[Congressional Record Volume 145, Number 1 (Wednesday, January 6, 1999)]
[Extensions of Remarks]
[Page E11]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




     INTRODUCTION OF VETERANS' ACCESS TO EMERGENCY CARE ACT OF 1999

                                 ______
                                 

                            HON. LANE EVANS

                              of illinois

                    in the house of representatives

                       Wednesday, January 6, 1999

  Mr. EVANS. Mr. Speaker, today I am introducing legislation to assure 
that all veterans enrolled in VA health care will receive coverage for 
emergency care services delivered both in and outside of VA facilities.
  Currently, most veterans lack access to reimbursement for such care 
unless the emergency occurs on VA grounds.
  Many VA medical centers don't routinely offer emergency services and 
those that do lack an emergency room that is open twenty-four hours a 
day. Compounding the problem is the fact that most VA medical centers 
are further from their patients' places of residence than other 
community providers.
  If a veteran receives emergency room care from a non-VA provider, he 
or she is denied reimbursement even if a trip to the nearest VA 
hospital would be life threatening.
  Last year the President asked all federal agencies to identify where 
they were deficient in complying with the Patient Bill of Rights. The 
VA determined it needed legislation to reimburse veterans for emergency 
care it didn't provide. Wile being encouraged to view VA as their 
managed care provider, veterans could risks financial ruin if VA failed 
to comply with the same emergency care reimbursement standards applied 
to private-sector managed health care providers.
  Even before veterans began enrolling last year for VA care, VA's 
responsibility for reimbursing veterans for the cost of emergency 
health care services was confusing. VA would provide emergency care to 
only those veterans who were either already at VA when the emergency 
occurred or to those veterans who were able to physically present 
themselves at a VA facility before receiving required emergency care 
from a non-VA provider.
  VA's physical ``tag up'' requirement creates confusion for the 
majority of veterans who are not on grounds during an emergency. Too 
often in crisis situations, veterans lack the time to resolve who will 
pay for their care before seeking treatment.
  This situation is likely to become even more confusing as VA begins 
to market itself as a managed care provider featuring enrollment, a 
basic benefits package and a new primary care focus--characteristics 
commonly associated with Health Maintenance Organizations (HMOs). Most 
HMOs reimburse enrollees for pre-authorized emergency care. The pending 
legislation would give VA the authority to reimburse emergency care 
delivered by any provider if veterans had no other coverage for such 
care.
  Many veterans are literally ``banking on'' VA either furnishing or 
reimbursing their care for any condition in an emergency. Too many 
veterans and their families have been financially devastated because 
they assume VA will be there for them in a health crisis. I believe 
veterans should be able to count on VA in an emergency.
  I am encouraged by the recent recommendation by a coalition of 
veterans service organizations, the Independent Budget group, to add 
funds to the FY 2000 VA Medical Care budget in order to provide 
emergency care to veterans. I encourage my colleagues to cosponser and 
support this important legislation.

                          ____________________