VA Proposed Rule for Veteran Community Care Program

The Department of Veterans Affairs (VA) has issued a proposed rule detailing access standards under the new Veterans Community Care Program, as required by the MISSION Act of 2018. The proposed rule also establishes a new benefit for veterans to access urgent care services.

The access standards will be used to determine whether a veteran can access care outside a VA medical facility at an eligible community provider. Specifically, the agency proposes access standards of:

  • A 30-minute average drive time standard for primary care, mental health and non-institutional extended care services
  • A 60-minute average drive time standard for specialty care
  • Appointment wait-time standards of 20 days for primary care, mental health care and non-institutional extended care services, and 28 days for specialty care, with certain exceptions

For urgent care, the VA proposes a veteran could receive care at any provider in the community care network, with the possibility of a co-pay charge. Additional details on the establishment of an eligible community provider network are not included in the proposed rule and are expected to be issued in a separate interim final rule in late spring. The MISSON Act requires the program to be implemented by June 6. Comments are due March 4.