WASHINGTON - Senior senators reached agreement Thursday on the framework for a bipartisan bill expanding veterans' ability to get health care outside the government's scandal-beset Veterans Affairs hospitals and clinics.
The bill would allow veterans who experience waits of 30 days or more for VA appointments or who live at least 40 miles from a VA hospital or clinic to use private doctors enrolled as providers for Medicare, military TRICARE or other government health care programs.
It would let the VA immediately fire as many as 450 senior regional executives and hospital administrators for poor performance. The bill resembles a measure passed last month by the House, but includes a 28-day appeal process omitted by the House legislation.
"Right now we have a crisis on our hands and it's imperative that we deal with that crisis," said Sen. Bernie Sanders, I-Vt., chairman of the Senate Veterans Affairs Committee.
The legislation is a response to a building national uproar over veterans' health care following allegations that surfaced in April that as many as 40 veterans may have died while waiting an average 115 days for appointments at the Phoenix VA hospital or its walk-in clinics.
Since then, investigators have found long wait times and falsified records covering them up at other VA facilities nationwide.
Sanders and Sen. John McCain, R-Ariz., announced the agreement Thursday following two days of intense negotiations. Both had introduced competing versions earlier in the week.
McCain said the bill was "a way to help to relieve this terrible tragedy that has befallen our nation's veterans."
The bill also authorizes the VA to lease 26 new health facilities in 18 states and spend $500 million to hire more doctors and nurses. The VA now has 150 hospitals and 820 clinics nationwide. Senate leaders said they hoped to bring the legislation to the floor soon but offered no specifics.
Meanwhile, President Barack Obama's choice to be the top health official at the Veterans Affairs Department withdrew his nomination Thursday, saying he feared his confirmation could spark a prolonged political battle.
Jeffrey Murawsky, health care chief for the VA's Chicago-based regional office, was nominated last month to be the department's new undersecretary for health care, replacing Robert Petzel, who resigned under pressure. Petzel had been scheduled to retire later this year but was asked to leave early amid a firestorm over delays in patient care and preventable deaths at veterans hospitals.
Murawsky now oversees seven VA hospitals and 30 clinics in Illinois, Indiana, Wisconsin and Michigan, including one in suburban Chicago where there are allegations that its staff used secret lists to conceal long patient wait times for appointments. Murawsky was a doctor at the Hines, Illinois, hospital and remains on its staff.
The White House said in a statement that Murawsky feared a prolonged fight over his confirmation, adding that he believed the role was too important not to be filled quickly.
Obama accepted Murawsky's withdrawal and will move quickly to find a replacement, the White House statement said. The VA is required by law to convene a commission to seek and review candidates for the position, which oversees the Veterans Health Administration, the largest single health provider in the nation with 9 million patients, 150 hospitals and 820 walk-in clinics.
Robert Jesse, Petzel's chief deputy, has served as acting undersecretary since Petzel resigned May 16.
Also Thursday, acting VA Secretary Sloan Gibson was visiting the VA facilities in Phoenix, where the furor started.
Gibson, who was confirmed in February as the department's second-ranking official, was put into the secretary's job temporarily last Friday when Obama accepted retired Gen. Eric Shinseki's resignation after five years as VA secretary.