```

[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 1182 Reported in Senate (RS)]

                                                       Calendar No. 284
109th CONGRESS
  1st Session
                                S. 1182

                          [Report No. 109-177]

   To amend title 38, United States Code, to improve health care for 
                   veterans, and for other purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                              June 7, 2005

   Mr. Craig introduced the following bill; which was read twice and 
             referred to the Committee on Veterans' Affairs

                           November 10, 2005

                Reported by Mr. Craig, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL

 
   To amend title 38, United States Code, to improve health care for 
                   veterans, and for other purposes.

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

<DELETED>SECTION 1. SHORT TITLE; REFERENCES TO TITLE 38, UNITED STATES 
              CODE.</DELETED>

<DELETED>    (a) Short Title.--This Act may be cited as the ``Veterans 
Health Care Act of 2005''.</DELETED>
<DELETED>    (b) References.--Except as otherwise expressly provided, 
whenever in this Act an amendment or repeal is expressed in terms of an 
amendment or repeal to a section or other provision, the reference 
shall be considered to be made to a section or other provision of title 
38, United States Code.</DELETED>

<DELETED>SEC. 2. COPAYMENT EXEMPTION FOR HOSPICE CARE.</DELETED>

<DELETED>    Section 1710 is amended--</DELETED>
        <DELETED>    (1) in subsection (f)(1), by inserting ``(other 
        than hospice care)'' after ``nursing home care''; and</DELETED>
        <DELETED>    (2) in subsection (g)(1), by inserting ``(other 
        than hospice care)'' after ``medical services''.</DELETED>

<DELETED>SEC. 3. NURSING HOME BED LEVELS; EXEMPTION FROM EXTENDED CARE 
              SERVICES COPAYMENTS FOR FORMER POWS.</DELETED>

<DELETED>    Section 1710B is amended--</DELETED>
        <DELETED>    (1) by striking subsection (b);</DELETED>
        <DELETED>    (2) by redesignating subsections (c) through (e) 
        as subsections (b) through (d), respectively; and</DELETED>
        <DELETED>    (3) in subsection (b)(2), as redesignated--
        </DELETED>
                <DELETED>    (A) by redesignating subparagraphs (B) and 
                (C) as subparagraphs (C) and (D), respectively; 
                and</DELETED>
                <DELETED>    (B) by inserting after subparagraph (A) 
                the following:</DELETED>
                <DELETED>    ``(B) to a veteran who is a former 
                prisoner of war;''.</DELETED>

<DELETED>SEC. 4. REIMBURSEMENT FOR CERTAIN VETERANS' OUTSTANDING 
              EMERGENCY TREATMENT EXPENSES. .</DELETED>

<DELETED>     (a) In General.--Subchapter III of chapter 17 is amended 
by inserting after section 1725 the following:</DELETED>
<DELETED>``Sec. 1725A. Reimbursement for emergency treatment expenses 
              for which certain veterans remain personally 
              liable</DELETED>
<DELETED>    ``(a)(1) Subject to subsection (c), the Secretary may 
reimburse a veteran described in subsection (b) for expenses resulting 
from emergency treatment furnished to the veteran in a non-Department 
facility for which the veteran remains personally liable.</DELETED>
<DELETED>    ``(2) In any case in which reimbursement is authorized 
under subsection (a)(1), the Secretary, in the Secretary's discretion, 
may, in lieu of reimbursing the veteran, make payment--</DELETED>
        <DELETED>    ``(A) to a hospital or other health care provider 
        that furnished the treatment; or</DELETED>
        <DELETED>    ``(B) to the person or organization that paid for 
        such treatment on behalf of the veteran.</DELETED>
<DELETED>    ``(b) A veteran referred to in subsection (a) is an 
individual who--</DELETED>
        <DELETED>    ``(1) is enrolled in the health care system 
        established under section 1705(a) of this title;</DELETED>
        <DELETED>    ``(2) received care under this chapter during the 
        24-month period preceding the furnishing of such emergency 
        treatment;</DELETED>
        <DELETED>    ``(3) is entitled to care or services under a 
        health-plan contract that partially reimburses the cost of the 
        veteran's emergency treatment;</DELETED>
        <DELETED>    ``(4) is financially liable to the provider of 
        emergency care treatment for costs not covered by the veteran's 
        health-plan contract, including copayments and deductibles; 
        and</DELETED>
        <DELETED>    ``(5) is not eligible for reimbursement for 
        medical care or services under section 1725 or 1728 of this 
        title.</DELETED>
<DELETED>    ``(c)(1) Any amount paid by the Secretary under subsection 
(a) shall exclude the amount of any payment the veteran would have been 
required to make to the United States under this chapter if the veteran 
had received the emergency treatment from the Department.</DELETED>
<DELETED>    ``(2) The Secretary may not provide reimbursement under 
this section with respect to any item or service--</DELETED>
        <DELETED>    ``(A) provided or for which payment has been made, 
        or can reasonably be expected to be made, under the veteran's 
        health-plan contract; or</DELETED>
        <DELETED>    ``(B) for which payment has been made or can 
        reasonably be expected to be made by a third party.</DELETED>
<DELETED>    ``(3)(A) Payment by the Secretary under this section on 
behalf of a veteran to a provider of emergency treatment shall, unless 
rejected and refunded by the provider within 30 days of receipt, 
extinguish any liability on the part of the veteran for that 
treatment.</DELETED>
<DELETED>    ``(B) The absence of a contract or agreement between the 
Secretary and the provider, any provision of a contract or agreement, 
or an assignment to the contrary shall not operate to modify, limit, or 
negate the requirement under subparagraph (A).</DELETED>
<DELETED>    ``(4) In accordance with regulations prescribed by the 
Secretary, the Secretary shall--</DELETED>
        <DELETED>    ``(A) establish criteria for determining the 
        amount of reimbursement (which may include a maximum amount) 
        payable under this section; and</DELETED>
        <DELETED>    ``(B) delineate the circumstances under which such 
        payment may be made, including requirements for requesting 
        reimbursement.</DELETED>
<DELETED>    ``(d)(1) In accordance with regulations prescribed by the 
Secretary, the United States shall have the independent right to 
recover any amount paid under this section if, and to the extent that, 
a third party subsequently makes a payment for the same emergency 
treatment.</DELETED>
<DELETED>    ``(2) Any amount paid by the United States to the veteran, 
the veteran's personal representative, successor, dependents, or 
survivors, or to any other person or organization paying for such 
treatment shall constitute a lien in favor of the United States against 
any recovery the payee subsequently receives from a third party for the 
same treatment.</DELETED>
<DELETED>    ``(3) Any amount paid by the United States to the provider 
that furnished the veteran's emergency treatment shall constitute a 
lien against any subsequent amount the provider receives from a third 
party for the same emergency treatment for which the United States made 
payment.</DELETED>
<DELETED>    ``(4) The veteran or the veteran's personal 
representative, successor, dependents, or survivors shall--</DELETED>
        <DELETED>    ``(A) ensure that the Secretary is promptly 
        notified of any payment received from any third party for 
        emergency treatment furnished to the veteran;</DELETED>
        <DELETED>    ``(B) immediately forward all documents relating 
        to a payment described in subparagraph (A);</DELETED>
        <DELETED>    ``(C) cooperate with the Secretary in an 
        investigation of a payment described in subparagraph (A); 
        and</DELETED>
        <DELETED>    ``(D) assist the Secretary in enforcing the United 
        States right to recover any payment made under subsection 
        (c)(3).</DELETED>
<DELETED>    ``(e) The Secretary may waive recovery of a payment made 
to a veteran under this section that is otherwise required under 
subsection (d)(1) if the Secretary determines that such waiver would be 
in the best interest of the United States, as defined by regulations 
prescribed by the Secretary.</DELETED>
<DELETED>    ``(f) For purposes of this section--</DELETED>
        <DELETED>    ``(1) the term `health-plan contract' includes--
        </DELETED>
                <DELETED>    ``(A) an insurance policy or contract, 
                medical or hospital service agreement, membership or 
                subscription contract, or similar arrangement, under 
                which health services for individuals are provided or 
                the expenses of such services are paid;</DELETED>
                <DELETED>    ``(B) an insurance program described in 
                section 1811 of the Social Security Act (42 U.S.C. 
