On Wednesday June 5, 2019 The Veteran’s Health Administrated released two final rules: the Veterans Community Care Program (VCCP) and Urgent Care. These final rules enable eligible veterans to receive hospital care, medical services, and urgent care services from eligible providers when certain criteria are met. The rule becomes effective June 6, 2019.

Veterans Community Care Program enables veterans to seek care within the community or via teletherapy, establishes parameters for eligibility

The VCCP final rule establishes eligibility for veterans to seek healthcare services outside of VA facilities through the establishment of access standards and enables telehealth services if agreed upon by all parties. To receive services under VCCP, veterans will need to obtain authorization; the authorization will cover an episode of care for up to one-year.

The rule finalized proposals of wait-times and drive-times as access standards for eligibility under VCCP. The VA must be able to furnish care within these access standards; if a VA cannot meet either or both conditions, the veteran is eligible to receive services under VCCP.  The following access standards have been finalized:

Primary-care wait times:

• 20-days, or
• 30-minute drive-time

Specialty care wait-times:

• 28-days, or
• 60-minute drive time

Previously, veterans who had to drive more than 40-miles or wait longer than 30-days for care could choose to see a private doctor outside of the VA facility. The Agency also stated their intention to pursue future rulemaking to reduce the primary care wait-time standards from 20-days to 14- days in future years.

Veterans now eligible to seek urgent care outside of VA health facilities without prior authorization

The VA’s Urgent Care final rule allows veterans to seek urgent care services outside of the VA healthcare system; the VA defines urgent care as a benefit that is limited to immediate episodic care, provided in a single visit. The rule finalizes that follow-up care must be coordinated with the VA and a VA-authorized primary care provider. Urgent care visits that the Agency deems as preventative care, dental care, or management of chronic disease are not covered under the VA urgent care benefit.