S. 5497: Providing Veterans Essential Medications Act

This bill would change how the Department of Veterans Affairs (VA) handles certain expensive prescription drugs for veterans living in State homes that provide nursing home care under contract with the VA.

What the bill does

Under current law, the VA pays State homes a set amount for care provided to eligible veterans. This bill would add a new rule for costly medications given to those veterans. For medications that meet the bill’s cost threshold, the VA would have to either:

• reimburse the State home for the medication’s cost, or
• provide the medication directly to the State home.

The State home would get to choose which of those two options applies.

What counts as a “costly medication”

A medication would count as “costly” if the average wholesale price for a one-month supply, plus a 3% transaction fee, is more than 8.5% of the VA payment the State home receives for that veteran’s care for that month.

Which facilities are covered

The new rule would apply only to a covered State home, meaning a State home that provides nursing home care to a veteran under a contract or agreement with the VA and gives that veteran one of these costly medications.

Practical effect

In practice, the bill would shift the financial burden of certain high-priced drugs away from State homes and toward the VA. It is aimed at making sure State homes are not left paying large medication costs out of their own budgets when caring for veterans in nursing homes.

Relevant Companies

None found