[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 2649 Introduced in Senate (IS)]

<DOC>






118th CONGRESS
  1st Session
                                S. 2649

   To improve community care provided by the Department of Veterans 
                    Affairs, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 27, 2023

  Mr. Tester introduced the following bill; which was read twice and 
             referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
   To improve community care provided by the Department of Veterans 
                    Affairs, 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 ``Making Community 
Care Work for Veterans Act of 2023''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
                TITLE I--IMPROVEMENTS TO COMMUNITY CARE

Sec. 101. Requirement that appointments for care or services under 
                            Community Care Program of Department of 
                            Veterans Affairs are timely scheduled.
Sec. 102. Modifications to access standards for care furnished through 
                            Community Care Program of Department of 
                            Veterans Affairs.
Sec. 103. Consideration of telehealth in determining whether an 
                            appointment can be scheduled within the 
                            access standards of the Department of 
                            Veterans Affairs.
Sec. 104. Finality of decision by veteran and veteran's referring 
                            clinician.
Sec. 105. Benefits for persons disabled by treatment under Community 
                            Care Program of Department of Veterans 
                            Affairs.
Sec. 106. Extension of period for submittal of claims by health care 
                            entities and providers.
Sec. 107. Program on self-referral of veterans for certain services 
                            under Veterans Community Care Program.
Sec. 108. Report on referrals for non-Department of Veterans Affairs 
                            health care.
Sec. 109. Requirement that health care providers under Community Care 
                            Program of Department of Veterans Affairs 
                            provide certain data.
Sec. 110. High-compliance rating program for providers under Veterans 
                            Community Care Program of Department of 
                            Veterans Affairs.
Sec. 111. Adoption of national interoperability standards between 
                            Department of Veterans Affairs and 
                            community care providers.
Sec. 112. Analysis of feasibility and advisability of establishing a 
                            community care network for the provision of 
                            care to veterans in the Republic of the 
                            Philippines.
Sec. 113. Pilot program on consolidating the community care dental 
                            treatment plan approval process of 
                            Department of Veterans Affairs.
Sec. 114. Reviews of payment rate waivers under Veterans Community Care 
                            Program.
Sec. 115. Comptroller General report on dentistry under Veterans 
                            Community Care Program.
                    TITLE II--HEALTH CARE EMPLOYEES

Sec. 201. Establishment of Start and Stay at VA program.
Sec. 202. Expansion of period of payment under Employee Incentive 
                            Scholarship Program.
Sec. 203. Mentorship program for executive leadership teams at medical 
                            centers of the Department of Veterans 
                            Affairs.
                  TITLE III--OTHER HEALTH CARE MATTERS

Sec. 301. Timing for scheduling of appointments at facilities of 
                            Department of Veterans Affairs.
Sec. 302. Modification of requirements for standards for quality of 
                            care from Department of Veterans Affairs.
Sec. 303. Mental Health Residential Rehabilitation Treatment Program of 
                            the Department of Veterans Affairs.
Sec. 304. Electronic document submission option for the CHAMPVA 
                            program.
Sec. 305. Review of workflows associated with processing referrals 
                            between facilities of the Veterans Health 
                            Administration.

                TITLE I--IMPROVEMENTS TO COMMUNITY CARE

SEC. 101. REQUIREMENT THAT APPOINTMENTS FOR CARE OR SERVICES UNDER 
              COMMUNITY CARE PROGRAM OF DEPARTMENT OF VETERANS AFFAIRS 
              ARE TIMELY SCHEDULED.

    (a) In General.--Section 1703 of title 38, United States Code, is 
amended--
            (1) by redesignating subsections (m), (n), and (o) as 
        subsections (n), (o), and (p), respectively; and
            (2) by inserting after subsection (l) the following new 
        subsection (m):
    ``(m) Scheduling of Appointments.--(1) The Secretary shall ensure 
that an appointment for a covered veteran for care or services under 
this section--
            ``(A) in the case of a non-urgent appointment, is scheduled 
        (but may occur at a later date) not later than seven days after 
        the earlier of the date on which--
                    ``(i) a clinician of the Department determines that 
                the veteran requires care; or
                    ``(ii) the veteran presents to the Department 
                requesting care; and
            ``(B) in the case of an appointment for urgent care, is 
        completed not later than 48 hours after the earlier of the date 
        on which--
                    ``(i) a clinician of the Department determines that 
                the veteran requires care; or
                    ``(ii) the veteran presents to the Department 
                requesting care.
    ``(2) Not less frequently than quarterly, 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 average time it takes each medical facility of the Department to 
schedule appointments for care or services under this section, broken 
out by primary care, mental health care, and each type of specialty 
care.
    ``(3)(A) Each medical facility of the Department for which any 
average time reported under paragraph (2) is more than seven days shall 
submit to the Under Secretary for Health, not later than 30 days after 
the date of the report--
            ``(i) an explanation for why such average time is more than 
        seven days, which may include staffing shortages, insufficient 
        network, surge of appointments, and any other factor increasing 
        such average time;
            ``(ii) a remediation plan to bring such average time to not 
        more than seven days; and
            ``(iii) an explanation for how each issue specified in 
        clause (i) is being mitigated.
    ``(B) With respect to any explanation under subparagraph (A)(i) 
that specifies insufficient network, the Under Secretary for Health 
shall--
            ``(i) consult with any third party administrator 
        responsible for administering such network on how network 
        insufficiency can be overcome; and
            ``(ii) examine whether the third party administrator is 
        meeting contractual obligations.''.
    (b) Effective Date.--The Secretary of Veterans Affairs shall comply 
with the requirements under section 1703(m)(1) of title 38, United 
States Code, as added by subsection (a)(2), by not later than 180 days 
after the date of the enactment of this Act.

SEC. 102. MODIFICATIONS TO ACCESS STANDARDS FOR CARE FURNISHED THROUGH 
              COMMUNITY CARE PROGRAM OF DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--Section 1703B of title 38, United States Code, is 
amended--
            (1) by striking subsections (a) through (d) and inserting 
        the following:
    ``(a) Threshold Eligibility Standards for Access to Community 
Care.--A covered veteran shall be eligible to elect to receive, 
pursuant to subsection (d)(3) of section 1703 of this title, non-
Department hospital care, medical services, or extended care services 
under such section pursuant to subsection (d)(1)(D) of such section 
using the following eligibility standards for access to community care:
            ``(1) With respect to primary care, mental health care, or 
        non-institutional extended care services, if the Secretary 
        cannot schedule an appointment for the covered veteran with a 
        health care provider of the Department--
                    ``(A) not more than 30 minutes average driving time 
                from the residence of the veteran; and
                    ``(B) not later than 20 days from 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, to the first next available 
                appointment date relevant to the requested medical 
                service.
            ``(2) With respect to specialty care or specialty services, 
        if the Secretary cannot schedule an appointment for the covered 
        veteran with a health care provider of the Department--
                    ``(A) not more than 60 minutes average driving time 
                from the residence of the veteran; and
                    ``(B) not later than 28 days from 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, to the first next available 
                appointment date relevant to the requested medical 
                service.'';
            (2) by redesignating subsections (e), (f), (g), (h), and 
        (i) as subsections (b), (c), (d), (e), and (f), respectively;
            (3) in subsection (b), as redesignated by paragraph (2)--
                    (A) in the matter preceding paragraph (1), by 
                striking ``Not later than 3 years after the date on 
                which the Secretary establishes access standards under 
                subsection (a) and not less frequently than once every 
                3 years thereafter'' and inserting ``Review and 
                Report.--Not less frequently than once every three 
                years'';
                    (B) in paragraph (1), by striking ``such 
                standards'' and inserting ``the eligibility standards 
                for access to community care under subsection (a)''; 
                and
                    (C) in paragraph (2), by striking ``and any 
                modification to the access standards with respect to 
                the review conducted under paragraph (1)'' and 
                inserting ``of such review and such recommendations as 
                the Secretary may have with respect to such eligibility 
                standards'';
            (4) in subsection (c), as so redesignated--
                    (A) in paragraph (1)--
                            (i) by striking ``(1) Subject to paragraph 
                        (3)'' and inserting ``Requirement To Meet 
                        Standards.--(1) Subject to paragraphs (3) and 
                        (4)''; and
                            (ii) by inserting ``and health care 
                        providers specified under section 1703(c) of 
                        this title'' before the period at the end;
                    (B) in paragraph (2), by striking ``The Secretary'' 
                and inserting ``Subject to paragraphs (3) and (4), the 
                Secretary''; and
                    (C) by adding at the end the following new 
                paragraph:
    ``(4)(A) A health care provider specified under section 1703(c) of 
this title that is furnishing care pursuant to a contract, agreement, 
or other arrangement between such provider and the Secretary may 
request a waiver to the requirement under this subsection to meet the 
access standards established under subsection (a).
    ``(B) Any waiver requested by a health care provider under 
subparagraph (A) must be requested in writing and submitted to the 
Secretary for approval.
    ``(C) In evaluating a waiver request by a health care provider 
under subparagraph (A), the Secretary shall consider the factors 
specified under paragraph (3)(D) that are relevant to the health care 
provider.'';
            (5) in subsection (d)(1), as so redesignated, by striking 
        ``(1) The Secretary'' and inserting ``Publication.--(1) The 
        Secretary'';
            (6) in subsection (e)(1), as so redesignated, by striking 
        ``(1) Consistent with'' and inserting ``Determination Regarding 
        Eligibility.--(1) Consistent with''; and
            (7) in subsection (f), as so redesignated, by striking ``In 
        this section'' and inserting ``Definitions.--In this section''.
    (b) Conforming Amendments.--Section 1703(d) of such title is 
amended--
            (1) in paragraph (1)(D), by striking ``developed by the 
        Secretary''; and
            (2) in paragraph (3), by striking ``developed by the 
        Secretary''.