                1395c) or established by section 1831 of that Act (42 
                U.S.C. 1395j);</DELETED>
                <DELETED>    ``(C) a State plan for medical assistance 
                approved under title XIX of such Act (42 U.S.C. 1396 et 
                seq.); and</DELETED>
                <DELETED>    ``(D) a workers' compensation law or plan 
                described in section 1729(A)(2)(B) of this 
                title;</DELETED>
        <DELETED>    ``(2) the term `third party' means--</DELETED>
                <DELETED>    ``(A) a Federal entity;</DELETED>
                <DELETED>    ``(B) a State or political subdivision of 
                a State;</DELETED>
                <DELETED>    ``(C) an employer or an employer's 
                insurance carrier; and</DELETED>
                <DELETED>    ``(D) a person or entity obligated to 
                provide, or pay the expenses of, such emergency 
                treatment; and</DELETED>
        <DELETED>    ``(3) the term `emergency treatment' has the 
        meaning given such term in section 1725 of this 
        title.''.</DELETED>
<DELETED>    (b) Clerical Amendment.--The table of sections at the 
beginning of chapter 17 is amended by inserting after the item relating 
to section 1725 the following:</DELETED>

<DELETED>``Sec. 1725A. Reimbursement for emergency treatment expenses 
                            for which certain veterans remain 
                            personally liable.''.

<DELETED>SEC. 5. CARE FOR NEWBORN CHILDREN OF WOMEN VETERANS RECEIVING 
              MATERNITY CARE .</DELETED>

<DELETED>    (a) In General.--Subchapter VIII of chapter 17 is amended 
by adding at the end the following:</DELETED>
<DELETED>``Sec. 1786. Care for newborn children of women veterans 
              receiving maternity care</DELETED>
<DELETED>    ``The Secretary may furnish care to a newborn child of a 
woman veteran, who is receiving maternity care furnished by the 
Department, for not more than 14 days after the birth of the child if 
the veteran delivered the child in a Department facility or in another 
facility pursuant to a Department contract for the delivery 
services.''.</DELETED>
<DELETED>    (b) Clerical Amendment.--The table of sections at the 
beginning of chapter 17 is amended by inserting after the item relating 
to section 1785 the following:</DELETED>

<DELETED>``Sec. 1786. Care for newborn children of women veterans 
                            receiving maternity care.''.

<DELETED>SEC. 6. ENHANCEMENT OF PAYER PROVISIONS FOR HEALTH CARE 
              FURNISHED TO CERTAIN CHILDREN OF VIETNAM 
              VETERANS.</DELETED>

<DELETED>    (a) Health Care for Spina Bifida and Associated 
Disabilities.--Section 1803 is amended--</DELETED>
        <DELETED>    (1) by redesignating subsection (c) as subsection 
        (d); and</DELETED>
        <DELETED>    (2) by inserting after subsection (b) the 
        following:</DELETED>
<DELETED>    ``(c)(1) If a payment made by the Secretary for health 
care under this section is less than the amount billed for such health 
care, the health care provider or agent of the health care provider 
may, in accordance with paragraphs (2) through (4), seek payment for 
the difference between the amount billed and the amount paid by the 
Secretary from a responsible third party to the extent that the 
provider or agent would be eligible to receive payment for such health 
care from such third party.</DELETED>
<DELETED>    ``(2) The health care provider or agent may not impose any 
additional charge on the beneficiary who received the health care, or 
the family of such beneficiary, for any service or item for which the 
Secretary has made payment under this section;</DELETED>
<DELETED>    ``(3) The total amount of payment a health care provider 
or agent may receive for health care furnished under this section may 
not exceed the amount billed to the Secretary.</DELETED>
<DELETED>    ``(4) The Secretary, upon request, shall disclose to such 
third party information received for the purposes of carrying out this 
section.''.</DELETED>
<DELETED>    (b) Health Care for Birth Defects and Associated 
Disabilities.--Section 1813 is amended--</DELETED>
        <DELETED>    (1) by redesignating subsection (c) as subsection 
        (d); and</DELETED>
        <DELETED>    (2) by inserting after subsection (b) the 
        following:</DELETED>
<DELETED>    ``(c)(1) If payment made by the Secretary for health care 
under this section is less than the amount billed for such health care, 
the health care provider or agent of the health care provider may, in 
accordance with paragraphs (2) through (4), seek payment for the 
difference between the amount billed and the amount paid by the 
Secretary from a responsible third party to the extent that the 
provider or agent would be eligible to receive payment for such health 
care from such third party.</DELETED>
<DELETED>    ``(2) The health care provider or agent may not impose any 
additional charge on the beneficiary who received health care, or the 
family of such beneficiary, for any service or item for which the 
Secretary has made payment under this section;</DELETED>
<DELETED>    ``(3) The total amount of payment a health care provider 
or agent may receive for health care furnished under this section may 
not exceed the amount billed to the Secretary; and</DELETED>
<DELETED>    ``(4) The Secretary, upon request, shall disclose to such 
third party information received for the purposes of carrying out this 
section.''.</DELETED>

<DELETED>SEC. 7. IMPROVEMENTS TO HOMELESS PROVIDERS GRANT AND PER DIEM 
              PROGRAM.</DELETED>

<DELETED>    (a) Permanent Authority.--Section 2011 (a) is amended--
</DELETED>
        <DELETED>    (1) in paragraph (1), by striking ``(1)''; 
        and</DELETED>
        <DELETED>    (2) by striking paragraph (2).</DELETED>
<DELETED>    (b) Authorization of Appropriations.--Section 2013 is 
amended to read as follows:</DELETED>
<DELETED>``Sec. 2013. Authorization of appropriations</DELETED>
<DELETED>    ``There are authorized to be appropriated $130,000,000 for 
fiscal year 2006 and each subsequent fiscal year to carry out this 
subchapter.''.</DELETED>

<DELETED>SEC. 8. MARRIAGE AND FAMILY THERAPISTS.</DELETED>

<DELETED>    (a) Qualifications.--Section 7402(b) is amended--
</DELETED>
        <DELETED>    (1) by redesignating paragraph (10) as paragraph 
        (11); and</DELETED>
        <DELETED>    (2) by inserting after paragraph (9) the 
        following:</DELETED>
<DELETED>    ``(10) Marriage and family therapist.--To be eligible to 
be appointed to a marriage and family therapist position, a person 
must--</DELETED>
        <DELETED>    ``(A) hold a master's degree in marriage and 
