[House Report 119-259]
[From the U.S. Government Publishing Office]
119th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 119-259
=======================================================================
RURAL VETERANS' IMPROVED ACCESS TO BENEFITS ACT
OF 2025
----------------
September 9, 2025.--Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
----------------
Mr. Bost, from the Committee on Veterans' Affairs,
submitted the following
R E P O R T
[To accompany H.R. 3951]
[Including cost estimate of the Congressional Budget Office]
The Committee on Veterans' Affairs, to whom was referred
the bill (H.R. 3951) to amend the Veterans' Benefits
Improvements Act of 1996 and the Johnny Isakson and David P.
Roe, M.D. Veterans Health Care and Benefits Improvement Act of
2020 to improve the temporary licensure requirements for
contract health care professionals who perform medical
disability examinations for the Department of Veterans Affairs,
and for other purposes, having considered the same, reports
favorably thereon without amendment and recommends that the
bill do pass.
CONTENTS
Page
Amendment........................................................
Purpose and Summary.............................................. 2
Background and Need for Legislation.............................. 2
Hearings......................................................... 4
Subcommittee Consideration....................................... 5
Committee Consideration.......................................... 5
Committee Votes.................................................. 5
Committee Oversight Findings..................................... 5
Statement of General Performance Goals and Objectives............ 5
Earmarks and Tax and Tariff Benefits............................. 6
Committee Cost Estimate.......................................... 6
Budget Authority and Congressional Budget Office Estimate........ 6
Federal Mandates Statement....................................... 7
Advisory Committee Statement..................................... 7
Applicability to Legislative Branch.............................. 7
Statement on Duplication of Federal Programs..................... 7
Section-by-Section Analysis of the Legislation................... 7
Changes in Existing Law Made by the Bill, as Reported............ 8
Purpose and Summary
H.R. 3951, the ``Rural Veterans' Improved Access to
Benefits Act of 2025,'' was introduced by Representative Juan
Ciscomani of Arizona on June 12th, 2025. The bill would improve
the temporary licensure requirements for contracted healthcare
professionals who perform medical disability examinations for
the Department of Veterans Affairs (VA). This would allow any
person who would otherwise be eligible for appointment in the
VA Veterans Health Administration (VHA) to perform medical
disability examinations for the VA in states where they are not
otherwise licensed. Covered medical professionals would also
need to hold a valid medical license, must not be barred from
practicing medicine in any State, and must be authorized by the
VA to perform medical disability exams. This bill would also
extend the expiration date of this authority until January 5,
2031.
Background and Need for Legislation
Section 1: Short Title
This Act may be cited as the ``Rural Veterans' Improved
Access to Benefits Act of 2025.''
Section 2: Improvements To Temporary Licensure Requirements for
Contract Health Care Professionals Who Perform Medical
Disability Examinations For The Department Of Veterans Affairs
When a veteran files a disability benefits claim, VA will
schedule them for compensation and pension exams if there is
insufficient information to determine whether that veteran is
entitled to their claimed benefits for a disability resulting
from their military service. With the passage of the Veterans'
Benefits Improvement Act of 1996 (P.L. 104-275), Congress
granted temporary authority for certain contracted medical
professionals to perform compensation and pension exams outside
of the state that granted that professional their medical
license. Since 2016, physicians working under the supervision
of VA have been allowed to work across state lines.\1\
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\1\Statement for the Record of the American Legion, (June 24,
2025), HHRG-119-VR09-20250624-SD014.pdf (house.gov).
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Prior to 2016, disability examinations were primarily
performed by VHA-employed disability examiners.\2\ By 2017, VA
had achieved a 1:1 ratio between contracted and VHA-employed
disability examiners, and that ratio rose to an almost 3:1
ratio by 2021.\3\ Today, roughly 95% of these exams nationwide
are performed by contracted examiners from four vendors.
---------------------------------------------------------------------------
\2\Statement for the Record of the American Legion, (June 24,
2025), HHRG-119-VR09-20250624-SD014.pdf (house.gov).
