VA Healthcare Legislation

In the wake of the scandalous revelations of extraordinary wait times and falsification of records at VA Medical Centers, Congress is in the process of considering reform legislation.  The principal bill is the House of Representatives’ HR 4810, which would:

• Direct the VA to enter into contracts for private care to be given to veterans who have waited longer than VA’s wait-time goals, or been notified that the necessary care is not available within those wait-times, or live more than 40 miles from the nearest VAMC (this authority would terminate after two years);
• Allow veterans to receive care from private facilities through completion of the “episode of care,” but no longer than 60 days;
• Allow care to be provided by, and reimbursement (at the highest of VA’s, Medicare’s, or Tricare’s rates) to be paid to, facilities with which VA does not contract, if the wait-time goals cannot be met by a facility with which VA has a contract.

The Senate passed its own bill, which is similar but lacks the reimbursement rate and 60-day limit provisions.  The House is insisting on the reimbursement provisions and the bills have been referred to conference committee.  As of July 1, there had been no resolution.