[Congressional Record Volume 163, Number 124 (Monday, July 24, 2017)]
[House]
[Pages H6171-H6172]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         VA PROVIDER EQUITY ACT

  Mr. ROE of Tennessee. Mr. Speaker, I move to suspend the rules and 
pass the bill (H.R. 1058) to amend title 38, United States Code, to 
clarify the role of podiatrists in the Department of Veterans Affairs, 
as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 1058

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``VA Provider Equity Act''.

     SEC. 2. ROLE OF PODIATRISTS IN DEPARTMENT OF VETERANS 
                   AFFAIRS.

       (a) Inclusion as Physician.--
       (1) In general.--Subchapter I of chapter 74 of title 38, 
     United States Code, is amended by adding at the end the 
     following new section:

     ``Sec. 7413. Treatment of podiatrists; clinical oversight 
       standards

       ``(a) Podiatrists.--Except as provided by subsection (b), a 
     doctor of podiatric medicine who is appointed as a podiatrist 
     under section 7401(1) of this title is eligible for any 
     supervisory position in the Veterans Health Administration to 
     the same degree that a physician appointed under such section 
     is eligible for the position.
       ``(b) Establishment of Clinical Oversight Standards.--The 
     Secretary, in consultation with appropriate stakeholders, 
     shall establish standards to ensure that specialists 
     appointed in the Veterans Health Administration to 
     supervisory positions do not provide direct clinical 
     oversight for purposes of peer review or practice evaluation 
     for providers of other clinical specialties.''.
       (2) Clerical amendment.--The table of sections at the 
     beginning of such chapter is amended by inserting after the 
     item relating to section 7412 the following new item:

``7413. Treatment of podiatrists; clinical oversight standards.''.

       (b) Modification and Clarification of Pay Grade.--
       (1) Grade.--The list in section 7404(b) of such title is 
     amended--
       (A) by striking ``PHYSICIAN AND DENTIST SCHEDULE'' and 
     inserting ``PHYSICIAN AND SURGEON (MD/DO), PODIATRIC SURGEON 
     (DPM), AND DENTIST AND ORAL SURGEON (DDS, DMD) SCHEDULE'';
       (B) by striking, ``Physician grade'' and inserting 
     ``Physician and surgeon grade''; and
       (C) by striking ``PODIATRIST, CHIROPRACTOR, AND,'' and 
     inserting ``CHIROPRACTOR AND''.
       (2) Application.--The amendment made by paragraph (1) shall 
     apply with respect to a pay period of the Department of 
     Veterans Affairs beginning on or after the date that is 30 
     days after the date of the enactment of this Act.

     SEC. 3. 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.

       Section 5503(d)(7) of title 38, United States Code, is 
     amended by striking ``September 30, 2024'' and inserting 
     ``September 30, 2026''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Tennessee (Mr. Roe) and the gentleman from Minnesota (Mr. Walz) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Tennessee.


