119-hr740

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 740 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 740

 To improve the provision of care and services under the Veterans 
 Community Care Program of the Department of Veterans Affairs, and for 
 other purposes.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 January 28, 2025

 Mr. Bost (for himself, Mr. Bergman, Mr. Hamadeh of Arizona, Mrs. 
 Miller-Meeks, Mr. Barrett, Mrs. Kiggans of Virginia, and Mrs. King-
 Hinds) introduced the following bill; which was referred to the 
 Committee on Veterans' Affairs

_______________________________________________________________________

 A BILL

 To improve the provision of care and services under the Veterans 
 Community Care Program of the Department of Veterans Affairs, 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; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Veterans' Assuring 
Critical Care Expansions to Support Servicemembers Act of 2025'' or the 
``Veterans' ACCESS Act of 2025''.

    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
 TITLE I--IMPROVEMENT OF VETERANS COMMUNITY CARE PROGRAM

Sec. 101. Codification of requirements for eligibility standards for 
 access to community care from Department of 
 Veterans Affairs.

Sec. 102. Requirement that Secretary notify veterans of eligibility for 
 care under Veterans Community Care Program.

Sec. 103. Consideration under Veterans Community Care Program of 
 veteran preference for care, continuity of 
 care, and need for caregiver or attendant.

Sec. 104. Notification of denial of request for care under Veterans 
 Community Care Program.

Sec. 105. Discussion of telehealth options under Veterans Community 
 Care Program.

Sec. 106. Extension of deadline for submittal of claims by health care 
 entities and providers under prompt payment 
 standard.
 TITLE II--MENTAL HEALTH TREATMENT PROGRAMS

Sec. 201. Definitions.

Sec. 202. Standardized process to determine eligibility of covered 
 veterans for participation in certain 
 mental health treatment programs.

Sec. 203. Improvements to Department of Veterans Affairs Mental Health 
 Residential Rehabilitation Treatment 
 Program.
 TITLE III--OTHER HEALTH CARE MATTERS

Sec. 301. Plan on establishment of interactive, online self-service 
 module for care.

Sec. 302. Modification of requirements for Center for Innovation for 
 Care and Payment of the Department of 
 Veterans Affairs and requirement for pilot 
 program.

Sec. 303. Reports.

 TITLE I--IMPROVEMENT OF VETERANS COMMUNITY CARE PROGRAM

SEC. 101. CODIFICATION OF REQUIREMENTS FOR ELIGIBILITY STANDARDS FOR 
 ACCESS TO COMMUNITY CARE FROM DEPARTMENT OF VETERANS 
 AFFAIRS.

    (a) Eligibility Access Standards.--

Section 1703B of title 38, 
United States Code, is amended--

    (1) by striking subsections

    (a) through

    (e) and inserting 
 the following:
 ``

    (a) Eligibility Standards for Access to Community Care.--

    (1) A 
covered veteran shall be eligible to elect to receive non-Department 
hospital care, medical services, or extended care services, excluding 
nursing home care, through the Veterans Community Care Program under 

section 1703 of this title pursuant to subsection
            (d) (1)
            (D) of such 
section using the following eligibility access standards:
 ``
        (A) With respect to primary care, mental health care, or 
 extended care services, excluding nursing home care, if the 
 Department cannot schedule an appointment for the covered 
 veteran with a health care provider of the Department who can 
 provide the needed service--
 ``
            (i) within 30 minutes average driving time (or 
 such shorter average driving time as the Secretary may 
 prescribe) from the residence of the veteran unless a 
 longer average driving time has been agreed to by the 
 veteran in consultation with a health care provider of 
 the veteran; and
 ``
            (ii) within 20 days (or such shorter period as 
 the Secretary may prescribe) of the date of request for 
 such an appointment unless a later date has been agreed 
 to by the veteran in consultation with a health care 
 provider of the veteran.
 ``
        (B) With respect to specialty care, if the Department 
 cannot schedule an appointment for the covered veteran with a 
 health care provider of the Department who can provide the 
 needed service--
 ``
            (i) within 60 minutes average driving time (or 
 such shorter average driving time as the Secretary may 
 prescribe) from the residence of the veteran unless a 
 longer average driving time has been agreed to by the 
 veteran in consultation with a health care provider of 
 the veteran; and
 ``
            (ii) within 28 days (or such shorter period as 
 the Secretary may prescribe) of the date of request for 
 such an appointment unless a later date has been agreed 
 to by the veteran in consultation with a health care 
 provider of the veteran.
 ``

    (2) For the purposes of determining the eligibility of a covered 
veteran for care or services under paragraph

    (1) , the Secretary shall 
not take into consideration the availability of telehealth appointments 
from the Department when determining whether the Department is able to 
furnish such care or services in a manner that complies with the 
eligibility access standards under such paragraph.
 ``

    (3) In the case of a covered veteran who has had an appointment 
with a health care provider of the Department canceled by the 
Department for a reason other than the request of the veteran, in 
calculating a wait time for a subsequent appointment under paragraph

    (1) , the Secretary shall calculate such wait time from the date of the 
request for the original, canceled appointment.
 ``

    (4) If a veteran agrees to a longer average drive time or a later 
date under subparagraph
        (A) or
        (B) of paragraph

    (1) , the Secretary 
shall document the agreement to such longer average drive time or later 
date in the electronic health record of the veteran and provide the 
veteran a copy of such documentation. Such copy may be provided 
electronically.
 ``

    (b) Application.--The Secretary shall ensure that the eligibility 
access standards established under subsection

