[Federal Register Volume 84, Number 18 (Monday, January 28, 2019)]
[Rules and Regulations]
[Page 407]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-28285]



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 Rules and Regulations
                                                 Federal Register
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 This section of the FEDERAL REGISTER contains regulatory documents 
 having general applicability and legal effect, most of which are keyed 
 to and codified in the Code of Federal Regulations, which is published 
 under 50 titles pursuant to 44 U.S.C. 1510.
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  Federal Register / Vol. 84, No. 18 / Monday, January 28, 2019 / Rules 
and Regulations  

[[Page 407]]



DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17


Confidentiality of Certain Medical Records Under the MISSION Act

AGENCY: Department of Veterans Affairs.

ACTION: Notification of change to agency practice.

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SUMMARY: This Department of Veterans Affairs (VA) document provides an 
update to VA's requirements for obtaining a signed release of 
information for third party billing practices from VA beneficiaries 
with a sensitive diagnosis under the United States Code to align with 
the amendments made by the VA MISSION Act of 2018.

DATES: Effective January 28, 2019.

FOR FURTHER INFORMATION CONTACT: Jennifer Adams, Office of Community 
Care (10D), Veterans Health Administration, Department of Veterans 
Affairs, 810 Vermont Avenue NW, Washington, DC 20420, 
[email protected], (615) 355-1539. This is not a toll free 
number.

SUPPLEMENTARY INFORMATION: On June 6, 2018, section 132 of Public Law 
115-182, the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson 
VA Maintaining Internal Systems and Strengthening Integrated Outside 
Networks Act of 2018 (MISSION Act), amended 38 U.S.C. 7332, 
Confidentiality of certain medical records, which protects certain 
sensitive diagnoses (i.e., drug abuse, alcoholism or alcohol abuse, 
infection with the human immunodeficiency virus, or sickle cell anemia) 
from being disclosed unless expressly authorized by the patient. The VA 
Mission Act of 2018 amended section 7332 by providing a new exception 
to the requriment that a patient must expressely authorize VA to 
disclose medical records containing a sensitive diagnosis. The 
exception removed VA's requirement when VA is billing a third-party for 
medical care cost recovery.
    In addition to this document, VA will announce these changes on 
Veteran-facing websites to reach as many VA beneficiaires as possible. 
VA will also conduct a briefing with Veteran Service Organizations to 
ensure they are informed of the changes. For any VA beneficiary who has 
previously signed a release of information declining to allow VA to 
bill encounters containing a sensitive diagnosis, VA will provide a 
one-time notification prior to submitting claims with a sensitive 
diagnosis to a third-party health insurer. The written notification 
will include a summary of the new law, how the change affects the 
patient, and a description of the types of services affected by the 
change.
    After all of the aforementioned notifications are complete, VA will 
begin submitting claims to health insurance companies for encounters 
with dates of service on or after the publication date of this document 
in the Federal Register that contain a sensitive diagnosis without a 
signed release of information. While VA's billing authorities allow for 
a window of up to 6 years to bill a health insurance company for 
services provided, VA will not pursue any back billing for these 
services unless a signed Request For and Authorization to Release 
Medical Records or Health Information (VHA-10-5345) form for such 
release has been received from the patient. All required payer policies 
still apply to any services submitted for reimbursement.

Signing Authority

    The Secretary of Veterans Affairs, or designee, approved this 
document and authorized the undersigned to sign and submit the document 
to the Office of the Federal Register for publication electronically as 
an official document of the Department of Veterans Affairs. Robert L. 
Wilkie, Secretary, Department of Veterans Affairs, approved this 
document on December 21, 2018, for publication.

    Dated: December 21, 2018.
Luvenia Potts,
Program Specialist, Office of Regulation Policy & Management, Office of 
the Secretary, Department of Veterans Affairs.
[FR Doc. 2018-28285 Filed 1-25-19; 8:45 am]
 BILLING CODE 8320-01-P