Announcement for Public Meeting Regarding Health Care Access Standards, 30819-30821 [2018-13951]
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sradovich on DSK3GMQ082PROD with NOTICES
Federal Register / Vol. 83, No. 126 / Friday, June 29, 2018 / Notices
Analyst, Office of the Deputy Under
Secretary for Health for Community
Care, Veterans Health Administration,
Department of Veterans Affairs, 810
Vermont Avenue NW, Washington, DC
20420, (202) 461–4112. This is not a toll
free number.
SUPPLEMENTARY INFORMATION: The John
S. McCain III, Daniel K. Akaka, and
Samuel R. Johnson VA Maintaining
Internal Systems and Strengthening
Integrated Outside Networks Act of
2018, Public Law 115–182, (the VA
MISSION Act) creates a new 38 U.S.C.
1703B that contains requirements for
VA to facilitate the establishment and
use of access standards. Section
1703B(c) specifically requires VA to
consult with all pertinent Federal
entities, entities in the private sector,
and other nongovernmental entities in
establishing access standards. This
notice and request for information
serves as one of the means for VA to
consult with these groups and entities.
We note that VA will also hold a public
hearing on Friday, July 13, 2018, to
provide these groups and entities an
opportunity to provide additional
information. VA will use the comments
it receives to help determine the access
standards in compliance with the VA
MISSION Act. VA will then submit a
report, no later than March 3, 2019, as
required by section 1703B(d)(1),
detailing the access standards to the
appropriate committees of Congress.
The access standards will ultimately be
published in the Federal Register and
will be made available on a VA internet
website.
In order to submit a report to Congress
detailing the access standards by March
3, 2019, VA must expedite this
consultation, which will be
foundational to the process of
determining the access standards.
Hence, this notice and request for
information has a comment period of 30
days. VA believes that 30 days is
sufficient to provide comments, as the
groups and entities with expertise in
access standards will likely have the
information readily available or can
quickly compile and submit such
information.
This notice is a request for
information only. Commenters are
encouraged to provide complete but
concise responses to the questions
outlined below. VA may choose to
contact individual commenters, and
such communications would serve to
further clarify their written comments.
Request for Information: VA requests
information that will assist in
developing the access standards
required by the VA MISSION Act. This
VerDate Sep<11>2014
17:58 Jun 28, 2018
Jkt 244001
includes information regarding the
development of these access standards,
including but not limited to
information, with regard to health plans,
on the use of access standards for the
design of health plan provider networks,
referrals from network providers to outof-network providers, the appeals
process for exemptions from benefit
limits to out-of-network providers, and
with respect to health systems, the
existence of standards for appointment
wait times, the use of travel distance for
establishing service areas, the
development or use of guidelines to
refer patients to out of system providers,
and the measurement of performance
against regulatory standards.
Specifically, VA requests information
from health plans and systems related to
the below:
1. Do health plans use internal access
standards for the design of provider
networks and the application of in
network/out of network benefits that are
more stringent than regulatory standards
(time or distance of travel, appointment
wait times, provider/member ratios)? If
so, what are these internal standards?
How does the health plan measure
performance against regulatory and
internal access standards? How does the
health plan respond to findings when
access standards are not being met? Are
current regulatory access standards costeffective while maintaining quality
standards? Do health plans have a
process to handle routine requests from
members or referring providers for
exemptions to benefit limits when
members seek out of network care or a
lower tier provider?
2. Do health plans allow for appeals
by providers or members to request
exemptions from benefit limits related
to out of network care or care by a lower
tier provider? Is external review allowed
for such appeals?
3. What are health plan practices
regarding internal, regulatory, and/or
accreditation standards for appointment
wait times, including variance by
specialty or type of service? How does
the health plan use travel distance or
time and/or provider-to-population
ratios in deciding which geographic
areas to consider as primary or
secondary service areas?
4. Are clinicians within the health
system given guidelines or rules on
when to refer patients to out of system
providers? For example, are clinicians
encouraged to refer out of system if insystem wait times are longer than
standard, travel time or distance to an
in-system provider is too long, the
patient’s ability to travel is
compromised or the frequency of
PO 00000
Frm 00137
Fmt 4703
Sfmt 4703
30819
treatment makes travel to an in-network
provider difficult?