        family therapy, or a comparable degree in mental health, from a 
        college or university approved by the Secretary; and</DELETED>
        <DELETED>    ``(B) be licensed or certified to independently 
        practice marriage and family therapy in a State, except that 
        the Secretary may waive the requirement of licensure or 
        certification for an individual marriage and family therapist 
        for a reasonable period of time recommended by the Under 
        Secretary for Health.''.</DELETED>
<DELETED>    (b) Report on Marriage and Family Therapy Workload.--
</DELETED>
        <DELETED>    (1) In general.--Not later than 90 days after the 
        date of enactment of this Act, the Under Secretary for Health, 
        Department of Veterans Affairs, shall submit to the Committee 
        on Veterans' Affairs of the Senate and the Committee on 
        Veterans' Affairs of the House of Representatives a report on 
        the provisions of post-traumatic stress disorder treatment by 
        marriage and family therapists.</DELETED>
        <DELETED>    (2) Contents.--The report submitted under 
        paragraph (1) shall include--</DELETED>
                <DELETED>    (A) the actual and projected workloads in 
                facilities of the Veterans Readjustment Counseling 
                Service and the Veterans Health Administration for the 
                provision of marriage and family counseling for 
                veterans diagnosed with, or otherwise in need of 
                treatment for, post-traumatic stress 
                disorder;</DELETED>
                <DELETED>    (B) the resources available and needed to 
                support the workload projections described in 
                subparagraph (A);</DELETED>
                <DELETED>    (C) an assessment by the Under Secretary 
                for Health of the effectiveness of treatment by 
                marriage and family therapists; and</DELETED>
                <DELETED>    (D) recommendations, if any, for 
                improvements in the provision of such counseling 
                treatment.</DELETED>

<DELETED>SEC. 9. PAY COMPARABILITY FOR CHIEF NURSING OFFICER, OFFICE OF 
              NURSING SERVICES.</DELETED>

<DELETED>    Section 7404 is amended--</DELETED>
        <DELETED>    (1) in subsection (d), by striking ``subchapter 
        III'' and inserting ``paragraph (e), subchapter III,''; 
        and</DELETED>
        <DELETED>    (2) by adding at the end the following:</DELETED>
<DELETED>    ``(e) The position of Chief Nursing Officer, Office of 
Nursing Services, shall be exempt from the provisions of section 7451 
of this title and shall be paid at a rate not to exceed the maximum 
rate established for the Senior Executive Service under section 5382 of 
title 5 United States Code, as determined by the 
Secretary.''.</DELETED>

<DELETED>SEC. 10. REPEAL OF COST COMPARISON STUDIES 
              PROHIBITION.</DELETED>

<DELETED>    Section 8110(a) is amended--</DELETED>
        <DELETED>    (1) by striking paragraph (5); and</DELETED>
        <DELETED>    (2) by redesignating paragraph (6) as paragraph 
        (5).</DELETED>

<DELETED>SEC. 11. IMPROVEMENTS AND EXPANSION OF MENTAL HEALTH 
              SERVICES.</DELETED>

<DELETED>    (a) In General.--The Secretary of Veterans affairs shall--
</DELETED>
        <DELETED>    (1) expand the number of clinical treatment teams 
        principally dedicated to the treatment of post-traumatic stress 
        disorder in medical facilities of the Department of Veterans 
        Affairs;</DELETED>
        <DELETED>    (2) expand and improve the services available to 
        diagnose and treat substance abuse;</DELETED>
        <DELETED>    (3) expand and improve tele-health initiatives to 
        provide better access to mental health services in areas of the 
        country in which the Secretary determines that a need for such 
        services exist due to the distance of such locations from an 
        appropriate facility of the Department of Veterans 
        Affairs;</DELETED>
        <DELETED>    (4) improve education programs available to 
        primary care delivery professionals and dedicate such programs 
        to recognize, treat, and clinically manage veterans with mental 
        health care needs;</DELETED>
        <DELETED>    (5) expand the delivery of mental health services 
        in community-based outpatient clinics of the Department of 
        Veterans Affairs in which such services are not available as of 
        the date of enactment of this Act; and</DELETED>
        <DELETED>    (6) expand and improve the Mental Health Intensive 
        Case Management Teams for the treatment and clinical case 
        management of veterans with serious or chronic mental 
        illness.</DELETED>
<DELETED>    (b) Authorization of Appropriations.--There are authorized 
to be appropriated in each of fiscal years 2006 and 2007, $95,000,000 
to improve and expand the treatment services and options available to 
veterans in need of mental health treatment from the Department of 
Veterans Affairs, of which--</DELETED>
        <DELETED>    (1) $5,000,000 shall be allocated to carry out 
        subsection (a)(1);</DELETED>
        <DELETED>    (2) $50,000,000 shall be allocated to carry out 
        subsection (a)(2);</DELETED>
        <DELETED>    (3) $10,000,000 shall be allocated to carry out 
        subsection (a)(3);</DELETED>
        <DELETED>    (4) $1,000,000 shall be allocated to carry out 
        subsection (a)(4);</DELETED>
        <DELETED>    (5) $20,000,000 shall be allocated to carry out 
        subsection (a)(5); and</DELETED>
        <DELETED>    (6) $5,000,000 shall be allocated to carry out 
        subsection (a)(6).</DELETED>

<DELETED>SEC. 12. DATA SHARING IMPROVEMENTS.</DELETED>

<DELETED>    Notwithstanding any other provision of law, the Department 
of Veterans Affairs and the Department of Defense may exchange 
protected health information for--</DELETED>
        <DELETED>    (1) patients receiving treatment from the 
        Department of Veterans Affairs; or</DELETED>
        <DELETED>    (2) individuals who may receive treatment from the 
        Department of Veterans Affairs in the future, including all 
        current and former members of the Armed Services.</DELETED>

<DELETED>SEC. 13. EXPANSION OF NATIONAL GUARD OUTREACH 
              PROGRAM.</DELETED>

<DELETED>    (a) Requirement.--The Secretary of Veterans Affairs shall 
expand the total number of personal employed by the Department of 
Veterans Affairs as part of the Readjustment Counseling Service's 
Global War on Terrorism Outreach Program (referred to in this section 
as the ``Program'').</DELETED>
<DELETED>    (b) Coordination.--In carrying out subsection (a), the 
