The bill
VA Billing Accountability Act
HR. 5981, 119th Congress — read as touching Hospitals & Health Systems.
VA Billing Accountability Act
Download PDFBill ID: 119/hr/5981
Last Updated: November 13, 2025
Sponsored by
Rep. Smucker, Lloyd [R-PA-11]
ID: S001199
Follow the money
The sponsor
Rep. Smucker, Lloyd [R-PA-11]
Every bill has someone who introduced it. That name is where the paper trail starts.
The money
$78,897 raised
20 itemised contributions to this sponsor, pulled from FEC filings.
The alignment
70% match to Project 2025
This bill's text tracks the "Department of Veterans Affairs" section, p. 679-681 of the Mandate for Leadership.
Bill's Journey to Becoming a Law
Track this bill's progress through the legislative process
Latest Action
Invalid Date
Introduced
📍 Current Status
Next: The bill will be reviewed by relevant committees who will debate, amend, and vote on it.
🏛️
Committee Review
🗳️
Floor Action
✅
Passed Senate
🏛️
House Review
🎉
Passed Congress
🖊️
Presidential Action
⚖️
Became Law
📚 How does a bill become a law?
1. Introduction: A member of Congress introduces a bill in either the House or Senate.
2. Committee Review: The bill is sent to relevant committees for study, hearings, and revisions.
3. Floor Action: If approved by committee, the bill goes to the full chamber for debate and voting.
4. Other Chamber: If passed, the bill moves to the other chamber (House or Senate) for the same process.
5. Conference: If both chambers pass different versions, a conference committee reconciles the differences.
6. Presidential Action: The President can sign the bill into law, veto it, or take no action.
7. Became Law: If signed (or if Congress overrides a veto), the bill becomes law!
Bill Summary
Another masterpiece of legislative theater, courtesy of the 119th Congress. The VA Billing Accountability Act - because what's more accountable than creating a new law to fix the problems created by previous laws?
Let's dissect this mess:
**New regulations being created or modified:** This bill amends title 38 of the United States Code to authorize the Secretary of Veterans Affairs to waive copayment requirements for hospital care and medical services in cases where the VA screws up. Because, you know, it's not like they have better things to do than fix their own mistakes.
**Affected industries and sectors:** The obvious ones are veterans' healthcare providers, pharmaceutical companies, and third-party billing entities. But let's be real, this bill is just a Band-Aid on the festering wound that is the VA's bureaucratic incompetence.
**Compliance requirements and timelines:** The Secretary of Veterans Affairs has 180 days to review and improve copayment billing internal controls and notification procedures. Because, clearly, the problem here is not enough paperwork and red tape. Oh, and there are new notification deadlines for veterans: 180 days for care at VA facilities and 18 months for non-VA facilities.
**Enforcement mechanisms and penalties:** Ah, the teeth of this bill - or rather, the lack thereof. The Secretary can waive copayment requirements if they deem it necessary, but there's no real mechanism to hold them accountable for their own mistakes. It's like giving a doctor a get-out-of-jail-free card for malpractice.
**Economic and operational impacts:** This bill is a drop in the bucket compared to the VA's overall budget, but it will still cost taxpayers millions to implement and maintain. And let's not forget the opportunity costs - time and resources spent on this bill could be better spent actually fixing the VA's problems rather than just papering over them.
In conclusion, this bill is a classic case of "legislative lip service." It's a half-hearted attempt to address the symptoms of a deeper disease: bureaucratic incompetence and a lack of accountability. The real diagnosis? A bad case of " Politician-itis" - a chronic condition characterized by an inability to make tough decisions or take actual responsibility.
Treatment? Elect better politicians. But let's be real, that's not going to happen anytime soon.