Signing Authority
The Secretary of Veterans Affairs, or
designee, approved this document and
authorized the undersigned to sign and
submit the document to the Office of the
Federal Register for publication
electronically as an official document of
the Department of Veterans Affairs.
Jacquelyn Hayes-Byrd, Acting Chief of
Staff, Department of Veterans Affairs,
approved this document on June 25,
2018, for publication.
Dated: June 25, 2018.
Jeffrey M. Martin,
Impact Analyst, Office of Regulation Policy
& Management, Office of the Secretary,
Department of Veterans Affairs.
[FR Doc. 2018–13952 Filed 6–28–18; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
Announcement for Public Meeting
Regarding Health Care Access
Standards
Department of Veterans Affairs.
Announcement of public
meeting.
AGENCY:
ACTION:
The Department of Veterans
Affairs (VA) is holding a public meeting
to seek information from pertinent
entities relating to implementation of
1703B of title 38, United States Code, as
added by section 104(a) of the John S.
McCain III, Daniel K. Akaka, and
Samuel R. Johnson VA Maintaining
Internal Systems and Strengthening
Integrated Outside Networks (MISSION)
Act of 2018 (the VA MISSION Act)
which directs VA to establish access
standards for furnishing hospital care,
medical services, and extended care
services to covered veterans for
purposes of the Veterans Community
Care Program. In establishing these
access standards, VA is required to
consult with all pertinent Federal,
private sector, and non-governmental
entities. VA requests information from
the public regarding the development of
these access standards, including but
not limited to information on the use of
access standards for the design of health
plan provider networks, referrals from
network providers to out-of-network
providers, the appeals process for
exemptions from benefit limits to out-ofnetwork providers, the existence of
standards for appointment wait times,
the use of travel distance for
establishing service areas, the
development or use of guidelines to
SUMMARY:
E:\FR\FM\29JNN1.SGM
29JNN1
sradovich on DSK3GMQ082PROD with NOTICES
30820
Federal Register / Vol. 83, No. 126 / Friday, June 29, 2018 / Notices
refer patients to out of network
providers, and the measurement of
performance against federal and state
regulatory standards. Responses to this
notice will support industry research
and VA’s development of access
standards.
DATES: VA will hold the public meeting
on July 13, 2018, in Arlington, VA. The
meeting will start at 9:00 a.m. and
conclude on or before 5:00 p.m. Checkin will begin at 8:00 a.m.
ADDRESSES: The meeting will be held at
the VHA National Conference Center at
2011 Crystal Drive, Arlington, VA
22202. This facility is accessible to
individuals with disabilities.
* In-person attendance will be limited
to 50 individuals. Advanced registration
for individuals and groups is strongly
encouraged (see registration instructions
below). For listening purposes only
(phone lines will be muted), the meeting
will be available via audio which can be
accessed by dialing 1–800–767–1750
access code 21398.
Please submit all written comments
no later than Monday, July 30, by any
of the following methods:
• Federal Rulemaking Portal: Go to
https://www.regulations.gov. Follow the
online instructions for submitting
comments.
• Mail, Hand Delivery, Courier:
Postmarked no later than July 30, 2018,
to: Director of Regulations Management
(00REG), Department of Veterans
Affairs, 810 Vermont Ave. NW, Room
1063B, Washington, DC 20420.
Note: Copies of comments received
will be available for public inspection in
the Office of Regulation Policy and
Management, Room 1063B, between the
hours of 8:00 a.m. and 4:30 p.m.,
Monday through Friday (except Federal
Holidays). Please call (202) 461–4902
(this is not a toll-free number) for an
appointment.
• Fax: (202) 273–9026, ATTENTION:
Director of Regulations Management
(00REG). All submissions must include
the agency name and docket number.
Note that all comments received will be
posted and can be viewed online
through the Federal Docket Management
System at https://www.regulations.gov.
