NAVAPD Statement for the Record: Senate Veterans Affairs Committee Hearing
On December 10, 2025, the National Association of VA Physicians and Dentists (NAVAPD) submitted a formal Statement for the Record to the Senate Veterans Affairs Committee, pursuant to an invitation extended by Senators Moran and Blumenthal. Within this testimony, NAVAPD reaffirmed its dedication to ensuring that veterans receive exemplary care within the VA healthcare system, supplemented by private sector services exclusively when warranted and subject to VA approval and authorization.
Overview of the Hearing
The Senate Committee convened to review twenty-four legislative proposals pertaining to veterans’ healthcare. NAVAPD, together with six distinguished organizations—the Association of VA Hematology/Oncology, Association of VA Nurse Anesthetists, Association of VA Psychologist Leaders, Association of VA Social Workers, Nurses Organization of Veterans Affairs, and the Veterans’ Healthcare Policy Institute—provided commentary on three specific bills.
Legislation Considered
The testimony addressed the following bills: S.926 (“Saving Our Veterans’ Lives Act of 2025”), S.2397 (Coordinating and Aligning Records to Improve and Normalize Governance for Our Veterans Health Act of 2025, the “CARING Act”), and S.1868 (“Critical Access for Veterans Care Act of 2025”). The signatory organizations conveyed unreserved support for S.926 and S.2397 while articulating significant concerns regarding S.1868.
Saving Our Veterans’ Lives Act of 2025 (S.926)
S.926 proposes, subsequent to a pilot program, that all veterans—regardless of their enrollment status in VA healthcare—be granted access to firearms lockboxes. The urgency of this measure is underscored by data indicating that suicide rates among veterans are twice those of their civilian counterparts, with firearms representing the most prevalent means. Specifically, 74.8% of male and 45.4% of female veteran suicides involve firearms, and 90% of such attempts result in fatality. Research further reveals that half of suicide attempts occur within ten minutes of the onset of a crisis, frequently precipitated by interpersonal conflict.
Secure storage of firearms is a proven suicide-prevention strategy, restricting immediate access during critical moments. Many suicide attempts arise from acute emotional distress rather than premeditation. Assisting individuals by limiting access to lethal means during these periods considerably reduces risk. Notably, 51% of veterans possess at least one firearm, and over half store them loaded and unsecured.
At present, the VA implements a pilot initiative providing free lockboxes to enrolled veterans assessed at moderate or high risk for suicide upon request. This program, however, lacks permanent funding and comprehensive adoption. S.926 offers a solution by guaranteeing adequate resources and universal availability of lockboxes, irrespective of risk or enrollment status.
Critical Access for Veterans Care Act of 2025 (S.1868)
NAVAPD and its partner organizations oppose S.1868, contending that it fails to enhance access, expedite treatment, alleviate travel burdens, or improve care capacity for rural veterans. Instead, the legislation threatens to erode crucial eligibility criteria governing when veterans may utilize Community Care providers.
The bill stipulates that veterans residing within thirty-five miles of designated Critical Access Hospitals (CAHs) may bypass the VA and self-refer to these private facilities, purportedly to expedite care for those lacking timely access. NAVAPD disputes these assertions, emphasizing that the VA MISSION Act of 2018 already ensures veterans’ access to emergency medical and psychiatric services, as well as urgent care. Veterans may also seek private-sector outpatient care if subject to excessive wait times or travel distances. Additionally, numerous CAHs are situated near VA facilities.
Should S.1868 be enacted, care would shift from VA clinics and rural hospitals to CAHs, resulting in the reallocation of VA funding. Declining patient volumes could compel VA facilities to curtail services or close, to the detriment of veterans dependent on these resources.
The broader landscape reflects a rural healthcare crisis: over 100 hospitals have shuttered in fifteen years, more than 700 rural hospitals are at the brink of bankruptcy, and over 300 face imminent closure. These developments have increased travel distances for care, forcing some patients—particularly those with limited mobility or emergent health needs—to forgo treatment. Medicaid reductions are anticipated to affect more than ten million individuals, exacerbating coverage gaps. Furthermore, 86% of U.S. counties are classified as primary care shortage areas.
S.1868 undermines the principle of VA authorization, dismissing it as an “unnecessary roadblock.” NAVAPD and its co-signatories assert that this mischaracterization ignores the essential oversight, fiscal responsibility, and patient safety ensured by the authorization process. Utilization review is a standard procedure for third-party payors, and most private-sector physicians lack the specialized expertise and integrated systems that distinguish VA care. The signatories do, however, support the bill’s provision to equalize CAH reimbursement rates for veterans and non-veteran patients, affirming that financial inducements must not dictate prioritization of care.
CARING for Our Veterans Health Act of 2025 (S.2397)
The CARING Act addresses shortcomings within the Veterans Community Care Program (VCCP) by implementing rigorous oversight and mandatory performance standards. The legislation endeavors to remedy persistent deficiencies in provider training completion and documentation timeliness. NAVAPD recognizes the VA’s legal and ethical obligation to ensure that its contracted providers possess the specialized expertise necessary for treating conditions frequently arising from military service.
The MISSION Act requires that community mental health providers demonstrate competencies equivalent to those of VA specialists. In response, the VA developed eight comprehensive training modules, each approximately one hour in duration, addressing mental health challenges common among veterans, including posttraumatic stress, military sexual trauma, suicide prevention, and opioid safety. However, a recent Government Accountability Office (GAO) report indicated that most community care providers neglected or refused to complete the mandated training. During the reporting period, more than 8,000 veterans with active suicide-risk flags were referred to community providers, virtually none of whom had completed suicide-prevention or lethal-means safety training. Additionally, few providers completed training in posttraumatic stress disorder or military sexual trauma, and only a small proportion undertook required opioid-safety modules—a pattern corroborated by a 2021 VA Office of Inspector General investigation.
Further deficiencies exist in the transmission of essential medical records. Community providers are contractually obligated to submit clinical documentation within thirty days of both the initial and final appointments; the GAO found widespread noncompliance, with initial visit records missing for one-third of referred veterans and final documentation absent for all cases reviewed.
Decades of empirical research have demonstrated that VA health outcomes are at least equivalent, if not superior, to those achieved in the private sector across nearly all medical conditions. The CARING Act is a direct response to these documented failures, demanding clear performance benchmarks and comprehensive monitoring. Its focus on documentation and record alignment introduces robust accountability measures, incentivizing community providers to fulfill training requirements.
Conclusion
NAVAPD remains steadfast in its commitment to monitoring legislative developments affecting veterans’ healthcare. The association will continue to advocate for strong in-house care, judicious use of community care when indicated under the rigorous standards of the MISSION Act, and unwavering support for the delivery of quality care by its members.