[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 1182 Introduced in Senate (IS)]







109th CONGRESS
  1st Session
                                S. 1182

   To amend title 38, United States Code, to improve health care for 
                   veterans, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              June 7, 2005

   Mr. Craig introduced the following bill; which was read twice and 
             referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
   To amend title 38, United States Code, to improve health care for 
                   veterans, and for other purposes.

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

SECTION 1. SHORT TITLE; REFERENCES TO TITLE 38, UNITED STATES CODE.

    (a) Short Title.--This Act may be cited as the ``Veterans Health 
Care Act of 2005''.
    (b) References.--Except as otherwise expressly provided, whenever 
in this Act an amendment or repeal is expressed in terms of an 
amendment or repeal to a section or other provision, the reference 
shall be considered to be made to a section or other provision of title 
38, United States Code.

SEC. 2. COPAYMENT EXEMPTION FOR HOSPICE CARE.

    Section 1710 is amended--
            (1) in subsection (f)(1), by inserting ``(other than 
        hospice care)'' after ``nursing home care''; and
            (2) in subsection (g)(1), by inserting ``(other than 
        hospice care)'' after ``medical services''.

SEC. 3. NURSING HOME BED LEVELS; EXEMPTION FROM EXTENDED CARE SERVICES 
              COPAYMENTS FOR FORMER POWS.

    Section 1710B is amended--
            (1) by striking subsection (b);
            (2) by redesignating subsections (c) through (e) as 
        subsections (b) through (d), respectively; and
            (3) in subsection (b)(2), as redesignated--
                    (A) by redesignating subparagraphs (B) and (C) as 
                subparagraphs (C) and (D), respectively; and
                    (B) by inserting after subparagraph (A) the 
                following:
                    ``(B) to a veteran who is a former prisoner of 
                war;''.

SEC. 4. REIMBURSEMENT FOR CERTAIN VETERANS' OUTSTANDING EMERGENCY 
              TREATMENT EXPENSES. .

