Hoeven: Congress Passes VA Community Care Reform

Senator Worked to Include Expanded Long-Term Care & Caregiver Benefits, Eliminate 30-Day/40-Mile Rule

WASHINGTON – Senator John Hoeven today helped pass the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act, legislation that streamlines the Department of Veterans Affairs (VA) community care programs into a new Veteran Community Care Program and improves upon the Veterans Choice Program. The bill has passed both the Senate and the House of Representatives and will now go to the president to be signed into law. Hoeven worked to ensure the legislation included the following priorities to provide veterans with quality health care, closer to home:

  • Key provisions from his Veterans Access to Long Term Care and Health Services Act to increase access to long-term care (LTC) options for veterans in their home communities and near their loves.
  • Expands caregiver benefits for veterans of all eras. Under current law, these benefits are only available to caregivers of post-9/11 veterans. This provision will help support all veterans and the family and friends that care for them.
  •  Removes the arbitrary 30-day/40-mile rule, which acted as a barrier to veterans receiving care in their home communities and often required veterans to travel long distances to receive health care. Last Congress, Hoeven helped introduce and the Senate passed the Access to Community Care for Veterans Act, legislation to fix the 40-mile issue.

“Our veterans shouldn’t have to travel across the state just to receive the care they need,” said Hoeven. “Our legislation will help make more long-term care services available to our veterans, provides caregiver benefits regardless of when the veteran served and eliminates the 30-day, 40-mile rule under the Veterans Choice Program. That means veterans will be better able to seek services from local providers, both for long-term care and medical care, and the friends and family who care for veterans will receive better support. This is all about providing quality and convenient health care for our veterans.”  


Currently, only 14 out of 80 North Dakota nursing homes contract with the VA due to the agency’s difficult regulations and reporting requirements. The provisions Hoeven secured will allow the VA to enter into provider agreements with qualified health care and long-term care facilities, provide relief from expensive federal contracting requirements and enable more LTC providers to accept veteran patients. 

“VA provider agreements are an essential step to ensuring veterans have access to long-term and post-acute care,” said Mark Parkinson, president and CEO of the American Health Care Association (AHCA). “This legislation will help remove some of existing red tape that may prevent some providers from being able to provide care, broadening options for veterans who need both nursing center care and home and community-based services. AHCA would like to thank our Congressional leaders on this issue, including Senators John Hoeven and Mike Rounds and Congressman Bruce Poliquin, among others, who have been strongly advocating to get this issue across the finish line for our nation’s veterans.”

“The North Dakota Long Term Care Association and its provider members applaud Senator Hoeven for his leadership in introducing the Veterans Access to Long Term Care and Health Services Act and his work to secure important provisions from the bill in the VA MISSION Act of 2018. This important legislation ensures that America’s heroes have wider access to the quality health care they deserve with our long-term care providers in North Dakota and across the country,” said Shelly Peterson, President of the North Dakota Long Term Care Association.


In addition to the provisions outlined above, the VA MISSION Act will help improve veteran access to community care by:

  • Providing $5.2 billion for the Veterans Choice Fund
  • Creating standards for timely payment to community care providers.
  • Authorizing access to walk-in community clinics for enrolled veterans who have used VA health care services in the last two years.
  • Strengthening the process for ensuring responsible prescribing of opioids to veterans for VA and partnering health care providers.
  • Ensuring providers removed or suspended from VA practice do not treat veterans in the community.
  • Improving the recruitment of VA health care professionals.
  • Requiring the VA to schedule medical appointments in a timely manner.

Today’s legislation follows Hoeven’s work to secure and implement the Veterans Care Coordination initiative at the Fargo VA Health Center in 2016. The initiative allows veterans seeking community care to coordinate all of their health care through the Fargo VA rather than Health Net. The initiative also placed a Health Net representative at the Fargo VA to improve provider reimbursements and reduce denial of veterans’ claims. Hoeven’s staff has worked directly with the Fargo VA and providers since the implementation of the Veterans Choice Program to resolve outstanding payments by Health Net.