Healthcare Department of Veteran’s Affairs Issues Ruling on Beneficiary Travel Rules for VA

Just got this today!
Note this applies to all Americans being serviced by VARO/OPC Manila.
ANNOUNCEMENT

Department of Veteran’s Affairs Issues Ruling on Beneficiary Travel Rules for Care Provided Outside the United States

March 2016

On January 29, 2016, the Department of Veterans Affairs issued a legal opinion concerning Beneficiary travel outside of the United States. VA's regulations at 38 C.F.R. § 70.1(a) limit VA's authority to provide payments for travel expenses incurred outside the U.S. This includes any travel expenses incurred overseas for care provided at or coordinated through the VA Outpatient Clinic in Manila. While this regulation is in place, VA may not provide reimbursement for travel expenses incurred outside the U.S. [including] for C&P exams.

Effective April 11, 2016, the VA Manila Outpatient Clinic, consistent with the Beneficiary Travel rules worldwide, will discontinue paying beneficiary travel. The delayed implementation of this ruling gives the Outpatient Clinic time to notify Veterans who have previously scheduled appointments that they will no longer receive reimbursement for their travel to their clinic appointments.

• Veterans already scheduled appointments through June 11, 2016 are being contacted by way of email, text and telephone calls to advise them about beneficiary travel being discontinued by April 11, 2016.
  

• Veterans who have scheduled appointments and have already purchased airline tickets may submit a beneficiary travel claim along with paid receipts showing purchase was made prior to April 10, 2016. These Veterans will be reimbursed airline travel.
  

• Veterans who come to the clinic by way of a hired vehicle after April 10, 2016 will no longer be reimbursed.
  

Four Areas the VA Manila Outpatient Clinic is focusing on to deliver care and services directly to Veterans throughout the Philippines.

1. Enrolling all Veteran’s into the electronic MyHealtheVet (MHV) system. Ninety-Four percent of Veterans accessing care in the VA Manila Outpatient Clinic are already enrolled in MyHealtheVet (MHV) and can use this system to do the following:
   
   1. Veterans can communicate directly, by secure message, to their primary care team, Doctor, Nurse, pharmacy, laboratory personnel and other support services to include the patient advocate and clinic scheduling clerk.
      
      
   2. Veterans can reorder/refill their medications on-line.
      
      
   3. Veterans can request information and can ask to change or cancel clinic appointments on-line.
      

1. Medication audio refill/ Clinic audio reminder and messaging.
   
   1. Veterans can refill their medications by calling audio refill.
      
      
   2. Veterans are reminded about appointments and given a chance to cancel or reschedule the appointment if necessary.
      
      
   3. Veterans are automatically notified about clinic closures.
      

1. Laboratory Services in the Community
   
   1. Veterans living outside of metro manila will be able to have their labs drawn in their community once the lab contract is finalized.
      
      
   2. Veteran’s health conditions and medications can be monitored through telephone care once the labs are emailed from their community laboratory to the VA Manila Outpatient Clinic.
      

1. Telephone Care Access
   
   1. Veterans can speak directly to a nurse, pharmacist and scheduling clerk regarding their care coordination and services.
      
      
   2. Veterans will be contacted by their Primary Care Physician regarding care that can be coordinated over the phone.
      
      
   3. Veterans can consult with their primary care team members regarding results and to review medical records, lab results, imaging studies, medication profile and pathology results.
      

Veteran’s Access to Primary Care, Specialty Care and Diagnostic Services will Not Change

• Eligible Veterans, who want to continue their care at the VA Manila Outpatient Clinic, can schedule an appointment with their primary care provider.
  
  
• Veterans without an appointment can come to the clinic on a walk-in basis.
  
  
• Eligible Veterans will be referred to the community for non-VA care and services if not available in the clinic.

For questions contact Vicki Randall, Clinic Manager at (632)318-8335 or email: vicki.randall@va.gov

 

QUESTION:

Does the VA have a list of Doctors In the Duma area where the VA will pick up the cost for service-connected issues?

I ask this as the VA here in the States has a "new" deal for rural Vets who live MORE THAN 40 miles away from the nearest VA Clinic (whether it can treat your medical issue or not!) OR, if you have to wait more than 30 days for your specific VA appointment. You just need to be physically domiciled with a physical address of MORE than 40 miles from the nearest VA CLINIC, OR, have a wait time of more than 30 days for your appointment.

This "new" VA program is in the process of creating a list of Doctors who will accept payment from the VA for VA service-connected issues in the Veteran's LOCAL area. But right now, this "new" program for local medical service is a Flippin' Goat-rope as the VA seems to have problems allowing this new program to be implemented in a way that is favorable to the Veteran.

