(This measure has not been amended since it was introduced. The summary has been expanded because action occurred on the measure.)
Veteran Access to Care Act of 2014 - (Sec. 2) Directs the Secretary of Veterans Affairs (VA) to enter into contracts with such non-VA facilities as may be necessary to furnish hospital care and medical services to veterans who:
Allows eligible veterans who opt for hospital care or medical services in a non-VA facility to receive such care or services through the completion of the episode of care, but for no longer than 60 days.
Directs the Secretary to submit a quarterly report to Congress on the provision of such hospital care and medical services through contracts with non-VA facilities.
Terminates the Secretary's authority to contract with non-VA facilities for the provision of such care and services two years after this Act's enactment.
(Sec. 3) Directs the Secretary, to the extent that appropriations are available to the VHA for medical services, to reimburse non-VA facilities with which the VA does not have such a contract for providing hospital care and medical services to such veterans, if such care and services cannot be provided within the VHA's wait-time goals in a facility with which the VA has a contract. Sets the reimbursement rate for such care or services at the greatest of the VA, Medicare, or TRICARE (a Department of Defense [DOD] managed care program) payment rate for such care or services.
Terminates the Secretary's authority to reimburse non-VA facilities for the provision of such care and services two years after this Act's enactment.
(Sec. 4) Directs the Secretary, within 120 days of this Act's enactment, to enter into a contract or contracts with a private entity or entities with experience in VHA and private delivery systems and in health care management to conduct an independent assessment of the hospital care and medical services furnished in VA facilities.
Lists the factors that must be addressed in assessing veterans access to, and the quality of, hospital care and medical services in VA facilities.
Directs the Secretary to submit reports to the congressional veterans committees regarding: (1) the findings and recommendations of the independent assessment; and (2) the Secretary's response to those findings, including an action plan for fully implementing such recommendations.
(Sec. 5) Prohibits the Secretary from paying awards and bonuses to VA employees for FY2014-FY2016.
(Sec. 6) Requires the Director of the Office of Management and Budget (OMB), within 30 days of this Act's enactment, to transmit to Congress:
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4810 Introduced in House (IH)]
113th CONGRESS
2d Session
H. R. 4810
To direct the Secretary of Veterans Affairs to enter into contracts for
the provision of hospital care and medical services at non-Department
of Veterans Affairs facilities for Department of Veterans Affairs
patients with extended waiting times for appointments at Department
facilities, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 9, 2014
Mr. Miller of Florida (for himself, Mr. McCarthy of California, Mr.
Lamborn, Mr. Bilirakis, Mr. Roe of Tennessee, Mr. Flores, Mr. Runyan,
Mr. Benishek, Mr. Huelskamp, Mr. Coffman, Mr. Wenstrup, Mr. Cook, Mrs.
Walorski, Mr. Jolly, Mrs. Kirkpatrick, Mr. Barber, Mr. Barr, Mr.
Burgess, Mr. Cassidy, Mr. Cramer, Mr. Crawford, Mr. Culberson, Mr.
Gingrey of Georgia, Mr. Hastings of Washington, Mr. Huizenga of
Michigan, Mr. Johnson of Ohio, Mr. Latta, Mr. Nunnelee, Mr. McKinley,
Mrs. McMorris Rodgers, Mr. Ribble, Ms. Ros-Lehtinen, Mr. Ruiz, Mr.
Salmon, Mr. David Scott of Georgia, Ms. Sinema, Mr. Stockman, Mr.
Southerland, Mr. Upton, Mr. Valadao, Mr. Vela, Mr. Whitfield, Ms.
Duckworth, Mr. Michaud, Mr. Rogers of Alabama, Mr. Palazzo, Mr. Nunes,
Mr. Rigell, Mr. Daines, Mr. Buchanan, Mr. Thornberry, Mr. Wilson of
South Carolina, Mr. Farenthold, Mr. Lance, Mr. Faleomavaega, Mr.
Cotton, Mr. Bucshon, Mr. Neugebauer, Mr. Amash, Mr. Harper, Mrs. Miller
of Michigan, Mr. Pearce, Mr. Barrow of Georgia, Mr. Walberg, Mr.
Cuellar, Mr. Mica, Mr. O'Rourke, Mr. Duncan of Tennessee, Mr. Murphy of
Pennsylvania, Ms. Brownley of California, Mr. Owens, Mr. Gibbs, Mrs.
