[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 1863 Introduced in Senate (IS)]

<DOC>






117th CONGRESS
  1st Session
                                S. 1863

To amend title 38, United States Code, to improve access to health care 
                 for veterans, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 26, 2021

   Mr. Moran (for himself, Mr. Boozman, Mr. Cassidy, Mr. Tillis, Mr. 
 Sullivan, Mrs. Blackburn, Mr. Cramer, and Mr. Tuberville) 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 improve access to health care 
                 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; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Guaranteeing 
Healthcare Access to Personnel Who Served Act''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
                    TITLE I--MISSION ACT PROTECTION

                  Subtitle A--Access to Community Care

Sec. 101. Modifications to access standards for care furnished through 
                            Community Care Program of Department of 
                            Veterans Affairs.
Sec. 102. Strategic plan to ensure continuity of care in the case of 
                            the realignment of a medical facility of 
                            the Department.
        Subtitle B--Community Care Self-scheduling Pilot Program

Sec. 111. Definitions.
Sec. 112. Pilot program establishing a community care self-scheduling 
                            appointment system.
Sec. 113. Capabilities of self-scheduling appointment system.
Sec. 114. Report.
        Subtitle C--Non-Department of Veterans Affairs Providers

Sec. 121. Credentialing verification requirements for providers of non-
                            Department of Veterans Affairs health care 
                            services.
Sec. 122. Inapplicability of certain providers to provide non-
                            Department of Veterans Affairs care.
          TITLE II--IMPROVEMENT OF RURAL HEALTH AND TELEHEALTH

Sec. 201. Establishment of strategic plan requirement for Office of 
                            Connected Care of Department of Veterans 
                            Affairs.
Sec. 202. Comptroller General report on transportation services by 
                            third parties for rural veterans.
Sec. 203. Comptroller General report on telehealth services of the 
                            Department of Veterans Affairs.
                   TITLE III--FOREIGN MEDICAL PROGRAM

Sec. 301. Analysis of feasibility and advisability of expanding 
                            assistance and support to caregivers to 
                            include caregivers of veterans in the 
                            Republic of the Philippines.
Sec. 302. Comptroller General report on Foreign Medical Program of 
                            Department of Veterans Affairs.
                      TITLE IV--MENTAL HEALTH CARE

Sec. 401. Analysis of feasibility and advisability of Department of 
                            Veterans Affairs providing evidence-based 
                            treatments for the diagnosis of treatment-
                            resistant depression.
Sec. 402. Modification of resource allocation system to include peer 
                            specialists.
Sec. 403. Gap analysis of psychotherapeutic interventions of the 
                            Department of Veterans Affairs.
                         TITLE V--OTHER MATTERS

Sec. 501. Online health care education portal.
Sec. 502. Exclusion of application of Paperwork Reduction Act to 
                            research activities of the Veterans Health 
                            Administration.

                    TITLE I--MISSION ACT PROTECTION

                  Subtitle A--Access to Community Care

SEC. 101. MODIFICATIONS TO ACCESS STANDARDS FOR CARE FURNISHED THROUGH 
              COMMUNITY CARE PROGRAM OF DEPARTMENT OF VETERANS AFFAIRS.

