What Is A Veterans Care Agreement

With respect to gaps in coverage of general care and services, until the contract network of community providers was fully established, VA was able to modify some of its current community care contracts for expansion until the new network was fully operational. However, even these extensions have not been able to absorb all existing agreements with Choice providers used in each of the 21 Integrated Veteran Service Networks (ISTS) to obtain care and services outside of VA`s community care contracts. Using April 2019 data, there were still more than 22,000 Choice supplier agreements in all SINCs. There are some differences between SINS with respect to the use of Program of Choice provider agreements, for example, VISN 8 had 3,809 outstanding Vendor of Choice agreements, while VISN 17 had only 71. Paragraph (b)(2)(v) of § 17.4110 sets a discretionary standard that would allow VA to reject an application for certification if VA determines that VA is unlikely to enter into a veteran care agreement with the applicant due to programmatic considerations. We believe this basis for rejection is reasonable because section 1703A is a permissive procurement authority that allows (but does not require) the VA to enter into and use veterans` care agreements. Therefore, there is little or no benefit to a supplier or entity, or to VA, to continue the 1703A(c) certification process, including obtaining and monitoring certified status, if VA determines, in the exercise of its programmatic judgment, that it is unlikely to enter into an LCA with the entity or supplier. In these circumstances, VA may refuse the request in order to avoid unnecessary resource expenses on the part of the institution or provider and the VA. The VA`s conclusion that the basis for rejection in § 17.4110(b)(2)(v) is met is assessed on a case-by-case basis. We will not regulate the more specific circumstances in which VA might apply this rejection basis, although such circumstances would generally exist if VA were unlikely to enter into a VCA with a company or provider, since the care or services necessary for a covered person are instead available through a VA facility, a contract. or a partition agreement (see 38 U.S.C. 1703A(a)(1)). For example, if a company or provider was already involved in VA`s contracted community care network, or if VA`s contracted community care network already has adequate coverage of the services that the company or provider provides in a given location, it would be unlikely that VA would attempt to enter into an ACV with that company or provider.

(iv) VA will refuse an application for certification if VA determines that the applicant is already serving hospital treatment, medical services and extended care services in accordance with Chapter 17 of Title 38, United States. C, is excluded because VA has already determined that the plaintiff has filed a fraudulent claim with VA, as that term is defined in 38 U.S.C. 1703D(i)(4). for the payment of hospital treatment, medical services or long-term care services. The Department of Veterans Affairs (VA) released a preliminary final rule on Veterans Care Agreements (LCAs) on May 14. This rule implements section 101 of the Maintenance of Internal Systems and Strengthening of Integrated External Networks Act 2018 (VA MISSION Act, P.L. 115-182), which authorizes the VA to enter into agreements to “provide the necessary care and services when such care and services are not available to certain persons through a VA-sharing facility, contract or agreement.” .

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