Related Topics
Military & Veterans Affairs
Generated using Llama 3.1 70B (Dr. Haus personality)
💰 Campaign Finance Network
Rep. Smucker, Lloyd [R-PA-11]
Congress 119 • 2024 Election Cycle
Total Contributions
$78,897
16 donors
PACs
$0
Organizations
$0
Committees
$0
Individuals
$78,897
No PAC contributions found
No organization contributions found
No committee contributions found
1
MASRY, LOUIS
$9,900
2
SCHWARZMAN, STEPHEN A.
$6,600
3
SCHWARZMAN, CHRISTINE
$6,600
4
PARKER, ALEXANDRA MRS.
$6,600
5
PARKER, SEAN MR.
$6,600
6
KIMBELL, JEFFREY
$6,600
7
WALTERS, WILLIAM
$5,000
8
REYNOLDS, GARY A.
$4,597
9
FLANIGAN, TIMOTHY
$3,300
10
HOLLINGER, DAVID L. MR.
$3,300
11
ELY, JAMES S. MR. III
$3,300
12
GILBERT, DAN MR.
$3,300
13
RIZIK, MATTHEW
$3,300
14
SCULLY, THOMAS MR.
$3,300
15
STEPHENS, WARREN
$3,300
16
FISHER, KENNETH
$3,300
Donor Network - Rep. Smucker, Lloyd [R-PA-11]
PACs
Organizations
Individuals
Politicians
Hub layout: Politicians in center, donors arranged by type in rings around them.
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Showing 43 nodes and 20 connections (48 secondary connections hidden)
Total contributions: $78,897
Top Donors - Rep. Smucker, Lloyd [R-PA-11]
Showing top 16 donors by contribution amount
16 Individuals
Industry Impact
Which industries are materially affected by specific provisions in this bill. 2 harmed.
- −Hospitals & Health Systemsconfidence 0.90
Section 2(a) and (b) allow the VA Secretary to waive copayments for veterans when VA error delays notification beyond 180 days (hospital care, nursing home care, medical services, medications). This reduces revenue for VA facilities and potentially for non-VA providers paid through VA, imposing a cost on hospitals and health systems that rely on VA copayment collections.
- −Long-Term Care & Nursing Homesconfidence 0.85
Section 2(a) includes 'Nursing Home Care' in the waiver authority, allowing the Secretary to waive copayments for nursing home care when VA error delays notification beyond 180 days. This reduces payments to nursing home operators, imposing a cost on the long-term care industry.
Project 2025 Policy Matches
This bill shows semantic similarity to the following sections of the Project 2025 policy document.AI-enhanced analysis provides detailed alignment ratings.
Department of Veterans Affairs
Moderate
Vector: 66%Pages: 679-681AI Enhanced
AI Analysis:
"HR 5981 aligns with Project 2025's focus on improving VA operational efficiency, transparency, and accountability in healthcare delivery, particularly through billing reforms and system improvements. While the bill does not directly address education programs, innovation offices, or caregiver expansions, it supports broader goals of enhancing veteran experience and administrative effectiveness within the VHA."
