(Senate - April 03, 2017)

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[Congressional Record Volume 163, Number 57 (Monday, April 3, 2017)]
[Pages S2163-S2164]
From the Congressional Record Online through the Government Publishing Office []


  Mr. TESTER. Madam President, I ask unanimous consent that the 
Committee on Veterans' Affairs be discharged from further consideration 
of S. 544 and the Senate proceed to its immediate consideration.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The clerk will report the bill by title.
  The senior assistant legislative clerk read as follows:

       A bill (S. 544) to amend the Veterans Access, Choice, and 
     Accountability Act of 2014 to modify the termination date for 
     the Veterans Choice Program, and for other purposes.

  There being no objection, the Senate proceeded to consider the bill.
  Mr. TESTER. Madam President, I know of no further debate on the bill.
  The bill was ordered to be engrossed for a third reading and was read 
the third time.
  The PRESIDING OFFICER. The bill having been read the third time, the 
question is, Shall the bill pass?
  The bill (S. 544) was passed, as follows:

                                 S. 544

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

                   CHOICE PROGRAM.

       Section 101(p)(2) of the Veterans Access, Choice, and 
     Accountability Act of 2014 (Public Law 113-146; 38 U.S.C. 
     1701 note) is amended by striking ``, or the date that is 3 
     years after the date of the enactment of this Act, whichever 
     occurs first''.

                   CARE UNDER CHOICE PROGRAM.

       (a) In General.--Section 101(e) of the Veterans Access, 
     Choice, and Accountability Act of 2014 (Public Law 113-146; 
     38 U.S.C. 1701 note) is amended--
       (1) in the subsection heading, by striking ``Other Health-
     care Plan'' and inserting ``Responsibility for Costs of 
     Certain Care'';
       (2) in paragraph (1), in the paragraph heading, by striking 
     ``to secretary'' and inserting ``on health-care plans'';
       (3) by striking paragraphs (2) and (3);
       (4) by redesignating paragraph (4) as paragraph (2); and
       (5) by adding at the end the following new paragraph:
       ``(3) Recovery of costs for certain care.--
       ``(A) In general.--In any case in which an eligible veteran 
     is furnished hospital care or medical services under this 
     section for a non-service-connected disability described in 
     subsection (a)(2) of section 1729 of title 38, United States 
     Code, or for a condition for which recovery is authorized or 
     with respect to which the United States is deemed to be a 
     third party beneficiary under Public Law 87-693, commonly 
     known as the `Federal Medical Care Recovery Act' (42 U.S.C. 
     2651 et seq.), the Secretary shall recover or collect from a 
     third party (as defined in subsection (i) of such section 
     1729) reasonable charges for such care or services to the 
     extent that the veteran (or the provider of the care or 
     services) would be eligible to receive payment for such care 
     or services from such third party if the care or services had 
     not been furnished by a department or agency of the United 
       ``(B) Use of amounts.--Amounts collected by the Secretary 
     under subparagraph (A) shall be deposited in the Medical 
     Community Care account of the Department. Amounts so 
     deposited shall remain available until expended.''.
       (b) Conforming Amendment.--Paragraph (1) of such section is 
     amended by striking ``paragraph (4)'' and inserting 
     ``paragraph (2)''.

                   AFFAIRS HEALTH CARE.

       Section 7332(b)(2) of title 38, United States Code, is 
     amended by adding at the end the following new subparagraph:
       ``(H)(i) To a non-Department entity (including private 
     entities and other Federal agencies) that provides hospital 
     care or medical services to veterans as authorized by the 
       ``(ii) An entity to which a record is disclosed under this 
     subparagraph may not redisclose or use such record for a 
     purpose other than that for which the disclosure was made.''.

