Critical Access for Veterans Care Act
Sponsored By: Senator Kevin Cramer
Introduced
Summary
Expands veterans' access to care at Critical Access Hospitals by creating a new 35-mile eligibility path and removing preauthorization barriers so veterans can seek nearby CAH and affiliated rural clinic care more easily. This change also shifts payment and claims rules to align with Medicare rates and cost-based reimbursement.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
Medicare pay and faster VA payments
If enacted, VA would pay critical access hospitals at the Medicare cost‑based rate and affiliated provider‑based rural clinics at the rate under section 1833 for care under the 35‑mile pathway. Claims for that care would need a special identifier and would be reimbursed at the Medicare cost level. The VA and CMS could issue guidance to align claims rules with Medicare contractors. VA would have to review and pay those claims within 60 days of submission.
More local care for nearby veterans
If enacted, you could get VA community care at a nearby critical access hospital or its affiliated rural clinic if you live within 35 miles. This would apply when you seek care at that hospital or clinic, or at a VA‑specified provider referred by them. The VA could not require prior authorization or a referral before that care. The bill would use the Medicare definition of "critical access hospital" to decide which hospitals count.
Sponsors & CoSponsors
Sponsor
Kevin Cramer
ND • R
Cosponsors
Tim Sheehy
MT • R
Sponsored 5/22/2025
Roll Call Votes
No roll call votes available for this bill.
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