Care Veterans Deserve Act of 2019

I 116TH CONGRESS 1ST SESSION H. R. 23 To eliminate the sunset date for the Veterans Choice Program of the Depart- ment of Veterans Affairs, to expand eligibility for such program, and to extend certain operating hours for pharmacies and medical facilities of the Department, and for other purposes. IN THE HOUSE OF REPRESENTATIVES JANUARY 3, 2019 Mr. HUDSON introduced the following bill; which was referred to the Committee on Veterans’ Affairs A BILL To eliminate the sunset date for the Veterans Choice Pro- gram of the Department of Veterans Affairs, to expand eligibility for such program, and to extend certain oper- ating hours for pharmacies and medical facilities of the Department, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Care Veterans Deserve 4 Act of 2019’’. 5 SEC. 2. EXPANSION OF VETERANS CHOICE PROGRAM. 6 (a) ELIMINATION OF SUNSET.— 7 VerDate Sep 11 2014 01:36 Jan 08, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H23.IH H23 pamtmann on DSKBFK8HB2PROD with BILLS 2 •HR 23 IH (1) IN GENERAL.—Section 101 of the Veterans 1 Access, Choice, and Accountability Act of 2014 2 (Public Law 113–146; 38 U.S.C. 1701 note) is 3 amended— 4 (A) by striking subsection (p); and 5 (B) by redesignating subsections (q), (r), 6 (s), and (t) as subsections (p), (q), (r), and (s), 7 respectively. 8 (2) CONFORMING AMENDMENTS.—Such section 9 is amended— 10 (A) in subsection (i)(2), by striking ‘‘dur- 11 ing the period in which the Secretary is author- 12 ized to carry out this section pursuant to sub- 13 section (p)’’; and 14 (B) in subsection (p)(2), as redesignated 15 by paragraph (1)(B), by striking subparagraph 16 (F). 17 (b) EXPANSION OF ELIGIBILITY FOR PROGRAM.— 18 (1) IN GENERAL.—Subsection (b)(2) of such 19 section is amended— 20 (A) in subparagraph (C)(ii), by striking 21 ‘‘or’’; 22 (B) in subparagraph (D)(ii)(II), by strik- 23 ing the period at the end and inserting ‘‘; or’’; 24 and 25 VerDate Sep 11 2014 01:36 Jan 08, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H23.IH H23 pamtmann on DSKBFK8HB2PROD with BILLS 3 •HR 23 IH (C) by adding at the end the following new 1 subparagraph: 2 ‘‘(E) has a service-connected disability 3 rated at 50 percent or more.’’. 4 (2) CONFORMING AMENDMENT.—Subsection 5 (g)(3) of such section is amended by striking ‘‘or 6 (D)’’ and inserting ‘‘, (D), or (E)’’. 7 SEC. 3. ACCESS OF VETERANS TO WALK-IN CLINICS. 8 (a) IN GENERAL.—Subchapter I of chapter 17 of title 9 38, United States Code, is amended by inserting after sec- 10 tion 1703 the following new section: 11 ‘‘§ 1703A. Hospital care and medical services at walk- 12 in clinics 13 ‘‘(a) IN GENERAL.—The Secretary shall enter into 14 a contract with a national chain of walk-in clinics to pro- 15 vide the hospital care and medical services offered in such 16 clinics to veterans enrolled in the system of annual patient 17 enrollment established and operated under section 1705 18 of this title. 19 ‘‘(b) NO AUTHORIZATION OR COPAYMENT RE- 20 QUIRED.—In receiving hospital care or medical services at 21 a walk-in clinic under subsection (a), a veteran is not re- 22 quired— 23 ‘‘(1) to obtain authorization before receiving 24 such care or services at the clinic; or 25 VerDate Sep 11 2014 01:36 Jan 08, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H23.IH H23 pamtmann on DSKBFK8HB2PROD with BILLS 4 •HR 23 IH ‘‘(2) to pay a copayment to the clinic or the De- 1 partment in connection with the receipt of such care 2 or services. 3 ‘‘(c) LOCATIONS.—The Secretary may not require a 4 national chain of walk-in clinics to expand their locations 5 as a condition of a contract entered into under subsection 6 (a). 7 ‘‘(d) TRANSMITTAL OF INFORMATION.—(1) The na- 8 tional chain of walk-in clinics with which the Secretary 9 has entered into a contract under subsection (a) shall es- 10 tablish an automated system that transmits to the Sec- 11 retary on a weekly basis information regarding the hos- 12 pital care or medical services provided to veterans under 13 this section during such week. 14 ‘‘(2) The automated system under paragraph (1) 15 shall be established in a manner that allows the system 16 to securely transmit information to the electronic health 17 record of a veteran regarding the hospital care and med- 18 ical services provided to the veteran under this section. 