    (a) apply--
 ``

    (1) to all care and services within the medical benefits 
 package of the Department to which a covered veteran is 
 eligible under 

section 1703 of this title, excluding nursing 
 home care; and
 ``

    (2) to all covered veterans, regardless of whether a 
 veteran is a new or established patient.
 ``
            (c) Periodic Review of Access Standards.--Not later than three 
years after the date of the enactment of the Veterans' Assuring 
Critical Care Expansions to Support Servicemembers Act of 2025, and not 
less frequently than once every three years thereafter, the Secretary 
shall--
 ``

    (1) conduct a review of the eligibility access standards 
 under subsection

    (a) in consultation with--
 ``
        (A) such Federal entities as the Secretary 
 considers appropriate, including the Department of 
 Defense, the Department of Health and Human Services, 
 and the Centers for Medicare & Medicaid Services;
 ``
        (B) entities and individuals in the private 
 sector, including--
 ``
            (i) veteran patients;
 ``
            (ii) veterans service organizations; and
 ``
            (iii) health care providers participating 
 in the Veterans Community Care Program under 
 

section 1703 of this title; and
 ``
            (C) other entities that are not part of the 
 Federal Government; and
 ``

    (2) submit to the appropriate committees of Congress a 
 report on--
 ``
        (A) the findings of the Secretary with respect to 
 the review conducted under paragraph

    (1) ; and
 ``
        (B) such recommendations as the Secretary may 
 have with respect to the eligibility access standards 
 under subsection

    (a) .'';

    (2) by striking subsection

    (g) ;

    (3) by redesignating subsections

    (f) ,

    (h) , and
            (i) as 
 subsections
            (d) ,

    (e) , and

    (f) , respectively;

    (4) in subsection
            (d) , as redesignated by paragraph

    (3) --
        (A) by striking ``established'' each place it 
 appears; and
        (B) in paragraph

    (1) , by striking ``

    (1) Subject 
 to'' and inserting ``Compliance by Community Care 
 Providers With Access Standards.--

    (1) Subject to'';

    (5) in subsection

    (e) , as redesignated by paragraph

    (3) --
        (A) in paragraph

    (1) --
            (i) by striking ``

    (1) Consistent with'' and 
 inserting ``Determination Regarding 
 Eligibility.--

    (1) Consistent with''; and
            (ii) by striking ``designated access 
 standards established under this section'' and 
 inserting ``eligibility access standards under 
 subsection

    (a) ''; and
        (B) in paragraph

    (2)
        (B) , by striking ``designated 
 access standards established under this section'' and 
 inserting ``eligibility access standards under 
 subsection

    (a) ''; and

    (6) in subsection

    (f) , as redesignated by paragraph

    (3) --
        (A) in the matter preceding paragraph

    (1) , by 
 striking ``In this section'' and inserting 
 ``

=== Definitions. ===
-In this section''; and
        (B) in paragraph

    (2) --
            (i) by striking ``covered veterans'' and 
 inserting ``covered veteran''; and
            (ii) by striking ``veterans described'' and 
 inserting ``a veteran described''.

    (b) Conforming Amendments.--

Section 1703
            (d) of such title is 
amended--

    (1) in paragraph

    (1)
            (D) , by striking ``designated access 
 standards developed by the Secretary under 

section 1703B of 
 this title'' and inserting ``eligibility access standards under 
 

section 1703B

    (a) of this title''; and

    (2) in paragraph

    (3) , by striking ``designated access 
 standards developed by the Secretary under 

section 1703B of 
 this title'' and inserting ``eligibility access standards under 
 

section 1703B

    (a) of this title''.

SEC. 102. REQUIREMENT THAT SECRETARY NOTIFY VETERANS OF ELIGIBILITY FOR 
 CARE UNDER VETERANS COMMUNITY CARE PROGRAM.

 

Section 1703

    (a) of title 38, United States Code, is amended by 
adding at the end the following new paragraph:
 ``

    (5)
        (A) The Secretary shall notify each covered veteran in writing 
of the eligibility of such veteran for care or services under this 
section as soon as possible, but not later than two business days, 
after the date on which the Secretary is aware that the veteran is 
seeking care or services and is eligible for such care or services 
under this section.
 ``
        (B) With respect to each covered veteran eligible for care or 
services under subsection
            (d) , the Secretary shall provide such veteran 
periodic reminders, as the Secretary determines appropriate, of their 
ongoing eligibility under such subsection.
 ``
            (C) Any notification or reminder under this paragraph may be 
provided electronically.''.

SEC. 103. CONSIDERATION UNDER VETERANS COMMUNITY CARE PROGRAM OF 
 VETERAN PREFERENCE FOR CARE, CONTINUITY OF CARE, AND NEED 
 FOR CAREGIVER OR ATTENDANT.

 

Section 1703
            (d) (2) of title 38, United States Code, is amended by 
adding at the end the following new subparagraphs:
 ``
        (F) The preference of the covered veteran for where, 
 when, and how to seek hospital care, medical services, or 
 extended care services.
 ``
        (G) Continuity of care.
 ``
        (H) Whether the covered veteran requests or requires the 
 assistance of a caregiver or attendant when seeking hospital 
 care, medical services, or extended care services.''.

SEC. 104. NOTIFICATION OF DENIAL OF REQUEST FOR CARE UNDER VETERANS 
 COMMUNITY CARE PROGRAM.

 

Section 1703 of title 38, United States Code, is amended--

    (1) by redesignating subsection

    (o) as subsection

    (p) ; and

    (2) by inserting after subsection

    (n) the following new 
 subsection

    (o) :
 ``

    (o) Notification of Denial of Request for Care and How To 
Appeal.--

    (1) If a request by a veteran for care or services under this 
section is denied, the Secretary shall notify the veteran in writing as 
soon as possible, but not later than two business days, after the 
denial is made--
 ``
        (A) of the reason for the denial; and
 ``
        (B) with instructions on how to appeal such denial using 
 the clinical appeals process of the Veterans Health 
 Administration.
 ``

    (2) If a denial under paragraph

    (1) is due to not meeting the 
eligibility access standards under 

section 1703B

    (a) of this title, 
notice under such paragraph shall include an explanation for why the 
Secretary does not consider the veteran to have met such standards.
 ``

    (3) Any notification under this subsection may be provided 
electronically.''.

