[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3858 Introduced in House (IH)]

113th CONGRESS
  2d Session
                                H. R. 3858

   To amend title 38, United States Code, to direct the Secretary of 
Veterans Affairs to enter into contracts with health care providers to 
improve health care access and care coordination for veterans, and for 
                            other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 13, 2014

  Mr. Kinzinger of Illinois introduced the following bill; which was 
             referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
   To amend title 38, United States Code, to direct the Secretary of 
Veterans Affairs to enter into contracts with health care providers to 
improve health care access and care coordination 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; SENSE OF CONGRESS.

    (a) Short Title.--This Act may be cited as the ``Veteran-Centered 
Access to Coordinated Health Care Act of 2014''.
    (b) Sense of Congress.--It is the sense of Congress that--
            (1) veterans who are authorized by the Secretary of 
        Veterans Affairs to receive health care in the community must 
        not lose the high quality, safety, care coordination, and other 
        veteran-centric elements that the health care system of the 
        Department of Veterans Affairs provides;
            (2) many veterans receive health care from both the 
        Department and community providers but the lack of care 
        coordination among the Department and community providers when 
        veterans receive purchased care places veterans at risk for 
        poor health outcomes and results in inefficient use of finite 
        health care resources;
            (3) veteran-centric care coordination is associated with 
        improved patient outcomes, as Department and non-Department 
        health care teams coordinate and collaborate to provide the 
        best care for veterans; and
            (4) if the Secretary purchases care for veterans from the 
        private sector, such care must be secured in a cost-effective 
        manner, in a way that complements the larger health care system 
        of the Department by using industry standards for care and 
        costs.

SEC. 2. COMPREHENSIVE CONTRACT CARE COORDINATION PROGRAM FOR VETERANS.