  Mr. TESTER. Madam President, I ask unanimous consent that the motion 
to reconsider be considered made and laid upon the table.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. TESTER. Madam President, I want to thank Senator Moran and 
members of the Veterans' Affairs Committee for all their good work, 
Senator McCain for his good work, and Chairman John Isakson for his 
good work on this bill.
  This Veterans Choice Program Improvement Act is an important piece of 
legislation that is going to really ensure that veterans can access 
care in their communities. It is a critically important piece of 
legislation that we should get done and get done now.
  I think this body could learn from the work that was done on the 
Veterans' Affairs Committee under the leadership of Chairman Isakson 
for the veterans of this country. I don't think my home State of 
Montana is any exception. Veterans have been waiting far too long for 
an appointment at the VA and oftentimes had to drive 100 miles for an 
appointment. That is why we set up the Choice Program. It was supposed 
to allow these veterans to get their healthcare closer to home. 
Unfortunately, it did not work the way it should have. And we were 
inundated with redtape and a government contractor that struggled to 
schedule appointments with providers on time.
  This Veterans Choice Program Improvement Act is not the end all. It 
is not what is going to fix the Choice Program in its entirety, but it 
certainly is a step in the right direction, a step that needed to be 
taken, and I commend the body for allowing this step to be taken.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Kansas.
  Mr. MORAN. Madam President, I thank the Senator from Montana for his 
efforts to see that this legislation gets passed. I am pleased to see 
that we have been joined in a unanimous way by the Senate, Republicans 
and Democrats working together to see that our veterans receive better 
  In addition to the Senator from Montana, I thank Mr. McCain, the 
Senator from Arizona, who is joining us on the floor. I also thank 
Senator Isakson in particular, the chairman of the Veterans' Affairs 
Committee, for his leadership in seeing that we are here today to bring 
this legislation across the finish line.
  The House passed legislation similar to this, so this is an 
opportunity for us to get an accomplishment--not for a pat on our backs 
but for the improvement in the care of those who served

[[Page S2164]]