\3\Statement for the Record of the American Legion, (June 24,
2025), HHRG-119-VR09-20250624-SD014.pdf (house.gov).
---------------------------------------------------------------------------
In 2020, Congress passed the Johnny Isakson and David P.
Roe, M.D. Veterans Health Care and Benefits Improvement Act of
2020 (P.L. 115-315) which amended section 504 of the Veterans'
Benefits Improvements Act of 1996 (P.L. 104-275; 38 U.S.C. 5101
note) to expand the authority to perform medical disability
examinations, pursuant to a contract to perform such exams
outside the state of their medical licensure, to contracted
physicians, physician assistants, nurse practitioners,
audiologists, and psychologists to perform medical disability
examinations. Certain medical professionals within this covered
group were required to have a current, unrestricted license to
practice health care, could not be barred from practicing such
health care profession, and were required to possess the
authority to perform medical disability examinations pursuant
to a contract with the VA.
While VA, veteran advocates, contracted vendors, and
veterans agree that this authority has helped rural and tribal
veterans receive medical disability examinations closer to
where they live, this temporary authority is set to expire on
January 6, 2026. This section would extend the expiration date
of this temporary authority from January 5, 2026, until January
5, 2031. Further, this section would expand the group of
medical professionals covered by this section to any health
care professional eligible for appointment in VHA to perform
medical disability examinations. By expanding this authority,
the Committee understands this section to expand access to
contracted disability examiners for veterans for whom access to
currently authorized, qualified healthcare professionals is
limited.
In a June 24, 2025, legislative hearing of the Subcommittee
on Disability Assistance and Memorial Affairs, Mrs. Candance
Wheeler, Senior Director, Government and Legislative Affairs,
Tragedy Assistance Program for Survivors (TAPS), testified on
the importance of this legislation for veterans facing access
to timely disability evaluations:
``This important legislation addresses the challenges
many veterans face in accessing timely evaluations
necessary for their benefits, especially veterans who
live in rural areas. It allows qualified health care
professionals with a valid, unrestricted license--
regardless of their state--to conduct VA medical
disability exams, as long as they're not barred from
practicing anywhere in the U.S. TAPS believes this bill
will help reduce wait times and improve benefit access
for veterans--especially those in rural or underserved
communities--by increasing the availability of
qualified medical examiners. It reflects a commitment
to ensuring all veterans receive the care and
evaluations they've earned, without being limited by
outdated licensing barriers.''\4\
---------------------------------------------------------------------------
\4\Candace Wheeler, Testimony of Tragedy Assistance Program for
Survivors (June 24, 2025), HHRG-119-VR09-Wstate-WheelerC-20250624.pdf
(House.gov).
The Committee believes that VA oversight over contracted
disability examinations has been inadequate at times. A July
2022 VA Office of Inspector General (OIG) report noted that VA
has failed to keep all licensed vendors accountable for meeting
VA's accuracy goals.\5\ This section would address that by
mandating a report to Congress on the use of this authority,
errors identified in executing this authority, and plans for
correcting these errors. The Committee believes this is
essential to ensure proper oversight by Congress.
---------------------------------------------------------------------------
\5\Department of Veterans Affairs, Office of Inspector General,
Contract Medical Exam Program Limitations Put Veterans at Risk for
Inaccurate Claims Decisions (Report No. 21-01237-127) (June 8, 2022),
VAOIG-21-01237-127.pdf.
---------------------------------------------------------------------------
The Committee believes that this section is critical to
ensure that veterans maintain their access to contracted
disability examiners that are located close to the communities
in which they reside. The Committee believes this section
expanding the license portability authority to medical
professionals eligible for employment by the VA further would
improve veterans' access to contracted disability examiners.
Hearings
On June 24, 2025, the Committee on Veterans Affairs
Subcommittee on Disability Assistance and Memorial Affairs held
a legislative hearing on H.R. 3951 and other bills that were
pending before the subcommittee.
The following witnesses testified:
The Honorable Mike Bost, U.S. House of
Representatives; The Honorable Elise Stefanik, U.S.
