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Provider News

ICON: Latest NewsThis page provides the latest information for community providers who are partnering with VA to care for our nation’s Veterans. From here, you can access the latest news, policy changes, and health care program updates!

To get the latest updates directly in your e-mail inbox, we encourage you to sign up for our monthly community provider newsletter.

Sign up for Monthly Provider UpdatesProvider Updates–Past Issues

Urgent Care Offered Under MISSION Act

June 6, 2019

As part of implementing the VA MISSION Act of 2018, VA offers an urgent care benefit that provides eligible Veterans with greater choice and access to timely, high-quality care. With urgent care Veterans have a new option for care for the treatment of minor injuries and illnesses such as colds such as strep throat, or pink eye. Eligible Veterans will be able to receive urgent care from an urgent care provider that is part of VA’s and TriWest's contracted network of community providers without prior authorization from VA. VA can pay for an urgent care claim only if:

  • The Veteran is eligible for the benefit,
  • the urgent care provider is part of VA’s contracted network of community providers, and
  • the services are not excluded under the benefit (excluded services include preventive services and dental services).

To learn more, go to TriWest Healthcare Alliance’s (TriWest) training on the Availity website.

  1. Visit the Availity website and login
  2. Navigate to the TriWest Payer Space
  3. Click on the “TriWest Learning Center” application
  4. Register for training

Provider Request For Veterans Care Agreement

June 6, 2019

The John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018, referred to as the “MISSION Act,” was enacted on June 6, 2018. The MISSION Act includes the ability for the Department of Veterans Affairs (VA) to purchase community care through the use of Veterans Care Agreements (VCA). VCAs are only used when there is no participating provider within the Patient-Centered Community Care contract (PC3), the Community Care Network (CCN), DOD sharing agreement, or local contracts.

Providers may a request a VCA, but are strongly encouraged to join our contracting partner networks to receive referrals. In order to request VCA consideration, a provider must submit their name, address, phone number, national provider identification (NPI) and a copy of their current valid state licensure to the OCC VCA Review Team. For more information, please review the Veterans Care Agreements fact sheet.

PC3 Network Providers: Join the network at TriWest Healthcare Alliance.

CCN Network Providers, Regions 1 and 2: Email the VA CCN Provider Contracting Team.

IMPORTANT: If you have already begun the VCA process with a local facility, there is no need to start another VCA application. Please contact the local facility that started your VCA process.

HNFS Has Stopped Accepting Medical Documentation As of January 1, 2019

February 5, 2019

Health Net Federal Services, LLC (HNFS) stopped accepting faxed medical records effective January 1, 2019 and deactivated their medical documentation fax line. Community providers must now send relevant medical records to the referring VA Medical Center. For more information, view the Medical Documentation Update on the HNFS website or call the HNFS Provider Service Line.

HNFS Provider Service Line: 844-728-1914
Open October 1, 2018 – June 30, 2020

Health Net Federal Services Contract Close Out – Filing Deadline Extended February 5, 2019

February 5, 2019

VA has reached an agreement with Health Net Federal Services (Health Net) to extend the final date for filing initial claims to March 26, 2019. Originally, community providers were required to file claims within 180 days of health care delivery.

Health Net was a Third Party Administrator for the Patient-Centered Community Care and Veterans Choice Program (VCP) community provider networks. (VCP ended on June 6, 2019.) Veteran health care provided through Health Net ceased in June 2018, and VA’s contract with Health Net ended September 30, 2018.

To meet the extended deadline, community providers must file initial claims for Health Net-authorized services with Health Net by March 26, 2019.

For more information about the Health Net close out, please see HNFS Contract Closeout–Provider Frequently Asked Questions. If you have questions and would like more information, please call the Health Net provider service line, or visit the Health Net website.

HNFS Provider Service Line:

VA Awards Contract for Regions 1-3 of VA’s New Community Care Network

December 28, 2018

VA has awarded a contract to Optum Public Sector Solutions, Inc. for management of Regions 1, 2, and 3 of VA’s new Community Care Network (CCN). Optum is part of UnitedHealthGroup, Inc. CCN is VA’s direct link with community providers to ensure VA provides Veterans with timely, high-quality care.

HealthShare Referral Manager

December 4, 2018

HealthShare Referral Manager (HSRM) is a commercial off-the-shelf solution that VA has selected to accelerate and better manage community care referrals and authorizations. HSRM streamlines referral and authorization management, and improves information sharing between VA and community providers. These improvements allow more timely access to care for Veterans and greater coordination between providers and VA. The information sheet, accessed through the link below, outlines the key benefits community providers will see with the use of HealthShare Referral Manager.

Opioid Safety Initiative

March 16, 2018

VHA appreciates community provider partnerships in the care of our nation’s Veterans; especially the continuity of effort for improving how community-based health services are provided for our Veterans. This correspondence serves to educate and ensure a greater awareness of the first evidence-based guideline to be shared with our community partners – the VHA Opioid Safety Initiative (OSI) – and to provide a registration link to VHA-developed online training for providers.