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Final rule lets urgent care centers treat veterans, get VA money

A U.S. Veterans Administration (VA) rule will allow selected walk-in medical treatment centers to receive payment from the VA for treating veterans, notwithstanding that they are not VA facilities.

The final rule, announced in advance of its June 5 publication, says it will provide a list of "qualifying non-VA entities or providers" that bill for federal services under place of service 17 (retail clinic) or place of service 20 (urgent care facility) from which veterans may receive episodic treatment to be paid for by the VA.

The covered treatment is meant to fill gaps in veterans' treatment not covered by true emergency treatment or their regular VA medical care. There are currently 1,063 VA outpatient clinics in the U.S. where veterans usually receive treatment. 

"Urgent care is considered to be a convenient option for care, but is not intended to be used as a substitute for traditional primary care that emphasizes longitudinal management and care coordination," says the rule, which was proposed on Jan. 31. The VA gives examples such as flu shots, prescription refills (though for a 14-day supply), and "certain lab tests, such as sexually transmitted disease testing and blood tests."

If the urgent care treatment expands into something more like regular treatment, "the veteran would be charged for the cost of care, but both the provider and the veteran would have the ability to appeal this determination," the rule says. Vets seeking follow-up on an urgent care visit are urged to contact VA or their VA-authorized primary care provider.

Veterans will be charged a $30 copay for the service; vets in certain "priority groups" based on service and disability will not pay this until their third visit within a calendar year.

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