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1 H.R. 4242, VA Care in the Community Act 1 (February 15, 2018)

handle is hein.congrec/vacrmut0001 and id is 1 raw text is: CONGRESSIONAL BUDGET OFFICE a COST ESTIMATE February 15, 2018 H.R. 4242 VA Care in the Community Act As ordered reported by the House Committee on Veterans' Affairs on December 19, 2017 SUMMARY H.R. 4242 would increase the use of community health care and long-term care by the Department of Veterans Affairs (VA) by broadening eligibility for such care and allowing VA to enter into agreements with health care providers in the private sector without complying with the Federal Acquisition Regulation (FAR). The bill also would change VA's coverage of ambulance services and transplant operations at nondepartment facilities. In addition, H.R. 4242 would allow VA to repay loans for and provide scholarships to its medical staff. In total, CBO estimates that implementing the bill would cost $38.8 billion over the 2018-2022 period, assuming appropriation of the necessary amounts. Enacting the bill would not affect direct spending or revenues; therefore, pay-as-you-go procedures do not apply. CBO estimates that enacting H.R. 4242 would not increase net direct spending or on- budget deficits in any of the four consecutive 10-year periods beginning in 2028. H.R. 4242 would impose an intergovernmental mandate as defined in the Unfunded Mandates Reform Act (UMRA) by preempting state laws that prohibit VA physicians from practicing telemedicine to treat veterans across state lines. Although it would limit the application of state regulations, that mandate would impose no duty on state governments that would result in additional spending or any significant loss of revenues. The bill contains no private-sector mandates as defined in UMRA. ESTIMATED COST TO THE FEDERAL GOVERNMENT The estimated budgetary effects of H.R. 4242 are shown in the following table. The costs of this legislation fall within budget function 700 (veterans benefits and services).

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