    (a) Access Standards.--
            (1) In general.--Section 1703B of title 38, United States 
        Code, is amended--
                    (A) by striking subsections (a) through (g) and 
                inserting the following:
    ``(a) Threshold Eligibility Standards for Access to Community 
Care.--(1) A covered veteran shall receive non-Department hospital 
care, medical services, or extended care services through the Veterans 
Community Care Program under section 1703 of this title pursuant to 
subsection (d)(1)(D) of such section using the following eligibility 
access standards:
            ``(A) With respect to primary care, mental health care, or 
        non-institutional extended care services, if the Department 
        cannot schedule an appointment for the covered veteran with a 
        health care provider of the Department--
                    ``(i) within 30 minutes average driving time from 
                the residence of the veteran; and
                    ``(ii) within 20 days of the date of request for 
                such an appointment unless a later date has been agreed 
                to by the veteran in consultation with the health care 
                provider.
            ``(B) With respect to specialty care or specialty services, 
        if the Department cannot schedule an appointment for the 
        covered veteran with a health care provider of the Department--
                    ``(i) within 60 minutes average driving time from 
                the residence of the veteran; and
                    ``(ii) within 28 days of the date of request for 
                such an appointment, unless a later date has been 
                agreed to by the veteran in consultation with the 
                health care provider.
    ``(2) For the purposes of determining the eligibility of a covered 
veteran for care or services under paragraph (1), the Secretary shall 
not take into consideration the availability of telehealth appointments 
from the Department when determining whether the Department is able to 
furnish such care or services in a manner that complies with the 
eligibility access standards under such paragraph.
    ``(b) Access to Care Standards for Community Care.--(1) Subject to 
subsection (c), the Secretary shall meet the following access to care 
standards when furnishing non-Department hospital care, medical 
services, or extended care services to a covered veteran through the 
Veterans Community Care Program under section 1703 of this title:
            ``(A) With respect to an appointment for primary care, 
        mental health care, or non-institutional extended care 
        services--
                    ``(i) within 30 minutes average driving time from 
                the residence of the veteran unless a longer driving 
                time has been agreed to by the veteran; and
                    ``(ii) within 20 days of the date of request for 
                such an appointment unless a later date has been agreed 
                to by the veteran.
            ``(B) With respect to an appointment for specialty care or 
        specialty services--
                    ``(i) within 60 minutes average driving time from 
                the residence of the veteran unless a longer driving 
                time has been agreed to by the veteran; and
                    ``(ii) within 28 days of the date of request for 
                such an appointment unless a later date has been agreed 
                to by the veteran.
    ``(2) The Secretary shall ensure that health care providers 
specified under section 1703(c) of this title are able to comply with 
the applicable access to care standards under paragraph (1) for such 
providers.
    ``(c) Waivers to Access to Care Standards for Community Care 
Providers.--(1) A Third Party Administrator may request a waiver to the 
access to care standards under subsection (b) if--
            ``(A)(i) the scarcity of available providers or facilities 
        in the region precludes the Third Party Administrator from 
        meeting those access to care standards; or
            ``(ii) the landscape of providers or facilities has 
        changed, and certain providers or facilities are not available 
        such that the Third Party Administrator is not able to meet 
        those access to care standards; and
            ``(B) to address the scarcity of available providers or the 
        change in the provider or facility landscape, as the case may 
        be, the Third Party Administrator has contracted with other 
        providers or facilities that may not meet those access to care 
        standards but are the currently available providers or 
        facilities most accessible to veterans within the region of 
        responsibility of the Third Party Administrator.
    ``(2) Any waiver requested by a Third Party Administrator under 
paragraph (1) must be requested in writing and submitted to the Office 
of Community Care of the Department for approval by that office.
    ``(3) As part of any waiver request under paragraph (1), a Third 
Party Administrator must include conclusive evidence and documentation 
that the access to care standards under subsection (b) cannot be met 
because of scarcity of available providers or changes to the landscape 
of providers or facilities.
    ``(4) In evaluating a waiver request under paragraph (1), the 
Secretary shall consider the following:
            ``(A) The number and geographic distribution of eligible 
        health care providers available within the geographic area and 
        specialty referenced in the waiver request.
            ``(B) The prevailing market conditions within the 
        geographic area and specialty referenced in the waiver request, 
        which shall include the number and distribution of health care 
        providers contracting with other health care plans (including 
        commercial plans and the Medicare program under title XVIII of 
        the Social Security Act (42 U.S.C. 1395 et seq.)) operating in 
        the geographic area and specialty referenced in the waiver 
        request.
            ``(C) Whether the service area is comprised of highly 
        rural, rural, or urban areas or some combination of such areas.
            ``(D) How significantly the waiver request differs from the 
        relevant access to care standards under subsection (b).
    ``(5) The Secretary shall not consider inability to contract as a 
valid sole rationale for granting a waiver under paragraph (1).
    ``(d) Calculation of Driving Time.--For purposes of calculating 
average driving time from the residence of the veteran under 
subsections (a) and (b), the Secretary shall use geographic information 
system software.
    ``(e) Periodic Review of Access Standards.--Not later than three 
years after the date of the enactment of the Guaranteeing Healthcare 
Access to Personnel Who Served Act, and not less frequently than once 
every three years thereafter, the Secretary shall--
            ``(1) conduct a review of the eligibility access standards 
        under subsection (a) and the access to care standards under 
        subsection (b), in consultation with--
                    ``(A) such Federal entities as the Secretary 
                considers appropriate, including the Department of 
                Defense, the Department of Health and Human Services, 
                and the Centers for Medicare & Medicaid Services;
                    ``(B) entities in the private sector; and
                    ``(C) other entities that are not part of the 
                Federal Government; and
            ``(2) submit to the appropriate committees of Congress a 
        report on--
                    ``(A) the findings of the Secretary with respect to 
                the review conducted under paragraph (1); and
                    ``(B) such recommendations as the Secretary may 
                have with respect to the eligibility access standards 
                under subsection (a) and the access to care standards 
                under subsection (b).
    ``(f) Publication of Eligibility Access Standards and Wait Times.--
(1) The Secretary shall publish on a publicly available internet 
website of the Department the eligibility access standards under 
subsection (a).
    ``(2)(A) The Secretary shall publish on a publicly available 
internet website of the Department the average wait time for a veteran 
to schedule an appointment at each medical center of the Department for 
the receipt of primary care and specialty care, measured from the date 
of request for the appointment to the date on which the care was 
provided.
    ``(B) The Secretary shall update the wait times published under 
subparagraph (A) not less frequently than monthly.'';
                    (B) by redesignating subsections (h) and (i) as 
                subsections (g) and (h), respectively;
                    (C) in subsection (g), as redesignated by 
                subparagraph (B)--
                            (i) in paragraph (1), by striking 
                        ``designated access standards established under 
                        this section'' and inserting ``eligibility 
                        access standards under subsection (a)''; and
                            (ii) in paragraph (2)(B), by striking 
                        ``designated access standards established under 
                        this section'' and inserting ``eligibility 
                        access standards under subsection (a)''; and
                    (D) in subsection (h), as so redesignated, by 
                adding at the end the following new paragraphs:
            ``(3) The term `inability to contract', with respect to a 
        Third Party Administrator, means the inability of the Third 
        Party Administrator to successfully negotiate and establish a 
        community care network contract with a provider or facility.
            ``(4) The term `Third Party Administrator' means an entity 
        that manages a provider network and performs administrative 
        services related to such network within the Veterans Community 
        Care Program under section 1703 of this title.''.
            (2) Conforming amendments.--Section 1703(d) of such title 
        is amended--
                    (A) in paragraph (1)(D), by striking ``designated 
                access standards developed by the Secretary under 
                section 1703B of this title'' and inserting 
                ``eligibility access standards under section 1703B(a) 
                of this title''; and
                    (B) in paragraph (3), by striking ``designated 
                access standards developed by the Secretary under 
                section 1703B of this title'' and inserting 
                ``eligibility access standards under section 1703B(a) 
                of this title''.
    (b) Prevention of Suspension of Veterans Community Care Program.--
Section 1703(a) of such title is amended by adding at the end the 
following new paragraph:
    ``(4) Nothing in this section shall be construed to authorize the 
Secretary to suspend the program established under paragraph (1).''; 
and

SEC. 102. STRATEGIC PLAN TO ENSURE CONTINUITY OF CARE IN THE CASE OF 
              THE REALIGNMENT OF A MEDICAL FACILITY OF THE DEPARTMENT.

    (a) Sense of Congress.--It is the sense of Congress that the 
Veterans Health Administration should work closely with Third Party 
Administrators to ensure that veterans do not experience a lapse of 
care when transitioning to receiving care or services under the 
Community Care Program due to the realignment of a medical facility of 
the Department of Veterans Affairs.
    (b) Development of Strategic Plan.--
            (1) In general.--The Secretary of Veterans Affairs, acting 
        through the Office of Community Care and the Office of Veterans 
        Access to Care of the Department, shall develop and 
        periodically update a strategic plan to ensure continuity of 
        health care under the Community Care Program for veterans 
        impacted by the realignment of a medical facility of the 
        Department.
            (2) Elements.--The strategic plan required under paragraph 
        (1) shall include, at a minimum, the following:
                    (A) An assessment of the progress of the Department 
                in identifying impending realignments of medical 
                facilities of the Department and the impact of such 
                realignments on the network of health care providers 
                under the Community Care Program within the catchment 
                area of such facilities.
                    (B) An outline of collaborative actions and 
                processes the Office of Community Care and the Office 
                of Veterans Access to Care of the Department can take 
                to address potential gaps in health care created by the 
                realignment of a medical facility of the Department.
                    (C) A description of how the Department can 
                identify to Third Party Administrators changes in the 
                catchment areas of medical facilities to be realigned 
                and develop a process with Third Party Administrators 
                to strengthen provider coverage in advance of such 
                realignments.
            (3) Submittal to congress.--Not later than 180 days after 
        the date of the enactment of this Act, the Under Secretary for 
        Health of the Department shall submit to the Committee on 
        Veterans' Affairs of the Senate and the Committee on Veterans' 
        Affairs of the House of Representatives the plan developed 
        under paragraph (1).
    (c) Definitions.--In this section:
            (1) Community care program.--The term ``Community Care 
        Program'' means the Veterans Community Care Program under 
        section 1703 of title 38, United States Code.
            (2) Realignment.--The term ``realignment'', with respect to 
        a facility of the Department of Veterans Affairs, includes--
                    (A) any action that changes the number of 
                facilities or relocates services, functions, or 
                personnel positions; and
                    (B) strategic collaborations between the Department 
                and non-Federal Government entities, including tribal 
                organizations.
            (3) Third party administrator.--The term ``Third Party 
        Administrator'' means an entity that manages a provider network 
        and performs administrative services related to such network 
        within the Veterans Community Care Program under section 1703 
        of title 38, United States Code.
            (4) Tribal organization.--The term ``tribal organization'' 
        has the meaning given that term in section 4 of the Indian 
        Self-Determination and Education Assistance Act (25 U.S.C. 
        5304).

