Veterans Health Care Freedom Act

II 118TH CONGRESS 1ST SESSION S. 1545 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 veterans the ability to choose health care providers. IN THE SENATE OF THE UNITED STATES MAY 10, 2023 Mrs. BLACKBURN (for herself, Mr. ROUNDS, Mr. CRAMER, and Mr. TUBERVILLE) introduced the following bill; which was read twice and 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 veterans the ability to choose health care pro- viders. 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’’. 5 VerDate Sep 11 2014 23:15 May 19, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1545.IS S1545 kjohnson on DSK79L0C42PROD with BILLS 2 •S 1545 IS SEC. 2. PILOT PROGRAM ON ABILITY OF VETERANS TO 1 CHOOSE HEALTH CARE PROVIDERS. 2 (a) PILOT PROGRAM.— 3 (1) REQUIREMENT.—The Secretary of Veterans 4 Affairs, acting through the Center for Innovation for 5 Care and Payment of the Department of Veterans 6 Affairs, shall carry out a pilot program to improve 7 the ability of eligible veterans to access hospital care, 8 medical services, and extended care services through 9 the covered care system by providing eligible vet- 10 erans the ability to choose health care providers. 11 (2) LOCATIONS.—The Secretary shall select a 12 minimum of four Veterans Integrated Service Net- 13 works in which to carry out the pilot program. 14 (b) REMOVAL OF CERTAIN REQUIREMENTS TO AC- 15 CESS CARE.—In carrying out the pilot program, the Sec- 16 retary shall furnish hospital care, medical services, and ex- 17 tended care services to eligible veterans through the cov- 18 ered care system as follows: 19 (1) At medical facilities of the Department of 20 Veterans Affairs, regardless of whether the facility is 21 in the same Veterans Integrated Service Network as 22 the Network in which the veteran resides. 23 (2) At non-Department facilities pursuant to, 24 as appropriate— 25 VerDate Sep 11 2014 23:15 May 19, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1545.IS S1545 kjohnson on DSK79L0C42PROD with BILLS 3 •S 1545 IS (A) section 1703 of title 38, United States 1 Code, without regard to the requirements speci- 2 fied in subsection (d) of such section; or 3 (B) section 1703A of such title, without re- 4 gard to whether the care or service is not fea- 5 sibly available to the eligible veteran from a fa- 6 cility of the Department or through a contract 7 or sharing agreement entered into pursuant to 8 a provision of law other than such section as re- 9 quired under subparagraphs (A) and (C) of 10 subsection (a)(1) of such section. 11 (c) ELECTION OF VETERAN.—In accordance with 12 subsections (d) and (e), an eligible veteran participating 13 in the pilot program may elect to receive hospital care, 14 medical services, and extended care services at any pro- 15 vider in the covered care system. 16 (d) COORDINATION OF CARE.— 17 (1) SELECTION.—Each eligible veteran partici- 18 pating in the pilot program shall select a primary 19 care provider in the covered care system. 20 (2) COORDINATION.—The primary care pro- 21 vider of an eligible veteran selected under paragraph 22 (1) shall— 23 (A) coordinate with the Secretary and 24 other health care providers the hospital care, 25 VerDate Sep 11 2014 23:15 May 19, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1545.IS S1545 kjohnson on DSK79L0C42PROD with BILLS 4 •S 1545 IS medical services, and extended care services fur- 1 nished to the veteran under the pilot program; 2 and 3 (B) refer the veteran to specialty care pro- 4 viders in the covered care system, as clinically 5 necessary. 6 (3) SYSTEMS.—The Secretary shall establish 7 systems as the Secretary determines appropriate to 8 ensure that a primary care provider can effectively 9 coordinate the hospital care, medical services, and 10 extended care services furnished to a veteran under 11 the pilot program. 