Citation Nr: A21019591
Decision Date: 12/08/21	Archive Date: 12/08/21

DOCKET NO. 200318-165896
DATE: December 8, 2021

ORDER

The appeal concerning payment for the cost of non-Department of Veterans Affairs (VA) medical services provided by Aegis Sciences Corporation on December 4, 2019, and December 11, 2019, is dismissed.

FINDING OF FACT

The Appellant seeks payment for medical care furnished on December 4, 2019, and December 11, 2019, through the Veterans Community Care Program (VCCP).

CONCLUSION OF LAW

The Board does not have jurisdiction to review the claims for payment of the cost of medical services provided by Aegis Sciences Corporation on December 4, 2019, and December 11, 2019; the appeal must be dismissed.  38 U.S.C. § 1703(f); 38 C.F.R. § 20.104(c).  

REASONS AND BASES FOR FINDING AND CONCLUSION

The Appellant is a provider that furnished services to the Veteran.  See generally 38 U.S.C. § 1703(c), (h); 38 C.F.R. § 17.4030.

On March 18, 2020, the Board of Veterans' Appeals (Board) received a VA Form 10182, Decision Review Request: Board Appeal electing the Direct Review docket to review a December 18, 2019, Explanation of Benefits (EOB) denying payment for a December 4, 2019, episode of care furnished by the Appellant associated with claim number 301934500019667000 and a December 20, 2019, EOB denying payment for a December 11, 2019, episode of care furnished by the Appellant associated with claim number 301935200021932000.  38 U.S.C. § 1703.

Decisions under the VCCP (effective June 6, 2019) do not fall within the Board's jurisdiction, including those related to denials of payment due to no prior authorization for Community Care.  38 U.S.C. § 1703(f) (the review of any decision regarding when care is authorized to be furnished through non-VA providers under the VCCP shall be subject to the VA's clinical appeals process, and such decisions may not be appealed to the Board).  The Appellant was notified of the potential jurisdictional defect in a September 2021 letter and provided an opportunity to submit additional evidence or argument.  The Appellant did not respond.  38 C.F.R. § 20.104(c).

The Board does not have jurisdiction to review the Appellant's claim.  38 U.S.C. § 1703(f).  The appeal is dismissed.  38 C.F.R. § 20.104(c).

 

DONNIE R. HACHEY

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	A. Odya-Weis

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.