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[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3989 Referred in Senate (RFS)]

<DOC>
114th CONGRESS
  2d Session
                                H. R. 3989

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                              May 24, 2016

Received; read twice and referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 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.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Support Our Military Caregivers 
Act''.

SEC. 2. EXTERNAL CLINICAL REVIEW OF DENIED APPLICATIONS BY CAREGIVERS 
              OF VETERANS.

    (a) In General.--Section 1720G of title 38, United States Code, is 
amended--
            (1) by redesignating subsections (d) and (e) as subsections 
        (e) and (f), respectively; and
            (2) by inserting after subsection (c) the following new 
        subsection (d):
    ``(d) External Clinical Review of Applications.--(1) Using amounts 
otherwise appropriated to carry out this section, an individual may 
elect to have an independent contractor described in paragraph (2) 
perform an external clinical review of any of the following:
            ``(A) The denial by the Secretary of an application by an 
        individual to be a caregiver or family caregiver eligible for 
        the program of comprehensive assistance administered by the 
        Secretary pursuant to this section.
            ``(B) With respect to such an application that the 
        Secretary has granted, a determination by the Secretary of the 
        level or amount of personal care services that a veteran 
        requires.
            ``(C) A request by a caregiver or family caregiver for a 
        reconsideration of the level or amount of personal care 
        services that a veteran requires based on changes to the health 
        or abilities of the veteran occurring since the Secretary 
        granted such an application.
            ``(D) The revocation by the Secretary of assistance 
        administered by the Secretary pursuant to this section.
    ``(2) An independent contractor described in this paragraph is an 
independent contractor that--
            ``(A) is awarded a contract by the Secretary to carry out 
        this section pursuant to full and open competition under the 
        Federal Acquisition Regulation;
            ``(B) has no direct or indirect financial relationship with 
        any non-Department provider of services to caregivers and 
        family caregivers pursuant to this title;
            ``(C) has not otherwise conducted an external clinical 
        review of benefits administered by the Secretary pursuant to 
        this title other than this section;
            ``(D) has sufficient training and expertise in medical 
        science and other appropriate health, educational, and 
        vocational training and legal matters to perform the reviews 
        described in paragraph (1); and
            ``(E) employs a panel of physicians or other appropriate 
        health care professionals who do not provide health care to the 
        individual who makes an election under paragraph (1).
    ``(3) Each external clinical review conducted pursuant to paragraph 
(1) shall--
            ``(A) be based on applicable information included in the 
        application for assistance described in such paragraph, 
        including clinical expertise, medical, technical, and 
        scientific evidence;
            ``(B) include an opportunity for both the individual who 
        elects for such review and, to the extent possible, the veteran 
        for whom care is being provided to offer opinions and 
        supporting data as to the level of care required; and
            ``(C) include a review of the initial clinical review of 
        such veteran and any other review made by the Secretary.
    ``(4) In carrying out the external clinical reviews pursuant to 
paragraph (1), the independent contractor shall, as determined 
appropriate by the Secretary--
            ``(A) collect and maintain information required; and
            ``(B) share such information with the Secretary.
    ``(5) The Secretary shall take into account, but is not bound by, 
any determination made by the independent contractor pursuant to 
paragraph (1) in determining the final decision with respect to the 
application for assistance. The Secretary may make a final decision 
that is contrary to such a determination if the Secretary includes 
clinically supported documentation with the decision.
    ``(6) The Secretary shall ensure that each external clinical review 
conducted by the independent contractor pursuant to paragraph (1) is 
completed and the Department is notified in writing of the results of 
the review by not later than 120 days after the date on which the 
individual makes the election under such paragraph. Not later than 30 
days after the delivery of the determination recommended by the 
independent contractors, the Secretary shall ensure that the veteran 
and the individual making the election under such paragraph is notified 
in writing of the final decision of the Secretary. In accordance with 
paragraph (5), such notification shall include an explanation of the 
recommended decision, a discussion of the facts and applicable 
regulations, and an explanation of the clinical rationale for the final 
decision.
    ``(7) The Secretary shall notify individuals who submit an 
application to be a caregiver or family caregiver eligible for the 
program of comprehensive assistance administered by the Secretary 
pursuant to this section of the ability of the individual to make an 
election under paragraph (1).
    ``(8) Nothing in this subsection may be construed to affect claims 
made by veterans for disability compensation under chapter 11 of this 
title.''.
    (b) Application.--The amendments made by subsection (a) shall apply 
with respect to elections under subsection (d) of section 1720G of 
title 38, United States Code, as added by subsection (a)(2), that are 
for applications or revocations for assistance for caregivers and 
family caregivers pursuant to such section for which the Secretary of 
Veterans Affairs has not made a final decision as of the date of the 
enactment of this Act.

SEC. 3. PROCESS TO DETERMINE ELIGIBILITY FOR CAREGIVERS OF VETERANS.

    (a) Directives.--The Secretary of Veterans Affairs shall issue 
directives regarding the policies, procedures, and operational 
requirements for the Family Caregiver Program, including with respect 
to determining the eligibility of an individual to participate in the 
Family Caregiver Program.
    (b) GAO Report.--The Comptroller General of the United States shall 
submit to the Committees on Veterans' Affairs of the House of 
Representatives and the Senate a report on the processes of the 
Secretary of Veterans Affairs with respect to--
            (1) determining the eligibility of an individual to 
        participate in the Family Caregiver Program;
            (2) adjudicating appeals to such determinations; and
            (3) the periodic eligibility reevaluation of an individual 
        participating in such program and the communication of any 
        changes as a result of such reevaluations to the veteran and 
        caregiver.
    (c) Family Caregiver Program Defined.--In this section, the term 
``Family Caregiver Program'' either the program of comprehensive 
assistance for family caregivers or the program of general caregiver 
support services established by section 1720G of title 38, United 
States Code.

SEC. 4. MODIFICATION TO LIMITATION ON AWARDS AND BONUSES.

    Section 705 of the Veterans Access, Choice, and Accountability Act 
of 2014 (Public Law 113-146; 38 U.S.C. 703 note) is amended to read as 
follows:

``SEC. 705. LIMITATION ON AWARDS AND BONUSES PAID TO EMPLOYEES OF 
              DEPARTMENT OF VETERANS AFFAIRS.

    ``The Secretary of Veterans Affairs shall ensure that the aggregate 
amount of awards and bonuses paid by the Secretary in a fiscal year 
under chapter 45 or 53 of title 5, United States Code, or any other 
awards or bonuses authorized under such title or title 38, United 
States Code, does not exceed the following amounts:
            ``(1) With respect to each of fiscal years 2017 through 
        2021, $230,000,000.
            ``(2) With respect to each of fiscal years 2022 through 
        2024, $360,000,000.''.

            Passed the House of Representatives May 23, 2016.

            Attest:

                                                 KAREN L. HAAS,

                                                                 Clerk.
```