[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 1604 Introduced in Senate (IS)]

113th CONGRESS
  1st Session
                                S. 1604

     To amend title 38, United States Code, to expand and enhance 
  eligibility for health care and services through the Department of 
               Veterans Affairs, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            October 29, 2013

  Mr. Sanders 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 expand and enhance 
  eligibility for health care and services through the Department of 
               Veterans Affairs, 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.

    This Act may be cited as the ``Veterans Health Care Eligibility 
Expansion and Enhancement Act of 2013''.

SEC. 2. ENHANCEMENT OF NATURE OF ELIGIBILITY FOR CARE OF CERTAIN 
              VETERANS.

    Section 1710(a)(3) of title 38, United States Code, is amended by 
striking ``may, to the extent resources and facilities are available 
and'' and inserting ``shall,''.

SEC. 3. REQUIREMENT FOR ENROLLMENT IN PATIENT ENROLLMENT SYSTEM OF 
              DEPARTMENT OF VETERANS AFFAIRS OF CERTAIN VETERANS 
              ELIGIBLE FOR ENROLLMENT BY LAW BUT NOT CURRENTLY 
              PERMITTED TO ENROLL.

    (a) Requirement for Enrollment.--Section 1705 of title 38, United 
States Code, is amended by adding at the end the following new 
subsection:
    ``(d)(1) The Secretary shall provide for the enrollment in the 
patient enrollment system of veterans specified in paragraph (2) by not 
later than December 31, 2014.
    ``(2) Veterans specified in this paragraph are as follows:
            ``(A) Veterans with noncompensable service-connected 
        disabilities rated as zero percent disabling who--
                    ``(i) are not otherwise permitted to enroll in the 
                system as of the date of the enactment of the Veterans 
                Health Care Eligibility Expansion and Enhancement Act 
                of 2013; and
                    ``(ii) as of the date of enrollment under this 
                section, do not have access to health insurance except 
                through a health exchange established pursuant to 
                section 1311 of the Patient Protection and Affordable 
                Care Act (42 U.S.C. 18031).
            ``(B) Veterans without service-connected disability who--
                    ``(i) are not otherwise permitted to enroll in the 
                system as of the date of the enactment of the Veterans 
                Health Care Eligibility Expansion and Enhancement Act 
                of 2013; and
                    ``(ii) as of the date of enrollment under this 
                section, do not have access to health insurance except 
                through a health exchange established pursuant to 
                section 1311 of the Patient Protection and Affordable 
                Care Act.
    ``(3) The Secretary shall determine whether a veteran does not have 
access to health insurance except through a health exchange for 
purposes of paragraph (2) using information obtained by the Secretary 
of Health and Human Services and the Secretary of the Treasury for 
purposes of determining whether the veteran maintains minimum essential 
coverage as required by section 5000A of the Internal Revenue Code of 
1986 and reported as required by section 6055 of the Internal Revenue 
Code of 1986.
    ``(4) A veteran who, after enrolling in the patient enrollment 
system pursuant to this subsection, obtains access to health insurance 
other than through a health exchange shall remain enrolled in the 
patient enrollment system notwithstanding obtaining access to such 
health insurance.
    ``(5) A veteran enrolled in the patient enrollment system pursuant 
to this subsection shall maintain the priority for care of the veteran 
at the time of enrollment unless and until a change in circumstances of 
the veteran results in a higher priority for care of the veteran under 
subsection (a).''.
    (b) Public Notice of Commencement of Enrollment.--The Secretary of 
Veterans Affairs shall publish in the Federal Register, and shall make 
available to the public on an Internet website of the Department of 
Veterans Affairs, a notice regarding the date on which veterans covered 
by subsection (d) of section 1705 of title 38, United States Code (as 
added by subsection (a) of this section), may commence enrollment in 
the patient enrollment system required by that section.

SEC. 4. FURTHER EXTENSION OF PERIOD OF ELIGIBILITY FOR HEALTH CARE FOR 
              VETERANS OF COMBAT SERVICE DURING CERTAIN PERIODS OF 
              HOSTILITIES AND WAR.

    Section 1710(e)(3) of title 38, United States Code, is amended--
            (1) in subparagraph (A), by striking ``the date that is 
        five years before the date of the enactment of the National 
        Defense Authorization Act for Fiscal Year 2008, after a period 
        of five years'' and inserting ``January 27, 2003, after a 
        period of 10 years''; and
            (2) in subparagraph (B), by striking ``more than five 
        years'' and all that follows and inserting ``before January 28, 
        2003, and who did not enroll in the patient enrollment system 
        under section 1705 of this title before January 28, 2008, after 
        January 27, 2018.''.

