Sponsors (46)
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Gives state-run veterans homes a choice for high‑cost prescriptions: they can either be reimbursed by the Department of Veterans Affairs (VA) for the medication or have the VA directly furnish it. This aims to prevent budget strain on state facilities when residents need very expensive drugs. It also defines what counts as a “costly medication” using a formula-based threshold and clarifies which facilities qualify as a “covered State home,” so the rules are clear and consistent nationwide.
Amend Section 1745(a)(3) of title 38, United States Code by striking the word "Payment" and inserting the following provisions (adding new subparagraphs).
Adds a new subparagraph (B): In addition to the payment described in subparagraph (A), the Secretary shall, at the election of a covered State home, either (i) reimburse the covered State home for a costly medication; or (ii) furnish such costly medication to the covered State home.
Adds a new subparagraph (C)(i) defining "costly medication" as a drug or medicine for which the average wholesale price for one month’s supply, plus a 3 percent transaction fee, exceeds 8.5 percent of the payment under subparagraph (A) by the Secretary to a covered State home for care provided to the veteran who receives such costly medication during such month.
Adds a new subparagraph (C)(ii) defining "covered State home" as a State home that, in the course of nursing home care provided pursuant to a contract (or agreement) under paragraph (1), provides to a veteran a costly medication.
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Referred to the House Committee on Veterans' Affairs.
Introduced March 10, 2025 by Mariannette Miller-Meeks · Last progress March 10, 2025
Referred to the Subcommittee on Health.
Referred to the House Committee on Veterans' Affairs.
Introduced in House