```

[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4063 Introduced in House (IH)]

<DOC>

114th CONGRESS
  1st Session
                                H. R. 4063

 To improve the use by the Secretary of Veterans Affairs of opioids in 
treating veterans, to improve patient advocacy by the Secretary, and to 
 expand the availability of complementary and integrative health, and 
                          for other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                           November 18, 2015

   Mr. Bilirakis (for himself, Mr. Kind, Miss Rice of New York, Mrs. 
 Walorski, Mr. McKinley, Mr. Bost, Mr. Coffman, Mr. Ross, Mr. Ryan of 
 Ohio, Mrs. Radewagen, Mr. Crawford, Mr. Mica, Ms. Frankel of Florida, 
 Ms. Kuster, Mr. McCaul, and Mr. Walz) introduced the following bill; 
   which was referred to the Committee on Veterans' Affairs, and in 
    addition to the Committee on Armed Services, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL

 
 To improve the use by the Secretary of Veterans Affairs of opioids in 
treating veterans, to improve patient advocacy by the Secretary, and to 
 expand the availability of complementary and integrative health, and 
                          for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Promoting 
Responsible Opioid Management and Incorporating Scientific Expertise 
Act'' or the ``Jason Simcakoski PROMISE Act''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
              TITLE I--OPIOID THERAPY AND PAIN MANAGEMENT

Sec. 101. Guidelines on management of opioid therapy by Department of 
                            Veterans Affairs and Department of Defense 
                            and implementation of such guidelines by 
                            Department of Veterans Affairs.
Sec. 102. Improvement of opioid safety measures by Department of 
                            Veterans Affairs.
Sec. 103. Strengthening of joint working group on pain management of 
                            the Department of Veterans Affairs and the 
                            Department of Defense.
Sec. 104. Review, investigation, and report on use of opioids in 
                            treatment by Department of Veterans 
                            Affairs.
                       TITLE II--PATIENT ADVOCACY

Sec. 201. Community meetings on improving care furnished by Department 
                            of Veterans Affairs.
Sec. 202. Improvement of awareness of patient advocacy program and 
                            patient bill of rights of Department of 
                            Veterans Affairs.
Sec. 203. Comptroller general report on patient advocacy program of 
                            Department of Veterans Affairs.
            TITLE III--COMPLEMENTARY AND INTEGRATIVE HEALTH

Sec. 301. Expansion of research and education on and delivery of 
                            complementary and integrative health to 
                            veterans.
Sec. 302. Pilot program on integration of complementary alternative 
                            medicines and related issues for veterans 
                            and family members of veterans.
               TITLE IV--FITNESS OF HEALTH CARE PROVIDERS

Sec. 401. Additional requirements for hiring of health care providers 
                            by Department of Veterans Affairs.
Sec. 402. Provision of information on health care providers of 
                            Department of Veterans Affairs to State 
                            Medical Boards.
Sec. 403. Report on compliance by Department of Veterans Affairs with 
                            reviews of health care providers leaving 
                            the Department or transferring to other 
                            facilities.
                    TITLE V--OTHER VETERANS MATTERS

Sec. 501. Audit of Veterans Health Administration programs of 
                            Department of Veterans Affairs.

              TITLE I--OPIOID THERAPY AND PAIN MANAGEMENT

SEC. 101. GUIDELINES ON MANAGEMENT OF OPIOID THERAPY BY DEPARTMENT OF 
              VETERANS AFFAIRS AND DEPARTMENT OF DEFENSE AND 
              IMPLEMENTATION OF SUCH GUIDELINES BY DEPARTMENT OF 
              VETERANS AFFAIRS.

    (a) In General.--Not later than one year after the date of the 
enactment of this Act, the Secretary of Veterans Affairs and the 
Secretary of Defense shall jointly update the VA/DOD Clinical Practice 
Guideline for Management of Opioid Therapy for Chronic Pain to include 
the following:
            (1) In accordance with subsection (b), common recommended 
        guidelines for safely prescribing opioids for the treatment of 
        chronic, non-cancer pain in outpatient settings as compiled by 
        the Director of the Centers for Disease Control and Prevention.
            (2) Enhanced guidance with respect to--
                    (A) the administration of two or more drugs that 
                may result in a life-limiting drug-to-drug interaction, 
                including benzodiazepines;
                    (B) the treatment of patients with current acute 
                psychiatric instability or substance use disorder or 
                patients at risk of suicide; and
                    (C) the use of opioid therapy to treat mental 
                health disorders other than opioid use disorder.
            (3) Enhanced guidance with respect to the treatment of 
        patients with behaviors or comorbidities, such as post-
        traumatic stress disorder, psychiatric disorders, or a history 
        of substance abuse or addiction, that requires a consultation 
        or comanagement of opioid therapy with one or more specialists 
        in pain management, mental health, or addictions.
            (4) Enhanced guidance with respect to the conduct by health 
        care providers of an effective assessment for patients 
        receiving opioid therapy, including patients on long-term 
        opioid therapy, to determine--
                    (A) whether opioid therapy is meeting the expected 
                goals of the patient and health care provider of 
                relieving pain, improving function, and providing 
                patient satisfaction; and
                    (B) whether opioid therapy should be continued.
            (5) Guidance that each health care provider of the 
        Department of Veterans Affairs and the Department of Defense, 
        before initiating opioid therapy to treat a patient as part of 
        the comprehensive assessment conducted by the health care 
        provider, use the Opioid Therapy Risk Report tool of the 
        Department of Veterans Affairs (or successor tool), which shall 
        include the ability to access the most recent patient 
        information from the prescription drug monitoring program of 
        each State that has such a program to assess the risk for 
        adverse outcomes of opioid therapy for the patient, including 
        with respect to the concurrent use of controlled substances, 
        including benzodiazepines.
            (6) Guidelines to govern the methodologies used by health 
        care providers of the Department of Veterans Affairs and the 
        Department of Defense to safely titrate and taper opioid 
        therapy when adjusting or discriminating the use of opioid 
        therapy, including with respect to--
                    (A) prescription of the lowest effective dose based 
                on patient need;
                    (B) use of opioid only for a limited period of 
                time; and
                    (C) augmentation of opioid therapy with other pain 
                management therapies and modalities.
            (7) Guidelines with respect to appropriate case management 
        for patients receiving opioid therapy who transition between 
        inpatient and outpatient health care settings, which may 
        include the use of care transition plans.