SEC. 105. DISCUSSION OF TELEHEALTH OPTIONS UNDER VETERANS COMMUNITY 
 CARE PROGRAM.

 

Section 1703 of title 38, United States Code, as amended by 

section 104, is further amended--

    (1) by redesignating subsection

    (p) as subsection

    (q) ; and

    (2) by inserting after subsection

    (o) the following new 
 subsection

    (p) :
 ``

    (p) Discussion of Options for Telehealth.--When discussing 
options for care or services for a covered veteran under this section, 
the Secretary shall ensure that the veteran is informed of the ability 
of the veteran to seek care or services via telehealth, either through 
a medical facility of the Department or under this section, if 
telehealth--
 ``

    (1) is available to the veteran;
 ``

    (2) is appropriate for the type of care or services the 
 veteran is seeking, as determined by the Secretary; and
 ``

    (3) is acceptable to the veteran.''.

SEC. 106. EXTENSION OF DEADLINE FOR SUBMITTAL OF CLAIMS BY HEALTH CARE 
 ENTITIES AND PROVIDERS UNDER PROMPT PAYMENT STANDARD.

 

Section 1703D

    (b) of title 38, United States Code, is amended by 
striking ``180 days'' and inserting ``one year''.

 TITLE II--MENTAL HEALTH TREATMENT PROGRAMS

SEC. 201. DEFINITIONS.

 In this title:

    (1) Covered treatment program.--The term ``covered 
 treatment program''--
        (A) means--
            (i) a mental health residential 
 rehabilitation treatment program of the 
 Department of Veterans Affairs; or
            (ii) a program of the Department for 
 residential care for mental health and 
 substance abuse disorders;
        (B) includes--
            (i) the programs designated as of the date 
 of the enactment of this Act as domiciliary 
 residential rehabilitation treatment programs; 
 and
            (ii) any programs designated as domiciliary 
 residential rehabilitation treatment programs 
 on or after such date of enactment; and
            (C) does not include Compensated Work Therapy 
 Transition Residence programs of the Department.

    (2) Covered veteran.--The term ``covered veteran'' means a 
 veteran described in 

section 1703

    (b) of title 38, United States 
 Code.

    (3) Social support systems.--The term ``social support 
 systems'', with respect to a covered veteran--
        (A) means--
            (i) a member of the family of the covered 
 veteran, including a parent, spouse, child, 
 step-family member, or extended family member; 
 or
            (ii) an individual who lives with the 
 veteran but is not a member of the family of 
 the veteran; and
        (B) does not include a facility-organized peer 
 support program.

    (4) Treatment track.--The term ``treatment track'' means a 
 specialized treatment program that is provided to a subset of 
 covered veterans in a covered treatment program who receive the 
 same or similar intensive treatment and rehabilitative 
 services.

SEC. 202. STANDARDIZED PROCESS TO DETERMINE ELIGIBILITY OF COVERED 
 VETERANS FOR PARTICIPATION IN CERTAIN MENTAL HEALTH 
 TREATMENT PROGRAMS.

    (a) Standardized Screening Process.--Not later than one year after 
the date of the enactment of this Act, the Secretary of Veterans 
Affairs shall establish a standardized screening process to determine, 
based on clinical need, whether a covered veteran satisfies criteria 
for priority or routine admission to a covered treatment program.

    (b) Eligibility Criteria for Priority Admission.--

    (1) In general.--Under the standardized screening process 
 required by subsection

    (a) , a covered veteran shall be eligible 
 for priority admission to a covered treatment program if the 
 covered veteran meets criteria established by the Secretary 
 that include any of the following:
        (A) Symptoms that--
            (i) significantly affect activities of 
 daily life; and
            (ii) increase the risk of such veteran for 
 adverse outcomes.
        (B) An unsafe living situation.
            (C) A high-risk flag for suicide.
            (D) A determination of being a high risk for 
 suicide.
        (E) Risk factors for overdose.
        (F) Non-responsive, relapsed, or unable to find 
 recovery from one other course of treatment, such as 
 outpatient or intensive outpatient treatment.
        (G) Such other criteria as the Secretary determines 
 appropriate.

    (2) Consideration.--In making a determination that a 
 covered veteran meets criteria established by the Secretary 
 under paragraph

    (1) for priority admission to a covered 
 treatment program, the Secretary shall consider any referral of 
 a health care provider of a covered veteran.
            (c) Time for Screening and Admission.--Under the standardized 
screening process required by subsection

    (a) , the Secretary shall 
ensure a covered veteran--

    (1) is screened not later than 48 hours after the date on 
 which the covered veteran, or a relevant health care provider, 
 makes a request for the covered veteran to be admitted to a 
 covered treatment program;

    (2) if determined eligible for priority admission to a 
 covered treatment program, is admitted to such covered 
 treatment program not later than 48 hours after the date of 
 such determination; and

    (3) is screened at an appropriate time for potential mild, 
 moderate, or severe traumatic brain injury.
            (d) Considerations.--In making placement decisions in a covered 
treatment program for veterans who meet criteria for priority 
admission, the Secretary shall--

    (1) consider the input of the covered veteran with respect 
 to the--
        (A) program specialty, subtype, and treatment track 
 offered to the covered veteran; and
        (B) geographic placement of the covered veteran; 
 and

    (2) maximize the proximity of the covered veteran to social 
 support systems.