Secretary shall coordinate participation in the Program by appropriate 
employees of the Veterans Benefits Administration and the Veterans 
Health Administration.</DELETED>
<DELETED>    (c) Information and Assessments.--The Secretary shall 
ensure that--</DELETED>
        <DELETED>    (1) all appropriate health, education, and 
        benefits information is available to returning members of the 
        National Guard; and</DELETED>
        <DELETED>    (2) proper assessments of the needs in each of 
        these areas is made by the Department of Veterans 
        Affairs.</DELETED>
<DELETED>    (d) Collaboration.--The Secretary of Veterans Affairs 
shall collaborate with appropriate State National Guard officials and 
provide such officials with any assets or services of the Department of 
Veterans Affairs that the Secretary determines to be necessary to carry 
out the Global War on Terrorism Outreach Program.</DELETED>

<DELETED>SEC. 14. EXPANSION OF TELE-HEALTH SERVICES.</DELETED>

<DELETED>    (a) In General.--The Secretary shall increase the number 
of Veterans Readjustment Counseling Service facilities capable of 
providing health services and counseling through tele-health linkages 
with facilities of the Veterans Health Administration.</DELETED>
<DELETED>    (b) Plan.--The Secretary shall submit to the Committee on 
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs 
of the House of Representatives a plan to implement the requirement 
under subsection (a), which shall describe the facilities that will 
have such capabilities at the end of each of fiscal years 2005, 2006, 
and 2007.</DELETED>

<DELETED>SEC. 15. MENTAL HEALTH DATA SOURCES REPORT.</DELETED>

<DELETED>    (a) In General.--Not less than 180 days after the date of 
enactment of this Act, the Secretary of Veterans Affairs shall submit a 
report to the Committee on Veterans' Affairs of the Senate and the 
Committee on Veterans' Affairs of the House of Representatives 
describing the mental health data maintained by the Department of 
Veterans Affairs.</DELETED>
<DELETED>    (b) Contents.--The report submitted under subsection (a) 
shall include--</DELETED>
        <DELETED>    (1) a comprehensive list of the sources of all 
        such data, including the geographic locations of facilities of 
        the Department of Veterans Affairs maintaining such 
        data;</DELETED>
        <DELETED>    (2) an assessment of the limitations or advantages 
        to maintaining the current data configuration and locations; 
        and</DELETED>
        <DELETED>    (3) any recommendations, if any, for improving the 
        collection, use, and location of mental health data maintained 
        by the Department of Veterans Affairs.</DELETED>

SECTION 1. SHORT TITLE; REFERENCES TO TITLE 38, UNITED STATES CODE; 
              TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Veterans Health 
Care Act of 2005''.
    (b) References.--Except as otherwise expressly provided, whenever 
in this Act an amendment or repeal is expressed in terms of an 
amendment or repeal to a section or other provision, the reference 
shall be considered to be made to a section or other provision of title 
38, United States Code.
    (c) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; references to title 38, United States Code; table 
                            of contents.
Sec. 2. Care for newborn children of women veterans receiving maternity 
                            care.
Sec. 3. Enhancement of payer provisions for health care furnished to 
                            certain children of Vietnam veterans.
Sec. 4. Improvements to homeless veterans service providers programs.
Sec. 5. Additional mental health providers.
Sec. 6. Pay comparability for Chief Nursing Officer, Office of Nursing 
                            Services.
Sec. 7. Repeal of cost comparison studies prohibition.
Sec. 8. Improvements and expansion of mental health services.
Sec. 9. Data sharing improvements.
Sec. 10. Expansion of National Guard Outreach Program.
Sec. 11. Expansion of tele-health services.
Sec. 12. Mental health data sources report.
Sec. 13. Strategic plan for long-term care.
Sec. 14. Blind rehabilitation outpatient specialists.
Sec. 15. Compliance report.
Sec. 16. Health care and services for veterans affected by Hurricane 
                            Katrina.
Sec. 17. Reimbursement for certain veterans' outstanding emergency 
                            treatment expenses.

SEC. 2. CARE FOR NEWBORN CHILDREN OF WOMEN VETERANS RECEIVING MATERNITY 
              CARE.

    (a) In General.--Subchapter VIII of chapter 17 is amended by adding 
at the end the following:
``Sec. 1786. Care for newborn children of women veterans receiving 
              maternity care
    ``The Secretary may furnish care to a newborn child of a woman 
veteran, who is receiving maternity care furnished by the Department, 
for not more than 14 days after the birth of the child if the veteran 
delivered the child in a Department facility or in another facility 
pursuant to a Department contract for the delivery services.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 is amended by inserting after the item relating to section 
1785 the following:

``Sec. 1786. Care for newborn children of women veterans receiving 
                            maternity care.''.

SEC. 3. ENHANCEMENT OF PAYER PROVISIONS FOR HEALTH CARE FURNISHED TO 
              CERTAIN CHILDREN OF VIETNAM VETERANS.

    (a) Health Care for Spina Bifida and Associated Disabilities.--
Section 1803 is amended--
            (1) by redesignating subsection (c) as subsection (d); and
            (2) by inserting after subsection (b) the following:
    ``(c)(1) If a payment made by the Secretary for health care under 
this section is less than the amount billed for such health care, the 
health care provider or agent of the health care provider may, in 
accordance with paragraphs (2) through (4), seek payment for the 
difference between the amount billed and the amount paid by the 
Secretary from a responsible third party to the extent that the 
provider or agent would be eligible to receive payment for such health 
care from such third party.
    ``(2) The health care provider or agent may not impose any 
additional charge on the beneficiary who received the health care, or 
the family of such beneficiary, for any service or item for which the 
Secretary has made payment under this section.
    ``(3) The total amount of payment a health care provider or agent 
may receive for health care furnished under this section may not exceed 
the amount billed to the Secretary.
    ``(4) The Secretary, upon request, shall disclose to such third 
party information received for the purposes of carrying out this 
section.''.
