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I
118TH CONGRESS
1ST SESSION H. R. 3176
To direct the Secretary of Veterans Affairs to carry out a pilot program
to improve the ability of veterans to access medical care in medical
facilities of the Department of Veterans Affairs and in the community
by providing the veterans the ability to choose health care providers.
IN THE HOUSE OF REPRESENTATIVES
MAY 10, 2023
Mr. BIGGS (for himself, Mr. ROSENDALE, Mr. GOOD of Virginia, Mr.
GIMENEZ, Ms. SALAZAR, Mr. ROY, Mr. CRANE, Mrs. BOEBERT, Ms.
HAGEMAN, Mr. TIFFANY, Mrs. LUNA, Mrs. LESKO, Mr. CLYDE, Mr.
OGLES, and Mr. BRECHEEN) introduced the following bill; which was re-
ferred to the Committee on Veterans’ Affairs
A BILL
To direct the Secretary of Veterans Affairs to carry out
a pilot program to improve the ability of veterans to
access medical care in medical facilities of the Depart-
ment of Veterans Affairs and in the community by pro-
viding the veterans the ability to choose health care
providers.
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 ‘‘Veterans Health Care
4
Freedom Act’’.
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SEC. 2. PILOT PROGRAM ON ABILITY OF VETERANS TO
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CHOOSE HEALTH CARE PROVIDERS.
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(a) PILOT PROGRAM.—
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(1) REQUIREMENT.—The Secretary of Veterans
4
Affairs, acting through the Center for Innovation for
5
Care and Payment, shall carry out a pilot program
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to improve the ability of eligible veterans to access
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hospital care, medical services, and extended care
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services through the covered care system by pro-
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viding the eligible veterans the ability to choose
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health care providers.
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(2) LOCATIONS.—The Secretary shall select a
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minimum of four Veterans Integrated Service Net-
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works in which to carry out the pilot program under
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paragraph (1). In making such selection, the Sec-
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retary shall ensure that the pilot program is carried
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out in varied geographic areas that include both
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rural and urban locations.
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(b) REMOVAL OF CERTAIN REQUIREMENTS TO AC-
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CESS CARE.—In carrying out the pilot program under
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subsection (a), the Secretary shall furnish hospital care,
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medical services, and extended care services to eligible vet-
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erans through the covered care system as follows:
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(1) At medical facilities of the Department of
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Veterans Affairs, regardless of whether the facility is
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•HR 3176 IH
in the same Veterans Integrated Service Network as
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the Network in which the veteran resides.
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(2) At non-Department facilities pursuant to,
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as appropriate—
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(A) section 1703 of title 38, United States
5
Code, without regard to the requirements speci-
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fied in subsection (d) of such section; or
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(B) section 1703A of such title, without re-
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gard to the requirements specified in subsection
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(a)(1)(C) of such section.
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(c) ELECTION
OF VETERAN.—In accordance with
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subsections (d) and (e), an eligible veteran participating
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in the pilot program may elect to receive hospital care,
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medical services, and extended care services at any pro-
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vider in the covered care system.
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(d) COORDINATION OF CARE.—
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(1) SELECTION.—Each eligible veteran partici-
17
pating in the pilot program shall select a primary
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care provider in the covered care system. The pri-
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mary care provider shall—
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(A) coordinate with the Secretary and
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other health care providers the hospital care,
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medical services, and extended care services fur-
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nished to the veteran under the pilot program;
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and
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(B) refer the veteran to specialty care pro-
1
viders in the covered care system, as clinically
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necessary.
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(2) SYSTEMS.—The Secretary shall establish
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systems as the Secretary determines appropriate to
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ensure that a primary care provider can effectively
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coordinate the hospital care, medical services, and
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extended care services furnished to a veteran under
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the pilot program.
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(e) SPECIALTY CARE.—
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(1) ACCESS.—Subject to subsection (d)(1)(B),
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an eligible veteran participating in the pilot program
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may select any specialty care provider in the covered
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care system from which to receive specialty care.
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(2) DESIGNATION.—The Secretary may des-
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ignate a specialty care provider as a primary care
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provider of an eligible veteran participating in the
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pilot program if the Secretary determines that such
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designation is in the health interests of the veteran
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(such as an endocrinologist with respect to a veteran
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diagnosed with diabetes, a neurologist with respect
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to a veteran diagnosed with Parkinson’s disease, or
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an obstetrician-gynecologist with respect to a female
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veteran).
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(f) MENTAL HEALTH CARE.—An eligible veteran
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participating in the pilot program may select a mental
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health care provider in the covered care system from which
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to receive mental health care.
