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14 th Annual TVR Training May 8, 2014 Tribal/IHS Reimbursement Agreements

14 th Annual TVR Training May 8, 2014 Tribal/IHS Reimbursement Agreements. Backgroun d. Legal authority established in 2010 (ACA) Reimbursement agreements allows the VA to pay Indian Health Service (IHS) and Tribal Health Programs (THP )

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14 th Annual TVR Training May 8, 2014 Tribal/IHS Reimbursement Agreements

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  1. 14th Annual TVR Training May 8, 2014 Tribal/IHS Reimbursement Agreements

  2. Background • Legal authority established in 2010 (ACA) • Reimbursement agreements allows the VA to pay Indian Health Service (IHS) and Tribal Health Programs (THP) • Reimbursement is for direct care services provided to eligible American Indian Veterans enrolled in VA

  3. Reimbursement Process • Initiated by Letter of Intent from Tribe to VAMC • Orientation Checklist provided by VA Centralized Business Office (CBO) • Tribe/VA meeting to review checklist • When checklist is complete, packet submitted to VA for review • Final Agreement signed by both parties

  4. Oklahoma Agreements • Muscogee (Creek) Nation: July 1, 2012, 1 hospital, 8 clinics • Pawnee IHS: March 22, 2013, 1 clinic • Choctaw Nation: March 31, 2013, 1 hospital, 8 clinics • Pawhuska IHS: May 16, 2013, 1 clinic • Claremore IHS: May 16, 2013, 1 hospital • Cherokee Nation: (under review) 1 hospital, 8 clinics • Chickasaw Nation: November 21, 2013, 1 hospital, 4 clinics

  5. Oklahoma Agreements • Wewoka Service Unit, May 16, 2013, 1 clinic • Clinton Service Unit, May 16, 2013, 3 clinics • Lawton Service Unit, May 16, 2013, 3 clinics • Ponca Tribe, November 21, 2013, 1 clinic • NE Tribal Health System February 11, 2014, 1 clinic • Indian Health Resource Center of Tulsa, April 30, 2014, 1 clinic

  6. Outcomes • Agreements increase access sites to care for American Indian Veterans with 6 hospitals and 40 clinics • Choice of Care Provider: Eligible Veterans can choose to receive their health care from IHS/THP and/or VA facility • CMOP: Saves patients travel/wait time in pharmacy & allows pharmacists more time to focus on patient care

  7. Mutual Benefits • Additional Resources: Allows tribes/IHS to expand care for users • Agreements allow for better coordination of care • Inpatient Care/Specialties: simplifies appointments since the Veteran is within the VA system • Shortens access times for medical care • Increases access at VA facilities for other Veterans

  8. Sustaining Agreements • Initial funding (fy12-16) to support reimbursements • Workload capture by VA is vital to ensure VERA reimbursement funds in out years • Native American Veterans need annual “vesting” level visits to retain active user status in VHA • Coordination of care between systems will maintain continuity of care for Veterans

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