Us Congress 2025-2026 Regular Session

Us Congress Senate Bill SB275 Compare Versions

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Old	New	Differences
1	1	II
2	2	119THCONGRESS
3	3	1
4	4	STSESSION S. 275
5	5	To improve the provision of care and services under the Veterans Community
6	6	Care Program of the Department of Veterans Affairs, and for other purposes.
7	7	IN THE SENATE OF THE UNITED STATES
8	8	JANUARY28, 2025
9	9	Mr. M
10	10	ORANintroduced the following bill; which was read twice and referred
11	11	to the Committee on Veterans’ Affairs
12	12	A BILL
13	13	To improve the provision of care and services under the
14	14	Veterans Community Care Program of the Department
15	15	of Veterans Affairs, and for other purposes.
16	16	Be it enacted by the Senate and House of Representa-1
17	17	tives of the United States of America in Congress assembled, 2
18	18	SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 3
19	19	(a) S
20	20	HORTTITLE.—This Act may be cited as the 4
21	21	‘‘Veterans’ Assuring Critical Care Expansions to Support 5
22	22	Servicemembers (ACCESS) Act of 2025’’. 6
23	23	(b) T
24	24	ABLE OFCONTENTS.—The table of contents for 7
25	25	this Act is as follows: 8
26	26	Sec. 1. Short title; table of contents.
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30	30	TITLE I—IMPROVEMENT OF VETERANS COMMUNITY CARE
31	31	PROGRAM
32	32	Sec. 101. Codification of requirements for eligibility standards for access to
33	33	community care from Department of Veterans Affairs.
34	34	Sec. 102. Requirement that Secretary notify veterans of eligibility for care
35	35	under Veterans Community Care Program.
36	36	Sec. 103. Consideration under Veterans Community Care Program of veteran
37	37	preference for care, continuity of care, and need for caregiver
38	38	or attendant.
39	39	Sec. 104. Notification of denial of request for care under Veterans Community
40	40	Care Program.
41	41	Sec. 105. Discussion of telehealth options under Veterans Community Care
42	42	Program.
43	43	Sec. 106. Extension of deadline for submittal of claims by health care entities
44	44	and providers under prompt payment standard.
45	45	TITLE II—MENTAL HEALTH TREATMENT PROGRAMS
46	46	Sec. 201. Definitions.
47	47	Sec. 202. Standardized process to determine eligibility of covered veterans for
48	48	participation in certain mental health treatment programs.
49	49	Sec. 203. Improvements to Department of Veterans Affairs Mental Health Res-
50	50	idential Rehabilitation Treatment Program.
51	51	TITLE III—OTHER HEALTH CARE MATTERS
52	52	Sec. 301. Plan on establishment of interactive, online self-service module for
53	53	care.
54	54	Sec. 302. Modification of requirements for Center for Innovation for Care and
55	55	Payment of the Department of Veterans Affairs and require-
56	56	ment for pilot program.
57	57	Sec. 303. Reports.
58	58	TITLE I—IMPROVEMENT OF VET-1
59	59	ERANS COMMUNITY CARE 2
60	60	PROGRAM 3
61	61	SEC. 101. CODIFICATION OF REQUIREMENTS FOR ELIGI-4
62	62	BILITY STANDARDS FOR ACCESS TO COMMU-5
63	63	NITY CARE FROM DEPARTMENT OF VET-6
64	64	ERANS AFFAIRS. 7
65	65	(a) E
66	66	LIGIBILITYACCESSSTANDARDS.—Section 8
67	67	1703B of title 38, United States Code, is amended— 9
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71	71	(1) by striking subsections (a) through (e) and 1
72	72	inserting the following: 2
73	73	‘‘(a) E
74	74	LIGIBILITYSTANDARDS FORACCESS TOCOM-3
75	75	MUNITYCARE.—(1) A covered veteran shall be eligible to 4
76	76	elect to receive non-Department hospital care, medical 5
77	77	services, or extended care services, excluding nursing home 6
78	78	care, through the Veterans Community Care Program 7
79	79	under section 1703 of this title pursuant to subsection 8
80	80	(d)(1)(D) of such section using the following eligibility ac-9
81	81	cess standards: 10
82	82	‘‘(A) With respect to primary care, mental 11
83	83	health care, or extended care services, excluding 12
84	84	nursing home care, if the Department cannot sched-13
85	85	ule an appointment for the covered veteran with a 14
86	86	health care provider of the Department who can pro-15
87	87	vide the needed service— 16
88	88	‘‘(i) within 30 minutes average driving 17
89	89	time (or such shorter average driving time as 18
90	90	the Secretary may prescribe) from the residence 19
91	91	of the veteran unless a longer average driving 20
92	92	time has been agreed to by the veteran in con-21
93	93	sultation with a health care provider of the vet-22
94	94	eran; and 23
95	95	‘‘(ii) within 20 days (or such shorter pe-24
96	96	riod as the Secretary may prescribe) of the date 25
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100	100	of request for such an appointment unless a 1
101	101	later date has been agreed to by the veteran in 2
102	102	consultation with a health care provider of the 3
103	103	veteran. 4
104	104	‘‘(B) With respect to specialty care, if the De-5
105	105	partment cannot schedule an appointment for the 6
106	106	covered veteran with a health care provider of the 7
107	107	Department who can provide the needed service— 8
108	108	‘‘(i) within 60 minutes average driving 9
109	109	time (or such shorter average driving time as 10
110	110	the Secretary may prescribe) from the residence 11
111	111	of the veteran unless a longer average driving 12
112	112	time has been agreed to by the veteran in con-13
113	113	sultation with a health care provider of the vet-14
114	114	eran; and 15
115	115	‘‘(ii) within 28 days (or such shorter pe-16
116	116	riod as the Secretary may prescribe) of the date 17
117	117	of request for such an appointment unless a 18
118	118	later date has been agreed to by the veteran in 19
119	119	consultation with a health care provider of the 20
120	120	veteran. 21
121	121	‘‘(2) For the purposes of determining the eligibility 22
122	122	of a covered veteran for care or services under paragraph 23
123	123	(1), the Secretary shall not take into consideration the 24
124	124	availability of telehealth appointments from the Depart-25
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128	128	ment when determining whether the Department is able 1
129	129	to furnish such care or services in a manner that complies 2
130	130	with the eligibility access standards under such paragraph. 3
131	131	‘‘(3) In the case of a covered veteran who has had 4
132	132	an appointment with a health care provider of the Depart-5
133	133	ment canceled by the Department for a reason other than 6
134	134	the request of the veteran, in calculating a wait time for 7
135	135	a subsequent appointment under paragraph (1), the Sec-8
136	136	retary shall calculate such wait time from the date of the 9
137	137	request for the original, canceled appointment. 10
138	138	‘‘(4) If a veteran agrees to a longer average drive 11
139	139	time or a later date under subparagraph (A) or (B) of 12
140	140	paragraph (1), the Secretary shall document the agree-13
141	141	ment to such longer average drive time or later date in 14
142	142	the electronic health record of the veteran and provide the 15
143	143	veteran a copy of such documentation. Such copy may be 16
144	144	provided electronically. 17
145	145	‘‘(b) A
146	146	PPLICATION.—The Secretary shall ensure that 18
147	147	the eligibility access standards established under sub-19
148	148	section (a) apply— 20
149	149	‘‘(1) to all care and services within the medical 21
150	150	benefits package of the Department to which a cov-22
151	151	ered veteran is eligible under section 1703 of this 23
152	152	title, excluding nursing home care; and 24
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156	156	‘‘(2) to all covered veterans, regardless of 1
157	157	whether a veteran is a new or established patient. 2
158	158	‘‘(c) P
159	159	ERIODICREVIEW OFACCESSSTANDARDS.— 3
160	160	Not later than three years after the date of the enactment 4
161	161	of the Veterans’ Assuring Critical Care Expansions to 5
162	162	Support Servicemembers (ACCESS) Act of 2025, and not 6
163	163	less frequently than once every three years thereafter, the 7
164	164	Secretary shall— 8
