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VA Eliminates Second VA Doctor Review Step to Access Care From Non-VA Providers

June 2025, Vol 2, No 6

The Department of Veterans Affairs (VA) recently announced changes that will make it easier for VA-enrolled veterans to access healthcare from non-VA providers.1

Since 2019, the MISSION Act has enabled VA-enrolled veterans to access healthcare from non-VA providers at the department’s expense when it is in their best medical interest. These decisions have been made jointly by veterans and their referring clinicians but were not considered final until they were reviewed by a second VA doctor. As of last month, VA has eliminated this step, which was contained within the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act.

Since 2019, the MISSION Act has given eligible veterans the option of seeking community care outside VA when they meet any one of 6 conditions:

  • When it is in the best medical interest of the veteran
  • The care required is not available at a VA medical facility
  • The veteran lives in a state or territory that does not have a full-service VA facility
  • VA cannot meet wait time or distance standards:
    • VA cannot offer an appointment within 20 days for primary care, mental health, or noninstitutional extended care, or within 28 days for specialty care
    • It takes more than a 30-minute drive to reach primary or mental health care, or a 60-minute drive for specialty care
  • VA service does not meet certain quality standards
  • The veteran meets the grandfathered distance and location provisions of the former Veterans Choice Program

The new process for determining best medical interest will be backed by training for Veterans Health Administration employees to ensure compliance with the Elizabeth Dole Act.

Reference

  1. Veterans Affairs. VA makes it easier for veterans to use community care. May 19, 2025. Accessed May 28, 2025. https://news.va.gov/press-room/va-makes-it-easier-for-veterans-to-use-community-care/

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