Expanded Access to Non-VA Care Through the Mission Act: Veterans Community Care Program (VCCP)

OMB 2900-0823

OMB 2900-0823

Section 101 of the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018 requires VA to implement the Veterans Community Care Program (VCCP) to furnish care in the community to covered Veterans through eligible entities and providers, under circumstances as further prescribed in the MISSION Act. VA currently collects information that will be required to implement the Veterans Community Care Program under the Veterans Choice Program, through an OMB approved collection 2900-0823. OMB collection 2900-0823 includes VA Form 10-10143, Election to Receive Authorized Non-VA Care and Selection of Provider for the Veterans Choice Program; VA Form 10-10143a, Health-Care Plan Information for the Veterans Choice Program; VA Form 10-10143b, Submission of Medical Record Information under the Veterans Choice Program; VA Form 10-10143c, Submission of Information on Credentials and Licenses by Eligible Entities and Providers; VA Form 10-10143e, Secondary Authorization Request for VA Community Care; and VA Form 10-10143f, Community Care Document Cover Sheet. A new form is being added to this collection: VA Form 10-10143g, Non-VA Hospital Emergency Notification.

The latest form for Expanded Access to Non-VA Care Through the Mission Act: Veterans Community Care Program (VCCP) expires 2020-10-31 and can be found here.

OMB Details

10-10143 Election to Receive Authorized Non-VA Care and Selection of Provider for the Veterans Community Care Program

Federal Enterprise Architecture: Health - Health Care Services


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