[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 1545 Introduced in Senate (IS)]
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118th CONGRESS
1st Session
S. 1545
To direct the Secretary of Veterans Affairs to carry out a pilot
program to improve the ability of veterans to access medical care in
medical facilities of the Department of Veterans Affairs and in the
community by providing veterans the ability to choose health care
providers.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 10, 2023
Mrs. Blackburn (for herself, Mr. Rounds, Mr. Cramer, and Mr.
Tuberville) introduced the following bill; which was read twice and
referred to the Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To direct the Secretary of Veterans Affairs to carry out a pilot
program to improve the ability of veterans to access medical care in
medical facilities of the Department of Veterans Affairs and in the
community by providing veterans the ability to choose health care
providers.
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 Freedom Act''.
SEC. 2. PILOT PROGRAM ON ABILITY OF VETERANS TO CHOOSE HEALTH CARE
PROVIDERS.
(a) Pilot Program.--
(1) Requirement.--The Secretary of Veterans Affairs, acting
through the Center for Innovation for Care and Payment of the
Department of Veterans Affairs, shall carry out a pilot program
to improve the ability of eligible veterans to access hospital
care, medical services, and extended care services through the
covered care system by providing eligible veterans the ability
to choose health care providers.
(2) Locations.--The Secretary shall select a minimum of
four Veterans Integrated Service Networks in which to carry out
the pilot program.
(b) Removal of Certain Requirements To Access Care.--In carrying
out the pilot program, the Secretary shall furnish hospital care,
medical services, and extended care services to eligible veterans
through the covered care system as follows:
(1) At medical facilities of the Department of Veterans
Affairs, regardless of whether the facility is in the same
Veterans Integrated Service Network as the Network in which the
veteran resides.
(2) At non-Department facilities pursuant to, as
appropriate--
(A) section 1703 of title 38, United States Code,
without regard to the requirements specified in
subsection (d) of such section; or
(B) section 1703A of such title, without regard to
whether the care or service is not feasibly available
to the eligible veteran from a facility of the
Department or through a contract or sharing agreement
entered into pursuant to a provision of law other than
such section as required under subparagraphs (A) and
(C) of subsection (a)(1) of such section.
(c) Election of Veteran.--In accordance with subsections (d) and
(e), an eligible veteran participating in the pilot program may elect
to receive hospital care, medical services, and extended care services
at any provider in the covered care system.
(d) Coordination of Care.--
(1) Selection.--Each eligible veteran participating in the
pilot program shall select a primary care provider in the
covered care system.
(2) Coordination.--The primary care provider of an eligible
veteran selected under paragraph (1) shall--
(A) coordinate with the Secretary and other health
care providers the hospital care, medical services, and
extended care services furnished to the veteran under
the pilot program; and
(B) refer the veteran to specialty care providers
in the covered care system, as clinically necessary.
(3) Systems.--The Secretary shall establish systems as the
Secretary determines appropriate to ensure that a primary care
provider can effectively coordinate the hospital care, medical
services, and extended care services furnished to a veteran
under the pilot program.
(e) Specialty Care.--
(1) Access.--Subject to subsection (d)(2)(B), an eligible
veteran participating in the pilot program may select any
specialty care provider in the covered care system from which
to receive specialty care.
(2) Designation.--The Secretary may designate a specialty
care provider as a primary care provider of an eligible veteran
participating in the pilot program if the Secretary determines
that such designation is in the health interests of the veteran
(such as an endocrinologist with respect to a veteran diagnosed
with diabetes, a neurologist with respect to a veteran
diagnosed with Parkinson's disease, or an obstetrician-
gynecologist with respect to a female veteran).
(f) Mental Health Care.--An eligible veteran participating in the
pilot program may select a mental health care provider in the covered
care system from which to receive mental health care.
(g) Information.--In carrying out the pilot program, the Secretary
shall furnish to eligible veterans the information on eligibility, cost
sharing, treatments, and providers required for veterans to make
informed decisions with respect to--
(1) selecting primary care providers and specialty care
providers; and
(2) treatments available to the veteran.
