Bill Details
Status
Latest action
2025-03-04 - Referred to the Subcommittee on Health.
Introduced Date
2025-01-31
Policy Area
Armed Forces and National Security
Committees
View committees (1)
Cosponsors
View cosponsors (1)
8
0
0
AI Summary This summary was generated by AI from the bill text. AI can get information wrong.
This bill would change how the Department of Veterans Affairs pays outside providers who care for veterans through the Community Care Program. Instead of paying based only on the provider’s main office or general rules, the VA would have to set payment rates based on the actual place where the care was given, such as a hospital, outpatient department, surgery center, or doctor’s office. The bill also says that if more than one payment rate could apply, the VA must pay the lowest one. These changes would begin on January 1, 2026.
- Payment rates would be set by location of care, not by where the provider’s headquarters is located.
- The bill names five types of care sites that must have separate rates: inpatient hospitals, on-campus outpatient departments, off-campus outpatient departments, ambulatory surgical centers, and physician offices.
- Claims would need a special location-based provider identification code so the VA can tell where the care was actually given.
- If more than one rate could apply, the VA would have to choose the lowest payment rate.
Official Summaries
No summaries available
Current Full Text
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 874 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 874
To amend title 38, United States Code, to modify the rate of pay for
care or services provided under the Community Care Program of the
Department of Veterans Affairs based on the location at which such care
or services were provided, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 31, 2025
Mr. McCormick introduced the following bill; which was referred to the
Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to modify the rate of pay for
care or services provided under the Community Care Program of the
Department of Veterans Affairs based on the location at which such care
or services were provided, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. RATES OF PAY FOR A PROVIDER OF CARE OR SERVICES FURNISHED TO
A VETERAN UNDER THE COMMUNITY CARE PROGRAM OF THE
DEPARTMENT OF VETERANS AFFAIRS.
(a) Rates.--Section 1703(i) of title 38, United States Code, is
amended--
(1) in paragraph (1)--
(A) by striking ``Except as provided in paragraph
(2), and to the extent practicable'' and inserting
``(A) To the extent practicable''; and
(B) by adding at the end the following new
subparagraphs:
``(B) The Secretary shall establish rates for payments under
subparagraph (A) that are specific with respect to the following
locations at which the care or services were provided (regardless of
the location of the headquarters of the provider):
``(i) An inpatient hospital.
``(ii) An on-campus hospital outpatient department.
``(iii) An off-campus hospital outpatient department.
``(iv) An ambulatory surgical center.
``(v) The office of a physician.
``(C) The Secretary shall ensure that a claim for payment under
this paragraph includes a unique, geographically specific national
provider identifier code that identifies the location of the provider
as described in subparagraph (B).''; and
(2) by adding at the end the following new paragraph:
``(7) If the Secretary may pay more than one rate under this
paragraph for care or services, the Secretary shall pay the lowest such
rate.''.
(b) Effective Date.--The amendments made by subsection (a) shall
take effect on January 1, 2026.
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