From FNC’s Chad Pergram:
Urgent: Summary of VA bill deal
SUMMARY—The Veterans’ Access to Care Act of 2014
Section 1 Short title and table of contents.
TITLE I-IMPROVEMENT OF ACCESS TO CARE FROM NON-DEPARTMENT OF VETERANS AFFAIRS PROVIDERS
Expanded availability of hospital care and medical services for veterans through the use of agreements (including contracts, intergovernmental agreements and provider agreements) with non-Department of Veterans Affairs entities, limited to
1) Providers participating in Medicare
2) Federally-qualified health center (FQHC)
3) Department of Defense DoD
4) Indian Health Service (IHS)
To the greatest extent possible, the VA will use agreements entered into under other provisions of law including PC3 and intergovernmental agreements with FQHC, DoD and IHS. Eligible veterans can choose from the providers listed above.
VA will coordinate care under this new authority using the Non-VA Care Coordination Program.
1) Eligible veterans must be already enrolled as of August 1, 2014 (or eligible to enroll under the 5 year enrollment window for Iraq/Afghanistan veterans), and
2) Attempts to schedule an appointment but is unable to receive an appointment within current wait time goals and elects to receive care outside VA, or
3) Resides more than 40 miles from VA facility, including a CBOC (or is required to travel by air, boat, or ferry more than 20 miles), or
4) Resides in a State w/o medical facility that provides hospital care, emergency services and standard surgical services, and resides more than 20 miles from such facility
If veteran chooses to participate and the VA confirms a wait time beyond current goals the veteran can go on the Electronic Wait List or if authorized by VA, utilize non-VA providers as described above.
Follow-up care limited to 60 days per episode of care.
Rates limited to Medicare rates unless a highly rural location.
Establishes a Veterans Choice Card
Various Reports required including IG report on accuracy and timeliness of payments and VA reports on program utilization.
Ensures veterans will disclose information on other health care plans prior to receiving coverage under this section. Ensures other health-care plans are primarily responsible for non-service connected care, VA is secondarily responsible. In these cases, providers will be responsible for seeking reimbursement from the appropriate health care plans.
Section 102 – Collaboration between VA and IHS
Would require VA, in consultation with IHS, to conduct more outreach to IHS tribal health programs to ensure they are aware of the opportunity to negotiate a reimbursement agreement, define metrics and report to Congress.
Section 103 – Collaboration between VA and Native Hawaiian Health Care Systems
Would require VA to enter into contracts or agreements with the Native Hawaiian health care systems for reimbursement of direct care services provided to eligible veterans.
Section 104 – Extension of ARCH
Would extend ARCH for two years.
Section 105 – Comptroller General (GAO) Report on Prompt Payment
Requires report within one year on timeliness of payments by the VA to non-VA providers.
TITLE II – HEALTH CARE ADMINISTRATIVE MATTERS
Section 201 – Independent assessment of the health care delivery systems and management processes of VA
Would require an independent assessment of hospital care and medical services furnished in VA medical facilities. Requires a program integrator if multiple contracts. Report to Congress within 10 months of contract award and VA plan of action within 120 days of first report.
Section 202 – Commission on Access to Care
Establishes a presidentially appointed Commission on Access to Care to examine the access of veterans to health care and strategically examine how best to organize VHA, locate health care resources, and deliver health care to veterans. The Commission would be required to report initial findings and recommendations within 90 days of its first meeting, and would be required to provide a final report within 180 days of such meeting.
Section 203 – Technology task force on review of scheduling system and software of the VA
Report from a technology organization(s) to propose specific actions that VA can take to improve its scheduling software and determine whether an existing off-the-shelf system would meet the Department’s needs within 45 days of enactment.
Section 204 – Extension of authority of the Department to collect payment for the provision of care to certain veterans
One year extensions under sections 1710(f)(2)(B) and 1729(a)(2)(E).
Section 205 – Improvement of access of veterans to mobile vet centers and medical units of the VA
Would require VA to improve access to health care services, including telemedicine, by standardizing requirements for the operation of mobile vet centers and mobile medical units. Requires annual report from VA.
Section 206 – Performance Metrics
Ensures that scheduling and wait-time metrics are not used as factors in determining the performance of certain employees for purposes of determining whether to pay performance awards to such employees. Modifies the performance plans of the directors of VISNs and VAMCs to ensure that such plans are based on the quality of care received by veterans including reviews and recommendations by the VAOIG and the Joint Commission.
Section 207 – Improved transparency concerning health care provided by VA
Section 703 – Extension of reduction in amount of pension furnished by Department of Veterans Affairs for certain veterans covered by Medicaid plans for services furnished by nursing facilities
Would amend section 5503(d)(7) to extend, through September 30, 2024, current eligibility restrictions for recipients of a VA pension who receive Medicaid-covered nursing home care..
Section 704 – Extension of requirement for collection of fees for housing loans guaranteed by the Secretary of Veterans Affairs
Would amend the fee schedule set forth in section 3729(b)(2) of title 38, U.S.C., by extending VA’s authority to collect certain fees through September 30, 2024.
Section 705 – Expansion of Marine Gunnery Sergeant John David Fry Scholarship
Would, for each of FYs 2014 through 2016, prohibit the Secretary of Veterans Affairs from paying awards or bonuses under chapter 45 or 53 of title 5, United States Code, or any other awards or bonuses authorized under such title.
Section 706 – Extension of Authority to Use Income Information
Extends authority under section 5317(g) through September 30, 2104.
Section 707 – Removal of senior executive employees of the VA for performance or misconduct
Provides the Secretary with authority to fire or downgrade senior executive employees at the VA based on performance or misconduct. Employees will be allowed an appeal to the Merit System Protection Board which will require an expedited review by the Administrative Judge within 21 days of the date of appeal. If no decision by the judge within 21 days the removal or transfer is final.
TITLE VIII – OTHER MATTERS
Section 801 – Appropriation of Amounts.
Provides $5 billion in mandatory emergency funding to pay for hiring staff and to pay for sections 301 and 302, maintain and operate VHA facilities, maintenance contracts, leases and minor construction. Requires a report from VA.
Section 802 – Veterans Choice Fund.
Provides $10 billion in mandatory emergency funding to carry out section 101. The funds shall remain available until expended.
Section 803 – Emergency Designations.
The Act is designated as an emergency requirement under section 4(g) of the Statutory Pay-As-You-Go Act of 2010 (2 U.S.C. 933(g)).
Senior Producer for Capitol Hill