H.R. 6526: Clarity on Care Options Act

This legislation, titled the "Clarity on Care Options Act," is designed to improve access to health care for beneficiaries of the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA). Here's a breakdown of what the bill proposes:

Public Directory of Healthcare Providers

The bill mandates the Secretary of Veterans Affairs to create and maintain a publicly available directory of health care providers who accept assignments under the CHAMPVA program. This directory will help CHAMPVA beneficiaries identify which providers are willing to accept their coverage.

Annual Provider Queries

Healthcare entities managing networks for the CHAMPVA program will be required, on an annual basis, to:

• Query each provider in their network to find out if they accept assignments under CHAMPVA.
• Submit the findings from these queries to the Secretary of Veterans Affairs.

Implementation Timeline

The initial round of provider queries must be completed within 90 days of the bill's enactment, while the first version of the directory must be made available to the public within 180 days.

Annual Reporting Requirements

Once the bill is enacted, the Secretary of Veterans Affairs is also required to submit annual reports to Congress for five years. These reports will provide:

• The number of providers in the networks who accept CHAMPVA assignments.
• The percentage of providers accepting assignments versus those not accepting them.
• Geographical areas with CHAMPVA beneficiaries that lack providers willing to accept assignments.

Definitions

The bill provides specific definitions related to its provisions, including:

• Accept assignment: Taking responsibility for a CHAMPVA beneficiary's care and agreeing to accept the amounts set by the CHAMPVA program as full payment for services rendered.
• CHAMPVA program: A program under the Department of Veterans Affairs that provides health care benefits to eligible beneficiaries.

Conclusion

This legislation aims to enhance transparency and accessibility of healthcare options for CHAMPVA beneficiaries by establishing a structured directory of willing healthcare providers.

Relevant Companies

None found