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Veteran's Health Care Policy Enhancement Act Of 2008

Floor Speech

Location: Washington, DC


Mr. MORAN of Kansas. I rise in support of H.R. 6445, as amended, the Veterans' Health Care Policy Enhancement Act of 2008, a bill that amends title 38 to the United States Code to prohibit the Secretary of Veterans Affairs from collecting certain copayments from veterans who are catastrophically disabled, and a number of other purposes. H.R. 6445 includes the text of four other bills introduced by Members, both Republican and Democrat, and all provisions have bipartisan support.

Section 2 of the bill would ensure that veterans who have been determined to be catastrophically disabled from nonservice-connected would not be required to pay any copayment for their inpatient, outpatient, and long-term care needs. These veterans, because of their very complex medical needs, depend heavily upon the VA for their health care.

There are currently about 25,000 seriously disabled veterans who would benefit from this provision, and I thank our new colleague, the gentleman from Louisiana, Representative Cazayoux, for introducing this bill.

Section 3 of the bill would eliminate an outdated statutory requirement that a veteran being treated for a nonservice-connected condition be hospitalized in order for the VA to provide counseling services to the family members. In today's delivery of health care, this makes no sense. We must ensure that all families, regardless of the nature of the veteran's condition, are eligible for needed and valuable support services that will aid in the treatment of that veteran patient. I want to thank my friend and colleague from the committee, the gentleman from Illinois (Mr. Hare) for bringing this provision forward.

Section 4 of the bill would require the VA to maintain current pain management policy and ensure that the policy is both effective and implemented in a consistent manner throughout the VA health care delivery system. The VA has long recognized the importance of providing early and appropriate care for management of pain.

In 1998, the VA developed a strategy of ``Pain Assessment, the Fifth Vital Sign,'' which established procedures for pain assessment, treatment, and outcomes at all VA clinical settings. The VA further enhanced its efforts in 2003, and issued a new directive establishing the National Pain Management Strategy. This legislation would support those VA efforts. I thank the gentleman, Mr. Walz, for introducing this measure to ensure the VA maintains a national standard to reduce the suffering of our veterans experiencing acute and chronic pain associated with a wide range of illnesses.

Section 5 of the bill would improve effectiveness of the VA's process for securing reimbursements from third-party insurance companies. This measure was introduced by our ranking member, the gentleman from Indiana (Mr. Buyer). Mr. Buyer has long been at the forefront of this issue. Every dollar that goes uncollected is one less additional dollar that can be used to enhance the care of our veterans.

The Government Accounting Office has consistently reported the VA's processes and procedures for billing and collecting third-party payments are ineffective and limit the revenue received from those third-party payers. However, in the latest GAO report, June of 2008, the GAO found that the Mid-Atlantic Consolidated Patient Accounting Center, CPAC, achieved better billing performances and reduced billing time, leading to improved collections. The GAO also noted the VA may be leaving over $1.4 billion in uncollected care.

In 2005, the VA created the Mid-Atlantic CPAC in Asheville, North Carolina, to maximize its collections by using a private sector model tailored to VA billing and collection needs. Last Congress, we directed the VA to establish a Revenue Demonstration Project to improve its collections and develop a systemwide model to improve its performance. In fiscal year 2007, CPAC achieved 110 percent of its expected collections, a $20.3 million increase from its performance in the previous fiscal year.

Approximately $12 million for the fiscal year 2007 in additional collections was generated as a result of the Revenue Improvement Demonstration Project. Expanding this project will continue to improve the VA's collections. Mr. Buyer's measure would require VA to establish no more than seven CPACs within 5 years, modeled after the successful Asheville, North Carolina project.

Improving collections is a win-win for our Nation's veterans, and I want to commend the ranking member for his continued work in this regard.

Finally, Section 6 of the bill would repeal outdated statutory language that requires the VA to provide separate written informed consent for HIV testing, as well as pre-and post-test counseling. Since the requirements were codified almost 20 years ago, there is a better understanding of HIV and its transmission.

The administration in its FY 2009 budget proposal requested this change in law so that veteran patients receive the same standard of HIV care that is recommended by the Centers for Disease Control and Prevention.

Ensuring veterans receive the best care possible requires effective use of VA authorities and resources for the provision of that medical care. I urge my colleagues to support the Veterans' Health Care Policy Enhancement Act.

I now reserve the balance of my time.


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