    (b) Health Care for Birth Defects and Associated Disabilities.--
Section 1813 is amended--
            (1) by redesignating subsection (c) as subsection (d); and
            (2) by inserting after subsection (b) the following:
    ``(c)(1) If payment made by the Secretary for health care under 
this section is less than the amount billed for such health care, the 
health care provider or agent of the health care provider may, in 
accordance with paragraphs (2) through (4), seek payment for the 
difference between the amount billed and the amount paid by the 
Secretary from a responsible third party to the extent that the 
provider or agent would be eligible to receive payment for such health 
care from such third party.
    ``(2) The health care provider or agent may not impose any 
additional charge on the beneficiary who received health care, or the 
family of such beneficiary, for any service or item for which the 
Secretary has made payment under this section.
    ``(3) The total amount of payment a health care provider or agent 
may receive for health care furnished under this section may not exceed 
the amount billed to the Secretary.
    ``(4) The Secretary, upon request, shall disclose to such third 
party information received for the purposes of carrying out this 
section.''.

SEC. 4. IMPROVEMENTS TO HOMELESS VETERANS SERVICE PROVIDERS PROGRAMS.

    (a) Permanent Authority.--Section 2011 (a) is amended--
            (1) in paragraph (1), by striking ``(1)''; and
            (2) by striking paragraph (2).
    (b) Authorization of Appropriations.--
            (1) Comprehensive service programs for homeless veterans.--
        Section 2013 is amended to read as follows:
``Sec. 2013. Authorization of appropriations
    ``There are authorized to be appropriated $130,000,000 for fiscal 
year 2006 and each subsequent fiscal year to carry out this 
subchapter.''.
            (2) Homeless veteran service provider technical assistance 
        program.--Section 2064(b) is amended to read as follows:
    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated $1,000,000 for each of fiscal years 2006 through 2011 to 
carry out the programs under this section.''.

SEC. 5. ADDITIONAL MENTAL HEALTH PROVIDERS.

    (a) Qualifications.--Section 7402(b) is amended--
            (1) by redesignating paragraph (10) as paragraph (12); and
            (2) by inserting after paragraph (9) the following:
    ``(10) Marriage and family therapist.--To be eligible to be 
appointed to a marriage and family therapist position, a person shall--
            ``(A) hold a master's degree in marriage and family 
        therapy, or a comparable degree in mental health, from a 
        college or university approved by the Secretary; and
            ``(B) be licensed or certified to independently practice 
        marriage and family therapy in a State, except that the 
        Secretary may waive the requirement of licensure or 
        certification for an individual marriage and family therapist 
        for a reasonable period of time recommended by the Under 
        Secretary for Health.
    ``(11) Licensed professional mental health counselors.--To be 
eligible to be appointed to a licensed professional mental health 
counselor position, a person shall--
            ``(A) hold a master's degree in mental health counseling, 
        or a related field, from a college or university approved by 
        the Secretary; and
            ``(B) be licensed or certified to independently practice 
        mental health counseling.''.
    (b) Report on Marriage and Family Therapy Workload.--
            (1) In general.--Not later than 90 days after the date of 
        enactment of this Act, the Under Secretary for Health, 
        Department of Veterans Affairs, shall submit to the Committee 
        on Veterans' Affairs of the Senate and the Committee on 
        Veterans' Affairs of the House of Representatives a report on 
        the provisions of post-traumatic stress disorder treatment by 
        marriage and family therapists.
            (2) Contents.--The report submitted under paragraph (1) 
        shall include--
                    (A) the actual and projected workloads in 
                facilities of the Veterans Readjustment Counseling 
                Service and the Veterans Health Administration for the 
                provision of marriage and family counseling for 
                veterans diagnosed with, or otherwise in need of 
                treatment for, post-traumatic stress disorder;
                    (B) the resources available and needed to support 
                the workload projections described in subparagraph (A);
                    (C) an assessment by the Under Secretary for Health 
                of the effectiveness of treatment by marriage and 
                family therapists; and
                    (D) recommendations, if any, for improvements in 
                the provision of such counseling treatment.

SEC. 6. PAY COMPARABILITY FOR CHIEF NURSING OFFICER, OFFICE OF NURSING 
              SERVICES.

    Section 7404 is amended--
            (1) in subsection (d), by striking ``subchapter III and 
        in'' and inserting ``subsection (e), subchapter III, and''; and
            (2) by adding at the end the following:
    ``(e) The position of Chief Nursing Officer, Office of Nursing 
Services, shall be exempt from the provisions of section 7451 of this 
title and shall be paid at a rate not to exceed the maximum rate 
established for the Senior Executive Service under section 5382 of 
title 5 United States Code, as determined by the Secretary.''.

SEC. 7. REPEAL OF COST COMPARISON STUDIES PROHIBITION.

    Section 8110(a) is amended--
            (1) by striking paragraph (5); and
            (2) by redesignating paragraph (6) as paragraph (5).

SEC. 8. IMPROVEMENTS AND EXPANSION OF MENTAL HEALTH SERVICES.

    (a) Findings.--Congress makes the following findings:
            (1) Mental health treatment capacity at community-based 
        outpatient clinics remains inadequate and inconsistent, despite 
        the requirement under section 1706(c) of title 38, United 
        States Code, that every primary care health care facility of 
        the Department of Veterans Affairs develop and carry out a plan 
        to meet the mental health care needs of veterans who require 
        such services.
            (2) In 2001, the minority staff of the Committee on 
        Veterans' Affairs of the Senate conducted a survey of 
        community-based outpatient clinics and found that there was no 
        established systemwide baseline of acceptable mental health 
        service levels at such clinics.
            (3) In February 2005, the Government Accountability Office 
        reported that the Department of Veterans Affairs had not fully 
        met any of the 24 clinical care and education recommendations 
        made in 2004 by the Special Committee on Post-Traumatic Stress 
        Disorder of the Under Secretary for Health, Veterans Health 
        Administration.
    (b) Clinical Services and Education.--
            (1) In general.--The Secretary of Veterans affairs shall--
                    (A) expand the number of clinical treatment teams 
                principally dedicated to the treatment of post-
                traumatic stress disorder in medical facilities of the 
                Department of Veterans Affairs;
                    (B) expand and improve the services available to 
                diagnose and treat substance abuse;
                    (C) expand and improve tele-health initiatives to 
                provide better access to mental health services in 
                areas of the country in which the Secretary determines 
                that a need for such services exist due to the distance 
                of such locations from an appropriate facility of the 
                Department of Veterans Affairs;
                    (D) improve education programs available to primary 
                care delivery professionals and dedicate such programs 
                to recognize, treat, and clinically manage veterans 
                with mental health care needs;
                    (E) expand the delivery of mental health services 
                in community-based outpatient clinics of the Department 
                of Veterans Affairs in which such services are not 
                available as of the date of enactment of this Act; and
                    (F) expand and improve the Mental Health Intensive 
                Case Management Teams for the treatment and clinical 
                case management of veterans with serious or chronic 
                mental illness.
