[Congressional Record (Bound Edition), Volume 155 (2009), Part 7]
[House]
[Pages 9063-9064]
[From the U.S. Government Publishing Office, www.gpo.gov]




  EXPANDING VETERAN ELIGIBILITY FOR REIMBURSEMENT IN NON-VA FACILITIES

  Mrs. HALVORSON. Madam Speaker, I move to suspend the rules and pass 
the bill (H.R. 1377) to amend title 38, United States Code, to expand 
veteran eligibility for reimbursement by the Secretary of Veterans 
Affairs for emergency treatment furnished in a non-Department facility, 
and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 1377

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

     SECTION 1. EXPANSION OF VETERAN ELIGIBILITY FOR REIMBURSEMENT 
                   BY SECRETARY OF VETERANS AFFAIRS FOR EMERGENCY 
                   TREATMENT FURNISHED IN A NON-DEPARTMENT 
                   FACILITY.

       (a) Expansion of Eligibility.--Section 1725 of title 38, 
     United States Code, is amended--
       (1) in subsection (b)(3)(C), by striking ``or in part''; 
     and
       (2) in subsection (f)(2), by striking subparagraph (E).
       (b) Limitations on Reimbursement.--Subsection (c) of such 
     section is amended by adding at the end the following new 
     paragraph:
       ``(4)(A) If the veteran has contractual or legal recourse 
     against a third party that would only, in part, extinguish 
     the veteran's liability to the provider of the emergency 
     treatment, and payment for the treatment may be made both 
     under subsection (a) and by the third party, the amount 
     payable for such treatment under such subsection shall be the 
     amount by which the costs for the emergency treatment exceed 
     the amount payable or paid by the third party, except that 
     the amount payable may not exceed the maximum amount payable 
     established under paragraph (1)(A).
       ``(B) In any case in which a third party is financially 
     responsible for part of the veteran's emergency treatment 
     expenses, the Secretary shall be the secondary payer.
       ``(C) A payment in the amount payable under subparagraph 
     (A) shall be considered payment in full and shall extinguish 
     the veteran's liability to the provider.
       ``(D) The Secretary may not reimburse a veteran under this 
     section for any copayment or similar payment that the veteran 
     owes the third party or for which the veteran is responsible 
     under a health-plan contract.''.
       (c) Effective Date.--
       (1) In general.--The amendments made by subsections (a) and 
     (b) shall take effect on the date of the enactment of this 
     Act, and shall apply with respect to emergency treatment 
     furnished on or after the date of the enactment of this Act.
       (2) Reimbursement for treatment provided before effective 
     date.--The Secretary may provide reimbursement under section 
     1725 of title 38, United States Code, as amended by 
     subsections (a) and (b), for emergency treatment furnished to 
     a veteran before the date of the enactment of this Act, if 
     the Secretary determines that, under the circumstances 
     applicable with respect to the veteran, it is appropriate to 
     do so.

