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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.

This bill pertains to the payment rates for care or services provided to veterans under the Community Care Program of the Department of Veterans Affairs (VA). The main changes proposed by the bill include:

Modification of Payment Rates

The bill seeks to amend the existing law (title 38, United States Code, section 1703(i)) which governs how the VA pays for care or services for veterans. The key modifications include:

  • Payment Rates Based on Location: The bill mandates that payment rates for services or care provided to veterans will be adjusted based on the specific location where the care is delivered. This means that different rates may apply depending on whether the service was provided in an inpatient hospital, an outpatient department (on-campus or off-campus), an ambulatory surgical center, or a physician's office.
  • Unique Provider Identifier Codes: The bill introduces a requirement for a unique, geographically specific national provider identifier code for claims. This code will ensure that payments are associated with the actual location of service provision rather than just where the service provider is headquartered.
  • Lowest Rate Payment: If there are multiple payment rates applicable for care or services at a specific location, the bill states that the VA must pay the lowest applicable rate for that service.

Implementation Timeline

The changes proposed in this bill would take effect on January 1, 2026.

Summary

The focus of this bill is to ensure that the rates paid for veteran care are fair and reflective of the current healthcare environment by considering the geographic location of care provided, and to streamline the claims process by using specific identifiers that correspond with those locations.

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Sponsors

2 bill sponsors

Actions

3 actions

Date Action
Mar. 04, 2025 Referred to the Subcommittee on Health.
Jan. 31, 2025 Introduced in House
Jan. 31, 2025 Referred to the House Committee on Veterans' Affairs.

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