[Congressional Record Volume 165, Number 58 (Wednesday, April 3, 2019)]
[Senate]
[Pages S2241-S2242]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. THUNE (for himself and Mr. Rounds):
  S. 1001. A bill to amend the Indian Health Care Improvement Act to 
allow the Indian Health Service to cover the cost of a copayment of an 
Indian or Alaska Native veteran receiving medical care or services from 
the Department of Veterans Affairs, and for other purposes; to the 
Committee on Indian Affairs.
  Mr. THUNE. Mr. President, I ask unanimous consent that the text of 
the bill be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1001

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Tribal Veterans Health Care 
     Enhancement Act''.

     SEC. 2. LIABILITY FOR PAYMENT.

       Section 222 of the Indian Health Care Improvement Act (25 
     U.S.C. 1621u) is amended by adding at the end the following:
       ``(d) Veterans Affairs Copayments.--The Service may pay, in 
     accordance with section 412, the cost of a copayment assessed 
     by the Department of Veterans Affairs to an eligible Indian 
     veteran (as defined in section 412) for covered medical care 
     (as defined in such section).''.

     SEC. 3. COPAYMENTS FOR TRIBAL VETERANS RECEIVING CERTAIN 
                   MEDICAL SERVICES.

       Title IV of the Indian Health Care Improvement Act (25 
     U.S.C. 1641 et seq.) is amended by adding at the end the 
     following:

     ``SEC. 412. PAYMENTS FOR ELIGIBLE INDIAN VETERANS RECEIVING 
                   COVERED MEDICAL CARE AT VA FACILITIES.

       ``(a) Definitions.--In this section:
       ``(1) Appropriate committees of congress.--The term 
     `appropriate committees of Congress' means--
       ``(A) in the Senate--
       ``(i) the Committee on Veterans' Affairs; and

[[Page S2242]]

       ``(ii) the Committee on Indian Affairs; and
       ``(B) in the House of Representatives--
       ``(i) the Committee on Veterans' Affairs; and
       ``(ii) the Committee on Natural Resources.
       ``(2) Covered medical care.--The term `covered medical 
     care' means any medical care or service that is--
       ``(A) authorized for an eligible Indian veteran under the 
     contract health service and referred by the Service; and
       ``(B) administered at a facility of the Department of 
     Veterans Affairs, including any services rendered under a 
     contract with a non-Department of Veterans Affairs health 
     care provider.
       ``(3) Eligible indian veteran.--The term `eligible Indian 
     veteran' means an Indian or Alaska Native veteran who is 
     eligible for assistance from the Service.
       ``(b) Memorandum of Understanding.--
       ``(1) In general.--Notwithstanding any other provision of 
     law, except as provided in paragraph (3), the Secretary (or a 
     designee, including the director of any area office of the 
     Service), the Secretary of Veterans Affairs (or a designee), 
     and any tribal health program, as applicable, shall enter 
     into a memorandum of understanding, in consultation with 
     Indian tribes to be impacted by the memorandum of 
     understanding (on a national or regional basis), that 
     authorizes the Secretary or tribal health program, as 
     applicable, to pay to the Secretary of Veterans Affairs any 
     copayments owed to the Department of Veterans Affairs by 
     eligible Indian veterans for covered medical care.
       ``(2) Factors for consideration.--In entering into a 
     memorandum of understanding under paragraph (1), the 
     Secretary, the Secretary of Veterans Affairs, and any tribal 
     health program, as applicable, shall take into consideration 
     any findings contained in the report under subsection (e).
       ``(3) Exception.--The Secretary, the Secretary of Veterans 
     Affairs, and any tribal health program, as applicable, shall 
     not be required to enter into a memorandum of understanding 
     under paragraph (1) if the Secretary, the Secretary of 
     Veterans Affairs, and any tribal health program, as 
     applicable, jointly certify to the appropriate committees of 
     Congress that such a memorandum of understanding would--
       ``(A) decrease the quality of health care provided to 
     eligible Indian veterans;
       ``(B) impede the access of those veterans to health care; 
     or
       ``(C) substantially decrease the quality of, or access to, 
     health care by individuals receiving health care from the 
     Department of Veterans Affairs or beneficiaries of the 
     Service.
       ``(c) Payment by Service.--Notwithstanding any other 
     provision of law and in accordance with the relevant 
     memorandum of understanding described in subsection (b), the 
     Service may cover the cost of any copayment assessed by the 
     Department of Veterans Affairs to an eligible Indian veteran 
     receiving covered medical care.
       ``(d) Authorization To Accept Funds.--Notwithstanding 
     section 407(c), section 2901(b) of the Patient Protection and 
     Affordable Care Act (25 U.S.C. 1623(b)), or any other 
     provision of law, and in accordance with the relevant 
     memorandum of understanding described in subsection (b), the 
     Secretary of Veterans Affairs may accept a payment from the 
     Service under subsection (c).
       ``(e) Report.--Not later than 90 days after the date of 
     enactment of this section, the Secretary and the Secretary of 
     Veterans Affairs shall submit to the appropriate committees 
     of Congress a report that describes--
       ``(1) the number of veterans, disaggregated by State, who--
       ``(A) are eligible for assistance from the Service; and
       ``(B) have received health care at a medical facility of 
     the Department of Veterans Affairs;
       ``(2) the number of veterans, disaggregated by State and 
     calendar year, who--
       ``(A) are eligible for assistance from the Service; and
       ``(B) were referred to a medical facility of the Department 
     of Veterans Affairs from a facility of the Service during the 
     period--
       ``(i) beginning on January 1, 2013; and
       ``(ii) ending on December 31, 2018; and
       ``(3) an update regarding efforts of the Secretary and the 
     Secretary of Veterans Affairs to streamline health care for 
     veterans who are eligible for assistance from the Service and 
     have received health care at a medical facility of the 
     Department of Veterans Affairs and at a facility of the 
     Service, including a description of--
       ``(A) any changes to the provision of health care required 
     under this Act; and
       ``(B) any barriers to efficiently streamline the provision 
     of health care to veterans who are eligible for assistance 
     from the Service.''.
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