Veteran Access To Care Act Of 2014 (H
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The Veteran Access to Care Act of 2014 () is a bill that would allow United States
veterans A veteran () is a person who has significant experience (and is usually adept and esteemed) and expertise in a particular occupation or field. A military veteran is a person who is no longer serving in a military. A military veteran that has ...
to receive their healthcare from non-VA facilities under certain conditions. The bill is a response to the
Veterans Health Administration scandal of 2014 The Veterans Health Administration controversy of 2014 is a reported pattern of negligence in the treatment of United States military veterans. Critics charged that patients at the VHA hospitals had not met the target of getting an appointment ...
, in which it was discovered that there was systematic lying about the wait times veterans experienced waiting to be seen by doctors.Griffin, Richard J., Acting Inspector General
Interim Report: Review of Patient Wait Times, Scheduling Practices, and Alleged Patient Deaths at the Phoenix Health Care System
VA Office of Inspector General, Veterans Health Administration, Dept. of Veterans Affairs, May 28, 2014, 14-02603-178, Washington, D.C., retrieved June 7, 2014
By June 5, 2014, Veterans Affairs internal investigations had identified a total of 35 veterans who had died while waiting for care in the Phoenix VHA system. Another audit determined that "more than 57,000 veterans waited at least 90 days to see a doctor, while another 63,000 over the last decade never received an initial appointment." The bill was introduced into the
United States House of Representatives The United States House of Representatives, often referred to as the House of Representatives, the U.S. House, or simply the House, is the Lower house, lower chamber of the United States Congress, with the United States Senate, Senate being ...
during the
113th United States Congress The 113th United States Congress was a meeting of the legislative branch of the United States federal government, from January 3, 2013, to January 3, 2015, during the fifth and sixth years of Presidency of Barack Obama, Barack Obama's presiden ...
.


Background

CNN CNN (Cable News Network) is a multinational cable news channel headquartered in Atlanta, Georgia, U.S. Founded in 1980 by American media proprietor Ted Turner and Reese Schonfeld as a 24-hour cable news channel, and presently owned by the M ...
reported on April 30, 2014, that at least 40
United States Armed Forces The United States Armed Forces are the military forces of the United States. The armed forces consists of six service branches: the Army, Marine Corps, Navy, Air Force, Space Force, and Coast Guard. The president of the United States is the ...
veterans A veteran () is a person who has significant experience (and is usually adept and esteemed) and expertise in a particular occupation or field. A military veteran is a person who is no longer serving in a military. A military veteran that has ...
died while waiting for care at the
Phoenix, Arizona Phoenix ( ; nv, Hoozdo; es, Fénix or , yuf-x-wal, Banyà:nyuwá) is the List of capitals in the United States, capital and List of cities and towns in Arizona#List of cities and towns, most populous city of the U.S. state of Arizona, with 1 ...
,
Veterans Health Administration The Veterans Health Administration (VHA) is the component of the United States Department of Veterans Affairs (VA) led by the Under Secretary of Veterans Affairs for Health that implements the healthcare program of the VA through a national ...
facilities. By June 5, 2014, Veterans Affairs internal investigations had identified a total of 35 veterans who had died while waiting for care in the Phoenix VHA system. An investigation of delays in treatment throughout the Veterans Health Administration system is being conducted by the Veterans Affairs
Office of the Inspector General In the United States, Office of Inspector General (OIG) is a generic term for the oversight division of a federal or state agency aimed at preventing inefficient or unlawful operations within their parent agency. Such offices are attached to man ...
, and the House has passed legislation to fund a $1 million criminal investigation by the
Justice Department A justice ministry, ministry of justice, or department of justice is a ministry or other government agency in charge of the administration of justice. The ministry or department is often headed by a minister of justice (minister for justice in a ...
. On May 16, 2014, the Veterans Health Administration's top health official, Dr. Robert Petzel, retired early at the request of
Secretary of Veterans Affairs The United States secretary of veterans affairs is the head of the United States Department of Veterans Affairs, the department concerned with veterans' benefits, health care, and national veterans' memorials and cemeteries. The secretary is a me ...
Eric Shinseki Eric Ken Shinseki (; born November 28, 1942) is a retired United States Army general who served as the seventh United States Secretary of Veterans Affairs (2009–2014). His final United States Army post was as the 34th Chief of Staff of the Arm ...
. On May 30, 2014, Secretary Shinseki, himself, resigned from office amid the fallout from the controversy.Obama, Barack, President of the United States
Statement by the President, May 30, 2014
Office of the Press Secretary, The White House, retrieved June 7, 2014
As of early June 2014, several other VA medical centers around the nation have been identified with the same problems as the Phoenix facility, and the investigations by the VA Inspector General, the Congress and others are widening. Giblin, Paul & Rebekah L. Sanders,
VA audit: Staff falsified records to collect bonuses
" from ''The Arizona Republic '' as published in ''USA TODAY,'' May 31, 2014, as retrieved June 7, 2014
Carter, Chelsea J.,
Were bonuses tied to VA wait times? Here's what we know
" Cable News Network (CNN), May 30, 2014, retrieved June 7, 2014
Andrews, Wyatt,
VA bonuses were incentive to hide wait times, whistleblowers say
" CBS News, May 13, 2014, retrieved June 7, 2014
Hennessy-Fiske, Molly & Richard Simon,