165	165	‘‘(1) conduct a review of the eligibility access 9
166	166	standards under subsection (a) in consultation 10
167	167	with— 11
168	168	‘‘(A) such Federal entities as the Secretary 12
169	169	considers appropriate, including the Depart-13
170	170	ment of Defense, the Department of Health and 14
171	171	Human Services, and the Centers for Medicare 15
172	172	& Medicaid Services; 16
173	173	‘‘(B) entities and individuals in the private 17
174	174	sector, including— 18
175	175	‘‘(i) veteran patients; 19
176	176	‘‘(ii) veterans service organizations; 20
177	177	and 21
178	178	‘‘(iii) health care providers partici-22
179	179	pating in the Veterans Community Care 23
180	180	Program under section 1703 of this title; 24
181	181	and 25
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185	185	‘‘(C) other entities that are not part of the 1
186	186	Federal Government; and 2
187	187	‘‘(2) submit to the appropriate committees of 3
188	188	Congress a report on— 4
189	189	‘‘(A) the findings of the Secretary with re-5
190	190	spect to the review conducted under paragraph 6
191	191	(1); and 7
192	192	‘‘(B) such recommendations as the Sec-8
193	193	retary may have with respect to the eligibility 9
194	194	access standards under subsection (a).’’; 10
195	195	(2) by striking subsection (g); 11
196	196	(3) by redesignating subsections (f), (h), and (i) 12
197	197	as subsections (d), (e), and (f), respectively; 13
198	198	(4) in subsection (d), as redesignated by para-14
199	199	graph (3)— 15
200	200	(A) by striking ‘‘established’’ each place it 16
201	201	appears; and 17
202	202	(B) in paragraph (1), by striking ‘‘(1) 18
203	203	Subject to’’ and inserting ‘‘C
204	204	OMPLIANCE BY 19
205	205	C
206	206	OMMUNITYCAREPROVIDERSWITHACCESS 20
207	207	S
208	208	TANDARDS.—(1) Subject to’’; 21
209	209	(5) in subsection (e), as so redesignated— 22
210	210	(A) in paragraph (1)— 23
211	211	(i) by striking ‘‘(1) Consistent with’’ 24
212	212	and inserting ‘‘D
213	213	ETERMINATIONREGARD-25
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217	217	INGELIGIBILITY.—(1) Consistent with’’; 1
218	218	and 2
219	219	(ii) by striking ‘‘designated access 3
220	220	standards established under this section’’ 4
221	221	and inserting ‘‘eligibility access standards 5
222	222	under subsection (a)’’; and 6
223	223	(B) in paragraph (2)(B), by striking ‘‘des-7
224	224	ignated access standards established under this 8
225	225	section’’ and inserting ‘‘eligibility access stand-9
226	226	ards under subsection (a)’’; and 10
227	227	(6) in subsection (f), as redesignated by para-11
228	228	graph (2)— 12
229	229	(A) in the matter preceding paragraph (1), 13
230	230	by striking ‘‘In this section’’ and inserting 14
231	231	‘‘D
232	232	EFINITIONS.—In this section’’; and 15
233	233	(B) in paragraph (2)— 16
234	234	(i) by striking ‘‘covered veterans’’ and 17
235	235	inserting ‘‘covered veteran’’; and 18
236	236	(ii) by striking ‘‘veterans described’’ 19
237	237	and inserting ‘‘a veteran described’’. 20
238	238	(b) C
239	239	ONFORMINGAMENDMENTS.—Section 1703(d) 21
240	240	of such title is amended— 22
241	241	(1) in paragraph (1)(D), by striking ‘‘des-23
242	242	ignated access standards developed by the Secretary 24
243	243	under section 1703B of this title’’ and inserting ‘‘eli-25
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247	247	gibility access standards under section 1703B(a) of 1
248	248	this title’’; and 2
249	249	(2) in paragraph (3), by striking ‘‘designated 3
250	250	access standards developed by the Secretary under 4
251	251	section 1703B of this title’’ and inserting ‘‘eligibility 5
252	252	access standards under section 1703B(a) of this 6
253	253	title’’. 7
254	254	SEC. 102. REQUIREMENT THAT SECRETARY NOTIFY VET-8
255	255	ERANS OF ELIGIBILITY FOR CARE UNDER 9
256	256	VETERANS COMMUNITY CARE PROGRAM. 10
257	257	Section 1703(a) of title 38, United States Code, is 11
258	258	amended by adding at the end the following new para-12
259	259	graph: 13
260	260	‘‘(5)(A) The Secretary shall notify each covered vet-14
261	261	eran in writing of the eligibility of such veteran for care 15
262	262	or services under this section as soon as possible, but not 16
263	263	later than two business days, after the date on which the 17
264	264	Secretary is aware that the veteran is seeking care or serv-18
265	265	ices and is eligible for such care or services under this 19
266	266	section. 20
267	267	‘‘(B) With respect to each covered veteran eligible for 21
268	268	care or services under subsection (d), the Secretary shall 22
269	269	provide such veteran periodic reminders, as the Secretary 23
270	270	determines appropriate, of their ongoing eligibility under 24
271	271	such subsection. 25
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275	275	‘‘(C) Any notification or reminder under this para-1
276	276	graph may be provided electronically.’’. 2
277	277	SEC. 103. CONSIDERATION UNDER VETERANS COMMUNITY 3
278	278	CARE PROGRAM OF VETERAN PREFERENCE 4
279	279	FOR CARE, CONTINUITY OF CARE, AND NEED 5
280	280	FOR CAREGIVER OR ATTENDANT. 6
281	281	Section 1703(d)(2) of title 38, United States Code, 7
282	282	is amended by adding at the end the following new sub-8
283	283	paragraphs: 9
284	284	‘‘(F) The preference of the covered veteran for 10
285	285	where, when, and how to seek hospital care, medical 11
286	286	services, or extended care services. 12
287	287	‘‘(G) Continuity of care. 13
288	288	‘‘(H) Whether the covered veteran requests or 14
289	289	requires the assistance of a caregiver or attendant 15
290	290	when seeking hospital care, medical services, or ex-16
291	291	tended care services.’’. 17
292	292	SEC. 104. NOTIFICATION OF DENIAL OF REQUEST FOR 18
293	293	CARE UNDER VETERANS COMMUNITY CARE 19
294	294	PROGRAM. 20
295	295	Section 1703 of title 38, United States Code, is 21
296	296	amended— 22
297	297	(1) by redesignating subsection (o) as sub-23
298	298	section (p); and 24
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302	302	(2) by inserting after subsection (n) the fol-1
303	303	lowing new subsection (o): 2
304	304	‘‘(o) N
305	305	OTIFICATION OFDENIAL OFREQUEST FOR 3
306	306	C
307	307	ARE ANDHOWTOAPPEAL.—(1) If a request by a vet-4
308	308	eran for care or services under this section is denied, the 5
309	309	Secretary shall notify the veteran in writing as soon as 6
310	310	possible, but not later than two business days, after the 7
311	311	denial is made— 8
312	312	‘‘(A) of the reason for the denial; and 9
313	313	‘‘(B) with instructions on how to appeal such 10
314	314	denial using the clinical appeals process of the Vet-11
315	315	erans Health Administration. 12
316	316	‘‘(2) If a denial under paragraph (1) is due to not 13
317	317	meeting the eligibility access standards under section 14
318	318	1703B(a) of this title, notice under such paragraph shall 15
319	319	include an explanation for why the Secretary does not con-16
320	320	sider the veteran to have met such standards. 17
321	321	‘‘(3) Any notification under this subsection may be 18
322	322	provided electronically.’’. 19
323	323	SEC. 105. DISCUSSION OF TELEHEALTH OPTIONS UNDER 20
324	324	VETERANS COMMUNITY CARE PROGRAM. 21
325	325	Section 1703 of title 38, United States Code, as 22
326	326	amended by section 104, is further amended— 23
327	327	(1) by redesignating subsection (p) as sub-24
328	328	section (q); and 25
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332	332	(2) by inserting after subsection (o) the fol-1
333	333	lowing new subsection (p): 2
334	334	‘‘(p) D
335	335	ISCUSSION OFOPTIONS FORTELEHEALTH.— 3
336	336	When discussing options for care or services for a covered 4
337	337	veteran under this section, the Secretary shall ensure that 5
338	338	the veteran is informed of the ability of the veteran to 6
339	339	seek care or services via telehealth, either through a med-7
340	340	ical facility of the Department or under this section, if 8
341	341	telehealth— 9
342	342	‘‘(1) is available to the veteran; 10
343	343	‘‘(2) is appropriate for the type of care or serv-11
