I
107TH CONGRESS
2D SESSION
H. R. 5675
To amend title 38, United States Code, to provide for a more equitable
geographic allocation of funds appropriated to the Department of Vet-
erans Affairs for medical care.
IN THE HOUSE OF REPRESENTATIVES
OCTOBER 16, 2002
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 appro-
priated to the Department of Veterans Affairs for med-
ical care.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘21st Century Veterans
Equitable Treatment Act’’.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) Veterans were promised by the Federal
Government that for their service to the country
they would be provided a lifetime of health care serv-
ices, as well as their own health care service net-
work.
(2) The current allocation system for appropria-
tions made to the Department of Veterans Affairs
for medical care, known as the Veterans Equitable
Resource Allocation (VERA) formula and estab-
lished by the Secretary of Veterans Affairs pursuant
to section 429 of the Departments of Veterans Af-
fairs and Housing and Urban Development, and
Independent Agencies Appropriations Act, 1997
(Public Law 104–204; 110 Stat. 2929), has proved
to be an ineffective means of allocating such funds
fairly across the 22 national service regions, known
as Veterans Integrated Service Networks (VISNs),
of the Department of Veterans Affairs.
(3) The VERA formula has resulted in a sys-
tem in which veterans in some regions of the country
are forced to compete with veterans in other regions
for critical medical care funds, whereas the system
should be providing the funding necessary to meet
the health care needs of all veterans, regardless of
where they live, to ensure that all veterans have ac-
cess to the level and quality of care that they have
all earned and deserve.
(4) The Secretary of Veterans Affairs estab-
lished a set of performance goals in fiscal year 2000,
which are referred to as ‘‘30–30–20’’, representing
the Secretary’s goal to schedule nonurgent primary
care visits within 30 days, specialty care visits within
30 days, and the maximum amount of time veterans
must wait once they arrive to be seen by a doctor
as 20 minutes.
(5) According to the Department’s Performance
Report for Fiscal Year 2001, nationally 87 percent
of primary care appointments were scheduled within
30 days of the desired date and 84 percent of spe-
cialty care appointments were scheduled within 30
days of the desired date, while in VISN 1, only 82
percent of primary care appointments were sched-
uled within 30 days of the desired date and only 80
percent of specialty care appointments were sched-
uled within 30 days of the desired date.
(6) Until the VERA formula is changed to en-
sure a more equitable and adequate distribution of
medical care funding within the Department of Vet-
erans Affairs system, providing appropriate access to
medical care for the Nation’s veterans must remain
a national priority with a method found to provide
a safety net that will ensure that veterans have ac-
cess to the health care they need without under-
mining the existing health care network of the De-
partment of Veterans Affairs.
SEC. 3. STANDARD FOR TIME FOR REFERRAL FOR SPE-
CIALIST CARE.
(a) TIME FOR SPECIALIST APPOINTMENTS.—(1) The
Secretary of Veterans Affairs shall establish by regulation
a maximum specialist referral period, subject to such ex-
ceptions as the Secretary considers necessary.
(2) For purposes of paragraph (1), the term ‘‘spe-
cialist 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 spe-
cialist pursuant to such referral.
(3) In establishing a maximum specialist referral pe-
riod 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 estab-
lished 30–30–20 performance goal of the Department for
such a referral period.
(b) STANDARD
FOR TRANSPORTATION.—The Sec-
retary shall take such steps as necessary to ensure that
the Department of Veterans Affairs is able to provide ap-
propriate transportation services for qualified veterans
within a reasonable time period of a scheduled appoint-
ment.
SEC. 4. CONTRACT CARE TO BE PROVIDED WHEN DEPART-
MENT OF VETERANS AFFAIRS CARE NOT
AVAILABLE IN ACCORDANCE WITH STAND-
ARDS.
(a) CONTRACT CARE.—In any case in which the Sec-
retary of Veterans Affairs is not able to provide hospital
care or medical services in accordance with the standard
prescribed under section 3(a) or to provide transportation
services in accordance with section 3(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 other-
wise eligible within the Department of Veterans Affairs
medical care system.
(b) REIMBURSEMENT RATE.—Whenever care or serv-
ices are provided under subsection (a), the Secretary shall
reimburse the provider of such care or services for the rea-
sonable 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 emer-
gency 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). Such steps may
include steps to take advantage of modern technology, in-
cluding so-called ‘‘smart card’’ technology that would
allow claims for such reimbursement to be processed elec-
tronically. 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.
SEC. 5. TERMINATION OF 24-MONTH RULE FOR REIM-
BURSEMENT 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.