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VA proposes to revise its designated access standards for purposes of the Veterans Community Care Program to consider a veteran’s preference for telehealth when scheduling appointments. VA additionally proposes to consider whether and how to address standards for when a VA provider is not available within the existing average drive time standards.

Statement of Need:

This rulemaking is needed to implement certain provisions of section 125 of Division U of the Consolidated Appropriations Act, 2023, the Joseph Maxwell Cleland and Robert Joseph Dole Memorial Veterans Benefits and Health Care Improvement Act of 2022 (hereinafter referred to as the Act).

Summary of the Legal Basis:

Pursuant to 38 U.S.C. 1703 and 1703B and subject to regulations at 38 CFR 17.4000-17.4040, VA administers the Veterans Community Care Program (VCCP) to furnish care in the community to covered Veterans at their election and subject to the availability of appropriations. Consistent with 38 U.S.C. 1703(d)(1)(D) and 1703B, current 38 CFR 17.4010(a)(4) establishes eligibility for the VCCP if a covered veteran has contacted VA to request required care or services, but VA has determined it is not able to furnish such care or services in a manner that complies with VA’s designated access standards in 17.4040. Section 125 of the Act amended section 1703B(f) to require VA to meet the access standards established under section 1703B(a) when furnishing care through VCCP and ensure that meeting such access standards is reflected in the contractual requirements of third-party administrators (TPA).

Alternatives:

VA does not interpret that there is an alternative to implementing certain provisions of section 125 of the Act. VA does not interpret that there is an alternative to a two-stage rulemaking because current VCCP regulations do not apply VA access standards to eligible entities and providers (non-VA providers) under TPA agreements, and to do so requires notice and comment prior to being implemented.

Anticipated Costs and Benefits:

VA does not anticipate this rulemaking would result in $200 million or more in costs or savings. VA anticipates benefits for Veterans as eligible entities and providers participating in VCCP would also be subject to measurable access standards designed to improve Veteran’s access to care. Actual costs will be determined and reflected in this section of ROCIS once the Reg is formally sent to OMB for a formal Executive Order 12866 review.

Risks:

None identified.