<enum>I</enum><header>Improvement of Veterans Community Care Program</header><section id="H3C3B22983A3948F8AF375F3568AA9CD3"><enum>101.</enum><header>Codification of requirements for eligibility standards for access to community care from Department of Veterans Affairs</header><subsection id="H97F26C51A94E404DA09044ED27BE07E0"><enum>(a)</enum><header>Eligibility access standards</header><text>Section 1703B of title 38, United States Code, is amended—</text><paragraph id="HD4CE11F377C244AAB0C92D982DFEB6D5"><enum>(1)</enum><text>by striking subsections (a) through (e) and inserting the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="HF55C8307DDCA483EB46C74EB5D1F4B75"><subsection id="HBBBE0A2BB6DD4B14B88C8F3F0B8F7125"><enum>(a)</enum><header>Eligibility standards for access to community care</header><paragraph commented="no" display-inline="yes-display-inline" id="H87124DC19354489A9549959AED5C03AD"><enum>(1)</enum><text>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:</text><subparagraph id="HA9302CC81D224CEA87E217176633A60B" indent="up1"><enum>(A)</enum><text>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—</text><clause id="H67A9089199D34EEBBA29A43544571BD0"><enum>(i)</enum><text>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</text></clause><clause id="H99302FD7E0B24BBCA315A5EA0E651694"><enum>(ii)</enum><text>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.</text></clause></subparagraph><subparagraph id="H63FA6417F64B4B9285EFEEAD0008DAB5" indent="up1"><enum>(B)</enum><text display-inline="yes-display-inline">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—</text><clause id="HCF51F09032F6425D8857D713DEBA67F3"><enum>(i)</enum><text>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</text></clause><clause id="H9446B79918224264AEB12E4F928E25C9"><enum>(ii)</enum><text>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.</text></clause></subparagraph></paragraph><paragraph id="HD5E7D29C3340434C91BCFD548C31ACBB" indent="up1"><enum>(2)</enum><text>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.</text></paragraph><paragraph id="H18F456EAACFA416CA7FF7536601B9BCF" indent="up1"><enum>(3)</enum><text>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.</text></paragraph><paragraph id="H2E9A32AB410C428197DF125A91AF6C50" indent="up1"><enum>(4)</enum><text>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.</text></paragraph></subsection><subsection id="HA6D4C70DABF64A9DA2C1682226985AAB"><enum>(b)</enum><header>Application</header><text>The Secretary shall ensure that the eligibility access standards established under subsection (a) apply—</text><paragraph commented="no" display-inline="no-display-inline" id="HEDF7B35065B14826BFA9DFE728153FC0"><enum>(1)</enum><text display-inline="yes-display-inline">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</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H584CAB90C1C44804A7929C7D5E5745CC"><enum>(2)</enum><text display-inline="yes-display-inline">to all covered veterans, regardless of whether a veteran is a new or established patient.</text></paragraph></subsection><subsection id="HD690E80889A94EF8ABA6DE300A5D32DB"><enum>(c)</enum><header>Periodic review of access standards</header><text>Not later than three years after the date of the enactment of the <short-title>Complete the Mission Act of 2024</short-title>, and not less frequently than once every three years thereafter, the Secretary shall—</text><paragraph id="H4E85792C5973445692090655E1538893"><enum>(1)</enum><text>conduct a review of the eligibility access standards under subsection (a) in consultation with—</text><subparagraph id="HB708E9144F70478E820884B33A53B748"><enum>(A)</enum><text>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;</text></subparagraph><subparagraph id="HE83CACDF9F534021BB9792868FB2927E"><enum>(B)</enum><text>entities and individuals in the private sector, including—</text><clause commented="no" display-inline="no-display-inline" id="H6A17D574990643B3843F9D5F1C017CD8"><enum>(i)</enum><text display-inline="yes-display-inline">veteran patients;</text></clause><clause commented="no" display-inline="no-display-inline" id="H6F507FB31357449791C7B49EB3F8261E"><enum>(ii)</enum><text display-inline="yes-display-inline">veterans service organizations; and</text></clause><clause commented="no" display-inline="no-display-inline" id="H1C5CD0952F374B47A2F2BAE709B530D7"><enum>(iii)</enum><text display-inline="yes-display-inline">health care providers participating in the Veterans Community Care Program under section 1703 of this title; and</text></clause></subparagraph><subparagraph id="H872B46730C704D99AF1FD2E6D95097BD"><enum>(C)</enum><text>other entities that are not part of the Federal Government; and</text></subparagraph></paragraph><paragraph id="HD70BF04853F6482DAEA3CF56DCBE6CC4"><enum>(2)</enum><text>submit to the appropriate committees of Congress a report on—</text><subparagraph id="H7347803923DD483D81E09A2C746FCA42"><enum>(A)</enum><text>the findings of the Secretary with respect to the review conducted under paragraph (1); and</text></subparagraph><subparagraph id="H5E989E76CF564A51AAD81AE943A29324"><enum>(B)</enum><text>such recommendations as the Secretary may have with respect to the eligibility access standards under subsection (a).</text></subparagraph></paragraph></subsection><after-quoted-block>;</after-quoted-block></quoted-block></paragraph><paragraph id="H3488F41EA8ED437DB1B6D1DD8AF0BA0A"><enum>(2)</enum><text>by striking subsection (g);</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H7C4B4E34F7B642248763491539D3C4D5"><enum>(3)</enum><text display-inline="yes-display-inline">by redesignating subsections (f), (h), and (i) as subsections (d), (e), and (f), respectively;</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HDAA5913211314143BA9867CA5B3CC4D9"><enum>(4)</enum><text>in subsection (d), as redesignated by paragraph (3)—</text><subparagraph commented="no" display-inline="no-display-inline" id="HC04404E8D05A48CDB2635B6E84A1D345"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>established</quote> each place it appears; and</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H3122519F5A0E4DE7B26B38FCA9952AF3"><enum>(B)</enum><text display-inline="yes-display-inline">in paragraph (1), by striking <quote>(1) Subject to</quote> and inserting <quote><header-in-text style="USC" level="subsection">Compliance by community care providers with access standards</header-in-text>.—(1) Subject to</quote>;</text></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H90E5583ECEF34498A2AEFE2CEAC0E7D2"><enum>(5)</enum><text display-inline="yes-display-inline">in subsection (e), as so redesignated—</text><subparagraph id="HA7F8614227B34309A79A97FD4F0B5D5E"><enum>(A)</enum><text>in paragraph (1)—</text><clause commented="no" display-inline="no-display-inline" id="H905794E8715641ADB0925151C3A02B1B"><enum>(i)</enum><text display-inline="yes-display-inline">by striking <quote>(1) Consistent with</quote> and inserting <quote><header-in-text style="USC" level="subsection">Determination regarding eligibility</header-in-text>.