H.R. 4810House113th Congress (2013-2015)Passed House

Veteran Access to Care Act of 2014

Introduced June 9, 2014

Legislative Activity

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12 earlier actions
SenateIntro Referral Latest Action

Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs.

June 11, 2014

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HouseIntro Referral

Introduced in House

June 9, 2014

HouseIntro Referral

Referred to the House Committee on Veterans' Affairs.

June 9, 2014

HouseFloor

Mr. Miller (FL) moved to suspend the rules and pass the bill.

June 10, 2014 • 12:29 PM

HouseFloor

Considered under suspension of the rules. (consideration: CR H5196-5200)

June 10, 2014 • 12:29 PM

HouseFloor

DEBATE - The House proceeded with forty minutes of debate on H.R. 4810.

June 10, 2014 • 12:29 PM

HouseFloor

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.

June 10, 2014 • 12:59 PM

HouseFloor

Considered as unfinished business. (consideration: CR H5203, H5211-5212)

June 10, 2014 • 1:20 PM

HouseFloor

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).

June 10, 2014 • 1:50 PM

HouseFloor

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).

June 10, 2014 • 1:50 PM

HouseFloor

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.

June 10, 2014 • 2:48 PM

HouseFloor

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)

June 10, 2014 • 2:48 PM

HouseFloor

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)

June 10, 2014 • 2:48 PM

SenateIntro Referral

Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs.

June 11, 2014

Floor Debate

22 members

What members said about H.R. 4810 on the floor

8 Republicans14 Democrats
Jeff Miller
Rep. Jeff MillerR-FL-1 · Jun 18, 2014

Mr. Speaker, pursuant to House Resolution 628, I offer a motion. Mr. Speaker, this motion is to authorize a conference to combine our two bills into something that is focused on the access and…

Jeff Miller
Rep. Jeff MillerR-FL-1 · Jun 10, 2014

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 4810) to direct the Secretary of Veterans Affairs to enter into contracts for the provision of hospital care and medical services at…

Keith Ellison
Rep. Keith EllisonD-MN-5 · Jun 18, 2014

Mr. Chairman, I have an amendment at the desk. Mr. Chairman, the purpose of this amendment is very simple. It is to help American workers as defense-related factories wind down production. The intent…

Peter J. Visclosky
Rep. Peter J. ViscloskyD-IN-1 · Jun 18, 2014

Will the gentleman yield? I appreciate the gentleman for offering the amendment. I do not oppose it. I would simply mention a concern I have, which is not with the intent of the gentleman's but,…

Kyrsten Sinema
Rep. Kyrsten SinemaD-AZ-9 · Jun 18, 2014

Mr. Speaker, I offer a motion. Mr. Speaker, I offer this motion to instruct because veterans in Arizona and across the country need action from Congress and from the Department of Veterans Affairs.…

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Rodney P. Frelinghuysen
Rep. Rodney P. FrelinghuysenR-NJ-11 · Jun 18, 2014

Will the gentleman yield? The committee wants to commend the gentleman for his support of this program. As you know, this program currently operates, I think, at 65 military installations and…

Sheila Jackson Lee
Rep. Sheila Jackson LeeD-TX-18 · Jun 18, 2014

Mr. Chairman, I have an amendment at the desk. Mr. Chairman, I, again, add my appreciation of the chairman and ranking member of the Appropriations Defense Subcommittee and add my appreciation of…

Rush Holt
Rep. Rush HoltD-NJ-12 · Jun 18, 2014

Mr. Chairman, I have an amendment at the desk. Mr. Chairman, I rise to offer an amendment to address another facet of a national tragedy, the epidemic of suicide among our soldiers and veterans. In…

Jerrold Nadler
Rep. Jerrold NadlerD-NY-10 · Jun 18, 2014

Mr. Chairman, I have an amendment at the desk. Mr. Chairman, this amendment would strike a legislative rider that was put in the bill to prevent the Department of Defense from decommissioning nuclear…

Earl Blumenauer
Rep. Earl BlumenauerD-OR-3 · Jun 18, 2014

Mr. Chairman, I have an amendment at the desk. Mr. Chairman, I yield myself 4 minutes. This is a simple amendment that would cut $3.4 million for a new nuclear-armed, air-launched cruise missile and…