12 (e) SPECIALTY CARE.— 13 (1) ACCESS.—Subject to subsection (d)(2)(B), 14 an eligible veteran participating in the pilot program 15 may select any specialty care provider in the covered 16 care system from which to receive specialty care. 17 (2) DESIGNATION.—The Secretary may des- 18 ignate a specialty care provider as a primary care 19 provider of an eligible veteran participating in the 20 pilot program if the Secretary determines that such 21 designation is in the health interests of the veteran 22 (such as an endocrinologist with respect to a veteran 23 diagnosed with diabetes, a neurologist with respect 24 to a veteran diagnosed with Parkinson’s disease, or 25 VerDate Sep 11 2014 23:15 May 19, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1545.IS S1545 kjohnson on DSK79L0C42PROD with BILLS 5 •S 1545 IS an obstetrician-gynecologist with respect to a female 1 veteran). 2 (f) MENTAL HEALTH CARE.—An eligible veteran 3 participating in the pilot program may select a mental 4 health care provider in the covered care system from which 5 to receive mental health care. 6 (g) INFORMATION.—In carrying out the pilot pro- 7 gram, the Secretary shall furnish to eligible veterans the 8 information on eligibility, cost sharing, treatments, and 9 providers required for veterans to make informed decisions 10 with respect to— 11 (1) selecting primary care providers and spe- 12 cialty care providers; and 13 (2) treatments available to the veteran. 14 (h) DURATION.— 15 (1) PHASE IN.—The Secretary shall carry out 16 the pilot program during the three-year period be- 17 ginning on the date that is one year after the date 18 of the enactment of this Act. 19 (2) PERMANENT REQUIREMENT.— 20 (A) VETERANS COMMUNITY CARE PRO- 21 GRAM.—Section 1703(d) of title 38, United 22 States Code, is amended— 23 (i) in paragraph (1), by striking ‘‘The 24 Secretary shall’’ and inserting ‘‘Except as 25 VerDate Sep 11 2014 23:15 May 19, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1545.IS S1545 kjohnson on DSK79L0C42PROD with BILLS 6 •S 1545 IS provided by paragraph (4), the Secretary 1 shall’’; and 2 (ii) by adding at the end the following 3 new paragraph: 4 ‘‘(4) Beginning on the date that is four years after 5 the date of the enactment of the Veterans Health Care 6 Freedom Act— 7 ‘‘(A) the requirements under paragraphs (1), 8 (2), and (3) shall not apply with respect to fur- 9 nishing hospital care, medical services, and extended 10 care services to a covered veteran under this section; 11 and 12 ‘‘(B) the Secretary shall furnish hospital care, 13 medical services, and extended care services to a cov- 14 ered veteran under this section with the same condi- 15 tions on the ability of the veteran to choose health 16 care providers as specified in the pilot program de- 17 scribed in section 2 of such Act.’’. 18 (B) VETERANS CARE AGREEMENTS.—Sec- 19 tion 1703A(a)(1) of such title is amended— 20 (i) in subparagraph (C), by striking 21 ‘‘For purposes’’ and inserting ‘‘Except as 22 provided by subparagraph (E), for pur- 23 poses’’; and 24 VerDate Sep 11 2014 23:15 May 19, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1545.IS S1545 kjohnson on DSK79L0C42PROD with BILLS 7 •S 1545 IS (ii) by adding at the end the following 1 new subparagraph: 2 ‘‘(E) Beginning on the date that is four years after 3 the date of the enactment of the Veterans Health Care 4 Freedom Act— 5 ‘‘(i) the requirement under subparagraph (A) 6 and (C) that care or services may only be furnished 7 under this section to covered individuals when such 8 care or services are not feasibly available to the cov- 9 ered individual from a facility of the Department or 10 through a contract or sharing agreement entered 11 into pursuant to a provision of law other than this 12 section shall not apply with respect to furnishing 13 hospital care, medical services, and extended care 14 services to a covered individual under this section; 15 and 16 ‘‘(ii) the Secretary shall furnish hospital care, 17 medical services, and extended care services to a cov- 18 ered individual under this section with the same con- 19 ditions on the ability of the individual to choose 20 health care providers as specified in the pilot pro- 21 gram described in section 2 of such Act.’’