I 

118TH CONGRESS 

2D SESSION H. R. 10267 

To improve the provision of care and services under the Veterans Community 

Care Program of the Department of Veterans Affairs, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 3, 2024 

Mr. BOST (for himself and Mr. BILIRAKIS) introduced the following bill; which 

was referred to the Committee on Veterans’ Affairs 

A BILL 

To improve the provision of care and services under the 

Veterans Community Care Program 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; TABLE OF CONTENTS. 

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

5 ‘‘Complete the Mission Act of 2024’’. 

6 (b) TABLE OF CONTENTS.—The table of contents for 

7 this Act is as follows: 

Sec. 1. Short title; table of contents. 

TITLE I—IMPROVEMENT OF VETERANS COMMUNITY CARE 

PROGRAM 


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Sec. 101. Codification of requirements for eligibility standards for access to 

community care from Department of Veterans Affairs. 

Sec. 102. Requirement that Secretary notify veterans of eligibility for care 

under Veterans Community Care Program. 

Sec. 103. Consideration under Veterans Community Care Program of veteran 

preference for care and need for caregiver or attendant. 

Sec. 104. Notification of denial of request for care under Veterans Community 

Care Program. 

Sec. 105. Discussion of telehealth options under Veterans Community Care 

Program. 

Sec. 106. Use of value-based reimbursement models under Veterans Community 

Care Program. 

Sec. 107. Extension of deadline for submittal of claims by health care entities 

and providers under prompt payment standard. 

TITLE II—OTHER HEALTH CARE MATTERS 

Sec. 201. Plan on establishment of interactive, online self-service module for 

care. 

Sec. 202. Publication of wait times for care at medical centers of Department 

of Veterans Affairs. 

Sec. 203. Modification of requirements for Center for Innovation for Care and 

Payment of the Department of Veterans Affairs and requirement for pilot program. 

Sec. 204. Standardized process to determine eligibility of covered veterans for 

participation in certain mental health treatment programs. 

Sec. 205. Reports. 

1 TITLE I—IMPROVEMENT OF VET2 ERANS COMMUNITY CARE 

3 PROGRAM 

4 SEC. 101. CODIFICATION OF REQUIREMENTS FOR ELIGI5 BILITY STANDARDS FOR ACCESS TO COMMU6 NITY CARE FROM DEPARTMENT OF VET7 ERANS AFFAIRS. 

8 (a) ELIGIBILITY ACCESS STANDARDS.—Section 

9 1703B of title 38, United States Code, is amended— 

10 (1) by striking subsections (a) through (e) and 

11 inserting the following: 

12 ‘‘(a) ELIGIBILITY STANDARDS FOR ACCESS TO COM13 MUNITY CARE.—(1) A covered veteran shall be eligible to 


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1 elect to receive non-Department hospital care, medical 

2 services, or extended care services, excluding nursing home 

3 care, through the Veterans Community Care Program 

4 under section 1703 of this title pursuant to subsection 

5 (d)(1)(D) of such section using the following eligibility ac6 cess standards: 

7 ‘‘(A) With respect to primary care, mental 

8 health care, or extended care services, excluding 

9 nursing home care, if the Department cannot sched10 ule an in-person appointment for the covered veteran 

11 with a health care provider of the Department who 

12 can provide the needed service— 

13 ‘‘(i) within 30 minutes average driving 

14 time (or such shorter average driving time as 

15 the Secretary may prescribe) from the residence 

16 of the veteran unless a longer average driving 

17 time has been agreed to by the veteran in con18 sultation with a health care provider of the vet19 eran; and 

20 ‘‘(ii) within 20 days (or such shorter pe21 riod as the Secretary may prescribe) of the date 

22 of request for such an appointment unless a 

23 later date has been agreed to by the veteran in 

24 consultation with a health care provider of the 

25 veteran. 


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1 ‘‘(B) With respect to specialty care, if the De2 partment cannot schedule an in-person appointment 

3 for the covered veteran with a health care provider 

4 of the Department who can provide the needed serv5 ice— 

6 ‘‘(i) within 60 minutes average driving 

7 time (or such shorter average driving time as 

8 the Secretary may prescribe) from the residence 

9 of the veteran unless a longer average driving 

10 time has been agreed to by the veteran in con11 sultation with a health care provider of the vet12 eran; and 

13 ‘‘(ii) within 28 days (or such shorter pe14 riod as the Secretary may prescribe) of the date 

15 of request for such an appointment unless a 

16 later date has been agreed to by the veteran in 

17 consultation with a health care provider of the 

18 veteran. 