Daniel T. Kildee
Rep. Daniel T. KildeeD-MI-5 · Jun 18, 2014

I have an amendment at the desk, Mr. Chairman. Mr. Chairman, much like the VA, the Department of Defense is confronting significant challenges regarding its care and transition of wounded warriors.…

Richard B. Nugent
Rep. Richard B. NugentR-FL-11 · Jun 18, 2014

Mr. Chairman, I have an amendment at the desk. Mr. Chairman, the Counter-electronics High Power Microwave Missile Project, better known as CHAMP, is an Air Force program to disrupt or eliminate an…

James R. Langevin
Rep. James R. LangevinD-RI-2 · Jun 18, 2014

Mr. Chairman, I have an amendment at the desk. Mr. Chairman, first of all, I rise to offer a very simple amendment to direct the Assistant Secretary of Defense for Health Affairs to increase…

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Tim Murphy
Rep. Tim MurphyR-PA-18 · Jun 18, 2014

Mr. Chairman, I have an amendment at the desk. I thank the gentleman and I also thank the chairman and the ranking member of the committee. I should say that, in addition to being a Member Congress,…

Michael H. Michaud
Rep. Michael H. MichaudD-ME-2 · Jun 10, 2014

Mr. Speaker, I yield myself as much time as I may consume. I rise in support of H.R. 4810, the Veteran Access to Care Act of 2014. I want to thank the chairman for bringing this bill forward. I also…

John K. Delaney
Rep. John K. DelaneyD-MD-6 · Jun 18, 2014

Mr. Chairman, I have an amendment at the desk. Mr. Chairman, I yield myself 3 minutes. We have all been very disturbed by the recent allegations of negligence and of the falsification of information…

Alan S. Lowenthal
Rep. Alan S. LowenthalD-CA-47 · Jun 18, 2014

Mr. Chairman, I have an amendment at the desk. Chairman Frelinghuysen and Ranking Member Visclosky, thank you for providing me this time to speak on the floor today. Mr. Chairman, as we all know,…

Joe Wilson
Rep. Joe WilsonR-SC-2 · Jun 11, 2014

Mr. Speaker, I submit the following remarks regarding my absence from votes which occurred on June 9, 2014 and June 10, 2014 as I participated in a primary election on June 10th. Listed below is how…

John Garamendi
Rep. John GaramendiD-CA-3 · Jun 18, 2014

Mr. Chairman, I have an amendment at the desk. Mr. Chairman, this amendment deals with a profoundly important issue that will be before the House of Representatives and this Nation for the next three…

Michael H. Michaud
Rep. Michael H. MichaudD-ME-2 · Jun 18, 2014

Mr. Speaker, I support the motion to concur in the Senate amendments, and a further amendment, and I support the motion to go to conference. The crisis within the VA is of national interest and must…

Mike Coffman
Rep. Mike CoffmanR-CO-6 · Jun 18, 2014

Mr. Chairman, I have an amendment at the desk. Mr. Chairman, this amendment seeks to take $15.7 million out of the Air Force research, development, test and evaluation account, equal to the amount…

Henry Cuellar
Rep. Henry CuellarD-TX-28 · Jun 10, 2014

Mr. Speaker, I first want to thank my good friend, the chairman, for the great work that he and his staff have been doing, and certainly the ranking member and his staff, who have worked so hard,…

Steve Daines
Rep. Steve DainesR-MT · Jun 18, 2014

Mr. Chairman, I have an amendment at the desk. Mr. Chairman, I yield myself such time as I may consume. Mr. Chairman, our Nation's nuclear triad is an essential aspect of our national defense and…

Tim Huelskamp
Rep. Tim HuelskampR-KS-1 · Jun 10, 2014

Mr. Speaker, I rise in strong support of the Veteran Access to Care Act of 2014. I want to thank the chairman for his leadership not only on this bill, but investigating the current situation at the…

Bill Text

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Referred in SenateIssued June 11, 2014

IIB

113th CONGRESS

2d Session

H. R. 4810

IN THE SENATE OF THE UNITED STATES

June 11, 2014

Received; read twice and referred to the Committee on Veterans' Affairs

AN ACT

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.

1.

Short title

This Act may be cited as the Veteran Access to Care Act of 2014.

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.

(g)

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.

(h)

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.

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.

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.

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.

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.

Passed the House of Representatives June 10, 2014.

Karen L. Haas,

Clerk