" Los Angeles Times, June 4, 2014, retrieved June 7, 2014
Associated Press (AP) Indianapolis, IN,
Coats, Donnelly demand answers on VA wait times
" WTHR News, June 4, 2014, retrieved June 7, 2014


Provisions of the bill

''This summary is based largely on the summary provided by the
Congressional Research Service The Congressional Research Service (CRS) is a public policy research institute of the United States Congress. Operating within the Library of Congress, it works primarily and directly for members of Congress and their committees and staff on a c ...
, a
public domain The public domain (PD) consists of all the creative work A creative work is a manifestation of creative effort including fine artwork (sculpture, paintings, drawing, sketching, performance art), dance, writing (literature), filmmaking, ...
source.'' The Veteran Access to Care Act of 2014 would, in section 2, direct the
Secretary of Veterans Affairs The United States secretary of veterans affairs is the head of the United States Department of Veterans Affairs, the department concerned with veterans' benefits, health care, and national veterans' memorials and cemeteries. The secretary is a me ...
(VA) to enter into contracts with such non-VA facilities as may be necessary to furnish
hospital A hospital is a health care institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emerge ...
care and medical services to veterans who: :*have waited longer than the wait-time goals of the
Veterans Health Administration The Veterans Health Administration (VHA) is the component of the United States Department of Veterans Affairs (VA) led by the Under Secretary of Veterans Affairs for Health that implements the healthcare program of the VA through a national ...
(VHA) (as of June 1, 2014) for an appointment for hospital care or medical services in a VA facility; :*have been notified by a VA facility that an appointment for hospital care or medical services is not available within such wait-time goals; or :*reside more than 40 miles from the VA medical facility, including a community-based outpatient clinic, that is closest to their residence. The bill would allow 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. The bill would direct 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. The bill would terminate 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. Section 3 would direct 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 Tricare (styled TRICARE) is a health care program of the United States Department of Defense Military Health System. Tricare provides civilian health benefits for U.S Armed Forces military personnel, military retirees, and their dependents, in ...
(a
Department of Defense Department of Defence or Department of Defense may refer to: Current departments of defence * Department of Defence (Australia) * Department of National Defence (Canada) * Department of Defence (Ireland) * Department of National Defense (Philippin ...
ODmanaged care program) payment rate for such care or services. The bill would terminate the Secretary's authority to reimburse non-VA facilities for the provision of such care and services two years after this Act's enactment. Section 4 would direct 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. The bill would list the factors that must be addressed in assessing veterans access to, and the quality of, hospital care and medical services in VA facilities. The bill would direct 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. Section 5 would prohibit the Secretary from paying awards and bonuses to VA employees for FY2014-FY2016. Section 6 would require the Director of the
Office of Management and Budget The Office of Management and Budget (OMB) is the largest office within the Executive Office of the President of the United States (EOP). OMB's most prominent function is to produce the president's budget, but it also examines agency programs, pol ...
(OMB), within 30 days of this Act's enactment, to transmit to Congress: :*an estimate of the budgetary effects of this Act's coverage of hospital care and medical services for veterans in non-VA facilities; :*any transfer authority needed to utilize the savings from denying VA awards and bonuses to satisfy such budgetary effects; and :*a request, if necessary, for additional funding, or the transfer or reprogramming of existing funding, for this Act's coverage of the hospital care and medical services provided to veterans in non-VA facilities.


Congressional Budget Office report

''This summary is based largely on the summary provided by the
Congressional Budget Office The Congressional Budget Office (CBO) is a federal agency within the legislative branch of the United States government that provides budget and economic information to Congress. Inspired by California's Legislative Analyst's Office that manages ...
, a
public domain The public domain (PD) consists of all the creative work A creative work is a manifestation of creative effort including fine artwork (sculpture, paintings, drawing, sketching, performance art), dance, writing (literature), filmmaking, ...
source.'' H.R. 4810 would authorize the
Department of Veterans Affairs The United States Department of Veterans Affairs (VA) is a Cabinet-level executive branch department of the federal government charged with providing life-long healthcare services to eligible military veterans at the 170 VA medical centers and ...
(VA) to increase the provision of health care by contracting out to non-VA providers. For that purpose, the Secretary would be able to use available appropriations. Thus, the
Congressional Budget Office The Congressional Budget Office (CBO) is a federal agency within the legislative branch of the United States government that provides budget and economic information to Congress. Inspired by California's Legislative Analyst's Office that manages ...
(CBO) anticipates that this bill would make available some appropriated funds that would otherwise lapse - an estimated $620 million over the 2014-2016 period. In addition to those direct spending costs shown above, the bill would also substantially increase spending for veterans' health care, if sufficient appropriations were provided for that purpose. The CBO has not completed an estimate of the discretionary costs.