        Subtitle B--Community Care Self-scheduling Pilot Program

SEC. 111. DEFINITIONS.

    In this subtitle:
            (1) Appropriate congressional committees.--The term 
        ``appropriate congressional committees'' means--
                    (A) the Committee on Veterans' Affairs and the 
                Committee on Appropriations of the Senate; and
                    (B) the Committee on Veterans' Affairs and the 
                Committee on Appropriations of the House of 
                Representatives.
            (2) Covered veteran.--The term ``covered veteran'' means a 
        covered veteran under section 1703(b) of title 38, United 
        States Code.
            (3) Pilot program.--The term ``pilot program'' means the 
        pilot program required under section 112(a).
            (4) Veterans community care program.--The term ``Veterans 
        Community Care Program'' means the program to furnish hospital 
        care, medical services, and extended care services to covered 
        veterans under section 1703 of title 38, United States Code.

SEC. 112. PILOT PROGRAM ESTABLISHING A COMMUNITY CARE SELF-SCHEDULING 
              APPOINTMENT SYSTEM.

    (a) Pilot Program.--Not later than 120 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall commence 
a pilot program under which covered veterans eligible for hospital 
care, medical services, or extended care services under subsection 
(d)(1) of section 1703 of title 38, United States Code, may use an 
internet website or mobile application that has the capabilities 
specified in section 113(a) to request, schedule, and confirm medical 
appointments with health care providers participating in the Veterans 
Community Care Program.
    (b) System Expansion or Development of New System.--In carrying out 
the pilot program, the Secretary may expand capabilities of an existing 
self-scheduling appointment system of the Department of Veterans 
Affairs or develop a new self-scheduling system mobile application or 
internet website.
    (c) Contract Authority for Developing a New System.--
            (1) In general.--If the Secretary elects to develop a new 
        self-scheduling system under subsection (b), the Secretary 
        shall seek to enter into a contract using competitive 
        procedures with one or more contractors to provide the 
        capabilities specified in section 113(a).
            (2) Notice of competition.--
                    (A) In general.--If the Secretary elects to develop 
                a new system under subsection (b), not later than 60 
                days after the date of the enactment of this Act, the 
                Secretary shall issue a request for proposals to 
                provide the capabilities specified in section 113(a).
                    (B) Open to any contractor.--A request for 
                proposals under subparagraph (A) shall be full and open 
                to any contractor that has an existing commercially 
                available, off-the-shelf, online patient self-
                scheduling system that includes the capabilities 
                specified in section 113(a).
            (3) Selection.--If the Secretary elects to develop a new 
        self-scheduling system under subsection (b), not later than 120 
        days after the date of the enactment of this Act, the Secretary 
        shall award a contract to one or more contractors pursuant to 
        the request for proposals under paragraph (2)(A).
    (d) Selection of Locations.--The Secretary shall select not fewer 
than five Veterans Integrated Services Networks of the Department in 
which to carry out the pilot program.
    (e) Duration of Pilot Program.--
            (1) In general.--Except as provided in paragraph (2), the 
        Secretary shall carry out the pilot program for an 18-month 
        period.
            (2) Extension.--The Secretary may extend the duration of 
        the pilot program and may expand the selection of Veterans 
        Integrated Services Networks under subsection (d) if the 
        Secretary determines that the pilot program is reducing the 
        wait times of veterans seeking hospital care, medical services, 
        or extended care services under the Veterans Community Care 
        Program.
    (f) Outreach.--The Secretary shall ensure that veterans 
participating in the Veterans Community Care Program in Veterans 
Integrated Services Networks in which the pilot program is being 
carried out are informed about the pilot program.
    (g) Mobile Application Defined.--In this section, the term ``mobile 
application'' means a software program that runs on the operating 
system of a cellular telephone, tablet computer, or similar portable 
computing device that transmits data over a wireless connection.

SEC. 113. CAPABILITIES OF SELF-SCHEDULING APPOINTMENT SYSTEM.

