Public Law 117–135: To improve mammography services furnished by the Department of Veterans Affairs, and for other purposes. Public Law135 Public Law 117–135136 Stat. 1244 2022-06-07 2022-06-07 United States Government Publishing OfficeNational Archives and Records AdministrationOffice of the Federal Registertext/xmlENPursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain. GPO Locator to USLM Converter 4.15.31;Stage2.202507022026-01-02 117public ?1243PUBLIC LAW 117–135—JUNE 7, 2022 MAKING ADVANCES IN MAMMOGRAPHY AND MEDICAL OPTIONS FOR VETERANS ACT 136 STAT. 1244 Public Law117–135 117th Congress
An Act To improve mammography services furnished by the Department of Veterans Affairs, and for other purposes.

June 7, 2022

[S. 2533]

   Be it enacted by the Senate and House of Representa­tives of the United States of America in Congress assembled,

Making Advances in Mammography and Medical Options for Veterans Act.

38 USC 7322 note.
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.(a) Short Title.—This Act may be cited as the “Making Advances in Mammography and Medical Options for Veterans Act”. (b) Table of Contents.—The table of contents for this Act is as follows: Sec. 1.  TITLE I— Sec. 101.  Sec. 102.  Sec. 103.  Sec. 104.  Sec. 105.  Sec. 106.  TITLE II— Sec. 201.  Sec. 202. 
<num value="I">TITLE I—</num><heading>SCREENING AND EARLY DETECTION</heading> <section id="d81613e192" identifier="/us/pl/117/135/tI/s101" style="-uslm-lc:I658143"><num class="fontsize12" value="101">SEC. 101. </num><heading>STRATEGIC PLAN FOR BREAST IMAGING SERVICES FOR VETERANS.</heading><subsection class="firstIndent0 fontsize10" id="y712bf655-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s101/a" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="a">(a) </num><heading class="fontsize10"><inline class="smallCaps">In General</inline>.<sidenote><p class="leftAlign firstIndent0 fontsize8" id="x712bf656-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">Deadline.</p></sidenote>—</heading><content>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a strategic plan for improving breast imaging services for veterans.</content></subsection> <subsection class="firstIndent0 fontsize10" id="y712bf657-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s101/b" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="b">(b) </num><heading class="fontsize10"><inline class="smallCaps">Elements</inline>.—</heading><chapeau>The strategic plan required by subsection (a) shall—</chapeau><paragraph class="fontsize10" id="y712bf658-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s101/b/1" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="1">(1) </num><content>cover the evolving needs of women veterans;</content></paragraph> <paragraph class="fontsize10" id="y712bf659-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s101/b/2" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="2">(2) </num><content>address geographic disparities of breast imaging furnished at a facility of the Department of Veterans Affairs <page identifier="/us/stat/131/1245">131 STAT. 1245</page> and the use of breast imaging through non-Department providers in the community;</content></paragraph> <paragraph class="fontsize10" id="y712bf65a-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s101/b/3" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="3">(3) </num><content>address the use of digital breast tomosynthesis (DBT–3D breast imaging);</content></paragraph> <paragraph class="fontsize10" id="y712bf65b-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s101/b/4" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="4">(4) </num><content>address the needs of male veterans who require breast cancer screening services; and</content></paragraph> <paragraph class="fontsize10" id="y712bf65c-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s101/b/5" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="5">(5) </num><sidenote><p class="leftAlign firstIndent0 fontsize8" id="x712bf65d-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">Recommenda-</p><p class="leftAlign firstIndent0 fontsize8" id="x712bf65e-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">tions.</p></sidenote><chapeau>provide recommendations on—</chapeau><subparagraph class="fontsize10" id="y712bf65f-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s101/b/5/A" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="A">(A) </num><content>potential expansion of breast imaging services furnished at facilities of the Department, including infrastructure and staffing needs;</content></subparagraph> <subparagraph class="fontsize10" id="y712bf660-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s101/b/5/B" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="B">(B) </num><content>the use of digital breast tomosynthesis;</content></subparagraph> <subparagraph class="fontsize10" id="y712bf661-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s101/b/5/C" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="C">(C) </num><content>the use of mobile mammography; and</content></subparagraph> <subparagraph class="fontsize10" id="y712bf662-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s101/b/5/D" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="D">(D) </num><content>other access and equity improvements for breast imaging.