19 ‘‘(3) Transmittal of information under paragraph (1) 20 may not be required as a condition of payment for hospital 21 care or medical services provided under this section.’’. 22 (b) CLERICAL AMENDMENT.—The table of sections 23 at the beginning of chapter 17 of such title is amended 24 VerDate Sep 11 2014 01:36 Jan 08, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H23.IH H23 pamtmann on DSKBFK8HB2PROD with BILLS 5 •HR 23 IH by inserting after the item relating to section 1703 the 1 following new item: 2 ‘‘1703A. Hospital care and medical services at walk-in clinics.’’. SEC. 4. LICENSURE OF HEALTH CARE PROFESSIONALS OF 3 THE DEPARTMENT OF VETERANS AFFAIRS 4 PROVIDING TREATMENT VIA TELEMEDICINE. 5 (a) IN GENERAL.—Subchapter III of chapter 17 of 6 title 38, United States Code, is amended by inserting after 7 section 1730C the following new section: 8 ‘‘§ 1730D. Licensure of health care professionals pro- 9 viding treatment via telemedicine 10 ‘‘(a) IN GENERAL.—Notwithstanding any provision 11 of law regarding the licensure of health care professionals, 12 a covered health care professional may practice the health 13 care profession of the health care professional at any loca- 14 tion in any State, regardless of where such health care 15 professional or the patient is located, if the health care 16 professional is using telemedicine to provide treatment to 17 an individual under this chapter. 18 ‘‘(b) LOCATION OF CARE.—Subsection (a) shall apply 19 to a covered health care professional providing treatment 20 to a patient regardless of whether such health care profes- 21 sional or patient is located in a facility owned by the Fed- 22 eral Government during such treatment. 23 ‘‘(c) RULE OF CONSTRUCTION.—Nothing in this sec- 24 tion may be construed to remove, limit, or otherwise affect 25 VerDate Sep 11 2014 01:36 Jan 08, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H23.IH H23 pamtmann on DSKBFK8HB2PROD with BILLS 6 •HR 23 IH any obligation of a covered health care professional under 1 the Controlled Substances Act (21 U.S.C. 801 et seq.). 2 ‘‘(d) DEFINITIONS.—In this section: 3 ‘‘(1) The term ‘covered health care professional’ 4 means a health care professional who is— 5 ‘‘(A) authorized by the Secretary to pro- 6 vide health care under this chapter, including a 7 private health care professional who provides 8 such care under a contract or agreement en- 9 tered into with the Secretary, including a con- 10 tract entered into under section 1703 of this 11 title; and 12 ‘‘(B) licensed, registered, or certified in a 13 State to practice the health care profession of 14 the health care professional. 15 ‘‘(2) The term ‘telemedicine’ means the use of 16 telecommunication technology and information tech- 17 nology to provide health care or support the provi- 18 sion of health care in situations in which the patient 19 and health care professional are separated by geo- 20 graphic distance.’’. 21 (b) CLERICAL AMENDMENT.—The table of sections 22 at the beginning of chapter 17 of such title is amended 23 by inserting after the item relating to section 1730C the 24 following new item: 25 VerDate Sep 11 2014 01:36 Jan 08, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H23.IH H23 pamtmann on DSKBFK8HB2PROD with BILLS 7 •HR 23 IH ‘‘1730D. Licensure of health care professionals providing treatment via tele- medicine.’’. (c) REPORT ON TELEMEDICINE.— 1 (1) IN GENERAL.—Not later than one year 2 after the date of the enactment of this Act, the Sec- 3 retary of Veterans Affairs shall submit to the Com- 4 mittee on Veterans’ Affairs of the Senate and the 5 Committee on Veterans’ Affairs of the House of 6 Representatives a report on the effectiveness of the 7 use of telemedicine by the Department of Veterans 8 Affairs. 