     (a) In General.--Subchapter III of chapter 17 is amended by 
inserting after section 1725 the following:
``Sec. 1725A. Reimbursement for emergency treatment expenses for which 
              certain veterans remain personally liable
    ``(a)(1) Subject to subsection (c), the Secretary may reimburse a 
veteran described in subsection (b) for expenses resulting from 
emergency treatment furnished to the veteran in a non-Department 
facility for which the veteran remains personally liable.
    ``(2) In any case in which reimbursement is authorized under 
subsection (a)(1), the Secretary, in the Secretary's discretion, may, 
in lieu of reimbursing the veteran, make payment--
            ``(A) to a hospital or other health care provider that 
        furnished the treatment; or
            ``(B) to the person or organization that paid for such 
        treatment on behalf of the veteran.
    ``(b) A veteran referred to in subsection (a) is an individual 
who--
            ``(1) is enrolled in the health care system established 
        under section 1705(a) of this title;
            ``(2) received care under this chapter during the 24-month 
        period preceding the furnishing of such emergency treatment;
            ``(3) is entitled to care or services under a health-plan 
        contract that partially reimburses the cost of the veteran's 
        emergency treatment;
            ``(4) is financially liable to the provider of emergency 
        care treatment for costs not covered by the veteran's health-
        plan contract, including copayments and deductibles; and
            ``(5) is not eligible for reimbursement for medical care or 
        services under section 1725 or 1728 of this title.
    ``(c)(1) Any amount paid by the Secretary under subsection (a) 
shall exclude the amount of any payment the veteran would have been 
required to make to the United States under this chapter if the veteran 
had received the emergency treatment from the Department.
    ``(2) The Secretary may not provide reimbursement under this 
section with respect to any item or service--
            ``(A) provided or for which payment has been made, or can 
        reasonably be expected to be made, under the veteran's health-
        plan contract; or
            ``(B) for which payment has been made or can reasonably be 
        expected to be made by a third party.
    ``(3)(A) Payment by the Secretary under this section on behalf of a 
veteran to a provider of emergency treatment shall, unless rejected and 
refunded by the provider within 30 days of receipt, extinguish any 
liability on the part of the veteran for that treatment.
    ``(B) The absence of a contract or agreement between the Secretary 
and the provider, any provision of a contract or agreement, or an 
assignment to the contrary shall not operate to modify, limit, or 
negate the requirement under subparagraph (A).
    ``(4) In accordance with regulations prescribed by the Secretary, 
the Secretary shall--
            ``(A) establish criteria for determining the amount of 
        reimbursement (which may include a maximum amount) payable 
        under this section; and
            ``(B) delineate the circumstances under which such payment 
        may be made, including requirements for requesting 
        reimbursement.
    ``(d)(1) In accordance with regulations prescribed by the 
Secretary, the United States shall have the independent right to 
recover any amount paid under this section if, and to the extent that, 
a third party subsequently makes a payment for the same emergency 
treatment.
    ``(2) Any amount paid by the United States to the veteran, the 
veteran's personal representative, successor, dependents, or survivors, 
or to any other person or organization paying for such treatment shall 
constitute a lien in favor of the United States against any recovery 
the payee subsequently receives from a third party for the same 
treatment.
    ``(3) Any amount paid by the United States to the provider that 
furnished the veteran's emergency treatment shall constitute a lien 
against any subsequent amount the provider receives from a third party 
for the same emergency treatment for which the United States made 
payment.
    ``(4) The veteran or the veteran's personal representative, 
successor, dependents, or survivors shall--
            ``(A) ensure that the Secretary is promptly notified of any 
        payment received from any third party for emergency treatment 
        furnished to the veteran;
            ``(B) immediately forward all documents relating to a 
        payment described in subparagraph (A);
            ``(C) cooperate with the Secretary in an investigation of a 
        payment described in subparagraph (A); and
            ``(D) assist the Secretary in enforcing the United States 
        right to recover any payment made under subsection (c)(3).
    ``(e) The Secretary may waive recovery of a payment made to a 
veteran under this section that is otherwise required under subsection 
(d)(1) if the Secretary determines that such waiver would be in the 
best interest of the United States, as defined by regulations 
prescribed by the Secretary.
    ``(f) For purposes of this section--
            ``(1) the term `health-plan contract' includes--
                    ``(A) an insurance policy or contract, medical or 
                hospital service agreement, membership or subscription 
                contract, or similar arrangement, under which health 
                services for individuals are provided or the expenses 
                of such services are paid;
                    ``(B) an insurance program described in section 
                1811 of the Social Security Act (42 U.S.C. 1395c) or 
                established by section 1831 of that Act (42 U.S.C. 
                1395j);
                    ``(C) a State plan for medical assistance approved 
                under title XIX of such Act (42 U.S.C. 1396 et seq.); 
                and
                    ``(D) a workers' compensation law or plan described 
                in section 1729(A)(2)(B) of this title;
            ``(2) the term `third party' means--
                    ``(A) a Federal entity;
                    ``(B) a State or political subdivision of a State;
                    ``(C) an employer or an employer's insurance 
                carrier; and
                    ``(D) a person or entity obligated to provide, or 
                pay the expenses of, such emergency treatment; and
            ``(3) the term `emergency treatment' has the meaning given 
        such term in section 1725 of this title.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 is amended by inserting after the item relating to section 
1725 the following:

``Sec. 1725A. Reimbursement for emergency treatment expenses for which 
                            certain veterans remain personally 
                            liable.''.

SEC. 5. CARE FOR NEWBORN CHILDREN OF WOMEN VETERANS RECEIVING MATERNITY 
              CARE .

    (a) In General.--Subchapter VIII of chapter 17 is amended by adding 
at the end the following:
``Sec. 1786. Care for newborn children of women veterans receiving 
              maternity care
    ``The Secretary may furnish care to a newborn child of a woman 
veteran, who is receiving maternity care furnished by the Department, 
for not more than 14 days after the birth of the child if the veteran 
delivered the child in a Department facility or in another facility 
pursuant to a Department contract for the delivery services.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 is amended by inserting after the item relating to section 
1785 the following:

``Sec. 1786. Care for newborn children of women veterans receiving 
                            maternity care.''.

SEC. 6. ENHANCEMENT OF PAYER PROVISIONS FOR HEALTH CARE FURNISHED TO 
              CERTAIN CHILDREN OF VIETNAM VETERANS.