—(1) Consistent with</quote>; and</text></clause><clause commented="no" display-inline="no-display-inline" id="HDB556FB9FD9F4FEA9B71CAD8D8057710"><enum>(ii)</enum><text display-inline="yes-display-inline">by striking <quote>designated access standards established under this section</quote> and inserting <quote>eligibility access standards under subsection (a)</quote>; and</text></clause></subparagraph><subparagraph id="H43C86C78AA7C49FEBBA5EFCE1CC48822"><enum>(B)</enum><text>in paragraph (2)(B), by striking <quote>designated access standards established under this section</quote> and inserting <quote>eligibility access standards under subsection (a)</quote>; and</text></subparagraph></paragraph><paragraph id="H4F6510394D144440B4E5751D5E96A6D3"><enum>(6)</enum><text>in subsection (f), as redesignated by paragraph (2)—</text><subparagraph commented="no" display-inline="no-display-inline" id="HCCF96C671C7147AF9EEB65C125F10963"><enum>(A)</enum><text display-inline="yes-display-inline">in the matter preceding paragraph (1), by striking <quote>In this section</quote> and inserting <quote><header-in-text style="USC" level="subsection">Definitions</header-in-text>.—In this section</quote>; and</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H037A12632C1342F782CF80B52EAB241B"><enum>(B)</enum><text>in paragraph (2)—</text><clause id="HF0D1C6D7DED647D497D9785FCC012C58"><enum>(i)</enum><text>by striking <quote>covered veterans</quote> and inserting <quote>covered veteran</quote>; and</text></clause><clause id="HA8DA9C2BD5964FA096EFBE1164F37B48"><enum>(ii)</enum><text>by striking <quote>veterans described</quote> and inserting <quote>a veteran described</quote>.</text></clause></subparagraph></paragraph></subsection><subsection id="H52CBADE4C12E4126AA946635914117DB"><enum>(b)</enum><header>Conforming amendments</header><text>Section 1703(d) of such title is amended—</text><paragraph id="H1E2011EC7731439B8D7CAB9F1C053BCF"><enum>(1)</enum><text>in paragraph (1)(D), by striking <quote>designated access standards developed by the Secretary under section 1703B of this title</quote> and inserting <quote>eligibility access standards under section 1703B(a) of this title</quote>; and</text></paragraph><paragraph id="H361C05BEF89244CDABFA0A3ACE357E1A"><enum>(2)</enum><text>in paragraph (3), by striking <quote>designated access standards developed by the Secretary under section 1703B of this title</quote> and inserting <quote>eligibility access standards under section 1703B(a) of this title</quote>.</text></paragraph></subsection></section><section id="HD216D15AB27B478AA398C570BAEFA1E2"><enum>102.</enum><header>Requirement that Secretary notify veterans of eligibility for care under Veterans Community Care Program</header><text display-inline="no-display-inline">Section 1703(a) of title 38, United States Code, is amended by adding at the end the following new paragraph:</text><quoted-block style="OLC" display-inline="no-display-inline" id="H5677CF3580524194AF9AEBA3B0B0049F"><paragraph commented="no" display-inline="no-display-inline" id="H39562B3975104EE9AFEEC28F6041C6D3" indent="up1"><enum>(5)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="H801F5E37B0854191A6ECDCDC6B4C602A"><enum>(A)</enum><text display-inline="yes-display-inline">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.</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" indent="up1" id="HEECF823B5AA248F38D2F17E88692FB27"><enum>(B)</enum><text display-inline="yes-display-inline">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.</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" indent="up1" id="H99E7C1CBC15B411DACA85C6AE0E9218B"><enum>(C)</enum><text display-inline="yes-display-inline">Any notification or reminder under this paragraph may be provided electronically.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></section><section id="HA67F5C3E9A1D4B048675E9CED0390D1A"><enum>103.</enum><header>Consideration under Veterans Community Care Program of veteran preference for care and need for caregiver or attendant</header><text display-inline="no-display-inline">Section 1703(d)(2) of title 38, United States Code, is amended by adding at the end the following new subparagraphs:</text><quoted-block id="H14DE79B9C31F4135B17AF8AFB327920D" display-inline="no-display-inline" style="OLC"><subparagraph id="H5D6F9C8EE73A4B0C8E755CDEFB9B8FCD" indent="up1"><enum>(F)</enum><text>The preference of the covered veteran for where, when, and how to seek hospital care, medical services, or extended care services.</text></subparagraph><subparagraph id="H8108D2A2E5FC40529104F58AD5FCAB18" indent="up1" commented="no" display-inline="no-display-inline"><enum>(G)</enum><text>Whether the covered veteran requests or requires the assistance of a caregiver or attendant when seeking hospital care, medical services, or extended care services.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></section><section commented="no" display-inline="no-display-inline" id="H2FE0E60DC44C40BC905EF782871508CB"><enum>104.</enum><header>Notification of denial of request for care under Veterans Community Care Program</header><text display-inline="no-display-inline">Section 1703 of title 38, United States Code, is amended—</text><paragraph id="H158FF1215E434702916F932F4D21529B"><enum>(1)</enum><text>by redesignating subsection (o) as subsection (p); and</text></paragraph><paragraph id="HDDA72D0F18B142B1AB5573935E4A392E"><enum>(2)</enum><text>by inserting after subsection (n) the following new subsection (o):</text><quoted-block style="OLC" display-inline="no-display-inline" id="H49A614DEA08B436190FC0B07E9589E17"><subsection commented="no" display-inline="no-display-inline" id="HA95D7454B9984E5B804DC8BD69FD7CA3"><enum>(o)</enum><header>Notification of denial of request for care and how To appeal</header><paragraph commented="no" display-inline="yes-display-inline" id="HE0F0793378A54E38AE7E5C9FF6F31DC0"><enum>(1)</enum><text display-inline="yes-display-inline">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—</text><subparagraph commented="no" display-inline="no-display-inline" id="HCCCF5E98267B43A9BA09ABD59DD8927B" indent="up1"><enum>(A)</enum><text display-inline="yes-display-inline">of the reason for the denial; and</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H799133FEC78A45D98A32B45C176C57D2" indent="up1"><enum>(B)</enum><text display-inline="yes-display-inline">with instructions on how to appeal such denial using the clinical appeals process of the Veterans Health Administration.</text></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HD01002AD148E4ECDB86E0734BD37B618" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text></paragraph><paragraph commented="no" display-inline="no-display-inline" indent="up1" id="HC6C78953ECE04B9FB33A3353E0CF182F"><enum>(3)</enum><text display-inline="yes-display-inline">Any notification under this subsection may be provided electronically.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section><section id="H3F9B5CEF0CAC40E7822A589B59629AC2"><enum>105.