House of Representatives; The Honorable Julia Brownley,
U.S. House of Representatives; The Honorable Chuck
Edwards, U.S. House of Representatives; The Honorable
Tom Barrett, U.S. House of Representatives; The
Honorable Tim Kennedy, U.S. House of Representatives;
The Honorable Jahana Hayes, U.S. House of
Representatives; Mrs. Julie Guleff, Caregiver and
Surviving Spouse of Stephen Guleff, Vietnam Veteran;
Mr. Michael J. Wishnie, William O. Douglas Clinical
Professor of Law and Director, Veterans Legal Services
Clinic, Yale Law School; Ms. Candace Wheeler, Senior
Director, Government and Legislative Affairs, Tragedy
Assistance Program for Survivors; Mr. Evan Deichert,
Acting Deputy Vice Chairman, Board of Veterans'
Appeals, U.S. Department of Veterans Affairs; Mr. Kevin
Friel, Executive Director, Pension & Fiduciary Service,
Veterans Benefits Administration, U.S. Department of
Veterans Affairs; Mr. James W. Smith II, Deputy
Executive Director, Policy and Procedures, Compensation
Service, Veterans Benefits Administration, U.S.
Department of Veterans Affairs; Dr. Colleen Richardson,
Executive Director, Caregiver Support Program, Veterans
Health Administration, U.S. Department of Veterans
Affairs; and Colonel (Ret.) Tiffany M. Wagner, USAF,
Clerk of the Court, U.S. Court of Appeals for Veterans
Claims.
The following individuals and organizations submitted
statements for the record:
The Honorable Debbie Wasserman-Schultz of Florida;
Gold Star Spouses of America; Veterans of Foreign Wars;
Vietnam Veterans of America; National Organization of
Veterans' Advocates; Disabled American Veterans;
Quality of Life Foundation; Jewish Federations of North
America; Paralyzed Veterans of America; Administrative
Conference of the United States; Afikim Foundation;
American Legion; Shiron Collective; American Federation
of Government Employees; Republican Jewish Coalition;
Adam Zimmerman, University of Southern California
Robert Kinglsey Professor of Law, in their personal
capacity; Jonah Platt in their personal capacity;
Shabbos Kestenbaum in their personal capacity; John
Ondrasik in their personal capacity; Lizzy Savetsky in
their personal capacity; Aviva Klompas in their
personal capacity; Lee Trink in their personal
capacity; Bethany Mandel in their personal capacity;
Iddo Goldberg in their personal capacity; Liora Rezin
their personal capacity; Jason Greenblatt in their
personal capacity; Sarah Stern in their personal
capacity; and Nicole Neily in their personal capacity.
Subcommittee Consideration
On Thursday, July 3, 2025, the Subcommittee on Disability
Assistance and Memorial Affairs was discharged from further
consideration of this legislation.
Committee Consideration
On May 6, 2025, the full Committee met in open markup
session with a quorum being present, and ordered H.R. 3951 be
reported favorably to the House of Representatives by voice
vote. During consideration of the bill, the following
amendments were considered:
An amendment #1 to H.R. 3951 was offered by
Representative Ramirez to add a new section that would
affirm that any collective bargaining agreement between
the Department of Veterans Affairs and any labor
organization that is an exclusive representative of
Federal Employees that was previously in effect on
March 26, 2025, would have the full force and effect
through the agreement's stated terms. This amendment
was not agreed to by a recorded vote of 11 yeas, 12
nays.
An amendment #2 to H.R. 3951 was offered by
Representative Ramirez to add a new section that would
direct VA to reinstate the Office of Equity Assurance
of the Veterans Benefits Administration; reinstate the
employment of each employee of this office who was
terminated after January 20, 2025; ensure that a
position is not eliminated pursuant to a reduction in
force; and provide to the Committees on Veterans
Affairs a briefing on the status of implementing the
GAO report GAO-23-106097. It would also require bi-
annual briefings to the Committees from the VA Under
Secretary for Benefits on data, research, and analysis
developed by the office. This amendment was not agreed
to by a recorded vote of 11 yeas, 12 nays.
