VA announces change to urgent care in Community Care Network Region 1

The U.S. Department of Veterans Affairs (VA) is transitioning its urgent care network manager, effective March 18, from TriWest Healthcare Alliance to Optum Public Sector Solutions, Inc. (Optum), which is part of UnitedHealth Group, Inc., in Community Care Network Region 1.

The change will result in new urgent care providers being added to VA’s contracted network, while others will be removed.

These changes in Veterans’ urgent care are part of the VA Maintaining Internal Systems and Strengthening Outside Networks Act of 2018 or MISSION Act. Veterans have the option for urgent care treatment of minor injuries and illnesses such as colds, sore throats and minor skin infections at in-network non-VA urgent care providers. Additionally, Veterans can receive same-day urgent care treatment at VA medical centers.

“VA is working to ensure Veterans in Region 1 understand how this change will affect them,” said VA Secretary Robert L. Wilkie. “The goal is to provide Veterans a seamless transition when seeking urgent care in their communities.”

Not all urgent care providers currently in the Region 1 network will be authorized to provide care after March 18. Conversely, new providers who are not currently authorized through the TriWest network will be available through Optum’s network beginning March 18. VA can only pay for urgent care if the provider is part of VA’s contracted network. If Veterans go to an out-of-network urgent care provider, they will be required to pay the full cost of care.

The change in network management will also affect pharmacies. Veterans who require urgent care prescriptions of 14 days or less can find an authorized in-network provider or contact their local VA medical facility to identify a VA network pharmacy to avoid paying out-of-pocket costs.

Community providers within Region 1 who want to provide urgent care services to Veterans after March 18 must establish a contract with Optum.

The change will impact Veterans in the following locations: Connecticut, Delaware, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, North Carolina, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, D.C. and West Virginia. Veterans in these states who need urgent care should use VA’s facility locator or contact their local VA medical facility for help identifying in-network urgent care providers.

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