HR740-119

What This Bill Does

The Veterans' ACCESS Act of 2025 expands and formalizes veterans' ability to use care outside the Department of Veterans Affairs system when VA cannot meet access standards. For primary care, mental health care, and extended care, VA must treat a covered veteran as eligible for community care when VA cannot schedule care within 30 minutes average driving time and 20 days of the request unless the veteran agrees to longer access. For specialty care, the standard is 60 minutes average driving time and 28 days. VA cannot count telehealth availability against those access standards, must restart wait-time calculations from the original request when VA cancels an appointment, must document any veteran agreement to longer travel or wait times, and must review the standards every three years with federal, veteran, provider, and private-sector input. The bill also requires two-business-day notices for community-care eligibility and denials, adds veteran preference and caregiver needs to care decisions, extends community-care provider claim deadlines from 180 days to one year, standardizes mental health residential treatment screening and admission metrics, and directs VA to build an online self-service module for appointments, referrals, reminders, appeals, and tracking.

Who Benefits and How

Veterans seeking VA community care benefit from clearer statutory travel and wait-time thresholds, faster written notice, appeal instructions when denied, and the ability to choose community care when VA cannot meet those standards. Veterans with serious mental health needs benefit from standardized screening for priority or routine residential treatment, with priority criteria covering suicide risk, overdose risk, unsafe living situations, severe symptoms, relapse, and failure of outpatient treatment. Veteran caregivers benefit because VA must consider whether a veteran needs caregiver or attendant assistance when deciding where and how care is provided. Community care providers benefit from more predictable eligibility and a one-year claim-submission window. Telehealth providers and healthcare IT vendors benefit from required telehealth discussions and VA's online self-service module. Veterans service organizations gain a formal consultation role in reports on clinical appeals.

Who Bears the Burden and How

VA scheduling administrators must apply statutory access standards, document exceptions, restart wait-time clocks after VA cancellations, send eligibility notices within two business days, and send denial notices with appeal instructions. VA mental health program administrators must build screening criteria, admission metrics, quality assessments, provider ratios, training measures, and transportation assessments for residential programs. VA medical facilities and Veterans Integrated Service Networks must be tracked against routine and priority admission performance. The VA Secretary must report repeatedly to congressional veterans committees on access standards, self-service implementation, innovation-center pilots, clinical appeals, eligibility, denials, and Third Party Administrator performance. Federal taxpayers may bear higher costs if more care shifts from VA facilities to community providers.

Key Provisions

• Establishes 30-minute/20-day community-care standards for primary care, mental health care, and extended care, and 60-minute/28-day standards for specialty care.
• Blocks VA from using available telehealth appointments to deny community-care eligibility under the access standards.
• Requires VA to notify veterans of community-care eligibility or denial within two business days and explain appeal rights.
• Expands care-placement factors to include veteran preference, continuity of care, and caregiver or attendant needs.
• Extends the community-care provider claim-submission deadline from 180 days to one year.
• Requires standardized mental health residential treatment screening, admission metrics, quality assessments, and transportation assessments.
• Directs VA to implement an online self-service module for appointments, referrals, reminders, appeals, and tracking.
• Requires recurring VA reports on clinical appeals, community-care eligibility, denial reasons, and Third Party Administrator performance.