    (a) Minimum Capabilities.--The Secretary of Veterans Affairs shall 
ensure that the self-scheduling appointment system used in the pilot 
program includes, at a minimum, the following capabilities:
            (1) Capability to request, schedule, modify, and cancel 
        appointments for primary care, specialty care, and mental 
        health care under the Veterans Community Care Program with 
        regard to each category of eligibility under section 1703(d)(1) 
        of title 38, United States Code.
            (2) Capability to support appointments for the provision of 
        health care under the Veterans Community Care Program 
        regardless of whether such care is provided in person or 
        through telehealth services.
            (3) Capability to view appointment availability in real 
        time to the extent practicable.
            (4) Capability to load relevant patient information from 
        the Decision Support Tool of the Department or any other 
        information technology system of the Department used to 
        determine the eligibility of veterans for health care under 
        section 1703(d)(1) of title 38, United States Code.
            (5) Capability to search for providers and facilities 
        participating in the Veterans Community Care Program based on 
        distance from the residential address of a veteran.
            (6) Capability to provide telephonic and electronic contact 
        information for all such providers that do not offer online 
        scheduling at the time.
            (7) Capability to store and print authorization letters for 
        veterans for health care under the Veterans Community Care 
        Program.
            (8) Capability to provide prompts or reminders to veterans 
        to schedule initial appointments or follow-up appointments.
            (9) Capability to be used 24 hours per day, seven days per 
        week.
            (10) Capability to integrate with the Veterans Health 
        Information Systems and Technology Architecture of the 
        Department, or any successor information technology system of 
        the Department.
            (11) Capability to integrate with information technology 
        systems of Third Party Administrators.
    (b) Independent Validation and Verification.--
            (1) Independent entity.--
                    (A) In general.--The Secretary shall seek to enter 
                into an agreement with an appropriate nongovernmental, 
                not-for-profit entity with expertise in health 
                information technology to independently validate and 
                verify that the self-scheduling appointment system used 
                in the pilot program includes the capabilities 
                specified in subsection (a).
                    (B) Timing.--The independent validation and 
                verification conducted under subparagraph (A) shall be 
                completed before the fielding of the self-scheduling 
                appointment system used in the pilot program to the 
                first Veterans Integrated Services Network of the 
                Department in which the pilot program is to be carried 
                out.
            (2) GAO evaluation.--
                    (A) In general.--The Comptroller General of the 
                United States shall evaluate the validation and 
                verification conducted under paragraph (1).
                    (B) Report.--Not later than 30 days after the date 
                on which the Comptroller General completes the 
                evaluation under paragraph (1), the Comptroller General 
                shall submit to the appropriate congressional 
                committees a report on such evaluation.
    (c) Certification.--
            (1) Capabilities included.--Not later than May 31, 2022, 
        the Secretary shall certify to the Committee on Veterans' 
        Affairs of the Senate and the Committee on Veterans' Affairs of 
        the House of Representatives that the self-scheduling 
        appointment system used in the pilot program and any other 
        patient self-scheduling appointment system developed or used by 
        the Department of Veterans Affairs as of the date of the 
        certification to schedule appointments under the Veterans 
        Community Care Program includes the capabilities specified in 
        subsection (a).
            (2) New systems.--If the Secretary develops a new self-
        scheduling appointment system to schedule appointments under 
        the Veterans Community Care Program that is not covered by a 
        certification made under paragraph (1), the Secretary shall 
        certify to the Committee on Veterans' Affairs of the Senate and 
        the Committee on Veterans' Affairs of the House of 
        Representatives that such new system includes the capabilities 
        specified in subsection (a) by not later than the date that is 
        30 days after the date on which the Secretary determines to 
        replace the previous self-scheduling appointment system.
            (3) Replacement of systems not certified.--If the Secretary 
        does not make a timely certification under paragraph (1) or 
        paragraph (2), as the case may be, the Secretary shall replace 
        any self-scheduling appointment system used by the Secretary to 
        schedule appointments under the Veterans Community Care Program 
        that is in use with a commercially available, off-the-shelf, 
        online self-scheduling appointment system that includes the 
        capabilities specified in subsection (a).
    (d) Third Party Administrator Defined.--In this section, the term 
``Third Party Administrator'' means an entity that manages a provider 
network and performs administrative services related to such network 
within the Veterans Community Care Program under section 1703 of title 
38, United States Code.

SEC. 114. REPORT.

    Not later than 180 days after the date of the enactment of this 
Act, and every 180 days thereafter, the Secretary of Veterans Affairs 
shall submit to the appropriate congressional committees a report that 
includes--
            (1) an assessment by the Secretary of the pilot program 
        during the 180-day period preceding the date of the report, 
        including--
                    (A) the cost of the pilot program;
                    (B) the volume of usage of the self-scheduling 
                appointment system under the pilot program;
                    (C) the quality of the pilot program;
                    (D) patient satisfaction with the pilot program;
                    (E) benefits to veterans of using the pilot 
                program;
                    (F) the feasibility of allowing self-scheduling for 
                different specialties under the pilot program;
                    (G) participating in the pilot program by health 
                care providers under the Veterans Community Care 
                Program; and
                    (H) such other findings and conclusions with 
                respect to the pilot program as the Secretary considers 
                appropriate; and
            (2) such recommendations as the Secretary considers 
        appropriate regarding--
                    (A) extension of the pilot program to other or all 
                Veterans Integrated Service Networks of the Department 
                of Veterans Affairs; and
                    (B) making the pilot program permanent.

        Subtitle C--Non-Department of Veterans Affairs Providers

SEC. 121. CREDENTIALING VERIFICATION REQUIREMENTS FOR PROVIDERS OF NON-
              DEPARTMENT OF VETERANS AFFAIRS HEALTH CARE SERVICES.

    (a) Credentialing Verification Requirements.--
            (1) In general.--Subchapter I of chapter 17 of title 38, 
        United States Code, is amended by inserting after section 1703E 
        the following new section:
``Sec. 1703F. Credentialing verification requirements for providers of 
              non-Department health care services
    ``(a) In General.--The Secretary shall ensure that Third Party 
Administrators and credentials verification organizations comply with 
the requirements specified in subsection (b) to help ensure certain 
health care providers are excluded from providing non-Department health 
care services.
    ``(b) Requirements Specified.--The Secretary shall require Third 
Party Administrators and credentials verification organizations to 
carry out the following:
            ``(1) Hold and maintain an active credential verification 
        accreditation from a national health care accreditation body.
            ``(2) Conduct initial verification of provider history and 
        license sanctions for all States and United States territories 
        for a period of time--
                    ``(A) that includes the period before the provider 
                began providing non-Department health care services; 
                and
                    ``(B) dating back not less than 10 years.
            ``(3) Not less frequently than every three years, perform 
        recredentialing, including verifying provider history and 
        license sanctions for all States and United States territories.
            ``(4) Implement continuous monitoring of each provider 
        through the National Practitioner Data Bank established 
        pursuant to the Health Care Quality Improvement Act of 1986 (42 
        U.S.C. 11101 et seq.).
    ``(c) Definitions.--In this section:
            ``(1) The term `credentials verification organization' 
        means an entity that manages the provider credentialing process 
        and performs credentialing verification for non-Department 
        providers that participate in the Veterans Community Care 
        Program under section 1703 of this title through a Veterans 
        Care Agreement.
            ``(2) The term `Third Party Administrator' means an entity 
        that manages a provider network and performs administrative 
        services related to such network within the Veterans Community 
        Care Program under section 1703 of this title.
            ``(3) The term `Veterans Care Agreement' means an agreement 
        for non-Department health care services entered into under 
        section 1703A of this title.
            ``(4) The term `non-Department health care services' means 
        services--
                    ``(A) provided under this subchapter at non-
                Department facilities (as defined in section 1701 of 
                this title);
                    ``(B) provided under section 101 of the Veterans 
                Access, Choice, and Accountability Act of 2014 (Public 
                Law 113-146; 38 U.S.C. 1701 note);
                    ``(C) purchased through the Medical Community Care 
                account of the Department; or
                    ``(D) purchased with amounts deposited in the 
                Veterans Choice Fund under section 802 of the Veterans 
                Access, Choice, and Accountability Act of 2014 (Public 
                Law 113-146; 38 U.S.C. 1701 note).''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of such subchapter is amended by inserting after the 
        item relating to section 1703E the following new item:

``1703F. Credentialing verification requirements for providers of non-
                            Department health care services.''.
    (b) Deadline for Implementation.--Not later than 180 days after the 
date of the enactment of this Act, the Secretary of Veterans Affairs 
shall commence the implementation of section 1703F of title 38, United 
States Code, as added by subsection (a)(1).