19 ‘‘(2) For the purposes of determining the eligibility 

20 of a covered veteran for care or services under paragraph 

21 (1), the Secretary shall not take into consideration the 

22 availability of telehealth appointments from the Depart23 ment when determining whether the Department is able 

24 to furnish such care or services in a manner that complies 

25 with the eligibility access standards under such paragraph. 


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1 ‘‘(3) In the case of a covered veteran who has had 

2 an appointment with a health care provider of the Depart3 ment canceled by the Department for a reason other than 

4 the request of the veteran, in calculating a wait time for 

5 a subsequent appointment under paragraph (1), the Sec6 retary shall calculate such wait time from the date of the 

7 request for the original, canceled appointment. 

8 ‘‘(4) If a veteran agrees to a longer average drive 

9 time or a later date under subparagraph (A) or (B) of 

10 paragraph (1), the Secretary shall document the agree11 ment to such longer average drive time or later date in 

12 the electronic health record of the veteran and provide the 

13 veteran a copy of such documentation. Such copy may be 

14 provided electronically. 

15 ‘‘(b) APPLICATION.—The Secretary shall ensure that 

16 the eligibility access standards established under sub17 section (a) apply— 

18 ‘‘(1) to all care and services within the medical 

19 benefits package of the Department to which a cov20 ered veteran is eligible under section 1703 of this 

21 title, excluding nursing home care; and 

22 ‘‘(2) to all covered veterans, regardless of 

23 whether a veteran is a new or established patient. 

24 ‘‘(c) PERIODIC REVIEW OF ACCESS STANDARDS.— 

25 Not later than three years after the date of the enactment 


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1 of the Complete the Mission Act of 2024, and not less 

2 frequently than once every three years thereafter, the Sec3 retary shall— 

4 ‘‘(1) conduct a review of the eligibility access 

5 standards under subsection (a) in consultation 

6 with— 

7 ‘‘(A) such Federal entities as the Secretary 

8 considers appropriate, including the Depart9 ment of Defense, the Department of Health and 

10 Human Services, and the Centers for Medicare 

11 & Medicaid Services; 

12 ‘‘(B) entities and individuals in the private 

13 sector, including— 

14 ‘‘(i) veteran patients; 

15 ‘‘(ii) veterans service organizations; 

16 and 

17 ‘‘(iii) health care providers partici18 pating in the Veterans Community Care 

19 Program under section 1703 of this title; 

20 and 

21 ‘‘(C) other entities that are not part of the 

22 Federal Government; and 

23 ‘‘(2) submit to the appropriate committees of 

24 Congress a report on— 


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1 ‘‘(A) the findings of the Secretary with re2 spect to the review conducted under paragraph 

3 (1); and 

4 ‘‘(B) such recommendations as the Sec5 retary may have with respect to the eligibility 

6 access standards under subsection (a).’’; 

7 (2) by striking subsection (g); 

8 (3) by redesignating subsections (f), (h), and (i) 

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

10 (4) in subsection (d), as redesignated by para11 graph (3)— 

12 (A) by striking ‘‘established’’ each place it 

13 appears; and 

14 (B) in paragraph (1), by striking ‘‘(1) 

15 Subject to’’ and inserting ‘‘COMPLIANCE BY

16 COMMUNITY CARE PROVIDERS WITH ACCESS

17 STANDARDS.—(1) Subject to’’; 

18 (5) in subsection (e), as so redesignated— 

19 (A) in paragraph (1)— 

20 (i) by striking ‘‘(1) Consistent with’’ 

21 and inserting ‘‘DETERMINATION REGARD22 ING ELIGIBILITY.—(1) Consistent with’’; 

23 and 

24 (ii) by striking ‘‘designated access 

25 standards established under this section’’ 


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1 and inserting ‘‘eligibility access standards 

2 under subsection (a)’’; and 

3 (B) in paragraph (2)(B), by striking ‘‘des4 ignated access standards established under this 

5 section’’ and inserting ‘‘eligibility access stand6 ards under subsection (a)’’; and 

7 (6) in subsection (f), as redesignated by para8 graph (2)— 

9 (A) in the matter preceding paragraph (1), 

10 by striking ‘‘In this section’’ and inserting 

11 ‘‘DEFINITIONS.—In this section’’; and 

12 (B) in paragraph (2)— 

13 (i) by striking ‘‘covered veterans’’ and 

14 inserting ‘‘covered veteran’’; and 

15 (ii) by striking ‘‘veterans described’’ 

16 and inserting ‘‘a veteran described’’. 

