Newsletter

June 2019

Vets Views

Page 3 

 

Retirement Services Officers (RSOs)

Do you have questions on benefits, SBP, Retiree Appreciation Days or anything else retirement-related? Then contact the RSO for your area or go to the Army Retirement Services website http://www.armyg1.army.mil/retire (Note: That’s the number 1 after the g).

Sister Service Retiree Publications

Air Force Afterburner: http://www.retirees.af.mil/afterburner/

Coast Guard Evening Colors: http://www.uscg.mil/ppc/retnews/

Marine Corps Semper Fi: https://www.manpower.usmc.mil, then click on “Semper Fidelis Online” under “News and Features” Navy Shift Colors: http://www.npc.navy.mil/ReferenceLibrary/Publications

FOR IMMEDIATE RELEASE

 5 June 2019

Today the U.S. Department of Veterans Affairs (VA) announced the publication in the Federal Register of two final regulations as part of its new Veterans Community Care Program under the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018.

Signed into law on June 6, 2018, the MISSION Act strengthens VA’s ability to deliver trusted, easy to access, high quality care at VA facilities, virtually through telehealth, and in Veterans’ communities. The law makes several improvements to VA care that begin on June 6, 2019.

“President Trump promised to give Veterans greater choice. We are honoring that promise by making sure Veterans have access to timely, high-quality care, whether from our VA facilities or our community providers,” said VA Secretary Robert Wilkie.

A key component of the MISSION Act is a new urgent care benefit that provides eligible Veterans with greater choice and access to timely, high-quality care. With urgent care, Veterans have a new option for care for the treatment of minor injuries and illnesses, such as colds, sore throats and minor skin infections. The benefit is offered in addition to the opportunity to receive care from a VA provider, as VA also offers same-day services.

VA also published the final regulation for the Veterans Community Care Program governing how eligible Veterans receive necessary hospital care, medical services, and extended care services from non-VA entities or providers in the community. The new Veterans Community Care Program replaces the Veterans Choice Program, which expires June 6, 2019.

VA previously published an interim final rule for Veterans Care Agreements (VCA) on May 14, 2019. VA may use VCAs to order care when that care is not otherwise feasibly available through VA’s contracted network. VCAs are intended to be used in limited situations. VA will purchase most community care for Veterans through its contracted network as part of its strong partnerships with third party administrators. Currently, these administrators are TriWest Healthcare Alliance and Optum Public.

VA is implementing improvements to its community care program as required by the VA MISSION Act. Veterans can find detailed information on urgent care eligibility, community care eligibility and MISSION Act implementation at www.missionact.va.gov

From the VA Web Site: New Appeals Process

“Tired of waiting” is a phrase we often hear associated with appeals. But since the implementation of the Appeals Modernization Act, Veterans who disagree with VA’s decisions on their compensation claims have had a new and quicker way to receive a second look. That benefit has now been extended to Veterans stuck in the legacy appeals process.

Dave McLenachan, director of VBA’s Appeals Management Office, unveiled the Decision Review Process last week in a VBA Facebook Live, noting that Veterans with appeals in the old process can—as soon as they receive a Statement of the Case (SOC) or Supplementary Statement of the Case (SSOC)—elect to transfer their appeals into the AMA process.

The opt-in notice will be included with SOCs and SSOCs, and must be returned to VA within 60 days. The benefits of opting in are eye-popping: appeals in the legacy process average 3-7 years for a single decision; the current average for claims in the AMA is 36 days.

And lest you think the AMA “leads to quicker denials,” consider that since RAMP started, AMO has processed more than 75,000 claims and awarded more than $378 million in retroactive benefits. That’s a lot of granting.

In the video, Mr. McLenachan also busts a few myths. My favorite is the “effective date protection”—your “backpay” date—which actually improves effective date provisions as long as a Veteran continually pursues the review of her claim.

That “continually pursues review” leads into the next busted myth: AMA is not a one-and-done; if the Veteran disagrees with the decision VA makes, she can move her claim into another lane, and there is no limit to how many times she can use the lanes, or in which order. None of the options go away! That means a Veteran could potentially receive three or more decisions (if they continue to disagree) in AMA before ever receiving one in the legacy appeals process!