344	344	ices the veteran is seeking, as determined by the 12
345	345	Secretary; and 13
346	346	‘‘(3) is acceptable to the veteran.’’. 14
347	347	SEC. 106. EXTENSION OF DEADLINE FOR SUBMITTAL OF 15
348	348	CLAIMS BY HEALTH CARE ENTITIES AND 16
349	349	PROVIDERS UNDER PROMPT PAYMENT 17
350	350	STANDARD. 18
351	351	Section 1703D(b) of title 38, United States Code, is 19
352	352	amended by striking ‘‘180 days’’ and inserting ‘‘one year’’. 20
353	353	TITLE II—MENTAL HEALTH 21
354	354	TREATMENT PROGRAMS 22
355	355	SEC. 201. DEFINITIONS. 23
356	356	In this title: 24
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360	360	(1) COVERED TREATMENT PROGRAM .—The 1
361	361	term ‘‘covered treatment program’’— 2
362	362	(A) means— 3
363	363	(i) a mental health residential reha-4
364	364	bilitation treatment program of the De-5
365	365	partment of Veterans Affairs; or 6
366	366	(ii) a program of the Department for 7
367	367	residential care for mental health and sub-8
368	368	stance abuse disorders; 9
369	369	(B) includes— 10
370	370	(i) the programs designated as of the 11
371	371	date of the enactment of this Act as domi-12
372	372	ciliary residential rehabilitation treatment 13
373	373	programs; and 14
374	374	(ii) any programs designated as domi-15
375	375	ciliary residential rehabilitation treatment 16
376	376	programs on or after such date of enact-17
377	377	ment; and 18
378	378	(C) does not include Compensated Work 19
379	379	Therapy Transition Residence programs of the 20
380	380	Department. 21
381	381	(2) C
382	382	OVERED VETERAN .—The term ‘‘covered 22
383	383	veteran’’ means a veteran described in section 23
384	384	1703(b) of title 38, United States Code. 24
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388	388	(3) SOCIAL SUPPORT SYSTEMS .—The term ‘‘so-1
389	389	cial support systems’’, with respect to a covered vet-2
390	390	eran— 3
391	391	(A) means— 4
392	392	(i) a member of the family of the cov-5
393	393	ered veteran, including a parent, spouse, 6
394	394	child, step-family member, or extended 7
395	395	family member; or 8
396	396	(ii) an individual who lives with the 9
397	397	veteran but is not a member of the family 10
398	398	of the veteran; and 11
399	399	(B) does not include a facility-organized 12
400	400	peer support program. 13
401	401	(4) T
402	402	REATMENT TRACK.—The term ‘‘treatment 14
403	403	track’’ means a specialized treatment program that 15
404	404	is provided to a subset of covered veterans in a cov-16
405	405	ered treatment program who receive the same or 17
406	406	similar intensive treatment and rehabilitative serv-18
407	407	ices. 19
408	408	SEC. 202. STANDARDIZED PROCESS TO DETERMINE ELIGI-20
409	409	BILITY OF COVERED VETERANS FOR PAR-21
410	410	TICIPATION IN CERTAIN MENTAL HEALTH 22
411	411	TREATMENT PROGRAMS. 23
412	412	(a) S
413	413	TANDARDIZED SCREENING PROCESS.—Not 24
414	414	later than one year after the date of the enactment of this 25
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418	418	Act, the Secretary of Veterans Affairs shall establish a 1
419	419	standardized screening process to determine, based on 2
420	420	clinical need, whether a covered veteran satisfies criteria 3
421	421	for priority or routine admission to a covered treatment 4
422	422	program. 5
423	423	(b) E
424	424	LIGIBILITYCRITERIA FORPRIORITYADMIS-6
425	425	SION.— 7
426	426	(1) I
427	427	N GENERAL.—Under the standardized 8
428	428	screening process required by subsection (a), a cov-9
429	429	ered veteran shall be eligible for priority admission 10
430	430	to a covered treatment program if the covered vet-11
431	431	eran meets criteria established by the Secretary that 12
432	432	include any of the following: 13
433	433	(A) Symptoms that— 14
434	434	(i) significantly affect activities of 15
435	435	daily life; and 16
436	436	(ii) increase the risk of such veteran 17
437	437	for adverse outcomes. 18
438	438	(B) An unsafe living situation. 19
439	439	(C) A high-risk flag for suicide. 20
440	440	(D) A determination of being a high risk 21
441	441	for suicide. 22
442	442	(E) Risk factors for overdose. 23
443	443	(F) Non-responsive, relapsed, or unable to 24
444	444	find recovery from one other course of treat-25
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448	448	ment, such as outpatient or intensive outpatient 1
449	449	treatment. 2
450	450	(G) Such other criteria as the Secretary 3
451	451	determines appropriate. 4
452	452	(2) C
453	453	ONSIDERATION.—In making a determina-5
454	454	tion that a covered veteran meets criteria established 6
455	455	by the Secretary under paragraph (1) for priority 7
456	456	admission to a covered treatment program, the Sec-8
457	457	retary shall consider any referral of a health care 9
458	458	provider of a covered veteran. 10
459	459	(c) T
460	460	IME FORSCREENING ANDADMISSION.—Under 11
461	461	the standardized screening process required by subsection 12
462	462	(a), the Secretary shall ensure a covered veteran— 13
463	463	(1) is screened not later than 48 hours after the 14
464	464	date on which the covered veteran, or a relevant 15
465	465	health care provider, makes a request for the cov-16
466	466	ered veteran to be admitted to a covered treatment 17
467	467	program; 18
468	468	(2) if determined eligible for priority admission 19
469	469	to a covered treatment program, is admitted to such 20
470	470	covered treatment program not later than 48 hours 21
471	471	after the date of such determination; and 22
472	472	(3) is screened at an appropriate time for po-23
473	473	tential mild, moderate, or severe traumatic brain in-24
474	474	jury. 25
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478	478	(d) CONSIDERATIONS.—In making placement deci-1
479	479	sions in a covered treatment program for veterans who 2
480	480	meet criteria for priority admission, the Secretary shall— 3
481	481	(1) consider the input of the covered veteran 4
482	482	with respect to the— 5
483	483	(A) program specialty, subtype, and treat-6
484	484	ment track offered to the covered veteran; and 7
485	485	(B) geographic placement of the covered 8
486	486	veteran; and 9
487	487	(2) maximize the proximity of the covered vet-10
488	488	eran to social support systems. 11
489	489	(e) C
490	490	ONDITIONSUNDERWHICHCARESHALLBE 12
491	491	F
492	492	URNISHEDTHROUGHNON-DEPARTMENTPROVIDERS.— 13
493	493	(1) P
494	494	RIORITY ADMISSION.—If the Secretary de-14
495	495	termines a covered veteran is eligible for priority ad-15
496	496	mission to a covered treatment program pursuant to 16
497	497	the standardized screening process required by sub-17
498	498	section (a) and the Secretary is unable to admit 18
499	499	such covered veteran to a covered treatment pro-19
500	500	gram at a facility of the Department of Veterans Af-20
501	501	fairs in a manner that complies with the require-21
502	502	ments under subsections (c) and (d), the Secretary 22
503	503	shall offer the covered veteran the option to receive 23
504	504	care at a non-Department facility that— 24
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508	508	(A) can admit the covered veteran within 1
509	509	the period required by subsection (c); 2
510	510	(B) is party to a contract or agreement 3
511	511	with the Department or enters into such a con-4
512	512	tract or agreement under which the Department 5
513	513	furnishes a program that is equivalent to a cov-6
514	514	ered treatment program to a veteran through 7
515	515	such non-Department facility; 8
516	516	(C) is licensed by a State; and 9
517	517	(D) is accredited by the Commission on 10
518	518	Accreditation of Rehabilitation Facilities or the 11
519	519	Joint Commission. 12
520	520	(2) R
521	521	OUTINE ADMISSION.—If the Secretary de-13
522	522	termines a covered veteran is eligible for routine ad-14
523	523	mission to a covered treatment program pursuant to 15
524	524	the standardized screening process required by sub-16
525	525	section (a) and the Secretary is unable to admit 17
526	526	such covered veteran to a covered treatment pro-18
527	527	gram at a facility of the Department of Veterans Af-19
