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  • Type: Software
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  • Keywords: ACA
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VA Code in Flight Submission - HealthCare Reform - Affordable Care Act v4.4
Please use this identifier to cite or link to this publication: http://hdl.handle.net/10909/11162
Submitted by OI&T EPMO Lean Systems Engineering Open Source Coordination Office on 09-08-2016.
Effective January 1, 2014, the Affordable Care Act (ACA) requires every individual taxpayer in the United States to maintain minimal essential health care coverage or face a tax penalty. The Department of Veterans Affairs (VA) Veterans Relationship Management (VRM) is tasked with supporting the establishment and development of the ACA project.

The VA is obligated to support the Patient Protection and Affordable Care Act (PPACA); referred to in this document as ACA. Effective January 1, 2014, every individual taxpayer in the United States must maintain minimal essential health care coverage or face a tax penalty. Enrollment in Veterans health care meets the minimal essential coverage threshold under 26 Code of Federal Regulations (CFR) 1.36B-2 (c)(2)(ii) of the Treasury Notice of Proposed Rulemaking (NPRM).

The VA is required to furnish communication (i.e., flat file) to the Internal Revenue Service (IRS) that contains information on all Veterans and beneficiaries who received minimum essential coverage (MEC) through enrollment in VA health benefits programs. Section 6055(a) requires every entity that provides MEC, to file annual returns reporting information for each, individual coverage provided. An IRS Form 1095B or equivalent communication shall be prepared annually for the prior tax year. A master list (flat file) will be sent to the IRS, and an IRS Form 1095B (with appropriate VA correspondence) shall be sent to qualified Veterans and beneficiaries by February of the following year.The Enrollment System (ES) shall accept, calculate, and respond to CMS queries for information on periods of MEC eligibility for Veterans. Finally, the ES shall be modified to automate ACA-related outreach communication efforts to resolve situations where Veterans are in one or more pending status. If the status cannot be resolved, the ES shall automatically resolve the pending status.

These additional functionalities will ensure that the VA is taking all appropriate and possible actions to ensure that Veterans and beneficiaries, who may receive MEC through the VA, are notified and given the opportunity to enroll for and receive MEC.

Revision Notes

Adding code for in flight version 4.4.

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