</content></subparagraph> </paragraph> </subsection> </section> <section id="d81613e274" identifier="/us/pl/117/135/tI/s102" style="-uslm-lc:I658143"><num class="fontsize12" value="102">SEC. 102. </num><heading>TELESCREENING MAMMOGRAPHY PILOT PROGRAM OF DEPARTMENT OF VETERANS AFFAIRS.</heading><subsection class="firstIndent0 fontsize10" id="y712c6b93-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s102/a" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="a">(a) </num><sidenote><p class="leftAlign firstIndent0 fontsize8" id="x712c6b94-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">Deadline.</p></sidenote><heading class="fontsize10"><inline class="smallCaps">In General</inline>.—</heading><chapeau>Commencing not later than 18 months after the date of the enactment of this Act, the Secretary of Veterans Affairs shall carry out a pilot program to provide telescreening mammography services for veterans who live in—</chapeau><paragraph class="fontsize10" id="y712c6b95-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s102/a/1" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="1">(1) </num><content>States where the Department of Veterans Affairs does not offer breast imaging services at a facility of the Department; or</content></paragraph> <paragraph class="fontsize10" id="y712c6b96-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s102/a/2" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="2">(2) </num><content>locations where access to breast imaging services at a facility of the Department is difficult or not feasible, as determined by the Secretary.</content></paragraph> </subsection> <subsection class="firstIndent0 fontsize10" id="y712c6b97-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s102/b" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="b">(b) </num><heading class="fontsize10"><inline class="smallCaps">Duration</inline>.—</heading><content>The Secretary shall carry out the pilot program under subsection (a) for a three-year period beginning on the commencement of the pilot program.</content></subsection> <subsection class="firstIndent0 fontsize10" id="y712c6b98-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s102/c" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="c">(c) </num><heading class="fontsize10"><inline class="smallCaps">Locations</inline>.—</heading><content>In carrying out the pilot program under subsection (a), the Secretary may use community-based outpatient clinics, mobile mammography, Federally qualified health centers (as defined in section 1861(aa)(4) of the Social Security Act (<ref href="/us/usc/t42/s1395x/aa/4">42 U.S.C. 1395x(aa)(4)</ref>)), rural health clinics, critical access hospitals, clinics of the Indian Health Service, and such other sites as the Secretary determines feasible to provide mammograms under the pilot program.</content></subsection> <subsection class="firstIndent0 fontsize10" id="y712c6b99-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s102/d" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="d">(d) </num><heading class="fontsize10"><inline class="smallCaps">Sharing of Images and Results</inline>.—</heading><chapeau>Under the pilot program under subsection (a)—</chapeau><paragraph class="fontsize10" id="y712c6b9a-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s102/d/1" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="1">(1) </num><content>mammography images generated shall be sent to a telescreening mammography center of the Department for interpretation by qualified radiologists; and</content></paragraph> <paragraph class="fontsize10" id="y712c6b9b-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s102/d/2" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="2">(2) </num><content>results shall be shared with the veteran and their primary care provider in accordance with policies established by the Secretary.</content></paragraph> </subsection> <subsection class="firstIndent0 fontsize10" id="y712c6b9c-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s102/e" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="e">(e) </num><heading class="fontsize10"><inline class="smallCaps">Report</inline>.—</heading><paragraph class="fontsize10" id="y712c6b9d-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s102/e/1" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="1">(1) </num><heading class="fontsize10"><inline class="smallCaps">In general</inline>.—</heading><content>Not later than one year after the conclusion of the pilot program under subsection (a), 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 evaluating the pilot program.