            (8) Guidelines with respect to appropriate transfer of case 
        management responsibility for patients receiving opioid therapy 
        who transition from receiving care furnished by the Secretary 
        of Defense to receiving care furnished by other health care 
        providers after the patient has been discharged or separated 
        from the Armed Forces.
            (9) Enhanced standards with respect to the use of routine 
        and random urine drug tests for all patients before and during 
        opioid therapy to help prevent substance abuse, dependence, and 
        diversion, including--
                    (A) that such tests occur not less frequently than 
                once each year; and
                    (B) that health care providers appropriately 
                interpret and respond to the results from such tests to 
                tailor pain therapy, safeguards, and risk management 
                strategies to each patient.
            (10) Guidance that health care providers discuss with 
        patients, before initiating opioid therapy, options for pain 
        management therapies without the use of opioids and options to 
        augment opioid therapy with other clinical and complementary 
        and integrative health services to minimize opioid dependence.
    (b) Treatment of Certain Guidelines Developed After Deadline.--If 
the Director of the Centers for Disease Control and Prevention issues 
the guidelines described in paragraph (1) of subsection (a) after the 
date on which the Secretary of Veterans Affairs and the Secretary of 
Defense jointly update the VA/DOD Clinical Practice Guideline for 
Management of Opioid Therapy for Chronic Pain pursuant to such 
subsection, the Secretaries shall jointly modify the VA/DOD Clinical 
Practice Guideline for Management of Opioid Therapy for Chronic Pain to 
incorporate such guidelines of the Director.
    (c) Consultation Before Update.--Before updating the guideline 
under subsection (a), the Secretary of Veterans Affairs and the 
Secretary of Defense shall jointly consult with the Pain Management 
Working Group of the Department of Veterans Affairs-Department of 
Defense Joint Executive Committee established by section 320 of title 
38, United States Code.
    (d) Definitions.--In this section:
            (1) The term ``controlled substance'' has the meaning given 
        that term in section 102 of the Controlled Substances Act (21 
        U.S.C. 802).
            (2) The term ``State'' means each of the several States, 
        territories, and possessions of the United States, the District 
        of Columbia, and the Commonwealth of Puerto Rico.

SEC. 102. IMPROVEMENT OF OPIOID SAFETY MEASURES BY DEPARTMENT OF 
              VETERANS AFFAIRS.

    (a) Expansion of Opioid Safety Initiative.--Not later than 180 days 
after the date of the enactment of this Act, the Secretary of Veterans 
Affairs shall expand the Opioid Safety Initiative of the Department of 
Veterans Affairs to include all medical facilities of the Department.
    (b) Pain Management Education and Training.--
            (1) In general.--In carrying out the Opioid Safety 
        Initiative of the Department, the Secretary shall require all 
        employees of the Department responsible for prescribing opioids 
        to receive education and training described in paragraph (2).
            (2) Education and training.--Education and training 
        described in this paragraph is education and training on pain 
        management and safe opioid prescribing practices for purposes 
        of safely and effectively managing patients with chronic pain, 
        including education and training on the following:
                    (A) The implementation of and full compliance with 
                the VA/DOD Clinical Practice Guideline for Management 
                of Opioid Therapy for Chronic Pain, including any 
                update to such guideline.
                    (B) The use of evidence-based pain management 
                therapies, including cognitive-behavioral therapy, non-
                opioid alternatives, and non-drug methods and 
                procedures to managing pain and related health 
                conditions including complementary alternative 
                medicines.
                    (C) Screening and identification of patients with 
                substance use disorder, including drug-seeking 
                behavior, before prescribing opioids, assessment of 
                risk potential for patients developing an addiction, 
                and referral of patients to appropriate addiction 
                treatment professionals if addiction is identified or 
                strongly suspected.
                    (D) Communication with patients on the potential 
                harm associated with the use of opioids and other 
                controlled substances, including the need to safely 
                store and dispose of supplies relating to the use of 
                opioids and other controlled substances.
                    (E) Such other education and training as the 
                Secretary considers appropriate to ensure that veterans 
                receive safe and high-quality pain management care from 
                the Department.
            (3) Use of existing program.--In providing education and 
        training described in paragraph (2), the Secretary shall use 
        the Interdisciplinary Chronic Pain Management Training Team 
        Program of the Department (or success program).
    (c) Pain Management Teams.--
            (1) In general.--In carrying out the Opioid Safety 
        Initiative of the Department, the director of each medical 
        facility of the Department shall identify and designate a pain 
        management team of health care professionals, which may include 
        board certified pain medicine specialists, responsible for 
        coordinating and overseeing pain management therapy at such 
        facility for patients experiencing acute and chronic pain that 
        is non-cancer related.
            (2) Establishment of protocols.--
                    (A) In general.--In consultation with the Directors 
                of each Veterans Integrated Service Network, the 
                Secretary shall establish standard protocols for the 
                designation of pain management teams at each medical 
                facility within the Department.
                    (B) Consultation on prescription of opioids.--Each 
                protocol established under subparagraph (A) shall 
                ensure that any health care provider without expertise 
                in prescribing analgesics or who has not completed the 
                education and training under subsection (b), including 
                a mental health care provider, does not prescribe 
                opioids to a patient unless that health care provider--
                            (i) consults with a health care provider 
                        with pain management expertise or who is on the 
                        pain management team of the medical facility; 
                        and
                            (ii) refers the patient to the pain 
                        management team for any subsequent 
                        prescriptions and related therapy.
            (3) Report.--
                    (A) In general.--Not later than one year after the 
                date of enactment of this Act, the director of each 
                medical facility of the Department shall submit to the 
                Under Secretary for Health and the director of the 
                Veterans Integrated Service Network in which the 
                medical facility is located a report identifying the 
                health care professionals that have been designated as 
                members of the pain management team at the medical 
                facility pursuant to paragraph (1).
                    (B) Elements.--Each report submitted under 
                subparagraph (A) with respect to a medical facility of 
                the Department shall include--
                            (i) a certification as to whether all 
                        members of the pain management team at the 
                        medical facility have completed the education 
                        and training required under subsection (b); and
                            (ii) a plan for the management and referral 
                        of patients to such pain management team if 
                        health care providers without expertise in 
                        prescribing analgesics prescribe opioid 
                        medications to treat acute and chronic pain 
                        that is non-cancer related.
    (d) Tracking and Monitoring of Opioid Use.--
            (1) Prescription drug monitoring programs of states.--In 
        carrying out the Opioid Safety Initiative and the Opioid 
        Therapy Risk Report tool of the Department, the Secretary 
        shall--
                    (A) ensure access by health care providers of the 
                Department to information on controlled substances, 
                including opioids and benzodiazepines, prescribed to 
                veterans who receive care outside the Department 
                through the prescription drug monitoring program of 
                each State with such a program, including by seeking to 
                enter into memoranda of understanding with States to 
                allow shared access of such information between States 
                and the Department;
                    (B) include such information in the Opioid Therapy 
                Risk Report; and
                    (C) require health care providers of the Department 
                to submit to the prescription drug monitoring program 
                of each State information on prescriptions of 
                controlled substances received by veterans in that 
                State under the laws administered by the Secretary.
            (2) Report on tracking of data on opioid use.--Not later 
        than 18 months after the date of the enactment of this Act, the 
        Secretary shall submit to the Committee on Veterans' Affairs of 
        the Senate and the Committee on Veterans' Affairs of the House 
        of Representatives a report on the feasibility and advisability 
        of improving the Opioid Therapy Risk Report tool of the 
        Department to allow for more advanced real-time tracking of and 
        access to data on--
                    (A) the key clinical indicators with respect to the 
                totality of opioid use by veterans;
                    (B) concurrent prescribing by health care providers 
                of the Department of opioids in different health care 
                settings, including data on concurrent prescribing of 
                opioids to treat mental health disorders other than 
                opioid use disorder; and
                    (C) mail-order prescriptions of opioid prescribed 
                to veterans under the laws administered by the 
                Secretary.
    (e) Availability of Opioid Receptor Antagonists.--
            (1) Increased availability and use.--
                    (A) In general.--The Secretary shall maximize the 
                availability of opioid receptor antagonists approved by 
                the Food and Drug Administration, including naloxone, 
                to veterans.
                    (B) Availability, training, and distributing.--In 
                carrying out subparagraph (A), not later than 90 days 
                after the date of the enactment of this Act, the 
                Secretary shall--
                            (i) equip each pharmacy of the Department 
                        with opioid receptor antagonists approved by 
                        the Food and Drug Administration to be 
                        dispensed to outpatients as needed; and
                            (ii) expand the Overdose Education and 
                        Naloxone Distribution program of the Department 
                        to ensure that all veterans in receipt of 
                        health care under laws administered by the 
                        Secretary who are at risk of opioid overdose 
                        may access such opioid receptor antagonists and 
                        training on the proper administration of such 
                        opioid receptor antagonists.
                    (C) Veterans who are at risk.--For purposes of 
                subparagraph (B), veterans who are at risk of opioid 
                overdose include--
                            (i) veterans receiving long-term opioid 
                        therapy;
                            (ii) veterans receiving opioid therapy who 
                        have a history of substance use disorder or 
                        prior instances of overdose; and
                            (iii) veterans who are at risk as 
                        determined by a health care provider who is 
                        treating the veteran.
            (2) Report.--Not later than 120 days after the date of the 
        enactment of this Act, the Secretary shall submit to the 
        Committee on Veterans' Affairs of the Senate and the Committee 
        on Veterans' Affairs of the House of Representatives a report 
        on carrying out paragraph (1), including an assessment of any 
        remaining steps to be carried out by the Secretary to carry out 
        such paragraph.
    (f) Inclusion of Certain Information and Capabilities in Opioid 
Therapy Risk Report Tool of the Department.--
            (1) Information.--The Secretary shall include in the Opioid 
        Therapy Risk Report tool of the Department--
                    (A) information on the most recent time the tool 
                was accessed by a health care provider of the 
                Department with respect to each veteran; and
                    (B) information on the results of the most recent 
                urine drug test for each veteran.
            (2) Capabilities.--The Secretary shall include in the 
        Opioid Therapy Risk Report tool the ability of the health care 
        providers of the Department to determine whether a health care 
        provider of the Department prescribed opioids to a veteran 
        without checking the information in the tool with respect to 
        the veteran.
    (g) Notifications of Risk in Computerized Health Record.--The 
Secretary shall modify the computerized patient record system of the 
Department to ensure that any health care provider that accesses the 
record of a veteran, regardless of the reason the veteran seeks care 
from the health care provider, will be immediately notified whether the 
veteran--
            (1) is receiving opioid therapy and has a history of 
        substance use disorder or prior instances of overdose;
            (2) has a history of opioid abuse; or
            (3) is at risk of becoming an opioid abuser as determined 
        by a health care provider who is treating the veteran.
    (h) Definitions.--In this section:
            (1) The term ``controlled substance'' has the meaning given 
        that term in section 102 of the Controlled Substances Act (21 
        U.S.C. 802).
            (2) The term ``State'' means each of the several States, 
        territories, and possessions of the United States, the District 
        of Columbia, and the Commonwealth of Puerto Rico.

SEC. 103. STRENGTHENING OF JOINT WORKING GROUP ON PAIN MANAGEMENT OF 
              THE DEPARTMENT OF VETERANS AFFAIRS AND THE DEPARTMENT OF 
              DEFENSE.

    (a) In General.--Not later than 90 days after the date of enactment 
of this Act, the Secretary of Veterans Affairs and the Secretary of 
Defense shall ensure that the Pain Management Working Group of the 
Health Executive Committee of the Department of Veterans Affairs-
Department of Defense Joint Executive Committee established under 
section 320 of title 38, United States Code, includes a focus on the 
following:
            (1) The opioid prescribing practices of health care 
        providers of each Department.
            (2) The ability of each Department to manage acute and 
        chronic pain among individuals receiving health care from the 
        Department, including training health care providers with 
        respect to pain management.
            (3) The use by each Department of complementary and 
        integrative health and complementary alternative medicines in 
        treating such individuals.
            (4) The concurrent use by health care providers of each 
        Department of opioids and prescription drugs to treat mental 
        health disorders, including benzodiazepines.
            (5) The practice by health care providers of each 
        Department of prescribing opioids to treat mental health 
        disorders.
            (6) The coordination in coverage of and consistent access 
        to medications prescribed for patients transitioning from 
        receiving health care from the Department of Defense to 
        receiving health care from the Department of Veterans Affairs.
            (7) The ability of each Department to identify and treat 
        substance use disorders among individuals receiving health care 
        from that Department.
    (b) Coordination and Consultation.--The Secretary of Veterans 
Affairs and the Secretary of Defense shall ensure that the working 
group described in subsection (a)--
            (1) coordinates the activities of the working group with 
        other relevant working groups established under section 320 of 
        title 38, United States Code, including the working groups on 
        evidence-based practice, patient safety, pharmacy, 
        psychological health, and psychological health;
            (2) consults with other relevant Federal agencies, 
        including the Centers for Disease Control and Prevention, with 
        respect to the activities of the working group; and
            (3) consults with the Department of Veterans Affairs and 
        the Department of Defense with respect to, reviews, and 
        comments on the VA/DOD Clinical Practice Guideline for 
        Management of Opioid Therapy for Chronic Pain, or any successor 
        guideline, before any update to the guideline is released.
    (c) Consultations.--The Secretary of Veterans Affairs and the 
Secretary of Defense shall ensure that the working group described in 
subsection (a) is able to meaningfully consult with respect to the 
updated guideline required under subsection (a) of section 101, as 
required by subsection (b) of such section, not later than 1 year after 
the date of enactment of this Act.

SEC. 104. REVIEW, INVESTIGATION, AND REPORT ON USE OF OPIOIDS IN 
              TREATMENT BY DEPARTMENT OF VETERANS AFFAIRS.

    (a) Comptroller General Report.--
            (1) In general.--Not later than two years after the date of 
        the enactment of this Act, the Comptroller General of the 
        United States shall submit to the Committee on Veterans' 
        Affairs of the Senate and the Committee on Veterans' Affairs of 
        the House of Representatives a report on the Opioid Safety 
        Initiative of the Department of Veterans Affairs and the opioid 
        prescribing practices of health care providers of the 
        Department.
            (2) Elements.--The report submitted under paragraph (1) 
        shall include the following:
                    (A) Recommendations on such improvements to the 
                Opioid Safety Initiative of the Department as the 
                Comptroller General considers appropriate.
                    (B) Information with respect to--
                            (i) deaths resulting from sentinel events 
                        involving veterans prescribed opioids by a 
                        health care provider of the Department;
                            (ii) overall prescription rates and 
                        prescriptions indications of opioids to treat 
                        non-cancer, non-palliative, and non-hospice 
                        care patients;
                            (iii) the prescription rates and 
                        prescriptions indications of benzodiazepines 
                        and opioids concomitantly by health care 
                        providers of the Department;
                            (iv) the practice by health care providers 
                        of the Department of prescribing opioids to 
                        treat patients without any pain, including to 
                        treat patients with mental health disorders 
                        other than opioid use disorder; and
                            (v) the effectiveness of opioid therapy for 
                        patients receiving such therapy, including the 
                        effectiveness of long-term opioid therapy.
                    (C) An evaluation of processes of the Department in 
                place to oversee opioid use among veterans, including 
                procedures to identify and remedy potential over-
                prescribing of opioids by health care providers of the 
                Department.
                    (D) An assessment of the implementation by the 
                Secretary of the VA/DOD Clinical Practice Guideline for 
                Management of Opioid Therapy for Chronic Pain.
    (b) Quarterly Progress Report on Implementation of Comptroller 
General Recommendations.--Not later than two years after the date of 
the enactment of this Act, and not later than 30 days after the end of 
each quarter thereafter, the Secretary of Veterans Affairs shall submit 
to the Committee on Veterans' Affairs of the Senate and the Committee 
on Veterans' Affairs of the House of Representatives a progress report 
detailing the actions by the Secretary during the period covered by the 
report to address any outstanding findings and recommendations by the 
Comptroller General of the United States under subsection (a) with 
respect to the Veterans Health Administration.
    (c) Annual Review of Prescription Rates.--Not later than one year 
after the date of the enactment of this Act, and not less frequently 
than annually for the following five years, the Secretary shall submit 
to the Committee on Veterans' Affairs of the Senate and the Committee 
on Veterans' Affairs of the House of Representatives a report, with 
respect to each medical facility of the Department of Veterans Affairs, 
to collect and review information on opioids prescribed by health care 
providers at the facility to treat non-cancer, non-palliative, and non-
hospice care patients that contains, for the one-year period preceding 
the submission of the report, the following:
            (1) The number of patients and the percentage of the 
        patient population of the Department who were prescribed 
        benzodiazepines and opioids concurrently by a health care 
        provider of the Department.
            (2) The number of patients and the percentage of the 
        patient population of the Department without any pain who were 
        prescribed opioids by a health care provider of the Department, 
        including those who were prescribed benzodiazepines and opioids 
        concurrently.
            (3) The number of non-cancer, non-palliative, and non-
        hospice care patients and the percentage of such patients who 
        were treated with opioids by a health care provider of the 
        Department on an inpatient-basis and who also received 
        prescription opioids by mail from the Department while being 
        treated on an inpatient-basis.
            (4) The number of non-cancer, non-palliative, and non-
        hospice care patients and the percentage of such patients who 
        were prescribed opioids concurrently by a health care provider 
        of the Department and a health care provider that is not health 
        care provider of the Department.
            (5) With respect to each medical facility of the 
        Department, information on opioids prescribed by health care 
        providers at the facility to treat non-cancer, non-palliative, 
        and non-hospice care patients, including information on--
                    (A) the prescription rate at which each health care 
                provider at the facility prescribed benzodiazepines and 
                opioids concurrently to such patients and the aggregate 
                such prescription rate for all health care providers at 
                the facility;
                    (B) the prescription rate at which each health care 
                provider at the facility prescribed benzodiazepines or 
                opioids to such patients to treat conditions for which 
                benzodiazepines or opioids are not approved treatment 
                and the aggregate such prescription rate for all health 
                care providers at the facility;
                    (C) the prescription rate at which each health care 
                provider at the facility prescribed or dispensed mail-
                order prescriptions of opioids to such patients while 
                such patients were being treated with opioids on an 
                inpatient-basis and the aggregate of such prescription 
                rate for all health care providers at the facility; and
                    (D) the prescription rate at which each health care 
                provider at the facility prescribed opioids to such 
                patients who were also concurrently prescribed opioids 
                by a health care provider that is not a health care 
                provider of the Department and the aggregate of such 
                prescription rates for all health care providers at the 
                facility.
            (6) With respect to each medical facility of the 
        Department, the number of times a pharmacist at the facility 
        overrode a critical drug interaction warning with respect to an 
        interaction between opioids and another medication before 
        dispensing such medication to a veteran.
    (d) Investigation of Prescription Rates.--If the Secretary 
determines that a prescription rate with respect to a health care 
provider or medical facility of the Department conflicts with or is 
otherwise inconsistent with the standards of appropriate and safe care, 
the Secretary shall--
            (1) immediately notify the Committee on Veterans' Affairs 
        of the Senate and the Committee on Veterans' Affairs of the 
        House of Representatives of such determination, including 
        information relating to such determination, prescription rate, 
        and health care provider or medical facility, as the case may 
        be; and
            (2) through the Office of the Medical Inspector of the 
        Veterans Health Administration, conduct a full investigation of 
        the health care provider or medical facility, as the case may 
        be.
    (e) Prescription Rate Defined.--In this section, the term 
``prescription rate'' means, with respect to a health care provider or 
medical facility of the Department, each of the following:
            (1) The number of patients treated with opioids by the 
        health care provider or at the medical facility, as the case 
        may be, divided by the total number of pharmacy users of that 
        health care provider or medical facility.
            (2) The average number of morphine equivalents per day 
        prescribed by the health care provider or at the medical 
        facility, as the case may be, to patients being treated with 
        opioids.
            (3) Of the patients being treated with opioids by the 
        health care provider or at the medical facility, as the case 
        may be, the average number of prescriptions of opioids per 
        patient.

                       TITLE II--PATIENT ADVOCACY

SEC. 201. COMMUNITY MEETINGS ON IMPROVING CARE FURNISHED BY DEPARTMENT 
              OF VETERANS AFFAIRS.

    (a) Community Meetings.--
            (1) Medical centers.--Not later than 90 days after the date 
        of the enactment of this Act, and not less frequently than once 
        every 90 days thereafter, the Secretary shall ensure that each 
        medical facility of the Department of Veterans Affairs hosts a 
        community meeting open to the public on improving health care 
        furnished by the Secretary.
            (2) Community based outpatient clinics.--Not later than one 
        year after the date of the enactment of this Act, and not less 
        frequently than annually thereafter, the Secretary shall ensure 
        that each community based outpatient clinic of the Department 
        hosts a community meeting open to the public on improving 
        health care furnished by the Secretary.
    (b) Attendance by Director of Veterans Integrated Service Network 
or Designee.--
            (1) In general.--Each community meeting hosted by a medical 
        facility or community based outpatient clinic under subsection 
        (a) shall be attended by the Director of the Veterans 
        Integrated Service Network in which the medical facility or 
        community based outpatient clinic, as the case may be, is 
        located. Subject to paragraph (2), the Director may delegate 
        such attendance only to an employee who works in the Office of 
        the Director.
            (2) Attendance by director.--Each Director of a Veterans 
        Integrated Service Network shall personally attend not less 
        than one community meeting under subsection (a) hosted by each 
        medical facility located in the Veterans Integrated Service 
        Network each year.
    (c) Notice.--The Secretary shall notify the Committee on Veterans' 
Affairs of the Senate, the Committee on Veterans' Affairs of the House 
of Representatives, and each Member of Congress (as defined in section 
104) who represents the area in which the medical facility is located 
of a community meeting under subsection (a) by not later than 10 days 
before such community meeting occurs.

SEC. 202. IMPROVEMENT OF AWARENESS OF PATIENT ADVOCACY PROGRAM AND 
              PATIENT BILL OF RIGHTS OF DEPARTMENT OF VETERANS AFFAIRS.

    Not later than 90 days after the date of the enactment of this Act, 
the Secretary of Veterans Affairs shall, in as many prominent locations 
as the Secretary determines appropriate to be seen by the largest 
percentage of patients and family members of patients at each medical 
facility of the Department of Veterans Affairs--
            (1) display the purposes of the Patient Advocacy Program of 
        the Department and the contact information for the patient 
        advocate at such medical facility; and
            (2) display the rights and responsibilities of--
                    (A) patients and family members and patients at 
                such medical facility; and
                    (B) with respect to community living centers and 
                other residential facilities of the Department, 
                residents and family members of residents at such 
                medical facility.

SEC. 203. COMPTROLLER GENERAL REPORT ON PATIENT ADVOCACY PROGRAM OF 
              DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--Not later than two years after the date of the 
enactment of this Act, the Comptroller General of the United States 
shall submit to the Committee on Veterans' Affairs of the Senate and 
the Committee on Veterans' Affairs of the House of Representatives a 
report on the Patient Advocacy Program of the Department of Veterans 
Affairs (in this section referred to as the ``Program'').
    (b) Elements.--The report required by subsection (a) shall include 
the following:
            (1) A description of the Program, including--
                    (A) the purpose of the Program;
                    (B) the activities carried out under the Program; 
                and
                    (C) the sufficiency of the Program in achieving the 
                purpose of the Program.
            (2) An assessment of the sufficiency of staffing of 
        employees of the Department responsible for carrying out the 
        Program.
            (3) An assessment of the sufficiency of the training of 
        such employees.
            (4) An assessment of--
                    (A) the awareness of the Program among veterans and 
                family members of veterans; and
                    (B) the use of the Program by veterans and family 
                members of veterans.
            (5) Such recommendations and proposals for improving or 
        modifying the Program as the Comptroller General considers 
        appropriate.
            (6) Such other information with respect to the Program as 
        the Comptroller General considers appropriate.

            TITLE III--COMPLEMENTARY AND INTEGRATIVE HEALTH

SEC. 301. EXPANSION OF RESEARCH AND EDUCATION ON AND DELIVERY OF 
              COMPLEMENTARY AND INTEGRATIVE HEALTH TO VETERANS.

    (a) Establishment.--There is established a commission to be known 
as the ``Creating Options for Veterans' Expedited Recovery'' or the 
``COVER Commission'' (in this Act referred to as the ``Commission''). 
The Commission shall examine the evidence-based therapy treatment model 
used by the Secretary of Veterans Affairs for treating mental health 
conditions of veterans and the potential benefits of incorporating 
complementary alternative treatments available in non-Department 
facilities (as defined in section 1701 of title 38, United States 
Code).
    (b) Duties.--The Commission shall perform the following duties:
            (1) Examine the efficacy of the evidence-based therapy 
        model used by the Secretary for treating mental health 
        illnesses of veterans and identify areas to improve wellness-
        based outcomes.
            (2) Conduct a patient-centered survey within each of the 
        Veterans Integrated Service Networks to examine--
                    (A) the experience of veterans with the Department 
                of Veterans Affairs when seeking medical assistance for 
                mental health issues through the health care system of 
                the Department;
                    (B) the experience of veterans with non-Department 
                facilities and health professionals for treating mental 
                health issues;
                    (C) the preference of veterans regarding available 
                treatment for mental health issues and which methods 
                the veterans believe to be most effective;
                    (D) the experience, if any, of veterans with 
                respect to the complementary alternative treatment 
                therapies described in paragraph (3);
                    (E) the prevalence of prescribing prescription 
                medication among veterans seeking treatment through the 
                health care system of the Department as remedies for 
                addressing mental health issues; and
                    (F) the outreach efforts of the Secretary regarding 
                the availability of benefits and treatments for 
                veterans for addressing mental health issues, including 
                by identifying ways to reduce barriers to gaps in such 
                benefits and treatments.
            (3) Examine available research on complementary alternative 
        treatment therapies for mental health issues and identify what 
        benefits could be made with the inclusion of such treatments 
        for veterans, including with respect to--
                    (A) music therapy;
                    (B) equine therapy;
                    (C) training and caring for service dogs;
                    (D) yoga therapy;
                    (E) acupuncture therapy;
                    (F) meditation therapy;
                    (G) outdoor sports therapy;
                    (H) hyperbaric oxygen therapy;
                    (I) accelerated resolution therapy;
                    (J) art therapy;
                    (K) magnetic resonance therapy; and
                    (L) other therapies the Commission determines 
                appropriate.
            (4) Study the sufficiency of the resources of the 
        Department to ensure the delivery of quality health care for 
        mental health issues among veterans seeking treatment within 
        the Department.
            (5) Study the current treatments and resources available 
        within the Department and assess--
                    (A) the effectiveness of such treatments and 
                resources in decreasing the number of suicides per day 
                by veterans;
                    (B) the number of veterans who have been diagnosed 
                with mental health issues;
                    (C) the percentage of veterans using the resources 
                of the Department who have been diagnosed with mental 
                health issues;
                    (D) the percentage of veterans who have completed 
                counseling sessions offered by the Department; and
                    (E) the efforts of the Department to expand 
                complementary alternative treatments viable to the 
                recovery of veterans with mental health issues as 
                determined by the Secretary to improve the 
                effectiveness of treatments offered with the 
                Department.
    (c) Membership.--
            (1) In general.--The Commission shall be composed of 10 
        members, appointed as follows:
                    (A) Two members appointed by the Speaker of the 
                House of Representatives, at least one of whom shall be 
                a veteran.
                    (B) Two members appointed by the Minority Leader of 
                the House of Representatives, at least one of whom 
                shall be a veteran.
                    (C) Two members appointed by the Majority Leader of 
                the Senate, at least one of whom shall be a veteran.
                    (D) Two members appointed by the Minority Leader of 
                the Senate, at least one of whom shall be a veteran.
                    (E) Two members appointed by the President, at 
                least one of whom shall be a veteran.
            (2) Qualifications.--Members of the Commission shall be--
                    (A) individuals who are of recognized standing and 
                distinction within the medical community with a 
                background in treating mental health;
                    (B) individuals with experience working with the 
                military and veteran population; and
                    (C) individuals who do not have a financial 
                interest in any of the complementary alternative 
                treatments reviewed by the Commission.
            (3) Chairman.--The President shall designate a member of 
        the Commission to be the Chairman.
            (4) Period of appointment.--Members of the Commission shall 
        be appointed for the life of the Commission.
            (5) Vacancy.--A vacancy in the Commission shall be filled 
        in the manner in which the original appointment was made.
            (6) Appointment deadline.--The appointment of members of 
        the Commission in this section shall be made not later than 90 
        days after the date of the enactment of this Act.
    (d) Powers of Commission.--
            (1) Meetings.--
                    (A) Initial meeting.--The Commission shall hold its 
                first meeting not later than 30 days after a majority 
                of members are appointed to the Commission.
                    (B) Meeting.--The Commission shall regularly meet 
                at the call of the Chairman. Such meetings may be 
                carried out through the use of telephonic or other 
                appropriate telecommunication technology if the 
                Commission determines that such technology will allow 
                the members to communicate simultaneously.
            (2) Hearings.--The Commission may hold such hearings, sit 
        and act at such times and places, take such testimony, and 
        receive evidence as the Commission considers advisable to carry 
        out the responsibilities of the Commission.
            (3) Information from federal agencies.--The Commission may 
        secure directly from any department or agency of the Federal 
        Government such information as the Commission considers 
        necessary to carry out the duties of the Commission.
            (4) Information from nongovernmental organizations.--In 
        carrying out its duties, the Commission may seek guidance 
        through consultation with foundations, veteran service 
        organizations, nonprofit groups, faith-based organizations, 
        private and public institutions of higher education, and other 
        organizations as the Commission determines appropriate.
            (5) Commission records.--The Commission shall keep an 
        accurate and complete record of the actions and meeting of the 
        Commission. Such record shall be made available for public 
        inspection and the Comptroller General of the United States may 
        audit and examine such record.
            (6) Personnel records.--The Commission shall keep an 
        accurate and complete record of the actions and meetings of the 
        Commission. Such record shall be made available for public 
        inspection and the Comptroller General of the United States may 
        audit and examine such records.
            (7) Compensation of members; travel expenses.--Each member 
        shall serve without pay but shall receive travel expenses to 
        perform the duties of the Commission, including per diem in 
        lieu of substances, at rates authorized under subchapter I of 
        chapter 57 of title 5, United States Code.
            (8) Staff.--The Chairman, in accordance with rules agreed 
        upon the Commission, may appoint fix the compensation of a 
        staff director and such other personnel as may be necessary to 
        enable the Commission to carry out its functions, without 
        regard to the provisions of title 5, United States Code, 
        governing appointments in the competitive service, without 
        regard to the provision of chapter 51 and subchapter III of 
        chapter 53 of such title relating to classification and General 
        Schedule pay rates, except that no rate of pay fixed under this 
        paragraph may exceed the equivalent of that payable for a 
        position at a level IV of the Executive Schedule under section 
        5316 of title 5, United States Code.
            (9) Personnel as federal employees.--
                    (A) In general.--The executive director and any 
                personnel of the Commission are employees under section 
                2105 of title 5, United States Code, for purpose of 
                chapters 63, 81, 83, 84, 85, 87, 89, and 90 of such 
                title.
                    (B) Members of the commission.--Subparagraph (A) 
                shall not be construed to apply to members of the 
                Commission.
            (10) Contracting.--The Commission may, to such extent and 
        in such amounts as are provided in appropriations Acts, enter 
        into contracts to enable the Commission to discharge the duties 
        of the Commission under this Act.
            (11) Expert and consultant service.--The Commission may 
        procure the services of experts and consultants in accordance 
        with section 3109 or title 5, United States Code, at rates not 
        to exceed the daily rate paid to a person occupying a position 
        at level IV of the Executive Schedule under section 3109 of 
        title 5, United States Code.
            (12) Postal service.--The Commission may use the United 
        States mails in the same manner and under the same conditions 
        as departments and agencies of the United States.
            (13) Physical facilities and equipment.--Upon the request 
        of the Commission, the Administrator of General Services shall 
        provide to the Commission, on a reimbursable basis, the 
        administrative support services necessary for the Commission to 
        carry out its responsibilities under this Act. These 
        administrative services may include human resource management, 
        budget, leasing accounting, and payroll services.
    (e) Report.--
            (1) Interim reports.--
                    (A) In general.--Not later than 60 days after the 
                date on which the Commission first meets, and each 30-
                day period thereafter ending on the date on which the 
                Commission submits the final report under paragraph 
                (2), the Commission shall submit to the Committees on 
                Veterans' Affairs of the House of Representatives and 
                the Senate and the President a report detailing the 
                level of cooperation the Secretary of Veterans Affairs 
                (and the heads of other departments or agencies of the 
                Federal Government) has provided to the Commission.
                    (B) Other reports.--In carrying out its duties, at 
                times that the Commission determines appropriate, the 
                Commission shall submit to the Committee on Veterans' 
                Affairs of the House of Representatives and the Senate 
                and any other appropriate entities an interim report 
                with respect to the findings identified by the 
                Commission.
            (2) Final report.--Not later than 18 months after the first 
        meeting of the Commission, the Commission shall submit to the 
        Committee on Veterans' Affairs of the House of Representatives 
        and the Senate, the President, and the Secretary of Veterans 
        Affairs a final report on the findings of the Commission. Such 
        report shall include the following:
                    (A) Recommendations to implement in a feasible, 
                timely, and cost efficient manner the solutions and 
                remedies identified within the findings of the 
                Commission pursuant to subsection (b).
                    (B) An analysis of the evidence-based therapy model 
                used by the Secretary of Veterans Affairs for treating 
                veterans with mental health care issues, and an 
                examination of the prevalence and efficacy of 
                prescription drugs as a means for treatment.
                    (C) The findings of the patient-centered survey 
                conducted within each of the Veterans Integrated 
                Service Networks pursuant to subsection (b)(2).
                    (D) An examination of complementary alternative 
                treatments described in subsection (b)(3) and the 
                potential benefits of incorporating such treatments in 
                the therapy models used by the Secretary for treating 
                veterans with mental health issues.
            (3) Plan.--Not later than 90 days after the date on which 
        the Commission submits the final report under paragraph (2), 
        the Secretary of Veterans Affairs shall submit to the Committee 
        on Veterans' Affairs of the House of Representatives and the 
        Senate a report on the following:
                    (A) An action plan for implementing the 
                recommendations established by the Commission on such 
                solutions and remedies for improving wellness-based 
                outcomes for veterans with mental health care issues.
                    (B) A feasible timeframe on when the complementary 
                alternative treatments described in subsection (b)(3) 
                can be implemented Departmentwide.
                    (C) With respect to each recommendation established 
                by the Commission, including any complementary 
                alternative treatment, that the Secretary determines is 
                not appropriate or feasible to implement, a 
                justification for such determination and an alternative 
                solution to improve the efficacy of the therapy models 
                used by the Secretary for treating veterans with mental 
                health issues.
    (f) Termination of Commission.--The Commission shall terminate 30 
days after the Commission submits the final report under subsection 
(e)(2).

SEC. 302. PILOT PROGRAM ON INTEGRATION OF COMPLEMENTARY ALTERNATIVE 
              MEDICINES AND RELATED ISSUES FOR VETERANS AND FAMILY 
              MEMBERS OF VETERANS.

    (a) Pilot Program.--
            (1) In general.--Not later than 180 days after the date on 
        which the Secretary of Veterans Affairs receives the final 
        report under section 301(e), the Secretary shall commence a 
        pilot program to assess the feasibility and advisability of 
        using wellness-based programs (as defined by the Secretary) to 
        complement the provision of pain management and related health 
        care services, including mental health care services, to 
        veterans.
            (2) Matters addressed.--In carrying out the pilot program, 
        the Secretary shall assess the following:
                    (A) Means of improving coordination between 
                Federal, State, local, and community providers of 
                health care in the provision of pain management and 
                related health care services to veterans.
                    (B) Means of enhancing outreach, and coordination 
                of outreach, by and among providers of health care 
                referred to in subparagraph (A) on the pain management 
                and related health care services available to veterans.
                    (C) Means of using wellness-based programs of 
                providers of health care referred to in subparagraph 
                (A) as complements to the provision by the Department 
                of pain management and related health care services to 
                veterans.
                    (D) Whether wellness-based programs described in 
                subparagraph (C)--
                            (i) are effective in enhancing the quality 
                        of life and well-being of veterans;
                            (ii) are effective in increasing the 
                        adherence of veterans to the primary pain 
                        management and related health care services 
                        provided such veterans by the Department;
                            (iii) have an effect on the sense of well-
                        being of veterans who receive primary pain 
                        management and related health care services 
                        from the Department; and
                            (iv) are effective in encouraging veterans 
                        receiving health care from the Department to 
                        adopt a more healthy lifestyle.
    (b) Duration.--The Secretary shall carry out the pilot program 
under subsection (a)(1) for a period of three years.
    (c) Locations.--
            (1) Facilities.--The Secretary shall carry out the pilot 
        program under subsection (a)(1) at facilities of the Department 
        providing pain management and related health care services, 
        including mental health care services, to veterans. In 
        selecting such facilities to carry out the pilot program, the 
        Secretary shall select not fewer than 15 medical centers of the 
        Department, of which not fewer than two shall be polytrauma 
        rehabilitation centers of the Department.
            (2) Medical centers with prescription rates of opioids that 
        conflict with care standards.--In selecting the medical centers 
        under paragraph (1), the Secretary shall give priority to 
        medical centers of the Department at which there is a 
        prescription rate of opioids that conflicts with or is 
        otherwise inconsistent with the standards of appropriate and 
        safe care.
    (d) Provision of Services.--Under the pilot program under 
subsection (a)(1), the Secretary shall provide covered services to 
covered veterans by integrating complementary and alternative medicines 
and integrative health services with other services provided by the 
Department at the medical centers selected under subsection (c).
    (e) Covered Veterans.--For purposes of the pilot program under 
subsection (a)(1), a covered veteran is any veteran who--
            (1) has a mental health condition diagnosed by a clinician 
        of the Department;
            (2) experiences chronic pain;
            (3) has a chronic condition being treated by a clinician of 
        the Department; or
            (4) is not described in paragraph (1), (2), or (3) and 
        requests to participate in the pilot program or is referred by 
        a clinician of the Department who is treating the veteran.
