Establishing a veterans recovery pilot program and fund for the reimbursement of expenses related to providing hyperbaric oxygen treatment to eligible veterans and making appropriations

Description

House File 518 creates a Veterans Recovery Pilot Program, administered by the Department of Veterans Affairs (DVA), for the reimbursement of expenses related to hyperbaric oxygen treatment for eligible veterans who have been diagnosed with post-traumatic stress disorder (PTSD) or a traumatic brain injury (TBI). The Bill requires the DVA to adopt administrative rules no later than January 1, 2026, to implement and administer the Pilot Program. The Bill creates a Veterans Recovery Fund under the control of the DVA to be used for expenses incurred for operating the Pilot Program and for expenses authorized to be reimbursed for hyperbaric oxygen treatment and any related travel and living expenses. Moneys in the Fund and any interest earned will not revert and remain in the Fund available for use until June 30, 2031. Any moneys remaining in the Fund as of June 30, 2031, will be transferred for deposit into the Veterans Trust Fund.

The Bill requires the DVA submit a biennial report by October 1 of each even-numbered year to the General Assembly regarding an evaluation of the effectiveness of the Pilot Program and the number of veterans and treatment facilities participating in the Pilot Program.

Background

Hyperbaric oxygen treatment involves breathing pure oxygen in a pressurized chamber. In a hyperbaric oxygen therapy chamber, the air pressure is increased to two to three times higher than normal air pressure. Under these conditions, the lungs can gather more oxygen than would be possible breathing pure oxygen at normal air pressure. The effects on the body include removing trapped air bubbles, enhancing the growth of new blood vessels and tissues, and supporting immune system activity.

The following states have enacted legislation providing or accommodating for hyperbaric oxygen treatment for veterans: Arizona, Florida, Indiana, Kentucky, Maryland, North Carolina, Oklahoma, Texas, and Virginia.

Assumptions

• The University of Iowa Hospitals and Clinics (UIHC) charges $1,239 per half hour of hyperbaric treatment.
• The Medicaid floor reimbursement rate for one half hour of hyperbaric oxygen treatment is $40.35 and there is a cost of $125.59 per treatment session for physician supervision of the treatment.
• The cost per one-hour treatment is estimated to range from $200 to $2,500.
• Based on the protocol used by the Louisiana State University in researching their study published in the Medical Gas Research journal in 2017, a complete treatment course will be two daily one-hour sessions performed five days per week until 40 sessions have been completed.
• The cost of providing 40 one-hour treatment sessions is estimated to range from $11,000 to $101,000.
• At an average of 80 miles round trip at the State travel reimbursement rates, each veteran served is estimated to incur $2,300 in living expenses, including travel, food, and lodging, over the course of four weeks.
• It is assumed that 10 veterans would receive treatment annually under the Pilot Program.
• Treating 10 veterans would cost between $110,000 and $1.0 million.
• The DVA will require additional staff to implement the Pilot Program. Figure 1 shows the required personnel and their salary and benefit ranges.

Figure 1 — Personnel Salaries

• There will be an estimated $77,000 in additional operating costs for computer equipment, office equipment, office space, software licenses, and other administrative expenses. Of this amount, $51,000 are one-time costs and $26,000 are ongoing costs.

Fiscal Impact

The total Pilot Program annual cost shown in Figure 2 is estimated to be between $668,000 and $1.8 million and includes the cost of treating 10 veterans, the cost for additional staff needed by the DVA, and ongoing operating costs. In addition, there would be an additional $51,000 in one-time costs for computer equipment and a State vehicle.

Figure 2 — Annual Pilot Program Estimated Cost RangeJob Classification Min Salary Max Salary Physician 264,461$ 355,642$ Program Planner 3 80,480 111,265 Program Planner 1 64,571 86,505 Administrative Assistant 1 60,085 79,684 Purchasing Agent 1 62,316 83,030 Total 532,000$ 716,000$Expense Min Cost Max Cost Salaries for DVA 532,000$ 716,000$ Treatment for 10 Veterans 110,000 1,010,000 Annual Operating Costs 26,000 26,000 Total 668,000$ 1,752,000$

Sources

• Department of Veterans Affairs
• Department of Health and Human Services
• Department of Administrative Services
• Board of Regents, University of Iowa Hospitals and Clinics
• Mayo Clinic
• Louisiana State University
• LSA analysis and calculations