Black, Mr. Gibson, Mr. Crenshaw, Mr. Forbes, Mr. Stivers, Mr. Cole, Mr.
Grimm, Mr. Barton, Mr. Smith of Texas, Mr. Schock, Mr. Tiberi, Mr.
Rodney Davis of Illinois, Mr. Calvert, Mr. Guthrie, Mr. Reed, Mr.
Wittman, Mr. Kline, Ms. Bordallo, Mr. Hudson, Mr. Costa, Mr. Smith of
Missouri, Mr. Sablan, Mr. Webster of Florida, Mr. Sam Johnson of Texas,
Mr. Butterfield, Mr. Rothfus, Mr. Fleischmann, Mr. Posey, Mr. Joyce,
Mr. Womack, Mr. Bishop of Georgia, Mr. McIntyre, Mr. Royce, Mr. Nugent,
Mr. Heck of Nevada, Ms. Kuster, Mr. Griffin of Arkansas, Mr. Meehan,
Mr. Bridenstine, Mr. Gerlach, Mr. Denham, Mr. Schweikert, and Mr.
Pompeo) introduced the following bill; which was referred to the
Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To direct the Secretary of Veterans Affairs to enter into contracts for
the provision of hospital care and medical services at non-Department
of Veterans Affairs facilities for Department of Veterans Affairs
patients with extended waiting times for appointments at Department
facilities, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Veteran Access to Care Act of
2014''.
SEC. 2. PROVISION OF HOSPITAL CARE AND MEDICAL SERVICES AT NON-
DEPARTMENT OF VETERANS AFFAIRS FACILITIES FOR DEPARTMENT
OF VETERANS AFFAIRS PATIENTS WITH EXTENDED WAITING TIMES
FOR APPOINTMENTS AT DEPARTMENT FACILITIES.
(a) In General.--As authorized by section 1710 of title 38, United
States Code, the Secretary of Veterans Affairs (in this Act referred to
as the ``Secretary'') shall enter into contracts with such non-
Department facilities as may be necessary in order to furnish hospital
care and medical services to covered veterans who are eligible for such
care and services under chapter 17 of title 38, United States Code. To
the greatest extent possible, the Secretary shall carry out this
section using contracts entered into before the date of the enactment
of this Act.
(b) Covered Veterans.--For purposes of this section, the term
``covered veteran'' means a veteran--
(1) who is enrolled in the patient enrollment system under
section 1705 of title 38, United States Code;
(2) who--
(A) has waited longer than the wait-time goals of
the Veterans Health Administration (as of June 1, 2014)
for an appointment for hospital care or medical
services in a facility of the Department;
(B) has been notified by a facility of the
Department that an appointment for hospital care or
medical services is not available within such wait-time
goals; or
(C) resides more than 40 miles from the medical
facility of the Department of Veterans Affairs,
including a community-based outpatient clinic, that is
closest to the residence of the veteran; and
(3) who makes an election to receive such care or services
in a non-Department facility.
(c) Follow-Up Care.--In carrying out this section, the Secretary
shall ensure that, at the election of a covered veteran who receives
hospital care or medical services at a non-Department facility in an
episode of care under this section, the veteran receives such hospital
care and medical services at such non-Department facility through the
completion of the episode of care (but for a period not exceeding 60
days), including all specialty and ancillary services deemed necessary
as part of the treatment recommended in the course of such hospital
care or medical services.
(d) Report.--The Secretary shall submit to Congress a quarterly
report on hospital care and medical services furnished pursuant to this
section. Such report shall include information, for the quarter covered
by the report, regarding--
(1) the number of veterans who received care or services at
non-Department facilities pursuant to this section;
(2) the number of veterans who were eligible to receive
care or services pursuant to this section but who elected to
continue waiting for an appointment at a Department facility;
(3) the purchase methods used to provide the care and
services at non-Department facilities, including the rate of
payment for individual authorizations for such care and
services; and
(4) any other matters the Secretary determines appropriate.
(e) Definitions.--For purposes of this section, the terms
``facilities of the Department'', ``non-Department facilities'',
``hospital care'', and ``medical services'' have the meanings given
such terms in section 1701 of title 38, United States Code.
(f) Implementation.--The Secretary shall begin implementing this
section on the date of the enactment of this Act.
(e) Construction.--Nothing in this section shall be construed to
authorize payment for care or services not otherwise covered under
chapter 17 of title 38, United States Code.
