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Audit of representative sample of veterans receiving care and services under Veterans Community Care Program

Title VI: Veterans’ Assuring Critical Care Expansions to Support Servicemembers · Subtitle A: Improvement of Veterans Community Care Program

Plain-language summaryAI

The Department of Veterans Affairs must conduct an annual audit for five years starting within one year of the law's enactment, reviewing a sample of veterans eligible for care under the Veterans Community Care Program. The audit will examine eligibility reasons, how many veterans are informed and choose to use the program, wait times for care, and details about appeals of denied care. The results of each audit must be reported to the relevant congressional committees.

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Section Text · Sec. 606.
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(1)

conduct an audit, for the one-year period preceding the audit, of—

(A)

the number of veterans eligible for care or services under section 1703 of title 38, United States Code, and the reasons for such eligibility, including multiple such reasons for veterans eligible under more than one eligibility criteria;

(B)

of those veterans eligible for care or services under section 1703 of title 38, United States Code, the number of veterans who are informed of such eligibility;

(C)

the number of veterans who opt to seek care or services under such section;

(D)

the number of veterans who do not opt to seek care or services under such section;

(E)

the timeliness of referrals for care or services under such section and the timeliness of receipt of such care or services, including whether care or services received by the veteran through a non-Department of Veterans Affairs provider had a shorter wait time than the average wait time for such care or services at a facility of the Department;

(F)

the number of requests for an appeal of a denial of care or services under such section using the clinical appeals process of the Veterans Health Administration;

(G)

the timeliness of each such appeal; and

(H)

the outcome of each such appeal; and

(2)

submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the audit conducted under paragraph (1).