No official summary available for this bill.
[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 10267 Introduced in House (IH)]
<DOC>
118th CONGRESS
2d Session
H. R. 10267
To improve the provision of care and services under the Veterans
Community Care Program of the Department of Veterans Affairs, and for
other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
December 3, 2024
Mr. Bost (for himself and Mr. Bilirakis) introduced the following bill;
which was referred to the Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To improve the provision of care and services under the Veterans
Community Care Program of the Department of Veterans Affairs, and for
other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Complete the
Mission Act of 2024''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--IMPROVEMENT OF VETERANS COMMUNITY CARE PROGRAM
Sec. 101. Codification of requirements for eligibility standards for
access to community care from Department of
Veterans Affairs.
Sec. 102. Requirement that Secretary notify veterans of eligibility for
care under Veterans Community Care Program.
Sec. 103. Consideration under Veterans Community Care Program of
veteran preference for care and need for
caregiver or attendant.
Sec. 104. Notification of denial of request for care under Veterans
Community Care Program.
Sec. 105. Discussion of telehealth options under Veterans Community
Care Program.
Sec. 106. Use of value-based reimbursement models under Veterans
Community Care Program.
Sec. 107. Extension of deadline for submittal of claims by health care
entities and providers under prompt payment
standard.
TITLE II--OTHER HEALTH CARE MATTERS
Sec. 201. Plan on establishment of interactive, online self-service
module for care.
Sec. 202. Publication of wait times for care at medical centers of
Department of Veterans Affairs.
Sec. 203. Modification of requirements for Center for Innovation for
Care and Payment of the Department of
Veterans Affairs and requirement for pilot
program.
Sec. 204. Standardized process to determine eligibility of covered
veterans for participation in certain
mental health treatment programs.
Sec. 205. Reports.
TITLE I--IMPROVEMENT OF VETERANS COMMUNITY CARE PROGRAM
SEC. 101. CODIFICATION OF REQUIREMENTS FOR ELIGIBILITY STANDARDS FOR
ACCESS TO COMMUNITY CARE FROM DEPARTMENT OF VETERANS
AFFAIRS.
(a) Eligibility Access Standards.--Section 1703B of title 38,
United States Code, is amended--
(1) by striking subsections (a) through (e) and inserting
the following:
``(a) Eligibility Standards for Access to Community Care.--(1) A
covered veteran shall be eligible to elect to receive non-Department
hospital care, medical services, or extended care services, excluding
nursing home care, through the Veterans Community Care Program under
section 1703 of this title pursuant to subsection (d)(1)(D) of such
section using the following eligibility access standards:
``(A) With respect to primary care, mental health care, or
extended care services, excluding nursing home care, if the
Department cannot schedule an in-person appointment for the
covered veteran with a health care provider of the Department
who can provide the needed service--
``(i) within 30 minutes average driving time (or
such shorter average driving time as the Secretary may
prescribe) from the residence of the veteran unless a
longer average driving time has been agreed to by the
veteran in consultation with a health care provider of
the veteran; and
``(ii) within 20 days (or such shorter period as
the Secretary may prescribe) of the date of request for
such an appointment unless a later date has been agreed
to by the veteran in consultation with a health care
provider of the veteran.
``(B) With respect to specialty care, if the Department
cannot schedule an in-person appointment for the covered
veteran with a health care provider of the Department who can
provide the needed service--
``(i) within 60 minutes average driving time (or
such shorter average driving time as the Secretary may
prescribe) from the residence of the veteran unless a
longer average driving time has been agreed to by the
veteran in consultation with a health care provider of
the veteran; and
``(ii) within 28 days (or such shorter period as
the Secretary may prescribe) of the date of request for
such an appointment unless a later date has been agreed
to by the veteran in consultation with a health care
provider of the veteran.
``(2) For the purposes of determining the eligibility of a covered
veteran for care or services under paragraph (1), the Secretary shall
not take into consideration the availability of telehealth appointments
from the Department when determining whether the Department is able to
furnish such care or services in a manner that complies with the
eligibility access standards under such paragraph.
