114TH CONGRESS 

2D SESSION H. R. 3989 

AN ACT 

To amend title 38, United States Code, to improve the 

process for determining the eligibility of caregivers of 

veterans to certain benefits administered by the Secretary of Veterans Affairs, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 
2 

•HR 3989 EH

1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Support Our Military 

3 Caregivers Act’’. 

4 SEC. 2. EXTERNAL CLINICAL REVIEW OF DENIED APPLICA5 TIONS BY CAREGIVERS OF VETERANS. 

6 (a) IN GENERAL.—Section 1720G of title 38, United 

7 States Code, is amended— 

8 (1) by redesignating subsections (d) and (e) as 

9 subsections (e) and (f), respectively; and 

10 (2) by inserting after subsection (c) the fol11 lowing new subsection (d): 

12 ‘‘(d) EXTERNAL CLINICAL REVIEW OF APPLICA13 TIONS.—(1) Using amounts otherwise appropriated to 

14 carry out this section, an individual may elect to have an 

15 independent contractor described in paragraph (2) per16 form an external clinical review of any of the following: 

17 ‘‘(A) The denial by the Secretary of an applica18 tion by an individual to be a caregiver or family 

19 caregiver eligible for the program of comprehensive 

20 assistance administered by the Secretary pursuant to 

21 this section. 

22 ‘‘(B) With respect to such an application that 

23 the Secretary has granted, a determination by the 

24 Secretary of the level or amount of personal care 

25 services that a veteran requires. 
3 

•HR 3989 EH

1 ‘‘(C) A request by a caregiver or family care2 giver for a reconsideration of the level or amount of 

3 personal care services that a veteran requires based 

4 on changes to the health or abilities of the veteran 

5 occurring since the Secretary granted such an appli6 cation. 

7 ‘‘(D) The revocation by the Secretary of assist8 ance administered by the Secretary pursuant to this 

9 section. 

10 ‘‘(2) An independent contractor described in this 

11 paragraph is an independent contractor that— 

12 ‘‘(A) is awarded a contract by the Secretary to 

13 carry out this section pursuant to full and open com14 petition under the Federal Acquisition Regulation; 

15 ‘‘(B) has no direct or indirect financial relation16 ship with any non-Department provider of services 

17 to caregivers and family caregivers pursuant to this 

18 title; 

19 ‘‘(C) has not otherwise conducted an external 

20 clinical review of benefits administered by the Sec21 retary pursuant to this title other than this section; 

22 ‘‘(D) has sufficient training and expertise in 

23 medical science and other appropriate health, edu24 cational, and vocational training and legal matters 
4 

•HR 3989 EH

1 to perform the reviews described in paragraph (1); 

2 and 

3 ‘‘(E) employs a panel of physicians or other ap4 propriate health care professionals who do not pro5 vide health care to the individual who makes an elec6 tion under paragraph (1). 

7 ‘‘(3) Each external clinical review conducted pursu8 ant to paragraph (1) shall— 

9 ‘‘(A) be based on applicable information in10 cluded in the application for assistance described in 

11 such paragraph, including clinical expertise, medical, 

12 technical, and scientific evidence; 

13 ‘‘(B) include an opportunity for both the indi14 vidual who elects for such review and, to the extent 

15 possible, the veteran for whom care is being provided 

16 to offer opinions and supporting data as to the level 

17 of care required; and 

18 ‘‘(C) include a review of the initial clinical re19 view of such veteran and any other review made by 

20 the Secretary. 

21 ‘‘(4) In carrying out the external clinical reviews pur22 suant to paragraph (1), the independent contractor shall, 

23 as determined appropriate by the Secretary— 

24 ‘‘(A) collect and maintain information required; 

25 and 
5 

•HR 3989 EH

1 ‘‘(B) share such information with the Secretary. 

2 ‘‘(5) The Secretary shall take into account, but is not 

3 bound by, any determination made by the independent 

4 contractor pursuant to paragraph (1) in determining the 

5 final decision with respect to the application for assist6 ance. The Secretary may make a final decision that is con7 trary to such a determination if the Secretary includes 

8 clinically supported documentation with the decision. 