A motion by Representative Jack Bergman to report H.R. 3951
favorably to the House of Representatives was agreed to by
voice vote.
Committee Votes
In compliance with clause 3(b) of rule XIII of the Rules of
the House of Representatives, two recorded votes were taken on
amendments or in connection with ordering H.R. 3951 reported to
the House.
Committee Oversight Findings
In compliance with clause 3(c)(1) of rule XIII and clause
(2)(b)(1) of rule X of the Rules of the House of
Representatives, the Committee's oversight findings and
recommendations are reflected in the descriptive portions of
this report.
Statement of General Performance Goals and Objectives
In accordance with clause 3(c)(4) of rule XIII of the Rules
of the House of Representatives, the Committee's performance
goals and objectives of H.R. 3951 are to ensure certain
licensed healthcare professionals performing medical disability
exams pursuant to a contract administered by the Secretary of
Veterans Affairs can perform such exams outside the state of
their medical licensure, and extending that authority to all
licensed healthcare professionals otherwise employable by VHA
to perform such exams.
Earmarks and Tax and Tariff Benefits
H.R. 3951 does not contain any Congressional earmarks,
limited tax benefits, or limited tariff benefits as defined in
clause 9 of rule XXI of the Rules of the House of
Representatives.
Committee Cost Estimate
The Committee adopts as its own the Congressional Budget
Office cost estimate on this measure.
Budget Authority and Congressional Budget Office
Cost Estimate
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Under current law, the Department of Veterans Affairs (VA)
can contract with physicians assistants, nurse practitioners,
audiologists, and psychologists to provide disability
examinations of veterans in any location in the United States,
regardless of whether the providers are licensed to practice in
that jurisdiction. That authority expires on January 5, 2026.
H.R. 3951 would extend the authority until January 5, 2031, and
would expand the types of professionals with whom VA can
contract for medical exams to any licensed health care
professional. The bill also would require VA to report to the
Congress on the department's use of the expanded authority.
Expanding the types of eligible health care providers who
may provide disability examinations in a jurisdiction could
change which providers perform exams but would not affect the
number of veterans eligible to receive VA benefits. As a
result, CBO estimates that enacting the provision would not
affect direct spending for disability compensation benefits.
The report required by the bill would include details on
the number and type of examinations provided by contracted
health care providers during the one-year period following
enactment. Under current law, VA may use mandatory
appropriations to pay for administrative expenses associated
with contract medical exams, including reports. Based on the
cost of similar reports, CBO estimates that providing the
report would increase direct spending by less than $500,000.
The CBO staff contact for this estimate is Logan Smith. The
estimate was reviewed by Christina Hawley Anthony, Deputy
Director of Budget Analysis.
Phillip L. Swagel,
Director, Congressional Budget Office.
Federal Mandates Statement
Section 423 of the Congressional Budget and Impoundment
Control Act (as amended by Section 101(a)(2) of the Unfunded
Mandate Reform Act, P.L. 104-4 is inapplicable to H.R. 3951.
Advisory Committee Statement
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act would be created by H.R.
3951.
Applicability to Legislative Branch
The Committee finds that H.R. 3951 does not relate to the
terms and conditions of employment or access to public services
or accommodations within the meaning of section102(b)(3) of the
Congressional Accountability Act.
Statement on Duplication of Federal Programs
Pursuant to clause 3(c)(5) of rule XIII of the Rules of the
House of Representatives, the Committee finds that no provision
of H.R. 3951 would establish or reauthorize a program of the
Federal Government known to be duplicative of another Federal
program, a program that was included in any report from the
Government Accountability Office to Congress pursuant to
section 21 of P.L. 111-139, or a program related to a program
identified in the most recent Catalog of Federal Domestic
Assistance.
Section-By-Section Analysis of the Legislation
Section 1. Short title
This section would establish the short title of the bill as
the ``Rural Veterans' Improved Access to Benefits Act of
2025.''