    (e) Conditions Under Which Care Shall Be Furnished Through Non-
Department Providers.--

    (1) Priority admission.--If the Secretary determines a 
 covered veteran is eligible for priority admission to a covered 
 treatment program pursuant to the standardized screening 
 process required by subsection

    (a) and the Secretary is unable 
 to admit such covered veteran to a covered treatment program at 
 a facility of the Department of Veterans Affairs in a manner 
 that complies with the requirements under subsections
            (c) and
            (d) , the Secretary shall offer the covered veteran the option 
 to receive care at a non-Department facility that--
        (A) can admit the covered veteran within the period 
 required by subsection
            (c) ;
        (B) is party to a contract or agreement with the 
 Department or enters into such a contract or agreement 
 under which the Department furnishes a program that is 
 equivalent to a covered treatment program to a veteran 
 through such non-Department facility;
            (C) is licensed by a State; and
            (D) is accredited by the Commission on 
 Accreditation of Rehabilitation Facilities or the Joint 
 Commission.

    (2) Routine admission.--If the Secretary determines a 
 covered veteran is eligible for routine admission to a covered 
 treatment program pursuant to the standardized screening 
 process required by subsection

    (a) and the Secretary is unable 
 to admit such covered veteran to a covered treatment program at 
 a facility of the Department of Veterans Affairs in a manner 
 that complies with the access standards for mental health care 
 established pursuant to 

section 1703B of title 38, United 
 States Code, the Secretary shall offer the covered veteran the 
 option to receive care at a non-Department facility that--
        (A) is party to a contract or agreement with the 
 Department or enters into such a contract or agreement 
 under which the Department furnishes a program that is 
 equivalent to a covered treatment program to a veteran 
 through such non-Department facility;
        (B) is licensed by a State; and
            (C) is accredited by the Commission on 
 Accreditation of Rehabilitation Facilities or the Joint 
 Commission.

    (3) Rule of construction.--This subsection shall not be 
 construed to affect a covered veteran in a covered treatment 
 program pursuant to a determination made on or before the date 
 of the enactment of this Act.

SEC. 203. IMPROVEMENTS TO DEPARTMENT OF VETERANS AFFAIRS MENTAL HEALTH 
 RESIDENTIAL REHABILITATION TREATMENT PROGRAM.

    (a) Performance Metrics.--

    (1) In general.--The Secretary of Veterans Affairs shall 
 develop metrics to track, and shall subsequently track, the 
 performance of medical facilities and Veterans Integrated 
 Service Networks of the Department of Veterans Affairs in 
 meeting the requirements for--
        (A) screening, under 

section 202, for a covered 
 treatment program; and
        (B) timely admission to a covered treatment program 
 under such screening.

    (2) Elements.--The metrics developed under paragraph

    (1) shall include metrics for tracking the performance of medical 
 facilities and Veterans Integrated Service Networks with 
 respect to routine and priority admission under a covered 
 treatment program.

    (b) Oversight.--The Secretary shall develop a process for 
systematically assessing the quality of care delivered by Department 
and non-Department providers treating covered veterans under this 
section, which shall include assessments of--

    (1) the extent to which the provider is delivering 
 evidence-based treatments to covered veterans;

    (2) clinical outcomes for covered veterans;

    (3) the ratio of licensed independent practitioners per 
 resident;

    (4) the rate of completion of training on military cultural 
 competence by licensed independent practitioners; and

    (5) potentially wasteful, fraudulent, or inappropriate 
 referral or billing practices.
            (c) Placement; Transportation.--

    (1) Locations.--If the Secretary determines that a covered 
 veteran is in need of residential care under a covered 
 treatment program, the Secretary shall provide to the covered 
 veteran a list of locations at which such covered veteran can 
 receive such residential care that meets--
        (A) the standards for screening under 

section 202; 
 and
        (B) the care needs of the covered veteran, 
 including applicable treatment tracks.

    (2) Transportation coverage.--The Secretary shall provide 
 transportation or pay for or reimburse the costs of 
 transportation for any covered veteran who is admitted into a 
 covered treatment program and needs transportation assistance--
        (A) from the residence of the covered veteran or a 
 facility of the Department or authorized non-Department 
 facility that does not provide such care to another 
 such facility that provides residential care covered 
 under a covered treatment program; and
        (B) back to the residence of the covered veteran 
 after the conclusion of a covered treatment program, if 
 applicable.
            (d) Appeals.--

    (1) In general.--The Secretary shall develop a national 
 policy and associated procedures under which a covered veteran, 
 a representative of a covered veteran, or a provider who 
 requests a covered veteran be admitted to a covered treatment 
 program, including a provider of the Department or a non-
 Department provider, may file a clinical appeal pursuant to 
 this subsection if the covered veteran is--
        (A) denied admission into a covered treatment 
 program; or
        (B) accepted into a covered treatment program but 
 is not offered bed placement in a timely manner.

    (2) Timeliness standards for review.--
        (A) In general.--The national policy and procedures 
 developed under paragraph

    (1) for appeals described in 
 such paragraph shall include timeliness standards for 
 the Department to review and make a decision on such an 
 appeal.
        (B) Decision.--The Secretary shall review and 
 respond to any appeal under paragraph

    (1) not later 
 than 72 hours after the Secretary receives such appeal.

    (3) Public guidance.--The Secretary shall develop, and make 
 available to the public, guidance on how a covered veteran, a 
 representative of the covered veteran, or a provider of the 
 covered veteran can file a clinical appeal pursuant to this 
 subsection--
        (A) if the covered veteran is denied admission into 
 a covered treatment program;
        (B) if the first date on which the covered veteran 
 may enter a covered treatment program does not comply 
 with the standards established by the Department under 
 

section 1703B of title 38, United States Code, for 
 purposes of determining eligibility for mental health 
 care under subsections
            (d) and

    (e) of 

section 1703 of 
 such title; or
            (C) with respect to such other factors as the 
 Secretary may specify.

