Department of Veterans Affairs pilot program on access to medical care

(a)

Pilot Program

During the five-year period beginning on the date of the enactment of this Act, the Secretary of Veterans Affairs shall conduct a pilot program under which the Secretary shall ensure that for each veteran seeking primary care from a covered medical facility, the standard for access to care, determined from the date on which the veteran contacts the Department seeking an appointment until the date on which a visit with a primary-care provider is completed, is 30 days. (b)

Covered facility

For purposes of the pilot program under this section, a covered medical facility is a medical facility of the Department of Veterans Affairs in Veterans Integrated Service Network 8. (c)

Review of performance

The Secretary shall periodically review the performance of covered medical facilities compared to the standard established under subsection (a). The Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives an annual report providing an assessment of the Department’s performance in meeting that standard. (d)

Provision of care at non-Department facilities

(1)

Provision of care

Effective on the first day of the first fiscal year beginning after the date of the enactment of this section, in a case in which the Secretary is unable to meet the standard for access to care under subsection (a) with respect to a veteran enrolled in the patient enrollment system of the Department of Veterans Affairs under section 1705, of title 38, United States Code, the Secretary shall use the authority of section 1703(a) of that title to furnish health care and services for that veteran in a non-Department facility. In any such case— (A)payments by the Secretary may not exceed the reimbursement rate for similar outpatient services paid by the Secretary of Health and Human Services under part B of the medicare program (as defined in section 1781(d)(4)(A) of that title); and (B)the non-Department facility may not bill the veteran for any difference between the facility’s billed charges and the amount paid by the Secretary under paragraph (1). (2)

Veteran choice to receive care at Department facility

A veteran for whom the Secretary furnishes health care or services at a non-Department facility under paragraph (1) may, after 30 days of receiving such care or services at the non-Department facility, choose to receive such care or services from a Department facility, if available. If a veteran so chooses, the veteran shall submit to the Secretary notice in writing of that choice. (e)

Continuity of care

For the purpose of providing for continuity of care, the Secretary shall develop a form to be used by veterans to authorize the Secretary to obtain any records created in connection with the veteran’s receipt of care from a non-Department facility. (f)

Quarterly reports

(1)

Requirement

Not later than 60 days after the end of a calendar-year quarter, the Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report for that calendar-year quarter on the experience of the Department during the quarter covered by the report with respect to waiting times for veterans seeking appointments at a covered facility. (2)

Contents

Each report under subparagraph (A) shall include— (A)the total number of veterans waiting by the following categories: (i)Those waiting under 30 days for scheduled appointments. (ii)Those waiting over 30 days but less than 60 days. (iii)Those waiting over 60 days but less than 4 months. (iv)Those waiting over 4 months but who cannot be scheduled within 6 months. (v)Any remaining veterans who cannot be scheduled, with the reasons therefor. (B)For each category set forth in subparagraph (A), distinctions between— (i)waiting times for primary care and specialty care; and (ii)waiting times for veterans who are newly enrolled versus those who were enrolled before October 1, 2001. (C)The number of veterans who have enrolled in the Department of Veterans Affairs health care system but have not since such enrollment sought care at a Department medical facility. (g)

Termination

The authority to conduct a pilot program under this section shall terminate on the date that is five years after the date of the enactment of this Act.