528	528	fairs in a manner that complies with the access 20
529	529	standards for mental health care established pursu-21
530	530	ant to section 1703B of title 38, United States 22
531	531	Code, the Secretary shall offer the covered veteran 23
532	532	the option to receive care at a non-Department facil-24
533	533	ity that— 25
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536	536	•S 275 IS
537	537	(A) is party to a contract or agreement 1
538	538	with the Department or enters into such a con-2
539	539	tract or agreement under which the Department 3
540	540	furnishes a program that is equivalent to a cov-4
541	541	ered treatment program to a veteran through 5
542	542	such non-Department facility; 6
543	543	(B) is licensed by a State; and 7
544	544	(C) is accredited by the Commission on Ac-8
545	545	creditation of Rehabilitation Facilities or the 9
546	546	Joint Commission. 10
547	547	(3) R
548	548	ULE OF CONSTRUCTION .—This subsection 11
549	549	shall not be construed to affect a covered veteran in 12
550	550	a covered treatment program pursuant to a deter-13
551	551	mination made on or before the date of the enact-14
552	552	ment of this Act. 15
553	553	SEC. 203. IMPROVEMENTS TO DEPARTMENT OF VETERANS 16
554	554	AFFAIRS MENTAL HEALTH RESIDENTIAL RE-17
555	555	HABILITATION TREATMENT PROGRAM. 18
556	556	(a) P
557	557	ERFORMANCEMETRICS.— 19
558	558	(1) I
559	559	N GENERAL.—The Secretary of Veterans 20
560	560	Affairs shall develop metrics to track, and shall sub-21
561	561	sequently track, the performance of medical facilities 22
562	562	and Veterans Integrated Service Networks of the 23
563	563	Department of Veterans Affairs in meeting the re-24
564	564	quirements for— 25
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568	568	(A) screening, under section 202, for a 1
569	569	covered treatment program; and 2
570	570	(B) timely admission to a covered treat-3
571	571	ment program under such screening. 4
572	572	(2) E
573	573	LEMENTS.—The metrics developed under 5
574	574	paragraph (1) shall include metrics for tracking the 6
575	575	performance of medical facilities and Veterans Inte-7
576	576	grated Service Networks with respect to routine and 8
577	577	priority admission under a covered treatment pro-9
578	578	gram. 10
579	579	(b) O
580	580	VERSIGHT.— 11
581	581	(1) I
582	582	N GENERAL.—The Secretary shall develop 12
583	583	a process for systematically assessing the quality of 13
584	584	care delivered by Department and non-Department 14
585	585	providers treating covered veterans under this sec-15
586	586	tion, which shall include assessments of— 16
587	587	(A) the extent to which the provider is de-17
588	588	livering evidence-based treatments to covered 18
589	589	veterans; 19
590	590	(B) clinical outcomes for covered veterans; 20
591	591	(C) the ratio of licensed independent prac-21
592	592	titioners per resident; 22
593	593	(D) the rate of completion of training on 23
594	594	military cultural competence by licensed inde-24
595	595	pendent practitioners; and 25
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598	598	•S 275 IS
599	599	(E) potentially wasteful, fraudulent, or in-1
600	600	appropriate referral or billing practices. 2
601	601	(c) P
602	602	LACEMENT; TRANSPORTATION.— 3
603	603	(1) L
604	604	OCATIONS.—If the Secretary determines 4
605	605	that a covered veteran is in need of residential care 5
606	606	under a covered treatment program, the Secretary 6
607	607	shall provide to the covered veteran a list of loca-7
608	608	tions at which such covered veteran can receive such 8
609	609	residential care that meets— 9
610	610	(A) the standards for screening under sec-10
611	611	tion 202; and 11
612	612	(B) the care needs of the covered veteran, 12
613	613	including applicable treatment tracks. 13
614	614	(2) T
615	615	RANSPORTATION COVERAGE .—The Sec-14
616	616	retary shall provide transportation or pay for or re-15
617	617	imburse the costs of transportation for any covered 16
618	618	veteran who is admitted into a covered treatment 17
619	619	program and needs transportation assistance— 18
620	620	(A) from the residence of the covered vet-19
621	621	eran or a facility of the Department or author-20
622	622	ized non-Department facility that does not pro-21
623	623	vide such care to another such facility that pro-22
624	624	vides residential care covered under a covered 23
625	625	treatment program; and 24
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629	629	(B) back to the residence of the covered 1
630	630	veteran after the conclusion of a covered treat-2
631	631	ment program, if applicable. 3
632	632	(d) A
633	633	PPEALS.— 4
634	634	(1) I
635	635	N GENERAL.—The Secretary shall develop 5
636	636	a national policy and associated procedures under 6
637	637	which a covered veteran, a representative of a cov-7
638	638	ered veteran, or a provider who requests a covered 8
639	639	veteran be admitted to a covered treatment program, 9
640	640	including a provider of the Department or a non-De-10
641	641	partment provider, may file a clinical appeal pursu-11
642	642	ant to this subsection if the covered veteran is— 12
643	643	(A) denied admission into a covered treat-13
644	644	ment program; or 14
645	645	(B) accepted into a covered treatment pro-15
646	646	gram but is not offered bed placement in a 16
647	647	timely manner. 17
648	648	(2) T
649	649	IMELINESS STANDARDS FOR REVIEW .— 18
650	650	(A) I
651	651	N GENERAL.—The national policy and 19
652	652	procedures developed under paragraph (1) for 20
653	653	appeals described in such paragraph shall in-21
654	654	clude timeliness standards for the Department 22
655	655	to review and make a decision on such an ap-23
656	656	peal. 24
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660	660	(B) DECISION.—The Secretary shall re-1
661	661	view and respond to any appeal under para-2
662	662	graph (1) not later than 72 hours after the Sec-3
663	663	retary receives such appeal. 4
664	664	(3) P
665	665	UBLIC GUIDANCE.—The Secretary shall 5
666	666	develop, and make available to the public, guidance 6
667	667	on how a covered veteran, a representative of the 7
668	668	covered veteran, or a provider of the covered veteran 8
669	669	can file a clinical appeal pursuant to this sub-9
670	670	section— 10
671	671	(A) if the covered veteran is denied admis-11
672	672	sion into a covered treatment program; 12
673	673	(B) if the first date on which the covered 13
674	674	veteran may enter a covered treatment program 14
675	675	does not comply with the standards established 15
676	676	by the Department under section 1703B of title 16
677	677	38, United States Code, for purposes of deter-17
678	678	mining eligibility for mental health care under 18
679	679	subsections (d) and (e) of section 1703 of such 19
680	680	title; or 20
681	681	(C) with respect to such other factors as 21
682	682	the Secretary may specify. 22
683	683	(4) R
684	684	ULE OF CONSTRUCTION .—Nothing in this 23
685	685	subsection may be construed as granting a covered 24
686	686	veteran the right to appeal a decision of the Sec-25
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689	689	•S 275 IS
690	690	retary with respect to admission to a covered treat-1
691	691	ment program to the Board of Veterans’ Appeals 2
692	692	under chapter 71 of title 38, United States Code. 3
693	693	(e) T
694	694	RACKING OFAVAILABILITY ANDWAITTIMES.— 4
695	695	(1) I
696	696	N GENERAL.—The Secretary shall, to the 5
697	697	extent practicable, create a method for tracking 6
698	698	availability and wait times under a covered treat-7
699	699	ment program across all facilities of the Depart-8
700	700	ment, Veterans Integrated Service Networks of the 9
701	701	Department, and non-Department providers 10
702	702	throughout the United States. 11
703	703	(2) A
704	704	VAILABILITY OF INFORMATION .—The Sec-12
705	705	retary shall, to the extent practicable, make the in-13
706	706	formation tracked under paragraph (1) available in 14
707	707	real time to— 15
708	708	(A) the mental health treatment coordina-16
709	709	tors at each facility of the Department; 17