our Nation. I asked this question on the Senate floor before: Of all 
the people in the United States, who would you expect to get the best 
care possible? While we want every American to have high-quality care 
and access to medical treatment, we certainly want to make certain 
those who served our country and to whom a commitment was made that 
they would receive care--we want that commitment fulfilled, and we want 
it done in a way that is advantageous and easy for our veterans.
  The Senator from Montana is correct. The Choice Act is a significant 
improvement, in my mind, for accessing care. Kansas is not quite as 
large as the State of Montana, but we are a large rural State, and it 
is a long distance to a VA hospital. So Choice was brought into play to 
try to alleviate the backlog, the lack of providers within the VA, and 
the wait times that veterans faced, but also to try to satisfy the 
needs of veterans who live long distances from a VA facility.
  So Choice is in place, but it still has been a difficult time for 
many veterans across the country and certainly at home. It is the most 
common conversation I have when I am back in Kansas. In fact, I had a 
townhall meeting in southwest Kansas, in Dodge City, and it is veterans 
who, in the public forum, will tell me about the problems with the VA 
and particularly with Choice, or they will line up after or before that 
meeting to tell me in person that they need help.
  This legislation does three significant things. More is to come. We 
need a permanent act. This is an extension of the Choice Act that 
expires on August 7, so continuing the program is the first step while 
we work out the desired outcome of a long-term permanent program.
  Secondly, it provides the money through that period of time. It 
allows the expenditure of dollars to pay for Choice.
  Third, it eliminates the intermediary--somebody separate from the VA 
in paying the bills--and that reduces the bureaucracy and burden on our 
  I was just looking through what we call casework, things Kansans 
bring to our office to try to get solved. Front and center is the 
number of veterans who are being harassed by collection agencies for 
bills they thought would be paid by the VA through the Choice Program, 
and they are not being paid in a timely fashion. This eliminates the 
intermediary--the manager of the program--from paying the bills and 
restores that authority to the VA to write out the checks with the goal 
of reducing the bureaucracy and paperwork for the veterans. It also 
increases the timeliness for the payment that is due the healthcare 
provider--the doctor, the pharmacy, and the hospital.
  Again, as a rural American, many of our providers are struggling. 
Hospital doors are a challenge to remain open in rural communities 
across my State. And that long wait for a reimbursement check for 
services provided months ago also creates a burden on that hospital, 
that healthcare provider. So timely payment certainly will benefit the 
veterans, but it also increases the chances of the stability of 
healthcare providers in rural communities across my State and around 
the country.
  Finally, it increases the ability for the sharing of medical records 
between the VA and that community healthcare provider.
  Choice is in place to help those veterans who need to have care more 
quickly and who need to have care closer to home. This bill improves 
that program and extends it, and that is a significant development. I 
appreciate the opportunity I have had to work with the Senators from 
Arizona, Montana, and Georgia to make sure we got to the point we are 
today. I appreciate my colleagues' unanimous support for the passage of 
this legislation.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Arizona.
  Mr. McCAIN. Madam President, I want to thank the Senator from Kansas 
for all the hard work he has done, and the Senator from Montana. On the 
rare occasion I come to praise him, I would like to give him my deep 
and heartfelt appreciation for his work in a bipartisan fashion on this 
issue. I mean that with all sincerity. I also thank our distinguished 
chairman, Senator Isakson. I also think I share with my colleagues an 
appreciation for Dr. Shulkin, the new Secretary of the Veterans' 
Administration, who has been an active and helpful participant in this 
  Most everything has been said except that I would like to remind my 
colleagues that we now have--since the enactment in 2014, over 7 
million appointments have been made using the Choice Program. Now, over 
30,000 appointments are successfully made each week under the Choice 
  The programs are set to expire in a few months, and, as pointed out 
by my colleagues, the VA has already begun to limit care for pregnant 
mothers, as well as cancer patients, because their treatment would 
extend beyond August. Soon all veterans will be kicked off the Choice 
  I would just like to point out to my colleagues, if I could, that 
this crisis started in Phoenix, AZ, where 15,000 veterans were put on a 
wait list and over 40 veterans died while awaiting care. That is not 
acceptable in this Nation.
  I believe the Choice Program is a major step forward. The truth is, 
the VA has a lot more to do to provide for the care we have obligated 
this Nation to on behalf of those who have fought and sacrificed for 
our Nation. The Choice Card has made a major step forward. I hope we 
can consider removing any geographic or other limitations associated 
with it. But what the Senators from Kansas and Montana have done today 
is to make sure this program continues and why it is important to pass 
it today--not one dollar Congress authorized to care for veterans under 
the Choice Program should go unused.
  Let me mention what we have done. There are 7 million additional 
appointments for veterans in their communities, and over 1.5 million 
veterans have benefited from using the Choice Card that they would not 
have had otherwise. Some 350,000 more doctors, nurse practitioners, and 
physician assistants are available to treat veterans. There are 235,000 
appointments per month through Veterans Choice--more than 10,000 per 
workday. The Veterans Choice Program more than doubles the number of 
medical providers nationwide that treat veterans. In Arizona, 11,700 
medical providers in veterans communities have treated over 100,000 
disabled veterans.
  The Veterans Choice Card is being used at 700 hospitals and nearly 
10,000 clinics nationwide. The Western Region is paying more than 90 
percent of Veterans Choice doctors in less than 30 days and answering 
900,000 phone calls per month, with an average time to answer of under 
25 seconds. Over 3,000 veterans received hepatitis C treatments due to 
Veterans Choice funding.
  There are still kinks in the operation. There are still bottlenecks. 
There are still times when veterans' payments, particularly, have not 
been done in a timely fashion, as the Senator from Kansas mentioned. 
Hopefully, that will change now. As with any program, it had its 
difficulties in its beginning. But I want to tell my colleagues that we 
should make the Choice Card available for any veteran, no matter where 
they happen to reside. It should be, I believe, the basis of our next 
effort. But in the meantime, I want to thank again the Senator from 
Kansas for his hard work.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. CORNYN. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.