[Congressional Record Volume 163, Number 57 (Monday, April 3, 2017)]
[Senate]
[Pages S2163-S2164]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
AMENDING THE VETERANS ACCESS, CHOICE, AND ACCOUNTABILITY ACT OF 2014
Mr. TESTER. Madam President, I ask unanimous consent that the
Committee on Veterans' Affairs be discharged from further consideration
of S. 544 and the Senate proceed to its immediate consideration.
The PRESIDING OFFICER. Without objection, it is so ordered.
The clerk will report the bill by title.
The senior assistant legislative clerk read as follows:
A bill (S. 544) to amend the Veterans Access, Choice, and
Accountability Act of 2014 to modify the termination date for
the Veterans Choice Program, and for other purposes.
There being no objection, the Senate proceeded to consider the bill.
Mr. TESTER. Madam President, I know of no further debate on the bill.
The bill was ordered to be engrossed for a third reading and was read
the third time.
The PRESIDING OFFICER. The bill having been read the third time, the
question is, Shall the bill pass?
The bill (S. 544) was passed, as follows:
S. 544
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. MODIFICATION OF TERMINATION DATE FOR VETERANS
CHOICE PROGRAM.
Section 101(p)(2) of the Veterans Access, Choice, and
Accountability Act of 2014 (Public Law 113-146; 38 U.S.C.
1701 note) is amended by striking ``, or the date that is 3
years after the date of the enactment of this Act, whichever
occurs first''.
SEC. 2. ELIMINATION OF REQUIREMENT TO ACT AS SECONDARY PAYER
FOR CARE RELATING TO NON-SERVICE-CONNECTED
DISABILITIES AND RECOVERY OF COSTS FOR CERTAIN
CARE UNDER CHOICE PROGRAM.
(a) In General.--Section 101(e) of the Veterans Access,
Choice, and Accountability Act of 2014 (Public Law 113-146;
38 U.S.C. 1701 note) is amended--
(1) in the subsection heading, by striking ``Other Health-
care Plan'' and inserting ``Responsibility for Costs of
Certain Care'';
(2) in paragraph (1), in the paragraph heading, by striking
``to secretary'' and inserting ``on health-care plans'';
(3) by striking paragraphs (2) and (3);
(4) by redesignating paragraph (4) as paragraph (2); and
(5) by adding at the end the following new paragraph:
``(3) Recovery of costs for certain care.--
``(A) In general.--In any case in which an eligible veteran
is furnished hospital care or medical services under this
section for a non-service-connected disability described in
subsection (a)(2) of section 1729 of title 38, United States
Code, or for a condition for which recovery is authorized or
with respect to which the United States is deemed to be a
third party beneficiary under Public Law 87-693, commonly
known as the `Federal Medical Care Recovery Act' (42 U.S.C.
2651 et seq.), the Secretary shall recover or collect from a
third party (as defined in subsection (i) of such section
1729) reasonable charges for such care or services to the
extent that the veteran (or the provider of the care or
services) would be eligible to receive payment for such care
or services from such third party if the care or services had
not been furnished by a department or agency of the United
States.
``(B) Use of amounts.--Amounts collected by the Secretary
under subparagraph (A) shall be deposited in the Medical
Community Care account of the Department. Amounts so
deposited shall remain available until expended.''.
(b) Conforming Amendment.--Paragraph (1) of such section is
amended by striking ``paragraph (4)'' and inserting
``paragraph (2)''.
SEC. 3. AUTHORITY TO DISCLOSE CERTAIN MEDICAL RECORDS OF
VETERANS WHO RECEIVE NON-DEPARTMENT OF VETERANS
AFFAIRS HEALTH CARE.
Section 7332(b)(2) of title 38, United States Code, is
amended by adding at the end the following new subparagraph:
``(H)(i) To a non-Department entity (including private
entities and other Federal agencies) that provides hospital
care or medical services to veterans as authorized by the
Secretary.
``(ii) An entity to which a record is disclosed under this
subparagraph may not redisclose or use such record for a
purpose other than that for which the disclosure was made.''.
