[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3989 Introduced in House (IH)]

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114th CONGRESS
  1st Session
                                H. R. 3989

   To amend title 38, United States Code, to improve the process for 
   determining the eligibility of caregivers of veterans to certain 
      benefits administered by the Secretary of Veterans Affairs.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            November 5, 2015

 Ms. Stefanik introduced the following bill; which was referred to the 
                     Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
   To amend title 38, United States Code, to improve the process for 
   determining the eligibility of caregivers of veterans to certain 
      benefits administered by the Secretary of Veterans Affairs.

    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 ``Support Our Military Caregivers 
Act''.

SEC. 2. EXTERNAL CLINICAL REVIEW OF DENIED APPLICATIONS BY CAREGIVERS 
              OF VETERANS.

    (a) In General.--Section 1720G of title 38, United States Code, is 
amended--
            (1) by redesignating subsections (d) and (e) as subsections 
        (e) and (f), respectively; and
            (2) by inserting after subsection (c) the following new 
        subsection (d):
    ``(d) External Clinical Review of Applications.--(1) Using amounts 
otherwise appropriated to carry out this section, an individual may 
elect to have an independent contractor described in paragraph (2) 
perform an external clinical review of any of the following:
            ``(A) The denial by the Secretary of an application by an 
        individual to be a caregiver or family caregiver eligible for 
        benefits administered by the Secretary pursuant to this 
        section.
            ``(B) With respect to such an application that the 
        Secretary has granted, a determination by the Secretary of the 
        level or amount of personal care services that a veteran 
        requires.
            ``(C) A request by a caregiver or family caregiver for a 
        reconsideration of the level or amount of personal care 
        services that a veteran requires based on changes to the health 
        or abilities of the veteran occurring since the Secretary 
        granted such an application.
            ``(D) The revocation by the Secretary of benefits 
        administered by the Secretary pursuant to this section.
    ``(2) An independent contractor described in this paragraph is an 
independent contractor that--
            ``(A) is awarded a contract by the Secretary to carry out 
        this section pursuant to full and open competition under the 
        Federal Acquisition Regulation;
            ``(B) has no direct or indirect financial relationship with 
        any non-Department provider of services to caregivers and 
        family caregivers pursuant to this title;
            ``(C) has not otherwise conducted an external clinical 
        review of benefits administered by the Secretary pursuant to 
        this title other than this section;
            ``(D) has sufficient training and expertise in medical 
        science and other appropriate health, educational, and 
        vocational training and legal matters to perform the reviews 
        described in paragraph (1); and
            ``(E) employs a panel of physicians or other appropriate 
        health care professionals who do not provide health care to the 
        individual who makes an election under paragraph (1).
    ``(3) Each external clinical review conducted pursuant to paragraph 
(1) shall--
            ``(A) be based on applicable information included in the 
        application for benefits described in such paragraph, including 
        clinical expertise, medical, technical, and scientific 
        evidence;
            ``(B) include an opportunity for the individual who elects 
        for such review to provide the opinions of the individual and 
        the veteran for whom care is provided; and
            ``(C) include a review of the initial clinical review of 
        such veteran and any other review made by the Secretary.
    ``(4) In carrying out the external clinical reviews pursuant to 
paragraph (1), the independent contractor shall, as determined 
appropriate by the Secretary--
            ``(A) collect and maintain information required; and
            ``(B) share such information with the Secretary.
    ``(5) The determination made by the independent contractor pursuant 
to paragraph (1) shall be final.
    ``(6) The Secretary shall ensure that each external clinical review 
conducted by the independent contractor pursuant to paragraph (1) is 
completed and the individual is notified in writing of the results of 
the review by not later than 120 days after the date on which the 
individual makes the election under such paragraph. Such notification 
shall include an explanation of the decision, a discussion of the facts 
and applicable regulations, and an explanation of the clinical 
rationale for the decision.
    ``(7) The Secretary shall notify individuals who submit an 
application to be a caregiver or family caregiver eligible for benefits 
administered by the Secretary pursuant to this section of the ability 
of the individual to make an election under paragraph (1).
    ``(8) Nothing in this subsection may be construed to affect claims 
made by veterans for disability compensation under chapter 11 of this 
title.''.
    (b) Application.--
            (1) In general.--Except as provided by paragraph (2), the 
        amendments made by subsection (a) shall apply with respect to 
        elections under subsection (d) of section 1720G of title 38, 
        United States Code, as added by subsection (a)(2), that are for 
        applications or revocations for benefits by caregivers and 
        family caregivers pursuant to such section for which the 
        Secretary of Veterans Affairs has not made a final decision as 
        of the date of the enactment of this Act.
            (2) Special rule.--A caregiver or family caregiver may make 
        an election for an external clinical review under subsection 
        (d)(1)(C) of section 1720G of title 38, United States Code, as 
        added by subsection (a)(2), regardless of whether the Secretary 
        of Veterans Affairs made the final decision with respect to the 
        application for benefits by the caregiver or family caregiver 
        before the date of the enactment of this Act.
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