710	710	(B) the leadership of each medical center 18
711	711	of the Department; 19
712	712	(C) the leadership of each Veterans Inte-20
713	713	grated Service Network; and 21
714	714	(D) the Office of the Under Secretary for 22
715	715	Health of the Department. 23
716	716	(f) T
717	717	RAINING ANDOVERSIGHT.— 24
718	718	(1) T
719	719	RAINING.— 25
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723	723	(A) IN GENERAL.—The Secretary shall up-1
724	724	date and implement training for staff of the 2
725	725	Department directly involved in a covered treat-3
726	726	ment program regarding referrals, screening, 4
727	727	admission, placement decisions, and appeals for 5
728	728	such program, including all changes to proc-6
729	729	esses and guidance under such program re-7
730	730	quired by this section and section 202. 8
731	731	(B) C
732	732	OVERED VETERANS AWAITING ADMIS -9
733	733	SION.—The training under subparagraph (A) 10
734	734	shall include procedures for the care of covered 11
735	735	veterans awaiting admission into a covered 12
736	736	treatment program and communication with 13
737	737	such covered veterans and the providers of such 14
738	738	covered veterans. 15
739	739	(C) T
740	740	IMING OF TRAINING.— 16
741	741	(i) I
742	742	N GENERAL.—The Secretary shall 17
743	743	require the training under subparagraph 18
744	744	(A) to be completed by staff required to 19
745	745	complete such training— 20
746	746	(I) not later than 60 days after 21
747	747	beginning employment at the Depart-22
748	748	ment in a position that includes work 23
749	749	directly involving a covered treatment 24
750	750	program; and 25
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754	754	(II) not less frequently than an-1
755	755	nually. 2
756	756	(ii) T
757	757	RACKING.—The Secretary shall 3
758	758	track completion of training required 4
759	759	under clause (i) by staff required to com-5
760	760	plete such training. 6
761	761	(2) O
762	762	VERSIGHT STANDARDS .—The Secretary 7
763	763	shall review and revise oversight standards for the 8
764	764	leadership of the Veterans Integrated Service Net-9
765	765	works and the Veterans Health Administration to 10
766	766	ensure that facilities and staff of the Department 11
767	767	are adhering to the policy on access to care of each 12
768	768	covered treatment program. 13
769	769	(g) C
770	770	ARECOORDINATION AND FOLLOW-UPCARE.— 14
771	771	(1) C
772	772	ONTINUITY OF CARE.—The Secretary shall 15
773	773	ensure each covered veteran who is screened for ad-16
774	774	mission to a covered treatment program is offered, 17
775	775	and provided if agreed upon, care options during the 18
776	776	period between screening of the covered veteran and 19
777	777	admission of the covered veteran to such program to 20
778	778	ensure the covered veteran does not experience any 21
779	779	lapse in care. 22
780	780	(2) C
781	781	ARE COORDINATION FOR SUBSTANCE USE 23
782	782	DISORDER.—For a covered veteran being treated for 24
783	783	substance use disorder, the Secretary shall— 25
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786	786	•S 275 IS
787	787	(A) ensure there is a care plan in place 1
788	788	during the period between any detoxification 2
789	789	services or inpatient care received by the cov-3
790	790	ered veteran and admission of the covered vet-4
791	791	eran to a covered treatment program; and 5
792	792	(B) communicate that care plan to the cov-6
793	793	ered veteran, the primary care provider of the 7
794	794	covered veteran, and the facility where the cov-8
795	795	ered veteran is or will be residing under such 9
796	796	program. 10
797	797	(3) C
798	798	ARE PLANNING PRIOR TO DISCHARGE .— 11
799	799	(A) I
800	800	N GENERAL.—The Secretary, in con-12
801	801	sultation with the covered veteran and the 13
802	802	treating providers of the covered veteran in a 14
803	803	covered treatment program, shall ensure the 15
804	804	completion of a care plan prior to the covered 16
805	805	veteran being discharged from such program. 17
806	806	(B) M
807	807	ATTERS TO BE INCLUDED .—The 18
808	808	care plan required under subparagraph (A) for 19
809	809	a covered veteran shall include details on the 20
810	810	course of treatment for the covered veteran fol-21
811	811	lowing completion of treatment under the cov-22
812	812	ered treatment program, including any nec-23
813	813	essary follow-up care. 24
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817	817	(C) SHARING OF CARE PLAN .—The care 1
818	818	plan required under subparagraph (A) shall be 2
819	819	shared with the covered veteran, the primary 3
820	820	care provider of the covered veteran, and any 4
821	821	other providers with which the covered veteran 5
822	822	consents to sharing the plan. 6
823	823	(D) D
824	824	ISCHARGE FROM NON -DEPARTMENT 7
825	825	FACILITY.—Upon discharge of a covered vet-8
826	826	eran under a covered treatment program from 9
827	827	a non-Department facility, the facility shall 10
828	828	share with the Department all care records 11
829	829	maintained by the facility with respect to the 12
830	830	covered veteran and shall work in consultation 13
831	831	with the Department on the care plan of the 14
832	832	covered veteran required under subparagraph 15
833	833	(A). 16
834	834	(h) R
835	835	EPORTS TOCONGRESS.— 17
836	836	(1) R
837	837	EPORT ON MODIFICATIONS TO PRO -18
838	838	GRAMS.— 19
839	839	(A) I
840	840	N GENERAL.—Not later than two 20
841	841	years after the date of the enactment of this 21
842	842	Act, the Secretary shall submit to the Com-22
843	843	mittee on Veterans’ Affairs of the Senate and 23
844	844	the Committee on Veterans’ Affairs of the 24
845	845	House of Representatives a report on modifica-25
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848	848	•S 275 IS
849	849	tions made to the guidance, operation, and 1
850	850	oversight of covered treatment programs to ful-2
851	851	fill the requirements of this section. 3
852	852	(B) E
853	853	LEMENTS.—The report required by 4
854	854	subparagraph (A) shall include— 5
855	855	(i) an assessment of whether costs of 6
856	856	covered treatment programs, including for 7
857	857	residential care provided through facilities 8
858	858	of the Department and non-Department 9
859	859	facilities, serve as a disincentive to place-10
860	860	ment in the such a program; 11
861	861	(ii) a description of actions taken by 12
862	862	the Department to address the findings 13
863	863	and recommendations by the Secretary 14
864	864	contained in the report under section 15
865	865	503(c) of the STRONG Veterans Act of 16
866	866	2022 (division V of Public Law 117–328; 17
867	867	136 Stat. 5515), including— 18
868	868	(I) such actions with respect to— 19
869	869	(aa) any new locations 20
870	870	added for covered treatment pro-21
871	871	grams; 22
872	872	(bb) any beds added at ex-23
873	873	isting facilities of such programs; 24
874	874	and 25
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878	878	(cc) any additional treat-1
879	879	ment tracks or sex-specific pro-2
880	880	grams created or added at facili-3
881	881	ties of the Department; and 4
882	882	(II) a breakdown of the number 5
883	883	and percentage of covered veterans 6
884	884	who are determined eligible for pri-7
885	885	ority placement into a covered treat-8
886	886	ment program and the number and 9
887	887	percentage of covered veterans who 10
888	888	are determined eligible for routine 11
889	889	placement into a covered treatment 12
890	890	program; and 13
891	891	(iii) such recommendations as the 14
892	892	Secretary may have for legislative or ad-15
893	893	ministrative action to address any funding 16
894	894	constraints or disincentives for use of a 17
895	895	covered treatment program. 18
896	896	(2) A
897	897	NNUAL REPORT ON OPERATION OF PRO -19
898	898	GRAMS.— 20
899	899	(A) I
900	900	N GENERAL.—Not later than one year 21
901	901	after the submission of the report under para-22
902	902	graph (1), and not less frequently than annu-23
903	903	ally thereafter during the period in which a cov-24
