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Chief Business Office Purchased Care

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Non-VA Medical Care Program

Non-VA medical care is care provided to eligible Veterans outside of the VA when VA facilities are not feasibly available. All VA Medical Centers (VAMCs) can use this program when needed. The use of non-VA medical care is governed by federal laws containing eligibility criteria and other policies specifying when and why it can be used. A preapproval for treatment in the community is required for non-VA medical care – unless the medical event is an emergency. Emergency events may be reimbursed on behalf of the Veteran in certain cases.

 
Emergency care  |  Preauthorized care  |  PC3  |  Project ARCH
State Veterans Home  |  Indian Health Services/Tribal Health Program
 

Emergency care services

There may be a time when a Veteran requires emergency care. When it is not possible to go to a VA Medical Center, a Veteran may have to seek treatment at the nearest hospital with an emergency room. The Department of Veterans Affairs (VA) is authorized under Title 38 United States Code (U.S.C.)  to make payment or reimbursement to a claimant for emergency treatment provided to Veterans meeting specific eligibility criteria.

Visit our Emergency Care page for more information.
 

Prior approval for Veteran care

The Non-VA Medical Care Program Office provides payment authorization for eligible Veterans to obtain routine outpatient medical services, and certain inpatient services, through community providers. This authorization may be granted when it has been determined that direct VA services are either geographically inaccessible or VA facilities are not available to meet a Veteran’s needs. All community services must be preapproved before a Veteran receives treatment.

Visit our Preapproved Medical Care page for more information.
 

Patient-Centered Community Care (PC3)

Patient-Centered Community Care (PC3) is a program that contracts with vendors to develop a network of health care providers to deliver covered care to Veterans. The covered care includes primary care, inpatient specialty care, outpatient specialty care, mental health care, limited emergency care, limited newborn care for enrolled female Veterans following delivery, skilled home health care, and home infusion therapy. Care is available through PC3 when local VA Medical Centers cannot readily provide the needed care to Veterans due to demand exceeding capacity, geographic inaccessibility or other limiting factors.

Visit our Patient-Centered Community Care page for more information.
 

Project ARCH (Access Received Closer to Home)

Project ARCH was originally a 3-year pilot program to provide specific non-VA medical care services through contractual agreements to eligible Veterans in Veteran Integrated Service Networks (VISNs) 1, 6, 15, 18 and 19. With the adoption of the Veterans Access, Choice and Accountably Act of 2014 (Public Law 113-146), the Project ARCH pilot program has been extended for two additional years, now ending in August 2016. Project ARCH intends to improve access to health care services for eligible Veterans by connecting them to services closer to their home. Project ARCH is managed by a parent Veterans Affairs Medical Center (VAMC) in each of the five VISNs, located in Northern Maine; Farmville, Va.; Pratt, Kan.; Flagstaff, Ariz.; and Billings, Mont.

Visit our Project ARCH program page for more information.

State Veterans Home (SVH) Per Diem Program

VA's State Home program provides an economical alternative to constructing, maintaining and operating VA facilities for the provision of care to eligible Veterans. Under this program, the states provide quality care for eligible Veterans in three different types of programs: nursing home, domiciliary, and adult day health care. VA contributions to state home per diem expenses are projected to be $1.07 billion in FY 2014.

Visit our State Veterans Home Per Diem Program page for more information.
 

Indian Health Services (IHS)/Tribal Health Program (THP) Reimbursement Agreements Program

The Chief Business Office Purchased Care, Office of Tribal Government Relations (OTGR), and VA Medical Centers (VAMCs) work together to implement the Tribal Reimbursement Agreements Program. The Tribal Reimbursement Agreements Program provides a means for IHS and THP health facilities to receive reimbursement from the VA for direct care services provided to American Indian and Alaskan Native eligible Veterans. This program is part of a larger effort set forth in the VA and IHS Memorandum of Understanding signed in October 2010 to improve access to care and care coordination for our nation’s Native Veterans.

Visit our IHS/THP page for more information.