Procedural history

The Choice Act proposal was introduced to the late senator John McCain on April 18, 2014 by disabled veteran Ricky C. Barnes of Phoenix, Arizona https://www.24-7pressrelease.com/press-release/494376/ricky-c-barnes-has-been-inducted-into-the-prestigious-marquis-whos-who-biographical-registry. Mr. Barnes aspiration for non-VA care for all veterans began 1999 and was finally introduced to the
United States House of Representatives The United States House of Representatives, often referred to as the House of Representatives, the U.S. House, or simply the House, is the Lower house, lower chamber of the United States Congress, with the United States Senate, Senate being ...
in 2014. He was also instrumental in the uncovering of the 2014 Phoenix VA Scandal. The Veteran Access to Care Act of 2014 was introduced into the
United States House of Representatives The United States House of Representatives, often referred to as the House of Representatives, the U.S. House, or simply the House, is the Lower house, lower chamber of the United States Congress, with the United States Senate, Senate being ...
on June 9, 2014, by Rep. Jeff Miller (R-FL). The bill was referred to the
United States House Committee on Veterans' Affairs The standing Committee on Veterans' Affairs in the United States House of Representatives oversees agencies, reviews current legislation, and recommends new bills or amendments concerning U.S. military veterans. Jurisdiction includes retiring and ...
. On June 20, 2014, the House voted to pass the bill i
Roll Call Vote 287
by a vote of 426–0. This was actually the second vote the House made on the bill because some members who missed the first vote asked for a re-vote so that they could be on the record in support of the bill. One of the Representatives who missed the vote did so because he was recovering from brain surgery. The Veteran Access to Care Act of 2014 was received in the
United States Senate The United States Senate is the upper chamber of the United States Congress, with the House of Representatives being the lower chamber. Together they compose the national bicameral legislature of the United States. The composition and pow ...
on June 11, 2014, and was referred to the
United States Senate Committee on Veterans' Affairs The United States Senate Committee on Veterans' Affairs deals with oversight of United States veterans problems and issues. Description The committee was created in 1970 to transfer responsibilities for veterans from the Finance and Labor commit ...
. On June 11, 2014, the Senate passed its own VA reform bill, the
Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 The Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 (; ), also known as the Veterans Choice Act, is a United States public law that is intended to address the ongoing Veterans Health Administration scandal of ...
. Chairman of the House Committee on Veterans Affairs Jeff Miller said that "many of the provisions included in today's Senate-passed bill are based on ideas that have already cleared the House, so I'm hopeful both chambers of Congress can soon agree on a final package to send to the president's desk."


Debate and discussion

Rep. Jeff Miller, who sponsored the bill, said that the wait times veterans were forced to face was "a national disgrace." Rep.
Michael Michaud Michael Herman Michaud (born January 18, 1955) is an American businessman and politician from Maine. Michaud served as the U.S. representative for from 2003 to 2015. He is a member of the Democratic Party. The primarily rural district comprise ...
(D-ME) argued that the care veterans receive at the VA is not the problem, but the wait times were. Michaud stated that "we often hear that the care veterans receive at the VA facilities is second to none. That is, if you can get in... Tens of thousands of veterans are not getting in." Rep.
Julia Brownley Julia Andrews Brownley (born August 28, 1952) is an American businesswoman and politician who has been the United States representative for California's 26th congressional district since 2013. A Democrat, she served in the California State Assem ...
(D-CA) argued that the legislation should consider time as well as distance when it came to allowing veterans to visit non-VA medical centers. Brownley argued that "those of us who represent urban areas like Southern California we all know that 40 miles can take the better part of a day to traverse back and forth."


See also

*
List of bills in the 113th United States Congress The bills of the 113th United States Congress list includes proposed federal laws that were introduced in the 113th United States Congress. This Congress lasted from January 3, 2013, to January 3, 2015. The United States Congress is the bicamer ...
*
List of Veterans Affairs medical facilities Veterans' health care in the United States is separated geographically into 19 regions (numbered 1, 2, 4-10, 12 and 15–23) In January 2002, the Veterans Health Administration announced the merger of VISNs 13 and 14 to create a new, combined netw ...
*
Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 The Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 (; ), also known as the Veterans Choice Act, is a United States public law that is intended to address the ongoing Veterans Health Administration scandal of ...


References


External links


Library of Congress - Thomas H.R. 4810beta.congress.gov H.R. 4810GovTrack.us H.R. 4810OpenCongress.org H.R. 4810House Republican Conference's legislative digest on H.R. 4810
{{DEFAULTSORT:Veteran Access to Care Act of 2014 (H.R. 4810 113th Congress) Proposed legislation of the 113th United States Congress