Tribal Veterans Health Care Enhancement Act

II 116TH CONGRESS 1ST SESSION S. 1001 To amend the Indian Health Care Improvement Act to allow the Indian Health Service to cover the cost of a copayment of an Indian or Alaska Native veteran receiving medical care or services from the Department of Veterans Affairs, and for other purposes. IN THE SENATE OF THE UNITED STATES APRIL 3, 2019 Mr. THUNE (for himself and Mr. ROUNDS) introduced the following bill; which was read twice and referred to the Committee on Indian Affairs A BILL To amend the Indian Health Care Improvement Act to allow the Indian Health Service to cover the cost of a copay- ment of an Indian or Alaska Native veteran receiving medical care or services from the Department of Vet- erans Affairs, 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 ‘‘Tribal Veterans Health 4 Care Enhancement Act’’. 5 VerDate Sep 11 2014 21:34 Apr 08, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1001.IS S1001 pamtmann on DSKBFK8HB2PROD with BILLS 2 •S 1001 IS SEC. 2. LIABILITY FOR PAYMENT. 1 Section 222 of the Indian Health Care Improvement 2 Act (25 U.S.C. 1621u) is amended by adding at the end 3 the following: 4 ‘‘(d) VETERANS AFFAIRS COPAYMENTS.—The Serv- 5 ice may pay, in accordance with section 412, the cost of 6 a copayment assessed by the Department of Veterans Af- 7 fairs to an eligible Indian veteran (as defined in section 8 412) for covered medical care (as defined in such sec- 9 tion).’’. 10 SEC. 3. COPAYMENTS FOR TRIBAL VETERANS RECEIVING 11 CERTAIN MEDICAL SERVICES. 12 Title IV of the Indian Health Care Improvement Act 13 (25 U.S.C. 1641 et seq.) is amended by adding at the end 14 the following: 15 ‘‘SEC. 412. PAYMENTS FOR ELIGIBLE INDIAN VETERANS RE- 16 CEIVING COVERED MEDICAL CARE AT VA FA- 17 CILITIES. 18 ‘‘(a) DEFINITIONS.—In this section: 19 ‘‘(1) APPROPRIATE COMMITTEES OF CON- 20 GRESS.—The term ‘appropriate committees of Con- 21 gress’ means— 22 ‘‘(A) in the Senate— 23 ‘‘(i) the Committee on Veterans’ Af- 24 fairs; and 25 VerDate Sep 11 2014 21:34 Apr 08, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1001.IS S1001 pamtmann on DSKBFK8HB2PROD with BILLS 3 •S 1001 IS ‘‘(ii) the Committee on Indian Affairs; 1 and 2 ‘‘(B) in the House of Representatives— 3 ‘‘(i) the Committee on Veterans’ Af- 4 fairs; and 5 ‘‘(ii) the Committee on Natural Re- 6 sources. 7 ‘‘(2) COVERED MEDICAL CARE.—The term ‘cov- 8 ered medical care’ means any medical care or service 9 that is— 10 ‘‘(A) authorized for an eligible Indian vet- 11 eran under the contract health service and re- 12 ferred by the Service; and 13 ‘‘(B) administered at a facility of the De- 14 partment of Veterans Affairs, including any 15 services rendered under a contract with a non- 16 Department of Veterans Affairs health care 17 provider. 18 ‘‘(3) ELIGIBLE INDIAN VETERAN.—The term 19 ‘eligible Indian veteran’ means an Indian or Alaska 20 Native veteran who is eligible for assistance from the 21 Service. 22 ‘‘(b) MEMORANDUM OF UNDERSTANDING.— 23 ‘‘(1) IN GENERAL.—Notwithstanding any other 24 provision of law, except as provided in paragraph 25 VerDate Sep 11 2014 21:34 Apr 08, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1001.IS S1001 pamtmann on DSKBFK8HB2PROD with BILLS 4 •S 1001 IS (3), the Secretary (or a designee, including the di- 1 rector of any area office of the Service), the Sec- 2 retary of Veterans Affairs (or a designee), and any 3 tribal health program, as applicable, shall enter into 4 a memorandum of understanding, in consultation 5 with Indian tribes to be impacted by the memo- 6 randum of understanding (on a national or regional 7 basis), that authorizes the Secretary or tribal health 8 program, as applicable, to pay to the Secretary of 9 Veterans Affairs any copayments owed to the De- 10 partment of Veterans Affairs by eligible Indian vet- 11 erans for covered medical care. 12 ‘‘(2) FACTORS FOR CONSIDERATION.