17 (b) CONFORMING AMENDMENTS.—Section 1703(d) 

18 of such title is amended— 

19 (1) in paragraph (1)(D), by striking ‘‘des20 ignated access standards developed by the Secretary 

21 under section 1703B of this title’’ and inserting ‘‘eli22 gibility access standards under section 1703B(a) of 

23 this title’’; and 

24 (2) in paragraph (3), by striking ‘‘designated 

25 access standards developed by the Secretary under 


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1 section 1703B of this title’’ and inserting ‘‘eligibility 

2 access standards under section 1703B(a) of this 

3 title’’. 

4 SEC. 102. REQUIREMENT THAT SECRETARY NOTIFY VET5 ERANS OF ELIGIBILITY FOR CARE UNDER 

6 VETERANS COMMUNITY CARE PROGRAM. 

7 Section 1703(a) of title 38, United States Code, is 

8 amended by adding at the end the following new para9 graph: 

10 ‘‘(5)(A) The Secretary shall notify each covered vet11 eran in writing of the eligibility of such veteran for care 

12 or services under this section as soon as possible, but not 

13 later than two business days, after the date on which a 

14 veteran eligible for such care or services under this section 

15 seeks care or services. 

16 ‘‘(B) With respect to each covered veteran eligible for 

17 care or services under subsection (d), the Secretary shall 

18 provide such veteran periodic reminders, as the Secretary 

19 determines appropriate, of their ongoing eligibility under 

20 such subsection. 

21 ‘‘(C) Any notification or reminder under this para22 graph may be provided electronically.’’. 


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1 SEC. 103. CONSIDERATION UNDER VETERANS COMMUNITY 

2 CARE PROGRAM OF VETERAN PREFERENCE 

3 FOR CARE AND NEED FOR CAREGIVER OR AT4 TENDANT. 

5 Section 1703(d)(2) of title 38, United States Code, 

6 is amended by adding at the end the following new sub7 paragraphs: 

8 ‘‘(F) The preference of the covered veteran for 

9 where, when, and how to seek hospital care, medical 

10 services, or extended care services. 

11 ‘‘(G) Whether the covered veteran requests or 

12 requires the assistance of a caregiver or attendant 

13 when seeking hospital care, medical services, or ex14 tended care services.’’. 

15 SEC. 104. NOTIFICATION OF DENIAL OF REQUEST FOR 

16 CARE UNDER VETERANS COMMUNITY CARE 

17 PROGRAM. 

18 Section 1703 of title 38, United States Code, is 

19 amended— 

20 (1) by redesignating subsection (o) as sub21 section (p); and 

22 (2) by inserting after subsection (n) the fol23 lowing new subsection (o): 

24 ‘‘(o) NOTIFICATION OF DENIAL OF REQUEST FOR

25 CARE AND HOW TO APPEAL.—(1) If a request by a vet26 eran for care or services under this section is denied, the 


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1 Secretary shall notify the veteran in writing as soon as 

2 possible, but not later than two business days, after the 

3 denial is made— 

4 ‘‘(A) of the reason for the denial; and 

5 ‘‘(B) with instructions on how to appeal such 

6 denial using the clinical appeals process of the Vet7 erans Health Administration. 

8 ‘‘(2) If a denial under paragraph (1) is due to not 

9 meeting the eligibility access standards under section 

10 1703B(a) of this title, notice under such paragraph shall 

11 include an explanation for why the Secretary does not con12 sider the veteran to have met such standards. 

13 ‘‘(3) Any notification under this subsection may be 

14 provided electronically.’’. 

15 SEC. 105. DISCUSSION OF TELEHEALTH OPTIONS UNDER 

16 VETERANS COMMUNITY CARE PROGRAM. 

17 Section 1703 of title 38, United States Code, as 

18 amended by section 104, is further amended— 

19 (1) by redesignating subsection (p) as sub20 section (q); and 

21 (2) by inserting after subsection (o) the fol22 lowing new subsection (p): 

23 ‘‘(p) DISCUSSION OF OPTIONS FOR TELEHEALTH.— 

24 When discussing options for care or services for a covered 

25 veteran under this section, the Secretary shall ensure that 


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1 the veteran is informed of the ability of the veteran to 

2 seek care or services via telehealth, either through a med3 ical facility of the Department or under this section, if 

4 telehealth— 

5 ‘‘(1) is available to the veteran; 

6 ‘‘(2) is appropriate for the type of care or serv7 ices the veteran is seeking, as determined by the 

8 Secretary; and 

9 ‘‘(3) is acceptable to the veteran.’’. 