Key themes:VA accountabilitybilling transparencyveteran experienceadministrative efficiencyhealthcare operations
— 646 — Mandate for Leadership: The Conservative Promise 3. Section 121 (developing and administering an education program that teaches veterans about their health care options available from the Department of Veterans Affairs). 4. Section 152 (returning the Office for Innovation of Care and Payment to the Office of Enterprise Integration with a joint governance process set up with the VHA). 5. Section 161 (overhauling Family Caregiver Program expansion, which has gone poorly, so that it focuses on consistency of eligibility and awareness that the most severely wounded or injured may require the program indefinitely). l Require the VHA to report publicly on all aspects of its operation, including quality, safety, patient experience, timeliness, and cost-effectiveness, using standards similar to those in the Medicare Accountable Care Organization program so that the government may monitor and achieve continuous improvement in the VA system more effectively. l Encourage VA Medical Centers to seek out relevant academic and private- sector input in their communities to improve the overall patient experience. Budget l Conduct an independent audit of the VA similar to the 2018 Department of Defense (DOD) audit to identify IT, management, financial, contracting, and other deficiencies. l Assess the misalignment of VHA facilities and rising infrastructure costs. The VHA operates 172 inpatient medical facilities nationally that are an average of 60 years old. Some of these facilities are underutilized and inadequately staffed. Facilities in certain urban and rural areas are seeing significant declines in the veteran population and strong competition for fresh medical staff. In 2018, Congress authorized an Asset Infrastructure Review (AIR) of national VHA medical markets to provide insight into where the VA health care budget should be responsibly allocated to serve veterans most effectively. However, the Senate Veterans Affairs Committee lacked the political will to act on the White House’s nominations of commission members, and this ultimately led to termination of the AIR process. The next Administration should seek out agile, creative, and politically acceptable operational solutions to this aging infrastructure status quo, — 647 — Department of Veterans Affairs reimagine the health care footprint in some locales, and spur a realignment of capacity through budgetary allocations. Specifically: 1. Embrace the expansion of Community Based Outpatient Clinics (CBOCs) as an avenue to maintain a VA footprint in challenging medical markets without investing further in obsolete and unaffordable VA health care campuses. 2. Explore the potential to pilot facility-sharing partnerships between the VA and strained local health care systems to reduce costs by leveraging limited talent and resources. Personnel l Extend the term of the Under Secretary for Health (USH) to five years. Additionally, authority should be given to reappoint this individual for a second five-year term both to allow for continuity and to protect the USH from political transition. l Establish a Senior Executive Service (SES) position of VHA Care System Chief Information Officer (CIO), selected by and reporting to the chief of the VHA Care System with a dotted line to the VA CIO. l Identify a workflow process to bring wait times in compliance with VA MISSION Act–required time frames wherever possible. 1. Assess the daily clinical appointment load for physicians and clinical staff in medical facilities where wait times for care are well outside of the time frames required by the VA MISSION Act. 2. Require VHA facilities to increase the number of patients seen each day to equal the number seen by DOD medical facilities: approximately 19 patients per provider per day. Currently, VA facilities may be seeing as few as six patients per provider per day. 3. Consider a pilot program to extend weekday appointment hours and offer Saturday appointment options to veterans if a facility continues to demonstrate that it has excess capacity and is experiencing delays in the delivery of care for veterans. 4. Identify clinical services that are consistently in high demand but require cost-prohibitive compensation to recruit and retain talent, and examine exceptions for higher competitive pay.
Department of Veterans Affairs
Moderate
Vector: 66%Pages: 676-678AI Enhanced
AI Analysis:
"The bill focuses on improving VA billing accountability and reducing administrative burdens, which aligns with Project 2025's broader goal of enhancing VA operations and addressing systemic problems, though it does not directly address the specific clinical policy, demographic, disability benefits, or infrastructure reforms emphasized in the policy."
Key themes:VA accountabilityadministrative efficiencytransparencyveteran serviceshealthcare billing
