I 

112TH CONGRESS 

1ST SESSION H. R. 3723 

To amend title 38, United States Code, to direct the Secretary of Veterans 

Affairs to enter into contracts with health care providers to improve 

access to health care for veterans who have difficulty receiving treatment 

at a health care facility of the Department of Veterans Affairs, and 

for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 16, 2011 

Mr. SCHILLING (for himself, Mr. HULTGREN, Mr. MCKINLEY, Mr. SCHOCK, 

and Mr. WALSH of Illinois) introduced the following bill; which was referred to the Committee on Veterans’ Affairs 

A BILL 

To amend title 38, United States Code, to direct the Secretary of Veterans Affairs to enter into contracts with 

health care providers to improve access to health care 

for veterans who have difficulty receiving treatment at 

a health care facility of the Department 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, 

3 SECTION 1. SHORT TITLE; SENSE OF CONGRESS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Enhanced Veteran Healthcare Experience Act of 2011’’. 


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1 (b) SENSE OF CONGRESS.—It is the sense of Con2 gress that— 

3 (1) the current health care system of the De4 partment of Veterans Affairs is neither fiscally effi5 cient nor effective in providing easily accessible 

6 treatment for all veterans; 

7 (2) health care can be provided more efficiently 

8 to provide veterans with care that is available closer 

9 to where they live and to allow veterans more flexi10 bility in choosing their own doctors; and 

11 (3) better health care can be provided to vet12 erans at little-to-no increased cost to the taxpayer by 

13 replacing the fee-based care system of the Depart14 ment with the veterans enhanced care program, as 

15 described under section 2, and reprogramming funds 

16 to this program. 

17 SEC. 2. ENHANCED CONTRACT CARE AUTHORITY FOR 

18 HEALTH CARE NEEDS OF VETERANS. 

19 (a) IN GENERAL.— 

20 (1) TYPE OF CARE.—Subsection (a) of section 

21 1703 of title 38, United States Code, is amended to 

22 read as follows: 

23 ‘‘(a)(1) The Secretary shall provide an eligible vet24 eran with covered health services that are provided by a 

25 non-Department provider whom the Secretary enters into 


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1 a contract with under this section if the Secretary deter2 mines that facilities of the Department are not capable 

3 of— 

4 ‘‘(A) economically furnishing covered health 

5 services to such veteran because of geographical in6 accessibility; or 

7 ‘‘(B) furnishing covered health services to such 

8 veteran because such facilities lack the required per9 sonnel, resources, or ability. 

10 ‘‘(2) In this subsection: 

11 ‘‘(A) The term ‘covered health services’ means, 

12 with respect to an eligible veteran, any hospital care, 

13 medical service, rehabilitative service, or preventative 

14 health service that is authorized to be provided by 

15 the Secretary to the veteran under this chapter or 

16 any other provision of law. 

17 ‘‘(B) The term ‘eligible veteran’ means a vet18 eran enrolled in the health care system established 

19 under section 1705(a) of this title who elects to re20 ceive care under this section.’’. 

21 (2) QUALIFIED PROVIDERS; QUALITY OF

22 CARE.—Such section is amended by adding at the 

23 end the following new subsections: 


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1 ‘‘(e) The Secretary may enter into a contract with 

2 a non-Department provider under this section if such pro3 vider— 

4 ‘‘(1) demonstrates the ability to provide non5 Department health care services to veterans; 

6 ‘‘(2) meets or exceeds internal credentialing 

7 standards of the Department and standards of the 

8 Utilization Review Accreditation Commission; 

9 ‘‘(3) has care coordinators who help veterans 

10 make, confirm, and keep medical appointments; 

11 ‘‘(4) has— 

12 ‘‘(A) a system that allows veterans to file 

13 complaints; and 

14 ‘‘(B) a demonstrated ability to respond to 

15 potential quality indicators and patient safety 

16 events; and 

17 ‘‘(5) has the ability to— 

18 ‘‘(A) process claims from others in the net19 work of the provider; 

20 ‘‘(B) bill a third party (as defined in sec21 tion 1725(f)(2) of this title) for care provided 

22 under this section, as appropriate; and 

23 ‘‘(C) transmit directly to the Secretary any 

24 amounts received pursuant to subparagraph 

25 (B). 


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1 ‘‘(f) In carrying out this section, the Secretary shall 

2 ensure the following: 

3 ‘‘(1) With respect to each medical center of the 

4 Department, the Secretary is consistent in deter5 mining the eligibility of veterans under subsection 

6 (a). 

7 ‘‘(2) The Secretary includes care coordinators 

8 of a non-Department provider described in sub9 section (e)(3) in initiatives of the Department to 

10 provide patient-centered care and uses such coordi11 nators when the Secretary is unable to assign a vet12 eran a case manager from the Department. 

13 ‘‘(3) The Department and a non-Department 

14 provider under this section exchange clinical infor15 mation to improve both clinical decision-making and 

16 the care a veteran receives. 

17 ‘‘(4) Both non-Department facilities under this 

18 section and Department facilities meet performance 

19 metrics regarding— 

20 ‘‘(A) the quality of health care provided; 

21 and 

22 ‘‘(B) the satisfaction of veterans. 

23 ‘‘(5) A non-Department facility under this sec24 tion or employee of the Department who exceeds 


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1 performance metrics under paragraph (4) are eligi2 ble for incentive or bonus payments. 

3 ‘‘(g)(1) Not later than October 31 of each year, the 

4 Secretary shall submit to the Committee of Veterans’ Af5 fairs of the Senate and the Committee on Veterans’ Af6 fairs of the House of Representatives a report on care pro7 vided under this section, including— 

8 ‘‘(A) the cost to the Department; 

9 ‘‘(B) the number of veterans receiving care 

10 under this section; 

11 ‘‘(C) the quality of such care and the satisfac12 tion of such veterans; and 

13 ‘‘(D) other matters the Secretary considers ap14 propriate. 

15 ‘‘(2) Not later than March 1 of each odd-numbered 

16 year, the Secretary shall submit to the Committee of Vet17 erans’ Affairs of the Senate and the Committee on Vet18 erans’ Affairs of the House of Representatives a report 

19 on the allocation of resources with respect to care provided 

20 by the Department and by non-Department facilities.’’. 

21 (3) EFFECTIVE DATE.—The amendments made 

22 by paragraphs (1) and (2) shall take effect on Octo23 ber 1, 2012. 

24 (b) AUTHORIZATION OF APPROPRIATIONS.—There is 

25 authorized to be appropriated to the Secretary to carry 


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1 out section 1703 of title 38, United States Code, as 

2 amended by this section, for fiscal year 2013 

3 $5,000,000,000. 

Æ 


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