Delegation for 12.19.23: Bad practice — hot tomato — another term — PGA Tour tax

VA alarm bells

Concerns about the care provided by a nurse practitioner prompted James A. Haley Veterans Hospital to bar the professional from practicing there.

Now, a bipartisan group of Florida lawmakers wants to know what went wrong and that the agency is reviewing all appropriate cases in its internal review.

Sen. Marco Rubio led a letter to Veterans Affairs (VA) Secretary Denis McDonough about the situation. The message says VA officials appropriately prohibited care from the nurse practitioner in June because care did not meet high standards, including “follow-up care and adequate evaluation and assessment.”

However, lawmakers expressed some concern to members of Congress, and patients weren’t immediately notified of the situation.

“We are concerned that the VA did not notify our offices or initiate a three-month clinical review of the situation until November 2023,” the letter states. “Florida’s veterans deserve the highest level of service and transparency about their health care, and we expect the VA to act expeditiously to notify veterans about the situation and the steps the VA is taking to rectify the situation.”

House members representing the Tampa Bay region joined the letter for Sen. Rick Scott, including Democratic Rep. Kathy Castor of Tampa and Republican Reps. Gus Bilirakis of Palm Harbor, Vern Buchanan of Longboat Key, Scott Franklin of Lakeland, Laurel Lee of Thonotosassa, Anna Paulina Luna of St. Petersburg and Greg Steube of Sarasota.

Beyond the lag in notification, lawmakers raised concern that the VA is conducting a broad enough review of cases handled by the practitioner.

“The nurse practitioner was employed by the Tampa VA for 21 years, yet the clinical review period only spans through October 2021,” the letter states. “We are concerned that there may be deceased patients outside the purview of the current clinical review impacted by the lack of proper care. We request that the VA provide a detailed accounting of whether the overall health and well-being of veteran patients seen by this provider was impacted due to a lack of follow-up care.”

The VA said it has started a review of some 3,000 patient cases and is trying to schedule follow-up visits with many living individuals who received care. Lawmakers want an assessment of the “detrimental oversight” to ensure such a situation never occurs again. The letter asks for a top-to-bottom review and an explanation of how the VA plans to remedy systemic problems.

“Veterans put their trust in the VA to receive high-quality health care from attentive and professional medical providers,” the letter states. “When the providers fail to meet these standards, veterans deserve timely communication about steps the VA is taking to address their health care needs and concerns going forward.”

Tossed tomatoes

Lawmakers in the Florida delegation have pushed for adjustments in how produce flows into the U.S. for years. Last week, Scott reiterated a demand to suspend the 2019 Tomato Suspension Agreement with Mexico because of its impacts on Florida farmers.

He sent the letter to Commerce Secretary Gina Raimondo less than two months after the agency ended an investigation that determined Mexico has complied with anti-dumping responsibilities.

Scott said the issue continues to create problems for Florida agriculture despite those findings.

“Mexico’s tomato dumping has hit small family operations particularly hard, and the impacts have been profoundly damaging to rural economies,” he said. “After 27 years, it is clear that the loopholes in the suspension agreements being exploited by Mexican producers cannot be closed, and the domestic industry will face further material injury, if necessary actions are not taken.”

Notably, Rubio co-led a letter in September with Rep. Jim Costa, a California Democrat, raising concerns about unfair trade practices. At the time, 22 of the 30 members of the Florida congressional delegation signed on, including House members from both sides of the aisle.

Scott considered it unacceptable the Commerce Department had yet to respond to that letter. Now, he wants to sit down with Raimondo and discuss his constituents’ concerns.

“I respectfully request a meeting with you to discuss this critical matter that impacts tomato growers in Florida,” he wrote.

Seeking another term

Rep. Neal Dunn has formally launched his re-election campaign. He will be running for a fifth consecutive term.

“My wife and I prayed a lot about this decision. What it ultimately came down to is our grandkids,” the Panama City Republican said.

“I look at them and ask what kind of country and world do we want to leave for them. Right now, the future looks dicey. Russia is on the march. China is on the march and we are over $33 trillion in debt, spending money foolishly, and our elite institutions are increasingly hostile to our traditional values.”

He wants to push back against that and keep Republicans in control of the U.S. House.

Dunn first won election in Florida’s 2nd Congressional District in 2016. In November, following redistricting, he secured a fourth term after winning the only incumbent-on-incumbent congressional race in Florida. He defeated former Rep. Al Lawson, a Tallahassee Democrat who has said he does not intend to challenge Dunn again.

Oceania diplomacy

Republicans concerned about a potential military conflict in Asia would like to see island nations in the Pacific allied with the U.S. and not China. Rep. Michael Waltz, a St. Augustine Beach Republican, introduced a bill this week seeking that end.

