The VA MISSION Act of 2018 brought about significant changes in how the Department of Veterans Affairs (VA) handles healthcare billing, particularly concerning sensitive health information. A key shift is the VA’s ability to bill health insurance providers, including employer-sponsored programs, for care, even for diagnoses previously considered sensitive, such as substance abuse or HIV. This change has implications for veterans and the broader healthcare landscape.
Prior to this act, the VA often required explicit permission to bill insurance for sensitive diagnoses. Now, to ensure financial support for veteran healthcare, the VA is submitting claims to health insurance carriers for all non-service-connected care provided. This includes instances where the veteran may not have provided explicit authorization for disclosing protected health information for billing purposes. This move is legally mandated, requiring the VA to bill health insurance – including spousal insurance if applicable – with the collected funds directly supporting VA medical centers and the overall costs of veteran healthcare.
What Effect Will Employer Insurance Programs Have On Care Coordination?
The shift towards billing employer insurance and other health plans aims to bolster the VA’s financial resources, which indirectly can enhance the quality and scope of services offered. Increased funding can contribute to improvements in various aspects of veteran care, potentially including care coordination. While the direct effect of billing employer insurance on care coordination might not be immediately apparent, the augmented financial capacity of the VA system could facilitate better resource allocation towards integrated care models. This could manifest in several ways:
- Enhanced Resources for VA Facilities: The additional revenue can be channeled into improving infrastructure, staffing, and technology within VA facilities. This, in turn, can support more efficient care coordination activities, such as improved communication systems between different departments within the VA and with external healthcare providers.
- Potential for Expanded Services: With increased financial stability, the VA may be able to expand its care coordination programs. This could involve developing more comprehensive programs that assist veterans in navigating the complexities of the healthcare system, both within and outside the VA.
- Indirect Impact on Integrated Care: While the MISSION Act also focuses on community care options, strengthening the VA’s financial base through insurance billing can ensure the VA remains a central hub for veteran healthcare. A well-funded VA system is better positioned to coordinate care effectively, whether that care is delivered within the VA or in the community.
It’s important for veterans to be aware of their rights in this evolving system. While the VA is now billing insurance, veterans retain the option to submit a restriction request to limit the disclosure of their health information for billing purposes. However, it’s crucial to understand that the VA is not obligated to grant these requests. Veterans seeking to explore this option can contact their nearest VA health facility and inquire with the privacy officer or billing office for detailed guidance.
In conclusion, the VA MISSION Act’s mandate to bill health insurance, including employer programs, is primarily a financial mechanism to support veteran healthcare costs. While the direct link to care coordination is indirect, the resulting financial strengthening of the VA system holds the potential to enhance various aspects of veteran care, possibly including improvements in care coordination through better resourced and more comprehensive VA services. Veterans should stay informed about these changes and exercise their rights to ensure their healthcare needs and privacy concerns are appropriately addressed within this evolving framework.