FOR FURTHER INFORMATION CONTACT:
Christina Hosenfeld, Management
Analyst, Office of the Deputy Under
Secretary for Health for Community
Care, Veterans Health Administration,
Department of Veterans Affairs, 810
Vermont Avenue NW, Washington, DC
20420, (202) 461–4112. This is not a toll
free number.
SUPPLEMENTARY INFORMATION: The John
S. McCain III, Daniel K. Akaka, and
Samuel R. Johnson VA Maintaining
VerDate Sep<11>2014
17:58 Jun 28, 2018
Jkt 244001
Internal Systems and Strengthening
Integrated Outside Networks Act of
2018, Public Law 115–182, (the VA
MISSION Act) created a new 1703B in
title 38, United States Code (U.S.C.),
that contains requirements for VA to
facilitate the establishment and use of
access standards. Section 1703B(c)
specifically requires VA to consult with
all pertinent Federal entities, entities in
the private sector, and other
nongovernmental entities in
establishing access standards. This
public meeting serves as one of the
means for VA to consult with these
groups and entities. We note that VA
has published a request for information
in the Federal Register in order to
provide these groups and entities an
opportunity to provide additional
information. The request for information
mentioned above can be found in
www.regulations.gov under the title of
‘‘Notice of Request for Information
Regarding Health Care Access
Standards.’’ Comments should indicate
that they are submitted in response to
‘‘Notice of Request for Information
Regarding Health Care Access
Standards.’’ VA will use the statements
and testimonials presented at the public
hearing to help determine the access
standards in compliance with the VA
MISSION Act. VA will then submit a
report, no later than March 3, 2019, as
required by section 1703B(d)(1),
detailing the access standards to the
appropriate committees of Congress.
The access standards will ultimately be
published in the Federal Register and
will be made available on a VA internet
website.
In order to submit a report to Congress
detailing the access standards by March
3, 2019, VA must expedite this
consultation, which will be
foundational to the process of
determining the access standards.
Registration: In-person attendance
and participation in this meeting is
limited to 50 individuals. VA has the
right to refuse registration for in-person
attendance once the maximum capacity
of 50 individuals has been reached.
Individuals interested in attending inperson should request registration by
emailing Krinessa Pinkett at
krinessa.pinkett@va.gov. A confirmation
message will be provided within 1–2
business days after a request has been
received, and individuals will be
notified via email by July 9, 2017,
confirming their attendance in-person.
Attendees wanting to offer oral
comments, testimonies, and/or technical
remarks should indicate their intentions
upon registration.
Individual registration: VA
encourages individual registrations for
PO 00000
Frm 00138
Fmt 4703
Sfmt 4703
those not affiliated with or representing
a group, association, or organization.
Group registration: Identification of
the name of the group, association, or
organization should be indicated in
your registration request. Due to the
meeting location’s maximum capacity,
VA may limit the size of a group’s
registration to allow receipt of
comments, testimonies, and/or technical
remarks from a broad, diverse group of
stakeholders. Oral comments,
testimonies, and/or technical remarks
may be limited from a group,
association or organization with more
than two (2) individuals representing
the same group, association, or
organization. Efforts will be made to
accommodate all attendees who wish to
attend in-person. However, VA will give
priority for in-person attendance to
pertinent Federal, private sector, and
non-governmental entities who request
registration before July 5, 4:00 p.m. ET,
and wish to provide oral comments,
testimonies, and/or technical remarks.
Please provide the number and names of
people your organization would like to
send in-person, and VA will
accommodate as space allows;
organizations should list names in the
order of importance of their attendance
to ensure that VA allows admission for
the right representatives. The length of
time allotted for attendees to provide
oral comments, testimonies and/or
technical remarks during the meeting
may be subject to the number of inperson attendees, and to ensure ample
time is allotted to those registered
attendees. There will be no opportunity
for audio-visual presentations during
the meeting. Written comments will be
accepted by those attending in-person
(see above instructions for submitting
written comments).
Audio (for listening purposes only):
Limited to the first 200 participants, on
a first come, first served basis.
Advanced registration is not required.
Audio attendees will not be allowed to
offer oral comments, testimonies, and/or
technical remarks as the phone line will
be muted. Written comments will be
accepted from those participating via
audio (see above instructions for
submitting written comments).
