‘Choice Act’ offers ODs new opportunities to care for veterans

‘Choice Act’ offers ODs new opportunities to care for veterans

A new, AOA-backed provision makes it easier for veterans to access care under the Veterans Choice Program, further expanding opportunities for optometrists to provide essential eye care to America's heroes.

Through the Choice Act, non-VA optometrists have new opportunities to help provide care to America's veterans when needed.

Introduced by Rep. Mike Coffman (R-Colo.) and signed into law on May 22, H.R. 2496—"Construction Authorization and Choice Improvement Act"—revised the Veterans Access, Choice and Accountability Act of 2014 (Choice Act) to make it even easier for veterans to qualify for care through non-Department of Veterans Affairs (VA) entities.

Passage of the bipartisan Choice Act last year created the Veterans Choice Program, which permitted the VA to pay for veterans' care from eligible non-VA providers should they face a wait time of more than 30 days or live more than 40 miles from a VA facility.

The changes in H.R. 2496 further clarify that distance requirement to include additional factors that might limit ability to travel for care, and also gave VA officials discretion in allowing veterans to qualify.

These changes are the second adjustment to the Veterans Choice Program this year; the first clarified the 40-mile proximity measure, an adjustment that roughly doubled the number of eligible veterans.

How to deliver care to veterans
Eye care clinics staffed by VA doctors of optometry, including residents, are among the busiest primary care settings in the veteran's health care system. Last year alone, more than 1.2 million veterans received comprehensive eye exams and other essential care through VA optometrists.

Going forward, the workload for VA optometry is only expected to rise. Serious eye trauma is the second most common injury among those who served in Iraq and Afghanistan, with 16 percent of all wounded service members experiencing problems ranging from distorted vision to blindness.

Through the Choice Act, non-VA optometrists have the opportunity to help provide care to America's veterans when needed. Consider the steps below from the VA to become a Veterans Choice Program care provider:

1. Become a Patient-Centered Community Care (PC3) provider. PC3 is already implemented nationwide by the VA to purchase care in local communities. Most PC3 providers are automatically eligible to participate in the Choice Program. To become a PC3 provider, doctors must establish a contract with one of the Third Party Administrators, Health Net or TriWest.

2. Become a Choice provider without becoming a PC3 provider. Doctors do not have to become a PC3 provider to participate in the Choice Program, but must establish a provider agreement with Health Net or TriWest, and meet these additional requirements:

  1. Must accept Medicare rates
  2. Meet all Medicare Conditions of Participation and Conditions for Coverage as required by the Department of Health and Human Services
  3. Services, facilities and providers shall be in compliance with all applicable federal and state regulatory requirements
  4. Must have a full, current and unrestricted license in the state services are delivered
  5. Must submit a copy of medical records to the TPA for the services provided to the veteran for inclusion in the veteran’s VA electronic record
  6. Providers on the CMS exclusionary list shall be prohibited from network participation

Click here to find additional information about program participation and how to contact Health Net or TriWest.

AOA supports greater access for America's veterans
The AOA is actively working to ensure veterans have greater access to doctors of optometry for essential eye health and vision care services, including supporting this legislation and others, such as H.R. 1688—an AOA-backed bill to increase the number of optometry residency positions within the VA.

AOA members can help build support for such legislation by visiting the AOA's Online Legislative Action Center and urging U.S. House members to take action.

June 3, 2015

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