Veterans seeking care in the Department of Veterans Affairs' community care program in 30 specialties will not have to get reauthorization from the VA for a year under a new policy announced by the department Monday.
VA officials said that, under the change, eligible veterans will receive 12 months of uninterrupted medical services from private providers covered by the department without needing a new authorization.
Before the change, which went into effect Monday, VA community care specialty referrals were reevaluated every 90 to 180 days, according to the department.
Read Next: VA to Ban Nearly All Abortions at VA Facilities, Drop Coverage for Procedure for Dependents
"No veteran should have their health care disrupted by red tape," VA Secretary Doug Collins said in a statement Monday. "This change means better continuity of care, which leads to better health outcomes."
The community care program allows veterans in the VA health system to get care from a community physician or health provider if they meet certain eligibility requirements or the VA is unable to provide timely or sufficient care.
Under the program, veterans can go to private doctors if they must wait more than 20 days for a primary or mental health care appointment at the VA or face a drive of 30 minutes or longer. For specialty care, the standards are a 60-minute drive or 28-day wait.
To get a community care referral, a veteran must get approval from a VA physician and authorization from their VA facility. In the past six months, the department has taken steps to ease the process, enacting a law in May that removes a requirement that a VA physician's referral to community care be reviewed by another physician or VA administrator for approval.
Now, it will allow veterans to stay in community care for one full year before needing a reauthorization.
"It ... improves convenience for veterans and cuts administrative work for VA staff and community care partners," Collins said.
Last year, Republican lawmakers raised concerns with the reauthorization requirements after hearing from veterans whose care was disrupted as a result of stricter adherence by VA administrators to the rules.
According to Sen. Jerry Moran of Kansas, now the chairman of the Senate Veterans Affairs Committee, the VA canceled community care authorizations for a veteran with two chemotherapy treatments left in his cancer regimen and, in another case, it denied nearby care to a veteran whose cancer recurred.
"We are ... alarmed by the volume of concerns we are hearing from veterans and VA staff who attribute limitations on care in the community to a lack of funding for VA," Moran wrote in a letter to then-VA Secretary Denis McDonough in July 2024.
Democrats have raised concerns that broadening access to community care will effectively lead eventually to the privatization of the VA by depriving the Veterans Health Administration of funds needed to support the department's own medical facilities and to provide quality care.
"Under this administration, we are seeing a chaotic approach to delivering veterans' health care that undercuts VA’s internal capacity, shifts more and more care to the community, and leaves veterans and VA employees in the lurch," said Rep. Julia Brownley, D-Calif., ranking member of the House Veterans Affairs Health Subcommittee during a July 15 hearing on community care.
Despite the changes, many veterans say they still face challenges gaining access to community care. At least half a dozen veterans have written Military.com in the last two months saying they have waited weeks and months to get care or are being referred to facilities miles from their homes.
One veteran who gets care through the Tennessee Valley VA Health Care System said a supervisor at his VA facility has denied his primary care provider's referral for care.
"They are also refusing to give me a written denial for denying care; therefore, I can't appeal. ... I'm screwed. If there is any way, please help," wrote the veteran.
Under the new one-year reauthorization policy, veterans will not have to get another authorization from the VA in these 30 specialties:
- Cardiology
- Dermatology
- Endocrinology
- Neurology and Otology
- Otolaryngology or ENT
- Gastroenterology
- Urogynecology
- Addiction Psychiatry Outpatient
- Family and Couples Psychotherapy Outpatient
- Mental Health Outpatient
- Nephrology
- Neurology
- Nutrition Intervention Services
- Oncology and Hematology
- Neuro-Ophthalmology
- Oculoplastic
- Eye Care Examination
- Optometry Routine
- Orthopedic Hand
- Orthopedic General
- Orthopedic Spine
- Pain Management
- Podiatry
- Podiatry DS
- Addiction Medicine Outpatient
- Pulmonary
- Physical Medicine and Rehabilitation (Physiatry)
- Rheumatology
- Sleep Medicine
- Urology
The VA is encouraging veterans to contact their VA medical center's community care office for more information on the new policy.
Related: Veterans' VA Referrals to Private Medical Care Will No Longer Require Additional Doctor Review
