Making Advances in Mammography and Medical Options for Veterans Act Public Law 117–135 Making Advances in Mammography and Medical Options for Veterans Act 135 117–135 Statute Compilation United States House of Representatives Office of the Legislative Counsel text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain. GPO Statute Compilations USLM converter, version 20240419 2025-08-21 Making Advances in Mammography and Medical Options for Veterans Act 16922 117 2022-06-07 Making Advances in Mammography and Medical Options for Veterans Act [(Public Law 117–135)] [This law has not been amended] [Currency: This publication is a compilation of the text of Public Law 117-135. It was last amended by the public law listed in the As Amended Through note above and below at the bottom of each page of the pdf version and reflects current law through the date of the enactment of the public law listed at https://www.govinfo.gov/app/collection/comps/] [Note: While this publication does not represent an official version of any Federal statute, substantial efforts have been made to ensure the accuracy of its contents. The official version of Federal law is found in the United States Statutes at Large and in the United States Code. The legal effect to be given to the Statutes at Large and the United States Code is established by statute (1 U.S.C. 112, 204).]
AN ACTTo improve mammography services furnished 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. [38 U.S.C. 7322 note] SHORT TITLE; TABLE OF CONTENTS. (a) Short Title.—This Act may be cited as the “Making Advances in Mammography and Medical Options for Veterans Act”. (b) Table of Contents.—The table of contents for this Act is as follows: Sec. 1. TITLE I— Sec. 101. Sec. 102. Sec. 103. Sec. 104. Sec. 105. Sec. 106. TITLE II— Sec. 201. Sec. 202.
<num style="-uslm-dtd:enum" value="I">TITLE I—</num><heading style="-uslm-dtd:header">SCREENING AND EARLY DETECTION </heading> <section identifier="/us/sComp/117/135/tI/s101" style="-uslm-dtd:section" styleType="OLC"> <num style="-uslm-dtd:enum" value="101">SEC. 101. </num><heading style="-uslm-dtd:header">STRATEGIC PLAN FOR BREAST IMAGING SERVICES FOR VETERANS. </heading> <subsection identifier="/us/sComp/117/135/tI/s101/a" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="a">(a) </num><heading style="-uslm-dtd:header">In General. </heading><content style="-uslm-dtd:text">Not later than one year after the date of the enactment of this Act, 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 strategic plan for improving breast imaging services for veterans.</content> </subsection> <subsection identifier="/us/sComp/117/135/tI/s101/b" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="b">(b) </num><heading style="-uslm-dtd:header">Elements.—</heading><chapeau style="-uslm-dtd:text">The strategic plan required by subsection (a) shall—</chapeau> <paragraph identifier="/us/sComp/117/135/tI/s101/b/1" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><content style="-uslm-dtd:text">cover the evolving needs of women veterans;</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s101/b/2" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><content style="-uslm-dtd:text">address geographic disparities of breast imaging furnished at a facility of the Department of Veterans Affairs and the use of breast imaging through non-Department providers in the community;</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s101/b/3" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="3">(3) </num><content style="-uslm-dtd:text">address the use of digital breast tomosynthesis (DBT-3D breast imaging);</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s101/b/4" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="4">(4) </num><content style="-uslm-dtd:text">address the needs of male veterans who require breast cancer screening services; and</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s101/b/5" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="5">(5) </num><chapeau style="-uslm-dtd:text">provide recommendations on—</chapeau> <subparagraph identifier="/us/sComp/117/135/tI/s101/b/5/A" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="A">(A) </num><content style="-uslm-dtd:text">potential expansion of breast imaging services furnished at facilities of the Department, including infrastructure and staffing needs;</content> </subparagraph> <subparagraph identifier="/us/sComp/117/135/tI/s101/b/5/B" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="B">(B) </num><content style="-uslm-dtd:text">the use of digital breast tomosynthesis;</content> </subparagraph> <subparagraph identifier="/us/sComp/117/135/tI/s101/b/5/C" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="C">(C) </num><content style="-uslm-dtd:text">the use of mobile mammography; and</content> </subparagraph> <subparagraph identifier="/us/sComp/117/135/tI/s101/b/5/D" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="D">(D) </num><content style="-uslm-dtd:text">other access and equity improvements for breast imaging.</content> </subparagraph> </paragraph> </subsection> </section> <section identifier="/us/sComp/117/135/tI/s102" style="-uslm-dtd:section" styleType="OLC"> <num style="-uslm-dtd:enum" value="102">SEC. 102. </num><heading style="-uslm-dtd:header">TELESCREENING MAMMOGRAPHY PILOT PROGRAM OF DEPARTMENT OF VETERANS AFFAIRS. </heading> <subsection identifier="/us/sComp/117/135/tI/s102/a" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="a">(a) </num><heading style="-uslm-dtd:header">In General.