904	904	ered treatment program is carried out, the Sec-25
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908	908	retary shall submit to the Committee on Vet-1
909	909	erans’ Affairs of the Senate and the Committee 2
910	910	on Veterans’ Affairs of the House of Represent-3
911	911	atives a report on the operation of such pro-4
912	912	grams. 5
913	913	(B) E
914	914	LEMENTS.—Subject to subparagraph 6
915	915	(C), each report required by subparagraph (A) 7
916	916	shall include the following: 8
917	917	(i) The number of covered veterans 9
918	918	served by a covered treatment program, 10
919	919	disaggregated by— 11
920	920	(I) Veterans Integrated Service 12
921	921	Network in which the covered veteran 13
922	922	receives care; 14
923	923	(II) facility, including facilities of 15
924	924	the Department and non-Department 16
925	925	facilities, at which the covered veteran 17
926	926	receives care; 18
927	927	(III) type of residential rehabili-19
928	928	tation treatment care received by the 20
929	929	covered veteran under such program; 21
930	930	(IV) sex of the covered veteran; 22
931	931	and 23
932	932	(V) race or ethnicity of the cov-24
933	933	ered veteran. 25
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937	937	(ii) Wait times under a covered treat-1
938	938	ment program for the most recent year 2
939	939	data is available, disaggregated by— 3
940	940	(I) treatment track or specificity 4
941	941	of residential rehabilitation treatment 5
942	942	care sought by the covered veteran; 6
943	943	(II) sex of the covered veteran; 7
944	944	(III) State or territory in which 8
945	945	the covered veteran is located; 9
946	946	(IV) Veterans Integrated Service 10
947	947	Network in which the covered veteran 11
948	948	is located; and 12
949	949	(V) facility of the Department at 13
950	950	which the covered veteran seeks care. 14
951	951	(iii) A list of all locations of a covered 15
952	952	treatment program and number of bed 16
953	953	spaces at each such location, disaggregated 17
954	954	by residential rehabilitation treatment care 18
955	955	or treatment track provided under such 19
956	956	program at such location. 20
957	957	(iv) A list of any new locations of cov-21
958	958	ered treatment programs added or removed 22
959	959	and any bed spaces added or removed dur-23
960	960	ing the one-year period preceding the date 24
961	961	of the report. 25
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965	965	(v) Average cost of a stay under a 1
966	966	covered treatment program, including total 2
967	967	stay average and daily average, at facilities 3
968	968	of the Department compared to non-De-4
969	969	partment facilities. 5
970	970	(vi) A review of staffing needs and 6
971	971	gaps with respect to covered treatment 7
972	972	programs. 8
973	973	(vii) Any recommendations for 9
974	974	changes to the operation of covered treat-10
975	975	ment programs, including any policy 11
976	976	changes, guidance changes, training 12
977	977	changes, or other changes. 13
978	978	(C) A
979	979	NONYMITY.—To ensure that the data 14
980	980	provided under this paragraph, or some portion 15
981	981	of that data, will not undermine the anonymity 16
982	982	of a veteran, the Secretary shall provide such 17
983	983	data pursuant to applicable Federal law and in 18
984	984	a manner that is wholly consistent with applica-19
985	985	ble Federal privacy and confidentiality laws, in-20
986	986	cluding— 21
987	987	(i) section 552a of title 5, United 22
988	988	States Code (commonly known as the ‘‘Pri-23
989	989	vacy Act of 1974’’); 24
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993	993	(ii) the Health Insurance Portability 1
994	994	and Accountability Act of 1996 (Public 2
995	995	Law 104–191); 3
996	996	(iii) parts 160 and 164 of title 45, 4
997	997	Code of Federal Regulations, or successor 5
998	998	regulations; and 6
999	999	(iv) sections 5701, 5705, and 7332 of 7
1000	1000	title 38, United States Code. 8
1001	1001	(i) R
1002	1002	EVISION OFGUIDANCE.—The Secretary shall 9
1003	1003	update the guidance of the Department on the operation 10
1004	1004	of covered treatment programs to reflect each of the re-11
1005	1005	quirements under subsections (b) through (h). 12
1006	1006	(j) D
1007	1007	EADLINE.—The Secretary shall carry out each 13
1008	1008	requirement under this section by not later than one year 14
1009	1009	after the date of the enactment of this Act, unless other-15
1010	1010	wise specified. 16
1011	1011	(k) C
1012	1012	OMPTROLLERGENERALREVIEW.— 17
1013	1013	(1) I
1014	1014	N GENERAL.—Not later than two years 18
1015	1015	after the date of the enactment of this Act, the 19
1016	1016	Comptroller General of the United States shall re-20
1017	1017	view access to care under a covered treatment pro-21
1018	1018	gram for covered veterans in need of residential 22
1019	1019	mental health care and substance use disorder care. 23
1020	1020	(2) E
1021	1021	LEMENTS.—The review required by para-24
1022	1022	graph (1) shall include the following: 25
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1026	1026	(A) A review of wait times under a covered 1
1027	1027	treatment program, disaggregated by— 2
1028	1028	(i) treatment track or specificity of 3
1029	1029	residential rehabilitation treatment care 4
1030	1030	needed; 5
1031	1031	(ii) sex of the covered veteran; 6
1032	1032	(iii) home State of the covered vet-7
1033	1033	eran; 8
1034	1034	(iv) home Veterans Integrated Service 9
1035	1035	Network of the covered veteran; and 10
1036	1036	(v) wait times for— 11
1037	1037	(I) facilities of the Department; 12
1038	1038	and 13
1039	1039	(II) non-Department facilities. 14
1040	1040	(B) A review of policy and training of the 15
1041	1041	Department on screening, admission, and place-16
1042	1042	ment under a covered treatment program. 17
1043	1043	(C) A review of the rights of covered vet-18
1044	1044	erans and providers to appeal admission deci-19
1045	1045	sions under a covered treatment program and 20
1046	1046	how the Department adjudicates appeals. 21
1047	1047	(D) When determining the facility at which 22
1048	1048	a covered veteran admitted to a covered treat-23
1049	1049	ment program will be placed in such program, 24
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1053	1053	a review of how the input of the covered veteran 1
1054	1054	is taken into consideration with respect to— 2
1055	1055	(i) program specialty, subtype, or 3
1056	1056	treatment track offered to the covered vet-4
1057	1057	eran; and 5
1058	1058	(ii) the geographic placement of the 6
1059	1059	covered veteran, including family- or occu-7
1060	1060	pation-related preferences or cir-8
1061	1061	cumstances. 9
1062	1062	(E) A review of staffing and staffing needs 10
1063	1063	and gaps of covered treatment programs, in-11
1064	1064	cluding with respect to— 12
1065	1065	(i) mental health providers and coor-13
1066	1066	dinators at the facility level; 14
1067	1067	(ii) staff of facilities of such pro-15
1068	1068	grams; 16
1069	1069	(iii) staff of Veterans Integrated Serv-17
1070	1070	ice Networks; and 18
1071	1071	(iv) overall administration of such 19
1072	1072	programs at the national level. 20
1073	1073	(F) Recommendations for improvement of 21
1074	1074	access by covered veterans to care under a cov-22
1075	1075	ered treatment program, including with respect 23
1076	1076	to— 24
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1080	1080	(i) any new sites or types of programs 1
1081	1081	needed or in development; 2
1082	1082	(ii) changes in training or policy; 3
1083	1083	(iii) changes in communications with 4
1084	1084	covered veterans; and 5
1085	1085	(iv) oversight of covered treatment 6
1086	1086	programs by the Department. 7
1087	1087	TITLE III—OTHER HEALTH CARE 8
1088	1088	MATTERS 9
1089	1089	SEC. 301. PLAN ON ESTABLISHMENT OF INTERACTIVE, ON-10
1090	1090	LINE SELF-SERVICE MODULE FOR CARE. 11
1091	1091	(a) I
1092	1092	NGENERAL.—The Secretary of Veterans Af-12
1093	1093	fairs, working with Third Party Administrators and acting 13
