patients in the VA system.

Additionally, the AAMC letter recommends that the VA establish a portal for community-based and VA providers, as well as administrative staff, to communicate all administrative and case management details.

Meanwhile, the Senate VA Committee Aug. 1 held a hearing to review a series of pending legislative items to address ongoing VA provider shortage issues. In particular, the committee considered the Senate companion to H.R. 5521, the VA Hiring Enhancement Act [see Washington Highlights, June 22]. This bill would exempt VA from private sector non-compete clauses when hiring new physicians to work in the VA. It would also clarify in statute that VA physicians need to complete all residency requirements in order to practice in a VA facility. Finally, the bill would allow VA to complete binding job offers with residents up to two years before the completion of their training.

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