    (4) Rule of construction.--Nothing in this subsection may 
 be construed as granting a covered veteran the right to appeal 
 a decision of the Secretary with respect to admission to a 
 covered treatment program to the Board of Veterans' Appeals 
 under chapter 71 of title 38, United States Code.

    (e) Tracking of Availability and Wait Times.--

    (1) In general.--The Secretary shall, to the extent 
 practicable, create a method for tracking availability and wait 
 times under a covered treatment program across all facilities 
 of the Department, Veterans Integrated Service Networks of the 
 Department, and non-Department providers throughout the United 
 States.

    (2) Availability of information.--The Secretary shall, to 
 the extent practicable, make the information tracked under 
 paragraph

    (1) available in real time to--
        (A) the mental health treatment coordinators at 
 each facility of the Department;
        (B) the leadership of each medical center of the 
 Department;
            (C) the leadership of each Veterans Integrated 
 Service Network; and
            (D) the Office of the Under Secretary for Health of 
 the Department.

    (f) Training and Oversight.--

    (1) Training.--
        (A) In general.--The Secretary shall update and 
 implement training for staff of the Department directly 
 involved in a covered treatment program regarding 
 referrals, screening, admission, placement decisions, 
 and appeals for such program, including all changes to 
 processes and guidance under such program required by 
 this section and 

section 202.
        (B) Covered veterans awaiting admission.--The 
 training under subparagraph
        (A) shall include 
 procedures for the care of covered veterans awaiting 
 admission into a covered treatment program and 
 communication with such covered veterans and the 
 providers of such covered veterans.
            (C) Timing of training.--
            (i) In general.--The Secretary shall 
 require the training under subparagraph
        (A) to 
 be completed by staff required to complete such 
 training--
            (I) not later than 60 days after 
 beginning employment at the Department 
 in a position that includes work 
 directly involving a covered treatment 
 program; and
            (II) not less frequently than 
 annually.
            (ii) Tracking.--The Secretary shall track 
 completion of training required under clause
            (i) by staff required to complete such 
 training.

    (2) Oversight standards.--The Secretary shall review and 
 revise oversight standards for the leadership of the Veterans 
 Integrated Service Networks and the Veterans Health 
 Administration to ensure that facilities and staff of the 
 Department are adhering to the policy on access to care of each 
 covered treatment program.

    (g) Care Coordination and Follow-Up Care.--

    (1) Continuity of care.--The Secretary shall ensure each 
 covered veteran who is screened for admission to a covered 
 treatment program is offered, and provided if agreed upon, care 
 options during the period between screening of the covered 
 veteran and admission of the covered veteran to such program to 
 ensure the covered veteran does not experience any lapse in 
 care.

    (2) Care coordination for substance use disorder.--For a 
 covered veteran being treated for substance use disorder, the 
 Secretary shall--
        (A) ensure there is a care plan in place during the 
 period between any detoxification services or inpatient 
 care received by the covered veteran and admission of 
 the covered veteran to a covered treatment program; and
        (B) communicate that care plan to the covered 
 veteran, the primary care provider of the covered 
 veteran, and the facility where the covered veteran is 
 or will be residing under such program.

    (3) Care planning prior to discharge.--
        (A) In general.--The Secretary, in consultation 
 with the covered veteran and the treating providers of 
 the covered veteran in a covered treatment program, 
 shall ensure the completion of a care plan prior to the 
 covered veteran being discharged from such program.
        (B) Matters to be included.--The care plan required 
 under subparagraph
        (A) for a covered veteran shall 
 include details on the course of treatment for the 
 covered veteran following completion of treatment under 
 the covered treatment program, including any necessary 
 follow-up care.
            (C) Sharing of care plan.--The care plan required 
 under subparagraph
        (A) shall be shared with the covered 
 veteran, the primary care provider of the covered 
 veteran, and any other providers with which the covered 
 veteran consents to sharing the plan.
            (D) Discharge from non-department facility.--Upon 
 discharge of a covered veteran under a covered 
 treatment program from a non-Department facility, the 
 facility shall share with the Department all care 
 records maintained by the facility with respect to the 
 covered veteran and shall work in consultation with the 
 Department on the care plan of the covered veteran 
 required under subparagraph
        (A) .

    (h) Reports to Congress.--

    (1) Report on modifications to programs.--
        (A) In general.--Not later than two years after the 
 date of the enactment of this Act, the Secretary shall 
 submit to the Committee on Veterans' Affairs of the 
 Senate and the Committee on Veterans' Affairs of the 
 House of Representatives a report on modifications made 
 to the guidance, operation, and oversight of covered 
 treatment programs to fulfill the requirements of this 
 section.
        (B) Elements.--The report required by subparagraph
        (A) shall include--
            (i) an assessment of whether costs of 
 covered treatment programs, including for 
 residential care provided through facilities of 
 the Department and non-Department facilities, 
 serve as a disincentive to placement in the 
 such a program;
            (ii) a description of actions taken by the 
 Department to address the findings and 
 recommendations by the Secretary contained in 
 the report under 

section 503
            (c) of the STRONG 
 Veterans Act of 2022 (division V of Public Law 
 117-328; 136 Stat. 5515), including--
            (I) such actions with respect to--

    (aa) any new locations 
 added for covered treatment 
 programs;

    (bb) any beds added at 
 existing facilities of such 
 programs; and
            (cc) any additional 
 treatment tracks or sex-
 specific programs created or 
 added at facilities of the 
 Department; and
            (II) a breakdown of the number and 
 percentage of covered veterans who are 
 determined eligible for priority 
 placement into a covered treatment 
 program and the number and percentage 
 of covered veterans who are determined 
 eligible for routine placement into a 
 covered treatment program; and
            (iii) such recommendations as the Secretary 
 may have for legislative or administrative 
 action to address any funding constraints or 
 disincentives for use of a covered treatment 
 program.