    (a) In General.--
            (1) Type of care.--Subsection (a) of section 1703 of title 
        38, United States Code, is amended to read as follows:
    ``(a)(1) The Secretary shall provide an eligible veteran with 
covered health services that are provided by a non-Department entity 
whom the Secretary enters into a contract with under this section if 
the Secretary determines that facilities of the Department are not 
capable of--
            ``(A) economically furnishing covered health services to 
        such veteran because of geographical inaccessibility; or
            ``(B) furnishing covered health services to such veteran 
        because such facilities lack--
                    ``(i) the required personnel who are appropriately 
                trained and experienced; or
                    ``(ii) the ability to provide timely and reasonable 
                access.
    ``(2) Except as otherwise provided by this chapter or other law, 
the Secretary shall ensure that health care provided to a veteran under 
this title by a non-Department entity, including under the Patient-
Centered Community Care program or any other care-coordination program, 
is provided in accordance with this section.
    ``(3) The Secretary shall provide covered health services pursuant 
to this chapter at a location that is in accordance with the following 
priority:
            ``(A) A facility of the Department.
            ``(B) A facility of a department or agency of the Federal 
        Government, or of a university, that the Secretary has entered 
        into a sharing agreement with respect to providing such health 
        services.
            ``(C) A non-Department facility in accordance with this 
        section.
            ``(D) A non-Department facility in accordance with a 
        provision of law other than this section.
    ``(4) The Secretary shall ensure that veterans who receive health 
care under this title from a non-Department entity are able to 
efficiently reenter the health care system of the Department, including 
by coordinating care.
    ``(5) In this subsection:
            ``(A) The term `covered health services' means, with 
        respect to an eligible veteran, any hospital care, medical 
        service, rehabilitative service, or preventative health service 
        that is authorized to be provided by the Secretary to the 
        veteran under this chapter or any other provision of law.
            ``(B) The term `eligible veteran' means a veteran enrolled 
        in the health care system established under section 1705(a) of 
        this title who elects to receive care under this section.''.
            (2) Qualified entities; care coordination.--Such section is 
        amended by adding at the end the following new subsections:
    ``(e) The Secretary shall enter into a contract with a non-
Department entity under this section. The Secretary shall ensure that 
the resources of the Department are not used to duplicate 
administrative functions and information technology systems that are 
provided by the non-Department entity under such a contract. A non-
Department entity shall be eligible for such a contract if the entity 
demonstrates experience with respect to--
            ``(1) the ability to provide non-Department health care 
        services to veterans;
            ``(2) meeting or exceeding internal credentialing standards 
        of the Department and standards of the Utilization Review 
        Accreditation Commission;
            ``(3) having care coordinators who help veterans make, 
        confirm, and keep medical appointments;
            ``(4) having the ability to obtain clinical information 
        from non-Department entities and submit such information to the 
        Department;
            ``(5) having--
                    ``(A) experience using an information technology 
                system that--
                            ``(i) has the ability to track and monitor 
                        veterans that is accessible by employees of the 
                        Department using a portal on an Internet 
                        website; and
                            ``(ii) allows veterans to file complaints; 
                        and
                    ``(B) the ability to respond to potential quality 
                indicators and patient safety events; and
            ``(6) having the experience and ability to--
                    ``(A) process claims in the provider network;
                    ``(B) bill a third party (as defined in section 
                1725(f)(2) of this title) for care provided under this 
                section, as appropriate; and
                    ``(C) transmit directly to the Secretary any 
                amounts received pursuant to subparagraph (B).
    ``(f) In carrying out this section, the Secretary shall ensure the 
following:
            ``(1) With respect to each medical center of the 
        Department, the Secretary is consistent in determining the 
        eligibility of veterans under subsection (a).
            ``(2) The Secretary requires care coordinators of a non-
        Department entity described in subsection (e)(3) who will 
        coordinate care of a veteran by the entity with a care 
        coordinator of the Department.
            ``(3) The Department and a non-Department entity under this 
        section exchange clinical information to improve both clinical 
        decisionmaking and the care a veteran receives.
            ``(4) Both non-Department facilities under this section and 
        Department facilities meet performance metrics regarding--
                    ``(A) the quality of health care provided;
                    ``(B) the satisfaction of veterans;
                    ``(C) clinical information return within 30 days of 
                a health care visit of a patient;
                    ``(D) a no-show rate at a rate less than the 
                industry standard;
                    ``(E) claims being paid within 30 days;
                    ``(F) timely access to health care, including 
                initial appointments occurring less than 30 days after 
                being requested;
                    ``(G) cost effectiveness; and
                    ``(H) sufficient volume and case mix to ensure 
                cost-effective vendor prices.
    ``(g)(1) Not later than October 31 of each year, 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 care provided under this section, including--
            ``(A) the cost to the Department;
            ``(B) the number of veterans receiving care under this 
        section as compared to the number of veterans receiving care 
        from non-Department facilities under other provisions of law;
            ``(C) the quality of such care and the satisfaction of such 
        veterans;
            ``(D) the performance metrics under subsection (f)(4); and
            ``(E) other matters the Secretary considers appropriate.
    ``(2) Not later than March 1 of each odd-numbered year, 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 allocation of resources with respect to 
care provided by the Department and by non-Department facilities.''.
            (3) Effective date.--The amendments made by this subsection 
        shall take effect 180 days after the date of the enactment of 
        this Act.
    (b) Reauthorization of Project Arch.--Section 403 of the Veterans' 
Mental Health and Other Care Improvements Act of 2008 (Public Law 110-
387; 38 U.S.C. 1703 note) is amended--
            (1) in subsection (a)(3), by striking ``A veteran'' and 
        inserting ``Except as provided by subsection (i), a veteran''; 
        and
            (2) by adding at the end the following new subsection:
    ``(i) Reauthorization.--
            ``(1) Recommencement.--Not later than 90 days after the 
        date of the enactment of the Veteran-Centered Collaborative 
        Health Care Act of 2014, the Secretary shall again commence the 
        conduct of the pilot program under subsection (a)(1).
            ``(2) Program locations.--Notwithstanding subsection 
        (a)(4), the Secretary shall carry out the pilot program 
        pursuant to paragraph (1) within each Veterans Integrated 
        Service Network.
            ``(3) Appointments.--In carrying out the pilot program 
        pursuant to paragraph (1), the Secretary shall ensure that 
        medical appointments for veterans occur during the 30-day 
        period beginning on the date that is 15 days after the date on 
        which the appointment is requested.
            ``(4) Outreach.--The Secretary shall ensure that a veteran 
        eligible for the pilot program carried out pursuant to 
        paragraph (1) is informed of such program.
            ``(5) Termination.--The authority of the Secretary to carry 
        out the pilot program pursuant to paragraph (1) shall terminate 
        on the date that is three years after the date on which the 
        Secretary commences such program under such paragraph.''.
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