I 

114TH CONGRESS 

1ST SESSION H. R. 3989 

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. 

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 5, 2015 

Ms. STEFANIK introduced the following bill; which was referred to the 

Committee on Veterans’ Affairs 

A BILL 

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. 

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

3 SECTION 1. SHORT TITLE. 

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

5 Caregivers Act’’. 


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1 SEC. 2. EXTERNAL CLINICAL REVIEW OF DENIED APPLICA2 TIONS BY CAREGIVERS OF VETERANS. 

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

4 States Code, is amended— 

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

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

7 (2) by inserting after subsection (c) the fol8 lowing new subsection (d): 

9 ‘‘(d) EXTERNAL CLINICAL REVIEW OF APPLICA10 TIONS.—(1) Using amounts otherwise appropriated to 

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

12 independent contractor described in paragraph (2) per13 form an external clinical review of any of the following: 

14 ‘‘(A) The denial by the Secretary of an applica15 tion by an individual to be a caregiver or family 

16 caregiver eligible for benefits administered by the 

17 Secretary pursuant to this section. 

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

19 the Secretary has granted, a determination by the 

20 Secretary of the level or amount of personal care 

21 services that a veteran requires. 

22 ‘‘(C) A request by a caregiver or family care23 giver for a reconsideration of the level or amount of 

24 personal care services that a veteran requires based 

25 on changes to the health or abilities of the veteran 


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1 occurring since the Secretary granted such an appli2 cation. 

3 ‘‘(D) The revocation by the Secretary of bene4 fits administered by the Secretary pursuant to this 

5 section. 

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

7 paragraph is an independent contractor that— 

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

9 carry out this section pursuant to full and open com10 petition under the Federal Acquisition Regulation; 

11 ‘‘(B) has no direct or indirect financial relation12 ship with any non-Department provider of services 

13 to caregivers and family caregivers pursuant to this 

14 title; 

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

16 clinical review of benefits administered by the Sec17 retary pursuant to this title other than this section; 

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

19 medical science and other appropriate health, edu20 cational, and vocational training and legal matters 

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

22 and 

23 ‘‘(E) employs a panel of physicians or other ap24 propriate health care professionals who do not proVerDate Sep 11 2014 02:30 Nov 11, 2015 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3989.IH H3989

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1 vide health care to the individual who makes an elec2 tion under paragraph (1). 

3 ‘‘(3) Each external clinical review conducted pursu4 ant to paragraph (1) shall— 

5 ‘‘(A) be based on applicable information in6 cluded in the application for benefits described in 

7 such paragraph, including clinical expertise, medical, 

8 technical, and scientific evidence; 

9 ‘‘(B) include an opportunity for the individual 

10 who elects for such review to provide the opinions of 

11 the individual and the veteran for whom care is pro12 vided; and 

13 ‘‘(C) include a review of the initial clinical re14 view of such veteran and any other review made by 

15 the Secretary. 

16 ‘‘(4) In carrying out the external clinical reviews pur17 suant to paragraph (1), the independent contractor shall, 

18 as determined appropriate by the Secretary— 

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

20 and 

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

22 ‘‘(5) The determination made by the independent 

23 contractor pursuant to paragraph (1) shall be final. 

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

25 clinical review conducted by the independent contractor 


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1 pursuant to paragraph (1) is completed and the individual 

2 is notified in writing of the results of the review by not 

3 later than 120 days after the date on which the individual 

4 makes the election under such paragraph. Such notifica5 tion shall include an explanation of the decision, a discus6 sion of the facts and applicable regulations, and an expla7 nation of the clinical rationale for the decision. 

8 ‘‘(7) The Secretary shall notify individuals who sub9 mit an application to be a caregiver or family caregiver 

10 eligible for benefits administered by the Secretary pursu11 ant to this section of the ability of the individual to make 

12 an election under paragraph (1). 

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

14 affect claims made by veterans for disability compensation 

15 under chapter 11 of this title.’’. 

16 (b) APPLICATION.— 

17 (1) IN GENERAL.—Except as provided by para18 graph (2), the amendments made by subsection (a) 

19 shall apply with respect to elections under subsection 

20 (d) of section 1720G of title 38, United States Code, 

21 as added by subsection (a)(2), that are for applica22 tions or revocations for benefits by caregivers and 

23 family caregivers pursuant to such section for which 

24 the Secretary of Veterans Affairs has not made a 


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1 final decision as of the date of the enactment of this 

2 Act. 

3 (2) SPECIAL RULE.—A caregiver or family care4 giver may make an election for an external clinical 

5 review under subsection (d)(1)(C) of section 1720G 

6 of title 38, United States Code, as added by sub7 section (a)(2), regardless of whether the Secretary of 

8 Veterans Affairs made the final decision with respect 

9 to the application for benefits by the caregiver or 

10 family caregiver before the date of the enactment of 

11 this Act. 

Æ 


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