</enum><header>Discussion of telehealth options under Veterans Community Care Program</header><text display-inline="no-display-inline">Section 1703 of title 38, United States Code, as amended by section 104, is further amended—</text><paragraph id="H35033F79D2AE48408CBB185E9694B1D7"><enum>(1)</enum><text>by redesignating subsection (p) as subsection (q); and</text></paragraph><paragraph id="H905785C22B9C45B590B043D883F57978"><enum>(2)</enum><text>by inserting after subsection (o) the following new subsection (p):</text><quoted-block id="H9AB5E9C394E44AC28543DF9C4D8F7CFA" display-inline="no-display-inline" style="OLC"><subsection id="H585EF916899B47B6A53E9F60DD813F52"><enum>(p)</enum><header>Discussion of options for telehealth</header><text>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—</text><paragraph id="H32AC6FD3D0054C3492D2EE02483E0292"><enum>(1)</enum><text>is available to the veteran;</text></paragraph><paragraph id="H1D453AB34EE741599D812E5AF2EC8037"><enum>(2)</enum><text>is appropriate for the type of care or services the veteran is seeking, as determined by the Secretary; and</text></paragraph><paragraph id="H700F95AB335144859684C5944F4A0D7D" commented="no" display-inline="no-display-inline"><enum>(3)</enum><text>is acceptable to the veteran.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section><section id="HA1F0147830B244A392F167B17B97F0FB"><enum>106.</enum><header>Use of value-based reimbursement models under Veterans Community Care Program</header><subsection commented="no" display-inline="no-display-inline" id="HED44B55293BC4E1C840D12625518E6D7"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1703(i)(5) of title 38, United States Code, is amended by striking <quote>may</quote> and inserting <quote>shall</quote>.</text></subsection><subsection commented="no" display-inline="no-display-inline" id="H3A7A89224AE14E418279EA232004F1F1"><enum>(b)</enum><header>Negotiation of terms</header><text>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).</text></subsection><subsection id="H619810C82930419CB1B174092C0FADB3"><enum>(c)</enum><header>Report on value-Based reimbursement models</header><text>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—</text><paragraph commented="no" display-inline="no-display-inline" id="H42C2DBA0B9094491A2DAF1F8B69A56F5"><enum>(1)</enum><text display-inline="yes-display-inline">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</text></paragraph><paragraph id="H646A164A2FCF4C6F80319251B7FB9FF1" commented="no" display-inline="no-display-inline"><enum>(2)</enum><text display-inline="yes-display-inline">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. </text></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HDCC0FFD04A224611A24829595AD516AF"><enum>(d)</enum><header>Rule of construction</header><text>This section shall not be construed to be a pilot program subject to the requirements of section 1703E of title 38, United States Code. </text></subsection><subsection id="HBD5AAAFB23AB4C79949E2BB7A982C2DA"><enum>(e)</enum><header>Third Party Administrator defined</header><text>In this section, the term <term>Third Party Administrator</term> 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. </text></subsection></section><section id="H440CB4E9F8784C36A2C6F132E9F6AFA5"><enum>107.</enum><header>Extension of deadline for submittal of claims by health care entities and providers under prompt payment standard</header><text display-inline="no-display-inline">Section 1703D(b) of title 38, United States Code, is amended by striking <quote>180 days</quote> and inserting <quote>one year</quote>. </text></section>

118 HR 10267 IH: Complete the Mission Act of 2024 U.S. House of Representatives 2024-12-03 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

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.

<enum>I</enum><header>Improvement of Veterans Community Care Program</header><section id="H3C3B22983A3948F8AF375F3568AA9CD3"><enum>101.</enum><header>Codification of requirements for eligibility standards for access to community care from Department of Veterans Affairs</header><subsection id="H97F26C51A94E404DA09044ED27BE07E0"><enum>(a)</enum><header>Eligibility access standards</header><text>Section 1703B of title 38, United States Code, is amended—</text><paragraph id="HD4CE11F377C244AAB0C92D982DFEB6D5"><enum>(1)</enum><text>by striking subsections (a) through (e) and inserting the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="HF55C8307DDCA483EB46C74EB5D1F4B75"><subsection id="HBBBE0A2BB6DD4B14B88C8F3F0B8F7125"><enum>(a)</enum><header>Eligibility standards for access to community care</header><paragraph commented="no" display-inline="yes-display-inline" id="H87124DC19354489A9549959AED5C03AD"><enum>(1)</enum><text>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:</text><subparagraph id="HA9302CC81D224CEA87E217176633A60B" indent="up1"><enum>(A)</enum><text>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—</text><clause id="H67A9089199D34EEBBA29A43544571BD0"><enum>(i)</enum><text>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</text></clause><clause id="H99302FD7E0B24BBCA315A5EA0E651694"><enum>(ii)</enum><text>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.</text></clause></subparagraph><subparagraph id="H63FA6417F64B4B9285EFEEAD0008DAB5" indent="up1"><enum>(B)</enum><text display-inline="yes-display-inline">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—</text><clause id="HCF51F09032F6425D8857D713DEBA67F3"><enum>(i)</enum><text>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</text></clause><clause id="H9446B79918224264AEB12E4F928E25C9"><enum>(ii)</enum><text>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.</text></clause></subparagraph></paragraph><paragraph id="HD5E7D29C3340434C91BCFD548C31ACBB" indent="up1"><enum>(2)</enum><text>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.</text></paragraph><paragraph id="H18F456EAACFA416CA7FF7536601B9BCF" indent="up1"><enum>(3)</enum><text>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.</text></paragraph><paragraph id="H2E9A32AB410C428197DF125A91AF6C50" indent="up1"><enum>(4)</enum><text>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.</text></paragraph></subsection><subsection id="HA6D4C70DABF64A9DA2C1682226985AAB"><enum>(b)</enum><header>Application</header><text>The Secretary shall ensure that the eligibility access standards established under subsection (a) apply—</text><paragraph commented="no" display-inline="no-display-inline" id="HEDF7B35065B14826BFA9DFE728153FC0"><enum>(1)</enum><text display-inline="yes-display-inline">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</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H584CAB90C1C44804A7929C7D5E5745CC"><enum>(2)</enum><text display-inline="yes-display-inline">to all covered veterans, regardless of whether a veteran is a new or established patient.