[Congressional Record Volume 163, Number 181 (Tuesday, November 7, 2017)]
[House]
[Pages H8558-H8560]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 VETERANS INCREASED CHOICE FOR TRANSPLANTED ORGANS AND RECOVERY ACT OF 
                                  2017

  Mr. BILIRAKIS. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 2601) to amend the Veterans Access, Choice, and 
Accountability Act of 2014 to improve the access of veterans to organ 
transplants, and for other purposes, as amended.

[[Page H8559]]

  The Clerk read the title of the bill.
  The text of the bill is as follows

                               H.R. 2601

       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 ``Veterans Increased Choice 
     for Transplanted Organs and Recovery Act of 2017'' or the 
     ``VICTOR Act of 2017''.

     SEC. 2. ORGAN TRANSPLANTS UNDER THE VETERANS CHOICE PROGRAM.

       Section 101(b)(2) of the Veterans Access, Choice, and 
     Accountability Act of 2014 (Public Law 113-146; 38 U.S.C. 
     1701 note) is amended--
       (1) in subparagraph (C)(ii), by striking ``or'';
       (2) in subparagraph (D)(ii)(II)(dd), by striking the period 
     and inserting ``; or''; and
       (3) by adding at the end the following new subparagraph:
       ``(E)(i) requires an organ or bone marrow transplant; and
       ``(ii)(I) has, in the opinion of the primary health care 
     provider of the veteran, a medically compelling reason to 
     travel outside the region of the Organ Procurement and 
     Transplantation Network, established under section 372 of the 
     National Organ Transplantation Act (Public Law 98-507; 42 
     U.S.C. 274), in which the veteran resides to receive such 
     transplant at a medical facility of the Department; or
       ``(II) faces an unusual or excessive burden in receiving 
     such transplant at a medical facility of the Department, 
     including--
       ``(aa) geographical challenges;
       ``(bb) environmental factors, including roads that are not 
     accessible to the general public, traffic, or hazardous 
     weather;
       ``(cc) a medical condition of the veteran that affects the 
     ability to travel; or
       ``(dd) other factors the Secretary determines appropriate, 
     including the preference of the veteran to receive such 
     transplant at a non-Department facility.''.

     SEC. 3. EFFECTIVE DATE.

       The amendments made by this Act shall take effect on the 
     later of--
       (1) October 1, 2018; and
       (2) the date of the enactment of this Act.

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


                             General Leave

  Mr. BILIRAKIS. Mr. Speaker, I ask unanimous consent that at all 
Members have 5 legislative days in which to revise and extend their 
remarks and include extraneous material on H.R. 2601, as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Florida?
  There was no objection.
  Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I rise today in support of H.R. 2601, as amended, the 
Veterans Increased Choice for Transplanted Organs and Recovery, or 
VICTOR, Act of 2017, which is sponsored by my good friend and fellow 
committee member, Dr. Neal Dunn from the great State of Florida.
  The VA healthcare system has offered solid organ transplant services 
since 1962 and bone marrow transplant services since 1982 through the 
VA Transplant Program, which manages 13 transplant centers across the 
country.
  However, since Congress created the Choice Program in 2014 to address 
access to care concerns at VA medical facilities, the committee has 
heard an increasing number of complaints about the VA Transplant 
Program from veterans who are concerned about the lengthy travel 
required for many veterans to reach a VA transplant center and 
bureaucratic barriers to receiving transplant care closer to home.