            (2) Authorization of appropriations.--There are authorized 
        to be appropriated $95,000,000 in each of fiscal years 2006 and 
        2007 to improve and expand the treatment services and options 
        available to veterans in need of mental health treatment from 
        the Department of Veterans Affairs, of which--
                    (A) $5,000,000 shall be allocated to carry out 
                paragraph (1)(A);
                    (B) $50,000,000 shall be allocated to carry out 
                paragraph (1)(B);
                    (C) $10,000,000 shall be allocated to carry out 
                paragraph (1)(C);
                    (D) $1,000,000 shall be allocated to carry out 
                paragraph (1)(D);
                    (E) $20,000,000 shall be allocated to carry out 
                paragraph (1)(E); and
                    (F) $5,000,000 shall be allocated to carry out 
                paragraph (1)(F).
    (c) Required Capacity for Community-Based Outpatient Clinics.--
            (1) Accountability for the provision of mental health 
        services.--The Under Secretary shall take appropriate steps and 
        provide necessary incentives (including appropriate performance 
        incentives) to ensure that each Regional Director of the 
        Veterans Health Administration is encouraged to--
                    (A) prioritize the provision of mental health 
                services to veterans in need of such services;
                    (B) foster collaborative working environments among 
                clinicians for the provision of mental health services; 
                and
                    (C) conduct mental health consultations during 
                primary care appointments.
            (2) Mental health and substance abuse services.--
                    (A) In general.--The Secretary shall ensure that 
                each community-based outpatient clinic of the 
                Department has the capacity to provide, or monitor the 
                provision of, mental health services to enrolled 
                veterans in need of such services.
                    (B) Settings.--In carrying out subparagraph (A), 
                the Secretary shall ensure that mental health services 
                are provided through--
                            (i) a community-based outpatient clinic of 
                        the Department by an employee of the 
                        Department;
                            (ii) referral to another facility of the 
                        Department;
                            (iii) contract with an appropriate mental 
                        health professional in the local community; or
                            (iv) tele-mental health service.
            (3) Reporting requirement.--Not later than January 31, 
        2008, the Secretary of Veterans Affairs shall submit a report 
        to Congress that--
                    (A) describes the status and availability of mental 
                health services at community-based outpatient clinics;
                    (B) describes the substance of services available 
                at such clinics; and
                    (C) includes the ratios between mental health staff 
                and patients at such clinics.
    (d) Cooperation on Mental Health Awareness and Prevention.--
            (1) Agreement.--The Secretary of Defense and the Secretary 
        of Veterans Affairs shall enter into a Memorandum of 
        Understanding--
                    (A) to ensure that separating service members 
                receive standardized individual mental health and 
                sexual trauma assessments as part of separation exams; 
                and
                    (B) that includes the development of shared 
                guidelines on how to conduct the assessments.
            (2) Establishment of joint veterans affairs-department of 
        defense workgroup on mental health.--
                    (A) In general.--Not later than 180 days after the 
                date of enactment of this Act, the Secretary of Defense 
                and the Secretary of Veterans Affairs shall establish a 
                joint workgroup on mental health, which shall be 
                comprised of not less than 7 leaders in the field of 
                mental health appointed from their respective 
                departments.
                    (B) Study.--Not later than 1 year after the 
                establishment of the workgroup under subparagraph (A), 
                the workgroup shall analyze the feasibility, content, 
                and scope of initiatives related to--
                            (i) combating stigmas and prejudices 
                        associated with service members who suffer from 
                        mental health disorders or readjustment issues, 
                        through the use of peer counseling programs or 
                        other educational initiatives;
                            (ii) ways in which the Department of 
                        Veterans Affairs can make their expertise in 
                        treating mental health disorders more readily 
                        available to Department of Defense mental 
                        health care providers;
                            (iii) family and spousal education to 
                        assist family members of veterans and service 
                        members to recognize and deal with signs of 
                        potential readjustment issues or other mental 
                        health disorders; and
                            (iv) the seamless transition of service 
                        members who have been diagnosed with mental 
                        health disorders from active duty to veteran 
                        status (in consultation with the Seamless 
                        Transition Task Force and other entities 
                        assisting in this effort).
                    (C) Report.--Not later than June 30, 2007, the 
                Secretary of Defense and the Secretary of Veterans 
                Affairs shall submit a report to Congress containing 
                the findings and recommendations of the workgroup 
                established under this paragraph.
    (e) Primary Care Consultations for Mental Health.--
            (1) Guidelines.--The Under Secretary for Health, Veterans 
        Health Administration, shall establish systemwide guidelines 
        for screening primary care patients for mental health disorders 
        and illnesses.
            (2) Training.--Based upon the guidelines established under 
        paragraph (1), the Under Secretary for Health, Veterans Health 
        Administration, shall conduct appropriate training for 
        clinicians of the Department of Veterans Affairs to carry out 
        mental health consultations.
    (f) Clinical Training and Protocols.--
            (1) Findings.--Congress finds that--
                    (A) the Iraq War Clinician Guide has tremendous 
                value; and
                    (B) the Secretary of Defense and the National 
                Center on Post Traumatic Stress Disorder should 
                continue to work together to ensure that the mental 
                health care needs of servicemembers and veterans are 
                met.
            (2) Collaboration.--The National Center on Post Traumatic 
        Stress Disorder shall collaborate with the Secretary of 
        Defense--
                    (A) to enhance the clinical skills of military 
                clinicians through training, treatment protocols, web-
                based interventions, and the development of evidence-
                based interventions; and
                    (B) to promote pre-deployment resilience and post-
                deployment readjustment among servicemembers serving in 
                Operation Iraqi Freedom and Operation Enduring Freedom.
            (3) Training.--The National Center on Post Traumatic Stress 
        Disorder shall work with the Secretary of Defense to ensure 
        that clinicians in the Department of Defense are provided with 
        the training and protocols developed pursuant to paragraph 
        (2)(A).
            (4) Authorization of appropriations.--There are authorized 
        to be appropriated $2,000,000 for 2006 to carry out this 
        subsection.

SEC. 9. DATA SHARING IMPROVEMENTS.

    Notwithstanding any other provision of law, the Department of 
Veterans Affairs and the Department of Defense may exchange protected 
health information for--
            (1) patients receiving treatment from the Department of 
        Veterans Affairs; or
            (2) individuals who may receive treatment from the 
        Department of Veterans Affairs in the future, including all 
        current and former members of the armed services.

SEC. 10. EXPANSION OF NATIONAL GUARD OUTREACH PROGRAM.

    (a) Requirement.--The Secretary of Veterans Affairs shall expand 
the total number of personal employed by the Department of Veterans 
Affairs as part of the Readjustment Counseling Service's Global War on 
Terrorism Outreach Program (referred to in this section as the 
``Program'').