(g) Termination.--The authority of the Secretary under this section
shall terminate with respect to any hospital care or medical services
furnished after the end of the 2-year period beginning on the date of
the enactment of this Act, except that in the case of an episode of
care for which hospital care or medical services is furnished in a non-
Department facility pursuant to this section before the end of such
period, such termination shall not apply to such care and services
furnished during the remainder of such episode of care but not to
exceed a period of 60 days.
SEC. 3. EXPANDED ACCESS TO HOSPITAL CARE AND MEDICAL SERVICES.
(a) In General.--To the extent that appropriations are available
for the Veterans Health Administration of the Department of Veterans
Affairs for medical services, to the extent that the Secretary of
Veterans Affairs is unable to provide access, within the wait-time
goals of the Veterans Health Administration (as of June 1, 2014), to
hospital care or medical services to a covered veteran who is eligible
for such care or services under chapter 17 of title 38, United States
Code, under contracts described in section 2, the Secretary shall
reimburse any non-Department facility with which the Secretary has not
entered into a contract to furnish hospital care or medical services
for furnishing such hospital care or medical services to such veteran,
if the veteran elects to receive such care or services from the non-
Department facility. The Secretary shall reimburse the facility for the
care or services furnished to the veteran at the greatest of the
following rates:
(1) VA payment rate.--The rate of reimbursement for such
care or services established by the Secretary of Veterans
Affairs.
(2) Medicare payment rate.--The payment rate for such care
or services or comparable care or services under the Medicare
program under title XVIII of the Social Security Act.
(3) TRICARE payment rate.--The reimbursement rate for such
care or services furnished to a member of the Armed Forces
under chapter 55 of title 10, United States Code.
(b) Covered Veterans.--For purposes of this section, the term
``covered veteran'' means a veteran--
(1) who is enrolled in the patient enrollment system under
section 1705 of title 38, United States Code; and
(2) who--
(A) has waited longer than the wait-time goals of
the Veterans Health Administration (as of June 1, 2014)
for an appointment for hospital care or medical
services in a facility of the Department;
(B) has been notified by a facility of the
Department that an appointment for hospital care or
medical services is not available within such wait-time
goals after the date for which the veteran requests the
appointment; or
(C) who resides more than 40 miles from the medical
facility of the Department of Veterans Affairs,
including a community-based outpatient clinic, that is
closest to the residence of the veteran.
(c) Definitions.--For purposes of this section, the terms
``facilities of the Department'', ``non-Department facilities'',
``hospital care'', and ``medical services'' have the meanings given
such terms in section 1701 of title 38, United States Code.
(d) Implementation.--The Secretary shall begin implementing this
section on the date of the enactment of this Act.
(e) Construction.--Nothing in this section shall be construed to
authorize payment for care or services not otherwise covered under
chapter 17 of title 38, United States Code.
(f) Termination.--The authority of the Secretary under this section
shall terminate with respect to care or services furnished after the
date that is 2 years after the date of the enactment of this Act.
SEC. 4. INDEPENDENT ASSESSMENT OF VETERANS HEALTH ADMINISTRATION
PERFORMANCE.
(a) Independent Assessment Required.--Not later than 120 days after
the date of the enactment of this Act, the Secretary of Veterans
Affairs shall enter into a contract or contracts with a private sector
entity or entities with experience in the delivery systems of the
Veterans Health Administration and the private sector and in health
care management to conduct an independent assessment of hospital care
and medical services furnished in medical facilities of the Department
of Veterans Affairs. Such assessment shall address each of the
following:
(1) The current and projected demographics and unique care
needs of the patient population served by the Department of
Veterans Affairs.
(2) The current and projected health care capabilities and
resources of the Department, including hospital care and
medical services furnished by non-Department facilities under
contract with the Department, to provide timely and accessible
care to eligible veterans.
(3) The authorities and mechanisms under which the
Secretary may furnish hospital care and medical services at
non-Department facilities, including an assessment of whether
the Secretary should have the authority to furnish such care
and services at such facilities through the completion of
episodes of care.
(4) The appropriate system-wide access standard applicable
to hospital care and medical services furnished by and through
the Department of Veterans Affairs and recommendations relating
to access standards specific to individual specialties and
standards for post-care rehabilitation.
(5) The current organization, processes, and tools used to
support clinical staffing and documentation.
(6) The staffing levels and productivity standards,
including a comparison with industry performance percentiles.