SEC. 5. RELOCATION AND RESTATEMENT OF LIMITATION ON REQUIREMENTS TO 
              FURNISH CERTAIN CARE AND SERVICES CONTINGENT ON THE 
              AVAILABILITY OF APPROPRIATIONS.

    (a) Relocation and Restatement.--Section 1707 of title 38, United 
States Code, is amended by adding at the end the following new 
subsection:
    ``(c)(1) The requirements specified in paragraph (2) shall be 
effective in any fiscal year only to the extent and in the amount 
provided in advance in appropriations Acts for such purposes.
    ``(2) The requirements specified in this paragraph are as follows:
            ``(A) The requirement in paragraphs (1), (2), and (3) of 
        section 1710(a) of this title that the Secretary provide 
        hospital care and medical services.
            ``(B) The requirement in section 1710A(a) of this title 
        that the Secretary provide nursing home care.
            ``(C) The requirement in section 1710B of this title that 
        the Secretary provide a program of extended care services.
            ``(D) The requirement in section 1745 of this title that 
        the Secretary provide nursing home care and prescription 
        medicines to veterans with service-connected disabilities in 
        State homes.''.
    (b) Conforming Repeal of Superseded Limitation.--Section 1710(a) of 
such title is amended--
            (1) by striking paragraph (4); and
            (2) by redesignating paragraph (5) as paragraph (4).

SEC. 6. MODIFICATION OF DETERMINATION OF ELIGIBILITY OF VETERANS FOR 
              TREATMENT AS A LOW-INCOME FAMILY FOR PURPOSES OF 
              ENROLLMENT IN THE PATIENT ENROLLMENT SYSTEM OF THE 
              DEPARTMENT OF VETERANS AFFAIRS.

    (a) Areas of Residence.--The Secretary of Veterans Affairs shall 
modify the areas in which veterans reside as specified for purposes of 
determining whether veterans qualify for treatment as low-income 
families for enrollment in the patient enrollment system of the 
Department of Veterans Affairs under section 1705(a)(7) of title 38, 
United States Code, to meet the requirements as follows:
            (1) Any area so specified shall be within only one State.
            (2) Any area so specified shall be co-extensive with one or 
        more counties (or similar political subdivisions) in the State 
        concerned.
    (b) Variable Income Thresholds.--The Secretary shall modify the 
thresholds for income as specified for purposes of determining whether 
veterans qualify for treatment as low-income families for enrollment in 
the patient enrollment system referred to in subsection (a) to meet the 
requirements as follows:
            (1) There shall be one income threshold for each State, 
        equal to the highest income threshold among the counties within 
        such State.
            (2) The calculation of the highest income threshold of a 
        county shall be consistent with the calculation used for 
        purposes of section 3(b) of the United States Housing Act of 
        1937 (42 U.S.C. 1437a(b)).
            (3) The timing and methodology for implementing any 
        modifications in geographic income thresholds pursuant to 
        paragraph (1) shall be determined by the Secretary in such a 
        manner as to permit the Department to build capacity for 
        enrolling such additional veterans in the patient enrollment 
        system of the Department as become eligible for enrollment as a 
        result of such modifications, except that all required 
        modifications shall be completed not later than five years 
        after date of the enactment of this Act.

SEC. 7. CONTRACTING FOR HEALTH CARE.

    (a) Use of Capitation-Based Resource Allocation in Entry Into 
Contracts.--In entering into contracts for the furnishing of health 
care services under the laws administered by the Secretary of Veterans 
Affairs (including under this Act and the amendments made by this Act), 
the Secretary shall use the capitation-based resource allocation model 
of the Department of Veterans Affairs.
    (b) Priority for Contracts With Certain Entities.--In entering into 
contracts for the furnishing of health care services under the laws 
administered by the Secretary, the Secretary shall afford a priority 
for entry into contracts for Federally Qualified Health Centers (FQHCs) 
and Community Health Centers (CHCs), whenever appropriate.
    (c) Best Practices.--The Secretary shall modify the guidance of the 
Department of Veterans Affairs on contracts for health care services in 
order to provide for the incorporation into such contracts of 
standardized requirements for such best practices under such contracts, 
including the following:
            (1) Requirements that contracts provide the Department on a 
        regular basis information on scheduling and appearance for 
        appointments for health care on a per-patient basis.
            (2) Such other best practices requirements as the Secretary 
        considers appropriate.
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