119-hr3643

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3643 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 3643

 To amend title 38, United States Code, to improve the annual reports 
 submitted to Congress with respect to the Veterans Benefits 
 Administration and the Veterans Health Administration, and for other 
 purposes.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 May 29, 2025

 Mr. McGuire (for himself and Mr. Bost) introduced the following bill; 
 which was referred to the Committee on Veterans' Affairs

_______________________________________________________________________

 A BILL

 To amend title 38, United States Code, to improve the annual reports 
 submitted to Congress with respect to the Veterans Benefits 
 Administration and the Veterans Health Administration, and for other 
 purposes.

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

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``VA Data Transparency and Trust 
Act''.

SEC. 2. IMPROVEMENTS TO ANNUAL REPORTS ON THE VETERANS BENEFITS 
 ADMINISTRATION AND THE VETERANS HEALTH ADMINISTRATION.

    (a) VHA Report.--

Section 7330B of title 38, United States Code, is 
amended to read as follows:
``

Sec. 7330B. Annual report on Veterans Health Administration and 
 furnishing of hospital care, medical services, and 
 nursing home care
 ``

    (a) Report Required.--During the period beginning on the date of 
the enactment of the VA Data Transparency and Trust Act and ending on 
the date that is five years after such date, the Secretary shall submit 
to the Committees on Veterans' Affairs of the House of Representatives 
and the Senate a report on, for the calendar year preceding the 
calendar year during which the report is submitted--
 ``

    (1) the furnishing of hospital care, medical services, 
 and nursing home care under the laws administered by the 
 Secretary; and
 ``

    (2) the administration of the furnishing of such care and 
 services by the Veterans Health Administration.
 ``

    (b) Elements.--Each report required by subsection

    (a) shall 
include each of the following for the year covered by the report:
 ``

    (1) The total number of veterans who received hospital 
 care, medical services, and nursing home care under the laws 
 administered by the Secretary furnished by the Veterans Health 
 Administration.
 ``

    (2) Information with respect to the health status of 
 veterans described in paragraph

    (1) , that includes the rate of 
 incidence among such veterans of major chronic conditions, 
 disaggregated by condition, including--
 ``
        (A) traumatic brain injury;
 ``
        (B) diabetes;
 ``
            (C) cardiovascular disease; and
 ``
            (D) cancer.
 ``

    (3) Demographic information with respect to such 
 veterans, disaggregated by--
 ``
        (A) age;
 ``
        (B) period of--
 ``
            (i) active military, naval, air, or space 
 service; or
 ``
            (ii) service in a Reserve component; and
 ``
            (C) sex.
 ``

    (4) Information with respect to furnishing of health care 
 during the period covered by the report to--
 ``
        (A) veterans who served on active duty during the 
 Post-9/11 Global Operations period (as defined in 
 

section 3105 of this title), including--
 ``
            (i) a summary of conditions the Secretary 
 determines are commonly present in such 
 veterans;
 ``
            (ii) a summary of common conditions in 
 such veterans that the Secretary determines 
 have arisen since the date of the submission of 
 the preceding report;
 ``
            (iii) an estimate of the number of such 
 veterans that belong to a different priority 
 group specified in subsection

    (a) of 

section 1705 of this title than on the date of the 
 submission of the preceding report; and
 ``
            (iv) an estimate of the number of such 
 veterans who are enrolled in a health insurance 
 plan that is not a health insurance plan under 
 the laws administered by the Secretary;
 ``
        (B) veterans with mental health conditions 
 (including traumatic brain injury and suicidal 
 ideation);
 ``
            (C) veterans with polytrauma;
 ``
            (D) veterans with spinal cord injury or 
 dysfunction;
 ``
        (E) veterans with service-connected disabilities, 
 including the average cost to the Department of 
 furnishing such care to such veterans; and
 ``
        (F) homeless veterans, including--
 ``
            (i) the average age of such veterans;
 ``
            (ii) estimates of the geographic 
 locations of such veterans;
 ``
            (iii) estimates of the average duration 
 of homelessness for such veterans; and
 ``
            (iv) the periods during which such 
 veterans performed active military, naval, air, 
 or space service.
 ``