``(3) In the case of a covered veteran who has had an appointment
with a health care provider of the Department canceled by the
Department for a reason other than the request of the veteran, in
calculating a wait time for a subsequent appointment under paragraph
(1), the Secretary shall calculate such wait time from the date of the
request for the original, canceled appointment.
``(4) If a veteran agrees to a longer average drive time or a later
date under subparagraph (A) or (B) of paragraph (1), the Secretary
shall document the agreement to such longer average drive time or later
date in the electronic health record of the veteran and provide the
veteran a copy of such documentation. Such copy may be provided
electronically.
``(b) Application.--The Secretary shall ensure that the eligibility
access standards established under subsection (a) apply--
``(1) to all care and services within the medical benefits
package of the Department to which a covered veteran is
eligible under section 1703 of this title, excluding nursing
home care; and
``(2) to all covered veterans, regardless of whether a
veteran is a new or established patient.
``(c) Periodic Review of Access Standards.--Not later than three
years after the date of the enactment of the Complete the Mission Act
of 2024, and not less frequently than once every three years
thereafter, the Secretary shall--
``(1) conduct a review of the eligibility access standards
under subsection (a) in consultation with--
``(A) such Federal entities as the Secretary
considers appropriate, including the Department of
Defense, the Department of Health and Human Services,
and the Centers for Medicare & Medicaid Services;
``(B) entities and individuals in the private
sector, including--
``(i) veteran patients;
``(ii) veterans service organizations; and
``(iii) health care providers participating
in the Veterans Community Care Program under
section 1703 of this title; and
``(C) other entities that are not part of the
Federal Government; and
``(2) submit to the appropriate committees of Congress a
report on--
``(A) the findings of the Secretary with respect to
the review conducted under paragraph (1); and
``(B) such recommendations as the Secretary may
have with respect to the eligibility access standards
under subsection (a).'';
(2) by striking subsection (g);
(3) by redesignating subsections (f), (h), and (i) as
subsections (d), (e), and (f), respectively;
(4) in subsection (d), as redesignated by paragraph (3)--
(A) by striking ``established'' each place it
appears; and
(B) in paragraph (1), by striking ``(1) Subject
to'' and inserting ``Compliance by Community Care
Providers With Access Standards.--(1) Subject to'';
(5) in subsection (e), as so redesignated--
(A) in paragraph (1)--
(i) by striking ``(1) Consistent with'' and
inserting ``Determination Regarding
Eligibility.--(1) Consistent with''; and
(ii) by striking ``designated access
standards established under this section'' and
inserting ``eligibility access standards under
subsection (a)''; and
(B) in paragraph (2)(B), by striking ``designated
access standards established under this section'' and
inserting ``eligibility access standards under
subsection (a)''; and
(6) in subsection (f), as redesignated by paragraph (2)--
(A) in the matter preceding paragraph (1), by
striking ``In this section'' and inserting
``Definitions.--In this section''; and
(B) in paragraph (2)--
(i) by striking ``covered veterans'' and
inserting ``covered veteran''; and
(ii) by striking ``veterans described'' and
inserting ``a veteran described''.
(b) Conforming Amendments.--Section 1703(d) of such title is
amended--
(1) in paragraph (1)(D), by striking ``designated access
standards developed by the Secretary under section 1703B of
this title'' and inserting ``eligibility access standards under
section 1703B(a) of this title''; and
(2) in paragraph (3), by striking ``designated access
standards developed by the Secretary under section 1703B of
this title'' and inserting ``eligibility access standards under
section 1703B(a) of this title''.
SEC. 102. REQUIREMENT THAT SECRETARY NOTIFY VETERANS OF ELIGIBILITY FOR
CARE UNDER VETERANS COMMUNITY CARE PROGRAM.