    (2) Annual report on operation of programs.--
        (A) In general.--Not later than one year after the 
 submission of the report under paragraph

    (1) , and not 
 less frequently than annually thereafter during the 
 period in which a covered treatment program is carried 
 out, the Secretary shall submit to the Committee on 
 Veterans' Affairs of the Senate and the Committee on 
 Veterans' Affairs of the House of Representatives a 
 report on the operation of such programs.
        (B) Elements.--Subject to subparagraph
            (C) , each 
 report required by subparagraph
        (A) shall include the 
 following:
            (i) The number of covered veterans served 
 by a covered treatment program, disaggregated 
 by--
            (I) Veterans Integrated Service 
 Network in which the covered veteran 
 receives care;
            (II) facility, including facilities 
 of the Department and non-Department 
 facilities, at which the covered 
 veteran receives care;
            (III) type of residential 
 rehabilitation treatment care received 
 by the covered veteran under such 
 program;
            (IV) sex of the covered veteran; 
 and
            (V) race or ethnicity of the 
 covered veteran.
            (ii) Wait times under a covered treatment 
 program for the most recent year data is 
 available, disaggregated by--
            (I) treatment track or specificity 
 of residential rehabilitation treatment 
 care sought by the covered veteran;
            (II) sex of the covered veteran;
            (III) State or territory in which 
 the covered veteran is located;
            (IV) Veterans Integrated Service 
 Network in which the covered veteran is 
 located; and
            (V) facility of the Department at 
 which the covered veteran seeks care.
            (iii) A list of all locations of a covered 
 treatment program and number of bed spaces at 
 each such location, disaggregated by 
 residential rehabilitation treatment care or 
 treatment track provided under such program at 
 such location.
            (iv) A list of any new locations of covered 
 treatment programs added or removed and any bed 
 spaces added or removed during the one-year 
 period preceding the date of the report.
            (v) Average cost of a stay under a covered 
 treatment program, including total stay average 
 and daily average, at facilities of the 
 Department compared to non-Department 
 facilities.
            (vi) A review of staffing needs and gaps 
 with respect to covered treatment programs.
            (vii) Any recommendations for changes to 
 the operation of covered treatment programs, 
 including any policy changes, guidance changes, 
 training changes, or other changes.
            (C) Anonymity.--To ensure that the data provided 
 under this paragraph, or some portion of that data, 
 will not undermine the anonymity of a veteran, the 
 Secretary shall provide such data pursuant to 
 applicable Federal law and in a manner that is wholly 
 consistent with applicable Federal privacy and 
 confidentiality laws, including--
            (i) section 552a of title 5, United States 
 Code (commonly known as the ``Privacy Act of 
 1974'');
            (ii) the Health Insurance Portability and 
 Accountability Act of 1996 (Public Law 104-
 191);
            (iii) parts 160 and 164 of title 45, Code 
 of Federal Regulations, or successor 
 regulations; and
            (iv) sections 5701, 5705, and 7332 of title 
 38, United States Code.
            (i) Revision of Guidance.--The Secretary shall update the guidance 
of the Department on the operation of covered treatment programs to 
reflect each of the requirements under subsections

    (b) through

    (h) .

    (j) Deadline.--The Secretary shall carry out each requirement under 
this section by not later than one year after the date of the enactment 
of this Act, unless otherwise specified.

    (k) Comptroller General Review.--

    (1) In general.--Not later than two years after the date of 
 the enactment of this Act, the Comptroller General of the 
 United States shall review access to care under a covered 
 treatment program for covered veterans in need of residential 
 mental health care and substance use disorder care.

    (2) Elements.--The review required by paragraph

    (1) shall 
 include the following:
        (A) A review of wait times under a covered 
 treatment program, disaggregated by--
            (i) treatment track or specificity of 
 residential rehabilitation treatment care 
 needed;
            (ii) sex of the covered veteran;
            (iii) home State of the covered veteran;
            (iv) home Veterans Integrated Service 
 Network of the covered veteran; and
            (v) wait times for--
            (I) facilities of the Department; 
 and
            (II) non-Department facilities.
        (B) A review of policy and training of the 
 Department on screening, admission, and placement under 
 a covered treatment program.
            (C) A review of the rights of covered veterans and 
 providers to appeal admission decisions under a covered 
 treatment program and how the Department adjudicates 
 appeals.
            (D) When determining the facility at which a 
 covered veteran admitted to a covered treatment program 
 will be placed in such program, a review of how the 
 input of the covered veteran is taken into 
 consideration with respect to--
            (i) program specialty, subtype, or 
 treatment track offered to the covered veteran; 
 and
            (ii) the geographic placement of the 
 covered veteran, including family- or 
 occupation-related preferences or 
 circumstances.
        (E) A review of staffing and staffing needs and 
 gaps of covered treatment programs, including with 
 respect to--
            (i) mental health providers and 
 coordinators at the facility level;
            (ii) staff of facilities of such programs;
            (iii) staff of Veterans Integrated Service 
 Networks; and
            (iv) overall administration of such 
 programs at the national level.
        (F) Recommendations for improvement of access by 
 covered veterans to care under a covered treatment 
 program, including with respect to--
            (i) any new sites or types of programs 
 needed or in development;
            (ii) changes in training or policy;
            (iii) changes in communications with 
 covered veterans; and
            (iv) oversight of covered treatment 
 programs by the Department.