  The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from 
Illinois (Mrs. Halvorson) and the gentleman from Tennessee (Mr. Roe) 
each will control 20 minutes.
  The Chair recognizes the gentlewoman from Illinois.
  Mrs. HALVORSON. Madam Speaker, I yield myself such time as I may 
consume.
  I rise in strong support of H.R. 1377, as amended, which would expand 
veteran eligibility for reimbursement by the Secretary of Veterans 
Affairs for emergency treatment furnished in a nondepartment facility. 
This legislation would assist veterans who get hurt while they are off 
duty and require emergency care in a non-VA medical facility.
  These veterans do not currently receive any reimbursement from the VA 
if they have third-party insurance that pays either full or a portion 
of the emergency care. This creates an inequity that penalizes veterans 
with insurance, including auto insurance, which is oftentimes mandated 
by law.
  A veteran with an insurance policy which covers any portion of the 
cost for emergency treatment would be burdened with the remaining 
amount not covered by insurance. This unfair policy has caused many 
veterans undue stress and has placed them in unnecessary financial 
hardship. H.R. 1377, as amended, eliminates this inequity by requiring 
the VA to pay for emergency care in a non-VA facility, even if the 
veteran holds a policy that will pay for any portion of their care.
  Madam Speaker, I would like to thank Ranking Member Buyer and the 
Health Subcommittee chairman, Mr. Michaud, for their contributions to 
this bill as well as the staff.
  I urge your support in passing H.R. 1377, as amended.
  Madam Speaker, I reserve the balance of my time.
  Mr. ROE of Tennessee. Madam Speaker, I yield myself such time as I 
may consume.
  I rise in support of H.R. 1377, as amended, to amend title 38, United 
States Code, to expand VA's authority to reimburse veterans for the 
cost of emergency care provided in a nondepartment facility. I want to 
thank the chairman for introducing this bill, which would provide 
financial protections for veterans in need of emergency care.
  Current law allows VA to reimburse a veteran for emergency treatment 
obtained in a non-VA facility only if the veteran does not have any 
other entitlement to pay from a private party. As a result, a veteran 
with a policy that covers only a small part of the emergency care costs 
could be personally liable for substantial out-of-pocket expenses.
  H.R. 1377, as amended, would change current law to authorize VA to 
cover additional expenses in cases where a veteran receives only 
partial payment from a third party. However, the legislation does make 
it clear that VA would be the secondary payer and that payment would be 
limited to the difference between the amount paid by the private 
insurance and the VA authorized rate. It also ensures that VA payment 
fully absolves a veteran from any liability to that provider.
  In addition to providing prospective protection for veterans, H.R. 
1377 was amended to allow the Secretary of Veterans Affairs to 
retroactively apply this law on a discretionary basis for a veteran who 
may have incurred a medical debt for emergency treatment prior to the 
date of enactment.
  Madam Speaker, the chairman has talked about the need for this 
discretionary authority. As such, Ranking Member Buyer requested during 
our markup last week that the bill report make it clear that it is the 
committee's intention for the Secretary to use this authority and take 
into consideration the facts and circumstances of each veteran's 
situation. A veteran should not be discouraged from seeking emergency 
care at the closest community hospital for fear of financial 
uncertainty.
  I urge my colleagues to support this bill.
  I reserve the balance of my time.
  Mrs. HALVORSON. I continue to reserve the balance of my time.
  Mr. ROE of Tennessee. I yield 2 minutes to the gentlewoman from 
Florida, Congresswoman Brown-Waite.
  Ms. GINNY BROWN-WAITE of Florida. Madam Speaker, I thank the 
gentleman for yielding.
  I rise today in support of H.R. 1377, a commonsense bill to reimburse 
veterans for emergency treatment in non-VA facilities. Our first 
Commander in Chief, George Washington, once said that the willingness 
with which our young people are likely to serve in any war, no matter 
how justified, will be directly proportional to how they perceive the 
veterans of earlier wars were treated and appreciated by their country. 
Taking care of those who have sacrificed for our Nation is truly our 
sacred duty. It is a national promise that goes back to Presidents 
Washington and Lincoln. Yet a couple of weeks ago, President Obama 
proposed billing veterans for treatment of combat-related injuries. 
Although the President announced that he was rescinding this proposal, 
it is nonetheless alarming to our veteran population.
  The courageous Americans who have served our country should know that 
all of us recognize their sacrifice, and this bill by Representative 
Filner will go a long way in doing just that.
  Back in Florida, I represent over 110,000 veterans, the second 
highest number of any Member of Congress. Many of these brave men and 
women are disabled either in battle or in the course of their service 
to the United States military. Yet, veterans in my district must 
frequently travel long distances to obtain care from a VA facility. As 
a result, those requiring emergency care must seek treatment

[[Page 9064]]

in a private or a community-run hospital. Passage of this bill will 
ensure that veterans are not saddled with massive emergency room bills.
  I thank my colleague, Mr. Filner, for introducing H.R. 1377. And I 
would hope that all Members of this body can support such a worthy 
message of support for our veterans.
  Mrs. HALVORSON. I continue to reserve the balance of my time, Madam 
Speaker.
  Mr. ROE of Tennessee. Madam Speaker, I yield myself 1 minute.
  Madam Speaker, I would like to thank the Subcommittee on Health 
chairman, Mike Michaud, and Ranking Member Henry Brown for their hard 
work on this legislation and Chairman Filner and Ranking Member Buyer 
for moving this bill so quickly through the committee process.
  I urge my colleagues to support this legislation.
  I yield back the balance of my time.