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(g) INFORMATION.—In carrying out the pilot pro-
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gram, the Secretary shall furnish to eligible veterans the
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information on eligibility, cost sharing, treatments, and
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providers required for veterans to make informed decisions
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with respect to—
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(1) selecting primary care providers and spe-
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cialty care providers; and
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(2) treatments available to the veteran.
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(h) DURATION.—
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(1) PHASE IN.—The Secretary shall carry out
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the pilot program during the three-year period be-
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ginning on the date that is one year after the date
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of the enactment of this Act.
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(2) PERMANENT REQUIREMENT.—
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(A) VETERANS
COMMUNITY
CARE
PRO-
19
GRAM.—Section 1703(d) of title 38, United
20
States Code, is amended—
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(i) in paragraph (1), by striking ‘‘The
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Secretary shall’’ and inserting ‘‘Except as
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provided by paragraph (4), the Secretary
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shall’’; and
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(ii) by adding at the end the following
1
new paragraph:
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‘‘(4) Beginning on the date that is four years after
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the date of the enactment of the Veterans Health Care
4
Freedom Act—
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‘‘(A) the requirements under paragraphs (1),
6
(2), and (3) shall not apply with respect to fur-
7
nishing hospital care, medical services, and extended
8
care services to a covered veteran under this section;
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and
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‘‘(B) the Secretary shall furnish hospital care,
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medical services, and extended care services to a cov-
12
ered veteran under this section with the same condi-
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tions on the ability of the veteran to choose health
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care providers as specified in the pilot program de-
15
scribed in section 2 of such Act.’’.
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(B) VETERANS CARE AGREEMENTS.—Sec-
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tion 1703A(a)(1) of such title is amended—
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(i) in subparagraph (C), by striking
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‘‘For purposes’’ and inserting ‘‘Except as
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provided by subparagraph (E), for pur-
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poses’’; and
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(ii) by adding at the end the following
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new subparagraph:
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‘‘(E) Beginning on the date that is four years after
1
the date of the enactment of the Veterans Health Care
2
Freedom Act—
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‘‘(i) the requirements under subparagraph (C)
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shall not apply with respect to furnishing hospital
5
care, medical services, and extended care services to
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a covered veteran under this section; and
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‘‘(ii) the Secretary shall furnish hospital care,
8
medical services, and extended care services to a cov-
9
ered veteran under this section with the same condi-
10
tions on the ability of the veteran to choose health
11
care providers as specified in the pilot program de-
12
scribed in section 2 of such Act.’’.
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(C) VISNS.—Beginning on the date that is
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four years after the date of the enactment of
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this Act, the Secretary shall furnish hospital
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care, medical services, and extended care serv-
17
ices to veterans under chapter 17 of title 38,
18
United States Code, at medical facilities of the
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Department of Veterans Affairs, regardless of
20
whether the facility is in the same Veterans In-
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tegrated Service Network as the Network in
22
which the veteran resides.
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(i) REPORTS.—
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(1) IMPLEMENTATION.—On a quarterly basis
1
during the two-year period beginning on the date of
2
the enactment of this Act, the Secretary shall submit
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to the Committees on Veterans’ Affairs of the House
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of Representatives and the Senate a report on the
5
implementation of the pilot program. One such re-
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port shall contain a description of the final design
7
of the pilot program.
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(2) ANNUAL.—On an annual basis during the
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period beginning on the date that is one year after
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the date of the submission of the final report under
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paragraph (1) and ending on the date of the conclu-
12
sion of the pilot program, the Secretary shall submit
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to the Committees on Veterans’ Affairs of the House
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of Representatives and the Senate a report on the
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results of the pilot program.
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(j) REGULATIONS.—The Secretary, in consultation
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with the Committees on Veterans’ Affairs of the House
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of Representatives and the Senate, may prescribe regula-
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tions to carry out this section.
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(k) NO ADDITIONAL APPROPRIATIONS.—No addi-
21
tional funds are authorized to be appropriated to carry
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out this section, and this section shall be carried out using
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amounts otherwise made available to the Veterans Health
24
Administration.
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(l) DEFINITIONS.—In this section:
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(1) The term ‘‘covered care system’’ means
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each—
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(A) medical facility of the Department;
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(B) health care provider specified in sub-
5
section 1703(c) of title 38, United States Code;
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and
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(C) eligible entity or provider that has en-
8
tered into a Veterans Care Agreement under
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section 1703A of such title.
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(2) The term ‘‘eligible veteran’’ means a vet-
11
eran who is enrolled in the patient enrollment sys-
12
tem of the Department of Veterans Affairs under
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section 1705 of title 38, United States Code.
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(3) The term ‘‘non-Department facility’’ has
15
the meaning given that term in section 1701 of title
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38, United States Code.
17
Æ
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