—In enter- 13 ing into a memorandum of understanding under 14 paragraph (1), the Secretary, the Secretary of Vet- 15 erans Affairs, and any tribal health program, as ap- 16 plicable, shall take into consideration any findings 17 contained in the report under subsection (e). 18 ‘‘(3) EXCEPTION.—The Secretary, the Sec- 19 retary of Veterans Affairs, and any tribal health 20 program, as applicable, shall not be required to 21 enter into a memorandum of understanding under 22 paragraph (1) if the Secretary, the Secretary of Vet- 23 erans Affairs, and any tribal health program, as ap- 24 plicable, jointly certify to the appropriate committees 25 VerDate Sep 11 2014 21:34 Apr 08, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1001.IS S1001 pamtmann on DSKBFK8HB2PROD with BILLS 5 •S 1001 IS of Congress that such a memorandum of under- 1 standing would— 2 ‘‘(A) decrease the quality of health care 3 provided to eligible Indian veterans; 4 ‘‘(B) impede the access of those veterans 5 to health care; or 6 ‘‘(C) substantially decrease the quality of, 7 or access to, health care by individuals receiving 8 health care from the Department of Veterans 9 Affairs or beneficiaries of the Service. 10 ‘‘(c) PAYMENT BY SERVICE.—Notwithstanding any 11 other provision of law and in accordance with the relevant 12 memorandum of understanding described in subsection 13 (b), the Service may cover the cost of any copayment as- 14 sessed by the Department of Veterans Affairs to an eligi- 15 ble Indian veteran receiving covered medical care. 16 ‘‘(d) AUTHORIZATION TO ACCEPT FUNDS.—Notwith- 17 standing section 407(c), section 2901(b) of the Patient 18 Protection and Affordable Care Act (25 U.S.C. 1623(b)), 19 or any other provision of law, and in accordance with the 20 relevant memorandum of understanding described in sub- 21 section (b), the Secretary of Veterans Affairs may accept 22 a payment from the Service under subsection (c). 23 ‘‘(e) REPORT.—Not later than 90 days after the date 24 of enactment of this section, the Secretary and the Sec- 25 VerDate Sep 11 2014 21:34 Apr 08, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1001.IS S1001 pamtmann on DSKBFK8HB2PROD with BILLS 6 •S 1001 IS retary of Veterans Affairs shall submit to the appropriate 1 committees of Congress a report that describes— 2 ‘‘(1) the number of veterans, disaggregated by 3 State, who— 4 ‘‘(A) are eligible for assistance from the 5 Service; and 6 ‘‘(B) have received health care at a medical 7 facility of the Department of Veterans Affairs; 8 ‘‘(2) the number of veterans, disaggregated by 9 State and calendar year, who— 10 ‘‘(A) are eligible for assistance from the 11 Service; and 12 ‘‘(B) were referred to a medical facility of 13 the Department of Veterans Affairs from a fa- 14 cility of the Service during the period— 15 ‘‘(i) beginning on January 1, 2013; 16 and 17 ‘‘(ii) ending on December 31, 2018; 18 and 19 ‘‘(3) an update regarding efforts of the Sec- 20 retary and the Secretary of Veterans Affairs to 21 streamline health care for veterans who are eligible 22 for assistance from the Service and have received 23 health care at a medical facility of the Department 24 VerDate Sep 11 2014 21:34 Apr 08, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1001.IS S1001 pamtmann on DSKBFK8HB2PROD with BILLS 7 •S 1001 IS of Veterans Affairs and at a facility of the Service, 1 including a description of— 2 ‘‘(A) any changes to the provision of health 3 care required under this Act; and 4 ‘‘(B) any barriers to efficiently streamline 5 the provision of health care to veterans who are 6 eligible for assistance from the Service.’’. 7 Æ VerDate Sep 11 2014 21:34 Apr 08, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6301 E:\BILLS\S1001.IS S1001 pamtmann on DSKBFK8HB2PROD with BILLS