II 

113TH CONGRESS 

1ST SESSION S. 1165 

To amend title 38, United States Code, to provide for certain requirements 

relating to the immunization of veterans, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JUNE 13, 2013 

Mr. TESTER (for himself, Mr. PRYOR, Mr. BEGICH, and Mr. WYDEN) introduced the following bill; which was read twice and referred to the Committee on Veterans’ Affairs 

A BILL 

To amend title 38, United States Code, to provide for certain 

requirements relating to the immunization of veterans, 

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. 

4 This Act may be cited as the ‘‘Access to Appropriate 

5 Immunizations for Veterans Act of 2013’’. 

6 SEC. 2. ENSURING VETERAN ACCESS TO APPROPRIATE IM7 MUNIZATIONS. 

8 (a) INCLUSION OF RECOMMENDED ADULT VACCINA9 TIONS AS MEDICAL SERVICES.— 


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1 (1) COVERED BENEFIT.—Subparagraph (F) of 

2 section 1701(9) of title 38, United States Code, is 

3 amended to read as follows: 

4 ‘‘(F) immunizations against infectious dis5 eases, including each immunization on the rec6 ommended adult immunization schedule at the 

7 time such immunization is indicated on that 

8 schedule;’’. 

9 (2) DEFINITION.—Section 1701 of such title is 

10 amended by adding after paragraph (9) the fol11 lowing new paragraph: 

12 ‘‘(10) The term ‘recommended adult immuniza13 tion schedule’ means the schedule established (and 

14 periodically reviewed and, as appropriate, revised) by 

15 the Advisory Committee on Immunization Practices 

16 established by the Secretary of Health and Human 

17 Services and delegated to the Centers for Disease 

18 Control and Prevention.’’. 

19 (b) REPORT TO CONGRESS.—Section 1704(1)(A) of 

20 such title is amended— 

21 (1) in clause (i), by striking ‘‘and’’ at the end; 

22 (2) in clause (ii), by striking the period at the 

23 end and inserting ‘‘; and’’; and 

24 (3) by inserting after clause (ii) the following 

25 new clause: 


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1 ‘‘(iii) to ensure that veterans have re2 ceived each immunization on the rec3 ommended adult immunization schedule at 

4 the time such immunization is indicated on 

5 that schedule.’’. 

6 (c) ASSURANCE THAT ADMINISTRATION OF VACCINA7 TIONS CONSTITUTES APPROPRIATE MANAGEMENT AND

8 COST-EFFECTIVE DELIVERY OF HEALTH CARE SERV9 ICES.— 

10 (1) IN GENERAL.—Section 1706(a) of such title 

11 is amended— 

12 (A) by striking ‘‘In managing the provi13 sion’’ and inserting ‘‘(1) In managing the provi14 sion’’; and 

15 (B) by adding at the end the following new 

16 paragraph: 

17 ‘‘(2)(A) In managing the provision of medical services 

18 under such section, the Secretary shall develop and imple19 ment quality measures and metrics to ensure that veterans 

20 receiving medical services under this title receive each im21 munization on the recommended adult immunization 

22 schedule at the time such immunization is indicated on 

23 that schedule. 


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1 ‘‘(B) Quality measures and metrics developed and im2 plemented under subparagraph (A) shall include targets 

3 for compliance. 

4 ‘‘(C) The Secretary shall, to the maximum extent fea5 sible, develop and implement measures and metrics re6 quired by subparagraph (A) concurrently and consistently 

7 with the metrics in place, as of the date of the enactment 

8 of this paragraph, with respect to influenza and pneumo9 coccal vaccinations.’’. 

10 (2) REPORT TO CONGRESS.—Section 1704(1) of 

11 such title is amended by adding at the end the fol12 lowing new subparagraph: 

13 ‘‘(H) Statistics related to the quality meas14 ures and metrics developed and implemented 

15 under section 1706(a)(2) of this title.’’. 

16 (3) EFFECTIVE DATES.— 

17 (A) DEVELOPMENT OF INITIAL SCHED18 ULE.—The Secretary shall establish the quality 

19 measures and metrics described in paragraph 

20 (2) of section 1706(a) of such title, as added by 

21 paragraph (1), through notice and comment 

22 rulemaking. The Secretary shall publish in the 

23 Federal Register proposed measures and 

24 metrics by no later than July 1, 2013, and shall 


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1 finalize such measures and metrics by no later 

2 than December 31, 2013. 

3 (B) IMPLEMENTATION OF MEASURES AND

4 METRICS.—The Secretary shall implement para5 graph (2) of such section on January 1, 2014. 

6 (C) REPORT TO CONGRESS.—Subpara7 graph (H) of paragraph (1) of section 1704 of 

8 such title, as added by paragraph (2), shall 

9 apply with respect to the first report submitted 

10 under such section after January 1, 2014. 

Æ 


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