Health Claims Processing – Follow-up Engagement

Questions and Answers

1. What is the FHCPS contract?
2. Who uses FHCPS?
3. Why is VAC getting the next FHCPS contract?
4. When will the next FHCPS contract start?
5. Will the next FHCPS contract affect my benefits and services?
6. Will my privacy and personal information be protected?
7. Have Veterans and other participants been consulted about the next FHCPS contract?
8. Who will be the next contractor and how will they be selected?
9. What is the duration and dollar amount of the next FHCPS contract?
10. Where can I get more information about FHCPS?

Q1. What is the Federal Health Claims Processing Services (FHCPS) contract?

A1. Veterans Affairs Canada (VAC), the Canadian Armed Forces (CAF), and the Royal Canadian Mounted Police (RCMP) deliver a wide range of health benefits and services to qualifying Veterans and their families, CAF, and RCMP members. The FHCPS contract is used to manage claims processing for most of these health care benefits and services. These services include:

• Assessing participants claims, and authorizing them if they qualify;
• Reimbursing participants or health care providers for authorized claims;
• Answering participant questions about health care authorizations and reimbursements;
• Registering and keeping a list of health care providers who can bill us directly; and
• Supporting VAC, CAF, and RCMP policies and processes, so we are transparent and accountable to clients.

Currently these services are provided through a contract with Medavie Blue Cross (MBC), which is anticipated to end in 2026.

Q2. Who uses FHCPS?

A2. All qualified CAF, RCMP members, and VAC participants with a Medavie Blue Cross health care card use FHCPS.

Q3. Why is VAC getting the next FHCPS contract?

A3. The current FHCPS contract is expected to end in 2026. This gives VAC, CAF, and the RCMP an opportunity to update how we authorize and process health care benefit claims.

Q4. When will the next FHCPS contract start?

A4. The next FHCPS contract will be operational once the current contract ends, which is anticipated for 2026.

Q5. Will the next FHCPS contract affect my benefits and services?

A5. No, the next contract will not change the benefits and services you receive or how you qualify for them. It will assist us in improving how we manage and pay for your benefits and services.

We expect a seamless transition to the next contract. You will continue to get the benefits and services to which you qualify.

Q6. Will my privacy and personal information be protected?

A6. Yes. We take the responsibility of protecting your personal information seriously. The FHCPS contractor must meet Government of Canada security standards and confirm your information is protected in accordance with the Privacy Act.

Q7. Will Veterans and other participants be consulted about the next FHCPS contract?

A7. Yes. We consulted participants who receive treatment benefits using a CAF, RCMP, or VAC-issued health care card in the summer of 2022. Using the Let’s Talk Veterans platform, we got feedback from 211 participants who helped us identify areas they want us to focus on, including:

• simplified processes for claim reimbursements;
• clearer information about eligibility requirements; and
• increased use of digital communication and tools.

We continue to consult with Veterans and other participants through various methods, including Let’s Talk Veterans consultations.

Q8. Who will be the next contractor and how will they be selected?

A8. The next contractor hasn’t been selected yet. Public Services and Procurement Canada (PSPC) is responsible for the procurement process. They are the Government of Canada’s Centre of Expertise for procurement and contracting. PSPC appointed an independent fairness monitor to make sure the process is open, fair, and competitive.

Our goals for the procurement process include:

• consulting with FHCPS users, employees, and other stakeholders;
• awarding a contract that provides the best possible health claims processing and related services;
• achieving good value for Canadians; and
• ensuring a seamless transition to the next contract.

PSPC posted a Request for Proposal (RFP) to CanadaBuys.ca in March 2023 and interested parties submitted their bids by July 2023. PSPC is evaluating the bids to find the best service and value for Canadians. The next contractor is expected to be announced in the fall of 2024.

Q9. What is the term and dollar amount of the next FHCPS contract?

A9. The term and dollar amount of the contract will be determined once it’s awarded, which is expected in the fall of 2024.

Q10. Where can I get more information about FHCPS?

A10. The FHCPS contract is used to process health claims for treatment benefits, long-term care, and the Veterans Independence Program (VIP). Visit our website to learn more about these benefits and services, and whether you qualify.

If you have further questions, please call 1-866-522-2122.