9 ‘‘(6) The Secretary shall ensure that each external 

10 clinical review conducted by the independent contractor 

11 pursuant to paragraph (1) is completed and the Depart12 ment is notified in writing of the results of the review by 

13 not later than 120 days after the date on which the indi14 vidual makes the election under such paragraph. Not later 

15 than 30 days after the delivery of the determination rec16 ommended by the independent contractors, the Secretary 

17 shall ensure that the veteran and the individual making 

18 the election under such paragraph is notified in writing 

19 of the final decision of the Secretary. In accordance with 

20 paragraph (5), such notification shall include an expla21 nation of the recommended decision, a discussion of the 

22 facts and applicable regulations, and an explanation of the 

23 clinical rationale for the final decision. 

24 ‘‘(7) The Secretary shall notify individuals who sub25 mit an application to be a caregiver or family caregiver 
6 

•HR 3989 EH

1 eligible for the program of comprehensive assistance ad2 ministered by the Secretary pursuant to this section of the 

3 ability of the individual to make an election under para4 graph (1). 

5 ‘‘(8) Nothing in this subsection may be construed to 

6 affect claims made by veterans for disability compensation 

7 under chapter 11 of this title.’’. 

8 (b) APPLICATION.—The amendments made by sub9 section (a) shall apply with respect to elections under sub10 section (d) of section 1720G of title 38, United States 

11 Code, as added by subsection (a)(2), that are for applica12 tions or revocations for assistance for caregivers and fam13 ily caregivers pursuant to such section for which the Sec14 retary of Veterans Affairs has not made a final decision 

15 as of the date of the enactment of this Act. 

16 SEC. 3. PROCESS TO DETERMINE ELIGIBILITY FOR CARE17 GIVERS OF VETERANS. 

18 (a) DIRECTIVES.—The Secretary of Veterans Affairs 

19 shall issue directives regarding the policies, procedures, 

20 and operational requirements for the Family Caregiver 

21 Program, including with respect to determining the eligi22 bility of an individual to participate in the Family Care23 giver Program. 

24 (b) GAO REPORT.—The Comptroller General of the 

25 United States shall submit to the Committees on Vet-
7 

•HR 3989 EH

1 erans’ Affairs of the House of Representatives and the 

2 Senate a report on the processes of the Secretary of Vet3 erans Affairs with respect to— 

4 (1) determining the eligibility of an individual 

5 to participate in the Family Caregiver Program; 

6 (2) adjudicating appeals to such determina7 tions; and 

8 (3) the periodic eligibility reevaluation of an in9 dividual participating in such program and the com10 munication of any changes as a result of such re11 evaluations to the veteran and caregiver. 

12 (c) FAMILY CAREGIVER PROGRAM DEFINED.—In 

13 this section, the term ‘‘Family Caregiver Program’’ either 

14 the program of comprehensive assistance for family care15 givers or the program of general caregiver support services 

16 established by section 1720G of title 38, United States 

17 Code. 

18 SEC. 4. MODIFICATION TO LIMITATION ON AWARDS AND 

19 BONUSES. 

20 Section 705 of the Veterans Access, Choice, and Ac21 countability Act of 2014 (Public Law 113–146; 38 U.S.C. 

22 703 note) is amended to read as follows: 
8 

•HR 3989 EH

1 ‘‘SEC. 705. LIMITATION ON AWARDS AND BONUSES PAID TO 

2 EMPLOYEES OF DEPARTMENT OF VETERANS 

3 AFFAIRS. 

4 ‘‘The Secretary of Veterans Affairs shall ensure that 

5 the aggregate amount of awards and bonuses paid by the 

6 Secretary in a fiscal year under chapter 45 or 53 of title 

7 5, United States Code, or any other awards or bonuses 

8 authorized under such title or title 38, United States 

9 Code, does not exceed the following amounts: 

10 ‘‘(1) With respect to each of fiscal years 2017 

11 through 2021, $230,000,000. 

12 ‘‘(2) With respect to each of fiscal years 2022 

13 through 2024, $360,000,000.’’. 

Passed the House of Representatives May 23, 2016. 

Attest: 

Clerk. 

114TH CONGRESS 

2D SESSION H. R. 3989 

AN ACT 

To amend title 38, United States Code, to improve 

for other purposes. tered by the Secretary of Veterans Affairs, and givers of veterans to certain benefits administhe process for determining the eligibility of care-