Section 1703(a) of title 38, United States Code, is amended by
adding at the end the following new paragraph:
``(5)(A) The Secretary shall notify each covered veteran in writing
of the eligibility of such veteran for care or services under this
section as soon as possible, but not later than two business days,
after the date on which a veteran eligible for such care or services
under this section seeks care or services.
``(B) With respect to each covered veteran eligible for care or
services under subsection (d), the Secretary shall provide such veteran
periodic reminders, as the Secretary determines appropriate, of their
ongoing eligibility under such subsection.
``(C) Any notification or reminder under this paragraph may be
provided electronically.''.
SEC. 103. CONSIDERATION UNDER VETERANS COMMUNITY CARE PROGRAM OF
VETERAN PREFERENCE FOR CARE AND NEED FOR CAREGIVER OR
ATTENDANT.
Section 1703(d)(2) of title 38, United States Code, is amended by
adding at the end the following new subparagraphs:
``(F) The preference of the covered veteran for where,
when, and how to seek hospital care, medical services, or
extended care services.
``(G) Whether the covered veteran requests or requires the
assistance of a caregiver or attendant when seeking hospital
care, medical services, or extended care services.''.
SEC. 104. NOTIFICATION OF DENIAL OF REQUEST FOR CARE UNDER VETERANS
COMMUNITY CARE PROGRAM.
Section 1703 of title 38, United States Code, is amended--
(1) by redesignating subsection (o) as subsection (p); and
(2) by inserting after subsection (n) the following new
subsection (o):
``(o) Notification of Denial of Request for Care and How To
Appeal.--(1) If a request by a veteran for care or services under this
section is denied, the Secretary shall notify the veteran in writing as
soon as possible, but not later than two business days, after the
denial is made--
``(A) of the reason for the denial; and
``(B) with instructions on how to appeal such denial using
the clinical appeals process of the Veterans Health
Administration.
``(2) If a denial under paragraph (1) is due to not meeting the
eligibility access standards under section 1703B(a) of this title,
notice under such paragraph shall include an explanation for why the
Secretary does not consider the veteran to have met such standards.
``(3) Any notification under this subsection may be provided
electronically.''.
SEC. 105. DISCUSSION OF TELEHEALTH OPTIONS UNDER VETERANS COMMUNITY
CARE PROGRAM.
Section 1703 of title 38, United States Code, as amended by section
104, is further amended--
(1) by redesignating subsection (p) as subsection (q); and
(2) by inserting after subsection (o) the following new
subsection (p):
``(p) Discussion of Options for Telehealth.--When discussing
options for care or services for a covered veteran under this section,
the Secretary shall ensure that the veteran is informed of the ability
of the veteran to seek care or services via telehealth, either through
a medical facility of the Department or under this section, if
telehealth--
``(1) is available to the veteran;
``(2) is appropriate for the type of care or services the
veteran is seeking, as determined by the Secretary; and
``(3) is acceptable to the veteran.''.
SEC. 106. USE OF VALUE-BASED REIMBURSEMENT MODELS UNDER VETERANS
COMMUNITY CARE PROGRAM.
(a) In General.--Section 1703(i)(5) of title 38, United States
Code, is amended by striking ``may'' and inserting ``shall''.
(b) Negotiation of Terms.--The Secretary of Veterans Affairs shall
negotiate with Third Party Administrators to establish the use of
value-based reimbursement models under the Veterans Community Care
Program under section 1703 of title 38, United States Code, pursuant to
the amendment made by subsection (a).
(c) Report on Value-Based Reimbursement Models.--Not later than one
year after negotiating under subsection (b) terms to establish the use
of value-based reimbursement models under the Veterans Community Care
Program under section 1703 of title 38, United States Code, the
Secretary, in consultation with the Center for Innovation for Care and
Payment of the Department of Veterans Affairs under section 1703E of
title 38, United States Code, and the Office of Integrated Veteran Care
of the Department, or successor office, shall submit to the Committee
on Veterans' Affairs of the Senate and the Committee on Veterans'
Affairs of the House of Representatives a report containing--
(1) an assessment of the efforts of the Department pursuant
to section 1703(i)(5) of such title, as amended by subsection
(a), to incorporate value-based reimbursement models to promote
the provision of high-quality care to veterans; and
(2) such recommendations for legislative or administrative
action as the Secretary considers appropriate to increase the
use of value-based reimbursement models throughout the Veterans
Community Care Program under section 1703 of such title.
