[Congressional Record Volume 150, Number 138 (Tuesday, December 7, 2004)]
[Senate]
[Page S11885]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




            VETERANS HEALTH PROGRAMS IMPROVEMENT ACT OF 2004

  Mr. GRAHAM of Florida. Mr. President, I rise today to applaud the 
passage of H.R. 3936, which is essentially a conference report on 
various veterans' health care measures. This bill will go far in giving 
the Department of Veterans Affairs, VA, the tools it needs to continue 
providing high-quality health care to our Nation's veterans. Though the 
bill contains many important provisions, I would like to draw attention 
to just a few of its key ones.
  H.R. 3936 would authorize specialized centers to improve the 
rehabilitation services available to veterans suffering from multiple 
combat injuries. The centers would focus on all aspects involved in the 
development of improved rehabilitation programs, including through 
research, education, and clinical activities. These comprehensive 
centers are designed specifically to fill the gap that currently exists 
in the treatment of the complex injuries that result from modern 
conflict. Due to technological advancements in warfare and body armor, 
as well as improvements in battlefield medical care, an increased 
number of service personnel are surviving wounds that probably would 
have been fatal in previous wars.
  The centers would be part of a larger collaboration effort between 
the Department of Veterans Affairs, VA, and the Department of Defense, 
DoD, in order to improve the rehabilitation process and treatment of 
these service members once they have returned from overseas. The 
initiative as a whole truly represents the way in which VA health care 
is evolving with changes in the areas of warfare and health care 
delivery.
  The Veterans Health Programs Improvement Act of 2004 also would 
require VA to track waiting times for specialty care services and 
subsequently issue to Congress a report on any such waiting times of 
more than 3 months. VA has been suffering from a severe shortage of 
specialty care physicians. This shortage has led to significant 
increases in the time it takes for veterans to get appointments for 
specialty services like audiology and ophthalmology.
  This compromise legislation would also provide a fix for the way VA 
per diem payments to State homes for veterans are handled, as they 
relate to Medicaid. Recently, many State homes have become Medicaid-
certified to secure eligibility for payment for any veteran who 
qualifies under the Medicaid program. However, Medicaid officials 
determined that VA per diem payments made to State homes for the care 
of veterans are ``additional payments'' made on behalf on an individual 
patient. Thus, VA's per diem payments must be reimbursed to the 
Medicaid program. This provision would specify that per diem payments 
made by VA for the care of veterans in State homes will not be used to 
offset or reduce any other payment made to assist veterans in securing 
health care services. The impact of this change will be felt in many 
States across the country, including my home State of Florida.
  Mr. President, I am proud to have contributed to legislation that is 
so vital to the continued provision of quality health care to our 
Nation's veterans. I thank my colleagues in both Chambers of Congress 
for their support of this measure.

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