</content></paragraph> <paragraph class="fontsize10" id="y712c6b9e-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s102/e/2" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="2">(2) </num><heading class="fontsize10"><inline class="smallCaps">Elements</inline>.—</heading><chapeau>The report required by paragraph (1) shall include the following:</chapeau><subparagraph class="fontsize10" id="y712c6b9f-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s102/e/2/A" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="A">(A) </num><sidenote><p class="leftAlign firstIndent0 fontsize8" id="x712c6ba0-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">Assessment.</p></sidenote><content>An assessment of the quality of the mammography provided under the pilot program under subsection (a).<page identifier="/us/stat/131/1246">131 STAT. 1246</page></content></subparagraph> <subparagraph class="fontsize10" id="y712c6ba1-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s102/e/2/B" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="B">(B) </num><content>Feedback from veterans and providers participating in the pilot program.</content></subparagraph> <subparagraph class="fontsize10" id="y712c6ba2-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s102/e/2/C" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="C">(C) </num><sidenote><p class="leftAlign firstIndent0 fontsize8" id="x712c6ba3-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">Recommenda-</p><p class="leftAlign firstIndent0 fontsize8" id="x712c6ba4-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">tions.</p></sidenote><content>A recommendation of the Secretary on the continuation or discontinuation of the pilot program.</content></subparagraph> </paragraph> </subsection> </section> <section id="d81613e394" identifier="/us/pl/117/135/tI/s103" style="-uslm-lc:I658143"><num class="fontsize12" value="103">SEC. 103. </num><heading>UPGRADE OF BREAST IMAGING AT FACILITIES OF DEPARTMENT OF VETERANS AFFAIRS TO THREE-DIMENSIONAL DIGITAL MAMMOGRAPHY.</heading><chapeau class="indentUp0 firstIndent0 fontsize10" id="x712cb9c5-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658120">  Not<sidenote><p class="leftAlign firstIndent0 fontsize8" id="x712cb9c6-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">Deadline.</p></sidenote> later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs shall—</chapeau><paragraph class="fontsize10" id="y712cb9c7-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s103/1" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="1">(1) </num><content>upgrade all mammography services at facilities of the Department of Veterans Affairs that provide such services to use digital breast tomosynthesis technology, also known as three-dimensional breast imaging; and</content></paragraph> <paragraph class="fontsize10" id="y712cb9c8-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s103/2" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="2">(2) </num><sidenote><p class="leftAlign firstIndent0 fontsize8" id="x712cb9c9-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">Reports.</p></sidenote><chapeau>submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report—</chapeau><subparagraph class="fontsize10" id="y712cb9ca-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s103/2/A" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="A">(A) </num><content>indicating that the upgrade under paragraph (1) has been completed; and</content></subparagraph> <subparagraph class="fontsize10" id="y712cb9cb-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s103/2/B" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="B">(B) </num><sidenote><p class="leftAlign firstIndent0 fontsize8" id="x712cb9cc-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">List.</p></sidenote><content>listing the facilities or other locations of the Department at which digital breast tomosynthesis technology is used.</content></subparagraph> </paragraph> </section> <section id="d81613e431" identifier="/us/pl/117/135/tI/s104" style="-uslm-lc:I658143"><num class="fontsize12" value="104">SEC. 104. </num><heading>STUDY ON AVAILABILITY OF TESTING FOR BREAST CANCER GENE AMONG VETERANS AND EXPANSION OF AVAILABILITY OF SUCH TESTING.</heading><subsection class="firstIndent0 fontsize10" id="y712d2efd-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s104/a" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="a">(a) </num><heading class="fontsize10"><inline class="smallCaps">Study</inline>.—</heading><paragraph class="fontsize10" id="y712d2efe-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s104/a/1" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="1">(1) </num><heading class="fontsize10"><inline class="smallCaps">In general</inline>.