SEC. 103. CONSIDERATION OF TELEHEALTH IN DETERMINING WHETHER AN 
              APPOINTMENT CAN BE SCHEDULED WITHIN THE ACCESS STANDARDS 
              OF THE DEPARTMENT OF VETERANS AFFAIRS.

    Section 1703(d) of title 38, United States Code, is amended by 
adding at the end the following new paragraph:
    ``(4) In determining under paragraph (1)(D) whether the Department 
is able to furnish care or services in a manner that complies with the 
access standards established under section 1703B(a) of this title, for 
purposes of determining the availability of an appointment, a 
telehealth appointment will only be considered as an available 
appointment if the veteran accepts the use of telehealth by the 
Department.''.

SEC. 104. FINALITY OF DECISION BY VETERAN AND VETERAN'S REFERRING 
              CLINICIAN.

    Section 1703(d) of title 38, United States Code, as amended by 
section 103, is further amended by adding at the end the following new 
paragraph:
    ``(5)(A) Subject to subparagraph (B), an agreement by a covered 
veteran and the covered veteran's referring clinician under paragraph 
(1)(E) regarding the best medical interest of the covered veteran is 
final and is not subject to review or approval by the Department.
    ``(B) A covered veteran and the covered veteran's referring 
clinician may correct any errors made with respect to an agreement 
described in subparagraph (A).''.

SEC. 105. BENEFITS FOR PERSONS DISABLED BY TREATMENT UNDER COMMUNITY 
              CARE PROGRAM OF DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--Subsection (a) of section 1151 of title 38, United 
States Code, is amended--
            (1) by redesignating paragraph (2) as paragraph (3);
            (2) in paragraph (1)(B), by striking ``or'' at the end; and
            (3) by inserting after paragraph (1) the following new 
        paragraph (2):
            ``(2) the disability or death was caused by hospital care, 
        a medical service, or an extended care service furnished the 
        veteran by a non-Department provider under section 1703 of this 
        title and the proximate cause of the disability or death was--
                    ``(A) carelessness, negligence, lack of proper 
                skill, error in judgment, or similar instance of fault 
                on the part of the provider in furnishing the hospital 
                care, medical service, or extended care service; or
                    ``(B) an event not reasonably foreseeable; or''.
    (b) Offset of Awards.--Such section is amended by adding at the end 
the following new subsection:
    ``(d) The amount of any judgment awarded to an individual in a 
civil action brought by the individual against a non-Department 
provider in a court of competent jurisdiction for a disability or death 
caused by hospital care, a medical service, or an extended care service 
furnished by a non-Department provider as described in subsection 
(a)(2) shall be offset by the amount of any compensation awarded to the 
individual under such subsection for such disability or death.''.

SEC. 106. EXTENSION OF PERIOD FOR SUBMITTAL OF CLAIMS BY HEALTH CARE 
              ENTITIES AND PROVIDERS.

    Section 1703D(b) of title 38, United States Code, is amended by 
striking ``180 days'' and inserting ``one year''.

SEC. 107. PROGRAM ON SELF-REFERRAL OF VETERANS FOR CERTAIN SERVICES 
              UNDER VETERANS COMMUNITY CARE PROGRAM.

    (a) In General.--The Secretary of Veterans Affairs shall carry out 
a program (in this section referred to as the ``Program'') under which 
the Secretary may furnish outpatient services specified in subsection 
(b) through a health care provider specified in section 1703(c) of 
title 38, United States Code, to a covered veteran who--
            (1) is eligible for such services under criteria to be 
        established by the Secretary; and
            (2) chooses to self-refer for such services.
    (b) Outpatient Services Specified.--The outpatient services 
specified in this subsection are the following:
            (1) Vaccinations.
            (2) Vision and hearing services.
    (c) Conditions Under Which Services Are Provided.--The Secretary 
shall provide services under the Program under the same conditions as 
such services would be required to be provided under section 1703(d) of 
title 38, United States Code.
    (d) Report on Program.--
            (1) In general.--Not later than two years after the date of 
        the enactment of this Act, and annually thereafter, the 
        Secretary shall submit to Congress a report on the Program.
            (2) Elements.--Each report required under paragraph (1) 
        shall include, for the one-year period preceding the date of 
        the report--
                    (A) the number of self-referrals made under the 
                Program, disaggregated by type of services sought;
                    (B) an assessment of the timeliness of appointments 
                made under the Program as compared with the timeliness 
                of other appointments made for the same service;
                    (C) an assessment of satisfaction of veterans with 
                the Program;
                    (D) an assessment of the impact of the Program on 
                the health of patients receiving services under the 
                Program; and
                    (E) such recommendations as the Secretary may have 
                for services to be added or removed from the Program.
    (e) Effective Date.--This section shall take effect on the date 
that is one year after the date of the enactment of this Act.
    (f) Covered Veteran Defined.--In this section, the term ``covered 
veteran'' means a veteran described in section 1703(b) of title 38, 
United States Code.

SEC. 108. REPORT ON REFERRALS FOR NON-DEPARTMENT OF VETERANS AFFAIRS 
              HEALTH CARE.

    Not later than 180 days after the date of the enactment of this 
Act, and not less frequently than monthly thereafter, the Secretary of 
Veterans Affairs shall submit to the Committee on Veterans' Affairs of 
the Senate and the Committee on Veterans' Affairs of the House of 
Representatives a report containing, with respect to referrals for non-
Department of Veterans Affairs health care originating from medical 
facilities of the Department during the one-month period preceding the 
date of the report, a measurement of, for each such facility of the 
Department--
            (1) the period of time between--
                    (A) the date that a clinician of the Department 
                determines that a veteran requires care, or a veteran 
                presents to the Department requesting care, and the 
                date that the referral for care is sent to a non-
                Department health care provider;
                    (B) the date that the referral for care is sent to 
                a non-Department health care provider and the date that 
                a non-Department health care provider accepts the 
                referral;
                    (C) the date that a non-Department health care 
                provider accepts the referral and the date that the 
                referral to a non-Department health care provider is 
                completed;
                    (D) the date that the referral to a non-Department 
                health care provider is completed and the date that an 
                appointment with a non-Department health care provider 
                is made; and
                    (E) the date that an appointment with a non-
                Department health care provider is made and the date 
                that an appointment with a non-Department health care 
                provider occurs; and
            (2) any other period of time that the Secretary determines 
        necessary to measure.

SEC. 109. REQUIREMENT THAT HEALTH CARE PROVIDERS UNDER COMMUNITY CARE 
              PROGRAM OF DEPARTMENT OF VETERANS AFFAIRS PROVIDE CERTAIN 
              DATA.

    (a) In General.--Beginning not later than one year after the date 
of the enactment of this Act, the Secretary of Veterans Affairs shall 
require that covered providers submit to the Secretary, at such time 
and in such manner as the Secretary may require, data required to be 
collected and considered by the Secretary under section 1703C(a)(3) of 
title 38, United States Code.
    (b) Exclusion of Covered Providers.--The Secretary may not permit a 
covered provider to participate in the Veterans Community Care Program 
under section 1703 of title 38, United States Code, if the provider has 
not provided to the Secretary data required under subsection (a).
    (c) Other Providers.--The Secretary shall encourage health care 
providers specified in section 1703(c) of title 38, United States Code, 
that are not covered providers to submit to the Secretary, on a 
voluntary basis, data described in subsection (a).
    (d) Type of Data Required and Waiver.--
            (1) Type of data.--The Secretary shall determine the data 
        required to be submitted by each type of covered provider under 
        subsection (a).
            (2) Waiver.--The Secretary may waive the requirement to 
        submit data under subsection (a) for a particular type of 
        covered provider if the Secretary determines that the submittal 
        by that type of provider of such data would--
                    (A) not be appropriate or relevant; or
                    (B) constitute too heavy of a burden on the 
                provider.
    (e) List of High-Performing Providers.--The Secretary shall publish 
and maintain on a website of the Department of Veterans Affairs that is 
available to the public an up-to-date list of all health care providers 
that--
            (1) have provided data described in subsection (a); and
            (2) are high-performing providers, as determined by the 
        Secretary.
    (f) Covered Provider Defined.--In this section, the term ``covered 
provider'' means a health care provider specified in section 1703(c) of 
title 38, United States Code, that the Secretary determines has 
sufficient resources to submit the data required under subsection (a) 
at the time and in the manner required by the Secretary under such 
subsection.

SEC. 110. HIGH-COMPLIANCE RATING PROGRAM FOR PROVIDERS UNDER VETERANS 
              COMMUNITY CARE PROGRAM OF DEPARTMENT OF VETERANS AFFAIRS.

