On April 29, the Senate Veterans’ Affairs Committee held a hearing to consider the bipartisan Veterans Health Administration (VHA) Novel Therapeutics Preparedness Act of 2026. The measure would establish a central authority to oversee the research and implementation of emerging mental health treatments, including psychedelic-assisted therapies.
The bill, introduced in March by Senators Tim Sheehy (R-MT) and Ruben Gallego (D-AZ), would require the Department of Veterans Affairs (VA) to create an Office of Novel Therapeutics—responsible for developing national clinical standards, readiness plans and workforce credentialing frameworks ahead of potential Food and Drug Administration (FDA) approvals of psychedelics like psilocybin, ibogaine and MDMA.
Under S.4220, the VA would also notably prohibit “step therapy” rules, which often force patients to try less expensive, older treatments before accessing new therapies. The bill would also establish a Veteran Advisory Committee to monitor patient safety and mandate a national preparedness strategy within 180 days of enactment.
During the hearing, Dr. Mark A. Koeniger, the VA’s acting assistant under secretary for Health for Patient Care Services, told lawmakers the VA already utilizes “novel therapeutics,” in the form of ketamine and esketamine, at 53 facilities.
“We understand that these novel therapeutics have a potential benefit,” Koeniger said. “What we want to do is to make sure that those are rolled out in a very objective and scientific way, because we certainly don’t want to injure veterans.”
Koeniger noted that while the VA is “anticipating that some [psychedelic drugs] be approved by the FDA,” the department is already laying bureaucratic groundwork through an integrated project team. He cautioned against the “duplication of activities” and offered to work with the committee to identify gaps between the bill’s requirements and current VA initiatives.
“I’m personally very anxious to get this going because a lot of veterans are now going to Mexico and other parts of the world and getting unregulated therapies.”
Sen. Gallego is an Iraq War veteran who is also co-sponsoring the Innovative Therapies Centers for Excellence Act, as Filter previously reported. He expressed urgency at the hearing, citing risks faced by veterans seeking unregulated treatments abroad.
“I’m personally very anxious to get this going because a lot of veterans are now going to Mexico and other parts of the world and getting unregulated therapies, which can be hit or miss, can be dangerous,” Gallego said.
His concerns follow a recent patient death at Ambio Life Science’s facility in Tijuana, Mexico, involving the potent psychedelic ibogaine, which is sometimes used for opioid withdrawal.
Melissa Lavasani, founder of the Washington, DC-based Psychedelic Medicine Coalition (PMC), attended the hearing, and feels that radical bureaucratic innovation at the VA is long overdue.
“What came through in this hearing is that the VA is being asked to solve 21st-century health challenges with a system that wasn’t built for them,” Lavasani told Filter. She added that the hearing showed “real bipartisan acknowledgment that we need to evaluate treatments that don’t fit neatly into existing frameworks, including psychedelic-assisted therapies.”
“Without system-level reforms … the VA risks repeating a familiar pattern: promising treatments are approved, but Veterans wait years.”
The bill also found support in written testimony submitted by Dr. Lynette Averill, chief science officer for the Veterans Mental Health Leadership Coalition and the advocacy group Reason for Hope. Averill argued that the measure is necessary to prevent a “familiar pattern” where newly approved treatments remain inaccessible to veterans for years due to a lack of readiness.
“Without system-level reforms to strengthen proactive planning and provide clear implementation authority for truly transformative approaches, the VA risks repeating a familiar pattern: promising treatments are approved, but Veterans wait years before they are meaningfully accessible,” Averill stated.
The push for new VA infrastructure comes amid threats to federal science and health spending. While the administration signaled interest in psychedelic research through President Donald Trump’s April 18 executive order, its proposed budget plans for 2027 include a 50 percent cut to the National Science Foundation and a 13 percent reduction for the National Institutes of Health. The administration’s April 24 dismissal of the entire National Science Board has been seen as another attack on research.
The hearing also occurred against a backdrop of increasing scrutiny of the burgeoning psychedelics industry. The Office of Congressional Conduct is currently reviewing a complaint against the Association for Prescription Psychedelics and its founder, former Representative Mimi Walters, over alleged mishandling of taxpayer-funded data. Separately, former Sen. Kyrsten Sinema, who has lobbied for ibogaine research, is named in a Justice Department complaint alleging potential violations of federal lobbying rules for former lawmakers.
The bill is “critical, not just as a research effort, but as the infrastructure needed to responsibly move these treatments into real-world care.”
Despite these controversies, recent executive actions have looked to accelerate the federal timeline for psychedelic medicines. Following Trump’s April 18 executive order, the FDA awarded “National Priority Vouchers” to Compass Pathways, Transcend Therapeutics, and the Usona Institute. These are intended to expedite the review of drugs like psilocybin and methylone, potentially reducing the federal review period from months to weeks.
Additionally, the FDA recently approved the first US clinical trial for DemeRx’s Noribogaine compound, a metabolite of ibogaine. The trial, which will evaluate Noribogaine’s efficacy in treating alcohol use disorder, is expected to begin this summer.
S.4220 is one of three psychedelic-related bills up for consideration this term—including the Innovative Therapies Centers for Excellence Act of 2026, sponsored by Sens. Gallego and Rob McCormick (R-PA), which aims to create a series of specialized VA hubs focused on advancing psychedelic medicine.
“The question now isn’t whether to explore these options,” Lavasani said, “it’s whether the VA is structurally prepared to test, validate, and, if supported by the evidence, deliver them at scale.“
That, she concluded, is where S.4220 “becomes critical, not just as a research effort, but as the infrastructure needed to responsibly move these treatments into real-world care.”
Photograph (cropped) via GetArchive/Public Domain