—</heading><content>The Secretary of Veterans Affairs shall conduct a study on the availability of access to testing for the breast cancer gene for veterans diagnosed with breast cancer, as recommended by the guidelines set forth by the National Comprehensive Cancer Network.</content></paragraph> <paragraph class="fontsize10" id="y712d2eff-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s104/a/2" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="2">(2) </num><heading class="fontsize10"><inline class="smallCaps">Elements</inline>.<sidenote><p class="leftAlign firstIndent0 fontsize8" id="x712d2f00-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">Examination.</p></sidenote>—</heading><chapeau>In conducting the study under paragraph (1), the Secretary shall examine—</chapeau><subparagraph class="fontsize10" id="y712d2f01-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s104/a/2/A" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="A">(A) </num><content>the feasibility of expanding the Joint Medicine Service of the Department of Veterans Affairs to provide genetic testing and counseling for veterans with breast cancer across the country; and</content></subparagraph> <subparagraph class="fontsize10" id="y712d2f02-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s104/a/2/B" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="B">(B) </num><content>access to such testing and counseling for veterans living in rural or highly rural areas, and any gaps that may exist with respect to such access.</content></subparagraph> </paragraph> </subsection> <subsection class="firstIndent0 fontsize10" id="y712d2f03-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s104/b" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="b">(b) </num><heading class="fontsize10"><inline class="smallCaps">Expansion of Availability of Testing</inline>.—</heading><paragraph class="fontsize10" id="y712d2f04-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s104/b/1" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="1">(1) </num><sidenote><p class="leftAlign firstIndent0 fontsize8" id="x712d2f05-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">Guidelines.</p></sidenote><heading class="fontsize10"><inline class="smallCaps">In general</inline>.—</heading><content>The Secretary shall update guidelines or institute new guidelines to increase the use of molecular testing and genetic counseling for veterans diagnosed with breast cancer, including veterans living in rural or highly rural areas.</content></paragraph> <paragraph class="fontsize10" id="y712d2f06-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s104/b/2" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="2">(2) </num><heading class="fontsize10"><inline class="smallCaps">Decision support tools</inline>.—</heading><content>In updating or instituting guidelines under paragraph (1), the Secretary may develop clinical decision support tools, such as clinical pathways, to facilitate delivery of breast cancer care that is in line with national cancer guidelines.</content></paragraph> </subsection> <subsection class="firstIndent0 fontsize10" id="y712d2f07-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s104/c" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="c">(c) </num><heading class="fontsize10"><inline class="smallCaps">Report</inline>.—</heading><chapeau>Not later than two years 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 a report on—</chapeau><paragraph class="fontsize10" id="y712d2f08-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s104/c/1" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="1">(1) </num><content>the results of the study under subsection (a);<page identifier="/us/stat/131/1247">131 STAT. 1247</page></content></paragraph> <paragraph class="fontsize10" id="y712d2f09-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s104/c/2" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="2">(2) </num><content>any updates to guidelines or new guidelines instituted under subsection (b);</content></paragraph> <paragraph class="fontsize10" id="y712d2f0a-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s104/c/3" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="3">(3) </num><content>breast cancer clinical pathways implemented by the Department of Veterans Affairs and the utilization of those pathways across the Department; and</content></paragraph> <paragraph class="fontsize10" id="y712d2f0b-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s104/c/4" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="4">(4) </num><content>any progress of the Department in improving access to and usage of molecular and genetic testing among veterans diagnosed with breast cancer, including for veterans living in rural or highly rural areas.</content></paragraph> </subsection> <subsection class="firstIndent0 fontsize10" id="y712d2f0c-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s104/d" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="d">(d) </num><heading class="fontsize10"><inline class="smallCaps">Definitions</inline>.