IT Impacts of the VA MISSION Act

Main objectives of the legislation include:

• Consolidating and strengthening the VA’s community care programs
• Funding the existing Veterans Choice program to ensure veterans continue to receive care through the Choice program until the new, consolidated Veterans Community Care Program takes effect
• Creating new flexibilities to aid the VA in managing its infrastructure portfolio through an Asset and Infrastructure (AIR) review process
• Expanding the Caregivers program to include eligible veterans from all eras of service
• Strengthening the VA’s workforce.

The legislation is strongly supported by the Trump administration. A press secretary statement released prior to the vote states, “The Administration strongly supports this legislation, which will transform the Department of Veterans Affairs (VA) into a modern, high-performing, and integrated healthcare system that will ensure our veterans receive the best healthcare possible from the VA, whether delivered in the VA’s own facilities or in the community.”

A summary of the legislation released by the House Committee on Veterans Affairs website reveals several IT related implications of the legislation:

• Sec. 114 - Processing of claims for reimbursement through electronic interface
  • Would allow VA to enter into an agreement with a third party entity to electronically process health care claims from community providers.
• Sec. 131 - Establishment of processes to ensure safe opioid prescribing practices by non-department of VA health care providers (IT related provision only)
  • Would also require VA to implement a process to make certain that community care providers have access to available and relevant medical history of the patient, including a list of all medication prescribed to the veteran as known by VA.
  • Would require that contracted providers submit medical records of any care or services furnished, including records of any prescriptions for opioids, to VA in a timeframe and format specified by VA. VA would be responsible for the recording those prescriptions in the electronic health record and enable other monitoring of the prescription as outlined in the Opioid Safety Initiative.
• Sec. 132 - Improving information sharing with community providers
  • Would clarify that VA could share medical record information with non-department entities for the purpose of providing health care to patients or performing other health care related activities and remove certain restrictions on VA’s ability to recover funds from third parties for the cost of non-service-connected care.
• Sec. 151 - Licensure of health care professionals of the VA providing treatment via telemedicine
  • Would create a new authority to allow VA health care professionals to practice telemedicine regardless of the location of the provider or patient during the treatment.
  • Would also make clear that telemedicine does not need to be delivered in a federal facility.
  • Would also invoke federal supremacy regarding state telemedicine delivery laws and regulations to ensure uniform care delivery nationally.
  • Would define a “covered health care professional” as a VA employee who is authorized to furnish health care and is required to adhere to all quality standards relating to the provision of medicine in accordance with VA policies.
  • Would require VA to submit a report to Congress within 1 year of enactment, providing data on provider and patient satisfaction, the effect of telemedicine on patient wait-times, health care utilization, and other measures.
• Sec. 162 - Implementation of information technology system of VA to assess and improve the family caregiver program.
  • Would require VA to implement an IT system that fully supports the Family Caregiver Program and allows for data assessment and comprehensive monitoring by not later than October 1, 2018.

If the MISSION Act passes, IT contractors may find opportunities to assist VA with medical record interoperability for community care providers, electronic claims processing for community providers, expansion of VA telemedicine and IT for veteran caregivers.

The legislation passed the House Committee on Veterans' Affairs on a vote 20-2 Tuesday and will now move to the full House. The administration is urging Congress to pass this bill before Memorial Day before funding for the current Choice program runs out.