Section 2 Improvements to temporary licensure requirements for contract
health care professionals who perform medical disability
examinations for the Department of Veterans Affairs
This section would further amend section 504 of the
Veterans' Benefits Improvements Act of 1996 (P.L. 104-275; 38
U.S.C. Sec. 5101 note), as amended by section 2002(1)(a) of the
Johnny Isakson and David P. Roe, M.D. Veterans Health Care and
Benefits Improvement Act of 2020 (P.L. 115-315; 38 U.S.C.
Sec. 5101 note) to expand the authority to perform medical
disability examinations, pursuant to a contract to perform such
exams outside the state of their medical licensure, to
contracted physicians, physician assistants, nurse
practitioners, audiologists, psychologists, and any other
licensed healthcare professional otherwise employable by the
VHA to perform medical disability examinations.
It would also amend section 2002(4)(a) of the Johnny
Isakson and David P. Roe, M.D. Veterans Health Care and
Benefits Improvement Act of 2020 (P.L. 116 315; 38 U.S.C.
Sec. 5101 note) by striking ``On the date that is five years
after the date of the enactment of this Act'' and inserting
``On January 5, 2031.''
Additionally, this section would amend 2002(2) by striking
``physicians assistants, nurse practitioners, audiologists, and
psychologists'' and inserting ``health care professionals.''
Finally, this section would direct the VA to submit a
report to the Committees on Veterans' Affairs of the House of
Representatives and the Senate regarding the use of this
authority, no later than 15 months after the date of enactment
of this Act. This report would include the number of
examinations conducted pursuant to a contract under such
authority; the cost, timeliness, and legal adequacy of such
examinations, disaggregated by health care professional and
contract; the number of such examinations conducted in each
State; the number of each kind of health care professional that
conducted such examinations; the number of examinations
erroneously conducted by a health care professional without
such a contract or unauthorized to enter into such a contract;
and a plan to correct errors in the use of such authority.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, existing law in which no change
is proposed is shown in roman):
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, and existing law in which no
change is proposed is shown in roman):
VETERANS' BENEFITS IMPROVEMENTS ACT OF 1996
* * * * * * *
TITLE V--DEPARTMENT OF VETERANS AFFAIRS
ADMINISTRATIVE MATTERS
* * * * * * *
SEC. 504. PILOT PROGRAM FOR USE OF CONTRACT HEALTH CARE PROFESSIONALS
FOR DISABILITY EXAMINATIONS.
(a) Authority.--The Secretary of Veterans Affairs, acting
through the Under Secretary for Benefits, may conduct a pilot
program under this section under which examinations with
respect to medical disability of applicants for benefits under
laws administered by the Secretary that are carried out through
the Under Secretary for Benefits may be made by persons other
than employees of the Department of Veterans Affairs. Any such
examination shall be performed pursuant to contracts entered
into by the Under Secretary for Benefits with those persons.
(b) Limitation.--The Secretary may carry out the pilot
program under this section as follows:
(1) In fiscal years before fiscal year 2015, through
not more than 10 regional offices of the Department of
Veterans Affairs.
(2) In fiscal year 2015, through not more than 12
regional offices of the Department.
(3) In fiscal year 2016, through not more than 15
regional offices of the Department.
(4) In fiscal year 2017 and each fiscal year
thereafter, through such regional offices of the
Department as the Secretary considers appropriate.
(c) Licensure of Contract Health Care Professionals.--
(1) In general.--Notwithstanding any law regarding
the licensure of health care professionals, only a
health care professional described in paragraph (2) may
conduct an examination pursuant to a contract entered
into under subsection (a) at any location in any State,
the District of Columbia, or a Commonwealth, territory,
or possession of the United States, so long as the
examination is within the scope of the authorized
duties under such contract.
