Revived VA Choice bill leans on telehealth, makes community care program permanent

The House Committee on Veterans Affairs introduced new VA Choice program reform legislation that would make the community choice program permanent and give VA healthcare providers the authority to practice telemedicine across state lines.

The VA MISSION Act of 2018 is similar to the plan included as part of the federal omnibus spending bill in March. Both Senate leadership and House Republicans agreed to the plan, but it was rejected after House Democrats made some last minute objections.

The VA Choice program will run out of funds in June, and the bill is meant to bolster that program and its funding to ensure it continues. The legislation includes $5.2 billion in funds to address the program’s funding shortfall and will fund the current program through the next year.

“This legislation must be passed, and if Congress fails to act veterans will pay for that failure,” Committee Chair Rep. Phil Roe, MD, R-Arizona, said in a statement. “It will put the department back on track to fulfilling President Lincoln’s promise to care for the men and women who have borne the battle.”

The President announced his support of the bill on Twitter.

The bill provides legislative authority to the Anywhere-to-Anywhere telehealth programs of former VA Secretary David Shulkin, MD, that allow VA providers to cross state lines to practice telemedicine. The goal is to combat wait-time issues that have plagued the agency while expanding access to rural areas.

If passed, the bill also would make clear that telemedicine services don’t need to be provided in a federal facility. It will “also invoke Federal supremacy regarding state telemedicine delivery laws and regulations to ensure uniform care delivery nationally.”

The legislation also would require all VA providers to adhere to all quality standards when practicing telemedicine. And the agency would need to report back to Congress within a year of enacting the program and provide data on provider and patient satisfaction and its effect on wait-times, among other measures.

Established in 2014 in response to the nationwide wait-time scandal, the Choice Program was one of Shulkin’s top priorities as secretary. He worked with Congress during his year-long tenure to expand the program through private-public partnerships, telemedicine and other policies. Acting Secretary Robert Wilkie has been continuing that push.

But Congress repeatedly noted its concerns about extending the program for more than a year, over concerns about moving veterans’ care to the private sector. Shulkin, Wilkie and the Trump Administration have all denied that was the goal.

However, Shulkin said his lack of willingness to privatize veterans care was the force behind his firing. The White House denied those claims.

The bill is scheduled for markup by the committee next Tuesday.

Twitter: @JessieFDavis
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