—</heading><chapeau style="-uslm-dtd:text">Commencing not later than 18 months after the date of the enactment of this Act, the Secretary of Veterans Affairs shall carry out a pilot program to provide telescreening mammography services for veterans who live in—</chapeau> <paragraph identifier="/us/sComp/117/135/tI/s102/a/1" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><content style="-uslm-dtd:text">States where the Department of Veterans Affairs does not offer breast imaging services at a facility of the Department; or</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s102/a/2" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><content style="-uslm-dtd:text">locations where access to breast imaging services at a facility of the Department is difficult or not feasible, as determined by the Secretary.</content> </paragraph> </subsection> <subsection identifier="/us/sComp/117/135/tI/s102/b" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="b">(b) </num><heading style="-uslm-dtd:header">Duration.—</heading><content style="-uslm-dtd:text">The Secretary shall carry out the pilot program under subsection (a) for a three-year period beginning on the commencement of the pilot program.</content> </subsection> <subsection identifier="/us/sComp/117/135/tI/s102/c" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="c">(c) </num><heading style="-uslm-dtd:header">Locations.—</heading><content style="-uslm-dtd:text">In carrying out the pilot program under subsection (a), the Secretary may use community-based outpatient clinics, mobile mammography, Federally qualified health centers (as defined in section 1861(aa)(4) of the Social Security Act (42 U.S.C. 1395x(aa)(4))), rural health clinics, critical access hospitals, clinics of the Indian Health Service, and such other sites as the Secretary determines feasible to provide mammograms under the pilot program.</content> </subsection> <subsection identifier="/us/sComp/117/135/tI/s102/d" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="d">(d) </num><heading style="-uslm-dtd:header">Sharing of Images and Results.—</heading><chapeau style="-uslm-dtd:text">Under the pilot program under subsection (a)—</chapeau> <paragraph identifier="/us/sComp/117/135/tI/s102/d/1" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><content style="-uslm-dtd:text">mammography images generated shall be sent to a telescreening mammography center of the Department for interpretation by qualified radiologists; and</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s102/d/2" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><content style="-uslm-dtd:text">results shall be shared with the veteran and their primary care provider in accordance with policies established by the Secretary.</content> </paragraph> </subsection> <subsection identifier="/us/sComp/117/135/tI/s102/e" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="e">(e) </num><heading style="-uslm-dtd:header">Report.—</heading> <paragraph identifier="/us/sComp/117/135/tI/s102/e/1" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><heading style="-uslm-dtd:header">In general.—</heading><content style="-uslm-dtd:text">Not later than one year after the conclusion of the pilot program 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 evaluating the pilot program.</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s102/e/2" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><heading style="-uslm-dtd:header">Elements.—</heading><chapeau style="-uslm-dtd:text">The report required by paragraph (1) shall include the following:</chapeau> <subparagraph identifier="/us/sComp/117/135/tI/s102/e/2/A" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="A">(A) </num><content style="-uslm-dtd:text">An assessment of the quality of the mammography provided under the pilot program under subsection (a).</content> </subparagraph> <subparagraph identifier="/us/sComp/117/135/tI/s102/e/2/B" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="B">(B) </num><content style="-uslm-dtd:text">Feedback from veterans and providers participating in the pilot program.</content> </subparagraph> <subparagraph identifier="/us/sComp/117/135/tI/s102/e/2/C" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="C">(C) </num><content style="-uslm-dtd:text">A recommendation of the Secretary on the continuation or discontinuation of the pilot program.</content> </subparagraph> </paragraph> </subsection> </section> <section identifier="/us/sComp/117/135/tI/s103" style="-uslm-dtd:section" styleType="OLC"> <num style="-uslm-dtd:enum" value="103">SEC. 103. </num><heading style="-uslm-dtd:header">UPGRADE OF BREAST IMAGING AT FACILITIES OF DEPARTMENT OF VETERANS AFFAIRS TO THREE-DIMENSIONAL DIGITAL MAMMOGRAPHY. </heading> <chapeau class="block" style="-uslm-dtd:text">Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs shall—</chapeau> <paragraph identifier="/us/sComp/117/135/tI/s103/1" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><content style="-uslm-dtd:text">upgrade all mammography services at facilities of the Department of Veterans Affairs that provide such services to use digital breast tomosynthesis technology, also known as three-dimensional breast imaging; and</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s103/2" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><chapeau style="-uslm-dtd:text">submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report—</chapeau> <subparagraph identifier="/us/sComp/117/135/tI/s103/2/A" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="A">(A) </num><content style="-uslm-dtd:text">indicating that the upgrade under paragraph (1) has been completed; and</content> </subparagraph> <subparagraph identifier="/us/sComp/117/135/tI/s103/2/B" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="B">(B) </num><content style="-uslm-dtd:text">listing the facilities or other locations of the Department at which digital breast tomosynthesis technology is used.