[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4103 Introduced in House (IH)]

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114th CONGRESS
  1st Session
                                H. R. 4103

  To amend title 38, United States Code, to improve the provision of 
         medical care to veterans at critical access hospitals.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           November 19, 2015

  Mr. Cramer introduced the following bill; which was referred to the 
  Committee on Veterans' Affairs, and in addition to the Committee on 
   Ways and Means, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
  To amend title 38, United States Code, to improve the provision of 
         medical care to veterans at critical access hospitals.

    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 ``Critical Access Hospitals for 
Veterans Act'' or the ``CAHV Act''.

SEC. 2. CARE TO VETERANS AT CRITICAL ACCESS HOSPITALS.

    (a) Agreement Between HHS and VA.--
            (1) In general.--Chapter 17 of title 38, United States 
        Code, is amended by inserting after section 1703 the following 
        new section:
``Sec. 1703A. Care at critical access hospitals
    ``(a) Furnishing of Care.--At the election of a veteran enrolled in 
the health care system established under section 1705(a) of this title, 
hospital care and medical services shall be furnished at critical 
access hospitals to the veteran pursuant to the agreement described in 
subsection (b)(1).
    ``(b) Agreement.--(1) The agreement described in this paragraph is 
an agreement entered into by the Secretary of Veterans Affairs and the 
Secretary of Health and Human Services under which--
            ``(A) the Secretary of Health and Human Services, acting 
        through the Centers for Medicare & Medicaid Services, shall, 
        notwithstanding any other provision of law--
                    ``(i) ensure that a critical access hospital may 
                submit claims to the Centers for Medicare & Medicaid 
                Services for hospital care and medical services that 
                are inpatient critical access hospital services and 
                outpatient critical access hospital services (as such 
                terms are defined in paragraphs (2) and (3), 
                respectively, of section 1861(mm) of the Social 
                Security Act (42 U.S.C. 1395x(mm))) furnished to a 
                veteran under subsection (a); and
                    ``(ii) subject to paragraphs (2) and (3), provide 
                payment to such critical access hospital for such 
                services furnished to such veteran in the same manner 
                and at 100 percent of the payment rate as would 
                otherwise be made to such critical access hospital 
                (including any cost-sharing obligation that would 
                otherwise apply) if such services were furnished to an 
                individual entitled to benefits under part A of title 
                XVIII of the Social Security Act or enrolled under part 
                B of such Act, as applicable; and
            ``(B) not later than 30 days after the Secretary of Health 
        and Human Services provides such payment to such critical 
        access hospital, the Secretary of Veterans Affairs shall 
        reimburse the Secretary of Health and Human Services an amount 
        equal to--
                    ``(i) the payment provided to the critical access 
                hospital pursuant to subparagraph (A) with respect to 
                such services described in such subparagraph furnished 
                to such veteran, minus
                    ``(ii) any portion of such payment for such 
                services furnished to such veteran for which payment 
                would otherwise be made under title XVIII of such Act 
                (including any cost-sharing obligation that would 
                otherwise apply) with respect to such veteran, without 
                application of this subsection, and which would not 
                otherwise be provided pursuant to this chapter.
    ``(2) In the case of care or services furnished to a veteran by a 
critical access hospital for which payment would not be made under 
title XVIII of the Social Security Act if such veteran were an 
individual entitled to benefits under part A of such title or enrolled 
under part B, as applicable, the Secretary of Veterans Affairs and the 
Secretary of Health and Human Services shall jointly determine the 
payment to be made under paragraph (1)(A) to such critical access 
hospital for such care or services furnished to such veteran. 
Subparagraphs (A)(i) and (B) of paragraph (1) shall apply with respect 
to such care and services and any payments made pursuant to the 
previous sentence, respectively, in the same manner as such 
subparagraphs apply to services described in and payments made under 
subparagraph (A)(ii) of such paragraph.
    ``(3) In the case of services described in paragraph (1)(B)(ii) 
furnished to a veteran for which payment would otherwise be made under 
title XVIII of the Social Security Act, any cost-sharing obligation 
otherwise applicable to such veteran under such title with respect to 
such services shall apply.
    ``(c) Eligibility.--A veteran shall be eligible for the hospital 
care and medical services furnished under subsection (a) if the veteran 
presents to a critical access hospital and provides the critical access 
hospital with any document issued by the Department of Veterans Affairs 
that describes the enrollment of the veteran in the health care system 
established under section 1705(a) of this title, including an 
identification card described in section 5706(f) of this title or a 
Veterans Choice Card described in section 101(f) of the Veterans 
Access, Choice, and Accountability Act of 2014 (38 U.S.C. 1701 note).
    ``(d) Care Provided.--The hospital care and medical services 
furnished to a veteran under subsection (a) shall be the care or 
services the eligible veteran is eligible to receive under this 
chapter.
    ``(e) Medical Records.--The Secretary of Veterans Affairs shall 
provide to a critical access hospital the medical records of a veteran 
being treated by such hospital if such hospital requests such records. 
To the extent practicable, the Secretary shall provide such records 
electronically.
    ``(f) Costs to Veterans.--Any copayments or other charges that the 
Secretary may collect from a veteran or third party pursuant to this 
chapter for hospital care or medical services furnished to a veteran at 
a non-Department facility shall apply to care or services furnished to 
the veteran under subsection (a).
    ``(g) Reports.--During the five-year period beginning on the date 
of the enactment of this section, and from time to time thereafter, the 
Secretary of Veterans Affairs, in consultation with the Secretary of 
Health and Human Services, shall submit to the Committees on Veterans' 
Affairs and Energy and Commerce of the House of Representatives and the 
Committees on Veteran's Affairs and Health, Education, Labor, and 
Pensions of the Senate an annual report on the hospital care and 
medical services furnished under subsection (a). Each such report shall 
explain how furnishing such care and services under subsection (a) 
affects the following:
            ``(1) The resources of the Department of Veterans Affairs.
            ``(2) The costs incurred by veterans to receive such care 
        and services.
            ``(3) The amount of time a veteran must wait to receive 
        hospital care and services.
    ``(h) Critical Access Hospital Defined.--In this section, the term 
`critical access hospital' means a hospital designated or certified as 
a critical access hospital pursuant to section 1820 of the Social 
Security Act (42 U.S.C. 1395i-4).''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of such chapter is amended by inserting after the 
        item relating to section 1703 the following new item:

``1703A. Care at critical access hospitals.''.
    (b) Medicare Condition of Participation.--Section 1820(e) of the 
Social Security Act (42 U.S.C. 1395i-4(e)) is amended--
            (1) in paragraph (2), by striking at the end ``and'';
            (2) by redesignating paragraph (3) as paragraph (4); and
            (3) by inserting after paragraph (2) the following new 
        paragraph:
            ``(3) agrees to furnish items and services to veterans in 
        accordance with the agreement entered into between the 
        Secretary and the Secretary of Veterans Affairs under section 
        1703A of title 38, United States Code; and''.
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