Veterans’ Assuring Critical Care Expansions to Support Servicemembers (ACCESS) Act of 2025
- Sponsor
- Sen. Moran, Jerry [R-KS]
- Committees
- Veterans' Affairs Committee (primary)
- Last action
- Jul 30, 2025
Bottom line
The Veterans' ACCESS Act aims to expand and streamline veteran access to community medical and mental health care by standardizing eligibility, improving transparency, and enhancing oversight of VA and non-VA services.
What it actually does
This bill significantly reforms the Department of Veterans Affairs (VA) Community Care Program by codifying eligibility standards, enhancing veteran notification and appeal rights, and requiring consideration of veteran preferences. It also establishes a standardized process for veteran eligibility and admission to mental health residential treatment programs, mandates improvements to these programs, and requires a pilot program for direct access to outpatient mental health and substance use services through community providers. Additionally, it directs the VA to develop an online self-service module for care requests and appeals.
Proponents argue
Supporters argue that the bill will ensure veterans receive timely access to necessary care, especially mental health services, by setting clear eligibility standards for community care and preventing the VA from using telehealth availability to deny in-person options. They contend that the standardized processes, enhanced notifications, and appeal rights will empower veterans and improve the efficiency and accountability of the VA's community care and mental health programs.
Opponents contend
Potential critics might raise concerns about the increased administrative burden and costs associated with implementing the numerous new requirements, such as standardized screening, extensive reporting, and the development of new IT systems. Some may also argue that expanding community care too broadly could strain VA's internal capacity or lead to fragmentation of care, though direct opposition to the bill's core goals of improving veteran access is generally uncommon.
The bill is moderately detailed, requiring careful reading to understand the specific changes to VA processes, eligibility standards, and mental health program requirements.
Sec. 101
Codification of Community Care Eligibility Standards
This section codifies specific eligibility standards for veterans to receive non-Department hospital care, medical services, or extended care services through the Veterans Community Care Program. It sets maximum driving times (30 minutes for primary/mental health/extended care, 60 minutes for specialty care) and wait times (20 days for primary/mental health/extended care, 28 days for specialty care). Crucially, it prohibits the VA from considering the availability of telehealth appointments when determining if these standards are met, ensuring veterans have access to in-person community care options if VA cannot meet the physical access standards. It also ensures wait times for canceled appointments are calculated from the original request date.
Supporters argue
Proponents argue this codification ensures veterans receive timely, geographically accessible care, preventing situations where telehealth is offered as the only alternative when in-person VA care is not readily available. It prioritizes veteran choice and physical access.
Critics contend
Some might argue that strictly excluding telehealth from eligibility determination could limit flexibility and potentially increase costs if veterans are referred to community care even when a suitable telehealth option is available and preferred by some.
Tradeoffs
The provision balances the desire for guaranteed in-person access with the potential for increased costs and administrative complexity for the VA, and the role of telehealth as a convenient care modality.
Sec. 102
Veteran Notification of Community Care Eligibility
This section requires the Secretary of Veterans Affairs to notify each eligible veteran in writing, within two business days, of their eligibility for care or services under the Veterans Community Care Program. It also mandates periodic reminders of ongoing eligibility and allows for electronic notification.
Sec. 103
Consideration of Veteran Preference and Continuity of Care
This section amends existing law to require the VA to consider a veteran's preference for where, when, and how to seek care, continuity of care, and the need for a caregiver or attendant when making decisions about community care.
Sec. 104
Notification of Community Care Denial and Appeal Process
If a veteran's request for community care is denied, the VA must notify the veteran in writing within two business days, stating the reason for denial and providing instructions on how to appeal using the Veterans Health Administration's clinical appeals process. If the denial is due to not meeting eligibility access standards, the notice must explain why.
Sec. 202
Standardized Eligibility for Mental Health Treatment Programs
This section mandates the VA to establish a standardized screening process for determining eligibility for mental health residential rehabilitation treatment programs. It defines criteria for 'priority admission' (e.g., unsafe living situation, suicide risk, non-responsive to other treatments) and sets strict timelines: screening within 48 hours of request, and admission for priority cases within 48 hours of determination. It also requires the VA to offer non-Department facility care if VA facilities cannot meet these timelines and standards.