    (5) Information with respect to veterans who received 
 long term care under the laws administered by the Secretary 
 during the period covered by the report, including--
 ``
        (A) the demographic information of such veterans, 
 including common chronic illnesses present in such 
 veterans;
 ``
        (B) the average amount of copayments for such 
 long term care made by such veterans;
 ``
            (C) a description of the types of such long term 
 care; and
 ``
            (D) funding levels for State homes as of the date 
 of the submission of the report.
 ``

    (6) The number of veterans who enrolled in the annual 
 system for patient enrollment under 

section 1705 of this title 
 during the period covered by the report, disaggregated by--
 ``
        (A) priority group specified in subsection

    (a) of 
 such section;
 ``
        (B) age;
 ``
            (C) sex;
 ``
            (D) annual income; and
 ``
        (E) enrollment in a health insurance plan that is 
 not a health insurance plan under the laws administered 
 by the Secretary.
 ``

    (7) With respect to veterans described in paragraph

    (6) , 
 the average period of time between the date on which such a 
 veteran was separated from active military, naval, air, or 
 space service and the earlier of--
 ``
        (A) the date on which the veteran enrolled in 
 such annual system for patient enrollment; and
 ``
        (B) the date on which the veteran first received 
 hospital care, medical services, or nursing home care 
 under the laws administered by the Secretary furnished 
 by the Veterans Health Administration.
 ``

    (8) The total number of visits to facilities of the 
 Department for hospital care, medical services, and nursing 
 home care under laws administered by the Secretary.
 ``

    (9) A summary of each type of hospital care, medical 
 service, or nursing home care under laws administered by the 
 Secretary furnished by the Veterans Health Administration to 
 veterans, including--
 ``
        (A) inpatient care;
 ``
        (B) outpatient care;
 ``
            (C) prescription drugs;
 ``
            (D) mental health care; and
 ``
        (E) primary care.
 ``

    (10) A statement of the percentage of hospital care, 
 medical service, or nursing home care under laws administered 
 by the Secretary furnished by the Veterans Health 
 Administration to veterans during the period covered by the 
 report intended to treat--
 ``
        (A) service-connected disabilities; and
 ``
        (B) non-service-connected disabilities.
 ``

    (11) With respect to prescription drugs and medicines 
 furnished to veterans by the Veterans Health Administration 
 during the period covered by the report, a statement of--
 ``
        (A) the total number of such prescriptions for 
 such drugs and medicine dispensed to veterans--
 ``
            (i) during the course of inpatient care 
 at a facility of the Department;
 ``
            (ii) at a community-based outpatient 
 clinic of the Department;
 ``
            (iii) at a non-Department facility; and
 ``
            (iv) through a mail-order prescription; 
 and
 ``
        (B) the average term of a prescription for each 
 drug or medicine furnished to a veteran by the Veterans 
 Health Administration during such period.
 ``

    (12) With respect to inpatient care provided to veterans 
 at facilities of the Department--
 ``
        (A) the average length of stay at such a facility 
 for a veteran in receipt of such inpatient care; and
 ``
        (B) the average cost to a veteran of such 
 inpatient care.
 ``

    (13) A summary of diagnostic services provided to 
 veterans during by the report that includes--
 ``
        (A) a statement of the percentage of such 
 diagnostic services provided for--
 ``
            (i) a service-connected disability; and
 ``
            (ii) a non-service connected disability; 
 and
 ``
        (B) a description of conditions diagnosed 
 pursuant to such diagnostic services, disaggregated by 
 body system associated with such condition.
 ``