1094	1094	through the Center for Innovation for Care and Payment 14
1095	1095	of the Department of Veterans Affairs under section 15
1096	1096	1703E of title 38, United States Code, shall develop and 16
1097	1097	implement a plan to establish an interactive, online self- 17
1098	1098	service module— 18
1099	1099	(1) to allow veterans to request appointments, 19
1100	1100	track referrals for health care under the laws admin-20
1101	1101	istered by the Secretary, whether at a facility of the 21
1102	1102	Department or through a non-Department provider, 22
1103	1103	and receive appointment reminders; 23
1104	1104	(2) to allow veterans to appeal and track deci-24
1105	1105	sions relating to— 25
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1109	1109	(A) denials of requests for care or services 1
1110	1110	under section 1703 of title 38, United States 2
1111	1111	Code; or 3
1112	1112	(B) denials of requests for care or services 4
1113	1113	at facilities of the Department, including under 5
1114	1114	section 1710 of such title; and 6
1115	1115	(3) to implement such other matters as deter-7
1116	1116	mined appropriate by the Secretary in consultation 8
1117	1117	with Third Party Administrators. 9
1118	1118	(b) S
1119	1119	UBMITTAL OFPLAN.— 10
1120	1120	(1) I
1121	1121	NITIAL PLAN.—Not later than 180 days 11
1122	1122	after the date of the enactment of this Act, the Sec-12
1123	1123	retary shall submit to the Committee on Veterans’ 13
1124	1124	Affairs of the Senate and the Committee on Vet-14
1125	1125	erans’ Affairs of the House of Representatives the 15
1126	1126	plan developed under subsection (a). 16
1127	1127	(2) Q
1128	1128	UARTERLY UPDATE .—Not less frequently 17
1129	1129	than quarterly following the submittal of the plan 18
1130	1130	under paragraph (1) and for two years thereafter, 19
1131	1131	the Secretary shall submit to the Committee on Vet-20
1132	1132	erans’ Affairs of the Senate and the Committee on 21
1133	1133	Veterans’ Affairs of the House of Representatives a 22
1134	1134	report containing any updates on the implementa-23
1135	1135	tion of such plan. 24
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1139	1139	(c) RULE OFCONSTRUCTION.—This section shall not 1
1140	1140	be construed to be a pilot program subject to the require-2
1141	1141	ments of section 1703E of title 38, United States Code. 3
1142	1142	(d) T
1143	1143	HIRDPARTYADMINISTRATORDEFINED.—In 4
1144	1144	this section, the term ‘‘Third Party Administrator’’ means 5
1145	1145	an entity that manages a provider network and performs 6
1146	1146	administrative services related to such network under sec-7
1147	1147	tion 1703 of title 38, United States Code. 8
1148	1148	SEC. 302. MODIFICATION OF REQUIREMENTS FOR CENTER 9
1149	1149	FOR INNOVATION FOR CARE AND PAYMENT 10
1150	1150	OF THE DEPARTMENT OF VETERANS AF-11
1151	1151	FAIRS AND REQUIREMENT FOR PILOT PRO-12
1152	1152	GRAM. 13
1153	1153	(a) I
1154	1154	NGENERAL.—Section 1703E of title 38, United 14
1155	1155	States Code, is amended— 15
1156	1156	(1) in subsection (a)— 16
1157	1157	(A) in paragraph (1), by striking ‘‘within 17
1158	1158	the Department’’ and inserting ‘‘within the Of-18
1159	1159	fice of the Secretary’’; 19
1160	1160	(B) in paragraph (2), by striking ‘‘may’’ 20
1161	1161	and inserting ‘‘shall’’; and 21
1162	1162	(C) in paragraph (3)— 22
1163	1163	(i) in subparagraph (A), by striking ‘‘; 23
1164	1164	and’’ and inserting a semicolon; 24
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1168	1168	(ii) in subparagraph (B), by striking 1
1169	1169	the period at the end and inserting ‘‘; or’’; 2
1170	1170	and 3
1171	1171	(iii) by adding at the end the fol-4
1172	1172	lowing new subparagraph: 5
1173	1173	‘‘(C) increase productivity, efficiency, and mod-6
1174	1174	ernization throughout the Department.’’; 7
1175	1175	(2) by striking subsection (d) and inserting the 8
1176	1176	following new subsection (d): 9
1177	1177	‘‘(d) B
1178	1178	UDGETARYLINEITEM.—The Secretary shall 10
1179	1179	include in the budget justification materials submitted to 11
1180	1180	Congress in support of the budget of the Department of 12
1181	1181	Veterans Affairs for a fiscal year (as submitted with the 13
1182	1182	budget of the President under section 1105(a) of title 31) 14
1183	1183	specific identification, as a budgetary line item, of the 15
1184	1184	amounts required to carry out this section.’’; 16
1185	1185	(3) in subsection (f)— 17
1186	1186	(A) in paragraph (1), by striking ‘‘in sub-18
1187	1187	chapters I, II, and III of this chapter’’ and in-19
1188	1188	serting ‘‘of this title, of title 38, Code of Fed-20
1189	1189	eral Regulations, and of any handbooks, direc-21
1190	1190	tives, or policy documents of the Department’’; 22
1191	1191	and 23
1192	1192	(B) in paragraph (2), in the matter pre-24
1193	1193	ceding subparagraph (A), by striking ‘‘waiving 25
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1197	1197	any authority’’ and inserting ‘‘waiving any pro-1
1198	1198	vision of this title’’; 2
1199	1199	(4) in subsection (g)(1), by inserting ‘‘fewer 3
1200	1200	than three or’’ before ‘‘more than 10’’; 4
1201	1201	(5) in subsection (i)— 5
1202	1202	(A) in paragraph (1), by striking ‘‘the 6
1203	1203	Under Secretary for Health and the Special 7
1204	1204	Medical Advisory Group established pursuant to 8
1205	1205	section 7312 of this title’’ and inserting ‘‘the 9
1206	1206	Under Secretary for Health, the Special Med-10
1207	1207	ical Advisory Group established pursuant to 11
1208	1208	section 7312 of this title, the Office of Inte-12
1209	1209	grated Veteran Care (or successor office), the 13
1210	1210	Office of Finance (or successor office), the Vet-14
1211	1211	eran Experience Office (or successor office), the 15
1212	1212	Office of Enterprise Integration (or successor 16
1213	1213	office), and the Office of Information and Tech-17
1214	1214	nology (or successor office)’’; and 18
1215	1215	(B) in paragraph (2), by striking ‘‘rep-19
1216	1216	resentatives of relevant Federal agencies, and 20
1217	1217	clinical and analytical experts with expertise in 21
1218	1218	medicine and health care management’’ and in-22
1219	1219	serting ‘‘representatives of relevant Federal 23
1220	1220	agencies, nonprofit organizations, and other 24
1221	1221	public and private sector entities, including 25
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1225	1225	those with clinical and analytical experts with 1
1226	1226	expertise in medicine and health care manage-2
1227	1227	ment’’; and 3
1228	1228	(6) by adding at the end the following new sub-4
1229	1229	section: 5
1230	1230	‘‘(k) R
1231	1231	EPORT ONACTIVITIES OFCENTER FORINNO-6
1232	1232	VATION FORCARE ANDPAYMENT.—Not less frequently 7
1233	1233	than annually, the Secretary shall submit to Congress a 8
1234	1234	report that contains, for the one-year period preceding the 9
1235	1235	date of the report— 10
1236	1236	‘‘(1) a full accounting of the activities, staff, 11
1237	1237	budget, and other resources and efforts of the Cen-12
1238	1238	ter; and 13
1239	1239	‘‘(2) an assessment of the outcomes of the ef-14
1240	1240	forts of the Center.’’. 15
1241	1241	(b) C
1242	1242	OMPTROLLER GENERALREPORT.—Not later 16
1243	1243	than 18 months after the date of the enactment of this 17
1244	1244	Act, the Comptroller General of the United States shall 18
1245	1245	submit to Congress a report— 19
1246	1246	(1) on the efforts of the Center for Innovation 20
1247	1247	for Care and Payment of the Department of Vet-21
1248	1248	erans Affairs in fulfilling the objectives and require-22
1249	1249	ments under section 1703E of title 38, United 23
1250	1250	States Code, as amended by subsection (a); and 24
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1254	1254	(2) containing such recommendations as the 1
1255	1255	Comptroller General considers appropriate. 2
1256	1256	(c) P
1257	1257	ILOTPROGRAM.— 3
1258	1258	(1) I
1259	1259	N GENERAL.—Not later than one year 4
1260	1260	after the date of the enactment of this Act, the Cen-5
1261	1261	ter for Innovation for Care and Payment of the De-6