[(2) Health care professional described.--A health
care professional described in this paragraph is a
physician, physician assistant, nurse practitioner,
audiologist, or psychologist, who--
[(A) has a current unrestricted license to
practice the health care profession of the
physician, physician assistant, nurse
practitioner, audiologist, or psychologist, as
the case may be;
[(B) is not barred from practicing such
health care profession in any State, the
District of Columbia, or a Commonwealth,
territory, or possession of the United States;
and
[(C) is performing authorized duties for the
Department of Veterans Affairs pursuant to a
contract entered into under subsection (a).]
(2) Health care professional described.--A health
care professional described in this paragraph is a
person who is eligible for appointment to a position in
the Veterans Health Administration covered by section
7402(b) of title 38, United States Code, who--
(A) has a current and unrestricted license to
practice the health care profession of the
health care professional;
(B) is not barred from practicing such health
care profession in any State; and
(C) is performing authorized duties for the
Department pursuant to a contract entered into
under subsection (a).
(d) Source of Funds.--Expenses of carrying out the pilot
program under this section, including payments for pilot
program examination travel and incidental expenses under the
terms and conditions set forth by 38 U.S.C. 111, shall be
reimbursed to the accounts available for the general operating
expenses of the Veterans Benefits Administration and
information technology systems from amounts available to the
Secretary of Veterans Affairs for payment of compensation and
pensions.
(e) Report to Congress.--Not later than three years after the
date of the enactment of this Act, the Secretary shall submit
to the Congress a report on the effect of the use of the
authority provided by subsection (a) on the cost, timeliness,
and thoroughness of medical disability examinations.
(f) Certain Information Provided to Health Care
Professional.--The Secretary shall provide to a health care
professional who performs an examination under subsection (a),
or a contractor performing a contract under such subsection,
the contact information of any agent or attorney recognized by
the Secretary under chapter 59 of title 38, United States Code,
with regards to a claim for benefits that gives rise to such
examination.
* * * * * * *
----------
JOHNNY ISAKSON AND DAVID P. ROE, M.D. VETERANS
HEALTH CARE AND BENEFITS IMPROVEMENT ACT OF
2020
* * * * * * *
TITLE II--BENEFITS
Subtitle A--Benefits Generally
* * * * * * *
SEC. 2002. MATTERS RELATING TO DEPARTMENT OF VETERANS AFFAIRS MEDICAL
DISABILITY EXAMINATIONS.
(a) Temporary Clarification of Licensure Requirements for
Contractor Medical Professionals to Perform Medical Disability
Examinations for the Department of Veterans Affairs Under Pilot
Program for Use of Contract Physicians for Disability
Examinations.--
(1) In general.--Subsection (c) of section 504 of the
Veterans' Benefits Improvements Act of 1996 (Public Law
104-275; 38 U.S.C. 5101 note) is amended to read as
follows:
``(c) Licensure of Contract Health Care Professionals.--
``(1) In general.--Notwithstanding any law regarding
the licensure of health care professionals, a health
care professional described in paragraph (2) may
conduct an examination pursuant to a contract entered
into under subsection (a) at any location in any State,
the District of Columbia, or a Commonwealth, territory,
or possession of the United States, so long as the
examination is within the scope of the authorized
duties under such contract.
``(2) Health care professional described.--A health
care professional described in this paragraph is a
physician, physician assistant, nurse practitioner,
audiologist, or psychologist, who--
``(A) has a current unrestricted license to
practice the health care profession of the
physician, physician assistant, nurse
practitioner, audiologist, or psychologist, as
the case may be;
``(B) is not barred from practicing such
health care profession in any State, the
District of Columbia, or a Commonwealth,
territory, or possession of the United States;
and
``(C) is performing authorized duties for the
Department of Veterans Affairs pursuant to a
contract entered into under subsection (a).''.
(2) Purpose.--The purpose of the amendment made by
paragraph (1) is to expand the license portability for
[physicians assistants, nurse practitioners,
audiologists, and psychologists] health care
professionals to supplement the capacity of employees
of the Department to provide medical examinations
described in subsection (b).
(3) Rule of construction.--The amendment made by
paragraph (1) shall not be construed to affect the
license portability for physicians in effect under
section 504(c) of such Act as in effect on the day
before the date of the enactment of this Act.
