Expanded Access to Non-VA Care Through the Mission Act: Veterans Community Care Program (VCCP)

ICR 202005-2900-018

OMB: 2900-0823

Federal Form Document

ICR Details
2900-0823 202005-2900-018
Historical Active 201905-2900-007
VA 2900-0823
Expanded Access to Non-VA Care Through the Mission Act: Veterans Community Care Program (VCCP)
Revision of a currently approved collection   No
Emergency 05/29/2020
Approved without change 05/29/2020
Retrieve Notice of Action (NOA) 05/28/2020
  Inventory as of this Action Requested Previously Approved
10/31/2020 6 Months From Approved 06/30/2020
22,758,371 0 22,258,371
3,007,560 0 2,924,227
0 0 0

Section 101 of the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018 requires VA to implement the Veterans Community Care Program (VCCP) to furnish care in the community to covered Veterans through eligible entities and providers, under circumstances as further prescribed in the MISSION Act. VA currently collects information that will be required to implement the Veterans Community Care Program under the Veterans Choice Program, through an OMB approved collection 2900-0823. OMB collection 2900-0823 includes VA Form 10-10143, Election to Receive Authorized Non-VA Care and Selection of Provider for the Veterans Choice Program; VA Form 10-10143a, Health-Care Plan Information for the Veterans Choice Program; VA Form 10-10143b, Submission of Medical Record Information under the Veterans Choice Program; VA Form 10-10143c, Submission of Information on Credentials and Licenses by Eligible Entities and Providers; VA Form 10-10143e, Secondary Authorization Request for VA Community Care; and VA Form 10-10143f, Community Care Document Cover Sheet. A new form is being added to this collection: VA Form 10-10143g, Non-VA Hospital Emergency Notification.
Under the Veterans Community Care Program (VCCP), authorized by 38 U.S.C. section 1703, VA may authorize emergency care for eligible veterans by an in-network provider so long as VA is notified within 72-hours of such care or services being furnished (See 38 C.F.R. § 17.4020). The information needed to authorize care under the 72-hour rule is information that can identify the veteran and provider and whether the episode meets the prudent layperson standard. This information is distinct from when a provider submits a claim for reimbursement. VA Form 10-10143g, Non-VA Hospital Emergency Notification, has been created for this purpose. This new form will be used to provide a 72-hour notification from a non-VA provider who supplies emergent care a Veteran. Due to the current COVID-19 national health situation, OCC respectfully requests an emergency PRA clearance for 10-10143g from OMB. This form has become critical because, at this time, many more Veterans are presenting to non-VA providers with health issues and concerns during the COVID-19 national emergency. Also, the form is needed to effectively pull responsibility for these 72-hour notifications off of the medical staff -- who are struggling to even answer the phones to take these notifications right now. OCC hopes to implement use of this necessary notification form by May 31, 2020.

PL: Pub.L. 115 - 182 101 Name of Law: VA MISSION Act of 2018
  
PL: Pub.L. 115 - 182 101 Name of Law: VA MISSION Act of 2018

Not associated with rulemaking

No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 22,758,371 22,258,371 0 500,000 0 0
Annual Time Burden (Hours) 3,007,560 2,924,227 0 83,333 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
VA Form 10-10143g, Non-VA Hospital Emergency Notification, has been created and added to 2900-0823. This form is necessary to provide a 72-hour notification from a non-VA provider who supplies emergent care a Veteran, as authorized under the Veterans Community Care Program (VCCP).

No
    Yes
    Yes
No
No
No
Yes
Frances O'Donnell 703 405-2449 fran.odonnell@cathexiscorp.com

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
05/28/2020


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