. 22 (C) VISNS.—Beginning on the date that is 23 four years after the date of the enactment of 24 this Act, the Secretary shall furnish hospital 25 VerDate Sep 11 2014 23:15 May 19, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1545.IS S1545 kjohnson on DSK79L0C42PROD with BILLS 8 •S 1545 IS care, medical services, and extended care serv- 1 ices to veterans under chapter 17 of title 38, 2 United States Code, at medical facilities of the 3 Department of Veterans Affairs, regardless of 4 whether the facility is in the same Veterans In- 5 tegrated Service Network as the Network in 6 which the veteran resides. 7 (i) REPORTS.— 8 (1) IMPLEMENTATION.— 9 (A) IN GENERAL.—On a quarterly basis 10 during the two-year period beginning on the 11 date of the enactment of this Act, the Secretary 12 shall submit to the Committee on Veterans’ Af- 13 fairs of the Senate and the Committee on Vet- 14 erans’ Affairs of the House of Representatives 15 a report on the implementation of the pilot pro- 16 gram. 17 (B) FINAL DESIGN.—One of the reports 18 required under subparagraph (A) shall contain 19 a description of the final design of the pilot pro- 20 gram. 21 (2) ANNUAL.—On an annual basis during the 22 period beginning on the date that is one year after 23 the date of the submission of the final report under 24 paragraph (1) and ending on the date of the conclu- 25 VerDate Sep 11 2014 23:15 May 19, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1545.IS S1545 kjohnson on DSK79L0C42PROD with BILLS 9 •S 1545 IS sion of the pilot program, the Secretary shall submit 1 to the Committee on Veterans’ Affairs of the Senate 2 and the Committee on Veterans’ Affairs of the 3 House of Representatives a report on the results of 4 the pilot program. 5 (j) REGULATIONS.—The Secretary, in consultation 6 with the Committee on Veterans’ Affairs of the Senate and 7 the Committee on Veterans’ Affairs of the House of Rep- 8 resentatives, may prescribe regulations to carry out this 9 section. 10 (k) NO ADDITIONAL APPROPRIATIONS.—No addi- 11 tional funds are authorized to be appropriated to carry 12 out this section and the amendments made by this section, 13 and this section and the amendments made by this section 14 shall be carried out using amounts otherwise made avail- 15 able to the Veterans Health Administration. 16 (l) DEFINITIONS.—In this section: 17 (1) COVERED CARE SYSTEM.—The term ‘‘cov- 18 ered care system’’ means each— 19 (A) medical facility of the Department; 20 (B) health care provider specified in sub- 21 section 1703(c) of title 38, United States Code; 22 and 23 VerDate Sep 11 2014 23:15 May 19, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1545.IS S1545 kjohnson on DSK79L0C42PROD with BILLS 10 •S 1545 IS (C) eligible entity or provider that has en- 1 tered into a Veterans Care Agreement under 2 section 1703A of such title. 3 (2) ELIGIBLE VETERAN.—The term ‘‘eligible 4 veteran’’ means a veteran who is enrolled in the pa- 5 tient enrollment system of the Department of Vet- 6 erans Affairs under section 1705 of title 38, United 7 States Code. 8 (3) HOSPITAL CARE; MEDICAL SERVICES; NON- 9 DEPARTMENT FACILITIES.—The terms ‘‘hospital 10 care’’, ‘‘medical services’’, and ‘‘non-Department fa- 11 cilities’’ have the meanings given those terms in sec- 12 tion 1701 of title 38, United States Code. 13 Æ VerDate Sep 11 2014 23:15 May 19, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6301 E:\BILLS\S1545.IS S1545 kjohnson on DSK79L0C42PROD with BILLS