Mr. TESTER. Madam President, I ask unanimous consent that the motion
to reconsider be considered made and laid upon the table.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. TESTER. Madam President, I want to thank Senator Moran and
members of the Veterans' Affairs Committee for all their good work,
Senator McCain for his good work, and Chairman John Isakson for his
good work on this bill.
This Veterans Choice Program Improvement Act is an important piece of
legislation that is going to really ensure that veterans can access
care in their communities. It is a critically important piece of
legislation that we should get done and get done now.
I think this body could learn from the work that was done on the
Veterans' Affairs Committee under the leadership of Chairman Isakson
for the veterans of this country. I don't think my home State of
Montana is any exception. Veterans have been waiting far too long for
an appointment at the VA and oftentimes had to drive 100 miles for an
appointment. That is why we set up the Choice Program. It was supposed
to allow these veterans to get their healthcare closer to home.
Unfortunately, it did not work the way it should have. And we were
inundated with redtape and a government contractor that struggled to
schedule appointments with providers on time.
This Veterans Choice Program Improvement Act is not the end all. It
is not what is going to fix the Choice Program in its entirety, but it
certainly is a step in the right direction, a step that needed to be
taken, and I commend the body for allowing this step to be taken.
I yield the floor.
The PRESIDING OFFICER. The Senator from Kansas.
Mr. MORAN. Madam President, I thank the Senator from Montana for his
efforts to see that this legislation gets passed. I am pleased to see
that we have been joined in a unanimous way by the Senate, Republicans
and Democrats working together to see that our veterans receive better
care.
In addition to the Senator from Montana, I thank Mr. McCain, the
Senator from Arizona, who is joining us on the floor. I also thank
Senator Isakson in particular, the chairman of the Veterans' Affairs
Committee, for his leadership in seeing that we are here today to bring
this legislation across the finish line.
The House passed legislation similar to this, so this is an
opportunity for us to get an accomplishment--not for a pat on our backs
but for the improvement in the care of those who served
[[Page S2164]]
our Nation. I asked this question on the Senate floor before: Of all
the people in the United States, who would you expect to get the best
care possible? While we want every American to have high-quality care
and access to medical treatment, we certainly want to make certain
those who served our country and to whom a commitment was made that
they would receive care--we want that commitment fulfilled, and we want
it done in a way that is advantageous and easy for our veterans.
The Senator from Montana is correct. The Choice Act is a significant
improvement, in my mind, for accessing care. Kansas is not quite as
large as the State of Montana, but we are a large rural State, and it
is a long distance to a VA hospital. So Choice was brought into play to
try to alleviate the backlog, the lack of providers within the VA, and
the wait times that veterans faced, but also to try to satisfy the
needs of veterans who live long distances from a VA facility.
So Choice is in place, but it still has been a difficult time for
many veterans across the country and certainly at home. It is the most
common conversation I have when I am back in Kansas. In fact, I had a
townhall meeting in southwest Kansas, in Dodge City, and it is veterans
who, in the public forum, will tell me about the problems with the VA
and particularly with Choice, or they will line up after or before that
meeting to tell me in person that they need help.
This legislation does three significant things. More is to come. We
need a permanent act. This is an extension of the Choice Act that
expires on August 7, so continuing the program is the first step while
we work out the desired outcome of a long-term permanent program.
Secondly, it provides the money through that period of time. It
allows the expenditure of dollars to pay for Choice.
Third, it eliminates the intermediary--somebody separate from the VA
in paying the bills--and that reduces the bureaucracy and burden on our
veterans.
I was just looking through what we call casework, things Kansans
bring to our office to try to get solved. Front and center is the
number of veterans who are being harassed by collection agencies for
bills they thought would be paid by the VA through the Choice Program,
and they are not being paid in a timely fashion. This eliminates the
intermediary--the manager of the program--from paying the bills and
restores that authority to the VA to write out the checks with the goal
of reducing the bureaucracy and paperwork for the veterans. It also
increases the timeliness for the payment that is due the healthcare
provider--the doctor, the pharmacy, and the hospital.