— 643 — Department of Veterans Affairs with a growth in same-day surgical procedures and outpatient care, so has the VA, and in 2018 Congress added access to private-sector urgent care outlets as one of the VA’s health care benefits. Today, the VA operates 172 inpatient VA Medical Centers (VAMCs), which are an average of 60 years old, and 1,113 Community Based Outpatient Clinics (CBOCs), which are newer facilities designed to meet the needs of veterans closer to home. The VA also manages a Community Care Network (CCN) through contracts with Optum and TriWest, third-party health care administrators responsible for build- ing and maintaining a robust population of community providers to meet the needs of veterans referred for care outside of the VA system. Currently, approximately 6.4 million veterans out of 18 million nationally (and out of the 9.1 million who are enrolled) use the VA for health care; the remainder use employer-sponsored plans, Tricare, Medicare, and Medicaid. The disability benefits system evolved significantly in the years between the Cold War era and the global war on terrorism, a period when the VA enrolled large numbers of veterans from World War II, Korea, and Vietnam who were seeking disability benefits and health care. Disability compensation is the largest VA benefit, but there also are dozens of others, the next largest of which are the GI Bill and the Home Loan Guaranty. These benefits are administered through 56 Regional Benefits Offices (RBOs) and hundreds of satellite sites around the country. The Agent Orange Act of 19914 significantly expanded the scope of disability ben- efits for those who had deployed to Vietnam, and the cost of those benefits began to increase dramatically as the Vietnam generation of veterans aged and began to expe- rience adverse health conditions, some of which were presumed to have been caused by defoliant chemicals used in Southeast Asia. In 2016 and 2017, a burdensome backlog of appeals of denied disability claims from multiple wartime generations—a backlog numbering in the hundreds of thousands—led to a joint effort by the VA, Vet- eran Service Organizations (VSOs), and Congress to pass legislation that streamlined appeal processes. Implemented in 2017, this historic “good governance” success has helped the VA to reduce the number of these appeals dramatically. The Sergeant First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxics (PACT) Act of 20225 addressed adverse health outcomes presumed to be the result of veterans’ exposure to airborne toxins during the global war on terrorism and further expanded disability benefits to the most recent gen- eration of veterans. These ambitious authorities, like the 1991 authorities, have the potential to overwhelm the VA’s ability to process new disability claims and adjudicate appeals. Currently, the VA is seeking to hire large numbers of personnel to process these claims while exploring the use of an automated process to accel- erate claims reviews and decisions. The ever-present lag in the hiring and training of new employees could result in major problems with the timely adjudication of benefits well into the next Administration in 2025. — 644 — Mandate for Leadership: The Conservative Promise In sum, the VA for the foreseeable future will experience significant fiscal, human capital, and infrastructure crosswinds and risks. Budgets are at historic highs, and with a workforce now above 400,000, the VA is contending with a lack of new veteran enrollees to offset the declining population of older veterans. Recruitment of medical and benefits personnel has become more challenging. Veterans are migrating from the northern states to the southern and western states for retirement and employment. Meanwhile, VA information technol- ogy (IT) is struggling to keep pace with the evolution of patient care and record keeping. Consequently, VA leaders in the next Administration must be wise and courageous political strategists, experienced managers to run day-to-day oper- ations more effectively, innovators to address the changing veteran landscape, and agile “fixers” to mitigate and repair systemic problems created or ignored by the present leadership team. VETERANS HEALTH ADMINISTRATION (VHA) Needed Reforms l Rescind all departmental clinical policy directives that are contrary to principles of conservative governance starting with abortion services and gender reassignment surgery. Neither aligns with service-connected conditions that would warrant VA’s providing this type of clinical care, and both follow the Left’s pernicious trend of abusing the role of government to further its own agenda. l Focus on the effects of shifting veteran demographics. At least during the next decade, the VA will experience a significant generational shift in its overall patient population. Of the approximately 18 million veterans alive today, roughly 9.1 million are enrolled for VA health care, and 6.4 million of these enrollees use VA health care consistently. These 6.4 million veterans are split almost evenly between those who are over age 65 and those who are under age 65, but the share of VA’s health care dollars is spent predominantly in the over-65 cohort. That share increases significantly as veterans live longer and use the VHA system at a higher rate. VHA enrollments of new users are increasingly at risk of being exceeded by the deaths of current enrollees, primarily because significant numbers of the Vietnam generation are reaching their life expectancy. The generational transition from Vietnam-era veterans to post-9/11 veterans will take several years to complete. The ongoing demographic transition is a catalyst for needed assessments of how the VA can improve the delivery of care to a numerically declining and differently dispersed national population
Department of Veterans Affairs
Weak
Vector: 70%Pages: 682-684AI Enhanced
AI Analysis:
"The bill focuses on VA billing accountability and copayment waivers for delayed notifications, while Project 2025 emphasizes streamlining disability claims processing, automation, and improving timeliness in benefits delivery through private-sector tools and management reforms. There is minimal thematic overlap, as the bill does not address claims adjudication, automation, or performance metrics central to the Project 2025 VA objectives."