</content> </subparagraph> </paragraph> </section> <section identifier="/us/sComp/117/135/tI/s104" style="-uslm-dtd:section" styleType="OLC"> <num style="-uslm-dtd:enum" value="104">SEC. 104. </num><heading style="-uslm-dtd:header">STUDY ON AVAILABILITY OF TESTING FOR BREAST CANCER GENE AMONG VETERANS AND EXPANSION OF AVAILABILITY OF SUCH TESTING. </heading> <subsection identifier="/us/sComp/117/135/tI/s104/a" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="a">(a) </num><heading style="-uslm-dtd:header">Study.—</heading> <paragraph identifier="/us/sComp/117/135/tI/s104/a/1" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><heading style="-uslm-dtd:header">In general.—</heading><content style="-uslm-dtd:text">The Secretary of Veterans Affairs shall conduct a study on the availability of access to testing for the breast cancer gene for veterans diagnosed with breast cancer, as recommended by the guidelines set forth by the National Comprehensive Cancer Network.</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s104/a/2" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><heading style="-uslm-dtd:header">Elements. </heading><chapeau style="-uslm-dtd:text">In conducting the study under paragraph (1), the Secretary shall examine—</chapeau> <subparagraph identifier="/us/sComp/117/135/tI/s104/a/2/A" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="A">(A) </num><content style="-uslm-dtd:text">the feasibility of expanding the Joint Medicine Service of the Department of Veterans Affairs to provide genetic testing and counseling for veterans with breast cancer across the country; and</content> </subparagraph> <subparagraph identifier="/us/sComp/117/135/tI/s104/a/2/B" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="B">(B) </num><content style="-uslm-dtd:text">access to such testing and counseling for veterans living in rural or highly rural areas, and any gaps that may exist with respect to such access.</content> </subparagraph> </paragraph> </subsection> <subsection identifier="/us/sComp/117/135/tI/s104/b" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="b">(b) </num><heading style="-uslm-dtd:header">Expansion of Availability of Testing.—</heading> <paragraph identifier="/us/sComp/117/135/tI/s104/b/1" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><heading style="-uslm-dtd:header">In general.—</heading><content style="-uslm-dtd:text">The Secretary shall update guidelines or institute new guidelines to increase the use of molecular testing and genetic counseling for veterans diagnosed with breast cancer, including veterans living in rural or highly rural areas.</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s104/b/2" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><heading style="-uslm-dtd:header">Decision support tools.—</heading><content style="-uslm-dtd:text">In updating or instituting guidelines under paragraph (1), the Secretary may develop clinical decision support tools, such as clinical pathways, to facilitate delivery of breast cancer care that is in line with national cancer guidelines.</content> </paragraph> </subsection> <subsection identifier="/us/sComp/117/135/tI/s104/c" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="c">(c) </num><heading style="-uslm-dtd:header">Report.—</heading><chapeau style="-uslm-dtd:text">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—</chapeau> <paragraph identifier="/us/sComp/117/135/tI/s104/c/1" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><content style="-uslm-dtd:text">the results of the study under subsection (a);</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s104/c/2" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><content style="-uslm-dtd:text">any updates to guidelines or new guidelines instituted under subsection (b);</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s104/c/3" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="3">(3) </num><content style="-uslm-dtd:text">breast cancer clinical pathways implemented by the Department of Veterans Affairs and the utilization of those pathways across the Department; and</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s104/c/4" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="4">(4) </num><content style="-uslm-dtd:text">any progress of the Department in improving access to and usage of molecular and genetic testing among veterans diagnosed with breast cancer, including for veterans living in rural or highly rural areas.</content> </paragraph> </subsection> <subsection identifier="/us/sComp/117/135/tI/s104/d" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="d">(d) </num><heading style="-uslm-dtd:header">Definitions.