10 SEC. 106. USE OF VALUE-BASED REIMBURSEMENT MODELS 

11 UNDER VETERANS COMMUNITY CARE PRO12 GRAM. 

13 (a) IN GENERAL.—Section 1703(i)(5) of title 38, 

14 United States Code, is amended by striking ‘‘may’’ and 

15 inserting ‘‘shall’’. 

16 (b) NEGOTIATION OF TERMS.—The Secretary of Vet17 erans Affairs shall negotiate with Third Party Administra18 tors to establish the use of value-based reimbursement 

19 models under the Veterans Community Care Program 

20 under section 1703 of title 38, United States Code, pursu21 ant to the amendment made by subsection (a). 

22 (c) REPORT ON VALUE-BASED REIMBURSEMENT

23 MODELS.—Not later than one year after negotiating 

24 under subsection (b) terms to establish the use of value25 based reimbursement models under the Veterans CommuVerDate Sep 11 2014 04:01 Dec 07, 2024 Jkt 059200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H10267.IH H10267

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1 nity Care Program under section 1703 of title 38, United 

2 States Code, the Secretary, in consultation with the Cen3 ter for Innovation for Care and Payment of the Depart4 ment of Veterans Affairs under section 1703E of title 38, 

5 United States Code, and the Office of Integrated Veteran 

6 Care of the Department, or successor office, shall submit 

7 to the Committee on Veterans’ Affairs of the Senate and 

8 the Committee on Veterans’ Affairs of the House of Rep9 resentatives a report containing— 

10 (1) an assessment of the efforts of the Depart11 ment pursuant to section 1703(i)(5) of such title, as 

12 amended by subsection (a), to incorporate value13 based reimbursement models to promote the provi14 sion of high-quality care to veterans; and 

15 (2) such recommendations for legislative or ad16 ministrative action as the Secretary considers appro17 priate to increase the use of value-based reimburse18 ment models throughout the Veterans Community 

19 Care Program under section 1703 of such title. 

20 (d) RULE OF CONSTRUCTION.—This section shall not 

21 be construed to be a pilot program subject to the require22 ments of section 1703E of title 38, United States Code. 

23 (e) THIRD PARTY ADMINISTRATOR DEFINED.—In 

24 this section, the term ‘‘Third Party Administrator’’ means 

25 an entity that manages a provider network and performs 


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1 administrative services related to such network under sec2 tion 1703 of title 38, United States Code. 

3 SEC. 107. EXTENSION OF DEADLINE FOR SUBMITTAL OF 

4 CLAIMS BY HEALTH CARE ENTITIES AND 

5 PROVIDERS UNDER PROMPT PAYMENT 

6 STANDARD. 

7 Section 1703D(b) of title 38, United States Code, is 

8 amended by striking ‘‘180 days’’ and inserting ‘‘one year’’. 

9 TITLE II—OTHER HEALTH CARE 

10 MATTERS 

11 SEC. 201. PLAN ON ESTABLISHMENT OF INTERACTIVE, ON12 LINE SELF-SERVICE MODULE FOR CARE. 

13 (a) IN GENERAL.—The Secretary of Veterans Af14 fairs, working with Third Party Administrators and acting 

15 through the Center for Innovation for Care and Payment 

16 of the Department of Veterans Affairs under section 

17 1703E of title 38, United States Code, shall develop and 

18 implement a plan to establish an interactive, online self19 service module— 

20 (1) to allow veterans to request appointments, 

21 track referrals for health care under the laws admin22 istered by the Secretary, whether at a facility of the 

23 Department or through a non-Department provider, 

24 and receive appointment reminders; 


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1 (2) to allow veterans to appeal and track deci2 sions relating to— 

3 (A) denials of requests for care or services 

4 under section 1703 of title 38, United States 

5 Code; or 

6 (B) denials of requests for care or services 

7 at facilities of the Department, including under 

8 section 1710 of such title; and 

9 (3) to implement such other matters as deter10 mined appropriate by the Secretary in consultation 

11 with Third Party Administrators. 

