II 

118TH CONGRESS 

2D SESSION S. 4437 

To require the Secretary of Veterans Affairs to carry out a pilot program 

to coordinate, navigate, and manage care and benefits for veterans enrolled in both the Medicare program and the system of annual patient 

enrollment of the Department of Veterans Affairs. 

IN THE SENATE OF THE UNITED STATES 

JUNE 3, 2024 

Mr. MORAN (for himself and Mr. KING) introduced the following bill; which 

was read twice and referred to the Committee on Veterans’ Affairs 

A BILL 

To require the Secretary of Veterans Affairs to carry out 

a pilot program to coordinate, navigate, and manage 

care and benefits for veterans enrolled in both the Medicare program and the system of annual patient enrollment of the Department 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 ‘‘Coordinating Care for 

5 Senior Veterans and Wounded Warriors Act’’. 


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1 SEC. 2. PILOT PROGRAM ON COORDINATION OF CARE BE2 TWEEN DEPARTMENT OF VETERANS AFFAIRS 

3 AND MEDICARE PROGRAM. 

4 (a) IN GENERAL.—The Secretary, in consultation 

5 with the Secretary of Health and Human Services, shall 

6 carry out a pilot program (in this section referred to as 

7 the ‘‘pilot program’’) to coordinate, navigate, and manage 

8 care and benefits for covered veterans. 

9 (b) PURPOSES OF PILOT PROGRAM.—The purposes 

10 of the pilot program are as follows: 

11 (1) To improve access to health care services 

12 for covered veterans at medical facilities of the De13 partment of Veterans Affairs, from health care pro14 viders under the Veterans Community Care Program 

15 under section 1703 of title 38, United States Code, 

16 from health care providers with which the Depart17 ment has established a Veterans Care Agreement 

18 under section 1703A of such title, and from health 

19 care providers participating in the Medicare program 

20 under title XVIII of the Social Security Act (42 

21 U.S.C. 1395 et seq.). 

22 (2) To improve outcomes of care received by 

23 covered veterans. 

24 (3) To improve quality of care received by cov25 ered veterans. 


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1 (4) To lower costs of care received by covered 

2 veterans. 

3 (5) To eliminate gaps in care and duplication of 

4 services and expenses for covered veterans. 

5 (6) To improve care coordination for covered 

6 veterans, including coordination of patient informa7 tion and medical records between providers. 

8 (c) ADMINISTRATION.— 

9 (1) IN GENERAL.—The Secretary shall carry 

10 out the pilot program through the Center for Inno11 vation for Care and Payment of the Department of 

12 Veterans Affairs. 

13 (2) LOCATIONS.—The Secretary shall carry out 

14 the pilot program in not less than three but not 

15 more than five Veterans Integrated Service Net16 works with a large number of covered veterans and 

17 varying degrees of urbanization, including— 

18 (A) locations that are in rural or highly 

19 rural areas, as determined through the use of 

20 the Rural-Urban Commuting Areas coding sys21 tem of the Department of Agriculture; and 

22 (B) locations that are medically under23 served. 

24 (d) CASE MANAGER.— 


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1 (1) ASSIGNMENT OF CASE MANAGER.—In car2 rying out the pilot program, the Secretary shall as3 sign each covered veteran participating in the pilot 

4 program a case manager responsible for developing 

5 an individualized needs assessment for such veteran 

6 and, based on such assessment, a care coordination 

7 plan with defined treatment goals. 

8 (2) ACCESSING SERVICES.—A case manager as9 signed to a covered veteran under paragraph (1) is 

10 responsible for assisting such veteran in accessing 

11 services needed by such veteran and navigating the 

12 systems of care under the laws administered by the 

13 Secretary and under the Medicare program under 

14 title XVIII of the Social Security Act (42 U.S.C. 

15 1395 et seq.). 

16 (e) USE OF EXISTING MODELS.—In designing the 

17 pilot program, the Secretary shall, to the extent prac18 ticable, use existing models, including value-based care 

19 models, used by commercial health care programs to im20 prove access, health outcomes, quality, and customer expe21 rience and lower per capita costs. 

22 (f) CONTRACTING WITH PRIVATE SECTOR ENTI23 TIES.— 

24 (1) IN GENERAL.—The Secretary shall, to the 

25 greatest extent practicable, contract with private secVerDate Sep 11 2014 02:02 Jul 20, 2024 Jkt 049200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S4437.IS S4437

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1 tor entities carrying out commercial health care pro2 grams for assistance in designing, implementing, 

3 and managing care and benefits under the pilot pro4 gram, to include providing care coordination. 

