2026-13971: Expansion of VA Process for 72-Hour Notification of Emergency Treatment

Federal Register, Volume 91 Issue 131 (Friday, July 10, 2026) [Federal Register Volume 91, Number 131 (Friday, July 10, 2026)] [Rules and Regulations] [Pages 42670-42672] From the Federal Register Online via the Government Publishing Office [www.gpo.gov] [FR Doc No: 2026-13971] ======================================================================= ----------------------------------------------------------------------- DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 [Docket No. VA-2025-VHA-0007] RIN 2900-AS29 Expansion of VA Process for 72-Hour Notification of Emergency Treatment

Agency

Department of Veterans Affairs.

Action

Final rule. -----------------------------------------------------------------------

Summary

The Department of Veterans Affairs (VA) adopts as final, with minor changes, a proposed rule amending its medical regulations to add a new method for veterans, their representatives, and eligible entities or providers to notify VA for the determination of whether emergency treatment can be authorized under the Veterans Community Care Program (VCCP). This will streamline the notification process and make it easier for veterans to have their care authorized under VCCP.

Dates

This rule is effective August 10, 2026.

For Further Information Contact

Joseph Duran, Director, Policy, Office of Integrated Veteran Care, Veterans Health Administration, (303) 370- 1637.

Supplementary Information

On July 22, 2025, VA published a rulemaking in the Federal Register that proposed to allow veterans, their representatives, and eligible entities or providers to notify VA through a centralized web-based process for determination of whether the emergency treatment can be authorized under the VCCP. 90 FR 34407. VA authorizes payment of emergency treatment furnished to covered veterans by eligible entities or providers under the VCCP if the veteran notifies the appropriate official at the nearest VA medical facility within 72 hours of such care being furnished and VA approves such care. 38 CFR 17.4020(c)(2) and (c)(4); other requirements under Sec. 17.4020(c) also apply. VA specifically proposed to revise Sec. 17.4020(c)(4)(i) to add the option of notification through a centralized notification process instead of only allowing notice to be provided to the appropriate VA official at the [[Page 42671]] nearest VA facility. 90 FR 34407. As stated in the proposed rule, although the centralized process is more administratively efficient and beneficial to veterans and local VA facilities, VA would maintain the current method of contacting the appropriate VA official at the nearest VA facility as a valid method of providing 72-hour notice to avoid confusion for veterans, their representatives, and eligible entities or providers who are accustomed to and prefer the current method of notification. Id at 34408. VA also proposed to amend Sec. 17.4020(c)(4)(i) to include that information on the centralized notification process would be accessible through VA's website at www.va.gov. Id. VA provided the public with a 60-day comment period, which ended on September 22, 2025. VA received three comments from the public. One comment was not relevant to this issue and the other two supported the proposed rulemaking. One of these supportive comments also included a suggestion, as discussed below. In the proposed rule, VA stated that information on the centralized notification process would be accessible through VA's website at www.va.gov, versus a more specific Emergency Care Reporting (ECR) website as located on the Community Care section of the www.va.gov.com site. 90 FR 34407. One commenter recommended maintaining the ECR Portal link and instructions on the Community Care web page within www.va.gov because veterans use the Community Care web page as a valuable resource. VA agrees with the commenter about the importance of maintaining the ECR portal link and instructions on the Community Care web page. Based on the feedback from the commenter, VA will update the website reference in Sec. 17.4020(c)(4)(i) as proposed to include the more specific www.va.gov/resources/getting-emergency-care-at-non-va-facilities/ or successor website. VA will also make a technical change to provide that the website ``is'' accessible on the website and not ``will be'' accessible on the website. This change provides clarity that the website is currently operational. The regulation will state that the notification be made to the appropriate VA official at the nearest VA facility or by using the centralized notification process (information on the centralized notification process is accessible through VA's website at https://www.va.gov/resources/getting-emergency-care-at-non-va-facilities/ or successor website). This will ensure that veterans can easily find information related to notification of emergency treatment. Based on the rationale set forth in the Supplementary Information section of the proposed rule and this final rule, VA adopts the proposed rule as final with the changes explained herein. Executive Orders 12866, 13563, and 14192 VA examined the impact of this rulemaking as required by Executive Orders 12866 (Sept. 30, 1993) and 13563 (Jan. 18, 2011), which direct agencies to assess all costs and benefits of available regulatory alternatives and, if regulation is necessary, to select regulatory approaches that maximize net benefits. The Office of Information and Regulatory Affairs has determined that this final rule is not a significant regulatory action under E.O. 12866, as supplemented by Executive Order 13563. This final rule is a deregulatory action under Executive Order 14192. Economic Impact: VA has determined there are no costs or transfers associated with this rule because the rule codifies the current practice of providing notice of emergency treatment to a centralized entity while still allowing individuals to notify the appropriate VA official at the nearest VA facility. VA designated this as a deregulatory action under Executive Order 14192 due to there being no increases in incremental costs or transfers and because the rulemaking also provides for a proven method of notification. While VA is unable to quantify savings, there will be increases in efficiency as this rulemaking simplifies centralized 72-hour notification without imposing new regulatory requirements. Regulatory Flexibility Act The Secretary hereby certifies that this final rule will not have a significant economic impact on a substantial number of small entities as they are defined in the Regulatory Flexibility Act, 5 U.S.C. 601- 612. This final rule adds a method for veterans, their representatives, and eligible entities or providers to contact VA for determination of whether emergency treatment can be authorized under the VCCP after the veteran has received such care. It will not have a substantial economic impact on small entities because it merely provides for an additional method of notification. Therefore, pursuant to 5 U.S.C. 605(b), the initial and final regulatory flexibility analysis requirements of 5 U.S.C. 603 and 604 do not apply. Unfunded Mandates This final rule will not result in the expenditure by State, local, and Tribal governments, in the aggregate, or by the private sector, of $100 million or more (adjusted annually for inflation) in any one year. Paperwork Reduction Act Although this final rule contains collection of information under the provisions of the Paperwork Reduction Act of 1995 (44 U.S.C. 3501- 3521), there are no provisions associated with this rulemaking constituting any new collection of information or any revisions to the existing collection of information. The collection of information for 38 CFR 17.4020 is currently approved by the Office of Management and Budget (OMB) and has been assigned OMB control number 2900-0823. List of Subjects in 38 CFR Part 17 Administrative practice and procedure, Alcohol abuse, Alcoholism, Claims, Day care, Dental health, Drug abuse, Foreign relations, Government contracts, Grant programs--health, Grant programs--veterans, Health care, Health facilities, Health professions, Health records, Homeless, Medical and dental schools, Medical devices, Medical research, Mental health programs, Nursing homes, Philippines, Reporting and recordkeeping requirements, Scholarships and fellowships, Travel and transportation expenses, Veterans. Signing Authority Douglas A. Collins, Secretary of Veterans Affairs, approved this document on July 7, 2026, 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. Jacquelyn Collins, Alternate Federal Register Liaison Officer, Department of Veterans Affairs. For the reasons set forth in the preamble, the Department of Veterans Affairs amends 38 CFR part 17 as follows: PART 17--MEDICAL 0