Best Practices from Partner Networking Calls

 

We Honor Veterans Partners and guest speakers have shared some of their best practices on Partner Networking Calls.  Below are some frequently asked questions that have been answered by Dr. Scott Shreve:

 

*If you are having trouble contacting someone or getting information from your local VA, contact the WHV team at veterans@nhpco.org and they will find the correct contact for you to reach out to.

Q: Does a Veteran that commits suicide from service-related PTSD qualify for benefits that a Veteran with direct service-related injury would?
A: If there is documentation that the Veteran has or is at risk for PTSD from a VA facility, they are eligible for their death to be considered service-related. Even if documentation does not exist at the time of death, families can demonstrate that the Veteran had PTSD-like symptoms.

Q: The VA continues to say that a Veteran I am working with is not eligible for hospice, what can we do?
A: The Veteran is not eligible for hospice until a VA physician says they are.

Q: Is there a way for patients to enroll with the CVA to receive benefits without the face-to-face meeting?
A: Currently there is no policy or legislation requiring a Veteran patient to be seen by a VA provider to receive care. However, a VA provider must determine if the patient is eligible for hospice care. If the patient cannot be seen face-to-face, please ask the director to review the case and approve them without a face-to-face meeting and without workplace credit.

Q: How long after a patient is enrolled in the VA and set to receive benefits will they receive benefits for hospice care?
A: After the DD-214 is obtained from the Veteran, contact the business office to ensure their enrollment. After that, it typically takes a 24-48 hour turn around for hospice patient benefits.

Q: Is there a resource available for preferred hospice providers for Veterans?
A: By law, the VA cannot have a preferred hospice provider in an area. The Veterans Choice Act, which does not cover hospice, allows a third-party administrator to assist the Veteran in receiving care if they are unable to at a VA facility.

Q: Is it permissible for a Veteran to receive concurrent care benefits through the VA while in hospice (e.g. receiving chemotherapy)?
A: Even if a Veteran’s course of disease is six months or less, the Veteran may receive palliative care (e.g. chemotherapy) with VA benefits while still receiving hospice care in the community.

Q: How can we strengthen our relationship with the VA hospitals in our area?
A: Building a relationship with the chaplain or others from the VA center would be a good first step. This is not a relationship to promote referrals but rather to share expertise and facilitate transitioning.

Q: I am a hospice and palliative care doctor looking to clarify hospice coverage for a certain category of VA patients. Our hospice agency has recently begun working with the Vets Home under a contract to provide hospice services, but apparently they are unable to refer highly service-connected veterans because of payment issues. I don’t have full details from their finance officer, but the admissions director said that any Vets 70% or more service-connected are under a care provision agreement which means they cannot also access the hospice benefit. Do you have any thoughts on allowing access to formal hospice care for these highly service-connected Vets at the nursing home?

A: For 70% or greater service connected Veterans in a SVH, the SVH is required to provide all services listed in the 38 CFR Part 51, and are not allowed to bill Medicare/Medicaid, private insurance, or the Veteran for those services listed in the 38 CFR Part 51. However, the SVH is not required to provide specialty care (meaning anything not listed in the 38 CFR Part 51, hospice is not listed here), and the Veteran can use their VA benefits if eligible, private insurance, or Medicare/Medicaid if eligible.

Q: Regarding opioid prescriptions I have heard that the VA has no way of doing a partial fill for patients outside the VA facility. The concern was mentioned that some Veterans die with large supplies of opioids in the home.  Are you seeing this?  Any advice?

A: We can authorize a partial supply on a prescription to "hold someone over" until their next appointment, etc.  We cannot do partials on controlled prescriptions though. The only way to limit the amount of drugs sent to a patient is to prescribe less.

Select one of the links below to listen to or read call summaries from previous Partner Networking Calls: