Tribal Veterans Health Care Enhancement Act

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Tribal Veterans Health Care 
Enhancement Act''.

SEC. 2. COPAYMENTS FOR INDIAN VETERANS RECEIVING CERTAIN MEDICAL 
              SERVICES.

    (a) Liability for Payment.--Section 222(a) of the Indian Health 
Care Improvement Act (25 U.S.C. 1621u(a)) is amended--
            (1) by striking ``A patient who'' and inserting the 
        following:
            ``(1) In general.--Subject to paragraph (2), a patient 
        who''; and
            (2) by adding at the end the following:
            ``(2) Veterans affairs copayments.--The Service may pay, in 
        accordance with section 405(d), the cost of a copayment 
        assessed by the Department of Veterans Affairs to an eligible 
        Indian veteran (as defined in section 405(d)(1)).''.
    (b) Sharing Arrangements With Federal Agencies.--Section 405 of the 
Indian Health Care Improvement Act (25 U.S.C. 1645) is amended--
            (1) by redesignating subsection (d) as subsection (e); and
            (2) by inserting after subsection (c) the following:
    ``(d) Payments for Eligible Indian Veterans Receiving Medical 
Services at VA Facilities.--
            ``(1) Definition of eligible indian veteran.--In this 
        subsection, the term `eligible Indian veteran' means an Indian 
        or Alaska Native veteran who receives any medical care or 
        service that is--
                    ``(A) authorized on referral by the Service; and
                    ``(B) administered at a facility of the Department 
                of Veterans Affairs.
            ``(2) Payment by service.--Notwithstanding any other 
        provision of law, the Service may cover the cost of any 
        copayment assessed by the Department of Veterans Affairs to an 
        eligible Indian veteran receiving services authorized under the 
        Purchased/Referred Care program.
            ``(3) Authorization to accept funds.--Notwithstanding 
        section 407(c) of this Act, section 2901(b) of the Patient 
        Protection and Affordable Care Act (25 U.S.C. 1623(b)), or any 
        other provision of law, the Secretary of Veterans Affairs may 
        accept a payment from the Service under paragraph (2).''.
    (c) Memorandum of Understanding; Report.--
            (1) Definitions.--In this subsection:
                    (A) Appropriate committees of congress.--The term 
                ``appropriate committees of Congress'' means--
                            (i) in the Senate--
                                    (I) the Committee on Veterans' 
                                Affairs; and
                                    (II) the Committee on Indian 
                                Affairs; and
                            (ii) in the House of Representatives--
                                    (I) the Committee on Veterans' 
                                Affairs; and
                                    (II) the Committee on Natural 
                                Resources.
                    (B) Beneficiary of the service.--The term 
                ``beneficiary of the Service'' means an individual who 
                is eligible for assistance from the Service.
                    (C) Director.--The term ``Director'' means the 
                Director of the Service.
                    (D) Indian tribe.--The term ``Indian tribe'' has 
                the meaning given that term in section 4 of the Indian 
                Self-Determination and Education Assistance Act (25 
                U.S.C. 450b).
                    (E) Secretary.--The term ``Secretary'' means the 
                Secretary of Veterans Affairs.
                    (F) Service.--The term ``Service'' means the Indian 
                Health Service.
            (2) Memorandum of understanding.--
                    (A) In general.--Notwithstanding any other 
                provision of law, except as provided in subparagraph 
                (C), the Secretary and the Director shall enter into a 
                memorandum of understanding, in consultation with 
                Indian tribes to be impacted by the memorandum of 
                understanding (on a national or regional basis), that 
                authorizes the Director to pay to the Secretary any 
                copayments owed to the Department of Veterans Affairs 
                by veterans who are beneficiaries of the Service for 
                services rendered by the Department of Veterans Affairs 
                (including any services rendered under a contract with 
                a non-Department health care provider) to those 
                veterans pursuant to a referral from a facility of the 
                Service under the Purchased/Referred Care program of 
                the Service.
                    (B) Factors for consideration.--In entering into a 
                memorandum of understanding under subparagraph (A), the 
                Secretary and the Director shall take into 
                consideration any findings contained in the report 
                under paragraph (3).
                    (C) Exception.--The Secretary and the Director 
                shall not be required to enter into a memorandum of 
                understanding under subparagraph (A) if the Secretary 
                and the Director jointly certify to the appropriate 
                committees of Congress that such a memorandum of 
                understanding would--
                            (i) decrease the quality of health care 
                        provided to veterans who are beneficiaries of 
                        the Service;
                            (ii) impede the access of those veterans to 
                        health care; or
                            (iii) substantially decrease the quality 
                        of, or access to, health care by individuals 
                        receiving health care from the Department of 
                        Veterans Affairs or beneficiaries of the 
                        Service.
            (3) Report.--Not later than 45 days after the date of 
        enactment of this Act, the Secretary and the Director shall 
        submit to the appropriate committees of Congress a report that 
        describes--
                    (A) the number of veterans, disaggregated by State, 
                who--
                            (i) are beneficiaries of the Service; and
                            (ii) have received health care at a medical 
                        facility of the Department of Veterans Affairs;
                    (B) the number of veterans, disaggregated by State 
                and calendar year, who--
                            (i) are beneficiaries of the Service; and
                            (ii) were referred to a medical facility of 
                        the Department of Veterans Affairs from a 
                        facility of the Service during the period--
                                    (I) beginning on January 1, 2010; 
                                and
                                    (II) ending on December 31, 2015; 
                                and
                    (C) an update regarding efforts of the Secretary 
                and the Director to streamline health care for veterans 
                who are beneficiaries of the Service and have received 
                health care at a medical facility of the Department of 
                Veterans Affairs and at a facility of the Service, 
                including a description of--
                            (i) any changes to the provision of health 
                        care required under the Indian Health Care 
                        Improvement Act (25 U.S.C. 1601 et seq.); and
                            (ii) any barriers to efficiently streamline 
                        the provision of health care to veterans who 
                        are beneficiaries of the Service.
                                                       

Summary: Tribal Veterans Health Care Enhancement Act This bill amends the Indian Health Care Improvement Act to allow the Indian Health Service (IHS) to pay copayments owed to the Department of Veterans Affairs (VA) by Indian veterans for services authorized under the PurchasedReferred Care program. The IHS and the VA, in consultation with impacted Indian tribes, must enter into a memorandum of understanding that authorizes the IHS to pay such copayments unless it would decrease the quality of, or access to, health care for individuals receiving care from the IHS or the VA. The IHS and the VA must report on veterans who are IHS beneficiaries and have received care from the VA.