</text></paragraph></subsection><subsection id="HD690E80889A94EF8ABA6DE300A5D32DB"><enum>(c)</enum><header>Periodic review of access standards</header><text>Not later than three years after the date of the enactment of the <short-title>Complete the Mission Act of 2024</short-title>, and not less frequently than once every three years thereafter, the Secretary shall—</text><paragraph id="H4E85792C5973445692090655E1538893"><enum>(1)</enum><text>conduct a review of the eligibility access standards under subsection (a) in consultation with—</text><subparagraph id="HB708E9144F70478E820884B33A53B748"><enum>(A)</enum><text>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;</text></subparagraph><subparagraph id="HE83CACDF9F534021BB9792868FB2927E"><enum>(B)</enum><text>entities and individuals in the private sector, including—</text><clause commented="no" display-inline="no-display-inline" id="H6A17D574990643B3843F9D5F1C017CD8"><enum>(i)</enum><text display-inline="yes-display-inline">veteran patients;</text></clause><clause commented="no" display-inline="no-display-inline" id="H6F507FB31357449791C7B49EB3F8261E"><enum>(ii)</enum><text display-inline="yes-display-inline">veterans service organizations; and</text></clause><clause commented="no" display-inline="no-display-inline" id="H1C5CD0952F374B47A2F2BAE709B530D7"><enum>(iii)</enum><text display-inline="yes-display-inline">health care providers participating in the Veterans Community Care Program under section 1703 of this title; and</text></clause></subparagraph><subparagraph id="H872B46730C704D99AF1FD2E6D95097BD"><enum>(C)</enum><text>other entities that are not part of the Federal Government; and</text></subparagraph></paragraph><paragraph id="HD70BF04853F6482DAEA3CF56DCBE6CC4"><enum>(2)</enum><text>submit to the appropriate committees of Congress a report on—</text><subparagraph id="H7347803923DD483D81E09A2C746FCA42"><enum>(A)</enum><text>the findings of the Secretary with respect to the review conducted under paragraph (1); and</text></subparagraph><subparagraph id="H5E989E76CF564A51AAD81AE943A29324"><enum>(B)</enum><text>such recommendations as the Secretary may have with respect to the eligibility access standards under subsection (a).</text></subparagraph></paragraph></subsection><after-quoted-block>;</after-quoted-block></quoted-block></paragraph><paragraph id="H3488F41EA8ED437DB1B6D1DD8AF0BA0A"><enum>(2)</enum><text>by striking subsection (g);</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H7C4B4E34F7B642248763491539D3C4D5"><enum>(3)</enum><text display-inline="yes-display-inline">by redesignating subsections (f), (h), and (i) as subsections (d), (e), and (f), respectively;</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HDAA5913211314143BA9867CA5B3CC4D9"><enum>(4)</enum><text>in subsection (d), as redesignated by paragraph (3)—</text><subparagraph commented="no" display-inline="no-display-inline" id="HC04404E8D05A48CDB2635B6E84A1D345"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>established</quote> each place it appears; and</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H3122519F5A0E4DE7B26B38FCA9952AF3"><enum>(B)</enum><text display-inline="yes-display-inline">in paragraph (1), by striking <quote>(1) Subject to</quote> and inserting <quote><header-in-text style="USC" level="subsection">Compliance by community care providers with access standards</header-in-text>.—(1) Subject to</quote>;</text></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H90E5583ECEF34498A2AEFE2CEAC0E7D2"><enum>(5)</enum><text display-inline="yes-display-inline">in subsection (e), as so redesignated—</text><subparagraph id="HA7F8614227B34309A79A97FD4F0B5D5E"><enum>(A)</enum><text>in paragraph (1)—</text><clause commented="no" display-inline="no-display-inline" id="H905794E8715641ADB0925151C3A02B1B"><enum>(i)</enum><text display-inline="yes-display-inline">by striking <quote>(1) Consistent with</quote> and inserting <quote><header-in-text style="USC" level="subsection">Determination regarding eligibility</header-in-text>.—(1) Consistent with</quote>; and</text></clause><clause commented="no" display-inline="no-display-inline" id="HDB556FB9FD9F4FEA9B71CAD8D8057710"><enum>(ii)</enum><text display-inline="yes-display-inline">by striking <quote>designated access standards established under this section</quote> and inserting <quote>eligibility access standards under subsection (a)</quote>; and</text></clause></subparagraph><subparagraph id="H43C86C78AA7C49FEBBA5EFCE1CC48822"><enum>(B)</enum><text>in paragraph (2)(B), by striking <quote>designated access standards established under this section</quote> and inserting <quote>eligibility access standards under subsection (a)</quote>; and</text></subparagraph></paragraph><paragraph id="H4F6510394D144440B4E5751D5E96A6D3"><enum>(6)</enum><text>in subsection (f), as redesignated by paragraph (2)—</text><subparagraph commented="no" display-inline="no-display-inline" id="HCCF96C671C7147AF9EEB65C125F10963"><enum>(A)</enum><text display-inline="yes-display-inline">in the matter preceding paragraph (1), by striking <quote>In this section</quote> and inserting <quote><header-in-text style="USC" level="subsection">Definitions</header-in-text>.—In this section</quote>; and</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H037A12632C1342F782CF80B52EAB241B"><enum>(B)</enum><text>in paragraph (2)—</text><clause id="HF0D1C6D7DED647D497D9785FCC012C58"><enum>(i)</enum><text>by striking <quote>covered veterans</quote> and inserting <quote>covered veteran</quote>; and</text></clause><clause id="HA8DA9C2BD5964FA096EFBE1164F37B48"><enum>(ii)</enum><text>by striking <quote>veterans described</quote> and inserting <quote>a veteran described</quote>.</text></clause></subparagraph></paragraph></subsection><subsection id="H52CBADE4C12E4126AA946635914117DB"><enum>(b)</enum><header>Conforming amendments</header><text>Section 1703(d) of such title is amended—</text><paragraph id="H1E2011EC7731439B8D7CAB9F1C053BCF"><enum>(1)</enum><text>in paragraph (1)(D), by striking <quote>designated access standards developed by the Secretary under section 1703B of this title</quote> and inserting <quote>eligibility access standards under section 1703B(a) of this title</quote>; and</text></paragraph><paragraph id="H361C05BEF89244CDABFA0A3ACE357E1A"><enum>(2)</enum><text>in paragraph (3), by striking <quote>designated access standards developed by the Secretary under section 1703B of this title</quote> and inserting <quote>eligibility access standards under section 1703B(a) of this title</quote>.</text></paragraph></subsection></section><section id="HD216D15AB27B478AA398C570BAEFA1E2"><enum>102.</enum><header>Requirement that Secretary notify veterans of eligibility for care under Veterans Community Care Program</header><text display-inline="no-display-inline">Section 1703(a) of title 38, United States Code, is amended by adding at the end the following new paragraph:</text><quoted-block style="OLC" display-inline="no-display-inline" id="H5677CF3580524194AF9AEBA3B0B0049F"><paragraph commented="no" display-inline="no-display-inline" id="H39562B3975104EE9AFEEC28F6041C6D3" indent="up1"><enum>(5)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="H801F5E37B0854191A6ECDCDC6B4C602A"><enum>(A)</enum><text display-inline="yes-display-inline">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.</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" indent="up1" id="HEECF823B5AA248F38D2F17E88692FB27"><enum>(B)</enum><text display-inline="yes-display-inline">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.</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" indent="up1" id="H99E7C1CBC15B411DACA85C6AE0E9218B"><enum>(C)</enum><text display-inline="yes-display-inline">Any notification or reminder under this paragraph may be provided electronically.