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 also 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.
The Senate deal came as acting VA Secretary Sloan Gibson announced that 18 veterans who were kept off official VA waiting lists in the Phoenix area have died. Gibson said he does not know whether the deaths were related to long waiting times to see a VA doctor.
The 18 veterans who died were among 1,700 veterans identified in a federal report as being kept off an electronic waiting list of scheduled appointments, Gibson said. Taking care of those 1,700 veterans is his top priority as VA chief, Gibson said during a tour of VA facilities in Phoenix, where the furor started.
The Senate bill is a response to a building national uproar about 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 data covering them up at VA facilities nationwide.
‘‘Right now we have a crisis on our hands and it’s imperative that we deal with that crisis,’’ said Senator Bernie Sanders of Vermont, an independent who leads the Senate Veterans Affairs Committee.
Sanders and Senator John McCain, an Arizona Republican, 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 Obama’s choice as top health official at the Veterans Affairs Department withdrew his nomination Thursday, saying he feared his confirmation could spark a long political battle.
Jeffrey Murawsky, health care chief for the VA’s Chicago-based regional office, was nominated last month as 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, Ill., hospital and remains on staff.
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In a statement, Murawsky said his withdrawal was ‘‘in consideration of recent events, but most importantly in the best interests of serving our nations’ veterans.’’
The White House said in a statement that Murawsky feared a prolonged fight on 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 panel 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.
Gibson took over the VA temporarily last Friday after former Secretary Eric Shinseki, a former Army general, resigned under pressure.
Gibson promised a number of changes to improve patient care, including greater use of non-VA doctors, especially in rural areas. He also said the agency has done away with a controversial 14-day waiting period for first appointments.