SEC. 122. INAPPLICABILITY OF CERTAIN PROVIDERS TO PROVIDE NON-
              DEPARTMENT OF VETERANS AFFAIRS CARE.

    Section 108 of the VA MISSION Act of 2018 (Public Law 115-182; 38 
U.S.C. 1701 note) 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) Application.--The requirement to deny or revoke the 
eligibility of a health care provider to provide non-Department health 
care services to veterans under subsection (a) shall apply to any 
removal under paragraph (1) of such subsection or violation under 
paragraph (2) of such subsection that occurred on or after the date 
that is five years before the date of the enactment of this Act.''.

          TITLE II--IMPROVEMENT OF RURAL HEALTH AND TELEHEALTH

SEC. 201. ESTABLISHMENT OF STRATEGIC PLAN REQUIREMENT FOR OFFICE OF 
              CONNECTED CARE OF DEPARTMENT OF VETERANS AFFAIRS.

    (a) Findings.--Congress makes the following findings:
            (1) The COVID-19 pandemic caused the Department of Veterans 
        Affairs to exponentially increase telehealth and virtual care 
        modalities, including VA Video Connect, to deliver health care 
        services to veteran patients.
            (2) Between January 2020 and January 2021, the number of 
        telehealth appointments offered by the Department increased by 
        1,831 percent.
            (3) The Department maintains strategic partnerships, such 
        as the Digital Divide Consult, with a goal of ensuring veterans 
        who reside in rural, highly rural, or medically underserved 
        areas have access to high-quality telehealth services offered 
        by the Department.
            (4) As of 2019, veterans who reside in rural and highly 
        rural areas make up approximately \1/3\ \\of veteran enrollees 
        in the patient enrollment system, and are on average, older 
        than their veteran peers in ubran areas, experience higher 
        degrees of financial instability, and live with a greater 
        number of complex health needs and comorbidities.
            (5) The Federal Communications Commission estimated in 2020 
        that 15 percent of veteran households do not have an internet 
        connection.
            (6) Under the Coronavirus Aid, Relief, and Economic 
        Security Act (Public Law 116-136), Congress granted the 
        Department additional authority to enter into short-term 
        agreements or contracts with private sector telecommunications 
        companies to provide certain broadband services for the 
        purposes of providing expanded mental health services to 
        isolated veterans through telehealth or VA Video Connect during 
        a public health emergency.
            (7) The authority described in paragraph (6) was not 
        utilized to the fullest extent by the Department.
            (8) Though the Department has made significant progress in 
        expanding telehealth services offered to veterans who are 
        enrolled in the patient enrollment system, significant gaps 
        still exist to ensure all veterans receive equal and high-
        quality access to virtual care.
            (9) Questions regarding the efficacy of using telehealth 
        for certain health care services and specialities remain, and 
        should be further studied.
            (10) The Department continues to expand telehealth and 
        virtual care offerings for primary care, mental health care, 
        specialty care, urgent care, and even remote intensive care 
        units.
    (b) Sense of Congress.--It is the sense of Congress that the 
telehealth services offered by the Department of Veterans Affairs 
should be routinely measured and evaluated to ensure the telehealth 
technologies and modalities delivered to veteran patients to treat a 
wide variety of health conditions are as effective as in-person 
treatment for primary care, mental health care, and other forms of 
specialty care.
    (c) Development of Strategic Plan.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs, 
        acting through the Office of Connected Care of the Department 
        of Veterans Affairs, shall develop a strategic plan to ensure 
        the effectiveness of the telehealth technologies and modalities 
        delivered by the Department to veterans who are enrolled in the 
        patient enrollment system.
            (2) Update.--
                    (A) In general.--The Secretary shall update the 
                strategic plan required under paragraph (1) not less 
                frequently than once every three years following 
                development of the plan.
                    (B) Consultation.--The Secretary shall prepare any 
                update required under subparagraph (A) in consultation 
                with the following:
                            (i) The Chief Officer of the Office of 
                        Connected Care of the Department.
                            (ii) The Executive Director of Telehealth 
                        Services of the Office of Connected Care.
                            (iii) The Executive Director of Connected 
                        Health of the Office of Connected Care.
                            (iv) The Executive Director of the Office 
                        of Rural Health of the Department.
                            (v) The Executive Director of Solution 
                        Delivery, IT Operations and Services of the 
                        Office of Information and Technology of the 
                        Department.
            (3) Elements.--The strategic plan required under paragraph 
        (1), and any update to that plan under paragraph (2), shall 
        include, at a minimum, the following:
                    (A) A comprehensive list of all health care 
                specialities the Department is currently delivering by 
                telehealth or virtual care.
                    (B) An assessment of the effectiveness and patient 
                outcomes for each type of health care speciality 
                delivered by telehealth or virtual care by the 
                Department.
                    (C) An assessment of satisfaction of veterans in 
                receiving care through telehealth or virtual care 
                disaggregated by age group and by Veterans Integrated 
                Service Network.
                    (D) An assessment of the percentage of virtual 
                visits delivered by the Department through each 
                modality including standard telephone telehealth, VA 
                Video Connect, and the Accessing Telehealth through 
                Local Area Stations program of the Department.
                    (E) An outline of all current partnerships 
                maintained by the Department to bolster telehealth or 
                virtual care services for veterans.
                    (F) An assessment of the barriers faced by the 
                Department in delivering telehealth or virtual care 
                services to veterans residing in rural and highly rural 
                areas, and the strategies the Department is deploying 
                beyond purchasing hardware for veterans who are 
                enrolled in the patient enrollment system.
                    (G) A detailed plan illustrating how the Department 
                is working with other Federal agencies, including the 
                Department of Health and Human Services, the Department 
                of Agriculture, the Federal Communications Commission, 
                and the National Telecommunications and Information 
                Administration, to enhance connectivity in rural, 
                highly rural, and medically underserved areas to better 
                reach all veterans.
                    (H) The feasibility and advisability of partnering 
                with Federally qualified health centers, rural health 
                clinics, and critical access hospitals to fill the gap 
                for health care services that exists for veterans who 
                reside in rural and highly rural areas.
                    (I) An evaluation of the number of veterans who are 
                enrolled in the patient enrollment system who have 
                previously received care under the Veterans Community 
                Care Program under section 1703 of title 38, United 
                States Code.
    (d) Submittal to Congress.--Not later than 180 days after the 
development of the strategic plan under paragraph (1) of subsection 
(c), and not later than 180 days after each update under paragraph (2) 
of such subsection thereafter, 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 that 
includes the following:
            (1) The completed strategic plan or update, as the case may 
        be.
            (2) An identification of areas of improvement by the 
        Department in the delivery of telehealth and virtual care 
        services to veterans who are enrolled in the patient enrollment 
        system, with a timeline for improvements to be implemented.
    (e) Definitions.--
            (1) Patient enrollment system.--The term ``patient 
        enrollment system'' means the system of annual patient 
        enrollment of the Department of Veterans Affairs established 
        and operated under section 1705(a) of title 38, United States 
        Code.
            (2) Rural; highly rural.--The terms ``rural'' and ``highly 
        rural'' have the meanings given those terms in the Rural-Urban 
        Commuting Areas coding system of the Department of Agriculture.
            (3) VA video connect.--The term ``VA Video Connect'' means 
        the program of the Department of Veterans Affairs to connect 
        veterans with their health care team from anywhere, using 
        encryption to ensure a secure and private connection.
            (4) Veteran.--The term ``veteran'' has the meaning given 
        that term in section 101(2) of title 38, United States Code.