—</heading><content style="-uslm-dtd:text">In this section, the terms “rural” and “highly rural” have the meanings given those terms in the Rural-Urban Commuting Areas coding system of the Department of Agriculture.</content> </subsection> </section> <section identifier="/us/sComp/117/135/tI/s105" style="-uslm-dtd:section" styleType="OLC"> <num style="-uslm-dtd:enum" value="105">SEC. 105. </num><heading style="-uslm-dtd:header">MAMMOGRAPHY ACCESSIBILITY FOR PARALYZED AND DISABLED VETERANS. </heading> <subsection identifier="/us/sComp/117/135/tI/s105/a" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="a">(a) </num><heading style="-uslm-dtd:header">Study.—</heading> <paragraph identifier="/us/sComp/117/135/tI/s105/a/1" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><heading style="-uslm-dtd:header">In general.—</heading><content style="-uslm-dtd:text">The Secretary of Veterans Affairs shall conduct a study on the accessibility of breast imaging services at facilities of the Department of Veterans Affairs for veterans with paralysis, spinal cord injury or disorder (SCI/D), or another disability.</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s105/a/2" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><heading style="-uslm-dtd:header">Accessibility. </heading><content style="-uslm-dtd:text">The study required by paragraph (1) shall include an assessment of the accessibility of the physical infrastructure at breast imaging facilities of the Department, including the imaging equipment, transfer assistance, and the room in which services will be provided as well as adherence to best practices for screening and treating veterans with a spinal cord injury or disorder.</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s105/a/3" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="3">(3) </num><heading style="-uslm-dtd:header">Screening rates.—</heading> <subparagraph identifier="/us/sComp/117/135/tI/s105/a/3/A" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="A">(A) </num><heading style="-uslm-dtd:header">Measurement.—</heading><content style="-uslm-dtd:text">The study required by paragraph (1) shall include a measurement of breast cancer screening rates for veterans with a spinal cord injury or disorder during the two-year period preceding the commencement of the study, including a breakout of the screening rates for such veterans living in rural or highly rural areas.</content> </subparagraph> <subparagraph identifier="/us/sComp/117/135/tI/s105/a/3/B" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="B">(B) </num><heading style="-uslm-dtd:header">Development of method.—</heading><content style="-uslm-dtd:text">If the Secretary is unable to provide the measurement required under subparagraph (A), the Secretary shall develop a method to track breast cancer screening rates for veterans with a spinal cord injury or disorder.</content> </subparagraph> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s105/a/4" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="4">(4) </num><heading style="-uslm-dtd:header">Report.—</heading><chapeau style="-uslm-dtd:text">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 the findings of the study required by paragraph (1), including—</chapeau> <subparagraph identifier="/us/sComp/117/135/tI/s105/a/4/A" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="A">(A) </num><content style="-uslm-dtd:text">the rates of screening among veterans with a spinal cord injury or disorder, including veterans living in rural or highly rural areas, as required under paragraph (3)(A); or</content> </subparagraph> <subparagraph identifier="/us/sComp/117/135/tI/s105/a/4/B" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="B">(B) </num><content style="-uslm-dtd:text">if such rates are not available, a description of the method developed to measure such rates as required under paragraph (3)(B).</content> </subparagraph> </paragraph> </subsection> <subsection identifier="/us/sComp/117/135/tI/s105/b" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="b">(b) </num><heading style="-uslm-dtd:header">Care From Non-Department Providers.—</heading><chapeau style="-uslm-dtd:text">The Secretary shall update the policies and directives of the Department to ensure that, in referring a veteran with a spinal cord injury or disorder for care from a non-Department provider, the Secretary shall—</chapeau> <paragraph identifier="/us/sComp/117/135/tI/s105/b/1" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><content style="-uslm-dtd:text">confirm with the provider the accessibility of the breast imaging site, including the imaging equipment, transfer assistance, and the room in which services will be provided; and</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s105/b/2" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><content style="-uslm-dtd:text">provide additional information to the provider on best practices for screening and treating veterans with a spinal cord injury or disorder.</content> </paragraph> </subsection> <subsection identifier="/us/sComp/117/135/tI/s105/c" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="c">(c) </num><heading style="-uslm-dtd:header">Definitions.