H.R. 5286 — Introduced in House

I 113th CONGRESS 2d Session H. R. 5286 IN THE HOUSE OF REPRESENTATIVES July 30, 2014 Mr. Larson of Connecticut introduced the following bill; which was referred to the Committee on Veterans’ Affairs A BILL To amend title 38, United States Code, to provide for a more equitable geographic allocation of funds appropriated to the Department of Veterans Affairs for medical care. 1. Short title This Act may be cited as the Veterans Equitable Treatment Act. 2. Standard for time for referral for specialist care (a) Time for specialist appointments (1) Requirement The Secretary of Veterans Affairs shall establish by regulation a maximum specialist referral period, subject to such exceptions as the Secretary considers necessary. (2) Specialist referral period defined For purposes of paragraph (1), the term specialist referral period means the period of time between (A) the date on which a veteran is referred to a specialty clinic of the Department by the veteran’s primary care physician within the Department of Veterans Affairs health care system, and (B) the date for which the veteran is scheduled for an appointment with a Department specialist pursuant to such referral. (3) Department policies In establishing a maximum specialist referral period under paragraph (1), the Secretary shall act in a manner consistent with the current treatment policies of the Department based on clinical need and with the established 30–30–20 performance goal of the Department for such a referral period. (b) Standard for transportation The Secretary shall take such steps as necessary to ensure that the Department of Veterans Affairs is able to provide appropriate transportation services for qualified veterans within a reasonable time period of a scheduled appointment. 3. Contract care to be provided when Department of Veterans Affairs care not available in accordance with standards (a) Contract care In any case in which the Secretary of Veterans Affairs is not able to provide hospital care or medical services in accordance with the standard prescribed under section 2(a) or to provide transportation services in accordance with section 2(b), the Secretary shall promptly provide for such care or transportation from a private source. Hospital care or medical services so provided shall be those for which the veteran is otherwise eligible within the Department of Veterans Affairs medical care system. (b) Reimbursement rate Whenever care or services are provided under subsection (a), the Secretary shall reimburse the provider of such care or services for the reasonable value of such care or services, as determined by the Secretary. Such reimbursement shall be provided in the same manner as applies to reimbursement for emergency treatment under section 1725 of title 38, United States Code, subject to such of the terms and conditions otherwise applicable to such reimbursements under such section as the Secretary determines to be appropriate for purposes of this section. (c) Expedited reimbursement procedures The Secretary shall take appropriate steps to expedite the reimbursement required by subsection (b) and consistent with the Veterans Health Administration policy that 90 percent of all non-VA Contract Care claims are processed within 30 days of receipt. Such steps may include steps to make use of advanced technology, such as smart card technology that would allow claims for such reimbursement to be processed electronically. The Secretary shall, to the extent possible, also apply such steps for expediting reimbursement to claims for emergency services provided to veterans for which the Secretary provides reimbursement under provisions of law in effect before the date of the enactment of this Act. 4. Termination of 24-month rule for reimbursement for emergency services The provisions of subparagraph (B) of section 1725(b)(2) of title 38, United States Code, shall not apply with respect to emergency treatment furnished on or after the date of the enactment of this Act. 5. Reports The Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report at the end of each fiscal-year quarter on the waiting times for appointments in the Department of Veterans Affairs medical care system. The report shall describe any reductions in such waiting times and any experience with appointment delays.