    (a) Program.--The Secretary of Veterans Affairs shall establish a 
program under which the Secretary provides a rating of ``High 
Compliance'' for community care providers that comply with the 
qualifications under subsection (b).
    (b) Provider Qualifications.--The Secretary shall provide a 
community care provider with a rating of ``High Compliance'' pursuant 
to the program established under subsection (a) if the provider--
            (1) completes certain continuing medical education courses 
        provided by the VHA TRAIN program or related to the Opioid 
        Safety Initiative, as determined by the Secretary;
            (2) sends to the specific authorizing office or designated 
        Community Care Program office of the Veterans Health 
        Administration the complete medical records and all required 
        treatment documentation, as identified by the Secretary, of not 
        less than 95 percent of the veterans treated by the provider 
        under the Veterans Community Care Program under section 1703 of 
        title 38, United States Code, not later than 15 days after the 
        completion of treatment of such veterans; and
            (3) complies with such other criteria as the Secretary may 
        determine appropriate.
    (c) Financial Incentive.--The Secretary may provide a financial 
incentive for community care providers with a ``High Compliance'' 
rating.
    (d) Program Promotion.--The Secretary shall establish a plan to 
promote the program established under subsection (a) and encourage the 
participation of community care providers in such program.
    (e) Publication of List.--
            (1) Initial publication.--The Secretary shall publish on a 
        publicly available website of the Veterans Health 
        Administration a list of community care providers that earn a 
        ``High Compliance'' rating pursuant to the program established 
        under subsection (a).
            (2) Update.--The Secretary shall update the list required 
        under paragraph (1) not less frequently than weekly.
    (f) Report.--Not later than one year after the establishment of the 
program 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 on the program, including--
            (1) the courses under the VHA TRAIN program or the Opioid 
        Safety Initiative determined by the Secretary for purposes of 
        subsection (b)(1); and
            (2) the status of the plans of the Secretary for promotion 
        under subsection (c) of the program established under 
        subsection (a).
    (g) Definitions.--In this section:
            (1) Community care provider.--The term ``community care 
        provider'' means a health care provider specified in subsection 
        (c) of section 1703 of title 38, United States Code, that is 
        participating in the Veterans Community Care Program under such 
        section.
            (2) Opioid safety initiative.--The term ``Opioid Safety 
        Initiative'' means programs, processes, and guidelines of the 
        Veterans Health Administration related to the management of 
        opioid therapy and chronic pain.
            (3) VHA train program.--The term ``VHA TRAIN program'' 
        means the free program of the Veterans Health Administration 
        that offers veteran-specific continuing medical education 
        courses, or successor similar program.

SEC. 111. ADOPTION OF NATIONAL INTEROPERABILITY STANDARDS BETWEEN 
              DEPARTMENT OF VETERANS AFFAIRS AND COMMUNITY CARE 
              PROVIDERS.

    (a) In General.--The Secretary of Veterans Affairs, in consultation 
with the Secretary of Health and Human Services, the Administrator of 
the Centers for Medicare & Medicaid Services, and the National 
Coordinator for Health Information Technology, shall create and 
implement a plan for the Department of Veterans Affairs to adopt 
national interoperability standards for the electronic coordination of 
care and transfer of health information (including information relating 
to dental health) between the Department and community care providers 
for the purposes of health care scheduling, provisioning, coordination, 
and quality assessment.
    (b) Exceptions and Accommodations for Providers With Fewer 
Patients.--The plan required to be created and implemented under 
subsection (a) shall include appropriate exceptions and accommodations 
for community care providers, especially providers in rural areas and 
smaller providers, who see fewer patients under the laws administered 
by the Secretary of Veterans Affairs and who have not adopted 
electronic health records to ensure those providers have the option to 
share health information with the Department of Veterans Affairs via 
non-electronic methods.
    (c) Reports.--
            (1) Report on plan.--Not later than one year after the date 
        of the enactment of this Act, the Secretary of Veterans Affairs 
        shall submit to Congress a report on the plan required under 
        subsection (a), which shall include--
                    (A) a gap analysis between current interoperability 
                standards in use between the Department of Veterans 
                Affairs and community care providers and opportunities 
                and advancements in care delivery and coordination and 
                related matters using available current standards and 
                standards under development within the Federal and non-
                Federal health care sector, including an analysis of 
                participation by the Department and community care 
                providers in the Trusted Exchange Framework and Common 
                Agreement;
                    (B) recommendations for further development of 
                interoperability standards;
                    (C) a proposed timeline for adopting 
                interoperability standards under such plan by both the 
                Department and community care providers; and
                    (D) an indication of any resources or legislative 
                authorities the Secretary may request from Congress to 
                develop and implement adoption of interoperability 
                standards under such plan.
            (2) Report on implementation.--Not later than 18 months 
        after the date of the enactment of this Act, and every 180 days 
        thereafter until the date that is four years after the date of 
        the enactment of this Act, the Secretary shall submit to 
        Congress a report on the implementation and revision of the 
        plan required under subsection (a), which shall include--
                    (A) updates on current gaps in interoperability 
                standards in use between the Department and community 
                care providers and recommendations for further 
                development of such standards; and
                    (B) updates on implementation of the plan and 
                adoption of the plan by community care providers and 
                the Department.
    (d) Community Care Provider Defined.--In this section, the term 
``community care provider'' means a non-Department health care provider 
providing care (including dental care)--
            (1) under section 1703 of title 38, United States Code;
            (2) pursuant to a Veterans Care Agreement under section 
        1703A of such title; or
            (3) under any other law administered by the Secretary.

SEC. 112. ANALYSIS OF FEASIBILITY AND ADVISABILITY OF ESTABLISHING A 
              COMMUNITY CARE NETWORK FOR THE PROVISION OF CARE TO 
              VETERANS IN THE REPUBLIC OF THE PHILIPPINES.

    (a) In General.--Not later than one year after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall complete 
an analysis of the feasibility and advisability of establishing a 
community care network for the provision of care to veterans in the 
Republic of the Philippines.
    (b) Report.--Not later than 180 days after the completion of the 
analysis conducted 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 a report that 
includes the following:
            (1) The results of such analysis.
            (2) An assessment of the number of veterans residing in the 
        Republic of the Philippines who are eligible for the Foreign 
        Medical Program.
            (3) An assessment of the staffing needs and associated 
        costs of establishing a community care network in the Republic 
        of the Philippines.
            (4) An assessment of the infrastructure needs and 
        associated costs of establishing a community care network in 
        the Republic of the Philippines.
            (5) An assessment of the challenges of establishing a 
        community care network in the Republic of the Philippines.
            (6) An assessment of how the Secretary would determine 
        payment rates for providers participating in a community care 
        network in the Republic of the Philippines to account for 
        variances in medical costs in the Republic of the Philippines.
            (7) An assessment of the impact of a community care network 
        in the Republic of the Philippines on the timeliness of 
        reimbursement of providers under the Foreign Medical Program.
            (8) Such other elements as the Secretary considers 
        appropriate.
    (c) Foreign Medical Program Defined.--In this section, the term 
``Foreign Medical Program'' means the program under which the Secretary 
of Veterans Affairs provides hospital care and medical services under 
section 1724 of title 38, United States Code.

SEC. 113. PILOT PROGRAM ON CONSOLIDATING THE COMMUNITY CARE DENTAL 
              TREATMENT PLAN APPROVAL PROCESS OF DEPARTMENT OF VETERANS 
              AFFAIRS.

    (a) In General.--Commencing not later than 180 days after the date 
of the enactment of this Act, the Secretary of Veterans Affairs shall 
carry out a two-year pilot program (in this section referred to as the 
pilot program) to test the efficacy of--
            (1) hiring general dentists at the facility level to manage 
        approval by the Department of Veterans Affairs of treatment 
        plans requested by dental providers in providing community 
        care; and
            (2) hiring dental specialists at the Veterans Integrated 
        Service Network level to aid in approving treatment plans for 
        specialty dental care requested by dental providers in 
        providing community care.
    (b) Locations.--The Secretary shall select not fewer than two 
Veterans Integrated Service Networks of the Department at which to 
carry out the pilot program.
    (c) Reports.--
            (1) Initial report.--Not later than one year after the 
        commencement 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 pilot program, including--
                    (A) an identification of the Veterans Integrated 
                Service Networks participating in the pilot program;
                    (B) a description of the implementation of the 
                pilot program;
                    (C) an identification of any barriers or challenges 
                to implementing the pilot program;
                    (D) aggregated feedback with respect to the pilot 
                program from dentists of the Department in Veterans 
                Integrated Service Networks participating in the pilot 
                program; and
                    (E) aggregated feedback from dental providers 
                providing community care within Veterans Integrated 
                Service Networks participating in the pilot program 
                regarding any changes in the timeliness of treatment 
                plan approvals by the Department.
            (2) Final report.--Not later than 90 days before the 
        completion 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 pilot program that--
                    (A) includes the matters required under paragraph 
                (1);
                    (B) includes recommendations on whether the pilot 
                program should be continued or adopted throughout the 
                Department; and
                    (C) indicates whether the Secretary requests action 
                by Congress to make the pilot program permanent.
    (d) Community Care Defined.--In this section, the term ``community 
care'' means dental care provided--
            (1) under section 1703 of title 38, United States Code; or
            (2) pursuant to a Veterans Care Agreement under section 
        1703A of such title.

SEC. 114. REVIEWS OF PAYMENT RATE WAIVERS UNDER VETERANS COMMUNITY CARE 
              PROGRAM.

    (a) In General.--Not later than 180 days after the date of the 
enactment of this Act, and annually thereafter, the Secretary of 
Veterans Affairs shall--
            (1) conduct a review of payment rate waivers for third 
        party administrators under the Veterans Community Care Program 
        under section 1703 of title 38, United States Code, to identify 
        whether those waivers are helping to alleviate community-
        specific challenges, including scarcity of medical services 
        associated with access to care; and
            (2) submit to Congress a report on the results of the 
        review.
    (b) Inclusion in Rate Review.--Each review required under 
subsection (a) shall include--
            (1) a review of the total number of payment rate waivers 
        requested for each region, including the number granted, 
        denied, or withdrawn;
            (2) the process for review of payment rate waivers;
            (3) the average time to process payment rate waivers in 
        each region;
            (4) the impact of payment rate waivers granted in a region 
        on access to care in that region; and
            (5) trends identified by the Secretary with respect to 
        payment rate waivers.