—</heading><content style="-uslm-dtd:text">In this section, the terms “rural” and “highly rural” have the meanings given those terms in the Rural-Urban Commuting Areas coding system of the Department of Agriculture.</content> </subsection> </section> <section identifier="/us/sComp/117/135/tI/s106" style="-uslm-dtd:section" styleType="OLC"> <num style="-uslm-dtd:enum" value="106">SEC. 106. </num><heading style="-uslm-dtd:header">REPORT ON ACCESS TO AND QUALITY OF MAMMOGRAPHY SCREENINGS FURNISHED BY DEPARTMENT OF VETERANS AFFAIRS. </heading> <subsection identifier="/us/sComp/117/135/tI/s106/a" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="a">(a) </num><heading style="-uslm-dtd:header">In General.—</heading><content style="-uslm-dtd:text">Not later than two years after the date of the enactment of this Act, the Inspector General of the Department of Veterans Affairs shall submit to the Secretary of Veterans Affairs, the Committee on Veterans’ Affairs of the Senate, and the Committee on Veterans’ Affairs of the House of Representatives a report on mammography services furnished by the Department of Veterans Affairs.</content> </subsection> <subsection identifier="/us/sComp/117/135/tI/s106/b" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="b">(b) </num><heading style="-uslm-dtd:header">Elements.—</heading><chapeau style="-uslm-dtd:text">The report required by subsection (a) shall include an assessment of—</chapeau> <paragraph identifier="/us/sComp/117/135/tI/s106/b/1" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><content style="-uslm-dtd:text">the access of veterans to mammography screenings, whether at a facility of the Department or through a non-Department provider, including any staffing concerns of the Department in providing such screenings;</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s106/b/2" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><content style="-uslm-dtd:text">the quality of such screenings and reading of the images from such screenings, including whether such screenings use three-dimensional mammography;</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s106/b/3" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="3">(3) </num><content style="-uslm-dtd:text">the communication of the results of such screenings, including whether results are shared in a timely manner, whether results are shared via the Joint Health Information Exchange or another electronic mechanism, and whether results are incorporated into the electronic health record of the veteran;</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s106/b/4" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="4">(4) </num><content style="-uslm-dtd:text">the performance of the Women’s Breast Oncology System of Excellence of the Department; and</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tI/s106/b/5" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="5">(5) </num><content style="-uslm-dtd:text">the access of veterans diagnosed with breast cancer to a comprehensive breast cancer care team of the Department.</content> </paragraph> </subsection> <subsection identifier="/us/sComp/117/135/tI/s106/c" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="c">(c) </num><heading style="-uslm-dtd:header">Follow-Up.—</heading><content style="-uslm-dtd:text">Not later than 180 days after the submittal of the report 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 plan to address the deficiencies identified in the report under subsection (a), if any.</content> </subsection> </section> <num style="-uslm-dtd:enum" value="II">TITLE II—</num><heading style="-uslm-dtd:header">PARTNERSHIPS FOR RESEARCH AND ACCESS TO CARE </heading> <section identifier="/us/sComp/117/135/tII/s201" style="-uslm-dtd:section" styleType="OLC"> <num style="-uslm-dtd:enum" value="201">SEC. 201. </num><heading style="-uslm-dtd:header">PARTNERSHIPS WITH NATIONAL CANCER INSTITUTE TO EXPAND ACCESS OF VETERANS TO CANCER CARE. </heading> <subsection identifier="/us/sComp/117/135/tII/s201/a" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="a">(a) </num><heading style="-uslm-dtd:header">Access to Care in Each VISN.—</heading> <paragraph identifier="/us/sComp/117/135/tII/s201/a/1" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><heading style="-uslm-dtd:header">In general.—</heading><content style="-uslm-dtd:text">The Secretary of Veterans Affairs shall enter into a partnership with not fewer than one cancer center of the National Cancer Institute of the National Institutes of Health in each Veterans Integrated Service Network of the Department of Veterans Affairs to expand access to high-quality cancer care for women veterans.</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tII/s201/a/2" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><heading style="-uslm-dtd:header">Treatment of rural veterans.—</heading><content style="-uslm-dtd:text">The Secretary, in carrying out partnerships entered into under paragraph (1), shall ensure that veterans with breast cancer who reside in rural areas or States without a cancer center that has entered into such a partnership with the Secretary are able to receive care through such a partnership via telehealth.</content> </paragraph> </subsection> <subsection identifier="/us/sComp/117/135/tII/s201/b" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="b">(b) </num><heading style="-uslm-dtd:header">Report on Partnership To Increase Access to Clinical Trials.