    (a) Health Care for Spina Bifida and Associated Disabilities.--
Section 1803 is amended--
            (1) by redesignating subsection (c) as subsection (d); and
            (2) by inserting after subsection (b) the following:
    ``(c)(1) If a payment made by the Secretary for health care under 
this section is less than the amount billed for such health care, the 
health care provider or agent of the health care provider may, in 
accordance with paragraphs (2) through (4), seek payment for the 
difference between the amount billed and the amount paid by the 
Secretary from a responsible third party to the extent that the 
provider or agent would be eligible to receive payment for such health 
care from such third party.
    ``(2) The health care provider or agent may not impose any 
additional charge on the beneficiary who received the health care, or 
the family of such beneficiary, for any service or item for which the 
Secretary has made payment under this section;
    ``(3) The total amount of payment a health care provider or agent 
may receive for health care furnished under this section may not exceed 
the amount billed to the Secretary.
    ``(4) The Secretary, upon request, shall disclose to such third 
party information received for the purposes of carrying out this 
section.''.
    (b) Health Care for Birth Defects and Associated Disabilities.--
Section 1813 is amended--
            (1) by redesignating subsection (c) as subsection (d); and
            (2) by inserting after subsection (b) the following:
    ``(c)(1) If payment made by the Secretary for health care under 
this section is less than the amount billed for such health care, the 
health care provider or agent of the health care provider may, in 
accordance with paragraphs (2) through (4), seek payment for the 
difference between the amount billed and the amount paid by the 
Secretary from a responsible third party to the extent that the 
provider or agent would be eligible to receive payment for such health 
care from such third party.
    ``(2) The health care provider or agent may not impose any 
additional charge on the beneficiary who received health care, or the 
family of such beneficiary, for any service or item for which the 
Secretary has made payment under this section;
    ``(3) The total amount of payment a health care provider or agent 
may receive for health care furnished under this section may not exceed 
the amount billed to the Secretary; and
    ``(4) The Secretary, upon request, shall disclose to such third 
party information received for the purposes of carrying out this 
section.''.

SEC. 7. IMPROVEMENTS TO HOMELESS PROVIDERS GRANT AND PER DIEM PROGRAM.

    (a) Permanent Authority.--Section 2011 (a) is amended--
            (1) in paragraph (1), by striking ``(1)''; and
            (2) by striking paragraph (2).
    (b) Authorization of Appropriations.--Section 2013 is amended to 
read as follows:
``Sec. 2013. Authorization of appropriations
    ``There are authorized to be appropriated $130,000,000 for fiscal 
year 2006 and each subsequent fiscal year to carry out this 
subchapter.''.

SEC. 8. MARRIAGE AND FAMILY THERAPISTS.

    (a) Qualifications.--Section 7402(b) is amended--
            (1) by redesignating paragraph (10) as paragraph (11); and
            (2) by inserting after paragraph (9) the following:
    ``(10) Marriage and family therapist.--To be eligible to be 
appointed to a marriage and family therapist position, a person must--
            ``(A) hold a master's degree in marriage and family 
        therapy, or a comparable degree in mental health, from a 
        college or university approved by the Secretary; and
            ``(B) be licensed or certified to independently practice 
        marriage and family therapy in a State, except that the 
        Secretary may waive the requirement of licensure or 
        certification for an individual marriage and family therapist 
        for a reasonable period of time recommended by the Under 
        Secretary for Health.''.
    (b) Report on Marriage and Family Therapy Workload.--
            (1) In general.--Not later than 90 days after the date of 
        enactment of this Act, the Under Secretary for Health, 
        Department 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 report on 
        the provisions of post-traumatic stress disorder treatment by 
        marriage and family therapists.
            (2) Contents.--The report submitted under paragraph (1) 
        shall include--
                    (A) the actual and projected workloads in 
                facilities of the Veterans Readjustment Counseling 
                Service and the Veterans Health Administration for the 
                provision of marriage and family counseling for 
                veterans diagnosed with, or otherwise in need of 
                treatment for, post-traumatic stress disorder;
                    (B) the resources available and needed to support 
                the workload projections described in subparagraph (A);
                    (C) an assessment by the Under Secretary for Health 
                of the effectiveness of treatment by marriage and 
                family therapists; and
                    (D) recommendations, if any, for improvements in 
                the provision of such counseling treatment.

SEC. 9. PAY COMPARABILITY FOR CHIEF NURSING OFFICER, OFFICE OF NURSING 
              SERVICES.

    Section 7404 is amended--
            (1) in subsection (d), by striking ``subchapter III'' and 
        inserting ``paragraph (e), subchapter III,''; and
            (2) by adding at the end the following:
    ``(e) The position of Chief Nursing Officer, Office of Nursing 
Services, shall be exempt from the provisions of section 7451 of this 
title and shall be paid at a rate not to exceed the maximum rate 
established for the Senior Executive Service under section 5382 of 
title 5 United States Code, as determined by the Secretary.''.

SEC. 10. REPEAL OF COST COMPARISON STUDIES PROHIBITION.

    Section 8110(a) is amended--
            (1) by striking paragraph (5); and
            (2) by redesignating paragraph (6) as paragraph (5).

SEC. 11. IMPROVEMENTS AND EXPANSION OF MENTAL HEALTH SERVICES.

