Improvement of availability of care for veterans from facilities and providers of the Department of Defense

(a)

Action plans

(1)

In general

Pursuant to the authorities under section 8111 of title 38, United States Code, and section 1104 of title 10, United States Code, the Secretary of Defense and the Secretary of Veterans Affairs shall develop and implement action plans at covered facilities— (A)to strengthen sharing of resources between the Department of Defense and the Department of Veterans Affairs under existing statutory authority; (B)to improve communication between the Department of Veterans Affairs and pertinent command and director leadership of military medical treatment facilities; (C)to increase utilization of military medical treatment facilities with excess capacity or space; (D)to increase case volume and complexity for graduate professional and other medical education programs of the Department of Defense and the Department of Veterans Affairs; and (E)to increase access to care for enrolled veterans in areas in which a military medical treatment facility is located that is identified by the Secretary of Defense as having excess capacity or space. (2)

Matters to be included

The action plans required under paragraph (1) shall include the following: (A)Cross-credentialing and privileging of health care providers to jointly care for enrolled veterans in medical facilities of the Department of Defense and the Department of Veterans Affairs. (B)Expedited access to installations of the Department of Defense for staff of the Department of Veterans Affairs and enrolled veterans. (C)The designation of a coordinator within each covered facility to serve as a liaison between the Department of Defense and the Department of Veterans Affairs and to lead the implementation of such action plan. (D)A mechanism for monitoring the effectiveness of such action plan on an ongoing basis, to include establishing relevant performance goals and collecting data to assess progress towards those goals. (E)Prioritized integration of relevant information technology and other systems or processes to enable seamless information sharing, medical records referrals and ancillary orders and results, payment methodologies and billing processes, and workload attribution when personnel of the Department of Veterans Affairs provide services at facilities of the Department of Defense or when personnel of the Department of Defense provide services at facilities of the Department of Veterans Affairs. (F)An oversight and accountability plan for the handling of adverse medical events and complaints from patients or staff, including a requirement to track any significant adverse medical events and provide information on such events in the briefing required under subsection (f). (G)Any other matter that the Secretary of Defense and the Secretary of Veterans Affairs consider appropriate. (b)

Approval of action plans

Before any action plan required under subsection (a) with respect to a covered facility shall be considered complete and submitted to the appropriate committees of Congress pursuant to subsection (e), the Secretary of Defense and the Secretary of Veterans Affairs shall ensure that approval for the action plan is obtained from— (1)the co-chairs of the Department of Veterans Affairs-Department of Defense Joint Executive Committee established under section 320 of title 38, United States Code; (2)the local installation commander for the covered facility of the Department of Defense; and (3)the director of the relevant medical center of the Department of Veterans Affairs with respect to any covered facility of the Department of Veterans Affairs. (c)

Requirements relating to sharing agreements

(1)

Lead coordinator

The Secretary of Defense and the Secretary of Veterans Affairs shall ensure that there is a lead coordinator at each facility of the Department of Defense or the Department of Veterans Affairs, as the case may be, with respect to which there is a sharing agreement in place. (2)

List of agreements

The Secretary of Defense and the Secretary of Veterans Affairs shall maintain on a publicly available website a list of the sharing agreements in place between the medical facilities of the Department of Defense and the Department of Veterans Affairs. (d)

Patient safety, complaints, and accountability

(1)

Secure complaint process

(A)

In general

The Secretary of Defense and the Secretary of Veterans Affairs shall establish a secure mechanism for enrolled veterans to report concerns regarding care received under an action plan required under subsection (a). (B)

Elements of mechanism

The mechanism established under subparagraph (A) shall protect confidentiality, prohibit retaliation, and ensure transmission of each complaint to both the Department of Defense and the Department of Veterans Affairs. (2)

Documentation and review

(A)

Documentation

The Secretary of Defense and the Secretary of Veterans Affairs shall maintain records of all complaints, adverse events, and safety incidents involving patients or staff pursuant to the action plans required by subsection (a). (B)

Review

The records maintained under subparagraph (A) shall be jointly reviewed on a quarterly basis by designated officials of the Department of Defense and the Department of Veterans Affairs. (3)

Notification and investigation

Any allegation of abuse, neglect, or misconduct involving personnel of the Department of Defense in the treatment of a veteran under an action plan shall be promptly referred by the Secretary of Veterans Affairs, the Secretary of Defense, and the commander or medical center director, as applicable, of the facility concerned to the Office of Inspector General of the Department of Defense and the Department of Veterans Affairs. (4)

Interim protective measures

Pending resolution of any investigation relating to conduct under an action plan, the Secretary of Veterans Affairs may suspend referrals of veterans to the provider or facility concerned. (e)

Submission to Congress

Not later than 30 days following the completion of the action plans required under subsection (a), the Secretary of Defense and the Secretary of Veterans Affairs shall submit such plans to the appropriate committees of Congress. (f)

Annual joint briefings on action plans

Not later than one year after submitting the action plans to the appropriate committees of Congress pursuant to subsection (e), the Secretary of Defense and the Secretary of Veterans Affairs shall provide to the appropriate committees of Congress a briefing containing— (1)a status update on the progress of implementing the action plans required under this section; (2)recommendations for developing subsequent action plans for each facility with respect to which there is a sharing agreement in place; (3)the number of patients served pursuant to the action plans, broken down by facility and service type; (4)the number of health care providers who were cross-credentialed or privileged to jointly care for beneficiaries in medical facilities of the Department of Defense or the Department of Veterans Affairs pursuant to the action plans, broken down by facility and service type; (5)the costs incurred and reimbursed between the Department of Defense and the Department of Veterans Affairs pursuant to the action plans, including an accounting of the use of the DOD–VA Health Care Sharing Incentive Fund established under section 8111(d)(2) of title 38, United States Code, if applicable; (6)a summary of the effectiveness of the mechanisms developed pursuant to the action plans related to oversight, accountability, data-gathering, and performance goals as well as any recommendations for improving such mechanisms; (7)a summary of any patient safety incidents or complaints and associated resolutions as well as any recommendations for improving the patient safety and complaint resolution process under the actions plans; and (8)a summary of the integration of information technology and other systems pursuant to the action plans as well as barriers to further integration and recommendations for improving such integration. (g)

Rule of construction

Nothing in this section shall be construed to allow the Department of Defense or the Department of Veterans Affairs to require a veteran to seek care at a facility of the Department of Defense or to allow military medical treatment facilities to be used as a facility of the Department of Veterans Affairs for purposes of determining eligibility of veterans for care from a non-Department of Veterans Affairs provider under the eligibility access standards developed under section 1703B of title 38, United States Code. (h)

Sunset

This section shall terminate on September 30, 2028. (i)

Definitions

In this section: (1)The term appropriate committees of Congress means— (A)the Committee on Armed Services and the Committee on Veterans’ Affairs of the Senate; and (B)the Committee on Armed Services and the Committee on Veterans’ Affairs of the House of Representatives. (2)The term covered facility means— (A)a military medical treatment facility (as such term is defined in section 1073c of title 10, United States Code); or (B)a medical facility of the Department of Veterans Affairs described in section 8101(3) of title 38, United States Code. (3)The term enrolled veteran means a veteran enrolled in the patient enrollment system of the Department of Veterans Affairs established and operated under section 1705(a) of title 38, United States Code. (4)The term sharing agreement means an agreement for the sharing of health-care resources between the Department of Defense and the Department of Veterans Affairs under section 1104 of title 10, United States Code, or section 8111 of title 38, United States Code. (5)The term veteran has the meaning given that term in section 101 of title 38, United States Code.