The Connecting Oceania’s Nations with Vanguard Exercises and National Empowerment (CONVENE) Act would direct the State Department to establish national security councils for each Compacts of Free Association (COFA) nation. That directly responds to China’s efforts to expand its control of smaller countries.

“The Chinese Communist Party continues to illegally enter the territorial waters of Micronesia, the Marshall Islands and Palau, threatening regional security,” Waltz said.

“China’s blatant disregard for international and maritime law underscores the urgency for a national security partnership between the United States and COFA nations to deter further interference and threats from China to their people, infrastructure and territory. A peaceful and prosperous Indo-Pacific is integral to protecting our own national security. That’s why I am proud to introduce legislation in the House to encourage cooperation between our nations to address and deter the growing threat of China to the Indo-Pacific.”

Sen. Joni Ernst, an Iowa Republican, will carry the Senate version of the bill.

In loving memory

The deadly impacts of Parkinson’s disease are something Bilirakis knows too well, having lost a brother to the disease in May at 61. Now, legislation addressing the health condition will bear Dr. Emmanuel Bilirakis’ name.

Last week, the House passed the Dr. Emmanuel Bilirakis and Honorable Jennifer Wexton National Plan to End Parkinson’s Act (HR 2365). Should it become law, the legislation will set up a federal advisory council of experts to provide reports on Parkinson’s advances and treatments to the Health and Human Services Department and Congress.

Of note, naming the bill for Emmanuel Bilirakis was the idea of Rep. Anna Eshoo, the ranking Democrat on the House Health Subcommittee. But following the passage of an amendment providing the bill’s moniker, Rep. Bilirakis added the name of Rep. Jennifer Wexton, a Virginia Democrat fighting the illness herself.

“I will continue this fight in memory of my dear brother, other family members, and on behalf of all Americans who are still struggling with this debilitating disease,” Bilirakis said. “It takes a terrible toll on the physical, emotional and economic well-being of everyone involved. The lack of treatment options leave patients, families and American taxpayers in a terrible quandary.

“We must change our approach to get better results, which is exactly what our legislation will do. It builds upon past successes and strives to replicate other national project models that have helped advance health care goals and treatment options. This critical legislation will provide hope to those who are suffering and hopefully lead to better patient outcomes with less expensive disease management.”

Bilirakis has worked on the legislation with Rep. Paul Tonko, a New York Democrat, hoping to better address the fastest-growing neurological disorder in the U.S.

“When the opportunity arose to partner with Congressman Bilirakis on this meaningful effort, I jumped right in and made it my personal mission to get this done on behalf of the millions of people living with Parkinson’s,” Tonko said. “It is incumbent on Congress to ensure Americans know they will be supported during this frightening and life-altering time. Our legislation does just that.”

Down a stroke

Congress could soon chip away at the PGA Tour’s tax-exempt status.

Buchanan said it’s time the country called a penalty on the nonprofit status enjoyed by the sports league. The Longboat Key Republican filed a bipartisan bill with Rep. Mike Thompson, a California Democrat, which would strip the PGA Tour of its tax-exempt status.

The lawmakers want to count a stroke against the PGA Tour for its decision to merge with LIV Golf, a league primarily owned by Saudi Arabia.

“With billions of dollars in annual revenue and record profits streaming in, coupled with their looming partnership with Saudi Arabia’s sovereign wealth fund, why in the world should hardworking American taxpayers subsidize the PGA’s tax-exempt status?” Buchanan said.

The legislation would impact any sports organization that earns more than $1 billion in any year over five years. Golfweek recently reported that the PGA Tour earned around $1.9 billion in 2022, up significantly from $1.59 billion in 2021.

Buchanan focused his criticism mainly on the fact that professional golf rakes in enormous amounts of money to still be considered a 501(c)(6) organization, a tax designation customarily reserved for chambers of commerce and other business leagues.

“We should be supporting local charities on Main Street, not foreign-backed professional sports organizations that are not dedicated to benefiting the American people,” Buchanan said. “That’s why I’m pleased to introduce this legislation with Congressman Thompson to end this special-interest giveaway and require the PGA Tour to pay taxes, just like every other American business.”

VAliens

Steube said the VA should not be treating undocumented individuals ahead of American veterans. The Sarasota Republican led a letter to the agency demanding answers following a Fox News report that medical resources are directed toward an influx of people illegally crossing the border.

“It is our duty to provide veterans with quality care, but the VA has been a total failure for so many of our veterans. Many veterans fight with the VA for years to get help. Some never receive it,” Steube said.