                              {time}  1545

  According to the Journal of the American Medical Association, a 
greater distance from a VA transplant center was associated with a 
lower likelihood of receiving a transplant and a greater likelihood of 
death among veteran transplant patients.
  That can't happen. This is unacceptable, in my opinion. H.R. 2601, as 
amended, represents a commonsense solution. That is what we are all 
about today: commonsense solutions for our true heroes. It would 
require the VA to consider whether there is a medically compelling 
reason to require a veteran to travel outside the organ procurement and 
transplantation network region that the veteran resides in to receive a 
transplant from a VA transplant center, or whether the veteran faces an 
unusual or excessive burden in receiving a transplant from a VA 
transplant center before referring a veteran to a VA transplant center, 
rather than to a community transplant center.
  This would greatly increase access to transplant care in the 
community for veteran transplant patients living far from VA transplant 
centers.
  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 rise in support of H.R. 2601, the VICTOR Act. This 
legislation will again eliminate barriers to high-quality organ 
transplant centers for certain veterans seeking their services by 
allowing veterans access to a transplant center, regardless of its 
location, when a provider determines there is a medically compelling 
reason to do so, or when the veteran would face unusual or excessive 
burden in receiving the transplant at a VA facility.
  That is smart. That is common sense. It makes the case that the 
transplant facilities at the VA are good, but, as Dr. Dunn pointed out, 
a diverse society, a diverse geographic spread of veterans, certain 
cases come up that make it medically wrong to try and transport someone 
to a further facility. And for all of those reasons, this is, again, 
one of those things that is just smart, all in the interest of the best 
care for our veterans.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BILIRAKIS. Mr. Speaker, I yield 2 minutes to the gentleman from 
Florida (Mr. Dunn), the sponsor of the bill and my good friend.
  Mr. DUNN. Mr. Speaker, let me start by saying thank you to Vice 
Chairman Bilirakis; and to our chairman, Dr. Roe; and also to the 
ranking member, Sergeant Major Walz from Minnesota. It has been great 
to work with them. They have been very helpful with this bill.
  I am honored to speak in support of my legislation, H.R. 2601, the 
Veterans Increased Choice for Transplanted Organs and Recovery, or 
VICTOR, Act.
  America owes our veterans every advantage when it comes to receiving 
an organ or bone marrow transplant, yet the current VA transplant 
policy often runs counter to the medical interest of the patient. There 
are only 14 facilities in the Nation where a veteran may receive a 
transplant in the VA healthcare system, and none of these facilities 
perform all types of transplants.
  Timely organ transplants often represent the difference between life 
and death. Unfortunately, due to government bureaucracy, our veterans 
are often forced to travel hundreds or thousands of miles repeatedly in 
order to get the chance to receive a new liver, heart, or kidney. That 
travel alone can prove fatal.
  Traveling to get a transplant isn't the only obstacle these patients 
face. Oftentimes, it is the program itself. The limited size and scope 
of the VA transplant program means veterans have a lower chance of 
getting a transplant and a greater chance of dying while on the waiting 
list.
  The VICTOR Act allows veterans who need an organ or bone marrow 
transplant through the VA system the ability to access a federally 
certified transplant center close to their home if the veteran and 
their doctor agree that that is medically safer. It will make it easier 
for veterans to access lifesaving medical care by allowing them a 
number of ways to qualify for care closer to home.
  As a surgeon and as a veteran, I believe this is good medicine and 
good public policy. The status quo puts roadblocks in front of veterans 
who need lifesaving transplant care, and the VICTOR Act eliminates 
these roadblocks and increases access to care our veterans have earned.
  Mr. WALZ. Mr. Speaker, I have no further speakers, and I reserve the 
balance of my time.
  Mr. BILIRAKIS. Mr. Speaker, I yield 2 minutes to the gentleman from 
Illinois (Mr. Bost).
  Mr. BOST. Mr. Speaker, I thank my friend for yielding as well. The VA 
currently requires veterans in need of organ transplants to travel to 
VA transplant centers to receive their transplant. Waiting times at 
these centers average 32 percent longer than those non-VA transplant 
centers.
  In addition, we have reports that show that the further the veteran 
is from a VA transplant center, the less likely the veteran is to 
receive the organ transplant. This can ultimately prove fatal. We owe 
it to our Nation's

[[Page H8560]]

heroes to provide them the best possible care, regardless of where they 
live.
  Mr. Speaker, I support the legislation offered by my friend and 
colleague from Florida, Dr. Dunn, to solve this problem. I am just 
amazed that we have waited this long to realize we had one.
  The VICTOR Act allows veterans who live more than 100 miles from one 
of the VA's 13 transplant centers to seek care at a federally 
certified, non-VA facility. I am proud to cosponsor the VICTOR Act 
because our veterans shouldn't be punished just because of where they 
live.
  Mr. WALZ. Mr. Speaker, again, it makes great sense. We are in full 
support of the bill. I urge my colleagues to join me in support of H.R. 
2601.
  Mr. Speaker, I yield back the balance of my time.
  Mr. BILIRAKIS. Mr. Speaker, I encourage all the Members to support 
this great piece of legislation.
  Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Florida (Mr. Bilirakis) that the House suspend the rules 
and pass the bill, H.R. 2601, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________