SEC. 202. COMPTROLLER GENERAL REPORT ON TRANSPORTATION SERVICES BY 
              THIRD PARTIES FOR RURAL VETERANS.

    (a) Report Required.--Not later than one year after the date of the 
enactment of this Act, the Comptroller General of the United States 
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 program established under section 111A(b) of title 38, 
United States Code.
    (b) Contents.--The report submitted under subsection (a) shall 
include the following:
            (1) A description of the program described in such 
        subsection, including descriptions of the following:
                    (A) The purpose of the program.
                    (B) The activities carried out under the program.
            (2) An assessment of the sufficiency of the program with 
        respect to the purpose of the program.
            (3) An assessment of the cost effectiveness of the program 
        in comparison to alternatives.
            (4) An assessment of the health benefits for veterans who 
        have participated in the program.
            (5) An assessment of the sufficiency of staffing of 
        employees of the Department of Veterans Affairs who are 
        responsible for facilitating the maintenance of the program.
            (6) An assessment, with respect to the purpose of the 
        program, of the number of vehicles owned by and operating in 
        conjunction with the program.
            (7) An assessment of the awareness and usage of the program 
        by veterans and their families.
            (8) An assessment of other options for transportation under 
        the program, such as local taxi companies and ridesharing 
        programs such as Uber and Lyft.

SEC. 203. COMPTROLLER GENERAL REPORT ON TELEHEALTH SERVICES OF THE 
              DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--Not later than 18 months after the date of the 
enactment of this Act, the Comptroller General of the United States 
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 telehealth services provided by the Department of Veterans 
Affairs.
    (b) Elements.--The report required by subsection (a) shall include 
an assessment of the following:
            (1) The telehealth and virtual health care programs of the 
        Department of Veterans Affairs, including VA Video Connect.
            (2) The challenges faced by the Department in delivering 
        telehealth and virtual health care to veterans who reside in 
        rural and highly rural areas due to lack of connectivity in 
        many rural areas.
            (3) Any mitigation strategies used by the Department to 
        overcome connectivity barriers for veterans who reside in rural 
        and highly rural areas.
            (4) The partnerships entered into by the Office of 
        Connected Care of the Department in an effort to bolster 
        telehealth services.
            (5) The extent to which the Department has examined the 
        effectiveness of health care services provided to veterans 
        through telehealth in comparison to in-person treatment.
            (6) Satisfaction of veterans with respect to the telehealth 
        services provided by the Department.
            (7) The use by the Department of telehealth appointments in 
        comparison to referrals to care under the Veterans Community 
        Care Program under section 1703 of title 38, United States 
        Code.
            (8) Such other areas as the Comptroller General considers 
        appropriate.

                   TITLE III--FOREIGN MEDICAL PROGRAM

SEC. 301. ANALYSIS OF FEASIBILITY AND ADVISABILITY OF EXPANDING 
              ASSISTANCE AND SUPPORT TO CAREGIVERS TO INCLUDE 
              CAREGIVERS OF VETERANS IN THE REPUBLIC OF THE 
              PHILIPPINES.

    (a) Findings.--Congress makes the following findings:
            (1) Although section 161 of the VA MISSION Act of 2018 
        (Public Law 115-182; 132 Stat. 1438) expanded the program of 
        comprehensive assistance for family caregivers of the 
        Department of Veterans Affairs under section 1720G(a) of title 
        38, United States Code, to veterans of all eras, it did not 
        expand the program to family caregivers for veterans overseas.
            (2) Although caregivers for veterans overseas can access 
        online resources as part of the program of support services for 
        caregivers of veterans under subsection (b) section 1720G of 
        such title, those caregivers miss out on all of the 
        comprehensive services and benefits provided under subsection 
        (a) of such section.
            (3) The Department has an outpatient clinic and a regional 
        benefits office in Manila, Republic of the Philippines, and the 
        Foreign Medical Program of the Department under section 1724 of 
        such title is used heavily in the Republic of the Philippines 
        by veterans who live in that country.
            (4) Due to the presence of facilities of the Department in 
        the Republic of the Philippines and the number of veterans who 
        reside there, that country is a suitable test case to analyze 
        the feasibility and advisability of expanding caregiver support 
        to caregivers of veterans overseas.
    (b) Analysis.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall complete 
an analysis of the feasibility and advisability of making assistance 
and support under section 1720G(a) of title 38, United States Code, 
available to caregivers of veterans in the Republic of the Philippines.
    (c) Report.--Not later than 180 days after the conclusion of the 
analysis conducted under subsection (b), 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 that 
includes the following:
            (1) The results of such analysis.
            (2) An assessment of the number of veterans who are 
        enrolled in the patient enrollment system and reside in the 
        Republic of the Philippines.
            (3) An assessment of the number of veterans who are 
        enrolled in the patient enrollment system and reside in the 
        Republic of the Philippines that have a caregiver to provide 
        them personal care services described in section 1720G(a)(C) of 
        title 38, United States Code.
            (4) An assessment of the staffing needs and associated cost 
        of making assistance and support to available to caregivers of 
        veterans in the Republic of the Philippines.
    (d) Definitions.--In this section:
            (1) Caregiver.--The term ``caregiver'' has the meaning 
        given that term in section 1720G(d) of title 38, United States 
        Code.
            (2) Patient enrollment system.--The term ``patient 
        enrollment system'' means the system of annual patient 
        enrollment of the Department of Veterans Affairs established 
        and operated under section 1705(a) of such title.
            (3) Veteran.--The term ``veteran'' has the meaning given 
        that term in section 101(2) of such title.

