[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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