‘Sent: Monday, August 03, 2015 12:25 PM. 1 SESE (+ SETTER Subject: Fw: quick change Fyi. USH has decided to restrict treatment to advanced liver disease patients (including referral to Choice). He is reportedly aware that this will result in significantly decreasing the amount of the $500M that will be used. There was no input from my office, or other VA offices that | am aware of - this was based on "checking with the private sector.” US. Department of Veterans Affairs 1717 H Street, NW Washington, DC 20006 oo Sent: Friday, July 31, 2015 10:25 AM 10: Subject: RE: quick change Will get back with you but this is the direction he said 100% clearly today. 4. At the facility level, will this mean deferring patients with less serious disease even if there is available capacity/funds? yes 2, IF the answer is yes, does Dr. Shulkin recognize that this will result in unused capacity and potentially unused funds? yes 3. If the answer is yes, does Dr. Shulkin recognize that Veterans’ and providers’ expectations are that everyone will be treated? Yes—we need to help the providers with this 4. IF the answer is yes, has OGC been advised, given the potential for tort claims? VVA has already threatened to seek an injunction regarding the prioritization scheme. Need to check 5. Does this apply to priority 1 Veterans, particularly those with service-connected HCV? Need to check 6. Does this apply to Choice referrals? yes(So rere Sent: Friday, July 31, 2015 10:14 AM Subject: Re: quick change ‘Thanks. A number of questions: 1. At the facility level, will this mean deferring patients with less serious disease even if there is available capacity/funds? 2. If the answer is yes, does Dr. Shulkin recognize that this will result unused funds? in unused capacity and potentially 3. If the answer is yes, does Dr. Shulkin recognize that Veterans’ and providers’ expectations are that everyone will be treated? 4. If the answer is yes, has OGC been advised, given the potential for tort claims? VVA has already threatened to seek an injunction regarding the prioritization scheme. 5. Does this apply to priority 1 Veterans, particularly those with service-connected HCV? 6. Does this apply to Choice referrals? Thx, USS. Department of Veterans Affairs 1717 H Street, NW Washington, DC 20006Sent: Friday, July 31, 2015 09:58 AM Subject: quick change Per Dr Shulkin, push for this year for treatment (and generally all treatment) needs to be those with ALD and cirrhosis not the asymptomatic patients...just fyi Perera