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VA Expands Choice Program Eligibility

Department of Veterans Affairs Press Release

On August 7, 2014, President Obama signed into law the Veterans Access, Choice, and Accountability Act of 2014 (Public Law 113-146) (Choice Act). Technical revisions to the Choice Act were made on September 26, 2014, when the President signed into law the Department of Veterans Affairs Expiring Authorities Act of 2014 (Public Law 113-175) and on December 16, 2014, when the President signed into law the Consolidated and Further Continuing Appropriations Act, 2015 (Public Law 113-235).

The Choice Act required VA to implement the Veterans Choice Program through an interim final rule, and on November 5, 2014, the Department of Veterans Affairs (VA) published an interim final rulemaking. In that rulemaking, VA adopted a straight-line method for determining eligibility for the Program based on the distance between a Veteran’s place of residence and the closest VA medical facility.

On April 24, 2015, VA published a second interim final rule that changed the way VA measures distance for purposes of determining eligibility. VA now considers the distance a Veteran must drive to the nearest VA medical facility, rather than the straight- line or geodesic distance to such a facility. This results in an expansion of eligibility for the Choice Program.

Effective immediately, VA is also changing the mileage calculation for beneficiary travel. The change will ensure consistency in VA’s mileage calculations. The beneficiary travel mileage calculation will now be made using the fastest route instead of the shortest route.

Summary

A Veteran who meets threshold eligibility criteria may be eligible for the Choice Program based on the distance from his or her place of residence to the closest VA medical facility. VA previously determined eligibility based on place of residence using a straight-line measure of distance. VA is now using a driving distance measure.

For example: Under the new distance calculation, a Veteran who lives 40 miles or less, measured using a straight-line distance, from the nearest VA medical facility, but who needs to physically drive more than 40 miles to get there would be eligible for the Veterans Choice Program. Under the previous straight-line distance calculation, this Veteran would not have been eligible for the Program unless he or she was required to wait for an appointment longer than 30 days from his or her preferred date or the date determined to be medically necessary by his or her physician.

The expansion in eligibility increases Veterans’ access to high quality, timely healthcare. VA looks forward to continued collaboration with Veterans and our partners to ensure the success of the Veterans Choice Program.

Frequently Asked Questions:

Q. When is this rule change effective?
A. The interim final rule was published in the Federal Register on April 24, 2015, and is effective immediately upon publication.

Q: Why is VA changing this criterion now?
A: The change in criterion to the program will allow more Veterans to access care when and where they want it. VA believes a driving distance calculation is consistent with the law. The Choice Act does not state how distance should be calculated for purposes of determining eligibility based on place of residence. The straight-line measure adopted by the first interim final rule was consistent with language in the legislative history of the Choice Act. .

Q: What mapping tool is used to calculate the 40 miles?
A: VA will use the commercial product that is used by VA’s long-established beneficiary travel program. Because different mapping tools use different proprietary programming, the results may vary among products.

Q: Is the distance calculated the same way that is used to calculate mileage for beneficiary travel?
A: The mapping tool for beneficiary travel will now calculate the driving distance using the fastest route rather than the shortest route. This is a change to the beneficiary travel program that will make the distance determinations under the beneficiary travel program consistent with distance calculations under the Veterans Choice Program. The fastest route was chosen as the standard to ensure fairness to Veterans.

Q: Is it still 40 miles from any VA medical facility or is it 40 miles from a VA medical facility that actually provides the care needed?
A: This Choice Act requires VA to measure the distance from the Veteran’s residence to the closest VA medical facility, even if that facility does not provide the care that is needed. Absent a statutory change, VA does not have the flexibility to adopt an alternative approach. We are working with Congress to seek possible alternatives.

Q: How does VA plan to notify newly eligible Veterans?
A: All potentially eligible Veterans already received a Veterans Choice Card. VA will send follow-up letters notifying Veterans who are eligible under the revised mileage calculation.

Q. Who can a Veteran call if they have questions about the Veterans Choice Program or do not remember receiving their Veterans Choice Card?
A. If a Veteran does not remember receiving a Veterans Choice Card or has other questions about the Choice Program, they can call (866) 606-8198.

Q: Where can I get more information about the program?
A: Please review the VA Choice website at http://www.va.gov/opa/choiceact/