VA Contracts with TriWest to Support Patient-Centered Community Care and Veterans Choice Programs

TriWest has partnered with the Veterans Administration (VA) in 28 states in the western and southern parts of the country to administer VA’s Patient-Centered Community Care (PC3) and Veterans Choice (Choice) Programs. These programs provide Veterans with access to community providers when the VA is unable to meet their health care needs directly, timely, or within reasonable drive times. Health Net Federal Services (HNFS) was the VA’s Third-Party Administrator for North Carolina until Sept. 30, 2018, the date its contract ended. In order to ensure continuity of services, the VA has extended the contract with TriWest to support the PC3 and Choice and modified it to include responsibility for network build, customer support services, and claims payment in the areas previously supported by HNFS. For more details, see today’s CEO/CFO Memo. The memo also covers a new CMS cost estimator tool for hospital outpatient surgeries, the recent final rule from the US Department of Health and Human Services making Jan. 1 the effective date of its final regulations on drug ceiling prices and civil monetary penalties for manufacturers under the 340B Drug Pricing Program, and more payors news.

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