9 (2) ELEMENTS.—The report required by para- 10 graph (1) shall include an assessment of the fol- 11 lowing: 12 (A) The satisfaction of veterans with tele- 13 medicine furnished by the Department. 14 (B) The satisfaction of health care pro- 15 viders in providing telemedicine furnished by 16 the Department. 17 (C) The effect of telemedicine furnished by 18 the Department on the following: 19 (i) The ability of veterans to access 20 health care, whether from the Department 21 or from non-Department health care pro- 22 viders. 23 VerDate Sep 11 2014 01:36 Jan 08, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H23.IH H23 pamtmann on DSKBFK8HB2PROD with BILLS 8 •HR 23 IH (ii) The frequency of use by veterans 1 of telemedicine. 2 (iii) The productivity of health care 3 providers. 4 (iv) Wait times for an appointment 5 for the receipt of health care from the De- 6 partment. 7 (v) The reduction, if any, in the use 8 by veterans of services at Department fa- 9 cilities and non-Department facilities. 10 (D) The types of appointments for the re- 11 ceipt of telemedicine furnished by the Depart- 12 ment that were provided during the one-year 13 period preceding the submittal of the report. 14 (E) The number of appointments for the 15 receipt of telemedicine furnished by the Depart- 16 ment that were requested during such period, 17 disaggregated by Veterans Integrated Service 18 Network. 19 (F) Savings by the Department, if any, in- 20 cluding travel costs, of furnishing health care 21 through the use of telemedicine during such pe- 22 riod. 23 (3) TELEMEDICINE DEFINED.—In this sub- 24 section, the term ‘‘telemedicine’’ has the meaning 25 VerDate Sep 11 2014 01:36 Jan 08, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H23.IH H23 pamtmann on DSKBFK8HB2PROD with BILLS 9 •HR 23 IH given that term in section 1730D(d)(2) of title 38, 1 United States Code, as added by subsection (a). 2 SEC. 5. EXTENSION OF OPERATING HOURS FOR PHAR- 3 MACIES AND MEDICAL FACILITIES OF THE 4 DEPARTMENT OF VETERANS AFFAIRS. 5 (a) EXTENSION OF OPERATING HOURS FOR PHAR- 6 MACIES.—The Secretary of Veterans Affairs shall extend 7 the operating hours for each pharmacy of the Department 8 of Veterans Affairs during which the pharmacy offers 9 services comparable to retail pharmacies to include— 10 (1) operation on Saturday, Sunday, and Fed- 11 eral holidays; and 12 (2) operation until 8:00 p.m. on weekdays that 13 are not Federal holidays. 14 (b) CONTRACTS WITH PROVIDERS DURING NIGHTS 15 AND WEEKENDS.—The Secretary shall enter into con- 16 tracts, including through locum tenens arrangements, with 17 physicians and nurses that meet qualifications set forth 18 by the Secretary for purposes of this section under which 19 such physicians and nurses work at medical facilities of 20 the Department during nights and weekends. 21 (c) SUPPORT STAFF.—The Secretary may obtain ad- 22 ditional support staff as necessary to carry out this sec- 23 tion, including by hiring employees or contracting for serv- 24 ices. 25 VerDate Sep 11 2014 01:36 Jan 08, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H23.IH H23 pamtmann on DSKBFK8HB2PROD with BILLS 10 •HR 23 IH SEC. 6. CONDUCT OF BEST-PRACTICES PEER REVIEW OF 1 EACH MEDICAL CENTER OF THE DEPART- 2 MENT OF VETERANS AFFAIRS. 3 (a) IN GENERAL.—The Secretary of Veterans Affairs 4 may provide for the conduct by a nongovernmental hos- 5 pital organization of a best-practices peer review of each 6 medical center of the Department of Veterans Affairs to 7 evaluate the efficacy of health care delivered at each such 8 medical center. 9 (b) PRIORITY.—The Secretary shall give priority for 10 peer review conducted under subsection (a) to the medical 11 centers of the Department with the longest wait times for 12 an appointment or the worst health outcomes, as deter- 13 mined by the Secretary. 14 Æ VerDate Sep 11 2014 01:36 Jan 08, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6301 E:\BILLS\H23.IH H23 pamtmann on DSKBFK8HB2PROD with BILLS