I
119THCONGRESS
1
STSESSION H. R. 668
To require the Secretary of Veterans Affairs to carry out a pilot program
to coordinate, navigate, and manage care and benefits for veterans en-
rolled in both the Medicare program and the system of annual patient
enrollment of the Department of Veterans Affairs.
IN THE HOUSE OF REPRESENTATIVES
JANUARY23, 2025
Mr. C
ISCOMANI(for himself, Mr. DAVISof North Carolina, and Mr. TURNER
of Ohio) introduced the following bill; which was referred to the Com-
mittee on Veterans’ Affairs
A BILL
To require the Secretary of Veterans Affairs to carry out
a pilot program to coordinate, navigate, and manage
care and benefits for veterans enrolled in both the Medi-
care program and the system of annual patient enroll-
ment of the Department of Veterans Affairs.
Be it enacted by the Senate and House of Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE. 3
This Act may be cited as the ‘‘Coordinating Care for 4
Senior Veterans and Wounded Warriors Act’’. 5
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SEC. 2. PILOT PROGRAM ON COORDINATION OF CARE BE-1
TWEEN DEPARTMENT OF VETERANS AFFAIRS 2
AND MEDICARE PROGRAM. 3
(a) I
NGENERAL.—The Secretary, in consultation 4
with the Secretary of Health and Human Services, shall 5
carry out a pilot program (in this section referred to as 6
the ‘‘pilot program’’) to coordinate, navigate, and manage 7
care and benefits for covered veterans. 8
(b) P
URPOSES.—The purposes of the pilot program 9
are as follows: 10
(1) To improve access to health care services 11
for covered veterans at medical facilities of the De-12
partment of Veterans Affairs, from health care pro-13
viders under the Veterans Community Care Program 14
under section 1703 of title 38, United States Code, 15
from health care providers with which the Depart-16
ment has established a Veterans Care Agreement 17
under section 1703A of such title, and from health 18
care providers participating in the Medicare program 19
under title XVIII of the Social Security Act (42 20
U.S.C. 1395 et seq.). 21
(2) To improve outcomes of care received by 22
covered veterans. 23
(3) To improve quality of care received by cov-24
ered veterans. 25
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•HR 668 IH
(4) To lower costs of care received by covered 1
veterans. 2
(5) To eliminate gaps in care and duplication of 3
services and expenses for covered veterans. 4
(6) To improve care coordination for covered 5
veterans, including coordination of patient informa-6
tion and medical records between providers. 7
(c) A
DMINISTRATION.— 8
(1) I
N GENERAL.—The Secretary shall carry 9
out the pilot program through the Center for Inno-10
vation for Care and Payment of the Department of 11
Veterans Affairs. 12
(2) L
OCATIONS.—The Secretary shall carry out 13
the pilot program in not less than three but not 14
more than five Veterans Integrated Service Net-15
works with a large number of covered veterans and 16
varying degrees of urbanization, including— 17
(A) locations that are in rural or highly 18
rural areas, as determined through the use of 19
the Rural-Urban Commuting Areas coding sys-20
tem of the Department of Agriculture; and 21
(B) locations that are medically under-22
served. 23
(d) C
ASEMANAGER.— 24
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•HR 668 IH
(1) ASSIGNMENT OF CASE MANAGER .—In car-1
rying out the pilot program, the Secretary shall as-2
sign each covered veteran participating in the pilot 3
program a case manager responsible for developing 4
an individualized needs assessment for such veteran 5
and, based on such assessment, a care coordination 6
plan with defined treatment goals. 7
(2) A
CCESSING SERVICES.—A case manager as-8
signed to a covered veteran under paragraph (1) is 9
responsible for assisting such veteran in accessing 10
services needed by such veteran and navigating the 11
systems of care under the laws administered by the 12
Secretary and under the Medicare program under 13
title XVIII of the Social Security Act (42 U.S.C. 14
1395 et seq.). 15
(e) U
SE OFEXISTINGMODELS.—In designing the 16
pilot program, the Secretary shall, to the extent prac-17
ticable, use existing models, including value-based care 18
models, used by commercial health care programs to im-19
prove access, health outcomes, quality, and customer expe-20
rience and lower per capita costs. 21
(f) C
ONTRACTINGWITHPRIVATESECTORENTI-22
TIES.— 23
(1) I
N GENERAL.—The Secretary shall, to the 24
greatest extent practicable, contract with private sec-25
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tor entities carrying out commercial health care pro-1
grams for assistance in designing, implementing, 2
and managing care and benefits under the pilot pro-3
gram, to include providing care coordination. 4
(2) N
OTIFICATION.—If the Secretary deter-5