—</heading><content>In this section, the terms “rural” and “highly rural” have the meanings given those terms in the Rural-Urban Commuting Areas coding system of the Department of Agriculture.</content></subsection> </section> <section id="d81613e547" identifier="/us/pl/117/135/tI/s105" style="-uslm-lc:I658143"><num class="fontsize12" value="105">SEC. 105. </num><heading>MAMMOGRAPHY ACCESSIBILITY FOR PARALYZED AND DISABLED VETERANS.</heading><subsection class="firstIndent0 fontsize10" id="y712dca4d-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s105/a" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="a">(a) </num><heading class="fontsize10"><inline class="smallCaps">Study</inline>.—</heading><paragraph class="fontsize10" id="y712dca4e-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s105/a/1" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="1">(1) </num><heading class="fontsize10"><inline class="smallCaps">In general</inline>.—</heading><content>The Secretary of Veterans Affairs shall conduct a study on the accessibility of breast imaging services at facilities of the Department of Veterans Affairs for veterans with paralysis, spinal cord injury or disorder (SCI/D), or another disability.</content></paragraph> <paragraph class="fontsize10" id="y712dca4f-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s105/a/2" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="2">(2) </num><heading class="fontsize10"><inline class="smallCaps">Accessibility</inline>.<sidenote><p class="leftAlign firstIndent0 fontsize8" id="x712dca50-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">Assessment.</p></sidenote>—</heading><content>The study required by paragraph (1) shall include an assessment of the accessibility of the physical infrastructure at breast imaging facilities of the Department, including the imaging equipment, transfer assistance, and the room in which services will be provided as well as adherence to best practices for screening and treating veterans with a spinal cord injury or disorder.</content></paragraph> <paragraph class="fontsize10" id="y712dca51-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s105/a/3" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="3">(3) </num><heading class="fontsize10"><inline class="smallCaps">Screening rates</inline>.—</heading><subparagraph class="fontsize10" id="y712dca52-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s105/a/3/A" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="A">(A) </num><heading class="fontsize10"><inline class="smallCaps">Measurement</inline>.—</heading><content><sidenote><p class="leftAlign firstIndent0 fontsize8" id="x712dca53-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">Time period.</p></sidenote>The study required by paragraph (1) shall include a measurement of breast cancer screening rates for veterans with a spinal cord injury or disorder during the two-year period preceding the commencement of the study, including a breakout of the screening rates for such veterans living in rural or highly rural areas.</content></subparagraph> <subparagraph class="fontsize10" id="y712dca54-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s105/a/3/B" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="B">(B) </num><heading class="fontsize10"><inline class="smallCaps">Development of method</inline>.—</heading><content>If the Secretary is unable to provide the measurement required under subparagraph (A), the Secretary shall develop a method to track breast cancer screening rates for veterans with a spinal cord injury or disorder.</content></subparagraph> </paragraph> <paragraph class="fontsize10" id="y712dca55-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s105/a/4" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="4">(4) </num><heading class="fontsize10"><inline class="smallCaps">Report</inline>.—</heading><chapeau>Not later than two years 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 a report on the findings of the study required by paragraph (1), including—</chapeau><subparagraph class="fontsize10" id="y712dca56-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s105/a/4/A" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="A">(A) </num><content>the rates of screening among veterans with a spinal cord injury or disorder, including veterans living in rural or highly rural areas, as required under paragraph (3)(A); or</content></subparagraph> <subparagraph class="fontsize10" id="y712dca57-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s105/a/4/B" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="B">(B) </num><content>if such rates are not available, a description of the method developed to measure such rates as required under paragraph (3)(B).