(4) Sunset.--[On the date that is five years after
the date of the enactment of this Act] On January 5,
2031, subsection (c) of such section shall read as it
read on the day before the date of the enactment of
this Act.
(b) Temporary Halt on Elimination of Medical Examiner
Positions in Department of Veterans Affairs.--The Secretary of
Veterans Affairs shall temporarily suspend the efforts of the
Secretary in effect on the day before the date of the enactment
of this Act to eliminate medical examiner positions in the
Department of Veterans Affairs until the number of individuals
awaiting a medical examination with respect to medical
disability of the individuals for benefits under laws
administered by the Secretary that are carried out through the
Under Secretary for Benefits is equal to or less than the
number of such individuals who were awaiting such a medical
examination with respect to such purposes on March 1, 2020.
(c) Report on Provision of Medical Examinations.--
(1) In general.--Not later than 180 days after the
date of the enactment of this Act, the Secretary shall
submit to the appropriate committees of Congress a
report on the provision of medical examinations
described in subsection (b) by the Department.
(2) Contents.--The report submitted under paragraph
(1) shall cover the following:
(A) How the Secretary will increase the
capacity, efficiency, and timeliness of
physician assistants, nurse practitioners,
audiologists, and psychologists of the Veterans
Health Administration with respect to
completing medical examinations described in
subsection (b).
(B) The total number of full-time equivalent
employees among all physician assistants, nurse
practitioners, audiologists, and psychologists
needed for the increases described in
subparagraph (A).
(C) An assessment regarding the importance of
retaining a critical knowledge base within the
Department for performing medical examinations
for veterans filing claims for compensation
under chapters 11 and 13 of title 38, United
States Code, including with respect to military
sexual trauma, post-traumatic stress disorder,
traumatic brain injury, and toxic exposure.
(3) Collaboration.--The Secretary shall collaborate
with the veterans community and stakeholders in the
preparation of the report required by paragraph (1).
(4) Appropriate committees of congress defined.--In
this subsection, the term ``appropriate committees of
Congress'' means--
(A) the Committee on Veterans' Affairs and
the Committee on Appropriations of the Senate;
and
(B) the Committee on Veterans' Affairs and
the Committee on Appropriations of the House of
Representatives.
(d) Comptroller General of the United States Review.--
(1) Review required.--Not later than 360 days after
the date of the enactment of this Act, the Comptroller
General of the United States shall commence a review of
the implementation of the pilot program authorized
under subsection (a) of section 504 of the Veterans'
Benefits Improvements Act of 1996 (Public Law 104-275;
38 U.S.C. 5101 note).
(2) Elements.--The review conducted under paragraph
(1) shall include the following:
(A) An assessment of the use of subsection
(c) of section 504 of such Act, as amended by
subsection (a)(1) of this section.
(B) Efforts to retain and recruit medical
examiners as employees of the Department.
(C) Use of telehealth for medical
examinations described in subsection (b) that
are administered by the Department.
(e) Briefing on Recommendations of Comptroller General of the
United States.--Not later than 60 days after the date of the
enactment of this Act, the Secretary shall provide to the
Committee on Veterans' Affairs of the Senate and the Committee
on Veterans' Affairs of the House of Representatives a briefing
on how the Secretary will implement the recommendations of the
Comptroller General of the United States regarding--
(1) the monitoring of the training of providers of
examinations pursuant to contracts under section 504 of
the Veterans' Benefits Improvements Act of 1996 (Public
Law 104-275; 38 U.S.C. 5101 note); and
(2) ensuring such providers receive such training.
(f) Holding Underperforming Contract Medical Examiners
Accountable.--The Secretary shall take such actions as may be
necessary to hold accountable the providers of medical
examinations pursuant to contracts under section 504 of the
Veterans' Benefits Improvements Act of 1996 (Public Law 104-
275; 38 U.S.C. 5101 note) who are underperforming in the
meeting of the needs of veterans through the performance of
medical examinations pursuant to such contracts.
* * * * * * *
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