EXAMPLE:

Currently, I live in a rural area 28 miles from the nearest VA Medical Clinic. BUT, this clinic CANNOT and is NOT capable of treating almost all of my service-connected issues. Tough sh*t for me. I STILL cannot qualify for the "new" program because I physically live within 40 miles of this USELESS Clinic. This weird "interpretive" glitch in the law came about when Congress created/mandated this new law and program for the VETS, but the VA is STRICTLY intrepreting this law as they don't like Congress telling THEM how to manage VET health care (Nevermind the scandalous deaths of Veterans at the Phoenix VA Regional). In any event, this LAME 40 mile radius rule forces me to HAVE TO drive to the VA Medical Center 125 miles ONE WAY from where I live and spend ALL DAY of my time for a one hour appointment. (Thank goodness I have other health care insurance). So much for the VA really wanting to make my using MY VA health care an accessible and convenient option, huh? And I'm VA rated 100%, too.

Go figure....

But I'm wondering???? Since the Manila VA is so far away (I assume that Duma is beyond the 40 miles to the nearest VA Clinic), is the VA contracting out medical/dental/optical/psychiatric services for the Duma Vets that live there and need these service-connected conditions cared for?

This is a new thing the VA is doing for SOME qualifying Vets here in the States. (But they are telling Congress that not enough Vets are using this new program - geeee, I wonder why? - and they want to use this money for something else). I suspect some of this has to do with the institutional power and control the VA has or is afraid of losing control over.

But, since the VA has an established footprint in the Philippines, are they implimenting this "new" out-sourcing of care policy in the Philippines as well as in the States? The VA is the VA is the VA no matter where they are as they are managing the Veteran's service-connected health care right? And the VA is a Federally funded Department, right?

Just wondering if the VA is doing this or are about to do this in the Philippines.

This would be pretty ironic and funny for me if they did, as I would have a much easier time getting VA care in Dumaguete, Philippines (half-way around the world), than I can get VA care here in the good ol' US of A.

Such a deal!

V/R,
nwlivewire

 

I just submitted the question on IRIS. I also sent Vicki Randall an email asking for the documentation from the VA Council that states we are not authorized travel. I also sent an email to the VA IG

 

Good thinking c_acton98!

This deal of no longer authorizing travel reimbursement doesn't seem right to me.

What if you have a C&P exam in Manila? Or is the VA after a certain date, going to sub-contract that out to long-distance Duma Vets to locally approved C&P Doctors like they do here to the long-distance Vets in the States (and I have heard many horror stories of incompetent C&P sub-contractors, too).

I do quite a bit of "tele-conferencing" to Redding and use that USELESS clinic for the teleconference with the VA Docs in Redding. I save time and don't run the wheels off my car whenever I can. I lose the travel reimbursement to Redding, but that's fine with me as I hate the LONG drive in all kinds of weather, and the all day event of getting to Redding and back for a one hour appointment. I just really wish I could see a local Doctor instead of having to go all the way to Redding when I do need in-person medical attention or a standard medical procedure that takes prep time (like having a colonoscopy) before and after a procedure like that.

So it looks like Duma has a more convenient VA health care deal for Vets than where I am.

Hmmmmm..... Another good reason to be in the Philippines -- a Vet can be seen locally.

Such a deal!

V/R,
nwlivewire

 

Interested to know the outcome and/or replies to that.

 

Some good info here: Fact Sheets - Veterans Benefits Administration
I also have an emailed fact sheet sent from Manila VA but don't know how to attach here. Any suggestions?

It is in .docx format. The jist of it is the VA here only services service connected injuries and C&P exams (that's compensation and pension exams to see if you can get certified as service connected injury). If not service connected injury your out of luck. Unless considered a combat veteran then you can get service in Manila

 

My question to MS. RANDALL
I sent an email to you last night this is a follow-up.
In the US the VA instituted a new policy about Vets who live over 40 miles from VA facility or have to wait more than 30 days for an appointment.
HER REPLY
The choice program is not applicable to Veterans living in a foreign country. To remain eligible for medical care and medications, a Veteran must return to the clinic annually to see their primary doctor. There are times when your doctor may want to see you more often depending on your medical conditions and the medications you take. Your primary care physician is responsible for your care. If you require a procedure that is not available in the clinic, then your doctor will put in an order to authorize treatment outside the clinic. You can go to any facility you choose. If you choose a facility that extends a line of credit to VA, we will pay for services required to treat your service connected condition. If you choose a facility that only accepts cash or credit card, you will pay the charges and request reimbursement. Just remember your primary care doctor manages your care and is the only one that can authorize medical care and diagnostics outside of the clinic. This is not a change. The only change is beneficiary travel is discontinued April 11. Let me know if you have questions. vicki

BACK TO HER
What is VA going to do to be able to service these Vets? Is this a move in the direction of FMP
Are you saying the Vet does not have to see the primary care provider? As above is VA going to use local doctors like in the FMP?