    (14) An assessment of the extent to which veterans who 
 received hospital care, medical services, and nursing home care 
 furnished by the Veterans Health Administration during the 
 period covered by the report rely on the Veterans Health 
 Administration for health care, disaggregated by veterans--
 ``
        (A) who are--
 ``
            (i) younger than 65 years of age;
 ``
            (ii) 65 years of age or older;
 ``
            (iii) fully reliant on the Veterans 
 Health Administration;
 ``
            (iv) partially reliant on the Veterans 
 Health Administration; and
 ``
            (v) not reliant on the Veterans Health 
 Administration;
 ``
        (B) who received--
 ``
            (i) inpatient care; and
 ``
            (ii) outpatient care.
 ``

    (15) An assessment of the quality of health care 
 furnished to veterans by the Veterans Health Administration 
 that includes a measurement of--
 ``
        (A) the incidence of hospital acquired infections 
 among veterans;
 ``
        (B) the extent to which veterans are satisfied 
 with such health care, disaggregated by such health 
 care provided at--
 ``
            (i) a facility of the Department; and
 ``
            (ii) a non-Department facility.
 ``

    (16) A summary of the hospital care, medical services, 
 and nursing home care furnished by the Veterans Health 
 Administration--
 ``
        (A) required under VA MISSION Act of 2018 (Public 
 Law 115-182; 38 U.S.C. 301 note);
 ``
        (B) required under the Honoring our PACT Act of 
 2022 (Public Law 117-168);
 ``
            (C) under 

section 1781 of this title, that 
 includes an estimate of the average cost to the 
 Department of furnishing such care, disaggregated by 
 the age of the individual to which such care was 
 furnished; and
 ``
            (D) under 

section 1703 of this title.
 ``

    (17) A summary of collections of copayments for health 
 care under the laws administered by the Secretary that 
 includes--
 ``
        (A) a statement of the percentage of such 
 copayments made by--
 ``
            (i) veterans; and
 ``
            (ii) third parties; and
 ``
        (B) a comparison of such collections to health 
 care billings owed to the Department.
 ``

    (18) Data with respect to the Medical Care Collections 
 Fund established under 

section 1729A of this title that 
 includes, with respect to the period covered by the report--
 ``
        (A) an identification of the total number of 
 veterans from whom amounts were collected;
 ``
        (B) the average amount so collected--
 ``
            (i) per veteran; and
 ``
            (ii) per priority group specified in 
 subsection

    (a) of 

section 1705 of this title; 
 and
 ``
            (C) the total amount so collected.
 ``

    (19) Information with respect to physicians employed by 
 the Veterans Health Administration, that includes--
 ``
        (A) the number of such physicians who are full-
 time employees, disaggregated by--
 ``
            (i) specialty; and
 ``
            (ii) the type of medical facility where 
 the physician is employed;
 ``
        (B) the average annual salary for such 
 physicians, including bonuses and other pay awards; and
 ``
            (C) for such physicians who are primary care 
 physicians--
 ``
            (i) the average number of patients, 
 adjusted for patient health status, treated 
 per--
 ``
            (I) week; and
 ``
            (II) calendar year; and
 ``
            (ii) the average amount of time such 
 physicians spend with patients during 
 appointments for primary care.
 ``

    (20) Information with respect to medical professionals 
 employed by the Veterans Health Administration that includes a 
 statement of--
 ``
        (A) the average number of patients such a medical 
 professional treats each week; and
 ``
        (B) the average amount of time such physicians 
 spend with patients during appointments for primary 
 care.
 ``

    (21) An assessment of the management of facilities of 
 Veterans Health Administration that includes--
 ``
        (A) for each medical facility under the 
 jurisdiction of the Veterans Health Administration a 
 statement of--
 ``
            (i) the date of--
 ``
            (I) the original construction; 
 and
 ``
            (II) the most recent renovation 
 project carried out, if applicable;
 ``
            (ii) the total square feet;
 ``
            (iii) the cost to the Department of 
 regular maintenance and repairs;
 ``
        (B) for each such medical facility that provides 
 inpatient care, the rate of occupancy; and
 ``
            (C) for each such medical facility that provides 
 outpatient care, the number of patient visits, 
 disaggregated by type of health care provided at the 
 visit.
 ``