SEC. 302. COMPTROLLER GENERAL REPORT ON FOREIGN MEDICAL PROGRAM OF 
              DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--Not later than two years after the date of the 
enactment of this Act, the Comptroller General of the United States 
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 Foreign Medical Program.
    (b) Elements.--The report required by subsection (a) shall include, 
for the most recent five fiscal years for which data are available, an 
assessment of the following:
            (1) The number of veterans who live overseas and are 
        eligible for the Foreign Medical Program.
            (2) The number of veterans who live overseas, are 
        registered for the Foreign Medical Program, and use such 
        program.
            (3) The number of veterans who live overseas, are 
        registered for the Foreign Medical Program, and do not use such 
        program.
            (4) The number of veterans who are eligible for care 
        furnished by the Department of Veterans Affairs, live in the 
        United States, including territories of the United States, and 
        make use of such care, including through the Veterans Community 
        Care Program under section 1703 of title 38, United States 
        Code.
            (5) Any challenges faced by the Department in administering 
        the Foreign Medical Program, including--
                    (A) outreach to veterans on eligibility for such 
                program and ensuring veterans who live overseas are 
                aware of such program;
                    (B) executing timely reimbursements of claims by 
                veterans under such program; and
                    (C) need for and use of translation services.
            (6) Any trends relating to--
                    (A) the timeliness of processing by the Department 
                of claims under the Foreign Medical Program and 
                reimbursement of veterans under such program;
                    (B) types of care or treatment sought by veterans 
                who live overseas that is reimbursed under such 
                program; and
                    (C) types of care or treatment eligible for 
                reimbursement under such program that veterans have 
                difficulty accessing overseas.
            (7) Any barriers or obstacles cited by veterans who live 
        overseas who are registered for the Foreign Medical Program, 
        including any differences between veterans who use the program 
        and veterans who do not.
            (8) Satisfaction of veterans who live overseas with the 
        Foreign Medical Program.
            (9) Such other areas as the Comptroller General considers 
        appropriate.
    (c) Foreign Medical Program Defined.--In this section, the term 
``Foreign Medical Program'' means the program under with the Secretary 
of Veterans Affairs provides hospital care and medical services under 
section 1724 of title 38, United States Code.

                      TITLE IV--MENTAL HEALTH CARE

SEC. 401. ANALYSIS OF FEASIBILITY AND ADVISABILITY OF DEPARTMENT OF 
              VETERANS AFFAIRS PROVIDING EVIDENCE-BASED TREATMENTS FOR 
              THE DIAGNOSIS OF TREATMENT-RESISTANT DEPRESSION.

    (a) Findings.--Congress makes the following findings:
            (1) A systematic review in 2019 of the economics and 
        quality of life relating to treatment-resistant depression 
        summarized that major depressive disorder (in this subsection 
        referred to as ``MDD'') is a global public health concern and 
        that treatment-resistant depression in particular represents a 
        key unmet need. The findings of that review highlighted the 
        need for improved therapies for treatment-resistant depression 
        to reduce disease burden, lower medical costs, and improve the 
        quality of life of patients.
            (2) The Clinical Practice Guideline for the Management of 
        MDD (in this subsection referred to as the ``CPG'') developed 
        jointly by the Department of Veterans Affairs and the 
        Department of Defense defines treatment-resistant depression as 
        at least two adequate treatment trials and lack of full 
        response to each.
            (3) The CPG recommends electro-convulsive therapy (in this 
        subsection referred to as ``ECT'') as a treatment strategy for 
        patients who have failed multiple other treatment strategies.
            (4) The CPG recommends offering repetitive transcranial 
        magnetic stimulation (in this subsection referred to as 
        ``rTMS''), an intervention that is indicated by the Food and 
        Drug Administration, for treatment during a major depressive 
        episode in patients with treatment-resistant MDD.
            (5) The final report of the Creating Options for Veterans' 
        Expedited Recovery Commission (commonly referred to as the 
        ``COVER Commission'') established under section 931 of the 
        Jason Simcakoski Memorial and Promise Act (title IX of Public 
        Law 114-198; 38 U.S.C. 1701 note) found that treatment-
        resistant depression is a major issue throughout the mental 
        health treatment system, and that an estimated 50 percent of 
        depressed patients are inadequately treated by available 
        interventions.
            (6) The COVER Commission also reported data collected from 
        the Department of Veterans Affairs that found that only 
        approximately 1,166 patients throughout the Department were 
        referred for ECT in 2018 and only approximately 772 patients 
        were referred for rTMS during that year.
    (b) Analysis.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall complete 
an analysis of the feasibility and advisability of making repetitive 
transcranial magnetic stimulation available at all medical facilities 
of the Department of Veterans Affairs and electro-convulsive therapy 
available at one medical center located within each Veterans Integrated 
Service Network for the treatment of veterans who are enrolled in the 
patient enrollment system and have a diagnosis of treatment-resistant 
depression.
    (c) Inclusion of Assessment of Report.--The analysis conducted 
under subsection (b) shall include an assessment of the final report of 
the COVER Commission submitted under section 931(e)(2) of the Jason 
Simcakoski Memorial and Promise Act (title IX of Public Law 114-198; 38 
U.S.C. 1701 note).
    (d) Report.--Not later than 180 days after the conclusion of the 
analysis conducted under subsection (b), 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 that 
includes the following:
            (1) The results of such analysis.
            (2) An assessment of the number of veterans who are 
        enrolled in the patient enrollment system and who have a 
        diagnosis of treatment-resistant depression per Veterans 
        Integrated Service Network during the two-year period preceding 
        the date of the report.
            (3) An assessment of the number of the veterans who are 
        enrolled in the patient enrollment system who have a diagnosis 
        of treatment-resistant depression and who have received or are 
        currently receiving repetitive transcranial magnetic 
        stimulation or electro-convulsive therapy as a treatment 
        modality during the two-year period preceding the date of the 
        report.
            (4) An assessment of the number and locations of medical 
        centers of the Department that currently provide repetitive 
        transcranial magnetic stimulation to veterans who are enrolled 
        in the patient enrollment system and who have a diagnosis of 
        treatment-resistant depression.
            (5) An assessment of the number and locations of medical 
        centers of the Department that currently provide electro-
        convulsive therapy to veterans who are enrolled in the patient 
        enrollment system and who have a diagnosis of treatment-
        resistant depression.
    (e) Definitions.--In this section:
            (1) Patient enrollment system.--The term ``patient 
        enrollment system'' means the system of annual patient 
        enrollment of the Department of Veterans Affairs established 
        and operated under section 1705(a) of title 38, United States 
        Code.
            (2) Veteran.--The term ``veteran'' has the meaning given 
        that term in section 101(2) of title 38, United States Code.