mines that contracting with private sector entities 6
under paragraph (1) is not practicable, the Sec-7
retary shall submit to the Committee on Veterans’ 8
Affairs of the Senate and the Committee on Vet-9
erans’ Affairs of the House of Representatives— 10
(A) a notification of that determination; 11
(B) a description of the steps the Secretary 12
has taken to contract with a private sector enti-13
ty; 14
(C) a justification for why the Secretary 15
has determined that contracting with a private 16
sector entity is not practicable; and 17
(D) a plan for how the Secretary will carry 18
out the pilot program without contracting with 19
a private sector entity, including through the 20
use of employees of the Department of Veterans 21
Affairs or other government agencies, nonprofit 22
organizations, or other entities. 23
(g) M
ETRICS.— 24
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(1) IN GENERAL.—The Secretary shall track 1
metrics under the pilot program, including the fol-2
lowing: 3
(A) The number of veterans participating 4
in the pilot program, disaggregated by Veterans 5
Integrated Service Network. 6
(B) Reliance on health care services ad-7
ministered by the Secretary. 8
(C) Reliance on health care services admin-9
istered under the Medicare program under title 10
XVIII of the Social Security Act (42 U.S.C. 11
1395 et seq.). 12
(D) Quality of care, including patient out-13
comes. 14
(E) Cost of care. 15
(F) Access to care, including under the 16
designated access standards developed by the 17
Secretary under section 1703B of title 38, 18
United States Code. 19
(G) Patient satisfaction. 20
(H) Provider satisfaction. 21
(I) Care coordination, including timely in-22
formation sharing and medical documentation 23
return. 24
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(2) ELEMENTS.—In tracking metrics under 1
paragraph (1), the Secretary shall track information 2
relating to— 3
(A) whether care received by a covered vet-4
eran is related to a service-connected disability 5
(as defined in section 101 of title 38, United 6
States Code); 7
(B) the priority group under section 8
1705(a) of title 38, United States Code, 9
through which each covered veteran was en-10
rolled in the system of annual patient enroll-11
ment of the Department of Veterans Affairs 12
under such section; 13
(C) the type of care and services provided 14
to covered veterans; and 15
(D) the demographics of covered veterans 16
participating in the pilot program, including 17
age. 18
(h) D
URATION.—The Secretary shall carry out the 19
pilot program for a three-year period beginning on the 20
commencement of the pilot program. 21
(i) R
EPORTS.— 22
(1) D
EVELOPMENT, IMPLEMENTATION, RE-23
SULTS, AND DESIGN OF PILOT PROGRAM .— 24
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(A) IN GENERAL.—Not less frequently 1
than quarterly during the two-year period be-2
ginning on the date of the enactment of this 3
Act, the Secretary shall submit to the Com-4
mittee on Veterans’ Affairs of the Senate and 5
the Committee on Veterans’ Affairs of the 6
House of Representatives a report on the devel-7
opment, implementation, results, and design of 8
the pilot program, including information on the 9
metrics tracked under subsection (g). 10
(B) F
INAL DESIGN.—One of the reports 11
required under subparagraph (A) shall contain 12
a description of the final design of the pilot pro-13
gram. 14
(2) R
ESULTS OF PILOT PROGRAM .—Not later 15
than one year after the submission of the final re-16
port under paragraph (1), and not less frequently 17
than annually thereafter during the duration of the 18
pilot program, the Secretary shall submit to the 19
Committee on Veterans’ Affairs of the Senate and 20
the Committee on Veterans’ Affairs of the House of 21
Representatives a report on the results of the pilot 22
program. 23
(3) F
INAL REPORT.—Not later than 180 days 24
before the termination of the pilot program, the Sec-25
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retary shall submit to the Committee on Veterans’ 1
Affairs of the Senate and the Committee on Vet-2
erans’ Affairs of the House of Representatives a 3
final report on the pilot program, which shall include 4
the recommendation of the Secretary for whether the 5
pilot program should be extended or made perma-6
nent. 7
(j) D
EFINITIONS.—In this section: 8
(1) C
OVERED VETERAN .—The term ‘‘covered 9
veteran’’ means a veteran who is enrolled in both the 10
Medicare program under title XVIII of the Social 11
Security Act (42 U.S.C. 1395 et seq.) and the sys-12
tem of annual patient enrollment of the Department 13
of Veterans Affairs under section 1705(a) of title 14
38, United States Code. 15
(2) S
ECRETARY.—The term ‘‘Secretary’’ means 16
the Secretary of Veterans Affairs. 17
Æ
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