Summary: H.R.4788 — 103rd Congress (1993-1994)All Information (Except Text)

There is one summary for H.R.4788. Bill summaries are authored by CRS.

Shown Here:
Introduced in House (07/19/1994)

Veterans' Health Care Eligibility Reform Act of 1994 - Defines "continuum of health care" and "noninstitutional long-term care" under veterans' health care provisions. Directs the Secretary of Veterans Affairs to provide a continuum of health care to veterans eligible for veterans' benefits.

(Sec. 2) Directs the Secretary to provide institutional nursing home care to certain disabled veterans or those in receipt of a veterans' pension. Allows for recovery of nursing home care costs by the Secretary if the veteran is also eligible for such care through a State plan under title XIX (Medicaid) of the Social Security Act.

Designates a Department of Veterans Affairs facility as a Medicare provider for purposes of any program administered by the Secretary of Health and Human Services (HHS) under title XVIII (Medicare) of the Social Security Act. Declares a Department medical center as a Medicare HMO. Directs the HHS Secretary to reimburse a Department facility or medical center for providing services as a Medicare provider in the case of care for a non-service-connected disability of a veteran eligible for Medicare benefits.

(Sec. 3) Directs the Secretary to develop a plan to implement the provision of institutional long-term care for veterans who: (1) have a service-connected disability of less than 50 percent; (2) have an annual income below a formulated amount; (3) have a catastrophic nonservice-connected disability; or (4) require such care as a follow-up to inpatient care. Outlines, with respect to such care, provisions concerning: (1) premiums and copayments for covered veterans; (2) the issuance of a long-term care insurance contract; and (3) a report from the Secretary to the Congress on the costs of the plan and the insurance contract and legislation required for plan implementation.

(Sec. 4) Directs the Secretary to administer a program of health insurance known as the VA Group Health Plan as a managed-care plan meeting specified requirements. Allows any eligible veteran and his or her spouse or child to be enrolled in the Plan. Provides Plan enrollment requirements. Prohibits the Plan from imposing a limitation or exclusion of benefits relating to treatment for certain preexisting conditions. Directs the Secretary to administer the Plan so that no appropriated funds are required for Plan operation. Requires an annual report to the Congress by the Secretary on Plan operation, as well as an initial report.

(Sec. 5) Directs the Secretary to administer the health programs of the Veterans Health Administration (VHA) through use of a managed care medical practice model, with limitations. Directs the Secretary to organize the VHA health care delivery and resources into geographic regions known as veterans service areas.

(Sec. 6) Authorizes appropriations to the Secretary for FY 1995 through 1999 for: (1) acquiring medical equipment to relieve existing medical equipment backlogs in Department facilities; and (2) infrastructure improvement, patient care amenities, primary care services and personnel, and medical facility construction projects.