Sec. 203
Improvements to VA Mental Health Residential Rehabilitation Treatment Program
This section mandates a comprehensive set of improvements, including developing performance metrics for screening and admission, establishing a systematic process for assessing care quality (both VA and non-VA providers), providing transportation assistance, creating a national clinical appeals policy for denials or untimely bed placement, tracking program availability and wait times in real-time, updating staff training, and ensuring continuity of care and discharge planning. It also requires extensive reports to Congress and a Comptroller General review.
Sec. 302(c)
Pilot Program for Direct Access to Mental Health and Substance Use Services
This section mandates the Center for Innovation for Care and Payment to establish a three-year pilot program in at least five locations. This pilot will allow veterans enrolled in the VA system to directly access outpatient mental health and substance use services through specified community health care providers without requiring a referral or pre-authorization from the VA. The pilot prioritizes sites in diverse geographic areas, those with high rates of veteran suicide/overdose, long VA wait times, and value-based care models.
When determining a veteran's eligibility for community care based on driving time or wait time standards, the VA is explicitly prohibited from considering the availability of telehealth appointments from the Department.
Sec. 101(a)(2)
Why it matters:This is a substantively consequential clarification, ensuring that telehealth is not used as a loophole to deny in-person community care when the VA cannot meet its access standards. Its placement is standard legislative practice for defining scope.
Case for: Supporters argue this ensures veterans are not forced into telehealth when they need or prefer in-person care and when VA facilities cannot meet established access standards for physical locations.
Case against: Critics might argue that this could lead to unnecessary community care referrals and costs, even when telehealth could be an appropriate and convenient option for a veteran.
Estimated impact: Potentially increases the number of veterans eligible for community care, and thus VA expenditures on community care, by removing telehealth as a disqualifying factor for in-person access.
Amends Section 1703D(b) of title 38, United States Code, to extend the deadline for health care entities and providers to submit claims under the prompt payment standard from 180 days to one year.
Sec. 106
Why it matters:This is a technical but financially significant change for community care providers. Its placement is standard for amending existing code.
Case for: Proponents argue this provides much-needed flexibility for community care providers, reducing administrative burden and improving cash flow, which encourages more providers to participate in the VA Community Care Program.
Case against: Critics might argue that extending the deadline could delay VA's ability to reconcile accounts and potentially increase the risk of fraudulent or erroneous claims, though this is a less common concern.
Estimated impact: Improves financial stability for community care providers by giving them more time to submit claims, potentially increasing provider participation in the program.
Adds 'increase productivity, efficiency, and modernization throughout the Department' as a new purpose for the Center for Innovation for Care and Payment.
Sec. 302(a)(3)(C)
Why it matters:This is a significant expansion of the Center's mandate, broadening its scope beyond just care and payment models to encompass overall departmental operations. Its placement is standard for amending a list of functions.
Case for: Proponents argue this empowers the Center to drive broader, much-needed improvements across the entire VA, not just within specific care programs, leading to more comprehensive modernization.
Case against: Critics might argue that expanding the Center's mission too broadly could dilute its focus on care and payment innovation, potentially overstretching its resources.
Estimated impact: Expands the scope and influence of the Center for Innovation, potentially leading to department-wide operational changes and efficiencies.
Amends the waiver authority of the Center for Innovation for Care and Payment. It changes the scope of waivers from 'in subchapters I, II, and III of this chapter' to 'any provision of this title, of title 38, Code of Federal Regulations, and of any handbooks, directives, or policy documents of the Department.' It also changes 'may' to 'shall' for the Center's function to 'identify, test, and evaluate innovative approaches.'
Sec. 302(a)(3)(A) and (B), and (4)
Why it matters:These are highly consequential changes to the Center's power and mandate, significantly broadening its ability to bypass existing rules and making its innovation role mandatory. Such technical amendments are often buried due to their legalistic nature.
Case for: Proponents argue this expanded waiver authority and mandatory innovation role are essential for the Center to truly experiment and implement transformative changes without being bogged down by existing bureaucratic hurdles and outdated regulations.
Case against: Critics might raise concerns that such broad waiver authority could lead to a lack of oversight, inconsistent application of rules, or unintended negative consequences if not carefully managed, potentially undermining established protections or processes.
Estimated impact: Significantly increases the power and operational flexibility of the Center for Innovation, allowing it to implement changes more rapidly and broadly across the VA, potentially leading to both significant improvements and unforeseen challenges.