    (22) A summary of major capital spending pursuant to the 
 administration by the Veterans Health Administration of 
 furnishing medical care and services under the laws 
 administered by the Secretary that includes a description of--
 ``
        (A) planned construction of new facilities;
 ``
        (B) planned renovation of facilities; and
 ``
            (C) any purchase of medical equipment that totals 
 more than $20,000.
 ``

    (23) For each priority group specified in subsection

    (a) of 

section 1705 of this title--
 ``
        (A) demographic information of veterans that 
 comprise each such priority group;
 ``
        (B) an assessment of the extent to which veterans 
 that comprise each such priority group use the benefits 
 under the laws administered by the Secretary for which 
 such veterans are eligible; and
 ``
            (C) an estimate of the average cost to the 
 Department of furnishing health care under the laws 
 administered by the Secretary to veterans that comprise 
 each such priority group.
 ``

    (24) The percentage of hospital care, medical services, 
 and nursing home care provided to veterans in facilities of the 
 Department and in non-Department facilities and any changes in 
 such percentages compared to the year preceding the year 
 covered by the report.
 ``
            (c) Data Sharing System.--

    (1) The Secretary shall develop and 
carry out a data sharing system to grant individuals described in 
paragraph

    (2) access to aggregated, anonymized data with respect to 
veterans and individuals receiving health care furnished under laws 
administered by the Secretary.
 ``

    (2) An eligible individual described in this paragraph is a 
researcher who meets the criteria for data security and data protection 
established by the Secretary in regulations for the purposes of 
administering the data sharing system under paragraph

    (1) .
 ``

    (3) In developing the data sharing system under paragraph

    (1) , 
the Secretary shall consider the Centers for Medicare & Medicaid 
Services Qualified Entity Program (commonly referred to as the 
`Medicare Data Sharing for Performance Measurement Program') 
established pursuant to 

section 1874

    (e) of the Social Security Act (42 
U.S.C. 1395kk

    (e) , 1395kk-2).
 ``

    (4) The Secretary shall ensure that data available through such 
data sharing system includes--
 ``
        (A) each type data available under the Medicare Data 
 Sharing for Performance Measurement Program, where applicable;
 ``
        (B) data on veterans enrolled in the annual system for 
 patient enrollment established under 

section 1705 of this 
 title, including--
 ``
            (i) demographic data;
 ``
            (ii) the number of veterans that comprise each 
 priority group specified in subsection

    (a) of such 
 section; and
 ``
            (iii) the number of veterans with service-
 connected disabilities, disaggregated by level of 
 disability rating determined by the Secretary;
 ``
            (C) data on visits for health care under laws 
 administered by the Secretary furnished at facilities of the 
 Department, including--
 ``
            (i) types of health care providers furnishing 
 such health care during such visits;
 ``
            (ii) diagnostic codes associated with illnesses 
 in veterans diagnosed during the course of such visits;
 ``
            (iii) with respect to such visits for outpatient 
 care, an identification of the date of such visit; and
 ``
            (iv) with respect to such visits for inpatient 
 care, an identification of the applicable admission 
 date and discharge date; and
 ``
            (D) data on insurance claims submitted to the Secretary 
 for health care furnished at non-Department facilities, 
 including--
 ``
            (i) provider numbers of applicable insurance 
 companies;
 ``
            (ii) payments made by the Secretary to veterans 
 pursuant to such claims; and
 ``
            (iii) payments made by veterans with respect to 
 such insurance claims.
 ``
            (d) === Definitions. ===
-In this section, the terms `hospital care', 
`medical services', `nursing home care', `facilities of the 
Department', and `non-Department facilities' have the meanings given 
those terms in 

section 1701 of this title.''.