</content></subparagraph> </paragraph> </subsection> <subsection class="firstIndent0 fontsize10" id="y712dca58-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s105/b" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="b">(b) </num><heading class="fontsize10"><inline class="smallCaps">Care From Non-Department Providers</inline>.—</heading><chapeau><sidenote><p class="leftAlign firstIndent0 fontsize8" id="x712dca59-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">Updates.</p></sidenote>The Secretary shall update the policies and directives of the Department to ensure that, in referring a veteran with a spinal cord injury or disorder for care from a non-Department provider, the Secretary shall—</chapeau><page identifier="/us/stat/131/1248">131 STAT. 1248</page> <paragraph class="fontsize10" id="y712dca5a-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s105/b/1" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="1">(1) </num><content>confirm with the provider the accessibility of the breast imaging site, including the imaging equipment, transfer assistance, and the room in which services will be provided; and</content></paragraph> <paragraph class="fontsize10" id="y712dca5b-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s105/b/2" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="2">(2) </num><content>provide additional information to the provider on best practices for screening and treating veterans with a spinal cord injury or disorder.</content></paragraph> </subsection> <subsection class="firstIndent0 fontsize10" id="y712dca5c-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s105/c" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="c">(c) </num><heading class="fontsize10"><inline class="smallCaps">Definitions</inline>.—</heading><content>In this section, the terms “rural” and “highly rural” have the meanings given those terms in the Rural-Urban Commuting Areas coding system of the Department of Agriculture.</content></subsection> </section> <section id="d81613e666" identifier="/us/pl/117/135/tI/s106" style="-uslm-lc:I658143"><num class="fontsize12" value="106">SEC. 106. </num><heading>REPORT ON ACCESS TO AND QUALITY OF MAMMOGRAPHY SCREENINGS FURNISHED BY DEPARTMENT OF VETERANS AFFAIRS.</heading><subsection class="firstIndent0 fontsize10" id="y712e187d-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s106/a" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="a">(a) </num><heading class="fontsize10"><inline class="smallCaps">In General</inline>.—</heading><content>Not later than two years after the date of the enactment of this Act, the Inspector General of the Department of Veterans Affairs shall submit to the Secretary of Veterans Affairs, the Committee on Veterans’ Affairs of the Senate, and the Committee on Veterans’ Affairs of the House of Representatives a report on mammography services furnished by the Department of Veterans Affairs.</content></subsection> <subsection class="firstIndent0 fontsize10" id="y712e187e-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s106/b" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="b">(b) </num><heading class="fontsize10"><inline class="smallCaps">Elements</inline>.—</heading><chapeau><sidenote><p class="leftAlign firstIndent0 fontsize8" id="x712e187f-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">Assessment.</p></sidenote>The report required by subsection (a) shall include an assessment of—</chapeau><paragraph class="fontsize10" id="y712e1880-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s106/b/1" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="1">(1) </num><content>the access of veterans to mammography screenings, whether at a facility of the Department or through a non-Department provider, including any staffing concerns of the Department in providing such screenings;</content></paragraph> <paragraph class="fontsize10" id="y712e1881-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s106/b/2" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="2">(2) </num><content>the quality of such screenings and reading of the images from such screenings, including whether such screenings use three-dimensional mammography;</content></paragraph> <paragraph class="fontsize10" id="y712e1882-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s106/b/3" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="3">(3) </num><content>the communication of the results of such screenings, including whether results are shared in a timely manner, whether results are shared via the Joint Health Information Exchange or another electronic mechanism, and whether results are incorporated into the electronic health record of the veteran;</content></paragraph> <paragraph class="fontsize10" id="y712e1883-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s106/b/4" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="4">(4) </num><content>the performance of the Women’s Breast Oncology System of Excellence of the Department; and</content></paragraph> <paragraph class="fontsize10" id="y712e1884-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s106/b/5" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="5">(5) </num><content>the access of veterans diagnosed with breast cancer to a comprehensive breast cancer care team of the Department.