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.

New VA site-based payment rules

This bill would require the VA to set different payment rates for care based on the place the care was given. The VA would have to create site-specific rates not later than January 1, 2027. Each care site would need its own separate National Provider Identifier (NPI), and VA would not pay a claim unless the claim shows the site's NPI. For certain off-campus outpatient department services provided on or after January 1, 2027, that department would be treated as part of the provider, assigned its own identifier, and a veteran could not be billed unless the bill used that department's identifier. The VA Secretary would still be able to set facility fees and would not be required to pay independent and hospital-based physicians the same amount for the same service.