SEC. 115. COMPTROLLER GENERAL REPORT ON DENTISTRY UNDER VETERANS 
              COMMUNITY CARE PROGRAM.

    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 dental 
care furnished by the Secretary of Veterans Affairs under the Veterans 
Community Care Program under section 1703 of title 38, United States 
Code, to include a review of--
            (1) the impact current reimbursement rates provided by the 
        Department of Veterans Affairs to dental providers under such 
        program have on--
                    (A) the availability of dental care for veterans; 
                and
                    (B) the ability of third party administrators of 
                provider networks under such program to meet their 
                contractual obligations for network adequacy;
            (2) the satisfaction of dental providers providing dental 
        care under such program with the processes of the Department 
        for approving dental care under such program; and
            (3) the current processes of the Department for approving 
        emergent dental care under such program.

                    TITLE II--HEALTH CARE EMPLOYEES

SEC. 201. ESTABLISHMENT OF START AND STAY AT VA PROGRAM.

    (a) In General.--Chapter 76 of title 38, United States Code, is 
amended by adding at the end the following new subchapter:

              ``Subchapter X--Start and Stay at VA Program

``Sec. 7699C. Start and Stay at VA Program
    ``(a) In General.--As part of the Educational Assistance Program, 
the Secretary shall carry out a program under this subchapter to 
provide--
            ``(1) scholarships under section 7699C-1 of this title; and
            ``(2) lump sum education debt reduction under section 
        7699C-2 of this title.
    ``(b) Name of Program.--The program under this subchapter shall be 
known as the Start and Stay at VA Program (in this subchapter referred 
to as the `Program').
``Sec. 7699C-1. Scholarships
    ``(a) Covered Costs.--A scholarship provided to an individual under 
the Program shall consist of payment of reasonable education expenses 
of the individual for a course of education or training described in 
subsection (b)(3), including tuition, fees, books, and laboratory 
expenses.
    ``(b) Eligibility.--An individual is eligible to receive a 
scholarship under the Program if the individual--
            ``(1) is an employee of the Department serving as a medical 
        support assistant, advanced medical support assistant, lead 
        medical support assistant, or supervisory medical support 
        assistant;
            ``(2) as of the date on which the individual submits an 
        application for participation in the Program, has been 
        continuously employed by the Department in one or more of the 
        positions specified in paragraph (1) for a period of not less 
        than two years;
            ``(3) has been accepted for enrollment or is enrolled as a 
        student in a course of education or training--
                    ``(A) listed as a requirement for any shortage 
                occupation position, as determined by the Secretary;
                    ``(B) related to business, health care 
                administration, or human resources; or
                    ``(C) completion of which results in any other 
                degree or certification that the Secretary considers 
                appropriate for purposes of the Program; and
            ``(4) has a record of employment with the Department that, 
        in the judgment of the Secretary, demonstrates a high 
        likelihood that the individual will be successful in completing 
        such course of education or training and in gaining employment 
        in a field related to such course of education or training.
    ``(c) Period of Obligated Service.--
            ``(1) Agreement.--
                    ``(A) In general.--An agreement between the 
                Secretary and a participant under the Program who seeks 
                a scholarship under this section, in addition to the 
                requirements set forth in section 7604 of this title, 
                shall include the following:
                            ``(i) The agreement of the Secretary to 
                        provide the participant with a scholarship 
                        under the Program for a specified number of 
                        school years, which may not exceed the credit 
                        equivalent of four full school years, during 
                        which the participant pursues a course of 
                        education or training described in subsection 
                        (b)(3) that meets the requirements set forth in 
                        section 7602(a) of this title.
                            ``(ii) Subject to subparagraph (B), the 
                        agreement of the participant to serve as a 
                        full-time employee in the Department in a 
                        position described in subsection (b)(3)(A) for 
                        a period of time, not less than one year, that 
                        is equal to the period of the course of 
                        education or training for which a scholarship 
                        is provided under this section (in this section 
                        referred to as the `period of obligated 
                        service' of the participant).
                    ``(B) Part-time students.--In the case of a 
                participant who is a part-time student during a school 
                year with respect to which a scholarship is provided to 
                the participant under this section, the period of 
                obligated service of the participant incurred during 
                that school year shall be reduced in accordance with 
                the proportion that the number of credit hours carried 
                by the participant in that school year bears to the 
                number of credit hours required to be carried by a 
                full-time student in the course of education or 
                training pursued by the participant during that school 
                year, but in no event may the total period of obligated 
                service of the participant be reduced to less than one 
                year.
            ``(2) Service commencement date.--
                    ``(A) In general.--Except as provided in 
                subparagraph (F) of (G), not later than 60 days before 
                the service commencement date of a participant under 
                this section, the Secretary shall notify the 
                participant of that service commencement date. That 
                date is the beginning of the period of obligated 
                service of the participant.
                    ``(B) Doctors and similar health care 
                professionals.--In the case of a participant receiving 
                a degree from a school of medicine, osteopathy, 
                dentistry, optometry, or podiatry, the service 
                commencement date of the participant is the date the 
                participant becomes licensed to practice medicine, 
                osteopathy, dentistry, optometry, or podiatry, as the 
                case may be, in a State.
                    ``(C) Nurses.--In the case of a participant 
                receiving a degree from a school of nursing, the 
                service commencement date of the participant is the 
                later of--
                            ``(i) the course completion date of the 
                        participant; or
                            ``(ii) the date the participant becomes 
                        licensed as a registered nurse in a State.
                    ``(D) Other health care professionals.--In the case 
                of a participant not covered by subparagraph (B) or 
                (C), the service commencement date of the participant 
                is the later of--
                            ``(i) the course completion date of the 
                        participant; or
                            ``(ii) the date the participant meets any 
                        applicable licensure or certification 
                        requirements.
                    ``(E) Treatment of part-time students.--The 
                Secretary shall specify the service commencement date 
                for participants who were part-time students, which 
                shall include terms as similar as practicable to the 
                terms set forth in subparagraphs (B) through (D).
                    ``(F) Service during course of education or 
                training.--A participant may serve the period of 
                obligated service of the participant, or any portion of 
                such period of obligated service, during the period in 
                which the participant is enrolled as a student in a 
                course of education or training under subsection (b)(3) 
                if the participant is employed in a position described 
                in subparagraph (A) of such subsection.
                    ``(G) Service following licensure or ongoing 
                training.--With respect to a participant who is 
                licensed but may enter a residency or similar training 
                program, the Secretary may adjust the beginning of the 
                period of obligated service of the participant to begin 
                following completion of the residency or similar 
                training program.
                    ``(H) Course completion date defined.--In this 
                section, the term `course completion date' means the 
                date on which a participant under this section 
                completes the course of education or training of the 
                participant under this section.
    ``(d) Liability for Breach of Agreement.--
            ``(1) Liability during course of education or training.--
                    ``(A) In general.--Except as provided in paragraph 
                (3), a participant under this section shall be liable 
                to the United States for the amount that has been paid 
                to or on behalf of the participant under the agreement 
                under subsection (c)(1) if any of the following occurs:
                            ``(i) The participant fails to maintain an 
                        acceptable level of academic standing in the 
                        educational institution in which the 
                        participant is enrolled (as determined by the 
                        educational institution pursuant to direction 
                        by the Secretary).
                            ``(ii) The participant is dismissed from 
                        such educational institution for disciplinary 
                        reasons.
                            ``(iii) The participant voluntarily 
                        terminates the course of education or training 
                        in such educational institution before the 
                        completion of such course of education or 
                        training.
                            ``(iv) The participant, as applicable, 
                        during a period of time determined by the 
                        Secretary--
                                    ``(I) fails to become licensed to 
                                practice medicine, osteopathy, 
                                dentistry, podiatry, or optometry in a 
                                State;
                                    ``(II) fails to become licensed as 
                                a registered nurse in a State; or
                                    ``(III) in the case of any other 
                                health-care personnel who is not 
                                covered under subclause (I) or (II), 
                                fails to meet any applicable licensure 
                                or certification requirement.
                    ``(B) In lieu of service obligation.--Liability 
                under this paragraph is in lieu of any period of 
                obligated service arising under the agreement of the 
                participant under subsection (c)(1).
            ``(2) Liability during period of obligated service.--Except 
        as provided in paragraph (3), if a participant under this 
        section breaches the agreement under subsection (c)(1) by 
        failing for any reason to complete the period of obligated 
        service of the participant, the United States shall be entitled 
        to recover from the participant an amount equal to--
                    ``(A) the total amount paid under this section to 
                the participant; multiplied by
                    ``(B) a fraction--
                            ``(i) the numerator of which is--
                                    ``(I) the total number of months in 
                                the period of obligated service of the 
                                participant; minus
                                    ``(II) the number of months served 
                                by the participant; and
                            ``(ii) the denominator of which is the 
                        total number of months in the period of 
                        obligated service of the participant.
            ``(3) Limitation on liability for reduction in force.--
        Liability shall not arise under paragraph (1) or (2) in the 
        case of a individual covered by either such paragraph if the 
        individual does not obtain, or fails to maintain, employment as 
        an employee of the Department due to staffing changes approved 
        by the Secretary.
    ``(e) Payment of Amounts and Limitations.--
            ``(1) Total amount for a school year.--The total amount of 
        a scholarship payable to a participant under this section--
                    ``(A) may not exceed $20,000 for the equivalent of 
                one year of full-time coursework in a course of 
                education or training; or
                    ``(B) in the case of a participant who is a part-
                time student, may not exceed an amount that bears the 
                same ratio to the amount that would be paid under 
                subparagraph (A) if the student were a full-time 
                student in the course of education or training being 
                pursued by the participant as the coursework carried by 
                the participant compares to full-time coursework in 
                that course of education or training.
            ``(2) Maximum number of school years.--
                    ``(A) Total years.--The number of school years for 
                which a scholarship may be paid to a participant under 
                this section may not exceed eight school years.
                    ``(B) Full-time equivalent.--A participant may not 
                receive a scholarship under this section for more than 
                the equivalent of four years of full-time coursework.
            ``(3) Maximum total amount.--The total amount paid to or on 
        behalf of a participant through a scholarship under this 
        section may not exceed $80,000.
            ``(4) Payment of educational expenses by educational 
        institutions.--The Secretary may arrange with an educational 
        institution in which a participant under this section is 
        enrolled for the payment of education expenses under subsection 
        (a). Such payments may be made without regard to subsections 
        (a) and (b) of section 3324 of title 31.
``Sec. 7699C-2. Lump sum education debt reduction
    ``(a) Covered Costs.--Lump sum education debt reduction provided by 
the Secretary under this section to an individual shall consist of 
payment of principal and interest under a loan, the proceeds of which 
were used by or on behalf of that individual to pay costs relating to a 
course of education or training, including tuition expenses and other 
reasonable educational expenses, including fees, books, laboratory 
expenses, and reasonable living expenses.
    ``(b) Eligibility.--An individual is eligible to receive lump sum 
education debt repayment under this section if the individual--
            ``(1) owes any amount of principal and interest under a 
        loan, the proceeds of which were used by or on behalf of that 
        individual to pay costs relating to a course of education or 
        training;
            ``(2) commits to a period of obligated service under 
        subsection (d); and
            ``(3) has been offered employment in the Department in the 
        position of a medical support assistant, advanced medical 
        support assistant, lead medical support assistant, or 
        supervisory medical support assistant.
    ``(c) Payments.--
            ``(1) In general.--A lump sum education debt reduction 
        payment under this section shall consist of a payment to a 
        participant under this section of an amount not to exceed the 
        lesser of--
                    ``(A) the principal and interest on loans described 
                in subsection (a) that is outstanding for such 
                participant at the time of the payment; or
                    ``(B) $40,000.
            ``(2) Proof of use of amounts.--Participants under this 
        section in receipt of a lump sum education debt reduction 
        payment under this section must provide proof of payment 
        verifying the full lump sum payment received was paid to the 
        lender for the loan held by such participant not later than 45 
        days after receiving the lump sum payment.
    ``(d) Period of Obligated Service.--
            ``(1) In general.--In exchange for a one-time lump sum 
        education debt payment under this section, a participant under 
        this section shall agree to be employed for not less than three 
        years at the Department (in this section referred to as the 
        `period of obligated service').
            ``(2) Positions of employment.--
                    ``(A) Medical support.--Not fewer than two of the 
                years of the period of obligated service of a 
                participant under this section shall be served in the 
                position of medical support assistant, advanced medical 
                support assistant, lead medical support assistant, or 
                supervisory medical support assistant of the 
                Department.
                    ``(B) Hard-to-hire or hard-to-recruit.--The 
                remainder of any period of obligated service not 
                covered under subparagraph (A) shall be served in a 
                hard-to-hire or hard-to-recruit position as determined 
                by the Secretary.
    ``(e) Liability During Period of Obligated Service.--
            ``(1) In general.--Except as provided in paragraph (2), if 
        a participant under this section fails to complete the period 
        of obligated service of the participant for any reason, the 
        United States shall be entitled to recover from the participant 
        an amount equal to--
                    ``(A) the total amount paid under this section to 
                the participant; multiplied by
                    ``(B) a fraction--
                            ``(i) the numerator of which is--
                                    ``(I) the total number of months in 
                                the period of obligated service of the 
                                participant; minus
                                    ``(II) the number of months served 
                                by the participant; and
                            ``(ii) the denominator of which is the 
                        total number of months in the period of 
                        obligated service of the participant.
            ``(2) Exception.--Liability shall not arise under paragraph 
        (1) in the case of an individual covered by that paragraph if 
        the individual does not obtain, or fails to maintain, 
        employment as an employee of the Department due to staffing 
        changes approved by the Secretary.
``Sec. 7699C-3. Administration
    ``(a) Outreach.--
            ``(1) In general.--The Secretary shall develop an outreach 
        program to Tribal Colleges and Universities, historically Black 
        colleges and universities, high schools in rural areas, 
        community colleges, transition assistance programs for members 
        of the Armed Forces transitioning to civilian life, and spouses 
        of such members to provide information about the Program.
            ``(2) Tribal college or university defined.--In this 
        subsection, the term `Tribal College or University' has the 
        meaning given that term under section 316 of the Higher 
        Education Act of 1965 (20 U.S.C. 1059c).
    ``(b) Mentors.--The Secretary shall ensure that a mentor or mentors 
are available for each individual participating in the Program at the 
facility at which the individual is employed.
``Sec. 7699C-4. Limitation
    ``No individual may receive both a scholarship under section 7699C-
1 of this title and a lump sum education debt reduction under section 
7699C-2 of this title.
``Sec. 7699C-5. Termination
    ``The authority to carry out the Program shall terminate on the 
date that is 10 years after the date of the enactment of the Making 
Community Care Work for Veterans Act of 2023.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by adding at the end the following:

              ``subchapter x--start and stay at va program

``Sec.
``7699C. Start and Stay at VA Program.
``7699C-1. Scholarships.
``7699C-2. Lump sum education debt reduction.
``7699C-3. Administration.
``7699C-4. Limitation.
``7699C-5. Termination.''.
    (c) Conforming Amendments.--
            (1) Establishment of program.--Section 7601(a) of such 
        title is amended--
                    (A) in paragraph (6), by striking ``and'';
                    (B) in paragraph (7), by striking the period and 
                inserting ``; and''; and
                    (C) by adding at the end the following new 
                paragraph:
            ``(8) the program to provide scholarships and lump sum 
        education debt reduction provided for in subchapter X of this 
        chapter.''.
            (2) Eligibility.--Section 7602 of such title is amended--
                    (A) in subsection (a)(1)--
                            (i) by striking ``or IX'' and inserting 
                        ``IX, or X'';
                            (ii) by striking ``or for which a 
                        scholarship'' and inserting ``for which a 
                        scholarship''; and
                            (iii) by inserting ``or for which a 
                        scholarship or lump sum education debt 
                        reduction may be provided under subchapter X of 
                        this chapter,'' before ``as the case may be''; 
                        and
                    (B) in subsection (b), by striking ``or IX'' and 
                inserting ``IX, or X''.
            (3) Application.--Section 7603(a)(1) of such title is 
        amended by striking ``or IX'' and inserting ``IX, or X''.
            (4) Terms of agreement.--Section 7604 of such title is 
        amended by striking ``or IX'' each place it appears and 
        inserting ``IX, or X''.
            (5) Annual report.--Section 7632 of such title is amended--
                    (A) in paragraph (1), by striking ``and the 
                Readjustment Counseling Service Scholarship Program'' 
                and inserting ``the Readjustment Counseling Service 
                Scholarship Program, and the Start and Stay at VA 
                Program''; and
                    (B) in paragraph (4), by striking ``and per 
                participant in the Readjustment Counseling Service 
                Scholarship Program'' and inserting ``per participant 
                in the Readjustment Counseling Service Scholarship 
                Program, and per participant in the Start and Stay at 
                VA Program''.

SEC. 202. EXPANSION OF PERIOD OF PAYMENT UNDER EMPLOYEE INCENTIVE 
              SCHOLARSHIP PROGRAM.

    Section 7673(c) of title 38, United States Code, is amended--
            (1) in paragraph (1) by striking ``six'' and inserting 
        ``eight''; and
            (2) in paragraph (2) by striking ``three'' and inserting 
        ``four''.