                             General Leave

  Mrs. HALVORSON. Madam Speaker, I ask unanimous consent that all 
Members may have 5 legislative days in which to revise and extend their 
remarks and include extraneous material on H.R. 1377, as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Illinois?
  There was no objection.
  Mrs. HALVORSON. Madam Speaker, I also want to thank Chairman Filner 
and Ranking Member Buyer for working so hard together to make sure that 
these wonderful Veterans Affairs issues come before the body. No matter 
what rumor has ever come up that might come from the administration, 
the Veterans Committee has always made sure that the veterans are first 
and foremost in all of our minds.
  I urge my colleagues to unanimously support H.R. 1377, as amended.
  Ms. JACKSON-LEE of Texas. Madam Speaker, I stand in support of our 
veterans and in support of H.R. 1377, to amend title 38, United States 
Code, to expand veteran eligibility for reimbursement by the Secretary 
of Veterans Affairs for emergency treatment furnished in a non-
department facility and for other purposes by my colleague from 
California, Representative Bob Filner and the Members of the Veterans' 
Affairs Committee.
  H.R. 1377 would require the Department of Veterans Affairs to pay for 
emergency care that certain veterans receive at non-VA medical 
facilities or to reimburse veterans if they have paid for that care. 
Specifically, veterans with non-service-connected conditions whose 
third-party insurer does not cover the full cost of care would be 
reimbursed.
  The bill also permits the VA to reimburse veterans for emergency 
treatment that was provided prior to the date of enactment. Under 
current federal law, the Department of Veterans Affairs has the 
authority to reimburse certain veterans or pay for emergency treatment 
of a non-service connected condition if the VA is the payer of last 
resort. However, the VA currently does not pay for emergency treatment 
for non-service connected conditions in facilities outside the VA 
system if a veteran has third-party insurance that pays for any portion 
of the medical cost. H.R. 1377 would make these veterans eligible for 
reimbursements from the VA.
  I have been a strong advocate of supporting our veterans. We are 
providing for our veterans with legislation such as:
  H. Res. 234--which would designate a ``Welcome Home Vietnam Veterans 
Day.''
  H. Res. 1054--Honoring the service and achievements of women in the 
Armed Forces and female veterans (Rep. Davis (CA)--Armed Services).
  H.R. 2790--To establish the position of Director of Physician 
Assistant Services within the office of the Under Secretary of Veterans 
Affairs for Health as amended (Rep. Hare--Veterans' Affairs).
  H.R. 3889--To require the Secretary of Veterans Affairs to conduct a 
longitudinal study of the vocational rehabilitation programs 
administered by the Secretary (Rep. Boozman--Veterans' Affairs).
  H.R. 5554--Veterans Substance Use Disorders Prevention and Treatment 
Act of 2008 (Rep. Michaud--Veterans' Affairs)--Passed.
  H.R. 5664--To direct the Secretary of Veterans Affairs to update at 
least once every six years the plans and specifications for specially 
adapted housing furnished to veterans by the Secretary (Rep. 
Rodriguez--Veterans' Affairs).
  Currently, there are over 25 million veterans in the United States. 
There are more than 1,633,000 veterans living in Texas. According to 
the Texas Veterans Commission, there are 197,030 veterans in Harris 
County. In the 2007 fiscal year health care costs in the 18th district 
of Texas were over $80,000.
  Madam Speaker, I encourage my colleagues to join me in expanding 
Title 38 for reimbursement of emergency care in non-department 
facilities for veterans.
  Mrs. HALVORSON. Madam Speaker, I have no further requests for time, 
and I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentlewoman from Illinois (Mrs. Halvorson) that the House suspend the 
rules and pass the bill, H.R. 1377, 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.

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