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Veterans Affairs Mission Act

Wednesday, March 20, 2019   (0 Comments)
Posted by: Sheri Ryan
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ACS has received many questions from our membership regarding what's in store for VA come June, 2019 with the VA Mission Act of 2018 being enacted.  Debbie Ryan, CEO and Sheri Ryan, COO, ACS staff, met with Kirk Alkire, the new Military and Veterans Affairs Liaison with U.S. Senator Dan Sullivan's office on March 12, 2019 in hopes of getting answers to some of the concerns we had received.  

 

Mr. Alkire met with leadership at the VA recently and followed up with us on our questions.  Here are those responses.  

 

I wanted to follow up with you concerning the questions you brought to our office.  We recently met with leadership at the VA, and brought up the specific issues you asked in our meeting.  Below are the questions and VA responses:

 

1.  What changes to Chiropractic Care will come with the Mission Act?

 

A:   Chiropractic care will not change.  Current policy as of late 2018 (per VA’s updated “standard episodes of care)”.

 

For new or aggravated injuries

Acute phase: 12 visits authorized within first 90 days.  Then, 8 visits over next 90 days, then 8 visits over next 180 days totaling 28 visits authorized in first year.

 

For chronic/sustainment phase:  16 visits authorized per year.

 

2.  Is it the VA’s plan to consolidate all chiropractic care contracts with the South Central Foundation?

A:  No.  The VA uses TriWest’s network of chiropractic providers throughout the state (Choice network, will remain the same with the Mission ACT), in virtually every community.  South Central Foundation is a tribal health system for primary care in the Anchorage bowl and Mat-Su.  They do not provide specialty care and have no role in our chiropractic referrals.  They solely provide primary care to a number of our native and non-native Veterans in the local area.

 

3.  What is the plan for implementation of the Mission Act when Choice ends in June, 2019?

 

A: The RFP for the administrator of the Mission Act contracts has not been issued yet. It is scheduled to be released in June or July, with a contractor chosen in the December 2019 timeframe, and a contractor beginning their service in the June 2020 timeframe. Until that time, the current contracts administered by TriWest will continue.

 

Lastly, the VA is in the process of hiring a Chiropractor for their Anchorage hub to recapture some of their purchased care expenditures.  But they will otherwise rely on having local “care in the community” close to the Veteran’s home via the provider network


Dr. James Martin, on behalf of ACS, reached out to Congressman Don Young's office on March 15, 2019 and received the following response:  

The Office of Community Care has developed Standardized Episodes of Care (SEOC) for several specialties including Chiropractic, Acupuncture, and Physical Therapy treatments.  The number of treatments for each of these specialties has been established after review of evidenced based criteria.  The SEOCs have been issued to the VA facilities to be used when writing approvals.  The number of visits for each of these specialties is:  

Chiropractic--: Initial authorization- 90 days/12 visits; Continuation of initial authorization- 30 days/5 visits; Chiropractic Pain Management- 180 days/8 visits.  This is a total of 25 visits beginning 1/1/2019.  

Acupuncture--: 90 days/10 visits; Continuation of initial authorization- 90 days/8visits; Chronic Care Management- 180 days/8 visits.  This is a total of 26 visits/year, beginning 1/1/2019.

Physical Therapy--14 visits/90 days.  

When the veteran has used all visits approved under these SEOCs, they are instructed to return to their primary care providers for reevaluation to determine if further treatments within this specialty are warranted or if a different modality should be trialed.  

In order to support additional visits, the specialists should provide detailed documentation stating:

  • Treatment plan with expected stop date
  • Treatment goals with expected outcomes
  • Instruction in home exercise program
  • Documentation of procedures/treatments performed each visit
  • Pain assessment prior to treatment and following completion of treatment (this should be done at each visit)

Update 04/18/2019 - See the Veteran Community Care - General Information Fact Sheet dated 03/18/2019 regarding VA MISSION Act of 2018.  

 

If you have further questions/concerns regarding VA, please contact Sheri Ryan at sryan@akchiro.org or 907.903.1350.  

 

 


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Alaska Chiropractic Society, PO Box 111507, Anchorage, AK  99511-1507 
    
Phone: (907) 903-1350   Fax:  (907) 770-3790   Email:  info@akchiro.org