SEC. 203. MENTORSHIP PROGRAM FOR EXECUTIVE LEADERSHIP TEAMS AT MEDICAL 
              CENTERS OF THE DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--The Secretary of Veterans Affairs may establish a 
program to connect covered individuals (in this section referred to as 
``mentees'') with peer mentors to facilitate sharing of best practices 
and leadership experiences and to foster opportunities to develop 
knowledge and skills required to lead successfully at medical 
facilities of the Department (in this section referred to as the 
``mentorship program'').
    (b) Covered Individual Defined.--In this section, the term 
``covered individual'' means--
            (1) an individual in the position of Facility Director, 
        Chief of Staff, Associate Director of Patient Care Services, 
        Associate Director, Assistant Director, or Deputy Director at a 
        medical center of the Department; or
            (2) any other employee of the Department who is determined 
        by the Secretary to be an executive leader at a medical center 
        of the Department.
    (c) Eligibility.--The following employees of the Department are 
eligible for participation as mentees in the mentorship program:
            (1) An employee appointed to a position as a covered 
        individual on or after the date of the enactment of this Act.
            (2) A covered individual employed at a medical center of 
        the Department (regardless of appointment commencement date) 
        that meets one or more of the following criteria:
                    (A) Reports poor performance, as defined by the 
                Secretary, on the Strategic Analytics for Improvement 
                and Learning Value Model of the Department, or 
                successor similar model.
                    (B) Reports data under section 1703C(a)(3) of title 
                38, United States Code, as published on the Access to 
                Care website of the Department, or successor similar 
                website, that--
                            (i) does not consistently meet the level 
                        reported in the community surrounding such 
                        medical center, as determined by the Secretary; 
                        or
                            (ii) does not meet a threshold level 
                        determined by the Secretary.
                    (C) Has one or more recommendations from a report 
                by the Office of Inspector General of the Department of 
                Veterans Affairs that is still open more than one year 
                after the report was published.
            (3) A covered individual employed at a medical center of 
        the Department (regardless of appointment commencement date) 
        who is recommended by the director of the Veterans Integrated 
        Service Network overseeing such medical center.
    (d) Criteria for Peer Mentors.--Each peer mentor to be paired with 
a mentee under subsection (a) shall meet each of the following 
criteria:
            (1) Previous or current employment in the same position 
        title as the mentee.
            (2) Employment in that position for not less than two 
        years.
            (3) Employment at a medical center of the Department that 
        reports--
                    (A) above average performance, as defined by the 
                Secretary, on the Strategic Analytics for Improvement 
                and Learning Value Model of the Department, or 
                successor similar model; and
                    (B) data under section 1703C(a)(3) of title 38, 
                United States Code, as published on the Access to Care 
                website of the Department, or successor similar 
                website, that exceeds the level reported in the 
                community surrounding such medical center, as 
                determined by the Secretary.
    (e) Report.--Not later than one year after the date of the 
enactment of this Act, and annually thereafter for an additional three 
years, 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 mentorship program, including--
            (1) the number of mentees and peer mentors participating in 
        the mentorship program, disaggregated by medical center of the 
        Department;
            (2) the number of mentor-mentee pairings initiated under 
        each of the eligibility criteria outlined in paragraphs (1), 
        (2), and (3) of subsection (c), including information on any 
        circumstances in which multiple criteria under such paragraphs 
        were met;
            (3) a description of the actions taken by the Department to 
        encourage communication between mentees and peer mentors;
            (4) aggregated feedback from participants in the mentorship 
        program; and
            (5) the turnover rate for covered individuals.

                  TITLE III--OTHER HEALTH CARE MATTERS

SEC. 301. TIMING FOR SCHEDULING OF APPOINTMENTS AT FACILITIES OF 
              DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--Subchapter I of chapter 17 of title 38, United 
States Code, is amended by inserting after section 1706A the following 
new section:
``Sec. 1706B. Requirements for timing of scheduling of appointments at 
              Department facilities
    ``The Secretary shall ensure that an appointment for a veteran for 
care or services under this chapter from a facility of the Department--
            ``(1) in the case of a non-urgent appointment, is scheduled 
        (but may occur at a later date) not later than seven days after 
        the earlier of the date on which--
                    ``(A) a clinician of the Department determines that 
                the veteran requires care; or
                    ``(B) the veteran presents to the Department 
                requesting care; and
            ``(2) in the case of an appointment for urgent care, is 
        completed not later than 48 hours after the earlier of the date 
        on which--
                    ``(A) a clinician of the Department determines that 
                the veteran requires care; or
                    ``(B) the veteran presents to the Department 
                requesting care.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such subchapter is amended by inserting after the item relating to 
section 1706A the following new item:

``1706B. Requirements for timing of scheduling of appointments at 
                            Department facilities.''.
    (c) Effective Date.--The Secretary of Veterans Affairs shall comply 
with the requirements under section 1706B of title 38, United States 
Code, as added by subsection (a), by not later than 180 days after the 
date of the enactment of this Act.

SEC. 302. MODIFICATION OF REQUIREMENTS FOR STANDARDS FOR QUALITY OF 
              CARE FROM DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--Subsection (a) of section 1703C of title 38, 
United States Code, is amended--
            (1) in paragraph (2)--
                    (A) by striking ``In establishing'' and inserting 
                ``(A) In establishing''; and
                    (B) by adding at the end the following new 
                subparagraph:
    ``(B) The Secretary shall ensure that the standards for quality 
established under paragraph (1) are comparable to industry standards to 
ensure there is adequate data transference between care furnished by 
the Department and care furnished by a non-Department provider.'';
            (2) in paragraph (3)--
                    (A) in subparagraph (A), by striking ``; and'' and 
                inserting a semicolon;
                    (B) in subparagraph (B)--
                            (i) in the matter preceding clause (i), by 
                        striking ``to the following:'' and inserting 
                        ``to--'';
                            (ii) in clause (i)--
                                    (I) by striking ``Timely'' and 
                                inserting ``timely''; and
                                    (II) by striking the period at the 
                                end and inserting a semicolon;
                            (iii) in clause (ii)--
                                    (I) by striking ``Effective'' and 
                                inserting ``effective''; and
                                    (II) by striking the period at the 
                                end and inserting a semicolon;
                            (iv) in clause (iii)--
                                    (I) by striking ``Safety'' and 
                                inserting ``safety''; and
                                    (II) by striking the period at the 
                                end and inserting a semicolon;
                            (v) in clause (iv)--
                                    (I) by striking ``Efficiency'' and 
                                inserting ``efficiency''; and
                                    (II) by striking the period at the 
                                end and inserting ``; and''; and
                            (vi) by adding at the end the following new 
                        clause:
                    ``(v) equitable care; and''; and
                    (C) by adding at the end the following new 
                subparagraph:
            ``(C) measurements of standards for quality that include 
        measurements of--
                    ``(i) the degree to which care is furnished 
                uniquely to patient needs;
                    ``(ii) workforce safety;
                    ``(iii) employee engagement;
                    ``(iv) safety culture;
                    ``(v) outcomes on patient quality of life; and
                    ``(vi) such other matters as the Secretary 
                considers appropriate.'';
            (3) in paragraph (4), by striking ``and the Centers for 
        Medicare & Medicaid Services'' and inserting ``the Centers for 
        Medicare & Medicaid Services, and the Indian Health Service''; 
        and
            (4) by striking paragraph (5) and inserting the following 
        new paragraphs:
    ``(5) When collecting, considering, and applying data related to 
patient care for purposes of establishing standards for quality under 
paragraph (1), the Secretary shall ensure no metric is being over or 
under analyzed.
    ``(6) In establishing standards for quality under paragraph (1), 
the Secretary shall--
            ``(A) utilize the most current practices in extracting and 
        analyzing relevant data;
            ``(B) utilize all relevant data available to the Secretary;
            ``(C) ensure the most efficient use of time and resources 
        related to the use of data scientists employed by the 
        Department; and
            ``(D) collaborate, as appropriate, with entities specified 
        in paragraph (4).
    ``(7)(A) Not later than five years after the submittal of the 
report required by section 302(d)(2)(B) of the Making Community Care 
Work for Veterans Act of 2023, and not less frequently than once every 
five years thereafter, the Secretary shall update the standards for 
quality established under paragraph (1) pursuant to the requirements 
for the establishment of such standards under this subsection.
    ``(B) Not later than 30 days after any update under subparagraph 
(A) of standards for quality established under paragraph (1), the 
Secretary shall submit to the appropriate committees of Congress a 
report on such updated standards for quality.''.
    (b) Publication and Consideration of Public Comments.--Subsection 
(b) of such section is amended--
            (1) in paragraph (1)--
                    (A) by striking ``Not later than 1 year after the 
                date on which the Secretary establishes standards for 
                quality under subsection (a)'' and inserting ``Not less 
                frequently than once every three years''; and
                    (B) by inserting ``pursuant to standards for 
                quality under subsection (a)'' after ``medical 
                facilities of the Department''; and
            (2) in paragraph (2), by inserting ``or updates'' after 
        ``establishes''.
    (c) Report.--Not later than one year after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall submit 
to the appropriate committees of Congress a report on--
            (1) how the Secretary has consulted with entities specified 
        in paragraph (4) of section 1703C(a) of title 38, United States 
        Code, before the date of the enactment of this Act in 
        establishing standards for quality under such section;
            (2) how the Secretary has continued to consult with those 
        entities on and after such date of enactment; and
            (3) how the Secretary intends to leverage data sciences to 
        improve standards for quality care furnished by the Department 
        of Veterans Affairs.
    (d) Initial Update to Quality Care Metrics.--
            (1) Report.--Not later than one year after the date of the 
        enactment of this Act, the Secretary of Veterans Affairs shall 
        submit to the appropriate committees of Congress a report on 
        how the Secretary plans to implement the amendments made by 
        subsections (a) and (b).
            (2) Implementation.--Not later than two years after the 
        date of the enactment of this Act, the Secretary shall--
                    (A) implement the amendments made by subsections 
                (a) and (b), including by updating the standards for 
                quality established under section 1703C(a)(1) of title 
                38, United States Code; and
                    (B) submit to the appropriate committees of 
                Congress a report detailing the standards for quality 
                updated pursuant to such amendments.
    (e) Appropriate Committees of Congress Defined.--In this section, 
the term ``appropriate committees of Congress'' means--
            (1) the Committee on Veterans' Affairs and the Committee on 
        Appropriations of the Senate; and
            (2) the Committee on Veterans' Affairs and the Committee on 
        Appropriations of the House of Representatives.

SEC. 303. MENTAL HEALTH RESIDENTIAL REHABILITATION TREATMENT PROGRAM OF 
              THE DEPARTMENT OF VETERANS AFFAIRS.