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></section><section id="HA67F5C3E9A1D4B048675E9CED0390D1A"><enum>103.</enum><header>Consideration under Veterans Community Care Program of veteran preference for care and need for caregiver or attendant</header><text display-inline="no-display-inline">Section 1703(d)(2) of title 38, United States Code, is amended by adding at the end the following new subparagraphs:</text><quoted-block id="H14DE79B9C31F4135B17AF8AFB327920D" display-inline="no-display-inline" style="OLC"><subparagraph id="H5D6F9C8EE73A4B0C8E755CDEFB9B8FCD" indent="up1"><enum>(F)</enum><text>The preference of the covered veteran for where, when, and how to seek hospital care, medical services, or extended care services.</text></subparagraph><subparagraph id="H8108D2A2E5FC40529104F58AD5FCAB18" indent="up1" commented="no" display-inline="no-display-inline"><enum>(G)</enum><text>Whether the covered veteran requests or requires the assistance of a caregiver or attendant when seeking hospital care, medical services, or extended care services.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></section><section commented="no" display-inline="no-display-inline" id="H2FE0E60DC44C40BC905EF782871508CB"><enum>104.</enum><header>Notification of denial of request for care under Veterans Community Care Program</header><text display-inline="no-display-inline">Section 1703 of title 38, United States Code, is amended—</text><paragraph id="H158FF1215E434702916F932F4D21529B"><enum>(1)</enum><text>by redesignating subsection (o) as subsection (p); and</text></paragraph><paragraph id="HDDA72D0F18B142B1AB5573935E4A392E"><enum>(2)</enum><text>by inserting after subsection (n) the following new subsection (o):</text><quoted-block style="OLC" display-inline="no-display-inline" id="H49A614DEA08B436190FC0B07E9589E17"><subsection commented="no" display-inline="no-display-inline" id="HA95D7454B9984E5B804DC8BD69FD7CA3"><enum>(o)</enum><header>Notification of denial of request for care and how To appeal</header><paragraph commented="no" display-inline="yes-display-inline" id="HE0F0793378A54E38AE7E5C9FF6F31DC0"><enum>(1)</enum><text display-inline="yes-display-inline">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—</text><subparagraph commented="no" display-inline="no-display-inline" id="HCCCF5E98267B43A9BA09ABD59DD8927B" indent="up1"><enum>(A)</enum><text display-inline="yes-display-inline">of the reason for the denial; and</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H799133FEC78A45D98A32B45C176C57D2" indent="up1"><enum>(B)</enum><text display-inline="yes-display-inline">with instructions on how to appeal such denial using the clinical appeals process of the Veterans Health Administration.</text></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HD01002AD148E4ECDB86E0734BD37B618" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text></paragraph><paragraph commented="no" display-inline="no-display-inline" indent="up1" id="HC6C78953ECE04B9FB33A3353E0CF182F"><enum>(3)</enum><text display-inline="yes-display-inline">Any notification under this subsection may be provided electronically.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section><section id="H3F9B5CEF0CAC40E7822A589B59629AC2"><enum>105.</enum><header>Discussion of telehealth options under Veterans Community Care Program</header><text display-inline="no-display-inline">Section 1703 of title 38, United States Code, as amended by section 104, is further amended—</text><paragraph id="H35033F79D2AE48408CBB185E9694B1D7"><enum>(1)</enum><text>by redesignating subsection (p) as subsection (q); and</text></paragraph><paragraph id="H905785C22B9C45B590B043D883F57978"><enum>(2)</enum><text>by inserting after subsection (o) the following new subsection (p):</text><quoted-block id="H9AB5E9C394E44AC28543DF9C4D8F7CFA" display-inline="no-display-inline" style="OLC"><subsection id="H585EF916899B47B6A53E9F60DD813F52"><enum>(p)</enum><header>Discussion of options for telehealth</header><text>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—</text><paragraph id="H32AC6FD3D0054C3492D2EE02483E0292"><enum>(1)</enum><text>is available to the veteran;</text></paragraph><paragraph id="H1D453AB34EE741599D812E5AF2EC8037"><enum>(2)</enum><text>is appropriate for the type of care or services the veteran is seeking, as determined by the Secretary; and</text></paragraph><paragraph id="H700F95AB335144859684C5944F4A0D7D" commented="no" display-inline="no-display-inline"><enum>(3)</enum><text>is acceptable to the veteran.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section><section id="HA1F0147830B244A392F167B17B97F0FB"><enum>106.</enum><header>Use of value-based reimbursement models under Veterans Community Care Program</header><subsection commented="no" display-inline="no-display-inline" id="HED44B55293BC4E1C840D12625518E6D7"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1703(i)(5) of title 38, United States Code, is amended by striking <quote>may</quote> and inserting <quote>shall</quote>.</text></subsection><subsection commented="no" display-inline="no-display-inline" id="H3A7A89224AE14E418279EA232004F1F1"><enum>(b)</enum><header>Negotiation of terms</header><text>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).</text></subsection><subsection id="H619810C82930419CB1B174092C0FADB3"><enum>(c)</enum><header>Report on value-Based reimbursement models</header><text>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—</text><paragraph commented="no" display-inline="no-display-inline" id="H42C2DBA0B9094491A2DAF1F8B69A56F5"><enum>(1)</enum><text display-inline="yes-display-inline">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</text></paragraph><paragraph id="H646A164A2FCF4C6F80319251B7FB9FF1" commented="no" display-inline="no-display-inline"><enum>(2)</enum><text display-inline="yes-display-inline">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. </text></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HDCC0FFD04A224611A24829595AD516AF"><enum>(d)</enum><header>Rule of construction</header><text>This section shall not be construed to be a pilot program subject to the requirements of section 1703E of title 38, United States Code. </text></subsection><subsection id="HBD5AAAFB23AB4C79949E2BB7A982C2DA"><enum>(e)</enum><header>Third Party Administrator defined</header><text>In this section, the term <term>Third Party Administrator</term> 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. </text></subsection></section><section id="H440CB4E9F8784C36A2C6F132E9F6AFA5"><enum>107.</enum><header>Extension of deadline for submittal of claims by health care entities and providers under prompt payment standard</header><text display-inline="no-display-inline">Section 1703D(b) of title 38, United States Code, is amended by striking <quote>180 days</quote> and inserting <quote>one year</quote>. </text></section><enum>II</enum><header>Other Health Care Matters</header><section id="H34303F64D5524321B8D49E1A11F79F83"><enum>201.