January 18, 2019

New VA community care program regs stall at OMB over cost

From: Modern Healthcare

By Susannah Luthi


This potentially major extra cost of $5 billion to $8 billion comes with the not-yet-finalized and not-yet-public draft regulations that will likely shape the VA’s community health program into a model similar to TriCare Prime, according to sources familiar to talks. TriCare Prime is the managed-care HMO plan for active service military that pays drastically low rates for treatment in private clinics and hospitals but also offers care in military health facilities.

The size of this new cost projection is delaying the VA’s proposed model at the White House Office of Management and Budget, where officials are evaluating the draft regulations, said a source close to discussions.

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