West Roxbury Veterans Hospitial

West Roxbury Campus

The West Roxbury Campus serves as the tertiary inpatient medical center for the VA BHCS and the other VA medical centers in the VISN. Recently named a Center for Excellence in Cardiac Surgery this facility offers cardiac catheterization, CCU, and a renowned Open Heart Surgery Program. The West Roxbury campus also has a nationally recognized acute Spinal Cord Injury program, and is one of few facilities that has a CARF accredited acute rehabilitation program, supported by a swimming pool that is located in the hospital proper. This campus supports an interventional cardiology program with electrophysiology. In addition, West Roxbury serves as the referral center for intensive inpatient surgery and provides such unique and high-risk surgeries as, vascular surgery, specialized general and cancer related surgery, orthopedics, hand and joint replacement surgery, neurosurgery, plastic surgery, and urology. West Roxbury maintains a 24-hour emergency department.

DIRECTIONS
From I-95 / RT 128 heading North or South:
Take Exit #16A, which will place you directly onto RT 1 North. Stay on RT 1 North for approximately 4 miles. (you will pass through 4-5 sets of traffic lights) to the intersection with RT 109. (This will be a large intersection and you'll see the hospital complex ahead on your right-hand side). Go through this intersection (traffic light). Continue on RT 1 north for about 500 yards. You'll see a large sign for the VA Medical Center on your right Turn right into the hospital complex and take your second left. This road takes you in front of the hospital buildings.

Boston HCS

VA NEW ENGLAND HEALTHCARE SYSTEM
CENTRAL AREA SUB-REGION MANAGEMENT ASSISTANCE COUNCIL

A meeting of the Central Sub-Region Mini MAC was held at West Roxbury on
Tuesday, September 11, 2001 from 1:00 PM to 3:00 PM. The following were in
attendance:

Joseph E. Badzmierowski, Paralyzed Veterans of America
Ken Mederis, New England Paralyzed Veterans of American
General Weeks, Blinded Veterans Association
Dorothy Sayer, Veterans Council, Nat'l Alliance for the Mentally Ill
Patrick J. Leonard, DAV
Deborah Outing, Facilitator, Bedford

Purpose: To conduct the business of the VA New England Healthcare System
Central Sub-Region Mini MAC.

Desired Outcomes: 1) Patient Services/MAS Eligibility 2) Discussion of
Mission, Vision and Value Statement, 3) Boston Integration Update, and 4)
Review Central Sub-Region Mini-MAC Future Agenda Items

1. The minutes of July 10, 2001 meeting was accepted as published.

2. Cathleen Stephens, Chief Patient Services, Boston Healthcare System
discussed Eligibility Information.

Emergency care benefit does not apply to all veterans. To quality,
veterans must:
Be enrolled in VA Health Care:
Carry no other form of health insurance, including Medicare or Medicaid.
If any third party pays all or part of the bill, VA cannot provide
reimbursement.
When conditions are met, the veteran pays nothing and the VA pays 70
percent of the applicable Medicare and VA payment is considered payment in
full.
Under the new rules, civilian hospitals should report to VA within 48
hours of treating a veteran who has no other means of payment.
VA will reimburse health care providers for all medical services necessary
to stabilize the veteran's condition so the patient can be transferred to an
approved VA facility.
Veterans could be personally liable for medical bills if they decide to
drop their Medicare Part B coverage or their personal health insurance
coverage.
Prescription payments will increase from $2.00 per co-pay to a $7.00 per
co-pay.

After the presentation the following questions and answers were discussed:

I thought there was supposed to be a $841.00 cap of what the veteran
should pay? Yes, that information just came about two weeks ago. There
might be some veterans who are not eligible for that cap. This will
probably be the priority 7 veterans.
Will there be a cap per month? I'm not 100 percent certain about that.
But, I can get some information on that for you.
When reimbursing healthcare providers, what do you mean by veterans
"staying beyond the allotted point" in a civilian hospital? If a veteran
is admitted for chest pains for example, and we say we (VA) can take him on
hospital day number three, that would be the day that payment to the
hospital stops.
How is the word getting out to the veteran that prescription co-payments
are increasing?
Most of the veteran services agents know about this and we have put flyers
out in the hospital. We can also put a flyer in the appointment letters that
go out to veterans.

What will be the effective day of the increase in prescription
co-payments?
I believe the effective date will be November although I don't know the
exact date. I have not been given the date. After it is in the federal
register, people have a certain amount of time to comment, then after the
comments a final decision is to be made.
Why does the VA want to drop the Category 7 veterans?
Headquarters was actually thinking about sub-grouping this category. They
were talking instead of doing an "A", "B", "C", and "D" category. They were
also thinking about combining them as category 2's as well. There were a
lot of white papers written in headquarters to address this issue, but I don
't know what the final decision was.
If a veteran goes to the hospital, does the VA bill the hospital for his
reimbursement?
No, the hospital would bill us. They normally send us in a claim, which
is a 583, a copy of the bill and copies of medical records which will then
get reviewed by a clinician. Then the clinician will determine when the
veteran is stable for transfer.

Boston Healthcare System Update-There was no briefing given.

4. Mission, Vision and Value Statement Review

Handed out the Mission, Vision, and Value statement to stakeholders with a
request to get their opinion of the new wording. Comments received by the
Mini-Mac group in June were incorporated by Mr. Conte and George Donovan
into the new Mission statement. Stakeholders like the new Mission
statement.

5. Handouts - The following information was made available for the
participants:

Eligibility Update
Mission, Vision and Value final statement

6. Future Agenda Items - The members suggested the following for the next
meeting:

Issues of customer service at the Boston Healthcare System need to be
discussed
Definition of Mini-Mac and what it's used for.
Discussion of employee courteousness and attitude and how it can be
changed considering the Mission. Vision and Value statement.

7. The meeting adjourned at approximately 2:00 PM. The next meeting will
be held on October 9, 2001 from 1:00-3:00 at the West Roxbury facility.

Deborah Outing