II 111th CONGRESS 1st Session S. 423 IN THE SENATE OF THE UNITED STATES February 12, 2009 Mr. Akaka (for himself, Ms. Snowe, Mr. Johnson, Mr. Rockefeller, Mr. Sanders, Mr. Tester, Mr. Begich, Mr. Bingaman, Mrs. Boxer, Mr. Feingold, Ms. Landrieu, Mr. Lautenberg, Mr. Menendez, Ms. Murkowski, Ms. Stabenow, Mr. Thune, Mr. Vitter, Mr. Schumer, and Mr. Burr) 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 authorize advance appropriations for certain medical care accounts of the Department of Veterans Affairs by providing two-fiscal year budget authority, and for other purposes.

1.

Short title

This Act may be cited as the Veterans Health Care Budget Reform and Transparency Act of 2009.

2.

Findings

Congress makes the following findings: (1)Title 38, United States Code, authorizes the Secretary of Veterans Affairs to furnish hospital and domiciliary care, medical services, nursing home care, and related services to eligible and enrolled veterans, but only to the extent that appropriated resources and facilities are available for such purposes. (2)For 19 of the past 22 fiscal years, funds have not been appropriated for the Department of Veterans Affairs for the provision of health care as of the commencement of the new fiscal year, causing the Department great challenges in planning and managing care for enrolled veterans, to the detriment of veterans. (3)The cumulative effect of insufficient, late, and unpredictable funding for the Department for health care endangers the viability of the health care system of the Department and impairs the specialized health care resources the Department requires to maintain and improve the health of sick and disabled veterans. (4)Appropriations for the health care programs of the Department have too often proven insufficient over the past decade, requiring the Secretary to ration health care and Congress to approve supplemental appropriations for those programs. (5)Providing sufficient, timely, and predictable funding would ensure the Government meets its obligation to provide health care to sick and disabled veterans and ensure that all veterans enrolled for health care through the Department have ready access to timely and high quality care. (6)Providing sufficient, timely, and predictable funding would allow the Department to properly plan for and meet the needs of veterans.

3.

Two-fiscal year budget authority for certain medical care accounts of the Department of Veterans Affairs

(a)

Two-fiscal year budget authority

(1)

In general

Chapter 1 of title 38, United States Code, is amended by inserting after section 113 the following new section:

113A.

Two-fiscal year budget authority for certain medical care accounts

(a)

In general

Beginning with fiscal year 2011, new discretionary budget authority provided in an appropriations Act for the appropriations accounts of the Department specified in subsection (b) shall be made available for the fiscal year involved, and shall include new discretionary budget authority for such appropriations accounts that first become available for the first fiscal year after such fiscal year. (b)

Medical care accounts

The medical care accounts of the Department specified in this subsection are the medical care accounts of the Veterans Health Administration as follows: (1)Medical Services. (2)Medical Support and Compliance. (3)Medical Facilities.

. (2)

Clerical amendment

The table of sections at the beginning of chapter 1 of such title is amended by inserting after the item relating to section 113 the following new item: 113A. Two-fiscal year budget authority for certain medical care accounts. .

4.

Comptroller General of the United States study on adequacy and accuracy of baseline model projections of the Department of Veterans Affairs for health care expenditures

(a)

Study of adequacy and accuracy of baseline model projections

The Comptroller General of the United States shall conduct a study of the adequacy and accuracy of the budget projections made by the Enrollee Health Care Projection Model, its equivalent, or other methodologies, as utilized for the purpose of estimating and projecting health care expenditures of the Department of Veterans Affairs (in this section referred to as the Model) with respect to the fiscal year involved and the subsequent four fiscal years. (b)

Reports

(1)

In general

Not later than the date of each year in 2011, 2012, and 2013, on which the President submits the budget request for the next fiscal year under section 1105 of title 31, United States Code, the Comptroller General shall submit to the appropriate committees of Congress and to the Secretary a report. (2)

Elements

Each report under this paragraph shall include, for the fiscal year beginning in the year in which such report is submitted, the following: (A)A statement whether the amount requested in the budget of the President for expenditures of the Department for health care in such fiscal year is consistent with anticipated expenditures of the Department for health care in such fiscal year as determined utilizing the Model. (B)The basis for such statement. (C)Such additional information as the Comptroller General determines appropriate. (3)

Availability to the public

Each report submitted under this subsection shall also be made available to the public. (4)

Appropriate committees of Congress defined

In this subsection, the term appropriate committees of Congress means— (A)the Committees on Veterans' Affairs, Appropriations, and the Budget of the Senate; and (B)the Committees on Veterans' Affairs, Appropriations, and the Budget of the House of Representatives.