St. Cloud VA Health care
System announcement

News & Announcements

At the St. Cloud VA HCS, we are increasing readiness to begin implementing the MISSION Act on June 6. The MISSION Act is a far-reaching law with over 50 different sections. Implementing the entirety of the Act will take several years.

On June 6, the new Veteran Community Care program is among the most prominent parts of the law being implemented. The new Veteran Community Care program:

• Establishes a single community care program. All existing programs will be combined into one program. The Veterans Choice Program ends but some of its elements are being adopted into the new program.
• Establishes a new Community Care Network (CCN) that is set-up and ran by third-party administrators. VA and/or the Veteran will make community care appointments thru the CCN.
• Establishes expanded eligibility guidelines for Veterans to access Community Care.
• Provides for a new Urgent Care benefit for Veterans. Veterans will be able to use in-network Urgent Care centers without prior authorization from VA.

What does this mean for Veterans?

First, our Veterans can and will continue to get high-quality care in a timely manner delivered with a great customer experience from the St. Cloud VA. Your PACT and treatment teams will remain the primary pathway to get the care you need. The booklet titled Health Care Options Through VA (attached below) provides a broad overview of VA health care, including the new community care program. We’ve also attached the pamphlet titled Accessing & Managing Care at the St. Cloud VA HCS as a guide to getting care at the St. Cloud VA.

VA has used community care for years, whether it was called non-VA care, fee-basis care, or Choice care. The new Veterans Community Care program, to be finalized on June 6, streamlines several programs into a single program and expands the ways Veteran may be eligible to get care in the community. As before, the first step is to discuss your needs with your care team. If community care is right for you, we’ll make a referral and schedule the appointment in the community and the community provider will bill VA.

The new Urgent Care benefit, to be finalized on June 6, provides Veterans another option to get care needed right away, close to home. Veterans can choose between same-day services or walk-in access at many of our clinics, telephone care, visiting the St. Cloud VA Urgent Care Clinic in Bldg. 1 (open 7 days a week from 8 a.m. to 6 p.m.) or going to a community urgent care clinic.

How do Veterans use these benefits?

To use community care, first talk with your care team. If community care is right for you, we’ll make a referral and schedule the appointment in the community and the community provider will bill VA. Please view this short video for an overview of how the program works: https://www.youtube.com/watch?v=oggmxhj8QRk&feature=youtu.be

Sometimes a quick trip to a local walk-in retail health clinic or urgent care facility is a convenient alternative for minor injuries and illnesses. Starting June 6, VA will offer 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, sore throats, and minor skin infections. The benefit is offered in addition to the opportunity to receive care from a VA provider, as the St. Cloud VA also offers same-day services and operates the St. Cloud VA Urgent Care Clinic in Bldg. 1 (open 7 days a week from 8 a.m. to 6 p.m.).

Eligible Veterans will now also be able to receive urgent care from a community urgent care provider that is part of VA’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 use the benefit, a Veteran simply needs to find and travel to an in-network urgent care provider and tell them they are a Veteran seeking urgent care.

To find an available urgent care provider in VA’s contracted network of community providers, Veterans will be able to use VA’s provider locator on VA.gov (https://www.va.gov/find-locations/). Using the drop-down boxes, enter your zip code, search for “Community Care,” select the service type, and hit “search.” Additionally, VA staff can help find available in-network locations. Note that the provider locator will not be live until June 6.

Upon arrival and check-in, the provider will confirm eligibility and you’ll get the care you need. Afterwards, the bill is sent to VA and if necessary, VA will bill the Veteran for any copayment due.

If medications are ordered during the visit, for a 14-day or less supply Veterans can either fill the prescription at contracted pharmacy in the VA network, a VA facility or the prescription can be filled at a non-contracted pharmacy. If a non-contracted pharmacy is used, Veterans must pay for the prescriptions and file a claim for reimbursement with their local VA medical facility. Some Veterans may be required to make a copayment for medication.

To learn more about the Urgent Care benefit, please read the Urgent Care fact sheet attached below.

Going Forward

The St. Cloud VA values our relationships with our Veterans, and we are focused on getting you the right kind of care, in the right setting, when it is needed, using all the benefits and programs available to you.

For more information, visit www.missionact.va.gov.