Proposed Rule2025-13751
Expansion of VA Process for 72-Hour Notification of Emergency Treatment
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
July 22, 2025
Issuing agencies
Veterans Affairs Department
Abstract
The Department of Veterans Affairs (VA) proposes to revise its medical regulations to add a new method of notification for emergency treatment that is furnished by community providers to be authorized under the Veterans Community Care Program.
Full Text
<html>
<head>
<title>Federal Register, Volume 90 Issue 138 (Tuesday, July 22, 2025)</title>
</head>
<body><pre>
[Federal Register Volume 90, Number 138 (Tuesday, July 22, 2025)]
[Proposed Rules]
[Pages 34407-34409]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2025-13751]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 17
[Docket VA-2025-VHA-0007]
RIN 2900-AS29
Expansion of VA Process for 72-Hour Notification of Emergency
Treatment
AGENCY: Department of Veterans Affairs.
ACTION: Proposed rule.
-----------------------------------------------------------------------
SUMMARY: The Department of Veterans Affairs (VA) proposes to revise its
medical regulations to add a new method of notification for emergency
treatment that is furnished by community providers to be authorized
under the Veterans Community Care Program.
DATES: Comments must be received on or before September 22, 2025.
ADDRESSES: You may submit comments through <a href="http://www.regulations.gov">www.regulations.gov</a> under
RIN 2900-AS29. That website includes a plain-language summary of this
rulemaking. Instructions for accessing agency documents, submitting
comments, and viewing the rulemaking docket are available on
<a href="http://www.regulations.gov">www.regulations.gov</a> under ``FAQ.''
FOR FURTHER INFORMATION CONTACT: Joseph Duran, Veterans Health
Administration, (303) 370-1637.
SUPPLEMENTARY INFORMATION: On June 6, 2018, the President signed into
law the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA
Maintaining Internal Systems and Strengthening
[[Page 34408]]
Integrated Outside Networks (MISSION) Act of 2018 (Pub. L. 115-182).
Section 101 of the MISSION Act amended 38 U.S.C. 1703 by requiring VA
to implement a Veterans Community Care Program (VCCP) to furnish
required hospital care, medical services, and extended care services to
covered veterans through non-VA entities and providers who meet
eligibility criteria to provide care under VCCP. On February 22, 2019,
VA published a proposed rule to establish regulations for the VCCP. 84
FR 5629. In that proposed rule, VA sought to establish a regulation at
38 CFR 17.4020(c) to establish the required criteria for VA to
authorize emergency treatment as defined in 38 U.S.C. 1725(h)(1) under
the VCCP after the veteran had already received such care. 84 FR 5640.
We proposed that VA would consider emergency treatment as authorized
under the VCCP if notice of such treatment was provided to the
appropriate VA official at the nearest VA facility within 72 hours, and
in accordance with other requirements proposed in 38 CFR 17.4020(c). 84
FR 5640. For purposes of this rulemaking, the term ``emergency
treatment'' and ``emergency care'' are synonymous. In a final rule
published on June 6, 2019, VA responded to the commenters who urged VA
to establish a nationwide system, such as an online portal and national
call center, where all emergency care matters under the VCCP would be
administered. 84 FR 26303. VA stated that it would not make any changes
to the regulation based on those comments because local facilities were
in the best position to assess criteria related to the appropriateness
of authorizing emergency care. Id.
In March 2020, VA began to allow veterans, veteran's
representatives, and eligible entities or providers to contact VA
within 72 hours through a centralized notification process.
Notification of emergency treatment was centralized through a
contracted call center. In June 2020, VA began to accept notifications
from external fax, a shared email group, a call center, and from a VA
facility. In December 2020, a new web-based tool was launched called
the Emergency Care Reporting (ECR) Portal which allowed providers,
veterans, or their representatives to report emergent episodes of care.
In March 2021, VA limited the methods of notifications to the ECR
Portal, the Centralized Call Center, or to the closest VA facility. The
additional methods of emergency care reporting have been successful,
with the ECR Portal alone receiving between 150,000-170,000
notifications per month.
VA is therefore proposing to revise 38 CFR 17.4020(c)(4)(i) to
amend the requirement that notice be provided to the appropriate VA
official at the nearest VA facility by adding that notice can also be
provided through the centralized notification process. Although the
centralized process is more administratively efficient and beneficial
to veterans and local VA facilities, VA proposes to maintain the
current method of contacting the appropriate VA official at the nearest
VA facility as a valid method of providing 72-hour notice to avoid
confusion for veterans and providers or eligible entities who are
accustomed to and prefer the current method of notification. In
instances when notification is provided to the nearest VA facility, the
local facility staff would submit the notification information to the
Centralized Call Center or the ECR Portal for processing, as they do
now. This maintains centralized processing. In addition, the local
staff would provide the veteran, veteran's representative, or provider
information on how to utilize the centralized notification process and
encourage them to use it in the future.
