The Department of Veterans Affairs (VA) provides a nationwide system of health care services and benefits programs for America’s Veterans. Through the Veterans Health Administration (VHA), VA provides health care to approximately 5 million Veterans annually. VA operates the nation’s largest integrated health care system with more than 1,400 sites of care, including hospitals, community clinics, nursing homes, domiciliaries, readjustment counseling centers, and various other facilities. VA health care facilities provide a broad spectrum of medical, surgical, and rehabilitative care.
VA manages the largest medical education and health professions training program in the United States and maintains affiliations with more than 107 medical schools, 55 dental schools and more than 1,200 other schools across the country. Each year, about 90,000 health professionals are trained in VA medical centers. More than half of the physicians practicing in the United States had some of their professional education in the VA health care system.
In general, Veterans seeking health care at VA expense should be treated at VA facilities. Non-VA provided care, also known as Purchased Care, is only authorized under specific circumstances, such as when VA facilities/services are not feasibly available or cannot be economically provided to the Veteran. VA may purchase care outside of VA for any form of care a Veteran may need, including inpatient, outpatient, emergent medication prescriptions, and long-term care, as long as it is related to a service-connected condition.
Once Purchased Care is authorized at VA expense, VA will contact the community provider to schedule this care in the community. This guide details what non-VA providers should expect in terms of authorizations and referrals, claims payment, and the return of medical documentation back to the authorizing VA Medical Center (VAMC).