WASHINGTON (AP) — House and Senate negotiators opened compromise talks Tuesday on legislation to expand health care for veterans, and said they hope for quick response to a scandal that has uncovered long wait times, false record-keeping and accusations of criminal activity at the Department of Veterans Affairs.

At their core, the bills passed by the House and Senate would allow millions of former members of the armed forces to seek health care outside the government's veterans system if they were unable to get a timely appointment inside it.

"The simple truth of the matter is that the VA needs more doctors, more nurses, more mental health providers, and, in certain parts of the country, more space for a growing patient population," said Sen. Bernie Sanders, the Vermont Independent who chairs the Senate veterans committee.

Rep. Jeff Miller, R-Fla., and chairman of the House panel, noted the deaths reported among veterans awaiting care in Phoenix, Ariz., and said that for them, "our work begins too late. For veterans still waiting, our work begins" none too soon, he added.

Talking with reporters afterward, Miller said that because the House is insisting any increases be paid for, it will be necessary to "go outside the VA to look for offsets." He didn't elaborate what areas he had in mind.

Several Republicans questioned the Congressional Budget Office's estimates of the cost of the legislation, saying the non-partisan agency didn't factor in provisions that would save money.


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CBO put the cost of the Senate bill at $35 billion over three years. It said the price tag of the House measure is about $44 billion over six years.

Several aides said the goal is to reach agreement and pass a compromise by the end of July, although Miller declined to state a deadline for action.

The first day's meeting consisted entirely of prepared speeches, delivered in turn by members of the House and Senate.

The lawmakers met one day after the latest indication of a federal agency in deep trouble. In a letter to President Barack Obama, the U.S. Office of Special Counsel said the agency shows a "troubling pattern of deficient patient care" and also pays little attention to reports from its own whistleblowers.

The scandal — which cost former secretary Eric Shinseki his job — erupted this spring with reports — as yet unproven — that a delay in care at the agency's facility in Phoenix, Ariz., contributed to the deaths of about 35 veterans.

It quickly mushroomed when a VA report concluded that about 1,700 veterans in need of care were "at risk of being lost or forgotten" at the center after being kept off an official, electronic waiting list. Then came reports of problems at numerous facilities around the country, including widespread reports of records falsified to make it look like veterans were getting timely appointments even though they were not.

In a bow to the political influence of veterans, the House and Senate acted with unusual speed to respond, and both houses approved legislation earlier this month.

In addition to allowing veterans to seek care outside the VA system, both bills also authorize the agency to sign leases for new facilities, 27 in the House measure and 26 under the Senate bill.

Both bills enhance authority of the department's secretary to fire or demote senior executives, although the Senate-passed measure includes employee protections that the House bill lacks.

Both also crack down on bonuses, some of which were used as an incentive for employees to meet patient scheduling guidelines. The House measure bans bonuses at the department through 2016, while the Senate measure blocks them from being awarded based on prompt scheduling of medical appointments.

About 8.4 million veterans are enrolled in the agency's health care program, according to the nonpartisan Congressional Budget Office, although it said the number would rise with expanded access provided under the legislation.