Note: VA will conduct the public
meeting informally, and technical rules
of evidence will not apply. VA will
arrange for a written transcript of the
meeting and keep the official record
open for 15 days after the meeting to
allow submission of supplemental
information. You may make
arrangements for copies of the transcript
directly with the reporter, and the
transcript will also be posted in the
docket of the rule as part of the official
E:\FR\FM\29JNN1.SGM
29JNN1
Federal Register / Vol. 83, No. 126 / Friday, June 29, 2018 / Notices
record when the rule is published.
Should it be necessary to cancel the
meeting due to inclement weather or
other emergencies, VA will take
available measures to notify registered
participants.
sradovich on DSK3GMQ082PROD with NOTICES
Agenda
08:00–09:00 Arrival/Check-In
09:00–12:00 Morning Public Meeting
Session
12:00–13:00 Lunch Break (Note: Meals
will not be provided by VA.)
13:00–17:00 Afternoon Public Meeting
Session
17:00 Adjourn
Public Meeting Topics
Pursuant to section 1703B(c) of title
38, U.S.C., as added by section 104(a) of
Public Law 115–182, (the VA MISSION
Act), VA requests information that will
assist in developing the access
standards required by section
1703B(a)(1). This includes information
regarding the development of these
access standards, including but not
limited to information on the use of
access standards for the design of health
plan provider networks, referrals from
network providers to out-of-network
providers, the appeals process for
exemptions from benefit limits to out-ofnetwork providers, the existence of
standards for appointment wait times,
the use of travel distance for
establishing service areas, the
development or use of guidelines to
refer patients to out of system providers,
and the measurement of performance
against regulatory standards.
Specifically, VA requests information
from health plans and systems related to
the below:
1. Do health plans use internal access
standards for the design of provider
networks and the application of in
network/out of network benefits that are
more stringent than regulatory standards
(time or distance of travel, appointment
wait times, provider/member ratios)? If
so, what are these internal standards?
How does the health plan measure
performance against regulatory and
internal access standards? How does the
health plan respond to findings when
access standards are not being met? Are
current regulatory access standards costeffective while maintaining quality
standards? Do health plans have a
process to handle routine requests from
members or referring providers for
exemptions to benefit limits when
VerDate Sep<11>2014
17:58 Jun 28, 2018
Jkt 244001
members seek out of network care or a
lower tier provider?
2. Do health plans allow for appeals
by providers or members to request
exemptions from benefit limits related
to out of network care or care by a lower
tier provider? Is external review allowed
for such appeals?
3. What are health plan practices
regarding internal, regulatory, and/or
accreditation standards for appointment
wait times, including variance by
specialty or type of service? How does
the health plan use travel distance or
time and/or provider-to-population
ratios in deciding which geographic
areas to consider as primary or
secondary service areas?
4. Are clinicians within the health
system given guidelines or rules on
when to refer patients to out of system
providers? For example, are clinicians
encouraged to refer out of system if insystem wait times are longer than
standard, travel time or distance to an
in-system provider is too long, the
patient’s ability to travel is
compromised or the frequency of
treatment makes travel to an in-network
provider difficult?
Signing Authority
The Secretary of Veterans Affairs, or
designee, approved this document and
authorized the undersigned to sign and
submit the document to the Office of the
Federal Register for publication
electronically as an official document of
the Department of Veterans Affairs.
Jacquelyn Hayes-Byrd, Acting Chief of
Staff, Department of Veterans Affairs,
approved this document on June 25,
2018, for publication.
Dated: June 25, 2018.
Jeffrey M. Martin,
Impact Analyst, Office of Regulation Policy
& Management, Office of the Secretary,
Department of Veterans Affairs.
[FR Doc. 2018–13951 Filed 6–28–18; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
VA National Academic Affiliations
Council, Notice of Meeting
The Department of Veterans Affairs
(VA) gives notice under the Federal
Advisory Committee Act that the VA
National Academic Affiliations Council
(NAAC) will meet via conference call on
PO 00000
Frm 00139
Fmt 4703
Sfmt 9990
30821
July 11, 2018, from 10:00 a.m. to 12:00
p.m. EST. The meeting is open to the
public.
