The Senate on Wednesday passed a bill to streamline the VA's community care programs, mandate prompt payment for private providers and demand higher care standards from VA clinics, sending the reforms to President Donald Trump's desk.
The legislation package, which both Democrats and Republicans backed, took months of hard brokering, and Trump's signature will start the ball rolling on regulations. It passed with five Democratic and GOP senators opposed. The first set of regulations will focus on a key demand from the Trump administration: imposing designated access standards on VA clinics for veteran treatment.
The VA will have 120 days to release the first draft of the access standards, according to Darin Selnick, who served as the veterans affairs advisor on the White House Domestic Policy Council and at the VA and is also senior advisor for the conservative Concerned Veterans for America.
The regulations must be finalized in the next year before the current Choice program expires. This is a tight timeline, Selnick admitted, and said he wants the regulations to be flexible enough to modernize the VA health system and move it toward value-based care.
"This is the mechanism to get that done," Selnick said.
House VA Committee Chair Phil Roe (R-Tenn.) said as he is thinking about implementation of Choice he is turning his focus to the roll-out of the new electronic health record system which is slated to happen as the department has to consolidate and streamline the community care programs.
The Senate's Wednesday vote meant that Congress met Trump's Memorial Day deadline to get the legislation finalized — which at one point seemed like a heavy lift as negotiations lapsed late last year when Sen. Jerry Moran (R-Kan.) voted against the Senate VA Committee's version of the bill and pushed his bill that incorporated designated access standards in statute that the VA would have to adhere to.
The Senate VA Committee's Ranking Democrat Jon Tester of Montana praised the final result as a simpler program that balances working with the private sector and building capacity within the VA.
"The Choice program has been a wreck, every veteran up here will tell you that," Tester said.
He noted that the current Choice program was implemented quickly and "has had a lot of hiccups."
The rulemaking process will start without a permanent VA secretary. Current acting VA secretary Robert Wilkie has been nominated for the post, and his vetting process should begin next week.