    (a) General Requirements.--
            (1) Deadline.--The Secretary of Veterans Affairs shall 
        fulfill each requirement under this section by not later than 
        one year after the date of the enactment of this Act, unless 
        otherwise specified.
            (2) Guidance.--The Secretary shall update the guidance of 
        the Department of Veterans Affairs on the operation of the 
        Mental Health Residential Rehabilitation Treatment Program (in 
        this section referred to as the ``Program'') to reflect each of 
        the requirements under subsections (b) through (h).
    (b) Referral and Admission.--
            (1) Referral.--
                    (A) Standardized process.--The Secretary shall 
                establish a standardized consultation requirement or 
                other process for referrals to the Program.
                    (B) Timeliness standards.--The Secretary shall 
                specify timeliness standards for responding to 
                referrals and completing screenings for the Program, 
                including for when priority admission is requested, 
                from--
                            (i) providers of the Department;
                            (ii) non-Department providers; and
                            (iii) veteran patients (self-referrals).
            (2) Screening of priority veterans.--
                    (A) In general.--For any veteran who meets priority 
                admission standards under the Program during a 
                screening for the Program, the Secretary shall admit 
                the veteran not later than 72 hours after the time at 
                which the veteran was screened.
                    (B) Other admission options.--With respect to a 
                veteran specified in subparagraph (A), if there are no 
                available bed spaces for admission under the Program at 
                the facility of the Department or within the Veterans 
                Integrated Service Network nearest to the residence of 
                the veteran within the 72-hour period specified in such 
                subparagraph, the Secretary shall offer the veteran a 
                choice of care--
                            (i) at another facility of the Department 
                        anywhere in the United States that can admit 
                        the veteran within such period; or
                            (ii) at a non-Department residential care 
                        facility in the community that can admit the 
                        veteran within such period and--
                                    (I) has a contract or agreement 
                                with the Department in place; or
                                    (II) will enter into such a 
                                contract or agreement prior to 
                                furnishing such care.
            (3) Admission.--The Secretary shall specify timeliness 
        standards for the admission of a veteran into the Program, or 
        the referral of a veteran to a non-Department residential care 
        facility in the community, upon making an admission decision 
        with respect to the veteran.
            (4) Performance metrics.--
                    (A) In general.--The Secretary shall develop 
                metrics to track, and shall subsequently track, the 
                performance of the Department, and contractors of the 
                Department that provide residential care to veterans, 
                in meeting--
                            (i) the requirements for referral to the 
                        Program under paragraph (1) and any other 
                        provision of law;
                            (ii) the requirements for screening for the 
                        Program and other admission options under 
                        paragraph (2); and
                            (iii) the requirements for timely admission 
                        to the Program under paragraph (3).
                    (B) Elements.--The metrics developed under 
                subparagraph (A) shall include metrics for tracking 
                performance with respect to routine and priority access 
                under the Program.
    (c) Placement; Transportation.--
            (1) Locations; start dates.--If the Secretary determines 
        that a veteran is in need of residential care under the 
        Program, the Secretary shall provide the veteran with a list of 
        locations that meet--
                    (A) the care needs of the veteran, including 
                applicable treatment tracks; and
                    (B) the clinically indicated best start date for 
                the veteran to receive care, taking into account the 
                preferences of the veteran.
            (2) Wait times.--The Secretary shall make every effort to 
        limit the time a veteran waits for placement into the Program, 
        including by offering the veteran placement at one or more 
        locations outside of the area of the home facility of the 
        veteran or the home Veterans Integrated Service Network of the 
        veteran, or at a non-Department residential care facility, if 
        there are no other options that meet the care needs of the 
        veteran and are consistent with the policy of the Department on 
        wait times for access to care under the Program.
            (3) Transportation coverage.--The Secretary shall provide 
        transportation or pay for or reimburse the costs of 
        transportation for any veteran who is admitted into the Program 
        and needs transportation assistance--
                    (A) from the residence of the veteran or a facility 
                of the Department or authorized non-Department facility 
                that does not provide such care to another such 
                facility that provides residential care covered under 
                the Program; and
                    (B) back to the residence of the veteran after the 
                conclusion of the Program, if applicable.
    (d) Considerations.--In making screening, admission, and placement 
decisions under the Program, the Secretary shall consider the input and 
preferences of the veteran and the treating clinicians of the veteran, 
including with respect to wait times, the program specialty, subtype, 
or treatment track offered to the veteran, and the geographic placement 
of the veteran, including family- or occupation-related preferences or 
circumstances.
    (e) Appeals.--
            (1) In general.--The Secretary shall develop a national 
        policy and associated procedures under which a veteran, a 
        representative of a veteran, or a provider who refers a veteran 
        to the Program, including a provider of the Department or a 
        non-Department provider, may file an appeal if the veteran is 
        denied admission into the Program or is accepted into the 
        Program but is not offered bed placement in a timely manner.
            (2) Timeliness standards for review.--
                    (A) In general.--The national policy and procedures 
                developed under paragraph (1) for appeals described in 
                such paragraph shall include timeliness standards for 
                the Department to review and make a decision on such an 
                appeal.
                    (B) Priority admission.--The Secretary shall review 
                and respond to all appeals related to priority 
                admission to the Program not later than 72 hours after 
                receiving the appeal.
                    (C) Routine admission.--The Secretary shall review 
                and respond to all appeals related to routine admission 
                to the Program not later than five business days after 
                receiving the appeal.
            (3) Public guidance.--The Secretary shall develop, and make 
        available to the public, guidance on how a veteran, a 
        representative of the veteran, or a referring provider of the 
        veteran can file an appeal--
                    (A) if the veteran is denied admission into the 
                Program;
                    (B) if the veteran is admitted into the Program and 
                the first date on which the veteran may enter the 
                Program does not comply with the wait time standards 
                established by the Department and under this section 
                for purposes of priority or routine admission into the 
                Program; or
                    (C) with respect to such other factors as the 
                Secretary may specify.
    (f) Tracking of Availability and Wait Times.--
            (1) In general.--The Secretary shall create a method for 
        tracking availability and wait times under the Program across 
        all facilities and Veterans Integrated Service Networks of the 
        Department throughout the United States.
            (2) Availability of information.--The Secretary shall make 
        the information tracked under paragraph (1) available in real 
        time to--
                    (A) the mental health treatment coordinators at 
                each facility of the Department;
                    (B) the leadership of each medical center of the 
                Department;
                    (C) the leadership of each Veterans Integrated 
                Service Network; and
                    (D) the Office of the Under Secretary for Health of 
                the Department.
    (g) Training and Oversight.--
            (1) Training.--
                    (A) In general.--The Secretary shall update and 
                implement training for all staff of the Department 
                involved in the Program regarding referrals, screening, 
                admission, placement decisions, and appeals for the 
                Program, including all changes to processes and 
                guidance under the Program required by this section.
                    (B) Veterans awaiting admission.--The training 
                under subparagraph (A) shall include procedures for the 
                care of veterans awaiting admission into the Program 
                and communication with such veterans and their 
                referring providers.
                    (C) Timing of training.--
                            (i) In general.--The Secretary shall 
                        require the training under subparagraph (A) to 
                        be completed by staff required to complete such 
                        training--
                                    (I) upon being first employed in a 
                                position that includes work involving 
                                the Program; and
                                    (II) not less frequently than 
                                annually.
                            (ii) Tracking.--The Secretary shall track 
                        completion of training required under clause 
                        (i) by staff required to complete such training 
                        and ensure its completion as required under 
                        such clause.
            (2) Oversight standards.--The Secretary shall review and 
        revise oversight standards for the leadership of the Veterans 
        Integrated Service Networks to ensure that facilities and staff 
        of the Department are adhering to the policy of the Program on 
        access to care.
    (h) Care Coordination and Follow-Up Care.--
            (1) Continuity of care.--The Secretary shall ensure each 
        veteran who is screened for admission to the Program is 
        offered, and provided if agreed upon, care options during the 
        period between screening of the veteran and admission of the 
        veteran to the Program to ensure the veteran does not 
        experience any lapse in care.
            (2) Care coordination for substance use disorder.--For a 
        veteran being treated for substance use disorder, the Secretary 
        shall--
                    (A) ensure there is a care plan in place during the 
                period between any detoxification services or inpatient 
                care received by the veteran and admission of the 
                veteran to the Program; and
                    (B) communicate that care plan to the veteran, the 
                primary care provider of the veteran, and the facility 
                of the Program where the veteran is or will be 
                residing.
            (3) Care planning prior to discharge.--
                    (A) In general.--The Secretary, in consultation 
                with the veteran and the treating providers of the 
                veteran in the Program, shall ensure the completion of 
                a care plan prior to the veteran being discharged from 
                the Program.
                    (B) Matters to be included.--The care plan required 
                under subparagraph (A) for a veteran shall include 
                details on the course of treatment for the veteran 
                following completion of treatment under the Program, 
                including any needed follow-up care.
                    (C) Sharing of care plan.--The care plan required 
                under subparagraph (A) shall be shared with the 
                veteran, the primary care provider of the veteran, and 
                any other providers with which the veteran consents to 
                sharing the plan.
                    (D) Discharge from non-department facility.--Upon 
                discharge of a veteran under the Program from a non-
                Department facility, the facility shall share with the 
                Department all care records maintained by the facility 
                with respect to the veteran and shall work in 
                consultation with the Department on the care plan of 
                the veteran required under subparagraph (A).
    (i) Reports to Congress.--
            (1) Report on changes made to program.--
                    (A) In general.--Not later than two years after 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 changes made to 
                the guidance, operation, and oversight of the Program 
                to fulfill the requirements of this section.
                    (B) Funding.--The report required by subparagraph 
                (A) shall--
                            (i) examine how care provided to veterans 
                        under the Program is funded, including care 
                        provided through--
                                    (I) facilities of the Department; 
                                and
                                    (II) non-Department facilities;
                            (ii) assess whether costs of the Program, 
                        including for residential care provided through 
                        facilities of the Department and non-Department 
                        facilities, serve as a disincentive to 
                        placement in the Program;
                            (iii) identify the average cost of a stay 
                        under the Program, including total stay average 
                        and daily average, at--
                                    (I) a facility of the Department; 
                                and
                                    (II) a non-Department facility; and
                            (iv) include such recommendations as the 
                        Secretary may have for legislative or 
                        administrative action to address any funding 
                        constraints or disincentives for use of the 
                        Program.
                    (C) Actions taken to address recommendations.--
                            (i) In general.--The Secretary shall 
                        include with the report required by 
                        subparagraph (A) a description of actions taken 
                        by the Department to address the findings and 
                        recommendations by the Secretary contained in 
                        the report under section 503(c) of the STRONG 
                        Veterans Act of 2022 (division V of Public Law 
                        117-328).
                            (ii) Actions to be included.--Actions to be 
                        included under clause (i) shall include--
                                    (I) any new locations of the 
                                Program added;
                                    (II) any beds added at existing 
                                facilities of the Program; and
                                    (III) any additional treatment 
                                tracks or gender-specific programs 
                                created or added at facilities of the 
                                Department.
            (2) Annual report on operation of program.--
                    (A) In general.--Not later than one year after 
                submitting the report required by paragraph (1)(A), and 
                not less frequently than 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 on the 
                operation of the Program.
                    (B) Elements.--Each report required by subparagraph 
                (A) shall include the following:
                            (i) The number of veterans served by the 
                        Program, disaggregated by--
                                    (I) Veterans Integrated Service 
                                Network in which the veteran receives 
                                care;
                                    (II) facility, including facilities 
                                of the Department and non-Department 
                                facilities, at which the veteran 
                                receives care;
                                    (III) type of residential 
                                rehabilitation treatment care received 
                                by the veteran under the Program;
                                    (IV) gender of the veteran; and
                                    (V) race or ethnicity of the 
                                veteran.
                            (ii) Wait times under the Program for the 
                        most recent year data is available, 
                        disaggregated by--
                                    (I) treatment track or specificity 
                                of residential rehabilitation treatment 
                                care sought by the veteran;
                                    (II) gender of the veteran;
                                    (III) State or territory in which 
                                the veteran is located;
                                    (IV) Veterans Integrated Service 
                                Network in which the veteran is 
                                located; and
                                    (V) facility of the Department at 
                                which the veteran seeks care.
                            (iii) A list of all locations of the 
                        Program and number of bed spaces at each such 
                        location, disaggregated by residential 
                        rehabilitation treatment care or treatment 
                        track provided under the Program at such 
                        location.
                            (iv) A list of any new Program locations 
                        added or removed and any bed spaces added or 
                        removed during the one-year period preceding 
                        the date of the report.
                            (v) Average cost of a stay under the 
                        Program, including total stay average and daily 
                        average, at--
                                    (I) a facility of the Department; 
                                and
                                    (II) a non-Department facility.
                            (vi) A review of staffing needs and gaps 
                        with respect to the Program.
                            (vii) Any recommendations for changes to 
                        the operation of the Program, including any 
                        policy changes, guidance changes, training 
                        changes, or other changes.
    (j) Government Accountability Office Review on Access to Care Under 
the Program.--
            (1) In general.--Not later than two years after the date of 
        the enactment of this Act, the Comptroller General of the 
        United States shall review access to care under the Program for 
        veterans in need of residential mental health care and 
        substance use disorder care.
            (2) Elements.--The review required by paragraph (1) shall 
        include the following:
                    (A) A review of wait times under the Program, 
                disaggregated by--
                            (i) treatment track or specificity of 
                        residential rehabilitation treatment care 
                        needed;
                            (ii) gender of the veteran;
                            (iii) home State of the veteran;
                            (iv) home Veterans Integrated Service 
                        Network of the veteran; and
                            (v) wait times for--
                                    (I) facilities of the Department; 
                                and
                                    (II) non-Department facilities.
                    (B) A review of policy and training of the 
                Department on screening, admission, and placement under 
                the Program.
                    (C) A review of the rights of veterans and 
                referring providers to appeal admission decisions under 
                the Program and how the Department adjudicates appeals.
                    (D) A review of how the preferences of a veteran 
                admitted to the Program are taken into consideration 
                when determining the facility at which the veteran will 
                be placed in the Program.
                    (E) A review of staffing and staffing needs and 
                gaps of the Program, including with respect to--
                            (i) mental health providers and 
                        coordinators at the facility level;
                            (ii) staff of Program facilities; and
                            (iii) overall administration of the Program 
                        at the national level.
                    (F) Recommendations for improvement of access by 
                veterans to care under the Program, including with 
                respect to--
                            (i) any new sites or types of programs 
                        needed or in development;
                            (ii) changes in training or policy;
                            (iii) changes in communications with 
                        veterans; and
                            (iv) oversight of the Program by the 
                        Department.
    (k) Definitions.--In this section:
            (1) Mental health residential rehabilitation treatment 
        program.--The term ``Mental Health Residential Rehabilitation 
        Treatment Program''--
                    (A) means the array of programs and services of the 
                Department that comprise residential care for mental 
                health and substance use disorders; and
                    (B) includes the programs designated as of the date 
                of the enactment of this Act as domiciliary residential 
                rehabilitation treatment programs.
            (2) Treatment track.--The term ``treatment track'' means a 
        specialized treatment program that is provided to a subset of 
        veterans in the Program who receive the same or similar 
        intensive treatment and rehabilitative services.
            (3) United states.--The term ``United States'' means the 50 
        States, the District of Columbia, the Commonwealth of Puerto 
        Rico, Guam, the Virgin Islands, American Samoa, and any other 
        commonwealth, territory, or possession of the United States.