 TITLE III--OTHER HEALTH CARE MATTERS

SEC. 301. PLAN ON ESTABLISHMENT OF INTERACTIVE, ONLINE SELF-SERVICE 
 MODULE FOR CARE.

    (a) In General.--The Secretary of Veterans Affairs, working with 
Third Party Administrators and acting through the Center for Innovation 
for Care and Payment of the Department of Veterans Affairs under 

section 1703E of title 38, United States Code, shall develop and 
implement a plan to establish an interactive, online self-service 
module--

    (1) to allow veterans to request appointments, track 
 referrals for health care under the laws administered by the 
 Secretary, whether at a facility of the Department or through a 
 non-Department provider, and receive appointment reminders;

    (2) to allow veterans to appeal and track decisions 
 relating to--
        (A) denials of requests for care or services under 
 

section 1703 of title 38, United States Code; or
        (B) denials of requests for care or services at 
 facilities of the Department, including under 

section 1710 of such title; and

    (3) to implement such other matters as determined 
 appropriate by the Secretary in consultation with Third Party 
 Administrators.

    (b) Submittal of Plan.--

    (1) Initial plan.--Not later than 180 days after the date 
 of the enactment of this Act, the Secretary shall submit to the 
 Committee on Veterans' Affairs of the Senate and the Committee 
 on Veterans' Affairs of the House of Representatives the plan 
 developed under subsection

    (a) .

    (2) Quarterly update.--Not less frequently than quarterly 
 following the submittal of the plan under paragraph

    (1) and for 
 two years thereafter, the Secretary shall submit to the 
 Committee on Veterans' Affairs of the Senate and the Committee 
 on Veterans' Affairs of the House of Representatives a report 
 containing any updates on the implementation of such plan.
            (c) Rule of Construction.--This section shall not be construed to 
be a pilot program subject to the requirements of 

section 1703E of 
title 38, United States Code.
            (d) Third Party Administrator Defined.--In this section, the term 
``Third Party Administrator'' means an entity that manages a provider 
network and performs administrative services related to such network 
under 

section 1703 of title 38, United States Code.

SEC. 302. MODIFICATION OF REQUIREMENTS FOR CENTER FOR INNOVATION FOR 
 CARE AND PAYMENT OF THE DEPARTMENT OF VETERANS AFFAIRS 
 AND REQUIREMENT FOR PILOT PROGRAM.

    (a) In General.--

Section 1703E of title 38, United States Code, is 
amended--

    (1) in subsection

    (a) --
        (A) in paragraph

    (1) , by striking ``within the 
 Department'' and inserting ``within the Office of the 
 Secretary'';
        (B) in paragraph

    (2) , by striking ``may'' and 
 inserting ``shall''; and
            (C) in paragraph

    (3) --
            (i) in subparagraph
        (A) , by striking ``; 
 and'' and inserting a semicolon;
            (ii) in subparagraph
        (B) , by striking the 
 period at the end and inserting ``; or''; and
            (iii) by adding at the end the following 
 new subparagraph:
 ``
            (C) increase productivity, efficiency, and modernization 
 throughout the Department.'';

    (2) by striking subsection
            (d) and inserting the following 
 new subsection
            (d) :
 ``
            (d) Budgetary Line Item.--The Secretary shall include in the 
budget justification materials submitted to Congress in support of the 
budget of the Department of Veterans Affairs for a fiscal year (as 
submitted with the budget of the President under 

section 1105

    (a) of 
title 31) specific identification, as a budgetary line item, of the 
amounts required to carry out this section.'';

    (3) in subsection

    (f) --
        (A) in paragraph

    (1) , by striking ``in subchapters 
 I, II, and III of this chapter'' and inserting ``of 
 this title, of title 38, Code of Federal Regulations, 
 and of any handbooks, directives, or policy documents 
 of the Department''; and
        (B) in paragraph

    (2) , in the matter preceding 
 subparagraph
        (A) , by striking ``waiving any authority'' 
 and inserting ``waiving any provision of this title'';

    (4) in subsection

    (g)

    (1) , by inserting ``fewer than three 
 or'' before ``more than 10'';

    (5) in subsection
            (i) --
        (A) in paragraph

    (1) , by striking ``the Under 
 Secretary for Health and the Special Medical Advisory 
 Group established pursuant to 

section 7312 of this 
 title'' and inserting ``the Under Secretary for Health, 
 the Special Medical Advisory Group established pursuant 
 to 

section 7312 of this title, the Office of Integrated 
 Veteran Care (or successor office), the Office of 
 Finance (or successor office), the Veteran Experience 
 Office (or successor office), the Office of Enterprise 
 Integration (or successor office), and the Office of 
 Information and Technology (or successor office)''; and
        (B) in paragraph

    (2) , by striking ``representatives 
 of relevant Federal agencies, and clinical and 
 analytical experts with expertise in medicine and 
 health care management'' and inserting 
 ``representatives of relevant Federal agencies, 
 nonprofit organizations, and other public and private 
 sector entities, including those with clinical and 
 analytical experts with expertise in medicine and 
 health care management''; and

    (6) by adding at the end the following new subsection:
 ``

    (k) Report on Activities of Center for Innovation for Care and 
Payment.--Not less frequently than annually, the Secretary shall submit 
to Congress a report that contains, for the one-year period preceding 
the date of the report--
 ``

    (1) a full accounting of the activities, staff, budget, 
 and other resources and efforts of the Center; and
 ``

    (2) an assessment of the outcomes of the efforts of the 
 Center.''.