VA also proposes to amend Sec. 17.4020(c)(4)(i) to include that
information on the centralized notification process would be accessible
through VA's website at <a href="http://www.va.gov">www.va.gov</a>. The current web page is located on
the Community Care section of the website and provides the Centralized
Call Center telephone number, 844-72HRVHA or 844-724-7842, along with
the ECR Portal website at <a href="https://emergencycarereporting.communitycare.va.gov/request">https://emergencycarereporting.communitycare.va.gov/request</a>, and any additional
program details or updates. However, in the regulation, we propose to
merely reference the general VA website to permit for flexibility if
the location of the specific information changes or there are changes
to the phone number or website.
Executive Orders 12866, 13563, and 14192
VA examined the impact of this rulemaking as required by Executive
Orders 12866 (Sept. 30, 1993) and 13563 (Jan. 18, 2011), which direct
agencies to assess all costs and benefits of available regulatory
alternatives and, if regulation is necessary, to select regulatory
approaches that maximize net benefits. The Office of Information and
Regulatory Affairs has determined that this rulemaking is not a
significant regulatory action under Executive Order 12866, as
supplemented by Executive Order 13563. This proposed rule is expected
to be a deregulatory action under Executive Order 14192. The Regulatory
Impact Analysis associated with this rulemaking can be found as a
supporting document at <a href="http://www.regulations.gov">www.regulations.gov</a>.
Regulatory Flexibility Act
The Secretary hereby certifies that this proposed rule would not
have a significant economic impact on a substantial number of small
entities as they are defined in the Regulatory Flexibility Act, 5
U.S.C. 601-612. This proposed rule adds a method for veterans, their
representatives, and eligible entities or providers to contact VA for
determination of whether emergency treatment can be authorized under
the VCCP after the veteran has received such care. It will not have a
substantial economic impact on small entities because it merely
provides for an additional method of notification. Therefore, pursuant
to 5 U.S.C. 605(b), the initial and final regulatory flexibility
analysis requirements of 5 U.S.C. 603 and 604 do not apply.
Unfunded Mandates
This proposed rule would not result in the expenditure by State,
local, and tribal governments, in the aggregate, or by the private
sector, of $100 million or more (adjusted annually for inflation) in
any one year.
Paperwork Reduction Act
Although this proposed rule contains collection of information
under the provisions of the Paperwork Reduction Act of 1995 (44 U.S.C.
3501-3521), there are no provisions associated with this rulemaking
constituting any new collection of information or any revisions to the
existing collection of information. The collection of information for
38 CFR 17.4020 is currently approved by the Office of Management and
Budget (OMB) and has a valid OMB control number of 2900-0823.
List of Subjects in 38 CFR Part 17
Administrative practice and procedure, Alcohol abuse, Alcoholism,
Claims, Dental health, Drug abuse, Government contracts, Health care,
Health facilities, Health records, Homeless, Mental health programs,
Nursing homes, Philippines, Reporting and recordkeeping requirements,
Scholarships and fellowships, Travel and transportation expenses,
Veterans.
Signing Authority
Douglas A. Collins, Secretary of Veterans Affairs, approved this
document on July 14, 2025, and authorized its submission to the Office
[[Page 34409]]
of the Federal Register for publication electronically as an official
document of the Department of Veterans Affairs.
Taylor N. Mattson,
Alternate Federal Register Liaison Officer, Department of Veterans
Affairs.
For the reasons set forth in the preamble, the Department of
Veterans Affairs proposes to amend 38 CFR part 17 as follows:
PART 17--MEDICAL
0
1. The authority citation for part 17 continues to read as follows:
Authority: 38 U.S.C. 501, and as noted in specific sections.
* * * * *
0
2. Amend Sec. 17.4020 by revising paragraph (c)(4) to read as follows:
Sec. 17.4020 Authorized non-VA care.
* * * * *
(c) * * *
(4) Notice to VA must:
(i) Be made to the appropriate VA official at the nearest VA
facility or by using the centralized notification process. Information
on the centralized notification process will be accessible through VA's
website at <a href="http://www.va.gov">www.va.gov</a>;
(ii) Identify the covered veteran; and
(iii) Identify the eligible entity or provider.
* * * * *
[FR Doc. 2025-13751 Filed 7-21-25; 8:45 am]
BILLING CODE 8320-01-P
</pre></body>
</html>Indexed from Federal Register on July 22, 2025.
This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.