12 (b) SUBMITTAL OF PLAN.— 

13 (1) INITIAL PLAN.—Not later than 180 days 

14 after the date of the enactment of this Act, the Sec15 retary shall submit to the Committee on Veterans’ 

16 Affairs of the Senate and the Committee on Vet17 erans’ Affairs of the House of Representatives the 

18 plan developed under subsection (a). 

19 (2) QUARTERLY UPDATE.—Not less frequently 

20 than quarterly following the submittal of the plan 

21 under paragraph (1) and for two years thereafter, 

22 the Secretary shall submit to the Committee on Vet23 erans’ Affairs of the Senate and the Committee on 

24 Veterans’ Affairs of the House of Representatives a 


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1 report containing any updates on the implementa2 tion of such plan. 

3 (c) RULE OF CONSTRUCTION.—This section shall not 

4 be construed to be a pilot program subject to the require5 ments of section 1703E of title 38, United States Code. 

6 (d) THIRD PARTY ADMINISTRATOR DEFINED.—In 

7 this section, the term ‘‘Third Party Administrator’’ means 

8 an entity that manages a provider network and performs 

9 administrative services related to such network under sec10 tion 1703 of title 38, United States Code. 

11 SEC. 202. PUBLICATION OF WAIT TIMES FOR CARE AT MED12 ICAL CENTERS OF DEPARTMENT OF VET13 ERANS AFFAIRS. 

14 (a) IN GENERAL.—Subchapter I of chapter 17 of title 

15 38, United States Code, is amended by inserting after sec16 tion 1703F the following new section: 

17 ‘‘§ 1703G. Publication of wait times for care at med18 ical centers 

19 ‘‘(a) IN GENERAL.—The Secretary shall publish on 

20 a publicly available internet website of the Department the 

21 average wait time for a veteran to schedule an appoint22 ment at each medical center of the Department for the 

23 receipt of primary care, specialty care, and mental health 

24 care measured from the date of request for the appoint25 ment to the date on which the care was provided. 


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1 ‘‘(b) UPDATE.—The Secretary shall update the wait 

2 times published under subsection (a) not less frequently 

3 than monthly.’’. 

4 (b) CLERICAL AMENDMENT.—The table of sections 

5 at the beginning of such subchapter is amended by insert6 ing after the item relating to section 1703F the following 

7 new item: 

‘‘1703G. Publication of wait times for care at medical centers.’’. 

8 SEC. 203. MODIFICATION OF REQUIREMENTS FOR CENTER 

9 FOR INNOVATION FOR CARE AND PAYMENT 

10 OF THE DEPARTMENT OF VETERANS AF11 FAIRS AND REQUIREMENT FOR PILOT PRO12 GRAM. 

13 (a) IN GENERAL.—Section 1703E of title 38, United 

14 States Code, is amended— 

15 (1) in subsection (a)— 

16 (A) in paragraph (1), by striking ‘‘within 

17 the Department’’ and inserting ‘‘within the Of18 fice of the Secretary’’; 

19 (B) in paragraph (2), by striking ‘‘may’’ 

20 and inserting ‘‘shall’’; and 

21 (C) in paragraph (3)— 

22 (i) in subparagraph (A), by striking ‘‘; 

23 and’’ and inserting a semicolon; 


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1 (ii) in subparagraph (B), by striking 

2 the period at the end and inserting ‘‘; or’’; 

3 and 

4 (iii) by adding at the end the fol5 lowing new subparagraph: 

6 ‘‘(C) increase productivity, efficiency, and mod7 ernization throughout the Department.’’; 

8 (2) by striking subsection (d) and inserting the 

9 following new subsection (d): 

10 ‘‘(d) BUDGETARY LINE ITEM.—The Secretary shall 

11 include in the budget justification materials submitted to 

12 Congress in support of the budget of the Department of 

13 Veterans Affairs for a fiscal year (as submitted with the 

14 budget of the President under section 1105(a) of title 31) 

15 specific identification, as a budgetary line item, of the 

16 amounts required to carry out this section.’’; 

17 (3) in subsection (f)— 

18 (A) in paragraph (1), by striking ‘‘in sub19 chapters I, II, and III of this chapter’’ and in20 serting ‘‘of this title, of title 38, Code of Fed21 eral Regulations, and of any handbooks, direc22 tives, or policy documents of the Department’’; 

23 and 

24 (B) in paragraph (2), in the matter pre25 ceding subparagraph (A), by striking ‘‘waiving 