“That’s why you can imagine how much of an absurdity it is for our veterans to learn that the VA has been involved in processing medical claims for illegal immigrants. The VA should be 100% focused on those who served our country honorably — not illegal immigrants who break our nation’s laws. I am hopeful Secretary McDonough has answers for Congress regarding this troublesome arrangement.”

The letter bears the signature of 23 other lawmakers, including Reps. Aaron Bean and Dan Webster.

Free RPM coverage?

New biosensor technology that communicates with a smartphone can allow patients to send perpetual health information to physicians between doctor visits. But now, Medicare patients must still eat a 20% copay for remote patient monitoring (RPM).

Rep. Sheila Cherfilus-McCormick wants to see how many more patients would proactively use home health care if it were free. Last week, the Miramar Democrat introduced the RPM Cost Sharing Elimination Study Act with Democratic Reps. Raul Ruiz of California and Terri Sewell of Alabama. If passed, the bill would eliminate copays on RPM for a while and see if that ultimately improves outcomes and even saves the government money in the long run.

“As a former home care executive, I know how valuable remote monitoring can be in equalizing care and giving seniors the tools they need to manage their health from home,” Cherfilus-McCormick said. “My colleagues and I hope to identify what steps are needed to improve remote monitoring services and ensure better health outcomes for Medicare enrollees.”

Telehealth and home care advocates say expanding cheap access to RPM services could improve the system overall.

“Rural Americans must choose between enduring long travel times or paying unnecessary fees for simple and routine monitoring of their health conditions,” said Alan Morgan, CEO of the National Rural Health Association. “This legislation may serve as a substantial step toward improving rural health outcomes by encouraging wider use of Remote Patient Monitoring, which could eliminate travel times for rural patients and reduce the burden on health care providers.”

Sanctioning Maduro

Members of the Florida delegation want the U.S. to intervene to stop anti-democratic efforts by Venezuelan President Nicolás Maduro.

Reps. María Elvira Salazar, a Coral Gables Republican, and Debbie Wasserman Schultz, a Weston Democrat, introduced a bill to reauthorize 2019 sanctions.

The Venezuela Emergency Relief, Democracy Assistance, and Development (VERDAD) Act would push for the return of economic consequences shortly after the administration eased oil and other trade restrictions. The softening of sanctions was supposed to accompany a fair election, but allies of Maduro have challenged an opposition Primary win by critic María Corina Machado.

“The dictator Maduro and his lackeys are doing everything in their power to ensure Chavismo’s Primary opponent, María Corina Machado, never reaches Miraflores,” said Chair Salazar, referencing Maduro for his former support of anti-American Venezuelan leader Hugo Chávez. “Maduro is a tyrant who needs to go. My bill reauthorizing the VERDAD Act will show the Venezuelan people that America is still on their side in the fight against socialism.”

Introducing co-sponsors in the House included Reps. Carlos Giménez and Waltz. Meanwhile, Rubio and Scott introduced a companion bill in the Senate with fellow GOP Sens. Ted Cruz of Texas and Bill Haggerty of Tennessee. Wasserman Schultz is the only Democrat signed onto the legislation from the onset in either chamber.

On this day

Dec. 19, 1998 — “Bill Clinton Impeached: House approves articles alleging perjury, obstruction” via The Washington Post — The House impeached the President for only the second time in American history, charging Clinton with “high crimes and misdemeanors” for lying under oath and obstructing justice to cover up an Oval Office affair with a young intern. At 1:25 p.m. on a day of constitutional drama and personal trauma, the Republican-led House voted 228-206, primarily along party lines, to approve the first article of impeachment accusing the Democratic President of perjury before a grand jury. Within the hour, lawmakers passed another article alleging he tampered with witnesses and helped hide evidence but rejected two other articles on perjury and abuse of power.

Dec. 19, 2016 — “Electoral College settles Donald Trump’s victory, but little else” via The New York Times — In Florida, protesters swarmed the Capitol rotunda, one hoisting a “Trump Is Too Rusky” sign featuring a hammer and sickle. In Wisconsin’s Statehouse, a heckler shouted, “We’re all going to go to war and die thanks to you,” during the formal meeting of the Electoral College. In New York, an elector by the name of Clinton cast his vote for his wife and then came out to make plain that he believed Trump won the presidency only because of outside interference in the election.

Happy birthday

Best wishes to Reps. Jared Moskowitz, who turned 43 on Monday, Dec. 18, and Bill Posey, who turned 76 the same day.

___

Peter Schorsch publishes Delegation, compiled by Jacob Ogles, edited and assembled by Phil Ammann and Ryan Nicol.