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Department of Veterans Affairs Releases Finals Rule for Community Care, Urgent Care

June 7, 2019

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PRESS CONTACTS
Kate Ogden, Physician Payment & Quality Specialist

The Department of Veterans Affairs (VA) June 5 released final rules on community care and urgent care [see Washington Highlights, March 29]. In these final rules, the VA did not make any significant changes to the provisions set forth in the proposed rules, though they did provide extensive clarification on many issues raised during the comment period. In the urgent care final rule, the VA provided clarification on the use of copays for urgent care visits and reaffirmed that this expanded access to urgent care should only be for episodic care, not longitudinal care.

In the community care final rule, the VA finalized the access standards and eligibility requirements as previously proposed and reaffirmed that the access standards do not apply to non-VA, community-based providers. The VA also addressed comments related to transplant care, which the AAMC had commented on separately. The VA noted that they had received a request that veterans be permitted to be listed on multiple Organ Procurement Transplant Network (OPTN) lists to increase their chances of being matched with an organ. The VA stated that they are not making any changes based on this comment but noted that this would not be against the regulations. In the final rule, the VA also provided clarification on telehealth; payment to community-based providers; prescription drugs; durable medical equipment, prosthetics/orthotics, and supplies (DMEPOS); and prior authorization for episodes of care.

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