    (a) In General.--The Secretary of Veterans affairs shall--
            (1) expand the number of clinical treatment teams 
        principally dedicated to the treatment of post-traumatic stress 
        disorder in medical facilities of the Department of Veterans 
        Affairs;
            (2) expand and improve the services available to diagnose 
        and treat substance abuse;
            (3) expand and improve tele-health initiatives to provide 
        better access to mental health services in areas of the country 
        in which the Secretary determines that a need for such services 
        exist due to the distance of such locations from an appropriate 
        facility of the Department of Veterans Affairs;
            (4) improve education programs available to primary care 
        delivery professionals and dedicate such programs to recognize, 
        treat, and clinically manage veterans with mental health care 
        needs;
            (5) expand the delivery of mental health services in 
        community-based outpatient clinics of the Department of 
        Veterans Affairs in which such services are not available as of 
        the date of enactment of this Act; and
            (6) expand and improve the Mental Health Intensive Case 
        Management Teams for the treatment and clinical case management 
        of veterans with serious or chronic mental illness.
    (b) Authorization of Appropriations.--There are authorized to be 
appropriated in each of fiscal years 2006 and 2007, $95,000,000 to 
improve and expand the treatment services and options available to 
veterans in need of mental health treatment from the Department of 
Veterans Affairs, of which--
            (1) $5,000,000 shall be allocated to carry out subsection 
        (a)(1);
            (2) $50,000,000 shall be allocated to carry out subsection 
        (a)(2);
            (3) $10,000,000 shall be allocated to carry out subsection 
        (a)(3);
            (4) $1,000,000 shall be allocated to carry out subsection 
        (a)(4);
            (5) $20,000,000 shall be allocated to carry out subsection 
        (a)(5); and
            (6) $5,000,000 shall be allocated to carry out subsection 
        (a)(6).

SEC. 12. DATA SHARING IMPROVEMENTS.

    Notwithstanding any other provision of law, the Department of 
Veterans Affairs and the Department of Defense may exchange protected 
health information for--
            (1) patients receiving treatment from the Department of 
        Veterans Affairs; or
            (2) individuals who may receive treatment from the 
        Department of Veterans Affairs in the future, including all 
        current and former members of the Armed Services.

SEC. 13. EXPANSION OF NATIONAL GUARD OUTREACH PROGRAM.

    (a) Requirement.--The Secretary of Veterans Affairs shall expand 
the total number of personal employed by the Department of Veterans 
Affairs as part of the Readjustment Counseling Service's Global War on 
Terrorism Outreach Program (referred to in this section as the 
``Program'').
    (b) Coordination.--In carrying out subsection (a), the Secretary 
shall coordinate participation in the Program by appropriate employees 
of the Veterans Benefits Administration and the Veterans Health 
Administration.
    (c) Information and Assessments.--The Secretary shall ensure that--
            (1) all appropriate health, education, and benefits 
        information is available to returning members of the National 
        Guard; and
            (2) proper assessments of the needs in each of these areas 
        is made by the Department of Veterans Affairs.
    (d) Collaboration.--The Secretary of Veterans Affairs shall 
collaborate with appropriate State National Guard officials and provide 
such officials with any assets or services of the Department of 
Veterans Affairs that the Secretary determines to be necessary to carry 
out the Global War on Terrorism Outreach Program.

SEC. 14. EXPANSION OF TELE-HEALTH SERVICES.

    (a) In General.--The Secretary shall increase the number of 
Veterans Readjustment Counseling Service facilities capable of 
providing health services and counseling through tele-health linkages 
with facilities of the Veterans Health Administration.
    (b) Plan.--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 implement the requirement under 
subsection (a), which shall describe the facilities that will have such 
capabilities at the end of each of fiscal years 2005, 2006, and 2007.

SEC. 15. MENTAL HEALTH DATA SOURCES REPORT.

    (a) In General.--Not less than 180 days after the date of enactment 
of this Act, the Secretary of Veterans Affairs shall submit a report to 
the Committee on Veterans' Affairs of the Senate and the Committee on 
Veterans' Affairs of the House of Representatives describing the mental 
health data maintained by the Department of Veterans Affairs.
    (b) Contents.--The report submitted under subsection (a) shall 
include--
            (1) a comprehensive list of the sources of all such data, 
        including the geographic locations of facilities of the 
        Department of Veterans Affairs maintaining such data;
            (2) an assessment of the limitations or advantages to 
        maintaining the current data configuration and locations; and
            (3) any recommendations, if any, for improving the 
        collection, use, and location of mental health data maintained 
        by the Department of Veterans Affairs.
                                 <all>