—</heading><chapeau style="-uslm-dtd:text">Not later than 180 days 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—</chapeau> <paragraph identifier="/us/sComp/117/135/tII/s201/b/1" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><content style="-uslm-dtd:text">how the Secretary will ensure that the advancements made through the existing partnership between the Department of Veterans Affairs and the National Cancer Institute to provide veterans with access to clinical cancer research trials (commonly referred to as “NAVIGATE”) are permanently implemented; and</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tII/s201/b/2" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><content style="-uslm-dtd:text">the determination of the Secretary of whether expansion of such partnership to more than the original 12 facilities of the Department that were selected under such partnership is feasible.</content> </paragraph> </subsection> <subsection identifier="/us/sComp/117/135/tII/s201/c" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="c">(c) </num><heading style="-uslm-dtd:header">Periodic Reports.—</heading><chapeau style="-uslm-dtd:text">Not later than three years after the date of the enactment of this Act, and every three years 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—</chapeau> <paragraph identifier="/us/sComp/117/135/tII/s201/c/1" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><content style="-uslm-dtd:text">assessing how the partnerships entered into under subsection (a)(1) have impacted access by veterans to cancer centers of the National Cancer Institute, including an assessment of the telehealth options made available and used pursuant to such partnerships; and</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tII/s201/c/2" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><content style="-uslm-dtd:text">describing the advancements made with respect to access by veterans to clinical cancer research trials through the partnership described in subsection (b)(1), including how many of those veterans were women veterans, minority veterans (including racial and ethnic minorities), and rural veterans, and identifying opportunities for further innovation.</content> </paragraph> </subsection> </section> <section identifier="/us/sComp/117/135/tII/s202" style="-uslm-dtd:section" styleType="OLC"> <num style="-uslm-dtd:enum" value="202">SEC. 202. </num><heading style="-uslm-dtd:header">REPORT BY DEPARTMENT OF VETERANS AFFAIRS AND DEPARTMENT OF DEFENSE ON INTERAGENCY COLLABORATION ON TREATING AND RESEARCHING BREAST CANCER. </heading> <subsection identifier="/us/sComp/117/135/tII/s202/a" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="a">(a) </num><heading style="-uslm-dtd:header">In General.—</heading><content style="-uslm-dtd:text">Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs, in collaboration with the Secretary of Defense, shall submit to Congress a report on all current research and health care collaborations between the Department of Veterans Affairs and the Department of Defense on treating veterans and members of the Armed Forces with breast cancer.</content> </subsection> <subsection identifier="/us/sComp/117/135/tII/s202/b" style="-uslm-dtd:subsection" styleType="OLC"> <num style="-uslm-dtd:enum" value="b">(b) </num><heading style="-uslm-dtd:header">Elements.—</heading><chapeau style="-uslm-dtd:text">The report required by subsection (a)—</chapeau> <paragraph identifier="/us/sComp/117/135/tII/s202/b/1" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><content style="-uslm-dtd:text">shall include a description of potential opportunities for future interagency collaboration between the Department of Veterans Affairs and the Department of Defense with respect to treating and researching breast cancer; and</content> </paragraph> <paragraph identifier="/us/sComp/117/135/tII/s202/b/2" style="-uslm-dtd:paragraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><chapeau style="-uslm-dtd:text">may include a focus on—</chapeau> <subparagraph identifier="/us/sComp/117/135/tII/s202/b/2/A" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="A">(A) </num><content style="-uslm-dtd:text">with respect to women members of the Armed Forces with a diagnosis of or who are undergoing screening for breast cancer, transition of such members from receiving care from the Department of Defense to receiving care from the Department of Veterans Affairs;</content> </subparagraph> <subparagraph identifier="/us/sComp/117/135/tII/s202/b/2/B" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="B">(B) </num><content style="-uslm-dtd:text">collaborative breast cancer research opportunities between the Department of Veterans Affairs and the Department of Defense;</content> </subparagraph> <subparagraph identifier="/us/sComp/117/135/tII/s202/b/2/C" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="C">(C) </num><content style="-uslm-dtd:text">access to clinical trials; and</content> </subparagraph> <subparagraph identifier="/us/sComp/117/135/tII/s202/b/2/D" style="-uslm-dtd:subparagraph" styleType="OLC"> <num style="-uslm-dtd:enum" value="D">(D) </num><content style="-uslm-dtd:text">such other matters as the Secretary of Veterans Affairs and the Secretary of Defense consider appropriate.</content> </subparagraph> </paragraph> </subsection> </section>