(7) Information technology strategies of the Veterans
Health Administration, including an identification of
technology weaknesses and opportunities, especially as they
apply to clinical documentation of hospital care and medical
services provided in non-Department facilities.
(8) Business processes of the Veterans Health
Administration, including non-Department care, insurance
identification, third-party revenue collection, and vendor
reimbursement.
(b) Assessment Outcomes.--The assessment conducted pursuant to
subsection (a) shall include the following:
(1) An identification of improvement areas outlined both
qualitatively and quantitatively, taking into consideration
Department of Veterans Affairs directives and industry
benchmarks from outside the Federal Government.
(2) Recommendations for how to address the improvement
areas identified under paragraph (1) relating to structure,
accountability, process changes, technology, and other relevant
drivers of performance.
(3) The business case associated with making the
improvements and recommendations identified in paragraphs (1)
and (2).
(4) Findings and supporting analysis on how credible
conclusions were established.
(c) Program Integrator.--If the Secretary enters into contracts
with more than one private sector entity under subsection (a), the
Secretary shall designate one such entity as the program integrator.
The program integrator shall be responsible for coordinating the
outcomes of the assessments conducted by the private entities pursuant
to such contracts.
(d) Submittal of Reports to Congress.--
(1) Report on independent assessment.--Not later than 10
months after entering into the contract under subsection (a),
the Secretary shall submit to the Committees on Veterans'
Affairs of the Senate and House of Representatives the findings
and recommendations of the independent assessment required by
such subsection.
(2) Report on va action plan to implement recommendations
in assessment.--Not later than 120 days after the date of
submission of the report under paragraph (1), the Secretary
shall submit to such Committees on the Secretary's response to
the findings of the assessment and shall include an action
plan, including a timeline, for fully implementing the
recommendations of the assessment.
SEC. 5. LIMITATION ON AWARDS AND BONUSES TO EMPLOYEES OF DEPARTMENT OF
VETERANS AFFAIRS.
For each of fiscal years 2014 through 2016, the Secretary of
Veterans Affairs may not pay awards or bonuses under chapter 45 or 53
of title 5, United States Code, or any other awards or bonuses
authorized under such title.
SEC. 6. OMB ESTIMATE OF BUDGETARY EFFECTS AND NEEDED TRANSFER
AUTHORITY.
Not later than 30 days after the date of the enactment of this Act,
the Director of the Office of Management and Budget shall transmit to
the Committees on Appropriations, the Budget, and Veterans' Affairs of
the House of Representatives and of the Senate--
(1) an estimate of the budgetary effects of sections 2 and
3;
(2) any transfer authority needed to utilize the savings
from section 5 to satisfy such budgetary effects; and
(3) if necessary, a request for any additional budgetary
resources, or transfers or reprogramming of existing budgetary
resources, necessary to provide funding for sections 2 and 3.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Veterans' Affairs.
Mr. Miller (FL) moved to suspend the rules and pass the bill.
Considered under suspension of the rules. (consideration: CR H5196-5200)
DEBATE - The House proceeded with forty minutes of debate on H.R. 4810.
At the conclusion of debate, the Yeas and Nays were demanded and ordered. Pursuant to the provisions of clause 8, rule XX, the Chair announced that further proceedings on the motion would be postponed.
Considered as unfinished business. (consideration: CR H5203, H5211-5212)
Passed/agreed to in House: On motion to suspend the rules and pass the bill Agreed to by the Yeas and Nays: (2/3 required): 0 - 0 (Roll no. 275).
Roll Call #275 (House)On motion to suspend the rules and pass the bill Agreed to by the Yeas and Nays: (2/3 required): 0 - 0 (Roll no. 275).
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VACATING PROCEEDINGS ON ROLL CALL 275 - Mr. Rodney Davis (IL) asked unanimous consent that the proceedings on roll call vote number 275, the motion to suspend the rules on H.R. 4810, be vacated to the end that the Chair put the question de novo. Agreed to without objection.
Passed/agreed to in House: On motion to suspend the rules and pass the bill Agreed to by recorded vote (2/3 required): 426 - 0 (Roll no. 287).(text: CR H5196-5197)
Roll Call #287 (House)On motion to suspend the rules and pass the bill Agreed to by recorded vote (2/3 required): 426 - 0 (Roll no. 287). (text: CR H5196-5197)
Roll Call #287 (House)Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs.