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(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 23 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-
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cess to the level and quality of care that they have 
all earned and deserved. 
(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 Fiscal Year 
2006 Performance and Accountability Report, 89 
percent of primary care appointments were sched-
uled within 30 days of the desired date and only 86 
percent of specialty care appointments were sched-
uled within 30 days of the desired date in 2002. 
(6) By 2006, the Department’s Fiscal Year 
2006 Performance and Accountability Report states 
that 96 percent of primary care appointments were 
scheduled within 30 days of the desired date and 93 
percent of specialty care appointments were sched-
uled within 30 days of the desired date. 
(7) Although appointment performance has im-
proved, the increase primarily reflects the January 
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2003 ban on enrollment of new Priority 8 veterans 
in the VA health care system. 
(8) According to the Veterans Health Adminis-
tration (VHA) Directive 2007–010, the VHA policy 
for national timeliness standards for the processing 
of claims from non-Department of Veterans Affairs 
providers is that 95 percent of all non-Department 
provider claims are processed within 30 days of re-
ceipt. 
(9) 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 that includes Priority 8 vet-
erans, 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 access to the 
health care they need without undermining the exist-
ing health care network of the Department of Vet-
erans Affairs. 
SEC. 3. STANDARD FOR TIME FOR REFERRAL FOR SPE-
CIALIST CARE. 
(a) TIME FOR SPECIALIST APPOINTMENTS.— 
(1) REQUIREMENT.—The Secretary of Veterans 
Affairs shall establish by regulation a maximum spe-
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cialist 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 spe-
cialty clinic of the Department by the veteran’s pri-
mary care physician within the Department of Vet-
erans Affairs health care system, and (B) the date 
for which the veteran is scheduled for an appoint-
ment 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 Depart-
ment 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 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. 
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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. 
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