(d) Rule of Construction.--This section shall not be construed to
be a pilot program subject to the requirements of section 1703E of
title 38, United States Code.
(e) Third Party Administrator Defined.--In this section, the term
``Third Party Administrator'' means an entity that manages a provider
network and performs administrative services related to such network
under section 1703 of title 38, United States Code.
SEC. 107. EXTENSION OF DEADLINE FOR SUBMITTAL OF CLAIMS BY HEALTH CARE
ENTITIES AND PROVIDERS UNDER PROMPT PAYMENT STANDARD.
Section 1703D(b) of title 38, United States Code, is amended by
striking ``180 days'' and inserting ``one year''.
TITLE II--OTHER HEALTH CARE MATTERS
SEC. 201. PLAN ON ESTABLISHMENT OF INTERACTIVE, ONLINE SELF-SERVICE
MODULE FOR CARE.
(a) In General.--The Secretary of Veterans Affairs, working with
Third Party Administrators and acting through the Center for Innovation
for Care and Payment of the Department of Veterans Affairs under
section 1703E of title 38, United States Code, shall develop and
implement a plan to establish an interactive, online self-service
module--
(1) to allow veterans to request appointments, track
referrals for health care under the laws administered by the
Secretary, whether at a facility of the Department or through a
non-Department provider, and receive appointment reminders;
(2) to allow veterans to appeal and track decisions
relating to--
(A) denials of requests for care or services under
section 1703 of title 38, United States Code; or
(B) denials of requests for care or services at
facilities of the Department, including under section
1710 of such title; and
(3) to implement such other matters as determined
appropriate by the Secretary in consultation with Third Party
Administrators.
(b) Submittal of Plan.--
(1) Initial plan.--Not later than 180 days after the date
of the enactment of this Act, the Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and the Committee
on Veterans' Affairs of the House of Representatives the plan
developed under subsection (a).
(2) Quarterly update.--Not less frequently than quarterly
following the submittal of the plan under paragraph (1) and for
two years thereafter, the Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and the Committee
on Veterans' Affairs of the House of Representatives a report
containing any updates on the implementation of such plan.
(c) Rule of Construction.--This section shall not be construed to
be a pilot program subject to the requirements of section 1703E of
title 38, United States Code.
(d) Third Party Administrator Defined.--In this section, the term
``Third Party Administrator'' means an entity that manages a provider
network and performs administrative services related to such network
under section 1703 of title 38, United States Code.
SEC. 202. PUBLICATION OF WAIT TIMES FOR CARE AT MEDICAL CENTERS OF
DEPARTMENT OF VETERANS AFFAIRS.
(a) In General.--Subchapter I of chapter 17 of title 38, United
States Code, is amended by inserting after section 1703F the following
new section:
``Sec. 1703G. Publication of wait times for care at medical centers
``(a) In General.--The Secretary shall publish on a publicly
available internet website of the Department the average wait time for
a veteran to schedule an appointment at each medical center of the
Department for the receipt of primary care, specialty care, and mental
health care measured from the date of request for the appointment to
the date on which the care was provided.
``(b) Update.--The Secretary shall update the wait times published
under subsection (a) not less frequently than monthly.''.
(b) Clerical Amendment.--The table of sections at the beginning of
such subchapter is amended by inserting after the item relating to
section 1703F the following new item:
``1703G. Publication of wait times for care at medical centers.''.
