VA Finally Cuts the Red Tape on Community Care, Here’s How Veterans Can Use the New Policy Today

On May 19, 2025, the Department of Veterans Affairs quietly erased one of the biggest bureaucratic hurdles between veterans and the private-sector health care they often need. From now on, a VA doctor’s referral to Community Care no longer has to be second-guessed by another VA physician or administrator. The change—ordered by the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act—bars VA officials from overruling front-line clinicians for the next two years while Congress studies the results. Military.com

This Should Have Happened Years Ago

The VA Choice Act of 2014 and the MISSION Act of 2019 were both sold as tools to give veterans timely, nearby options when VA hospitals were backlogged or too far away. Yet the agency layered on an “administrative review,” forcing every Community Care referral to be rubber-stamped—or vetoed—by a committee that never saw the patient. Whistle-blowers and a 2024 Military.com investigation showed schedulers were pressured to keep veterans inside the VA system, even when wait-time rules clearly entitled them to outside care. Military.com

The result? Veterans with PTSD, TBI, chronic pain, or urgent surgical needs bounced between appointments, appeals, and worsening symptoms. Eliminating the second review is not a radical idea; it’s simply letting your primary VA clinician do the job Congress authorized back in 2019. The policy change acknowledges what veterans and advocates have argued for more than a decade: access delayed is access denied.

What Exactly Changed?

Old Rule
- VA doctor writes referral → separate “utilization review” panel can approve, modify, or reject it.
- Delays averaged days to weeks; Some referrals quietly died in queue
- Veterans had little recourse except patient-advocate complaints or congressional inquirie

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New Rule

- Referral stands as written.

- No extra clinical review or administrative veto for at least two years.

- Decision is immediate; scheduling with Community Care can begin right away.



Veterans can cite the Elizabeth Dole Act if any employee tries to impose a second review.

Five Ways to Leverage the New Freedom

1. Know the MISSION-Act eligibility triggers.
   You qualify for Community Care if the VA can’t see you within 20 days for primary/mental-health care or 28 days for specialty care or if you must drive more than 30 minutes for primary care / 60 minutes for specialty care. Track appointment offers and mileage; they are your proof. Military.com
2. Ask for the referral in writing—during the visit.
   Before you leave the exam room, tell your VA clinician you want Community Care and request that they enter the consult order immediately. Screen-capture My HealtheVet messages or print the after-visit summary as evidence.
3. Quote the law.
   If staff say “we still need it to be approved,” politely respond:

“Under Section 102 of the Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act, additional clinical review of my Community Care referral is prohibited. Please proceed with scheduling.”
Front-line employees are being retrained now, but a calm reminder helps. Military.com
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1. Choose your provider strategically.
   • For advanced mental-health options like TMS, ketamine infusions, or hyperbaric oxygen therapy, find a community clinic experienced in VA billing
   • Give the VA scheduler the exact clinic name, NPI, and contact information to speed authorization.
2. Escalate fast if the clock runs.
   • Day 5 with no progress? Call the facility’s Office of Community Care and the Patient Advocate line.
   • Day 10? Email your VISN Community Care director and copy your congressional constituent-services staffer. The law is on your side; use it.

What This Means for Veterans’ Health

• Shorter wait times for specialty care. Whether it’s a neurologist for migraines or a trauma-focused therapist, you can bypass month-long VA queues.
• More choice in cutting-edge therapies. Private-sector centers often offer protocols—like accelerated TMS or combination ketamine + psychotherapy—that few VA hospitals provide.
• Less travel, more continuity. Rural veterans who previously drove hours to a VA facility can now be treated close to home and loop their records back into the VA’s electronic health system.

Bottom Line

The VA’s new stance is a welcome course correction—but it only works if veterans know their rights and press for them. Document your eligibility, ask for the referral on the spot, and remind staff that the law forbids any extra hoops. For once, the door to Community Care is supposed to stay open. Make sure you walk through it—and bring your battle buddies with you.

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