    (f) Covered Services.--
            (1) In general.--For purposes of the pilot program, covered 
        services are services consisting of complementary and 
        integrative health services as selected by the Secretary.
            (2) Administration of services.--Covered services shall be 
        administered under the pilot program as follows:
                    (A) Covered services shall be administered by 
                professionals or other instructors with appropriate 
                training and expertise in complementary and integrative 
                health services who are employees of the Department or 
                with whom the Department enters into an agreement to 
                provide such services.
                    (B) Covered services shall be included as part of 
                the Patient Aligned Care Teams initiative of the Office 
                of Patient Care Services, Primary Care Program Office, 
                in coordination with the Office of Patient Centered 
                Care and Cultural Transformation.
                    (C) Covered services shall be made available to--
                            (i) covered veterans who have received 
                        conventional treatments from the Department for 
                        the conditions for which the covered veteran 
                        seeks complementary and integrative health 
                        services under the pilot program; and
                            (ii) covered veterans who have not received 
                        conventional treatments from the Department for 
                        such conditions.
    (g) Reports.--
            (1) In general.--Not later than 30 months after the date on 
        which the Secretary commences the pilot program under 
        subsection (a)(1), the Secretary shall submit to the Committee 
        on Veterans' Affairs of the Senate and the Committee on 
        Veterans' Affairs of the House of Representatives a report on 
        the pilot program.
            (2) Elements.--The report under paragraph (1) shall include 
        the following:
                    (A) The findings and conclusions of the Secretary 
                with respect to the pilot program under subsection 
                (a)(1), including with respect to--
                            (i) the use and efficacy of the 
                        complementary and integrative health services 
                        established under the pilot program;
                            (ii) the outreach conducted by the 
                        Secretary to inform veterans and community 
                        organizations about the pilot program; and
                            (iii) an assessment of the benefit of the 
                        pilot program to covered veterans in mental 
                        health diagnoses, pain management, and 
                        treatment of chronic illness.
                    (B) Identification of any unresolved barriers that 
                impede the ability of the Secretary to incorporate 
                complementary and integrative health services with 
                other health care services provided by the Department.
                    (C) Such recommendations for the continuation or 
                expansion of the pilot program as the Secretary 
                considers appropriate.
    (h) Complementary and Integrative Health Defined.--In this section, 
the term ``complementary and integrative health'' shall have the 
meaning given that term by the National Institutes of Health.

               TITLE IV--FITNESS OF HEALTH CARE PROVIDERS

SEC. 401. ADDITIONAL REQUIREMENTS FOR HIRING OF HEALTH CARE PROVIDERS 
              BY DEPARTMENT OF VETERANS AFFAIRS.

    As part of the hiring process for each health care provider 
considered for a position at the Department of Veterans Affairs after 
the date of the enactment of the Act, the Secretary of Veterans Affairs 
shall require from the medical board of each State in which the health 
care provider has a medical license--
            (1) information on any violation of the requirements of the 
        medical license of the health care provider during the 20-year 
        period preceding the consideration of the health care provider 
        by the Department; and
            (2) information on whether the health care provider has 
        entered into any settlement agreement for the disciplinary 
        charge relating to the practice of medicine by the health care 
        provider.

SEC. 402. PROVISION OF INFORMATION ON HEALTH CARE PROVIDERS OF 
              DEPARTMENT OF VETERANS AFFAIRS TO STATE MEDICAL BOARDS.

    Notwithstanding section 552a of title 5, United States Code, with 
respect to each health care provider of the Department of Veterans 
Affairs who has violated a requirement of the medical license of the 
health care provider, the Secretary of Veterans Affairs shall provide 
to the medical board of each State in which the health care provider is 
licensed detailed information with respect to such violation, 
regardless of whether such board has formally requested such 
information.

SEC. 403. REPORT ON COMPLIANCE BY DEPARTMENT OF VETERANS AFFAIRS WITH 
              REVIEWS OF HEALTH CARE PROVIDERS LEAVING THE DEPARTMENT 
              OR TRANSFERRING TO OTHER FACILITIES.

    Not later than two years after the date of the enactment of this 
Act, the Secretary of Veterans Affairs shall submit to the Committee on 
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs 
of the House of Representatives a report on the compliance by the 
Department of Veterans Affairs with the policy of the Department--
            (1) to conduct a review of each health care provider of the 
        Department who transfers to another medical facility of the 
        Department, retires, or is terminated to determine whether 
        there are any concerns, complaints, or allegations of 
        violations relating to the medical practice of the health care 
        provider; and
            (2) to take appropriate action with respect to any such 
        concern, complaint, or allegation.

                    TITLE V--OTHER VETERANS MATTERS

SEC. 501. AUDIT OF VETERANS HEALTH ADMINISTRATION PROGRAMS OF 
              DEPARTMENT OF VETERANS AFFAIRS.

    (a) Audit.--The Secretary of Veterans Affairs shall seek to enter 
into a contract with a nongovernmental entity under which the entity 
shall conduct a audits of the programs of the Veterans Health 
Administration of the Department of Veterans Affairs to identify ways 
to improve the furnishing of benefits and health care administered by 
the Veterans Health Administration to veterans and families of 
veterans.
    (b) Audit Requirements.--In carrying out each audit under 
subsection (a), the entity shall perform the following:
            (1) Five-year risk assessments to identify the functions, 
        staff organizations, and staff offices of the Veterans Health 
        Administration that would lead towards the greatest improvement 
        in furnishing of benefits and health care to veterans and 
        families of veterans.
            (2) Development of plans that are informed by the risk 
        assessment under paragraph (1) to conduct audits of the 
        functions, staff organizations, and staff offices identified 
        under paragraph (1).
            (3) Conduct audits in accordance with the plans developed 
        pursuant to paragraph (2).
    (c) Reports.--Not later than 90 days after the date on which each 
audit is completed under subsection (a), the Secretary shall submit to 
the Committees on Veterans' Affairs of the House of Representatives and 
the Senate a report that includes--
            (1) a summary of the audit;
            (2) the findings of the entity that conducted the audit 
        with respect to the audit; and
            (3) such recommendations as the Secretary determines 
        appropriate for legislative or administrative action to improve 
        the furnishing of benefits and health care to veterans and 
        families of veterans.
                                 <all>
```