SEC. 402. MODIFICATION OF RESOURCE ALLOCATION SYSTEM TO INCLUDE PEER 
              SPECIALISTS.

    (a) In General.--Not later than one year after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall modify 
the Veterans Equitable Resource Allocation system, or successor system, 
to ensure that resource allocations under such system, or successor 
system, include peer specialists appointed under section 7402(b)(13) of 
title 38, United States Code.
    (b) Veterans Equitable Resource Allocation System Defined.--In this 
section, the term ``Veterans Equitable Resource Allocation system'' 
means the resource allocation system established pursuant to section 
429 of the Departments of Veterans Affairs and House and Urban 
Development, and Independent Agencies Appropriations Act, 1997 (Public 
Law 104-204; 110 Stat. 2929).

SEC. 403. GAP ANALYSIS OF PSYCHOTHERAPEUTIC INTERVENTIONS OF THE 
              DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--Not later than 270 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall complete 
a gap analysis throughout the entire health care system of the Veterans 
Health Administration on the use and availability of psychotherapeutic 
interventions recommended in widely used clinical practice guidelines 
as recommended in the final report of the COVER Commission submitted 
under section 931(e)(2) of the Jason Simcakoski Memorial and Promise 
Act (title IX of Public Law 114-198; 38 U.S.C. 1701 note).
    (b) Elements.--The gap analysis required under subsection (a) shall 
include the following:
            (1) An assessment of the psychotherapeutic interventions 
        available and routinely delivered to veterans at medical 
        centers of the Department of Veterans Affairs within each 
        Veterans Integrated Service Network of the Department.
            (2) An assessment of the barriers faced by medical centers 
        of the Department in offering certain psychotherapeutic 
        interventions and why those interventions are not widely 
        implemented or are excluded from implementation throughout the 
        entire health care system of the Veterans Health 
        Administration.
    (c) Report and Plan.--Not later than 180 days after completing the 
gap analysis under subsection (a), the Secretary shall submit to the 
Committee on Veterans' Affairs of the Senate and the Committee on 
Veterans' Affairs of the House of Representatives--
            (1) a report on the results of the analysis; and
            (2) a plan with measurable, time-limited steps for the 
        Department to implement--
                    (A) to address the gaps that limit access of 
                veterans to care; and
                    (B) to treat various mental health conditions 
                across the entire health care system of the Veterans 
                Health Administration.

                         TITLE V--OTHER MATTERS

SEC. 501. ONLINE HEALTH CARE EDUCATION PORTAL.

    (a) In General.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall 
establish an online health care education portal to ensure veterans 
enrolled in the patient enrollment system of the Department of Veterans 
Affairs under section 1705(a) of title 38, United States Code, are 
aware of the health care services provided by the Department and 
understand their basic health care entitlements under the laws 
administered by the Secretary.
    (b) Interactive Modules.--
            (1) In general.--The health care education portal 
        established under subsection (a) shall include, at a minimum, 
        interactive online educational modules on the following:
                    (A) Health care from the Veterans Health 
                Administration in the community, including under the 
                Veterans Community Care Program under section 1703 of 
                title 38, United States Code.
                    (B) Telehealth services.
                    (C) The appeals process for the Veterans Health 
                Administration.
                    (D) Patient aligned care teams.
                    (E) Mental health care services.
                    (F) Suicide prevention services.
                    (G) Specialty care services.
                    (H) Dental health services.
                    (I) Women's health services.
                    (J) Navigating the publicly accessible internet 
                websites and mobile applications of the Veterans Health 
                Administration.
                    (K) Vaccinations offered through the Veterans 
                Health Administration.
                    (L) Toxic exposure.
                    (M) Military sexual trauma.
                    (N) Topics set forth under section 121(b) of the VA 
                MISSION Act of 2018 (Public Law 115-182; 38 U.S.C. 1701 
                note).
            (2) Module updates.--The Secretary shall update the 
        curriculum content of the modules described in paragraph (1) 
        not less frequently than annually to ensure such modules 
        contain the most current information on the module topic.
    (c) Health Care Education Portal Requirements.--The Secretary shall 
ensure that the health care education portal established under 
subsection (a) meets the following requirements:
            (1) The portal is directly accessible from--
                    (A) The main home page of the publicly accessible 
                internet website of the Department; and
                    (B) The main home page of the publicly accessible 
                internet website of each medical center of the 
                Department.
            (2) The portal is easily understandable and usable by the 
        general public.
    (d) Print Material.--In developing the health care education portal 
established under subsection (a), the Secretary shall ensure that 
materials included in such portal are accessible in print format at 
each medical center of the Department to veterans who may not have 
access to the internet.
    (e) Consultation and Contract Authority.--In carrying out the 
health care education portal established under subsection (a), the 
Secretary--
            (1) shall consult with organizations recognized by the 
        Secretary for the representation of veterans under section 5902 
        of title 38, United States Code; and
            (2) may enter into a contract with a company, non-profit 
        entity, or other entity specializing in development of 
        educational programs to design the portal and the curriculum 
        for modules under subsection (b).
    (f) Report.--Not later than one year after the establishment of the 
health care education portal under subsection (a), and annually 
thereafter, 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--
            (1) assessing the use by veterans of the portal, 
        including--
                    (A) overall usage of the portal; and
                    (B) use of each module under subsection (b);
            (2) assessing the effectiveness of the education program 
        contained in such portal;
            (3) evaluating the curriculum contained in such portal;
            (4) providing such recommendations on modifications to the 
        curriculum contained in such portal as the Secretary considers 
        appropriate; and
            (5) including such other elements the Secretary considers 
        appropriate.

SEC. 502. EXCLUSION OF APPLICATION OF PAPERWORK REDUCTION ACT TO 
              RESEARCH ACTIVITIES OF THE VETERANS HEALTH 
              ADMINISTRATION.

    (a) In General.--Subchapter II of chapter 73 of title 38, United 
States Code, is amended by adding at the end the following new section:

``SEC. 7330D. INAPPLICABILITY OF PAPERWORK REDUCTION ACT TO RESEARCH 
              ACTIVITIES.

    ``Subchapter I of chapter 35 of title 44 (commonly referred to as 
the `Paperwork Reduction Act') shall not apply to the voluntary 
collection of information during the conduct of research by the 
Veterans Health Administration, including the Office of Research and 
Development, or individuals or entities affiliated with the Veterans 
Health Administration.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such subchapter is amended by inserting after the item relating to 
section 7330C the following new item:

``7330D. Inapplicability of Paperwork Reduction Act to research 
                            activities.''.
                                 <all>