SEC. 203. MODIFICATION OF REQUIREMENTS FOR CENTER FOR INNOVATION FOR
CARE AND PAYMENT OF THE DEPARTMENT OF VETERANS AFFAIRS
AND REQUIREMENT FOR PILOT PROGRAM.
(a) In General.--Section 1703E of title 38, United States Code, is
amended--
(1) in subsection (a)--
(A) in paragraph (1), by striking ``within the
Department'' and inserting ``within the Office of the
Secretary'';
(B) in paragraph (2), by striking ``may'' and
inserting ``shall''; and
(C) in paragraph (3)--
(i) in subparagraph (A), by striking ``;
and'' and inserting a semicolon;
(ii) in subparagraph (B), by striking the
period at the end and inserting ``; or''; and
(iii) by adding at the end the following
new subparagraph:
``(C) increase productivity, efficiency, and modernization
throughout the Department.'';
(2) by striking subsection (d) and inserting the following
new subsection (d):
``(d) Budgetary Line Item.--The Secretary shall include in the
budget justification materials submitted to Congress in support of the
budget of the Department of Veterans Affairs for a fiscal year (as
submitted with the budget of the President under section 1105(a) of
title 31) specific identification, as a budgetary line item, of the
amounts required to carry out this section.'';
(3) in subsection (f)--
(A) in paragraph (1), by striking ``in subchapters
I, II, and III of this chapter'' and inserting ``of
this title, of title 38, Code of Federal Regulations,
and of any handbooks, directives, or policy documents
of the Department''; and
(B) in paragraph (2), in the matter preceding
subparagraph (A), by striking ``waiving any authority''
and inserting ``waiving any provision of this title'';
(4) in subsection (g)(1), by inserting ``fewer than three
or'' before ``more than 10'';
(5) in subsection (i)--
(A) in paragraph (1), by striking ``the Under
Secretary for Health and the Special Medical Advisory
Group established pursuant to section 7312 of this
title'' and inserting ``the Under Secretary for Health,
the Special Medical Advisory Group established pursuant
to section 7312 of this title, the Office of Integrated
Veteran Care (or successor office), the Office of
Finance (or successor office), the Veteran Experience
Office (or successor office), the Office of Enterprise
Integration (or successor office), and the Office of
Information and Technology (or successor office)''; and
(B) in paragraph (2), by striking ``representatives
of relevant Federal agencies, and clinical and
analytical experts with expertise in medicine and
health care management'' and inserting
``representatives of relevant Federal agencies,
nonprofit organizations, and other public and private
sector entities, including those with clinical and
analytical experts with expertise in medicine and
health care management''; and
(6) by adding at the end the following new subsection:
``(k) Report on Activities of Center for Innovation for Care and
Payment.--Not less frequently than annually, the Secretary shall submit
to Congress a report that contains, for the one-year period preceding
the date of the report--
``(1) a full accounting of the activities, staff, budget,
and other resources and efforts of the Center; and
``(2) an assessment of the outcomes of the efforts of the
Center.''.
(b) Comptroller General Report.--Not later than 18 months after the
date of the enactment of this Act, the Comptroller General of the
United States shall submit to Congress a report--
(1) on the efforts of the Center for Innovation for Care
and Payment of the Department of Veterans Affairs in fulfilling
the objectives and requirements under section 1703E of title
38, United States Code, as amended by subsection (a); and
(2) containing such recommendations as the Comptroller
General considers appropriate.
(c) Pilot Program.--
(1) In general.--Not later than one year after the date of
the enactment of this Act, the Center for Innovation for Care
and Payment of the Department of Veterans Affairs under section
1703E of title 38, United States Code, shall establish a three-
year pilot program in not fewer than five locations to allow
veterans enrolled in the system of annual patient enrollment of
the Department established and operated under section 1705(a)
of such title to access outpatient mental health and substance
use services through health care providers specified under
section 1703(c) of such title without referral or pre-
authorization.