Key themes:Department of Veterans Affairsaccountabilityprocess improvement
— 649 — Department of Veterans Affairs approaches and technology tools that currently exist in the private sector could be employed to improve existing VBA activities. This problem is most pronounced in the disability claims process, which needs more and better management attention focused on streamlining the procedures involved in processing claims and administering benefits. The VA must improve timeliness of claim adjudication and benefits delivery: Veterans want the VBA to provide timely responses to requests for benefits support, render empathetic customer service and understandable explanations of those benefits, and deliver those benefits without frustrating delays (weeks, not months). l Identify performance targets for benefits, report publicly on actual performance each quarter, and use these metrics to drive consistent improvement. l Develop a new pilot “Express 30” commitment for a veteran’s first fully developed disability compensation claim and organize the VBA to complete the first claim in 30 days. l Hire more private companies to perform disability medical examinations. Delays in completing the examinations could be eliminated with more external capacity. l Increase automation. Hiring additional staff to process claims is costly, is inflexible, and has yielded mixed results. Attempting to change laws and regulations simply to adjudicate claims would be a herculean effort given their complexity. The best way to provide benefits faster and more accurately is by using technology to perform most of the work. Technology currently exists in the private sector, but the VBA lacks the expertise to use it. This would be more of an organizational challenge than a technology hurdle. l Reduce improper payment and fraud. About $500 million is improperly paid out each year. Better tools, training, and management could reduce this substantially, but rule changes at the departmental level would be needed. Budget The VA’s Schedule for Rating Disabilities (VASRD) has assigned disability ratings to a growing number of health conditions over time; some are tenuously related or wholly unrelated to military service. The further growth in presumptive service-connected medical conditions pursued by Congress and Veteran Service Organizations, begun with Agent Orange and most recently for Burn Pits/Airborne — 650 — Mandate for Leadership: The Conservative Promise Toxins, has led to historic increases in mandatory VBA spending in recent years. The VA has a time-phased plan to reassess the VASRD and its ratings for com- pensation, but this internal process can be slow and laborious, requires Office of Management and Budget (OMB) approvals, and can become politically charged both in Congress and with VSOs. l The next Administration should explore how VASRD reviews could be accelerated with clearance from OMB to target significant cost savings from revising disability rating awards for future claimants while preserving them fully or partially for existing claimants. l The VBA’s Information Technology top-line budget should be reexamined and reassessed in light of the need for expanded automation across the enterprise. l Traditionally, VHA captures the large majority of VA IT funding. The VBA needs to make the case for a larger IT budget with clear requirements to support that request. Personnel l Pursue reforms of the Human Capital Management process and operations within the VBA to build a more blended workforce with more contractors to process claims. This would free federal employees to perform other duties and be involved solely with the final decision to award benefits. l Improve the VBA acquisition workforce. The VBA needs more world-class contractor support. Currently, few of the top companies have contracts with the VBA, and the VBA needs to conduct more outreach to the private sector through senior leader engagement and industry conferences. l To identify more effective and efficient ways to complete claims, establish a knowledge exchange program with top-tier private-sector companies that do similar work. The VBA is fundamentally a financial services organization. A significant amount of its work has a private-sector analogue that could be leveraged to improve service to veterans. l For most of its existence, the VBA has been a risk-averse, insular, paper-based organization, implementing technology only over the past decade. This insularity has led to a predominantly “build it ourselves” approach, partly because VBA staff has limited experience or insight into current private- sector tools and methods and partly because the VBA struggles to compete
Showing 3 of 5 policy matches
About These Correlations
Policy matches are calculated using a hybrid approach: initial candidates are found using semantic similarity between bill summaries and Project 2025 policy text, then an AI model (Llama 3.1 70B) provides detailed alignment ratings and analysis. Ratings range from 1 (minimal alignment) to 5 (very strong alignment). This analysis does not imply direct causation or intent.