(h) Duration.--
(1) Phase in.--The Secretary shall carry out the pilot
program during the three-year period beginning on the date that
is one year after the date of the enactment of this Act.
(2) Permanent requirement.--
(A) Veterans community care program.--Section
1703(d) of title 38, United States Code, is amended--
(i) in paragraph (1), by striking ``The
Secretary shall'' and inserting ``Except as
provided by paragraph (4), the Secretary
shall''; and
(ii) by adding at the end the following new
paragraph:
``(4) Beginning on the date that is four years after the date of
the enactment of the Veterans Health Care Freedom Act--
``(A) the requirements under paragraphs (1), (2), and (3)
shall not apply with respect to furnishing hospital care,
medical services, and extended care services to a covered
veteran under this section; and
``(B) the Secretary shall furnish hospital care, medical
services, and extended care services to a covered veteran under
this section with the same conditions on the ability of the
veteran to choose health care providers as specified in the
pilot program described in section 2 of such Act.''.
(B) Veterans care agreements.--Section 1703A(a)(1)
of such title is amended--
(i) in subparagraph (C), by striking ``For
purposes'' and inserting ``Except as provided
by subparagraph (E), for purposes''; and
(ii) by adding at the end the following new
subparagraph:
``(E) Beginning on the date that is four years after the date of
the enactment of the Veterans Health Care Freedom Act--
``(i) the requirement under subparagraph (A) and (C) that
care or services may only be furnished under this section to
covered individuals when such care or services are not feasibly
available to the covered individual from a facility of the
Department or through a contract or sharing agreement entered
into pursuant to a provision of law other than this section
shall not apply with respect to furnishing hospital care,
medical services, and extended care services to a covered
individual under this section; and
``(ii) the Secretary shall furnish hospital care, medical
services, and extended care services to a covered individual
under this section with the same conditions on the ability of
the individual to choose health care providers as specified in
the pilot program described in section 2 of such Act.''.
(C) VISNs.--Beginning on the date that is four
years after the date of the enactment of this Act, the
Secretary shall furnish hospital care, medical
services, and extended care services to veterans under
chapter 17 of title 38, United States Code, at medical
facilities of the Department of Veterans Affairs,
regardless of whether the facility is in the same
Veterans Integrated Service Network as the Network in
which the veteran resides.
(i) Reports.--
(1) Implementation.--
(A) In general.--On a quarterly basis during the
two-year period beginning on the date of the enactment
of this Act, the Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of
Representatives a report on the implementation of the
pilot program.
(B) Final design.--One of the reports required
under subparagraph (A) shall contain a description of
the final design of the pilot program.
(2) Annual.--On an annual basis during the period beginning
on the date that is one year after the date of the submission
of the final report under paragraph (1) and ending on the date
of the conclusion of the pilot program, the Secretary shall
submit to the Committee on Veterans' Affairs of the Senate and
the Committee on Veterans' Affairs of the House of
Representatives a report on the results of the pilot program.
(j) Regulations.--The Secretary, in consultation with the Committee
on Veterans' Affairs of the Senate and the Committee on Veterans'
Affairs of the House of Representatives, may prescribe regulations to
carry out this section.
(k) No Additional Appropriations.--No additional funds are
authorized to be appropriated to carry out this section and the
amendments made by this section, and this section and the amendments
made by this section shall be carried out using amounts otherwise made
available to the Veterans Health Administration.
(l) Definitions.--In this section:
(1) Covered care system.--The term ``covered care system''
means each--
(A) medical facility of the Department;
(B) health care provider specified in subsection
1703(c) of title 38, United States Code; and
(C) eligible entity or provider that has entered
into a Veterans Care Agreement under section 1703A of
such title.
(2) Eligible veteran.--The term ``eligible veteran'' means
a veteran who is enrolled in the patient enrollment system of
the Department of Veterans Affairs under section 1705 of title
38, United States Code.
(3) Hospital care; medical services; non-department
facilities.--The terms ``hospital care'', ``medical services'',
and ``non-Department facilities'' have the meanings given those
terms in section 1701 of title 38, United States Code.
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