</content></paragraph> </subsection> <subsection class="firstIndent0 fontsize10" id="y712e1885-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tI/s106/c" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="c">(c) </num><heading class="fontsize10"><inline class="smallCaps">Follow-Up</inline>.—</heading><content><sidenote><p class="leftAlign firstIndent0 fontsize8" id="x712e1886-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">Deadline.</p><p class="leftAlign firstIndent0 fontsize8" id="x712e1887-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">Plan.</p></sidenote>Not later than 180 days after the submittal of the report under subsection (a), 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 plan to address the deficiencies identified in the report under subsection (a), if any.</content></subsection> </section> <num value="II">TITLE II—</num><heading>PARTNERSHIPS FOR RESEARCH AND ACCESS TO CARE</heading> <section id="d81613e740" identifier="/us/pl/117/135/tII/s201" style="-uslm-lc:I658143"><num class="fontsize12" value="201">SEC. 201. </num><heading>PARTNERSHIPS WITH NATIONAL CANCER INSTITUTE TO EXPAND ACCESS OF VETERANS TO CANCER CARE.</heading><subsection class="firstIndent0 fontsize10" id="y712e8db8-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tII/s201/a" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="a">(a) </num><heading class="fontsize10"><inline class="smallCaps">Access to Care in Each VISN</inline>.—</heading><paragraph class="fontsize10" id="y712e8db9-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tII/s201/a/1" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="1">(1) </num><heading class="fontsize10"><inline class="smallCaps">In general</inline>.—</heading><content>The Secretary of Veterans Affairs shall enter into a partnership with not fewer than one cancer center of the National Cancer Institute of the National Institutes of Health in each Veterans Integrated Service Network of the <page identifier="/us/stat/131/1249">131 STAT. 1249</page> Department of Veterans Affairs to expand access to high-quality cancer care for women veterans.</content></paragraph> <paragraph class="fontsize10" id="y712e8dba-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tII/s201/a/2" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="2">(2) </num><heading class="fontsize10"><inline class="smallCaps">Treatment of rural veterans</inline>.—</heading><content>The Secretary, in carrying out partnerships entered into under paragraph (1), shall ensure that veterans with breast cancer who reside in rural areas or States without a cancer center that has entered into such a partnership with the Secretary are able to receive care through such a partnership via telehealth.</content></paragraph> </subsection> <subsection class="firstIndent0 fontsize10" id="y712e8dbb-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tII/s201/b" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="b">(b) </num><heading class="fontsize10"><inline class="smallCaps">Report on Partnership To Increase Access to Clinical Trials</inline>.—</heading><chapeau>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 a report on—</chapeau><paragraph class="fontsize10" id="y712e8dbc-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tII/s201/b/1" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="1">(1) </num><content>how the Secretary will ensure that the advancements made through the existing partnership between the Department of Veterans Affairs and the National Cancer Institute to provide veterans with access to clinical cancer research trials (commonly referred to as “NAVIGATE”) are permanently implemented; and</content></paragraph> <paragraph class="fontsize10" id="y712e8dbd-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tII/s201/b/2" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="2">(2) </num><sidenote><p class="leftAlign firstIndent0 fontsize8" id="x712e8dbe-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">Determination.</p></sidenote><content>the determination of the Secretary of whether expansion of such partnership to more than the original 12 facilities of the Department that were selected under such partnership is feasible.</content></paragraph> </subsection> <subsection class="firstIndent0 fontsize10" id="y712e8dbf-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tII/s201/c" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="c">(c) </num><heading class="fontsize10"><inline class="smallCaps">Periodic Reports</inline>.