The purpose of the Council is to
advise the Secretary on matters affecting
partnerships between VA and its
academic affiliates.
On July 11, 2018, the Council will
explore the current modernization effort
within the Veterans Health
Administration (VHA); receive a
briefing on the VHA electronic health
record modernization program; discuss
provisions of the recently enacted
Public Law 115–182 that impacts VA’s
clinical education mission; and receive
updates on the waiver process for VA
employees engaging in teaching
activities with for-profit educational
institutions; the activities of the
Council’s Subcommittee on Diversity
and Inclusion; the June 13, 2018
Roundtable of Graduate Medical
Education hosted by the House
Committee on Veterans’ Affairs; and the
recent efforts of the VA Strategic
Academic Advisory Council. The
Council will receive public comments
from 11:50 p.m. to 12:00 p.m. EST.
Interested persons may attend and/or
present oral statements to the Council.
The dial in number to attend the
conference call is: 1–800–767–1750. At
the prompt, enter access code 66983
then press #. Individuals seeking to
present oral statements are invited to
submit a 1–2 page summary of their
comments at the time of the meeting for
inclusion in the official meeting record.
Oral presentations will be limited to five
minutes or less, depending on the
number of participants. Interested
parties may also provide written
comments for review by the Council
prior to the meeting or at any time, by
email to Steve.Trynosky@va.gov, or by
mail to Stephen K. Trynosky J.D.,
M.P.H., M.M.A.S., Designated Federal
Officer, Office of Academic Affiliations
(10A2D), 810 Vermont Avenue NW,
Washington, DC 20420. Any member of
the public wishing to participate or
seeking additional information should
contact Mr. Trynosky via email or by
phone at (202) 461–6723.
Dated: June 26, 2018.
Jelessa M. Burney,
Federal Advisory Committee Management
Officer.
[FR Doc. 2018–14002 Filed 6–28–18; 8:45 am]
BILLING CODE P
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]]>Agencies
[Federal Register Volume 83, Number 126 (Friday, June 29, 2018)]
[Notices]
[Pages 30819-30821]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-13951]
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
Announcement for Public Meeting Regarding Health Care Access
Standards
AGENCY: Department of Veterans Affairs.
ACTION: Announcement of public meeting.
-----------------------------------------------------------------------
SUMMARY: The Department of Veterans Affairs (VA) is holding a public
meeting to seek information from pertinent entities relating to
implementation of 1703B of title 38, United States Code, as added by
section 104(a) of the John S. McCain III, Daniel K. Akaka, and Samuel
R. Johnson VA Maintaining Internal Systems and Strengthening Integrated
Outside Networks (MISSION) Act of 2018 (the VA MISSION Act) which
directs VA to establish access standards for furnishing hospital care,
medical services, and extended care services to covered veterans for
purposes of the Veterans Community Care Program. In establishing these
access standards, VA is required to consult with all pertinent Federal,
private sector, and non-governmental entities. VA requests information
from the public regarding the development of these access standards,
including but not limited to information on the use of access standards
for the design of health plan provider networks, referrals from network
providers to out-of-network providers, the appeals process for
exemptions from benefit limits to out-of-network providers, the
existence of standards for appointment wait times, the use of travel
distance for establishing service areas, the development or use of
guidelines to
[[Page 30820]]
refer patients to out of network providers, and the measurement of
performance against federal and state regulatory standards. Responses
to this notice will support industry research and VA's development of
access standards.
DATES: VA will hold the public meeting on July 13, 2018, in Arlington,
VA. The meeting will start at 9:00 a.m. and conclude on or before 5:00
p.m. Check-in will begin at 8:00 a.m.
ADDRESSES: The meeting will be held at the VHA National Conference
Center at 2011 Crystal Drive, Arlington, VA 22202. This facility is
accessible to individuals with disabilities.
* In-person attendance will be limited to 50 individuals. Advanced
registration for individuals and groups is strongly encouraged (see
registration instructions below). For listening purposes only (phone
lines will be muted), the meeting will be available via audio which can
be accessed by dialing 1-800-767-1750 access code 21398.