(2) Priority.--In selecting sites for the pilot program
under paragraph (1), the Secretary shall prioritize sites in
the following areas:
(A) Areas with varying degrees of urbanization,
including urban, rural, and highly rural areas.
(B) Areas with high rates of suicide among
veterans.
(C) Areas with high rates of overdose deaths among
veterans.
(D) Areas with high rates of calls to the Veterans
Crisis Line.
(E) Areas with long wait times for mental health
and substance use services at facilities of the
Department.
(F) Areas with outpatient mental health and
substance use programs that utilize a value-based care
model, to the extent practicable.
(3) Elements.--The Secretary, in implementing the pilot
program under paragraph (1), shall ensure the Department has a
care coordination system in place that includes--
(A) knowledge sharing, including the timely
exchange of medical documentation;
(B) assistance with transitions of care, including
the potential need for inpatient or residential
psychiatric services, substance use detoxification
services, post-detoxification step-down services, and
residential rehabilitation programs;
(C) continuous assessment of patient needs and
goals; and
(D) creating personalized, proactive care plans.
(4) Oversight and outcomes.--The Secretary shall develop
appropriate metrics and measures--
(A) to track and oversee sites at which the pilot
program under paragraph (1) is carried out;
(B) to monitor patient safety and outcomes under
the pilot program; and
(C) to assess and mitigate any barriers to
extending the pilot program across the entire Veterans
Health Administration.
(5) Annual report.--
(A) In general.--Not later than one year after the
commencement of the pilot program under paragraph (1),
and not less frequently than annually thereafter during
the duration of the pilot program, the Secretary shall
submit to the Committee on Veterans' Affairs of the
Senate and Committee on Veterans' Affairs of the House
of Representatives a report on the pilot program, which
shall include the following:
(i) The number of unique veterans who
participated in the pilot program.
(ii) The number of health care providers
who participated in the pilot program.
(iii) An assessment of the effectiveness of
the pilot program in increasing access to, and
improving outcomes for, mental health and
substance use treatment services.
(iv) The cost of the pilot program.
(v) Such other matters as the Secretary
considers appropriate.
(B) Final report.--The Secretary shall include in
the final report submitted under subparagraph (A), in
addition to the requirements under such subparagraph,
the assessment by the Secretary of the feasibility and
advisability of extending the pilot program across the
entire Veterans Health Administration, including a
plan, timeline, and required resources for such an
extension.
(6) Veterans crisis line defined.--In this subsection, the
term ``Veterans Crisis Line'' means the toll-free hotline for
veterans established under section 1720F(h) of title 38, United
States Code.
SEC. 204. STANDARDIZED PROCESS TO DETERMINE ELIGIBILITY OF COVERED
VETERANS FOR PARTICIPATION IN CERTAIN MENTAL HEALTH
TREATMENT PROGRAMS.
(a) Standardized Screening Process.--Not later than one year after
the date of the enactment of this Act, the Secretary of Veterans
Affairs shall establish a standardized screening process to determine,
based on clinical need, whether a covered veteran satisfies criteria
for priority or routine admission to a covered treatment program.
(b) Eligibility Criteria.--
(1) In general.--Under the standardized screening process
required by subsection (a), a covered veteran shall be eligible
for priority admission to a covered treatment program if the
covered veteran meets criteria that include, but are not
limited to, the following:
(A) Symptoms that--
(i) significantly affect activities of
daily life; and
(ii) increase the risk of such veteran for
adverse outcomes.
(B) An unsafe living situation.
(C) A high-risk flag for suicide.
(D) A determination of being a high risk for
suicide.
(E) Risk factors for overdose.
(F) Non-responsive, relapsed, or unable to find
recovery from one other course of treatment, such as
outpatient or intensive outpatient treatment.
(G) Other such criteria as the Secretary determines
appropriate.
(2) Consideration.--In making a determination under
paragraph (1), the Secretary shall consider any referral of a
health care provider of a covered veteran for such covered
veteran to be admitted to a covered treatment program.