</enum><header>Plan on establishment of interactive, online self-service module for care</header><subsection id="HECEF6810322D464C80EBCC1EF75B4423"><enum>(a)</enum><header>In general</header><text>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—</text><paragraph id="H326068B6D66D460C8E2F717265B9F4F0"><enum>(1)</enum><text>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;</text></paragraph><paragraph id="HA3048983AF70494287EF7A5767927C6A"><enum>(2)</enum><text>to allow veterans to appeal and track decisions relating to—</text><subparagraph id="HA3473917C4E449BB8B39FAF66F168220"><enum>(A)</enum><text>denials of requests for care or services under section 1703 of title 38, United States Code; or</text></subparagraph><subparagraph id="H5AF10984BBC74534AE51684493D23F26"><enum>(B)</enum><text>denials of requests for care or services at facilities of the Department, including under section 1710 of such title; and</text></subparagraph></paragraph><paragraph id="H91EF12148E7C4D8CA1680A537E2D4A62"><enum>(3)</enum><text>to implement such other matters as determined appropriate by the Secretary in consultation with Third Party Administrators.</text></paragraph></subsection><subsection id="HC599D645184341CBAF0709A62F18AD3C"><enum>(b)</enum><header>Submittal of plan</header><paragraph id="H25CFA34037334F2CAC9F0495AA4404FD"><enum>(1)</enum><header>Initial plan</header><text>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).</text></paragraph><paragraph id="H866B02F0A13B45F8B4D57FC066910DD3"><enum>(2)</enum><header>Quarterly update</header><text>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.</text></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HF95CAB430BDC488ABC79B02945EA5332"><enum>(c)</enum><header>Rule of construction</header><text>This section shall not be construed to be a pilot program subject to the requirements of section 1703E of title 38, United States Code. </text></subsection><subsection id="H5872CCD99DC3401C80289D29C5288AD2"><enum>(d)</enum><header>Third Party Administrator defined</header><text>In this section, the term <term>Third Party Administrator</term> 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.</text></subsection></section><section id="HE3634119CF984292A0F602F82DEB763F"><enum>202.</enum><header>Publication of wait times for care at medical centers of Department of Veterans Affairs</header><subsection commented="no" display-inline="no-display-inline" id="H4B1AFCC7873848D3B530E9511EAEF9FB"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text>Subchapter I of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/17">chapter 17</external-xref> of title 38, United States Code, is amended by inserting after <external-xref legal-doc="usc" parsable-cite="usc/38/1703F">section 1703F</external-xref> the following new section:</text><quoted-block style="USC" display-inline="no-display-inline" id="HAF5F7BE792B941EFA356B08F61A527C2"><section id="HD4DA82D433494945A82C336550CDB1A7"><enum>1703G.</enum><header>Publication of wait times for care at medical centers</header><subsection id="H902FC0D565154977A3379D7BC6EE1241"><enum>(a)</enum><header>In general</header><text>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.</text></subsection><subsection id="HBC18784A1FB84272BC4FF526EA366796"><enum>(b)</enum><header>Update</header><text>The Secretary shall update the wait times published under subsection (a) not less frequently than monthly.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection><subsection commented="no" display-inline="no-display-inline" id="H3FA82CD47C954330879379ED7250C26E"><enum>(b)</enum><header>Clerical amendment</header><text>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:</text><quoted-block style="USC" id="HF2EF7EFC060A4EFA82486BABC3677870"><toc><toc-entry level="section" idref="HD4DA82D433494945A82C336550CDB1A7">1703G. Publication of wait times for care at medical centers.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section><section id="H1077A0621CDC42CFA6CEEC6DD4C30474"><enum>203.</enum><header>Modification of requirements for Center for Innovation for Care and Payment of the Department of Veterans Affairs and requirement for pilot program</header><subsection id="H9949E30C68924129A3758689DA2D35C6"><enum>(a)</enum><header>In general</header><text>Section 1703E of title 38, United States Code, is amended—</text><paragraph id="H2C27AA2C0D99433B8A295CF10303CB76"><enum>(1)</enum><text>in subsection (a)—</text><subparagraph id="H8200E1F562A4405181C15D57BAEAAE39"><enum>(A)</enum><text>in paragraph (1), by striking <quote>within the Department</quote> and inserting <quote>within the Office of the Secretary</quote>;</text></subparagraph><subparagraph id="HF50D3C3C1892471F944F89779F54F44D"><enum>(B)</enum><text>in paragraph (2), by striking <quote>may</quote> and inserting <quote>shall</quote>; and</text></subparagraph><subparagraph id="HE033B2CB5D37403991D7E4C4FED0D212"><enum>(C)</enum><text>in paragraph (3)—</text><clause id="HA2FF2803E1444076A1FC6585BCA3AD57"><enum>(i)</enum><text>in subparagraph (A), by striking <quote>; and</quote> and inserting a semicolon;</text></clause><clause id="H9086E15BF0084D2E8BEC706F1D3A866C"><enum>(ii)</enum><text>in subparagraph (B), by striking the period at the end and inserting <quote>; or</quote>; and</text></clause><clause id="HF4435231097447D5878EE87B9682A86D"><enum>(iii)</enum><text>by adding at the end the following new subparagraph:</text><quoted-block style="OLC" display-inline="no-display-inline" id="HAA7E61424CB5407FB66B33C5D4176A00"><subparagraph id="H2F2BDB461B934A63BE608513F714E931" indent="up1"><enum>(C)</enum><text>increase productivity, efficiency, and modernization throughout the Department.</text></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block></clause></subparagraph></paragraph><paragraph id="H750939D9610948A395F87F2CE140F378"><enum>(2)</enum><text>by striking subsection (d) and inserting the following new subsection (d):</text><quoted-block style="OLC" display-inline="no-display-inline" id="H462877A04BE54179887914E6A99CFCF5"><subsection id="H7BB68DE09F144D1AB585A54A95B89E5D"><enum>(d)</enum><header>Budgetary line item</header><text>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.</text></subsection><after-quoted-block>;</after-quoted-block></quoted-block></paragraph><paragraph id="H6101DF868FCA4F7BADC1B0AC22671313"><enum>(3)</enum><text>in subsection (f)—</text><subparagraph id="H2A22748F499A4DC1B16BE8DB6B730365"><enum>(A)</enum><text>in paragraph (1), by striking <quote>in subchapters I, II, and III of this chapter</quote> and inserting <quote>of this title, of title 38, Code of Federal Regulations, and of any handbooks, directives, or policy documents of the Department</quote>; and</text></subparagraph><subparagraph id="H3715F2E0452D404980C3450E3ACD264C"><enum>(B)</enum><text>in paragraph (2), in the matter preceding subparagraph (A), by striking <quote>waiving any authority</quote> and inserting <quote>waiving any provision of this title</quote>;</text></subparagraph></paragraph><paragraph id="H61583FBD5AAF4F148EA8F8B0A12E4EEC"><enum>(4)</enum><text>in subsection (g)(1), by inserting <quote>fewer than three or</quote> before <quote>more than 10</quote>;</text></paragraph><paragraph id="H37EC319028694DF6A6402E0A76CE5CE9"><enum>(5)</enum><text>in subsection (i)—</text><subparagraph id="H5867BC8AC6EA46689C942C433837E2E8"><enum>(A)</enum><text>in paragraph (1), by striking <quote>the Under Secretary for Health and the Special Medical Advisory Group established pursuant to section 7312 of this title</quote> and inserting <quote>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)</quote>; and</text></subparagraph><subparagraph id="H8E21BC1216DD44BB96333485856931C7"><enum>(B)</enum><text>in paragraph (2), by striking <quote>representatives of relevant Federal agencies, and clinical and analytical experts with expertise in medicine and health care management</quote> and inserting <quote>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</quote>; and</text></subparagraph></paragraph><paragraph id="H76A4905AAA604D00B3881198B4F0B14E"><enum>(6)</enum><text>by adding at the end the following new subsection:</text><quoted-block style="OLC" display-inline="no-display-inline" id="H9A8DB7D14F594003A45F80578D1AE6A7"><subsection id="HF8EC04B28BFD4D41B34280A8BC864B61"><enum>(k)</enum><header>Report on activities of Center for Innovation for Care and Payment</header><text>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—</text><paragraph id="H90FA02B6F9494055B642870727493766"><enum>(1)</enum><text>a full accounting of the activities, staff, budget, and other resources and efforts of the Center; and</text></paragraph><paragraph id="HB37DB617E0C84A4DB89F6D9FEDF36322"><enum>(2)</enum><text>an assessment of the outcomes of the efforts of the Center.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection><subsection id="HBB2EA08DD60D4CBF99104BADF6390617"><enum>(b)</enum><header>Comptroller General Report</header><text>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—</text><paragraph id="H141928ED5E754DBBA8BB94537387B19F"><enum>(1)</enum><text>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</text></paragraph><paragraph id="H6F35D13D35324C42A9BBA2500D7E8A4C"><enum>(2)</enum><text>containing such recommendations as the Comptroller General considers appropriate.</text></paragraph></subsection><subsection id="H86537168C49E46D58C795AEDC727BBE4"><enum>(c)</enum><header>Pilot program</header><paragraph id="H15CB7E1CB147436C8A48E2BFA0F772F9"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph><paragraph id="HED573AEB95E4451ABFAE596F156A4FE0"><enum>(2)</enum><header>Priority</header><text>In selecting sites for the pilot program under paragraph (1), the Secretary shall prioritize sites in the following areas:</text><subparagraph id="H8BDFDDFC512F45D89EDB477E8F2F7934"><enum>(A)</enum><text>Areas with varying degrees of urbanization, including urban, rural, and highly rural areas.</text></subparagraph><subparagraph id="HF92FD4CAA56D4D25B3608636AD557E91"><enum>(B)</enum><text>Areas with high rates of suicide among veterans.</text></subparagraph><subparagraph id="H33FC4B14DD5246219DC7B9AF02360558"><enum>(C)</enum><text>Areas with high rates of overdose deaths among veterans.</text></subparagraph><subparagraph id="H544B41F6DD574835BD94F67B54659928"><enum>(D)</enum><text>Areas with high rates of calls to the Veterans Crisis Line.</text></subparagraph><subparagraph id="H262EAA4C7BAA4D97B4E58728093C87E0"><enum>(E)</enum><text>Areas with long wait times for mental health and substance use services at facilities of the Department.</text></subparagraph><subparagraph id="H00E3FECBC1854B92993A711A6F4ABD62"><enum>(F)</enum><text>Areas with outpatient mental health and substance use programs that utilize a value-based care model, to the extent practicable.</text></subparagraph></paragraph><paragraph id="H12164354AE964D8682D1770E8C5BB1AD"><enum>(3)</enum><header>Elements</header><text>The Secretary, in implementing the pilot program under paragraph (1), shall ensure the Department has a care coordination system in place that includes—</text><subparagraph id="H3E0280E3545B4BA48F890E38DC94E441"><enum>(A)</enum><text>knowledge sharing, including the timely exchange of medical documentation;</text></subparagraph><subparagraph id="H278F8BE9EEA44FBDB2114DBA58E2D622"><enum>(B)</enum><text>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;</text></subparagraph><subparagraph id="H59A35D420FA84270BC8A8FFC95458C00"><enum>(C)</enum><text>continuous assessment of patient needs and goals; and</text></subparagraph><subparagraph id="HDFB8179BFFFC4AF294798C5376A2D824"><enum>(D)</enum><text>creating personalized, proactive care plans.</text></subparagraph></paragraph><paragraph id="H96FEE06BECE149639086B9AA81063AC9"><enum>(4)</enum><header>Oversight and outcomes</header><text>The Secretary shall develop appropriate metrics and measures—</text><subparagraph id="H56A4742F8A834D2483E01C32B12B7857"><enum>(A)</enum><text>to track and oversee sites at which the pilot program under paragraph (1) is carried out;</text></subparagraph><subparagraph id="HFA926742832649BEBAF95EE26319B57A"><enum>(B)</enum><text>to monitor patient safety and outcomes under the pilot program; and</text></subparagraph><subparagraph id="H1410B51E541443BFA97500DBDE1F674A"><enum>(C)</enum><text>to assess and mitigate any barriers to extending the pilot program across the entire Veterans Health Administration.</text></subparagraph></paragraph><paragraph id="HEF7CB0132B354C008D08DC902A429E97"><enum>(5)</enum><header>Annual report</header><subparagraph id="H2B91553F87F74238988C6EE6EFD80C23"><enum>(A)</enum><header>In general</header><text>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:</text><clause id="HC8806E9F74EF47ED8FD48E9EC9F2DED3"><enum>(i)</enum><text>The number of unique veterans who participated in the pilot program.</text></clause><clause id="H1CCF9CFA14DB40A0BDD10A0631E19C5E"><enum>(ii)</enum><text>The number of health care providers who participated in the pilot program.</text></clause><clause id="H8DA61DB186934D969B04DE77A97BB166"><enum>(iii)</enum><text>An assessment of the effectiveness of the pilot program in increasing access to, and improving outcomes for, mental health and substance use treatment services.</text></clause><clause id="HFE3B4E39E3F84CBDBDA21585644D9C67"><enum>(iv)</enum><text>The cost of the pilot program.</text></clause><clause id="H9C7A9E4120B24FD0A44C16EFA868DCCE"><enum>(v)</enum><text>Such other matters as the Secretary considers appropriate.</text></clause></subparagraph><subparagraph id="H0AFBD9C1F58D40C5BF850648799F7072"><enum>(B)</enum><header>Final report</header><text>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.</text></subparagraph></paragraph><paragraph id="H9D128985D39F40EDA8555E84C97AF181"><enum>(6)</enum><header>Veterans crisis line defined</header><text>In this subsection, the term <term>Veterans Crisis Line</term> means the toll-free hotline for veterans established under section 1720F(h) of title 38, United States Code.</text></paragraph></subsection></section><section id="H701FF4EE81A546C4954F8416460E3087" display-inline="no-display-inline"><enum>204.</enum><header>Standardized process to determine eligibility of covered veterans for participation in certain mental health treatment programs</header><subsection id="HD93F9288B936462EA5DCFCD618A425B0"><enum>(a)</enum><header>Standardized screening process</header><text display-inline="yes-display-inline">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.