HER REPLY
The only change is beneficial travel is discontinued and no travel or per diem will be paid after April 11. Please understand this is not a local decision, it is the law. The foreign medical program and social security discontinued paying beneficiary travel for comp and pension exams on February 8. OGC advised agencies proving travel overseas on January 29. VA Manila delayed implementation so Veterans could plan. Keep the questions coming, we plan to develop a question and answer response that will be forwarded to all. enrolled Veterans next week. Feedback and questions are greatly appreciated. Vicki AGAIN did not address the question

 

IRIS RESPONSE

Recently you requested assistance from VA. Below is our response.

If you wish to reopen this issue, you may do so within the next 14 days.

Thank you for allowing us to be of service to you.

Response By Email (Department of Veterans Affairs) (03/20/2016 10:42 PM)

Greetings!

Sir,


Department of Veteran’s Affairs Issues Ruling on Beneficiary Travel Rules for Care Provided Outside the United States

March 2016


On January 29, 2016, the Department of Veterans Affairs issued a legal opinion concerning Beneficiary travel outside of the United States. VA's regulations at 38 C.F.R. § 70.1(a) limit VA's authority to provide payments for travel expenses incurred outside the U.S. This includes any travel expenses incurred overseas for care provided at or coordinated through the VA Outpatient Clinic in Manila. While this regulation is in place, VA may not provide reimbursement for travel expenses incurred outside the U.S. [including] for C&P exams.


Effective April 11, 2016, the VA Manila Outpatient Clinic, consistent with the Beneficiary Travel rules worldwide, will discontinue paying beneficiary travel. The delayed implementation of this ruling gives the Outpatient Clinic time to notify Veterans who have previously scheduled appointments that they will no longer receive reimbursement for their travel to their clinic appointments.

• Veterans already scheduled appointments through June 11, 2016 are being contacted by way of email, text and telephone calls to advise them about beneficiary travel being discontinued by April 11, 2016.

• Veterans who have scheduled appointments and have already purchased airline tickets may submit a beneficiary travel claim along with paid receipts showing purchase was made prior to April 10, 2016. These Veterans will be reimbursed airline travel.

• Veterans who come to the clinic by way of a hired vehicle after April 10, 2016 will no longer be reimbursed.


Four Areas the VA Manila Outpatient Clinic is focusing on to deliver care and services directly to Veterans throughout the Philippines.
1. Enrolling all Veteran’s into the electronic MyHealtheVet (MHV) system. Ninety-Four percent of Veterans accessing care in the VA Manila Outpatient Clinic are already enrolled in MyHealtheVet (MHV) and can use this system to do the following:
a. Veterans can communicate directly, by secure message, to their primary care team, Doctor, Nurse, pharmacy, laboratory personnel and other support services to include the patient advocate and clinic scheduling clerk.
b. Veterans can reorder/refill their medications on-line.
c. Veterans can request information and can ask to change or cancel clinic appointments on-line.

2. Medication audio refill/ Clinic audio reminder and messaging.
a. Veterans can refill their medications by calling audio refill.
b. Veterans are reminded about appointments and given a chance to cancel or reschedule the appointment if necessary.
c. Veterans are automatically notified about clinic closures.

3. Laboratory Services in the Community
a. Veterans living outside of metro manila will be able to have their labs drawn in their community once the lab contract is finalized.
b. Veteran’s health conditions and medications can be monitored through telephone care once the labs are emailed from their community laboratory to the VA Manila Outpatient Clinic.

4. Telephone Care Access
a. Veterans can speak directly to a nurse, pharmacist and scheduling clerk regarding their care coordination and services.
b. Veterans will be contacted by their Primary Care Physician regarding care that can be coordinated over the phone.
c. Veterans can consult with their primary care team members regarding results and to review medical records, lab results, imaging studies, medication profile and pathology results.

Veteran’s Access to Primary Care, Specialty Care and Diagnostic Services will Not Change
• Eligible Veterans, who want to continue their care at the VA Manila Outpatient Clinic, can schedule an appointment with their primary care provider.
• Veterans without an appointment can come to the clinic on a walk-in basis.
• Eligible Veterans will be referred to the community for non-VA care and services if not available in the clinic.


For questions contact Vicki Randall, Clinic Manager at (632)318-8335 or email: vicki.randall@va.gov

Thank you