Again, as a rural American, many of our providers are struggling.
Hospital doors are a challenge to remain open in rural communities
across my State. And that long wait for a reimbursement check for
services provided months ago also creates a burden on that hospital,
that healthcare provider. So timely payment certainly will benefit the
veterans, but it also increases the chances of the stability of
healthcare providers in rural communities across my State and around
the country.
Finally, it increases the ability for the sharing of medical records
between the VA and that community healthcare provider.
Choice is in place to help those veterans who need to have care more
quickly and who need to have care closer to home. This bill improves
that program and extends it, and that is a significant development. I
appreciate the opportunity I have had to work with the Senators from
Arizona, Montana, and Georgia to make sure we got to the point we are
today. I appreciate my colleagues' unanimous support for the passage of
this legislation.
I yield the floor.
The PRESIDING OFFICER. The Senator from Arizona.
Mr. McCAIN. Madam President, I want to thank the Senator from Kansas
for all the hard work he has done, and the Senator from Montana. On the
rare occasion I come to praise him, I would like to give him my deep
and heartfelt appreciation for his work in a bipartisan fashion on this
issue. I mean that with all sincerity. I also thank our distinguished
chairman, Senator Isakson. I also think I share with my colleagues an
appreciation for Dr. Shulkin, the new Secretary of the Veterans'
Administration, who has been an active and helpful participant in this
effort.
Most everything has been said except that I would like to remind my
colleagues that we now have--since the enactment in 2014, over 7
million appointments have been made using the Choice Program. Now, over
30,000 appointments are successfully made each week under the Choice
Program.
The programs are set to expire in a few months, and, as pointed out
by my colleagues, the VA has already begun to limit care for pregnant
mothers, as well as cancer patients, because their treatment would
extend beyond August. Soon all veterans will be kicked off the Choice
Program.
I would just like to point out to my colleagues, if I could, that
this crisis started in Phoenix, AZ, where 15,000 veterans were put on a
wait list and over 40 veterans died while awaiting care. That is not
acceptable in this Nation.
I believe the Choice Program is a major step forward. The truth is,
the VA has a lot more to do to provide for the care we have obligated
this Nation to on behalf of those who have fought and sacrificed for
our Nation. The Choice Card has made a major step forward. I hope we
can consider removing any geographic or other limitations associated
with it. But what the Senators from Kansas and Montana have done today
is to make sure this program continues and why it is important to pass
it today--not one dollar Congress authorized to care for veterans under
the Choice Program should go unused.
Let me mention what we have done. There are 7 million additional
appointments for veterans in their communities, and over 1.5 million
veterans have benefited from using the Choice Card that they would not
have had otherwise. Some 350,000 more doctors, nurse practitioners, and
physician assistants are available to treat veterans. There are 235,000
appointments per month through Veterans Choice--more than 10,000 per
workday. The Veterans Choice Program more than doubles the number of
medical providers nationwide that treat veterans. In Arizona, 11,700
medical providers in veterans communities have treated over 100,000
disabled veterans.
The Veterans Choice Card is being used at 700 hospitals and nearly
10,000 clinics nationwide. The Western Region is paying more than 90
percent of Veterans Choice doctors in less than 30 days and answering
900,000 phone calls per month, with an average time to answer of under
25 seconds. Over 3,000 veterans received hepatitis C treatments due to
Veterans Choice funding.
There are still kinks in the operation. There are still bottlenecks.
There are still times when veterans' payments, particularly, have not
been done in a timely fashion, as the Senator from Kansas mentioned.
Hopefully, that will change now. As with any program, it had its
difficulties in its beginning. But I want to tell my colleagues that we
should make the Choice Card available for any veteran, no matter where
they happen to reside. It should be, I believe, the basis of our next
effort. But in the meantime, I want to thank again the Senator from
Kansas for his hard work.
I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The senior assistant legislative clerk proceeded to call the roll.
Mr. CORNYN. Madam President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
____________________