</text></subsection><subsection id="H8EE6B0167600466BAC7C9C0365C00F4D" commented="no"><enum>(b)</enum><header>Eligibility criteria</header><paragraph id="H2CD186C55EFE43219353CBC376B21371" commented="no" display-inline="no-display-inline"><enum>(1)</enum><header>In general</header><text>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:</text><subparagraph id="HC214D1E2D1B145F89284A00DA764686D" commented="no"><enum>(A)</enum><text display-inline="yes-display-inline">Symptoms that—</text><clause id="H5F3A0CEE84D04FC689EAA3D7C2558C49" commented="no"><enum>(i)</enum><text>significantly affect activities of daily life; and</text></clause><clause id="H3394FC16E3234511B7D9495FC68A818C" commented="no"><enum>(ii)</enum><text>increase the risk of such veteran for adverse outcomes.</text></clause></subparagraph><subparagraph id="H9A6BD6534CC44D76BF8BB8BE50D1D1CB" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">An unsafe living situation.</text></subparagraph><subparagraph id="H404E07FB2C4B4E4DB3AF4398CDC4EFC1" commented="no"><enum>(C)</enum><text display-inline="yes-display-inline">A high-risk flag for suicide.</text></subparagraph><subparagraph id="HADDCEE812A6946A6897A07167DBC3F26" commented="no"><enum>(D)</enum><text display-inline="yes-display-inline">A determination of being a high risk for suicide.</text></subparagraph><subparagraph id="H142781C164AE4845839AAAA5BCBE62F9" commented="no"><enum>(E)</enum><text display-inline="yes-display-inline">Risk factors for overdose.</text></subparagraph><subparagraph id="H641A9DE9395F477F90AA82D0B38CF254" commented="no"><enum>(F)</enum><text display-inline="yes-display-inline">Non-responsive, relapsed, or unable to find recovery from one other course of treatment, such as outpatient or intensive outpatient treatment.</text></subparagraph><subparagraph id="H98E6A18F7A9047D9B459004B7B728E53"><enum>(G)</enum><text>Other such criteria as the Secretary determines appropriate.</text></subparagraph></paragraph><paragraph id="H02FAFB9B7CD646E7A884F25B527946F9" commented="no"><enum>(2)</enum><header>Consideration</header><text>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.</text></paragraph></subsection><subsection id="H936FC3D572544772A309B1652F2F2D2E"><enum>(c)</enum><header>Time for screening and admission</header><text>Under the standardized screening process required by subsection (a), the Secretary shall ensure a covered veteran—</text><paragraph id="H79E8CDF3A7164D11BCEEE934AA831AAB"><enum>(1)</enum><text>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</text></paragraph><paragraph id="H717A5CF7A4E84F5CBEE65F6544605D5D"><enum>(2)</enum><text>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.</text></paragraph></subsection><subsection id="H9982C39F044747ADA2BDB10DA9E58A21" commented="no"><enum>(d)</enum><header>Access standards for routine admission</header><text display-inline="yes-display-inline">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.</text></subsection><subsection id="H523EA13BB8D641A79048B99563F1A41C"><enum>(e)</enum><header>Conditions under which care shall be furnished through non-Department providers</header><text display-inline="yes-display-inline">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.</text></subsection><subsection id="H25CA7F0D658E4B50AA2EF962A556C916"><enum>(f)</enum><header>Definitions</header><text>In this section:</text><paragraph id="H2F047B2791C44206A458423AD31E857F" commented="no"><enum>(1)</enum><text>The term <term>covered treatment program</term>—</text><subparagraph id="H9DA197D159774733B83BDA05C7690C91" commented="no"><enum>(A)</enum><text display-inline="yes-display-inline">means a mental health residential rehabilitation treatment program of the Department of Veterans Affairs;</text></subparagraph><subparagraph id="HB92EA2D5FD854E40ADC1E23F0C23B24C" commented="no"><enum>(B)</enum><text>a program of the Department for residential care for mental health and substance abuse disorders;</text></subparagraph><subparagraph id="H05CB5120EED2445D8BF616784CDBB2FF" commented="no"><enum>(C)</enum><text display-inline="yes-display-inline">includes—</text><clause id="H7E5F311B644F4CB2ADB1104FCA2AED29" commented="no"><enum>(i)</enum><text>the programs designated as of the date of the enactment of this section as domiciliary residential rehabilitation treatment programs; and</text></clause><clause id="H94BAD925F78640CFAA04B767A02E935E" commented="no"><enum>(ii)</enum><text>any programs designated as domiciliary residential rehabilitation treatment programs on or after such date of enactment; and</text></clause></subparagraph><subparagraph id="H6D68B7267C9D432BA6F5CE3AC914E5D2" commented="no"><enum>(D)</enum><text>does not include Compensated Work Therapy Transition Residence programs of the Department.</text></subparagraph></paragraph><paragraph id="H83C8C852B74C4EAFAF9132986310F49F"><enum>(2)</enum><text>The term <term>covered veteran</term> means a veteran described in section 1703(b) of title 38, United States Code.</text></paragraph></subsection></section><section id="H4D1059371FA842E28624B2E67A3C7A84"><enum>205.</enum><header>Reports</header><subsection id="H6C063BD3B6DB43ABA812C27F121C4EB2"><enum>(a)</enum><header>Report on improvements to clinical appeals process</header><text>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.</text></subsection><subsection id="H7AEBE200441446109848360C4237A921"><enum>(b)</enum><header>Report on required care and services under community care program</header><text>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:</text><paragraph id="H81B3DB5E89B54C039E98D9099654EAE7"><enum>(1)</enum><text>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.</text></paragraph><paragraph id="H2C6C7AE2CC4F434896C0E4B0D6453FD6"><enum>(2)</enum><text>The number of veterans who opt to seek care or services under such section.</text></paragraph><paragraph id="HF28101445E87470AB3CF9B10786A6E29"><enum>(3)</enum><text>The number of veterans who do not opt to seek care or services under such section.</text></paragraph><paragraph id="H9A05AF3C092342ACA9E8446750A2E66A"><enum>(4)</enum><text>An assessment of the timeliness of referrals for care or services under such section.</text></paragraph><paragraph id="H4F6E8DF9D6824D208546C4ECB33C2CE0"><enum>(5)</enum><text>The number of times a veteran did not show for an appointment for care or services under such section.</text></paragraph><paragraph id="H401EA448F710426EA34BE3728863BD3B"><enum>(6)</enum><text>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.</text></paragraph><paragraph id="H11C05AB7E6B0416CA8C1739FAC3B9CE7"><enum>(7)</enum><text>The timeliness of each such appeal.</text></paragraph><paragraph id="H9A83323042094CDB96F68A4A22B6D20A"><enum>(8)</enum><text>The outcome of each such appeal.</text></paragraph></subsection><subsection id="H9389A3CD8ECD4CD08362CACAF3CE078E"><enum>(c)</enum><header>Veterans service organization defined</header><text>In this section, the term <term>veterans service organization</term> means any organization recognized by the Secretary under section 5902 of title 38, United States Code. </text></subsection></section>