Please submit all written comments no later than Monday, July 30,
by any of the following methods:
Federal Rulemaking Portal: Go to https://www.regulations.gov. Follow the online instructions for submitting
comments.
Mail, Hand Delivery, Courier: Postmarked no later than
July 30, 2018, to: Director of Regulations Management (00REG),
Department of Veterans Affairs, 810 Vermont Ave. NW, Room 1063B,
Washington, DC 20420.
Note: Copies of comments received will be available for public
inspection in the Office of Regulation Policy and Management, Room
1063B, between the hours of 8:00 a.m. and 4:30 p.m., Monday through
Friday (except Federal Holidays). Please call (202) 461-4902 (this is
not a toll-free number) for an appointment.
Fax: (202) 273-9026, ATTENTION: Director of Regulations
Management (00REG). All submissions must include the agency name and
docket number. Note that all comments received will be posted and can
be viewed online through the Federal Docket Management System at https://www.regulations.gov.
FOR FURTHER INFORMATION CONTACT: Christina Hosenfeld, Management
Analyst, Office of the Deputy Under Secretary for Health for Community
Care, Veterans Health Administration, Department of Veterans Affairs,
810 Vermont Avenue NW, Washington, DC 20420, (202) 461-4112. This is
not a toll free number.
SUPPLEMENTARY INFORMATION: The John S. McCain III, Daniel K. Akaka, and
Samuel R. Johnson VA Maintaining Internal Systems and Strengthening
Integrated Outside Networks Act of 2018, Public Law 115-182, (the VA
MISSION Act) created a new 1703B in title 38, United States Code
(U.S.C.), that contains requirements for VA to facilitate the
establishment and use of access standards. Section 1703B(c)
specifically requires VA to consult with all pertinent Federal
entities, entities in the private sector, and other nongovernmental
entities in establishing access standards. This public meeting serves
as one of the means for VA to consult with these groups and entities.
We note that VA has published a request for information in the Federal
Register in order to provide these groups and entities an opportunity
to provide additional information. The request for information
mentioned above can be found in www.regulations.gov under the title of
``Notice of Request for Information Regarding Health Care Access
Standards.'' Comments should indicate that they are submitted in
response to ``Notice of Request for Information Regarding Health Care
Access Standards.'' VA will use the statements and testimonials
presented at the public hearing to help determine the access standards
in compliance with the VA MISSION Act. VA will then submit a report, no
later than March 3, 2019, as required by section 1703B(d)(1), detailing
the access standards to the appropriate committees of Congress. The
access standards will ultimately be published in the Federal Register
and will be made available on a VA internet website.
In order to submit a report to Congress detailing the access
standards by March 3, 2019, VA must expedite this consultation, which
will be foundational to the process of determining the access
standards.
Registration: In-person attendance and participation in this
meeting is limited to 50 individuals. VA has the right to refuse
registration for in-person attendance once the maximum capacity of 50
individuals has been reached. Individuals interested in attending in-
person should request registration by emailing Krinessa Pinkett at
[email protected]. A confirmation message will be provided within
1-2 business days after a request has been received, and individuals
will be notified via email by July 9, 2017, confirming their attendance
in-person. Attendees wanting to offer oral comments, testimonies, and/
or technical remarks should indicate their intentions upon
registration.
Individual registration: VA encourages individual registrations for
those not affiliated with or representing a group, association, or
organization.
Group registration: Identification of the name of the group,
association, or organization should be indicated in your registration
request. Due to the meeting location's maximum capacity, VA may limit
the size of a group's registration to allow receipt of comments,
testimonies, and/or technical remarks from a broad, diverse group of
stakeholders. Oral comments, testimonies, and/or technical remarks may
be limited from a group, association or organization with more than two
(2) individuals representing the same group, association, or
organization. Efforts will be made to accommodate all attendees who
wish to attend in-person. However, VA will give priority for in-person
attendance to pertinent Federal, private sector, and non-governmental
entities who request registration before July 5, 4:00 p.m. ET, and wish
to provide oral comments, testimonies, and/or technical remarks. Please
provide the number and names of people your organization would like to
send in-person, and VA will accommodate as space allows; organizations
should list names in the order of importance of their attendance to
ensure that VA allows admission for the right representatives. The
length of time allotted for attendees to provide oral comments,
testimonies and/or technical remarks during the meeting may be subject
to the number of in-person attendees, and to ensure ample time is
allotted to those registered attendees. There will be no opportunity
for audio-visual presentations during the meeting. Written comments
will be accepted by those attending in-person (see above instructions
for submitting written comments).