—</heading><chapeau>Not later than three years after the date of the enactment of this Act, and every three 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—</chapeau><paragraph class="fontsize10" id="y712e8dc0-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tII/s201/c/1" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="1">(1) </num><sidenote><p class="leftAlign firstIndent0 fontsize8" id="x712e8dc1-e81c-11f0-a1e4-69761a48a15a" style="-uslm-lc:I658180">Assessment.</p></sidenote><content>assessing how the partnerships entered into under subsection (a)(1) have impacted access by veterans to cancer centers of the National Cancer Institute, including an assessment of the telehealth options made available and used pursuant to such partnerships; and</content></paragraph> <paragraph class="fontsize10" id="y712e8dc2-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tII/s201/c/2" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="2">(2) </num><content>describing the advancements made with respect to access by veterans to clinical cancer research trials through the partnership described in subsection (b)(1), including how many of those veterans were women veterans, minority veterans (including racial and ethnic minorities), and rural veterans, and identifying opportunities for further innovation.</content></paragraph> </subsection> </section> <section id="d81613e819" identifier="/us/pl/117/135/tII/s202" style="-uslm-lc:I658143"><num class="fontsize12" value="202">SEC. 202. </num><heading>REPORT BY DEPARTMENT OF VETERANS AFFAIRS AND DEPARTMENT OF DEFENSE ON INTERAGENCY COLLABORATION ON TREATING AND RESEARCHING BREAST CANCER.</heading><subsection class="firstIndent0 fontsize10" id="y712edbe3-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tII/s202/a" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="a">(a) </num><heading class="fontsize10"><inline class="smallCaps">In General</inline>.—</heading><content>Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs, in collaboration with the Secretary of Defense, shall submit to Congress a report on all current research and health care collaborations between the Department of Veterans Affairs and the Department of Defense on treating veterans and members of the Armed Forces with breast cancer.</content></subsection> <subsection class="firstIndent0 fontsize10" id="y712edbe4-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tII/s202/b" style="-uslm-lc:I658120"><num class="fontsize10" style="-uslm-lc:emspace2" value="b">(b) </num><heading class="fontsize10"><inline class="smallCaps">Elements</inline>.—</heading><chapeau>The report required by subsection (a)—</chapeau><paragraph class="fontsize10" id="y712edbe5-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tII/s202/b/1" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="1">(1) </num><content>shall include a description of potential opportunities for future interagency collaboration between the Department of Veterans Affairs and the Department of Defense with respect to treating and researching breast cancer; and</content></paragraph> <paragraph class="fontsize10" id="y712edbe6-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tII/s202/b/2" style="-uslm-lc:I658122"><num class="fontsize10" style="-uslm-lc:emspace2" value="2">(2) </num><chapeau>may include a focus on—<page identifier="/us/stat/131/1250">131 STAT. 1250</page></chapeau><subparagraph class="fontsize10" id="y712edbe7-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tII/s202/b/2/A" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="A">(A) </num><content>with respect to women members of the Armed Forces with a diagnosis of or who are undergoing screening for breast cancer, transition of such members from receiving care from the Department of Defense to receiving care from the Department of Veterans Affairs;</content></subparagraph> <subparagraph class="fontsize10" id="y712edbe8-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tII/s202/b/2/B" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="B">(B) </num><content>collaborative breast cancer research opportunities between the Department of Veterans Affairs and the Department of Defense;</content></subparagraph> <subparagraph class="fontsize10" id="y712edbe9-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tII/s202/b/2/C" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="C">(C) </num><content>access to clinical trials; and</content></subparagraph> <subparagraph class="fontsize10" id="y712edbea-e81c-11f0-a1e4-69761a48a15a" identifier="/us/pl/117/135/tII/s202/b/2/D" style="-uslm-lc:I658124"><num class="fontsize10" style="-uslm-lc:emspace2" value="D">(D) </num><content>such other matters as the Secretary of Veterans Affairs and the Secretary of Defense consider appropriate.</content></subparagraph> </paragraph> </subsection> </section> Approved June 7, 2022.
LEGISLATIVE HISTORY—S. 2533: CONGRESSIONAL RECORD, Vol. 168 (2022):

Mar. 23, considered and passed Senate.

May 18, considered and passed House.

 DAILY COMPILATION OF PRESIDENTIAL DOCUMENTS (2022):

June 7, Presidential remarks.

 ○