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1 any authority’’ and inserting ‘‘waiving any pro2 vision of this title’’; 

3 (4) in subsection (g)(1), by inserting ‘‘fewer 

4 than three or’’ before ‘‘more than 10’’; 

5 (5) in subsection (i)— 

6 (A) in paragraph (1), by striking ‘‘the 

7 Under Secretary for Health and the Special 

8 Medical Advisory Group established pursuant to 

9 section 7312 of this title’’ and inserting ‘‘the 

10 Under Secretary for Health, the Special Med11 ical Advisory Group established pursuant to 

12 section 7312 of this title, the Office of Inte13 grated Veteran Care (or successor office), the 

14 Office of Finance (or successor office), the Vet15 eran Experience Office (or successor office), the 

16 Office of Enterprise Integration (or successor 

17 office), and the Office of Information and Tech18 nology (or successor office)’’; and 

19 (B) in paragraph (2), by striking ‘‘rep20 resentatives of relevant Federal agencies, and 

21 clinical and analytical experts with expertise in 

22 medicine and health care management’’ and in23 serting ‘‘representatives of relevant Federal 

24 agencies, nonprofit organizations, and other 

25 public and private sector entities, including 


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1 those with clinical and analytical experts with 

2 expertise in medicine and health care manage3 ment’’; and 

4 (6) by adding at the end the following new sub5 section: 

6 ‘‘(k) REPORT ON ACTIVITIES OF CENTER FOR INNO7 VATION FOR CARE AND PAYMENT.—Not less frequently 

8 than annually, the Secretary shall submit to Congress a 

9 report that contains, for the one-year period preceding the 

10 date of the report— 

11 ‘‘(1) a full accounting of the activities, staff, 

12 budget, and other resources and efforts of the Cen13 ter; and 

14 ‘‘(2) an assessment of the outcomes of the ef15 forts of the Center.’’. 

16 (b) COMPTROLLER GENERAL REPORT.—Not later 

17 than 18 months after the date of the enactment of this 

18 Act, the Comptroller General of the United States shall 

19 submit to Congress a report— 

20 (1) on the efforts of the Center for Innovation 

21 for Care and Payment of the Department of Vet22 erans Affairs in fulfilling the objectives and require23 ments under section 1703E of title 38, United 

24 States Code, as amended by subsection (a); and 


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1 (2) containing such recommendations as the 

2 Comptroller General considers appropriate. 

3 (c) PILOT PROGRAM.— 

4 (1) IN GENERAL.—Not later than one year 

5 after the date of the enactment of this Act, the Cen6 ter for Innovation for Care and Payment of the De7 partment of Veterans Affairs under section 1703E 

8 of title 38, United States Code, shall establish a 

9 three-year pilot program in not fewer than five loca10 tions to allow veterans enrolled in the system of an11 nual patient enrollment of the Department estab12 lished and operated under section 1705(a) of such 

13 title to access outpatient mental health and sub14 stance use services through health care providers 

15 specified under section 1703(c) of such title without 

16 referral or pre-authorization. 

17 (2) PRIORITY.—In selecting sites for the pilot 

18 program under paragraph (1), the Secretary shall 

19 prioritize sites in the following areas: 

20 (A) Areas with varying degrees of urban21 ization, including urban, rural, and highly rural 

22 areas. 

23 (B) Areas with high rates of suicide among 

24 veterans. 


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1 (C) Areas with high rates of overdose 

2 deaths among veterans. 

3 (D) Areas with high rates of calls to the 

4 Veterans Crisis Line. 

5 (E) Areas with long wait times for mental 

6 health and substance use services at facilities of 

7 the Department. 

8 (F) Areas with outpatient mental health 

9 and substance use programs that utilize a 

10 value-based care model, to the extent prac11 ticable. 

12 (3) ELEMENTS.—The Secretary, in imple13 menting the pilot program under paragraph (1), 

14 shall ensure the Department has a care coordination 

15 system in place that includes— 

16 (A) knowledge sharing, including the time17 ly exchange of medical documentation; 

18 (B) assistance with transitions of care, in19 cluding the potential need for inpatient or resi20 dential psychiatric services, substance use de21 toxification services, post-detoxification step22 down services, and residential rehabilitation 

23 programs; 

24 (C) continuous assessment of patient needs 

25 and goals; and 


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1 (D) creating personalized, proactive care 

2 plans. 