    (b) Comptroller General Report.--Not later than 18 months after the 
date of the enactment of this Act, the Comptroller General of the 
United States shall submit to Congress a report--

    (1) on the efforts of the Center for Innovation for Care 
 and Payment of the Department of Veterans Affairs in fulfilling 
 the objectives and requirements under 

section 1703E of title 
 38, United States Code, as amended by subsection

    (a) ; and

    (2) containing such recommendations as the Comptroller 
 General considers appropriate.
            (c) Pilot Program.--

    (1) In general.--Not later than one year after the date of 
 the enactment of this Act, the Center for Innovation for Care 
 and Payment of the Department of Veterans Affairs under 

section 1703E of title 38, United States Code, shall establish a three-
 year pilot program in not fewer than five locations to allow 
 veterans enrolled in the system of annual patient enrollment of 
 the Department established and operated under 

section 1705

    (a) of such title to access outpatient mental health and substance 
 use services through health care providers specified under 
 

section 1703
            (c) of such title without referral or pre-
 authorization.

    (2) Priority.--In selecting sites for the pilot program 
 under paragraph

    (1) , the Secretary shall prioritize sites in 
 the following areas:
        (A) Areas with varying degrees of urbanization, 
 including urban, rural, and highly rural areas.
        (B) Areas with high rates of suicide among 
 veterans.
            (C) Areas with high rates of overdose deaths among 
 veterans.
            (D) Areas with high rates of calls to the Veterans 
 Crisis Line.
        (E) Areas with long wait times for mental health 
 and substance use services at facilities of the 
 Department.
        (F) Areas with outpatient mental health and 
 substance use programs that utilize a value-based care 
 model, to the extent practicable.

    (3) Elements.--The Secretary, in implementing the pilot 
 program under paragraph

    (1) , shall ensure the Department has a 
 care coordination system in place that includes--
        (A) knowledge sharing, including the timely 
 exchange of medical documentation;
        (B) assistance with transitions of care, including 
 the potential need for inpatient or residential 
 psychiatric services, substance use detoxification 
 services, post-detoxification step-down services, and 
 residential rehabilitation programs;
            (C) continuous assessment of patient needs and 
 goals; and
            (D) creating personalized, proactive care plans.

    (4) Oversight and outcomes.--The Secretary shall develop 
 appropriate metrics and measures--
        (A) to track and oversee sites at which the pilot 
 program under paragraph

    (1) is carried out;
        (B) to monitor patient safety and outcomes under 
 the pilot program; and
            (C) to assess and mitigate any barriers to 
 extending the pilot program across the entire Veterans 
 Health Administration.

    (5) Annual report.--
        (A) In general.--Not later than one year after the 
 commencement of the pilot program under paragraph

    (1) , 
 and not less frequently than annually thereafter during 
 the duration of the pilot program, the Secretary shall 
 submit to the Committee on Veterans' Affairs of the 
 Senate and Committee on Veterans' Affairs of the House 
 of Representatives a report on the pilot program, which 
 shall include the following:
            (i) The number of unique veterans who 
 participated in the pilot program.
            (ii) The number of health care providers 
 who participated in the pilot program.
            (iii) An assessment of the effectiveness of 
 the pilot program in increasing access to, and 
 improving outcomes for, mental health and 
 substance use treatment services.
            (iv) The cost of the pilot program.
            (v) Such other matters as the Secretary 
 considers appropriate.
        (B) Final report.--The Secretary shall include in 
 the final report submitted under subparagraph
        (A) , in 
 addition to the requirements under such subparagraph, 
 the assessment by the Secretary of the feasibility and 
 advisability of extending the pilot program across the 
 entire Veterans Health Administration, including a 
 plan, timeline, and required resources for such an 
 extension.

    (6) Veterans crisis line defined.--In this subsection, the 
 term ``Veterans Crisis Line'' means the toll-free hotline for 
 veterans established under 

section 1720F

    (h) of title 38, United 
 States Code.

SEC. 303. REPORTS.

    (a) Report on Improvements to Clinical Appeals Process.--Not later 
than one year after the date of the enactment of this Act, and not less 
frequently than once every three years thereafter, the Secretary of 
Veterans Affairs, in consultation with veterans service organizations, 
veterans, caregivers of veterans, employees of the Department of 
Veterans Affairs, and other stakeholders as determined by the 
Secretary, shall submit to the Committee on Veterans' Affairs of the 
Senate and Committee on Veterans' Affairs of the House of 
Representatives a report containing recommendations for legislative or 
administrative action to improve the clinical appeals process of the 
Department with respect to timeliness, transparency, objectivity, 
consistency, and fairness.

    (b) Report on Required Care and Services Under Community Care 
Program.--Not later than one year after the date of the enactment of 
this Act, and not less frequently than annually thereafter, the 
Secretary shall submit to the Committee on Veterans' Affairs of the 
Senate and Committee on Veterans' Affairs of the House of 
Representatives a report that contains, for the one-year period 
preceding the date of the report, the following:

    (1) The number of veterans eligible for care or services 
 under 

section 1703 of title 38, United States Code, and the 
 reasons for such eligibility, including multiple such reasons 
 for veterans eligible under more than one eligibility criteria.

    (2) The number of veterans who opt to seek care or services 
 under such section.

    (3) The number of veterans who do not opt to seek care or 
 services under such section.

    (4) An assessment of the timeliness of referrals for care 
 or services under such section.

    (5) The number of times a veteran did not show for an 
 appointment for care or services under such section.

    (6) The number of requests for an appeal of a denial of 
 care or services under such section using the clinical appeals 
 process of the Veterans Health Administration.

    (7) The timeliness of each such appeal.

    (8) The outcome of each such appeal.
            (c) Veterans Service Organization Defined.--In this section, the 
term ``veterans service organization'' means any organization 
recognized by the Secretary under 

section 5902 of title 38, United 
States Code.
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