(c) Time for Screening and Admission.--Under the standardized
screening process required by subsection (a), the Secretary shall
ensure a covered veteran--
(1) is screened not later than 48 hours after the date on
which the covered veteran, or a relevant health care provider,
makes a request for the covered veteran to be admitted to a
covered treatment program; and
(2) determined eligible for priority admission to a covered
treatment program is admitted to such covered treatment program
not later than 48 hours after the date of such determination.
(d) Access Standards for Routine Admission.--The Secretary shall
include the standardized screening process under this section in the
wait time access standards for eligibility for mental health care under
section 1703(d) of such title established by the Secretary under
section 1703B of such title.
(e) Conditions Under Which Care Shall Be Furnished Through Non-
Department Providers.--If the Secretary determines a covered veteran to
be eligible for either priority or routine admission to a covered
treatment program pursuant to the standardized screening process
required by subsection (a), and the Secretary is unable to admit such
covered veteran to a clinically necessary covered treatment program at
a facility of the Department of Veterans Affairs within 30 minutes
average driving time (or such shorter period as the Secretary may
prescribe) of the veteran's residence; and within 20 days (or such
shorter period as the Secretary may prescribe) of the date of request
for veterans eligible for routine admission, or within 48 hours (or
such shorter period as the Secretary may prescribe) for veterans deemed
eligible for priority admission unless a later date has been agreed to
by the veteran in consultation with their Department health care
provider.
(f) Definitions.--In this section:
(1) The term ``covered treatment program''--
(A) means a mental health residential
rehabilitation treatment program of the Department of
Veterans Affairs;
(B) a program of the Department for residential
care for mental health and substance abuse disorders;
(C) includes--
(i) the programs designated as of the date
of the enactment of this section as domiciliary
residential rehabilitation treatment programs;
and
(ii) any programs designated as domiciliary
residential rehabilitation treatment programs
on or after such date of enactment; and
(D) does not include Compensated Work Therapy
Transition Residence programs of the Department.
(2) The term ``covered veteran'' means a veteran described
in section 1703(b) of title 38, United States Code.
SEC. 205. REPORTS.
(a) Report on Improvements to Clinical Appeals Process.--Not later
than one year after the date of the enactment of this Act, and not less
frequently than once every three years thereafter, the Secretary of
Veterans Affairs, in consultation with veterans service organizations,
veterans, caregivers of veterans, employees of the Department of
Veterans Affairs, and other stakeholders as determined by the
Secretary, shall submit to the Committee on Veterans' Affairs of the
Senate and Committee on Veterans' Affairs of the House of
Representatives a report containing recommendations for legislative or
administrative action to improve the clinical appeals process of the
Department with respect to timeliness, transparency, objectivity,
consistency, and fairness.
(b) Report on Required Care and Services Under Community Care
Program.--Not later than one year after the date of the enactment of
this Act, and not less frequently than annually thereafter, the
Secretary shall submit to the Committee on Veterans' Affairs of the
Senate and Committee on Veterans' Affairs of the House of
Representatives a report that contains, for the one-year period
preceding the date of the report, the following:
(1) The number of veterans eligible for care or services
under section 1703 of title 38, United States Code, and the
reasons for such eligibility, including multiple such reasons
for veterans eligible under more than one eligibility criteria.
(2) The number of veterans who opt to seek care or services
under such section.
(3) The number of veterans who do not opt to seek care or
services under such section.
(4) An assessment of the timeliness of referrals for care
or services under such section.
(5) The number of times a veteran did not show for an
appointment for care or services under such section.
(6) The number of requests for an appeal of a denial of
care or services under such section using the clinical appeals
process of the Veterans Health Administration.
(7) The timeliness of each such appeal.
(8) The outcome of each such appeal.
(c) Veterans Service Organization Defined.--In this section, the
term ``veterans service organization'' means any organization
recognized by the Secretary under section 5902 of title 38, United
States Code.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Veterans' Affairs.
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