Audio (for listening purposes only): Limited to the first 200
participants, on a first come, first served basis. Advanced
registration is not required. Audio attendees will not be allowed to
offer oral comments, testimonies, and/or technical remarks as the phone
line will be muted. Written comments will be accepted from those
participating via audio (see above instructions for submitting written
comments).
Note: VA will conduct the public meeting informally, and technical
rules of evidence will not apply. VA will arrange for a written
transcript of the meeting and keep the official record open for 15 days
after the meeting to allow submission of supplemental information. You
may make arrangements for copies of the transcript directly with the
reporter, and the transcript will also be posted in the docket of the
rule as part of the official
[[Page 30821]]
record when the rule is published. Should it be necessary to cancel the
meeting due to inclement weather or other emergencies, VA will take
available measures to notify registered participants.
Agenda
08:00-09:00 Arrival/Check-In
09:00-12:00 Morning Public Meeting Session
12:00-13:00 Lunch Break (Note: Meals will not be provided by VA.)
13:00-17:00 Afternoon Public Meeting Session
17:00 Adjourn
Public Meeting Topics
Pursuant to section 1703B(c) of title 38, U.S.C., as added by
section 104(a) of Public Law 115-182, (the VA MISSION Act), VA requests
information that will assist in developing the access standards
required by section 1703B(a)(1). This includes information regarding
the development of these access standards, including but not limited to
information on the use of access standards for the design of health
plan provider networks, referrals from network providers to out-of-
network providers, the appeals process for exemptions from benefit
limits to out-of-network providers, the existence of standards for
appointment wait times, the use of travel distance for establishing
service areas, the development or use of guidelines to refer patients
to out of system providers, and the measurement of performance against
regulatory standards.
Specifically, VA requests information from health plans and systems
related to the below:
1. Do health plans use internal access standards for the design of
provider networks and the application of in network/out of network
benefits that are more stringent than regulatory standards (time or
distance of travel, appointment wait times, provider/member ratios)? If
so, what are these internal standards? How does the health plan measure
performance against regulatory and internal access standards? How does
the health plan respond to findings when access standards are not being
met? Are current regulatory access standards cost-effective while
maintaining quality standards? Do health plans have a process to handle
routine requests from members or referring providers for exemptions to
benefit limits when members seek out of network care or a lower tier
provider?
2. Do health plans allow for appeals by providers or members to
request exemptions from benefit limits related to out of network care
or care by a lower tier provider? Is external review allowed for such
appeals?
3. What are health plan practices regarding internal, regulatory,
and/or accreditation standards for appointment wait times, including
variance by specialty or type of service? How does the health plan use
travel distance or time and/or provider-to-population ratios in
deciding which geographic areas to consider as primary or secondary
service areas?
4. Are clinicians within the health system given guidelines or
rules on when to refer patients to out of system providers? For
example, are clinicians encouraged to refer out of system if in-system
wait times are longer than standard, travel time or distance to an in-
system provider is too long, the patient's ability to travel is
compromised or the frequency of treatment makes travel to an in-network
provider difficult?
Signing Authority
The Secretary of Veterans Affairs, or designee, approved this
document and authorized the undersigned to sign and submit the document
to the Office of the Federal Register for publication electronically as
an official document of the Department of Veterans Affairs. Jacquelyn
Hayes-Byrd, Acting Chief of Staff, Department of Veterans Affairs,
approved this document on June 25, 2018, for publication.
Dated: June 25, 2018.
Jeffrey M. Martin,
Impact Analyst, Office of Regulation Policy & Management, Office of the
Secretary, Department of Veterans Affairs.
[FR Doc. 2018-13951 Filed 6-28-18; 8:45 am]
BILLING CODE 8320-01-P