                             General Leave

  Mr. ROE of Tennessee. Mr. Speaker, I ask unanimous consent that all 
Members have 5 legislative days in which to revise and extend their 
remarks and to include extraneous material.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Tennessee?
  There was no objection.
  Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I rise today in support of H.R. 1058, as amended, the VA 
Provider Equity Act. This legislation would recognize the professional 
contribution of hardworking podiatrists within the Department of 
Veterans Affairs healthcare system.
  The VA standard for compensating podiatrists has not been updated in 
41 years. In that time, education and training for podiatrists has been 
revolutionized.
  As a result of the VA's failure to recognize and respond to 
advancements in podiatry practice, it has created significant 
disparities in pay and advancement opportunities for podiatrists 
practicing at the VA in comparison to their peers in the private 
sector.
  Consequently, the VA struggles to recruit and retain experienced, 
qualified podiatrists--those we want caring for our veterans--at a time 
when veteran need for podiatry care is increasing.
  This legislation would solve that problem by allowing VA podiatrists 
the opportunity to seek leadership opportunities at VA medical 
facilities and making podiatry pay equal to physician and dentist pay 
within the VA healthcare system.
  I am grateful to my good friend, fellow veteran, and committee 
member, Dr. Brad Wenstrup, the chairman of the Subcommittee on Health, 
for his leadership in recognizing what an important issue this is and 
being thoughtful and tenacious in pursuit of a solution to it.
  I am proud to join Dr. Wenstrup in fully supporting this legislation 
and urge all of my colleagues to do the same.
  Mr. Speaker, I reserve the balance of my time.
  Mr. WALZ. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I support H.R. 1058, as amended. The VA Provider Equity 
Act is a commonsense solution to a really important problem that is 
plaguing the VHA--a shortage of healthcare providers.
  This legislation would allow VHA to attract the talented and 
experienced podiatrists it needs to better treat conditions caused by 
lower extremity injuries.
  By allowing podiatrists the opportunity to advance within the VHA 
while earning pay comparable to what private sector podiatrists earn, 
VHA can better attract and retain these providers.
  I appreciate the gentleman from Ohio, Dr. Wenstrup's, work 
highlighting this, educating all of us on the committee, and making 
sure that the treatments of podiatrists between VHA and the private 
sector industry is aligned.
  Mr. Speaker, I urge my colleagues to support this good piece of 
legislation, and I reserve the balance of my time.
  Mr. ROE of Tennessee. Mr. Speaker, I yield 2 minutes to the gentleman 
from Ohio (Mr. Wenstrup). Colonel Wenstrup is a member of the Veterans' 
Affairs Committee.
  Mr. WENSTRUP. Mr. Speaker, I rise in support of H.R. 1058, the VA 
Provider Equity Act, as amended, which would strengthen access to the 
comprehensive first-class healthcare that veterans deserve.
  Podiatric care is one of the top needs at VA medical centers across 
the country. Veterans of the wars in Iraq and Afghanistan report high 
rate of musculoskeletal ailments resulting from lower extremity 
injuries inflicted by improvised explosive devices.
  Veterans of previous wars also experience higher instances of foot 
and ankle ailments caused by aging, diabetes, and service-connected 
disabilities. All of this leads to increased demand for podiatric care 
at the VHA.
  However, VA struggles to recruit and retain podiatrists due to a 
disparity in pay and leadership opportunities in comparison to both 
podiatrists in the private sector and to other physicians employed by 
the VA.
  This is because VA first established standards for podiatrists in 
1976, and podiatric education, training, and practice have changed 
considerably since that time. Nonetheless, VA's outdated standards have 
remained unchanged. This has translated into increased wait times. As 
of 2015, 93 percent of new podiatry patients wait more than 15 days for 
an appointment, and podiatry is the fourth most referred-out surgical 
service to community care.
  My bill, H.R. 1058, the VA Provider Equity Act, would make VA's 
doctors of podiatric medicine equal to doctors of osteopathy and 
medical doctors within VA in terms of pay and ensure that VA 
podiatrists are eligible for the same promotions and leadership 
opportunities as other VA physicians, which is consistent with the 
private sector.
  This bill will make it easier for VA to recruit and retain the 
specialists our veterans so desperately need. In turn, this will result 
in better care for veterans and savings to the taxpayer, as a recent 
study from the UCLA Center for Health Policy Research found that 
podiatry services provided to diabetic patients could have saved 
between $29 million and $97 million in 2014, in the State of California 
alone.

[[Page H6172]]

  Mr. Speaker, as the House Veterans' Affairs Committee and the rest of 
our colleagues in Congress continue to work together to help our 
veterans receive the care they need, I urge the passage of this bill.
  Mr. WALZ. Mr. Speaker, again, this is a smart piece of legislation. I 
thank the gentleman from Ohio for his work on this.
  Mr. Speaker, I urge passage of H.R. 1058, and I yield back the 
balance of my time.
  Mr. ROE of Tennessee. Mr. Speaker, once again, I encourage all 
Members to support this legislation, and I yield back the balance of my 
time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Tennessee (Mr. Roe) that the House suspend the rules and 
pass the bill, H.R. 1058, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. WALZ. Mr. Speaker, I object to the vote on the ground that a 
quorum is not present and make the point of order that a quorum is not 
present.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this question will be postponed.
  The point of no quorum is considered withdrawn.

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