VA Exceeding Budget, Returning to 180-Day Authorizations and Monitoring Provider Billing

The U.S. Department of Veterans Affairs (VA) recently announced that any authorization issued after June 28 will be for no more than 180 days in duration, and the VA will be monitoring claim and billing practices by home care agencies to ensure compliance.

HCAOA learned from the VA that there are home care agencies in the VA Community Care Network (VACCN) that continue to use the larger number of hours of care on the authorization instead of the smaller number of hours on the consults when providing and billing for services. Coupled with higher provider reimbursements, this has led to many VA hospitals exceeding their planned expenses. HCAOA members are urged to monitor their billing practices to ensure the number of hours on the consult is used for scheduling and billing.
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VA leadership engaged by the HCAOA did not favor this change, but VA budget leaders were adamant about the more frequent authorization review cadence.

HCAOA has learned that VA hospitals may even remove veterans from the care of agencies that bill according to the authorization hours and reassign them to agencies that are in compliance.