SEC. 304. ELECTRONIC DOCUMENT SUBMISSION OPTION FOR THE CHAMPVA 
              PROGRAM.

    (a) Online Portal.--Not later than 18 months after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall publish 
an online portal allowing--
            (1) individuals applying for medical care under section 
        1781 of title 38, United States Code, the ability to--
                    (A) submit application materials electronically;
                    (B) view the status of their application online; 
                and
                    (C) select their preferred method of communication 
                regarding their application, which the Department of 
                Veterans Affairs shall use upon their first attempt to 
                contact the individual if there are any issues with 
                their application;
            (2) individuals applying for or receiving medical care 
        under such section the ability to submit electronically--
                    (A) documentation regarding other health insurance 
                certification;
                    (B) documentation regarding school enrollment 
                certification; and
                    (C) any other documentation required to apply for 
                or continue coverage under such section; and
            (3) individuals receiving medical care under such section 
        and providers of medical care under such section the ability 
        to--
                    (A) submit medical claims documentation 
                electronically;
                    (B) request reprocessing of a denied claim 
                electronically; and
                    (C) file a reconsideration or appeal of a claim 
                electronically.
    (b) Contract.--The Secretary may enter into a contract with a non-
Department entity to carry out subsection (a).
    (c) Outreach.--Upon the implementation of the online portal 
required under subsection (a), the Secretary shall conduct outreach to 
ensure individuals eligible for care under section 1781 of title 38, 
United States Code, and providers of such care are aware of the portal.
    (d) Rule of Construction.--Nothing in this section shall be 
construed to limit the ability of the Secretary to collect application 
materials relating to medical care under section 1781 of title 38, 
United States Code, by mail or by fax.
    (e) Reports.--
            (1) In general.--Not later than 270 days after the date of 
        the enactment of this Act, and every 180 days thereafter for 
        three years, 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 
        progress of implementation of the online portal required under 
        subsection (a).
            (2) Elements.--Each report required under paragraph (1) 
        shall include--
                    (A) whether a contract with a non-Department entity 
                was procured to carry out subsection (a) and, if so, 
                information on which entity or entities to which the 
                contract was awarded;
                    (B) the number of applications for medical care 
                under section 1781 of title 38, United States Code, 
                that are currently pending, disaggregated by whether 
                they were received--
                            (i) by mail;
                            (ii) by fax; or
                            (iii) electronically;
                    (C) a description of efforts taken by the 
                Department to conduct outreach under subsection (c); 
                and
                    (D) an assessment of user satisfaction with the new 
                online portal required under subsection (a).

SEC. 305. REVIEW OF WORKFLOWS ASSOCIATED WITH PROCESSING REFERRALS 
              BETWEEN FACILITIES OF THE VETERANS HEALTH ADMINISTRATION.

    (a) In General.--The Secretary of Veterans Affairs shall conduct a 
review of the workflows directly associated with processing referrals 
of patients between facilities of the Veterans Health Administration to 
identify specific delays or bottlenecks in such referrals.
    (b) Inclusion of Consult Management Review.--The review required 
under subsection (a) shall include--
            (1) a review of the interfacility consult management 
        guidance of the Veterans Health Administration that assists 
        facilities in setting up a workflow for consults between 
        facilities; and
            (2) a review of the roles and responsibilities of the 
        individuals involved in the consult management process in 
        managing those consults, including the role of the referral 
        coordination team.
    (c) Report.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary shall submit to Congress a report 
on the results of the review conducted under subsection (a).
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