3 (4) OVERSIGHT AND OUTCOMES.—The Sec4 retary shall develop appropriate metrics and meas5 ures— 

6 (A) to track and oversee sites at which the 

7 pilot program under paragraph (1) is carried 

8 out; 

9 (B) to monitor patient safety and out10 comes under the pilot program; and 

11 (C) to assess and mitigate any barriers to 

12 extending the pilot program across the entire 

13 Veterans Health Administration. 

14 (5) ANNUAL REPORT.— 

15 (A) IN GENERAL.—Not later than one year 

16 after the commencement of the pilot program 

17 under paragraph (1), and not less frequently 

18 than annually thereafter during the duration of 

19 the pilot program, the Secretary shall submit to 

20 the Committee on Veterans’ Affairs of the Sen21 ate and Committee on Veterans’ Affairs of the 

22 House of Representatives a report on the pilot 

23 program, which shall include the following: 

24 (i) The number of unique veterans 

25 who participated in the pilot program. 


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1 (ii) The number of health care pro2 viders who participated in the pilot pro3 gram. 

4 (iii) An assessment of the effective5 ness of the pilot program in increasing ac6 cess to, and improving outcomes for, men7 tal health and substance use treatment 

8 services. 

9 (iv) The cost of the pilot program. 

10 (v) Such other matters as the Sec11 retary considers appropriate. 

12 (B) FINAL REPORT.—The Secretary shall 

13 include in the final report submitted under sub14 paragraph (A), in addition to the requirements 

15 under such subparagraph, the assessment by 

16 the Secretary of the feasibility and advisability 

17 of extending the pilot program across the entire 

18 Veterans Health Administration, including a 

19 plan, timeline, and required resources for such 

20 an extension. 

21 (6) VETERANS CRISIS LINE DEFINED.—In this 

22 subsection, the term ‘‘Veterans Crisis Line’’ means 

23 the toll-free hotline for veterans established under 

24 section 1720F(h) of title 38, United States Code. 


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1 SEC. 204. STANDARDIZED PROCESS TO DETERMINE ELIGI2 BILITY OF COVERED VETERANS FOR PAR3 TICIPATION IN CERTAIN MENTAL HEALTH 

4 TREATMENT PROGRAMS. 

5 (a) STANDARDIZED SCREENING PROCESS.—Not 

6 later than one year after the date of the enactment of this 

7 Act, the Secretary of Veterans Affairs shall establish a 

8 standardized screening process to determine, based on 

9 clinical need, whether a covered veteran satisfies criteria 

10 for priority or routine admission to a covered treatment 

11 program. 

12 (b) ELIGIBILITY CRITERIA.— 

13 (1) IN GENERAL.—Under the standardized 

14 screening process required by subsection (a), a cov15 ered veteran shall be eligible for priority admission 

16 to a covered treatment program if the covered vet17 eran meets criteria that include, but are not limited 

18 to, the following: 

19 (A) Symptoms that— 

20 (i) significantly affect activities of 

21 daily life; and 

22 (ii) increase the risk of such veteran 

23 for adverse outcomes. 

24 (B) An unsafe living situation. 

25 (C) A high-risk flag for suicide. 


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1 (D) A determination of being a high risk 

2 for suicide. 

3 (E) Risk factors for overdose. 

4 (F) Non-responsive, relapsed, or unable to 

5 find recovery from one other course of treat6 ment, such as outpatient or intensive outpatient 

7 treatment. 

8 (G) Other such criteria as the Secretary 

9 determines appropriate. 

10 (2) CONSIDERATION.—In making a determina11 tion under paragraph (1), the Secretary shall con12 sider any referral of a health care provider of a cov13 ered veteran for such covered veteran to be admitted 

14 to a covered treatment program. 

15 (c) TIME FOR SCREENING AND ADMISSION.—Under 

16 the standardized screening process required by subsection 

17 (a), the Secretary shall ensure a covered veteran— 

18 (1) is screened not later than 48 hours after the 

19 date on which the covered veteran, or a relevant 

20 health care provider, makes a request for the cov21 ered veteran to be admitted to a covered treatment 

22 program; and 

23 (2) determined eligible for priority admission to 

24 a covered treatment program is admitted to such 


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1 covered treatment program not later than 48 hours 

2 after the date of such determination. 

3 (d) ACCESS STANDARDS FOR ROUTINE ADMIS4 SION.—The Secretary shall include the standardized 

5 screening process under this section in the wait time ac6 cess standards for eligibility for mental health care under 

7 section 1703(d) of such title established by the Secretary 

8 under section 1703B of such title. 

