VA CCN February 2026 Provider Pulse

Stay Up to Date with VA Clinical Determinations and Indications

VA develops Clinical Determinations and Indications (CDI) as a reference to help determine whether a service is considered medically necessary for a Veteran. CDIs define clinical criteria and parameters to determine medical necessity to drive the most appropriate, evidence-based determinations for care.

All current CDIs are available online in the CDI Library. Bookmark the webpage and check back for updates. To submit a question about a published CDI, please use the CDI Question Submission Form and follow the instructions located at the bottom of the the CDI webpage.

For more information on CDIs, please check out the CDI Overview webinar on VHA TRAIN. If you have not already, you will need to create an account to access this webinar.

Building Suicide Prevention Capacity: Evidence-Based Suicide Prevention Training for CCN Providers

Project Safeguard is an initiative focused on strengthening suicide prevention capacity through access to evidence-based training and clinical best practices. This project offers structured education to enhance skills in suicide risk identification, engagement, and intervention.

This training was developed by the Center for Deployment Psychology and aligns with nationally recognized, evidence-based approaches and emphasizes trauma-informed care, clinical confidence, and practical tools that can be applied across care settings.

Why this matters:

• Suicide prevention is a top clinical priority for VA.
• Training in evidence-based practices helps providers respond effectively during moments of risk.
• Increased provider confidence and preparedness can save lives.

Providers are invited to participate in Project Safeguard training opportunities and join a growing network of clinicians committed to advancing Veteran suicide prevention. The training can be accessed on the Uniformed Services University Center for Deployment Psychology web page.

Stay tuned for more information about in-person training opportunities to support this initiative.

VA Direct: Secure Communication Supporting Timely, Coordinated Care

VA Direct is a secure messaging tool that strengthens care coordination between VA and CCN providers. VA Direct allows VA clinicians and participating community providers to exchange encrypted health information quickly and securely, supporting continuity of care when Veterans receive services in the community.

By improving the speed, reliability, and security of clinical communication, VA Direct helps reduce delays, minimizes gaps in information, and ensures that critical health data follows the Veteran across care settings.

Learn more by accessing the Connecting with VA Using Direct fact sheet.

Providers in the following locations are encouraged to engage with VA Direct as part of the effort to improve communication, efficiency, and Veteran outcomes. If you have any questions related to this, please reach out to TriWest’s point of contact for this program, Keita Franklin.

• Big Spring, Texas
• Harlingen, Texas
• Loma Linda, California

Together, Project Safeguard and VA Direct represent important efforts to strengthen Veteran care through improved coordination, clinical readiness, and shared responsibility for suicide prevention.

Important Notice for CCN Providers: Wegovy Recall Due to Particulate Matter

Novo Nordisk has issued a voluntary recall of select Wegovy (semaglutide) injection due to the potential presence of foreign particles in the solution. This recall affects specific lot numbers and is being conducted in coordination with the U.S. Food and Drug Administration (FDA).

Patient Safety:

• Particulate matter in injectable medications may pose risks, including injection site reactions, inflammation, or vascular complications.
• No widespread serious adverse events have been reported to date, but caution is warranted.

VA CCN Provider Handbook Updates

A) Additional information will be added to the Billing and Claims section of the CCN Provider Handbook:

Medicare fee schedules and other Medicare reimbursement mechanisms will be applied to all Medicare-covered procedure codes regardless of the provider type or taxonomy, Medicare certification status, place of service, claim type (institutional or professional), underlying patient condition, or medically necessary criteria established by entities other than VA.

B) Clarifying language was added to the Credentialing and Contract Provisions section of the CCN Provider Handbook:

OHI Billing and Claim Submission Requirements

TriWest is generally the primary payer for all VA-authorized services. Unless there is specific indication that TriWest is secondary payer on the authorization, the provider must bill TriWest as the primary payer. The provider is not permitted to bill any Other Health Insurance (OHI) for payment. TriWest will not reimburse services paid by another OHI until the payment is refunded, allowing TriWest to reimburse as the primary payer.

C) A new section will be added to the Medical Records and Documentation page of the CCN Provider Handbook:

Submitting High Risk Medical Documentation for VISN 22

VA has designated a separate process for submitting high-risk medical documentation for CCN providers in Veterans Integrated Service Network (VISN) 22, which is comprised of eight health care systems and 80 community clinics in Arizona, New Mexico and Southern California.

High risk medical documentation includes the following:

• Emergency department visits and admissions
• Mental health treatments and acute suicidal event records
• Cardiology consult results (including cardiac catheterization reports and corresponding radiologic images)
• Cancer surgeries and treatments including operative reports and pathology reports
• Dialysis Interdisciplinary Care Plan and monthly encounter notes
• Screening tests (ex. lung cancer screening)
• Mammography reports
• GI colonoscopy reports with pathology results

How to submit:

1. HealthShare Referral Manager (HSRM)
2. VA Health Information Exchange
3. Fax to 888-798-0815