5 (2) NOTIFICATION.—If the Secretary deter6 mines that contracting with private sector entities 

7 under paragraph (1) is not practicable, the Sec8 retary shall submit to the Committee on Veterans’ 

9 Affairs of the Senate and the Committee on Vet10 erans’ Affairs of the House of Representatives— 

11 (A) a notification of that determination; 

12 (B) a description of the steps the Secretary 

13 has taken to contract with a private sector enti14 ty; 

15 (C) a justification for why the Secretary 

16 has determined that contracting with a private 

17 sector entity is not practicable; and 

18 (D) a plan for how the Secretary will carry 

19 out the pilot program without contracting with 

20 a private sector entity, including through the 

21 use of employees of the Department of Veterans 

22 Affairs or other government agencies, nonprofit 

23 organizations, or other entities. 

24 (g) METRICS.— 


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1 (1) IN GENERAL.—The Secretary shall track 

2 metrics under the pilot program, including the fol3 lowing: 

4 (A) The number of veterans participating 

5 in the pilot program, disaggregated by Veterans 

6 Integrated Service Network. 

7 (B) Reliance on health care services ad8 ministered by the Secretary. 

9 (C) Reliance on health care services admin10 istered under the Medicare program under title 

11 XVIII of the Social Security Act (42 U.S.C. 

12 1395 et seq.). 

13 (D) Quality of care, including patient out14 comes. 

15 (E) Cost of care. 

16 (F) Access to care, including under the 

17 designated access standards developed by the 

18 Secretary under section 1703B of title 38, 

19 United States Code. 

20 (G) Patient satisfaction. 

21 (H) Provider satisfaction. 

22 (I) Care coordination, including timely in23 formation sharing and medical documentation 

24 return. 


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1 (2) ELEMENTS.—In tracking metrics under 

2 paragraph (1), the Secretary shall track information 

3 relating to— 

4 (A) whether care received by a covered vet5 eran is related to a service-connected disability 

6 (as defined in section 101 of title 38, United 

7 States Code); 

8 (B) the priority group under section 

9 1705(a) of title 38, United States Code, 

10 through which each covered veteran was en11 rolled in the system of annual patient enroll12 ment of the Department of Veterans Affairs 

13 under such section; 

14 (C) the type of care and services provided 

15 to covered veterans; and 

16 (D) the demographics of covered veterans 

17 participating in the pilot program, including 

18 age. 

19 (h) DURATION.—The Secretary shall carry out the 

20 pilot program for a 3-year period beginning on the com21 mencement of the pilot program. 

22 (i) REPORTS.— 

23 (1) DEVELOPMENT, IMPLEMENTATION, RE24 SULTS, AND DESIGN OF PILOT PROGRAM.— 


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1 (A) IN GENERAL.—Not less frequently 

2 than quarterly during the two-year period be3 ginning on the date of the enactment of this 

4 Act, the Secretary shall submit to the Com5 mittee on Veterans’ Affairs of the Senate and 

6 the Committee on Veterans’ Affairs of the 

7 House of Representatives a report on the devel8 opment, implementation, results, and design of 

9 the pilot program, including information on the 

10 metrics tracked under subsection (g). 

11 (B) FINAL DESIGN.—One of the reports 

12 required under subparagraph (A) shall contain 

13 a description of the final design of the pilot pro14 gram. 

15 (2) RESULTS OF PILOT PROGRAM.—Not later 

16 than one year after the submission of the final re17 port under paragraph (1), and not less frequently 

18 than annually thereafter during the duration of the 

19 pilot program, the Secretary shall submit to the 

20 Committee on Veterans’ Affairs of the Senate and 

21 the Committee on Veterans’ Affairs of the House of 

22 Representatives a report on the results of the pilot 

23 program. 

24 (3) FINAL REPORT.—Not later than 180 days 

25 before the termination of the pilot program, the SecVerDate Sep 11 2014 02:02 Jul 20, 2024 Jkt 049200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S4437.IS S4437

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1 retary shall submit to the Committee on Veterans’ 

2 Affairs of the Senate and the Committee on Vet3 erans’ Affairs of the House of Representatives a 

4 final report on the pilot program, which shall include 

5 the recommendation of the Secretary for whether the 

6 pilot program should be extended or made perma7 nent. 

8 (j) DEFINITIONS.—In this section: 

9 (1) COVERED VETERAN.—The term ‘‘covered 

10 veteran’’ means a veteran who is enrolled in both the 

11 Medicare program under title XVIII of the Social 

12 Security Act (42 U.S.C. 1395 et seq.) and the sys13 tem of annual patient enrollment of the Department 

14 of Veterans Affairs under section 1705(a) of title 

15 38, United States Code. 

16 (2) SECRETARY.—The term ‘‘Secretary’’ means 

17 the Secretary of Veterans Affairs. 

Æ 


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