    (b) Additional Data for Inclusion in Annual VBA Report.--Subchapter 
II of chapter 77 of title 38, United States Code, is amended by adding 
at the end the following new section (and conforming the table of 
sections at the beginning of such chapter accordingly):
``

Sec. 7735. Additional data for inclusion in annual report to 
 Congress; data sharing system
 ``

    (a) In General.--

    (1) During the period beginning on the date of 
the enactment of the VA Data Transparency and Trust Act and ending on 
the date that is five years after such date, the Secretary shall 
include in the Annual Benefits Report of the Veterans Benefits 
Administration the following:
 ``
        (A) The number of veterans in receipt of benefits under 
 the laws administered by the Secretary, disaggregated by--
 ``
            (i) age;
 ``
            (ii) income level;
 ``
            (iii) period and length of--
 ``
            (I) active military, naval, air, or space 
 service; or
 ``
            (II) service in a Reserve component.
 ``
        (B) A summary of the types of benefits under the laws 
 administered by the Secretary furnished to veterans.
 ``
            (C) Demographic data with respect to veterans with 
 service-connected disabilities, disaggregated by each schedule 
 of disability rating specified in 

section 1155 of this title, 
 including--
 ``
            (i) age;
 ``
            (ii) sex;
 ``
            (iii) race;
 ``
            (iv) highest level of educational attainment;
 ``
            (v) period and length of--
 ``
            (I) active military, naval, air, or space 
 service; or
 ``
            (II) service in a Reserve component.
 ``
            (D) A statement of the number of veterans with service-
 connected disabilities to whom the Secretary assigned a 
 disability rating different from the disability rating 
 initially assigned to the veteran.
 ``
        (E) The average amount of compensation under chapter 11 
 of this title paid to veterans--
 ``
            (i) with dependents;
 ``
            (ii) in receipt of special monthly compensation 
 under subsection

    (r) of 

section 1114 of this title; and
 ``
            (iii) with a disability rated as total by reason 
 of unemployability under 

section 1164 of this title.
 ``
        (F) Data with respect to veterans with disability ratings 
 reevaluated by the Secretary, including--
 ``
            (i) the number of such veterans;
 ``
            (ii) the conditions associated with such 
 disability ratings;
 ``
            (iii) the number of such veterans assigned, 
 pursuant to such reevaluation--
 ``
            (I) an increased disability rating; or
 ``
            (II) a decreased disability rating.
 ``
        (G) For each of fiscal years 1997 through 2024, a 
 statement of the number of reevaluations of disability ratings 
 initiated by the Secretary.
 ``
        (H) For each condition for which a presumption of 
 service-connection is established under chapter 11 of this 
 title--
 ``
            (i) the number of veterans with such condition in 
 receipt of compensation under such chapter, 
 disaggregated by each schedule of disability rating 
 specified in 

section 1155; and
 ``
            (ii) the average amount of such compensation paid 
 to such veterans.
 ``
            (I) For each non-service-connected disability that is 
 compensable under the laws administered by the Secretary, a 
 statement of the average amount of compensation under chapater 
 11 of this title paid to veterans with each such non-service-
 connected disability.
 ``
        (J) Data with respect to veterans in receipt of a pension 
 under chapter 15 of this title, including--
 ``
            (i) the number of such veterans, disaggregated 
 by--
 ``
            (I) age;
 ``
            (II) sex;
 ``
            (III) income level;
 ``
            (IV) period and length of--
 ``

