[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8057 Introduced in House (IH)]

<DOC>






119th CONGRESS
  2d Session
                                H. R. 8057

 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.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 24, 2026

   Mrs. Miller-Meeks (for herself and Mr. McCormick) introduced the 
   following bill; which was referred to the Committee on Veterans' 
                                Affairs

_______________________________________________________________________

                                 A BILL


 
 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.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. RATES OF PAY FOR A PROVIDER OF CARE OR SERVICES FURNISHED TO 
              A VETERAN UNDER THE COMMUNITY CARE PROGRAM OF THE 
              DEPARTMENT OF VETERANS AFFAIRS.

    (a) Rates.--Section 1703(i)(1) of title 38, United States Code, is 
amended--
            (1) by striking ``Except as provided in paragraph (2),'' 
        and inserting ``(A) Except as provided in paragraph (2),''; and
            (2) by adding at the end the following new subparagraphs:
    ``(B) Not later than January 1, 2027, the Secretary shall establish 
rates for payments to providers of care or services under subparagraph 
(A) that are specific with respect to the following sites of service at 
which the care or service is actually provided (regardless of the 
physical location of the headquarters of the provider):
            ``(i) A hospital outpatient department.
            ``(ii) An ambulatory surgical center.
            ``(iii) The office of a physician.
            ``(iv) Such other sites as the Secretary determines 
        appropriate in carrying out this paragraph.
    ``(C) The Secretary shall ensure that--
            ``(i) each site specified in subparagraph (B) obtains a 
        National Provider Identifier under section 6225 of the 
        Consolidated Appropriations Act, 2026 (Public Law 119-75) that 
        is separate and unique from such identifier for such provider; 
        and
            ``(ii) no payment for care or services under any provision 
        in this title may be made unless the claim for such payment 
        includes the National Provider Identifier for the site at which 
        such hospital care, medical services, or extended care services 
        were furnished.
    ``(D) In the case of covered OPD services (as defined in section 
1833(t)(1)(B) of the Social Security Act (42 U.S.C. 1395l(t)(1)(B)) 
that are provided on or after January 1, 2027, by a provider that is an 
off-campus outpatient department of a provider (as defined in section 
1833(t)(21)(B) of the Social Security Act (42 U.S.C. 1395l(t)(21(B)), 
disregarding clauses (ii) and (iv) thereof, as if such clauses did not 
exist), the Secretary shall ensure that such department is treated as a 
subpart of such provider and assigned a unique health identifier 
pursuant to subparagraph (C) of this paragraph, and that such provider 
includes such identifier on any claim form it submits under this 
subsection, and that such provider may not hold a veteran liable for 
such item or service unless such care or services are billed using the 
separate unique health identifier established for such department under 
this paragraph.
    ``(E) Nothing in this paragraph may be construed to--
            ``(i) prevent the Secretary from determining the 
        appropriate amount of a facility fee;
            ``(ii) require the Secretary to pay, for the same item or 
        service--
                    ``(I) an independent physician the same amount as 
                the Secretary would pay a hospital-based physician; or
                    ``(II) a hospital-based physician less than the 
                Secretary would pay an independent physician; or
            ``(iii) affect the authority of the Secretary under 
        paragraph (2).''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
take effect on January 1 of the first calendar year beginning after the 
date of the enactment of this Act.
                                 <all>