Hoeven Joins President as VA MISSION Act is Signed Into Law

Includes Hoeven’s Veterans Access to LTC and Health Services, Access to Community Care for Veterans Act to Fix 40-Mile Issue

WASHINGTON – Senator John Hoeven today joined the president as he signed into law the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act. The legislation streamlines the Department of Veterans Affairs (VA) community care programs into a new Veteran Community Care Program, improving upon the Veterans Choice Program. The bill includes Hoeven’s initiatives, including:

  • 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 loved ones.
  • 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.

“We appreciate the invitation to the White House for this bill signing, which will help deliver better health care to our veterans and build stronger partnerships with community providers,” said Hoeven. “In order to do that, this legislation needs to be implemented in the right way. That’s why we will work with stakeholders and veterans in North Dakota, as well as the administration, to prevent the issues we experienced with third party administrators under the Veterans Choice Program. Our veterans and the medical professionals that serve them deserve a straightforward process that provides certainty, both that veterans will receive care and providers will be reimbursed in a convenient and timely fashion.”  


Currently, only about 20 percent 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. 


In addition to the provisions outlined above, the VA MISSION Act will help improve veterans’ 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.


Hoeven will work with the Fargo VA Medical Center, Veteran Service Organizations, medical and long-term care providers and others to ensure the legislation is properly implemented and achieves the intent of Congress. This aligns with the senator’s efforts to provide veterans with quality health care, closer to home. 

That includes 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.