    (aa) active military, naval, air, 
 or space service; or
 ``

    (bb) service in a Reserve 
 component;
 ``
            (ii) the average period of time between the date 
 on which such a veteran was separated from active 
 military, naval, air, or space service and the date on 
 which the veteran received the first payment of pension 
 under such chapter; and
 ``
            (iii) for each of fiscal years 2000 through 2024, 
 the average amount of pension paid to such veterans.
 ``
        (K) Data with respect to individuals in receipt of 
 dependency and indemnity compensation under chapter 13 of this 
 title, including--
 ``
            (i) demographic data; and
 ``
            (ii) a summary of the reasons such individuals 
 are eligible for such dependency and indemnity 
 compensation.
 ``
            (L) The number of new claims for disability compensation 
 under the laws administered by the Secretary, and the average 
 period of time between the date on which such claim was 
 submitted and the date on which the Secretary issued a decision 
 with respect to such claim.
 ``
            (M) The number of supplemental claims for disability 
 compensation under such laws, and the average period of time 
 between the date on which such claim was submitted and the date 
 on which the Secretary issued a decision with respect to such 
 claim.
 ``
        (N) Data on the staffing levels of the Veterans Benefits 
 Administration, including the number of full-time employees of 
 the Veterans Benefits Administration responsible for processing 
 such claims for disability compensation.
 ``
        (O) A statement, for each of fiscal years 2000 through 
 2024, of the average amount of disability compensation under 
 chapter 11 of this title paid to veterans with service-
 connected disabilities, disaggreated by each schedule of rating 
 specified in 

section 1155 of this title.
 ``

    (2)
        (A) The first report submitted pursuant to subsection

    (a) shall include each element specified in paragraphs

    (1) through

    (15) of 
such subsection for--
 ``
            (i) the calendar year during which the first report is 
 submitted; and
 ``
            (ii) each calendar year during the five-year period that 
 precedes the date of the submission of the first report.
 ``
        (B) Each report submitted after the date on which the first 
report is submitted shall include each such element for the calendar 
year during which the report is submitted.
 ``

    (b) Data Sharing System.--

    (1) During the period the requirement 
under subsection

    (a) is in effect, the Secretary shall develop and 
carry out a data sharing system to grant eligible individuals described 
in paragraph

    (2) access to individual-level, anonymized data with 
respect to individuals in receipt of benefits furnished by the Under 
Secretary for Benefits.
 ``

    (2) An eligible individual described in this paragraph is 
researcher who meets the criteria for data security and data protection 
established by the Secretary in regulations for the purposes of 
administering the data sharing system under paragraph

    (1) .
 ``

    (3) Data available through such data sharing system shall 
include, for each individual in receipt of benefits furnished by the 
Under Secretary for Benefits--
 ``
        (A) demographic information, including--
 ``
            (i) age;
 ``
            (ii) sex;
 ``
            (iii) race;
 ``
            (iv) period and length of--
 ``
            (I) active military, naval, air, or space 
 service; or
 ``
            (II) service in a Reserve component;
 ``
            (v) branch of service in the Armed Forces;
 ``
            (vi) number of dependents; and
 ``
            (vii) State of residence;
 ``
        (B) information with respect to each service-connected 
 disability for which the individual has filed a claim for 
 disability compensation under laws administered by the 
 Secretary, including--
 ``
            (i) whether such claim was--
 ``
            (I) approved by the Secretary; or
 ``
            (II) denied by the Secretary;
 ``
            (ii) the diagnostic code for the service-
 connected disability; and
 ``
            (iii) the date on which--
 ``
            (I) the individual filed such claim; and
 ``
            (II) the Secretary issued a decision 
 under 

section 511 of this title with respect to 
 such claim; and
 ``
            (C) a description of any compensation under the laws 
 administered by the Secretary receives on annual basis, 
 including--
 ``
            (i) disability compensation;
 ``
            (ii) dependency and indemnity compensation;
 ``
            (iii) educational benefits;
 ``
            (iv) benefits under chapter 37 of this title;
 ``
            (v) special monthly compensation under subsection

    (r) of 

section 1114 of this title; and
 ``
            (vi) compensation for a disability rated as total 
 by reason of unemployability under 

section 1164 of this 
 title.
 ``

    (4) In carrying out such data sharing system, the Secretary shall 
ensure that--
 ``
        (A) no personally identifiable information about an 
 individual in receipt of benefits furnished by the Under 
 Secretary for Benefits is accessible through such data sharing 
 system; and
 ``
        (B) each individual about whom data is available under 
 the data sharing system is assigned a unique identifier for use 
 in such data sharing system.''.
 <all>