9 (e) CONDITIONS UNDER WHICH CARE SHALL BE

10 FURNISHED THROUGH NON-DEPARTMENT PROVIDERS.— 

11 If the Secretary determines a covered veteran to be eligible 

12 for either priority or routine admission to a covered treat13 ment program pursuant to the standardized screening 

14 process required by subsection (a), and the Secretary is 

15 unable to admit such covered veteran to a clinically nec16 essary covered treatment program at a facility of the De17 partment of Veterans Affairs within 30 minutes average 

18 driving time (or such shorter period as the Secretary may 

19 prescribe) of the veteran’s residence; and within 20 days 

20 (or such shorter period as the Secretary may prescribe) 

21 of the date of request for veterans eligible for routine ad22 mission, or within 48 hours (or such shorter period as the 

23 Secretary may prescribe) for veterans deemed eligible for 

24 priority admission unless a later date has been agreed to 


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1 by the veteran in consultation with their Department 

2 health care provider. 

3 (f) DEFINITIONS.—In this section: 

4 (1) The term ‘‘covered treatment program’’— 

5 (A) means a mental health residential re6 habilitation treatment program of the Depart7 ment of Veterans Affairs; 

8 (B) a program of the Department for resi9 dential care for mental health and substance 

10 abuse disorders; 

11 (C) includes— 

12 (i) the programs designated as of the 

13 date of the enactment of this section as 

14 domiciliary residential rehabilitation treat15 ment programs; and 

16 (ii) any programs designated as domi17 ciliary residential rehabilitation treatment 

18 programs on or after such date of enact19 ment; and 

20 (D) does not include Compensated Work 

21 Therapy Transition Residence programs of the 

22 Department. 

23 (2) The term ‘‘covered veteran’’ means a vet24 eran described in section 1703(b) of title 38, United 

25 States Code. 


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1 SEC. 205. REPORTS. 

2 (a) REPORT ON IMPROVEMENTS TO CLINICAL AP3 PEALS PROCESS.—Not later than one year after the date 

4 of the enactment of this Act, and not less frequently than 

5 once every three years thereafter, the Secretary of Vet6 erans Affairs, in consultation with veterans service organi7 zations, veterans, caregivers of veterans, employees of the 

8 Department of Veterans Affairs, and other stakeholders 

9 as determined by the Secretary, shall submit to the Com10 mittee on Veterans’ Affairs of the Senate and Committee 

11 on Veterans’ Affairs of the House of Representatives a 

12 report containing recommendations for legislative or ad13 ministrative action to improve the clinical appeals process 

14 of the Department with respect to timeliness, trans15 parency, objectivity, consistency, and fairness. 

16 (b) REPORT ON REQUIRED CARE AND SERVICES

17 UNDER COMMUNITY CARE PROGRAM.—Not later than 

18 one year after the date of the enactment of this Act, and 

19 not less frequently than annually thereafter, the Secretary 

20 shall submit to the Committee on Veterans’ Affairs of the 

21 Senate and Committee on Veterans’ Affairs of the House 

22 of Representatives a report that contains, for the one-year 

23 period preceding the date of the report, the following: 

24 (1) The number of veterans eligible for care or 

25 services under section 1703 of title 38, United 

26 States Code, and the reasons for such eligibility, inVerDate Sep 11 2014 04:01 Dec 07, 2024 Jkt 059200 PO 00000 Frm 00029 Fmt 6652 Sfmt 6201 E:\BILLS\H10267.IH H10267

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1 cluding multiple such reasons for veterans eligible 

2 under more than one eligibility criteria. 

3 (2) The number of veterans who opt to seek 

4 care or services under such section. 

5 (3) The number of veterans who do not opt to 

6 seek care or services under such section. 

7 (4) An assessment of the timeliness of referrals 

8 for care or services under such section. 

9 (5) The number of times a veteran did not 

10 show for an appointment for care or services under 

11 such section. 

12 (6) The number of requests for an appeal of a 

13 denial of care or services under such section using 

14 the clinical appeals process of the Veterans Health 

15 Administration. 

16 (7) The timeliness of each such appeal. 

17 (8) The outcome of each such appeal. 

18 (c) VETERANS SERVICE ORGANIZATION DEFINED.— 

19 In this section, the term ‘‘veterans service organization’’ 

20 means any organization recognized by the Secretary under 

21 section 5902 of title 38, United States Code. 

Æ 


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