Noteboom The Law Firm

VA Changing Payments For Non-VA Care

December 22, 2010 - February 16^th, 2011 will be the day the Department of Veterans Affairs (VA) changes their payment schemes for varying treatments that veterans receive from non-VA providers. On that date, the VA will use the standard payment rates Medicare uses for specific medical procedures and/or treatments.

Those treatments include:

• Anesthesia;
• Clinical laboratory care;
• End stage renal disease (ESRD);
• Ambulatory surgical center care; and
• Hospital outpatient perspective payment systems.

Spokespeople for the VA have stressed the change will have no bearing on VA health care given to veterans seen at VA medical centers. This change only affects the procedures and/or treatments for which the VA uses private contractors. The VA will be able to develop better-planned budgets because of the change in pay. They will also be able to focus on giving veterans better access to VA health care. By the VA using Medicare prices for these specific services, they will be able to make better use of their own available resources while keeping their focus on providing the best possible care to veterans.

Eligible veterans will not experience any interruption in service. Companies with existing contracts will not be effected either. Non-VA medical facilities as well as private doctors will continue to be paid for their services, but will be paid by the new payment schedules as established by the Centers for Medicare and Medicaid Services (CMS), Prospective Payment Systems (PPS), and fees schedules.

Switching to this pricing system is expected to save the VA about $1.8 billion, which the VA will use to invest in VA programs. Further, using these payment schedules will give the VA a series of constant costs, which will help the VA control their medical costs.