    (b) Coordination.--In carrying out subsection (a), the Secretary 
shall coordinate participation in the Program by appropriate employees 
of the Veterans Benefits Administration and the Veterans Health 
Administration.
    (c) Information and Assessments.--The Secretary shall ensure that--
            (1) all appropriate health, education, and benefits 
        information is available to returning members of the National 
        Guard; and
            (2) proper assessments of the needs in each of these areas 
        is made by the Department of Veterans Affairs.
    (d) Collaboration.--The Secretary of Veterans Affairs shall 
collaborate with appropriate State National Guard officials and provide 
such officials with any assets or services of the Department of 
Veterans Affairs that the Secretary determines to be necessary to carry 
out the Global War on Terrorism Outreach Program.

SEC. 11. EXPANSION OF TELE-HEALTH SERVICES.

    (a) In General.--The Secretary shall increase the number of 
Veterans Readjustment Counseling Service facilities capable of 
providing health services and counseling through tele-health linkages 
with facilities of the Veterans Health Administration.
    (b) Plan.--The Secretary shall submit to the Committee on Veterans' 
Affairs of the Senate and the Committee on Veterans' Affairs of the 
House of Representatives a plan to implement the requirement under 
subsection (a), which shall describe the facilities that will have such 
capabilities at the end of each of fiscal years 2005, 2006, and 2007.

SEC. 12. MENTAL HEALTH DATA SOURCES REPORT.

    (a) In General.--Not less than 180 days after the date of enactment 
of this Act, the Secretary of Veterans Affairs shall submit a report to 
the Committee on Veterans' Affairs of the Senate and the Committee on 
Veterans' Affairs of the House of Representatives describing the mental 
health data maintained by the Department of Veterans Affairs.
    (b) Contents.--The report submitted under subsection (a) shall 
include--
            (1) a comprehensive list of the sources of all such data, 
        including the geographic locations of facilities of the 
        Department of Veterans Affairs maintaining such data;
            (2) an assessment of the limitations or advantages to 
        maintaining the current data configuration and locations; and
            (3) any recommendations, if any, for improving the 
        collection, use, and location of mental health data maintained 
        by the Department of Veterans Affairs.

SEC. 13. STRATEGIC PLAN FOR LONG-TERM CARE.

    (a) Publication.--Not later than 180 days after the date of 
enactment of this Act, the Secretary of Veterans Affairs shall publish 
a strategic plan for long-term care.
    (b) Contents.--The plan published under subsection (a) shall--
            (1) contain policies and strategies for--
                    (A) the delivery of care in domiciliaries, 
                residential treatment facilities, and nursing homes, 
                and for seriously mentally ill veterans;
                    (B) maximizing the use of State veterans homes;
                    (C) locating domiciliary units as close to patient 
                populations as feasible; and
                    (D) identifying freestanding nursing homes as an 
                acceptable care model;
            (2) include data on--
                    (A) the care of catastrophically disabled veterans; 
                and
                    (B) the geographic distribution of catastrophically 
                disabled veterans;
            (3) address the spectrum of noninstitutional long-term care 
        options, including--
                    (A) respite care;
                    (B) home-based primary care;
                    (C) geriatric evaluation;
                    (D) adult day health care;
                    (E) skilled home health care; and
                    (F) community residential care; and
            (4) provide--
                    (A) cost and quality comparison analyses of all the 
                different levels of care;
                    (B) detailed information about geographic 
                distribution of services and gaps in care; and
                    (C) specific plans for working with Medicare, 
                Medicaid, and private insurance companies to expand 
                care.

SEC. 14. BLIND REHABILITATION OUTPATIENT SPECIALISTS.

    (a) Findings.--Congress makes the following findings:
            (1) There are approximately 135,000 blind veterans 
        throughout the United States, including approximately 35,000 
        who are enrolled with the Department of Veterans Affairs. An 
        aging veteran population and injuries incurred in Operation 
        Iraqi Freedom and Operation Enduring Freedom are increasing the 
        number of blind veterans.
            (2) Since 1996, when the Department of Veterans Affairs 
        hired its first 14 blind rehabilitation outpatient specialists 
        (referred to in this section as ``Specialists'', Specialists 
        have been a critical part of the continuum of care for blind 
        and visually impaired veterans.
            (3) The Department of Veterans Affairs operates 10 
        residential blind rehabilitation centers that are considered 
        among the best in the world. These centers have had long 
        waiting lists, with as many as 1,500 blind veterans waiting for 
        openings in 2004.
            (4) Specialists provide--
                    (A) critically needed services to veterans who are 
                unable to attend residential centers or are waiting to 
                enter such a program;
                    (B) a range of services, including training with 
                living skills, mobility, and adaptation of manual 
                skills; and
                    (C) pre-admission screening and follow-up care for 
                blind rehabilitation centers.
            (5) There are not enough Specialist positions to meet the 
        increased numbers and needs of blind veterans.
    (b) Establishment of Specialist Positions.--Not later than 30 
months after the date of enactment of this Act, the Secretary of 
Veterans Affairs shall establish a Specialist position at not fewer 
than 35 facilities of the Department of Veterans Affairs.
    (c) Selection of Facilities.--In identifying the most appropriate 
facilities to receive a Specialist position under this section, the 
Secretary shall--
            (1) give priority to facilities with large numbers of 
        enrolled legally blind veterans;
            (2) ensure that each facility does not have such a 
        position; and
            (3) ensure that each facility is in need of the services of 
        such Specialists.
    (d) Coordination.--The Secretary shall coordinate the provision of 
blind rehabilitation services for veterans with services for the care 
of the visually impaired offered by State and local agencies, 
especially if such State and local agencies can provide similar 
services to veterans in settings located closer to the residences of 
such veterans.
    (e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $3,500,000 for each of the 
fiscal years 2006 through 2011.

SEC. 15. COMPLIANCE REPORT.

    Section 1706(b)(5)(A) is amended by striking ``2004'' and inserting 
``2006''.

SEC. 16. HEALTH CARE AND SERVICES FOR VETERANS AFFECTED BY HURRICANE 
              KATRINA.

    (a) Requirement for Hospital Care and Medical Services for Priority 
8 Veterans Affected by Hurricane Katrina.--
            (1) In general.--Notwithstanding any other provision of law 
        and any notwithstanding any previous decisions made by the 
        Secretary of Veterans Affairs pursuant to chapter 17 of title 
        38 United States Code, the Secretary shall provide necessary 
        medical and health care services to any veteran affected by 
        Hurricane Katrina as if such veteran was enrolled for care 
        under section 1705 of title 38, United States Code.
            (2) Status of veterans.--For purposes of managing the 
        health care system, as required under section 1705 of title 38, 
        United States Code, a veteran who seeks care under paragraph 
        (1) shall not be considered to be an enrollee of the health 
        care system under such section unless the Secretary 
        subsequently designates such a veteran as such an enrollee.
