VA issues proposed rule for new community care program

by American Hospital Association

Washington, D.C. - February 23, 2019 - (The Ponder News) -- The Department of Veterans Affairs has proposed the criteria for determining when covered veterans may elect to receive necessary hospital, medical and extended care services from non-VA entities or providers under the Veterans Community Care Program. The AHA-supported MISSION Act of 2018 requires the agency to consolidate its existing community care programs into this new program by June.

Under the proposed rule, covered veterans would have to be enrolled in the VA health care system and meet at least one of six conditions: VA does not offer the required care or services; VA does not operate a full-service medical facility in the state in which the veteran resides; the veteran was eligible to receive care under the Veterans Choice Program and is eligible to receive care under certain grandfathering provisions; VA is not able to furnish care or services to a veteran in a manner that complies with VA’s designated access standards; the veteran and the referring clinician determine it is in the best medical interest of the veteran to receive care or services from an eligible entity or provider based on consideration of certain criteria VA proposes to establish; or the veteran is seeking care or services from a VA medical service line that VA has determined is not providing care that complies with VA’s standards of quality.

The proposed rule also designates access standards for the new program, as announced last month; describes non-VA entities and providers eligible to participate in the program; and clarifies payment rates and methodologies for those community providers to include rates for critical access hospitals and other types of providers. According to the agency, providers eligible to participate in the new program would be “substantively identical” to those permitted to participate under the VA’s current Veterans Choice or other community care programs.

The proposed rule will be published in tomorrow’s Federal Register with comments accepted for 30 days. VA last month issued a separate proposed rule implementing urgent care provisions for the new program.

HHS seeks input on how to improve HIPAA rules

American Hospital Association

Washington, D.C. - December 12, 2018 - (The Ponder News) -- The Department of Health and Human Services’ Office for Civil Rights will accept comments through Feb. 11 on potential changes to the Health Insurance Portability and Accountability Act rules to promote coordinated, value-based care, according to a request for information released today.

In addition to broad input on the HIPAA rules, the RFI seeks comments on specific areas of the Privacy Rule, including encouraging information-sharing for treatment and care coordination; facilitating parental involvement in care; addressing the opioid crisis and serious mental illness; accounting for disclosures of protected health information; and changing the requirement for certain providers to make a good faith effort to obtain an acknowledgment of receipt of the Notice of Privacy Practices.

“In addressing the opioid crisis, we’ve heard stories about how the Privacy Rule can get in the way of patients and families getting the help they need,” said HHS Deputy Secretary Eric Hargan. “We’ve also heard how the Rule may impede other forms of care coordination that can drive value. I look forward to hearing from the public on potential improvements to HIPAA, while maintaining the important safeguards for patients’ health information.”

The AHA plans to submit comments.