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 payment rules for veterans

If enacted, VA would change how it pays for Community Care by basing payments on the actual site where care is given. VA would be required to set site-specific rates no later than January 1, 2027. Each site would need a separate National Provider Identifier and VA could not pay a claim unless the claim included the site’s identifier. For off-campus hospital outpatient departments, VA would require a unique department identifier on claims and providers could not hold a veteran liable for the service unless that department identifier was used on the bill. The bill would also say VA may still set facility fees and decide payment differences between hospital-based and independent physicians.