    (b) Prohibition on Collection of Copayments for Veterans Affected 
by Hurricane Katrina.--In furnishing hospital care and medical services 
to any veteran affected by Hurricane Katrina, the Secretary shall not 
collect from, or with respect to, such veteran any payment for such 
care and services otherwise required under any provision of law, 
including any copayment for medications otherwise required under 
section 1722A of title 38, United States Code.
    (c) Definition.--In this section, the term ``veteran affected by 
Hurricane Katrina'' means any veteran who, as of August 29, 2005, 
resided in the catchment region of the Department of Veterans Affairs 
medical center in--
            (1) New Orleans, Louisiana;
            (2) Biloxi, Mississippi; or
            (3) Gulfport, Mississippi.
    (d) Sunset Provision.--The authority under this section shall 
expire on January 31, 2006.

SEC. 17. REIMBURSEMENT FOR CERTAIN VETERANS' OUTSTANDING EMERGENCY 
              TREATMENT EXPENSES. .

     (a) In General.--Subchapter III of chapter 17 is amended by 
inserting after section 1725 the following:
``Sec. 1725A. Reimbursement for emergency treatment expenses for which 
              certain veterans remain personally liable
    ``(a)(1) Subject to subsection (c), the Secretary may reimburse a 
veteran described in subsection (b) for expenses resulting from 
emergency treatment furnished to the veteran in a non-Department 
facility for which the veteran remains personally liable.
    ``(2) In any case in which reimbursement is authorized under 
subsection (a)(1), the Secretary, in the Secretary's discretion, may, 
in lieu of reimbursing the veteran, make payment--
            ``(A) to a hospital or other health care provider that 
        furnished the treatment; or
            ``(B) to the person or organization that paid for such 
        treatment on behalf of the veteran.
    ``(b) A veteran referred to in subsection (a) is an individual 
who--
            ``(1) is enrolled in the health care system established 
        under section 1705(a) of this title;
            ``(2) received care under this chapter during the 24-month 
        period preceding the furnishing of such emergency treatment;
            ``(3) is entitled to care or services under a health-plan 
        contract that partially reimburses the cost of the veteran's 
        emergency treatment;
            ``(4) is financially liable to the provider of emergency 
        care treatment for costs not covered by the veteran's health-
        plan contract, including copayments and deductibles; and
            ``(5) is not eligible for reimbursement for medical care or 
        services under section 1725 or 1728 of this title.
    ``(c)(1) Any amount paid by the Secretary under subsection (a) 
shall exclude the amount of any payment the veteran would have been 
required to make to the United States under this chapter if the veteran 
had received the emergency treatment from the Department.
    ``(2) The Secretary may not provide reimbursement under this 
section with respect to any item or service--
            ``(A) provided or for which payment has been made, or can 
        reasonably be expected to be made, under the veteran's health-
        plan contract; or
            ``(B) for which payment has been made or can reasonably be 
        expected to be made by a third party.
    ``(3)(A) Payment by the Secretary under this section on behalf of a 
veteran to a provider of emergency treatment shall, unless rejected and 
refunded by the provider within 30 days of receipt, extinguish any 
liability on the part of the veteran for that treatment.
    ``(B) The absence of a contract or agreement between the Secretary 
and the provider, any provision of a contract or agreement, or an 
assignment to the contrary shall not operate to modify, limit, or 
negate the requirement under subparagraph (A).
    ``(4) In accordance with regulations prescribed by the Secretary, 
the Secretary shall--
            ``(A) establish criteria for determining the amount of 
        reimbursement (which may include a maximum amount) payable 
        under this section; and
            ``(B) delineate the circumstances under which such payment 
        may be made, including requirements for requesting 
        reimbursement.
    ``(d)(1) In accordance with regulations prescribed by the 
Secretary, the United States shall have the independent right to 
recover any amount paid under this section if, and to the extent that, 
a third party subsequently makes a payment for the same emergency 
treatment.
    ``(2) Any amount paid by the United States to the veteran, the 
veteran's personal representative, successor, dependents, or survivors, 
or to any other person or organization paying for such treatment shall 
constitute a lien in favor of the United States against any recovery 
the payee subsequently receives from a third party for the same 
treatment.
    ``(3) Any amount paid by the United States to the provider that 
furnished the veteran's emergency treatment shall constitute a lien 
against any subsequent amount the provider receives from a third party 
for the same emergency treatment for which the United States made 
payment.
    ``(4) The veteran or the veteran's personal representative, 
successor, dependents, or survivors shall--
            ``(A) ensure that the Secretary is promptly notified of any 
        payment received from any third party for emergency treatment 
        furnished to the veteran;
            ``(B) immediately forward all documents relating to a 
        payment described in subparagraph (A);
            ``(C) cooperate with the Secretary in an investigation of a 
        payment described in subparagraph (A); and
            ``(D) assist the Secretary in enforcing the United States 
        right to recover any payment made under subsection (c)(3).
    ``(e) The Secretary may waive recovery of a payment made to a 
veteran under this section that is otherwise required under subsection 
(d)(1) if the Secretary determines that such waiver would be in the 
best interest of the United States, as defined by regulations 
prescribed by the Secretary.
    ``(f) For purposes of this section--
            ``(1) the term `health-plan contract' includes--
                    ``(A) an insurance policy or contract, medical or 
                hospital service agreement, membership or subscription 
                contract, or similar arrangement, under which health 
                services for individuals are provided or the expenses 
                of such services are paid;
                    ``(B) an insurance program described in section 
                1811 of the Social Security Act (42 U.S.C. 1395c) or 
                established by section 1831 of that Act (42 U.S.C. 
                1395j);
                    ``(C) a State plan for medical assistance approved 
                under title XIX of such Act (42 U.S.C. 1396 et seq.); 
                and
                    ``(D) a workers' compensation law or plan described 
                in section 1729(A)(2)(B) of this title;
            ``(2) the term `third party' means--
                    ``(A) a Federal entity;
                    ``(B) a State or political subdivision of a State;
                    ``(C) an employer or an employer's insurance 
                carrier; and
                    ``(D) a person or entity obligated to provide, or 
                pay the expenses of, such emergency treatment; and
            ``(3) the term `emergency treatment' has the meaning given 
        such term in section 1725 of this title.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 is amended by inserting after the item relating to section 
1725 the following:

``Sec. 1725A. Reimbursement for emergency treatment expenses for which 
                            certain veterans remain personally 
                            liable.''.
                                                       Calendar No. 284

109th CONGRESS

  1st Session

                                S. 1182

                          [Report No. 109-177]

_______________________________________________________________________

                                 A BILL

   To amend title 38, United States Code, to improve health care for 
                   veterans, and for other purposes.

_______________________________________________________________________

                           November 10, 2005

                       Reported with an amendment
```