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1 H.R. 5674, VA Maintaining Internal Systems and Strengthening Integrated outside Networks Act of 2018 1 (May 14, 2018)

handle is hein.congrec/vamisys0001 and id is 1 raw text is: CONGRESSIONAL BUDGET OFFICE a COST ESTIMATE May 14, 2018 H.R. 5674 VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 As reported by the House Committee on Veterans' Affairs on May 11, 2018 SUMMARY H.R. 5674 would change how the Department of Veterans Affairs (VA) purchases medical care and services for veterans from health care providers in the private sector. The bill also would expand the caregivers program and make other changes to VA's health care programs and compensation of employees. In total, CBO estimates that implementing the bill would cost $46.5 billion over the 2019-2023 period, assuming appropriation of the necessary amounts. In addition, H.R. 5674 would directly appropriate $5.2 billion for the Veterans Choice Program (VCP), increase the fees charged to veterans who obtain loans guaranteed by VA, and extend the current limit on pensions that can be paid to certain veterans who receive benefits from Medicaid. In total, CBO estimates that enacting the bill would increase direct spending by $4.5 billion over the 2018-2028 period. Pay-as-you-go procedures apply because enacting H.R. 5674 would affect direct spending. Enacting the bill would not affect revenues. CBO estimates that enacting H.R. 5674 would not increase net direct spending or on budget deficits by more than $2.5 billion in any of the four consecutive 10-year periods beginning in 2029. H.R. 5674 would impose intergovernmental mandates as defined in the Unfunded Mandates Reform Act (UMRA) by requiring states to grant VA personnel access to state programs that monitor prescription drugs and by preempting state laws that prohibit VA personnel from practicing telemedicine in another state. CBO estimates the costs of the mandates would not exceed the threshold established in UMRA ($80 million in 2018, adjusted annually for inflation).

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