1262	1262	partment of Veterans Affairs under section 1703E 7
1263	1263	of title 38, United States Code, shall establish a 8
1264	1264	three-year pilot program in not fewer than five loca-9
1265	1265	tions to allow veterans enrolled in the system of an-10
1266	1266	nual patient enrollment of the Department estab-11
1267	1267	lished and operated under section 1705(a) of such 12
1268	1268	title to access outpatient mental health and sub-13
1269	1269	stance use services through health care providers 14
1270	1270	specified under section 1703(c) of such title without 15
1271	1271	referral or pre-authorization. 16
1272	1272	(2) P
1273	1273	RIORITY.—In selecting sites for the pilot 17
1274	1274	program under paragraph (1), the Secretary shall 18
1275	1275	prioritize sites in the following areas: 19
1276	1276	(A) Areas with varying degrees of urban-20
1277	1277	ization, including urban, rural, and highly rural 21
1278	1278	areas. 22
1279	1279	(B) Areas with high rates of suicide among 23
1280	1280	veterans. 24
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1284	1284	(C) Areas with high rates of overdose 1
1285	1285	deaths among veterans. 2
1286	1286	(D) Areas with high rates of calls to the 3
1287	1287	Veterans Crisis Line. 4
1288	1288	(E) Areas with long wait times for mental 5
1289	1289	health and substance use services at facilities of 6
1290	1290	the Department. 7
1291	1291	(F) Areas with outpatient mental health 8
1292	1292	and substance use programs that utilize a 9
1293	1293	value-based care model, to the extent prac-10
1294	1294	ticable. 11
1295	1295	(3) E
1296	1296	LEMENTS.—The Secretary, in imple-12
1297	1297	menting the pilot program under paragraph (1), 13
1298	1298	shall ensure the Department has a care coordination 14
1299	1299	system in place that includes— 15
1300	1300	(A) knowledge sharing, including the time-16
1301	1301	ly exchange of medical documentation; 17
1302	1302	(B) assistance with transitions of care, in-18
1303	1303	cluding the potential need for inpatient or resi-19
1304	1304	dential psychiatric services, substance use de-20
1305	1305	toxification services, post-detoxification step- 21
1306	1306	down services, and residential rehabilitation 22
1307	1307	programs; 23
1308	1308	(C) continuous assessment of patient needs 24
1309	1309	and goals; and 25
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1313	1313	(D) creating personalized, proactive care 1
1314	1314	plans. 2
1315	1315	(4) O
1316	1316	VERSIGHT AND OUTCOMES .—The Sec-3
1317	1317	retary shall develop appropriate metrics and meas-4
1318	1318	ures— 5
1319	1319	(A) to track and oversee sites at which the 6
1320	1320	pilot program under paragraph (1) is carried 7
1321	1321	out; 8
1322	1322	(B) to monitor patient safety and out-9
1323	1323	comes under the pilot program; and 10
1324	1324	(C) to assess and mitigate any barriers to 11
1325	1325	extending the pilot program across the entire 12
1326	1326	Veterans Health Administration. 13
1327	1327	(5) A
1328	1328	NNUAL REPORT.— 14
1329	1329	(A) I
1330	1330	N GENERAL.—Not later than one year 15
1331	1331	after the commencement of the pilot program 16
1332	1332	under paragraph (1), and not less frequently 17
1333	1333	than annually thereafter during the duration of 18
1334	1334	the pilot program, the Secretary shall submit to 19
1335	1335	the Committee on Veterans’ Affairs of the Sen-20
1336	1336	ate and Committee on Veterans’ Affairs of the 21
1337	1337	House of Representatives a report on the pilot 22
1338	1338	program, which shall include the following: 23
1339	1339	(i) The number of unique veterans 24
1340	1340	who participated in the pilot program. 25
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1344	1344	(ii) The number of health care pro-1
1345	1345	viders who participated in the pilot pro-2
1346	1346	gram. 3
1347	1347	(iii) An assessment of the effective-4
1348	1348	ness of the pilot program in increasing ac-5
1349	1349	cess to, and improving outcomes for, men-6
1350	1350	tal health and substance use treatment 7
1351	1351	services. 8
1352	1352	(iv) The cost of the pilot program. 9
1353	1353	(v) Such other matters as the Sec-10
1354	1354	retary considers appropriate. 11
1355	1355	(B) F
1356	1356	INAL REPORT.—The Secretary shall 12
1357	1357	include in the final report submitted under sub-13
1358	1358	paragraph (A), in addition to the requirements 14
1359	1359	under such subparagraph, the assessment by 15
1360	1360	the Secretary of the feasibility and advisability 16
1361	1361	of extending the pilot program across the entire 17
1362	1362	Veterans Health Administration, including a 18
1363	1363	plan, timeline, and required resources for such 19
1364	1364	an extension. 20
1365	1365	(6) V
1366	1366	ETERANS CRISIS LINE DEFINED .—In this 21
1367	1367	subsection, the term ‘‘Veterans Crisis Line’’ means 22
1368	1368	the toll-free hotline for veterans established under 23
1369	1369	section 1720F(h) of title 38, United States Code. 24
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1373	1373	SEC. 303. REPORTS. 1
1374	1374	(a) R
1375	1375	EPORT ONIMPROVEMENTS TO CLINICALAP-2
1376	1376	PEALSPROCESS.—Not later than one year after the date 3
1377	1377	of the enactment of this Act, and not less frequently than 4
1378	1378	once every three years thereafter, the Secretary of Vet-5
1379	1379	erans Affairs, in consultation with veterans service organi-6
1380	1380	zations, veterans, caregivers of veterans, employees of the 7
1381	1381	Department of Veterans Affairs, and other stakeholders 8
1382	1382	as determined by the Secretary, shall submit to the Com-9
1383	1383	mittee on Veterans’ Affairs of the Senate and Committee 10
1384	1384	on Veterans’ Affairs of the House of Representatives a 11
1385	1385	report containing recommendations for legislative or ad-12
1386	1386	ministrative action to improve the clinical appeals process 13
1387	1387	of the Department with respect to timeliness, trans-14
1388	1388	parency, objectivity, consistency, and fairness. 15
1389	1389	(b) R
1390	1390	EPORT ONREQUIREDCARE ANDSERVICES 16
1391	1391	U
1392	1392	NDERCOMMUNITYCAREPROGRAM.—Not later than 17
1393	1393	one year after the date of the enactment of this Act, and 18
1394	1394	not less frequently than annually thereafter, the Secretary 19
1395	1395	shall submit to the Committee on Veterans’ Affairs of the 20
1396	1396	Senate and Committee on Veterans’ Affairs of the House 21
1397	1397	of Representatives a report that contains, for the one-year 22
1398	1398	period preceding the date of the report, the following: 23
1399	1399	(1) The number of veterans eligible for care or 24
1400	1400	services under section 1703 of title 38, United 25
1401	1401	States Code, and the reasons for such eligibility, in-26
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1404	1404	•S 275 IS
1405	1405	cluding multiple such reasons for veterans eligible 1
1406	1406	under more than one eligibility criteria. 2
1407	1407	(2) The number of veterans who opt to seek 3
1408	1408	care or services under such section. 4
1409	1409	(3) The number of veterans who do not opt to 5
1410	1410	seek care or services under such section. 6
1411	1411	(4) An assessment of the timeliness of referrals 7
1412	1412	for care or services under such section. 8
1413	1413	(5) The number of times a veteran did not 9
1414	1414	show for an appointment for care or services under 10
1415	1415	such section. 11
1416	1416	(6) The number of requests for an appeal of a 12
1417	1417	denial of care or services under such section using 13
1418	1418	the clinical appeals process of the Veterans Health 14
1419	1419	Administration. 15
1420	1420	(7) The timeliness of each such appeal. 16
1421	1421	(8) The outcome of each such appeal. 17
1422	1422	(c) V
1423	1423	ETERANSSERVICEORGANIZATIONDEFINED.— 18
1424	1424	In this section, the term ‘‘veterans service organization’’ 19
1425	1425	means any organization recognized by the Secretary under 20
1426	1426	section 5902 of title 38, United States Code. 21
1427	1427	Æ
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