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[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 159 Introduced in House (IH)]

112th CONGRESS
  1st Session
                                H. R. 159

   To direct the Secretary of Defense and the Secretary of Veterans 
 Affairs to carry out a pilot program under which the Secretaries make 
  payments for certain treatments of traumatic brain injury and post-
                       traumatic stress disorder.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                            January 5, 2011

 Mr. Sessions introduced the following bill; which was referred to the 
   Committee on Armed Services, and in addition to the Committee on 
 Veterans' Affairs, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL

 
   To direct the Secretary of Defense and the Secretary of Veterans 
 Affairs to carry out a pilot program under which the Secretaries make 
  payments for certain treatments of traumatic brain injury and post-
                       traumatic stress disorder.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``TBI Treatment Act''.

SEC. 2. PILOT PROGRAM ON PAYMENT FOR TREATMENT OF MEMBERS OF THE ARMED 
              FORCES AND VETERANS FOR TRAUMATIC BRAIN INJURY AND POST-
              TRAUMATIC STRESS DISORDER.

    (a) Payment Process.--The Secretary of Defense and the Secretary of 
Veterans Affairs shall carry out a five-year pilot program under which 
each such Secretary shall establish a process through which each 
Secretary shall provide payment for treatments (including diagnostic 
testing) of traumatic brain injury or post-traumatic stress disorder 
received by members of the Armed Forces and veterans in health care 
facilities other than military treatment facilities or Department of 
Veterans Affairs medical facilities. Such process shall provide that 
payment be made directly to the health care facility furnishing the 
treatment.
    (b) Conditions for Payment.--The approval by a Secretary for 
payment for a treatment pursuant to subsection (a) shall be subject to 
the following conditions:
            (1) Any drug or device used in the treatment must be 
        approved or cleared by the Food and Drug Administration for any 
        purpose.
            (2) The treatment or study protocol used in treating the 
        member or veteran must have been approved by an institutional 
        review board operating in accordance with regulations issued by 
        the Secretary of Health and Human Services.
            (3) The approved treatment or study protocol (including any 
        patient disclosure requirements) must be used by the health 
        care provider delivering the treatment.
            (4) The patient receiving the treatment or study protocol 
        must demonstrate an improvement as a result of the treatment on 
        one or more of the following:
                    (A) Standardized independent pre-treatment and 
                post-treatment neuropsychological testing.
                    (B) Accepted survey instruments.
                    (C) Neurological imaging.
                    (D) Clinical examination.
            (5) The patient receiving the treatment or study protocol 
        must be receiving the treatment voluntarily.
    (c) Additional Restrictions Prohibited.--Except as provided in this 
subsection (b), no restriction or condition for reimbursement may be 
placed on any health care provider that is operating lawfully under the 
laws of the State in which the provider is located with respect to the 
receipt of payment under this Act.
    (d) Payment Deadline.--The Secretary of Defense and the Secretary 
of Veterans Affairs shall make a payment for a treatment or study 
protocol pursuant to subsection (a) not later than 30 days after a 
member of the Armed Forces or veteran (or health care provider on 
behalf of such member or veteran) submits to the Secretary 
documentation regarding the treatment or study protocol. The Secretary 
of Defense and the Secretary of Veterans Affairs shall ensure that the 
documentation required under this subsection may not be an undue burden 
on the member of the Armed Forces or veteran or on the health care 
provider.
    (e) Payment Source.--Subsection (c)(1) of section 1074 of title 10, 
United States Code, shall apply with respect to the payment by the 
Secretary of Defense for treatment or study protocols pursuant to 
subsection (a) of traumatic brain injury and post-traumatic stress 
disorder received by members of the Armed Forces.
    (f) Payment Amount.--A payment under this Act shall be made at the 
equivalent Centers for Medicare and Medicaid Services reimbursement 
rate in effect for appropriate treatment codes for the State or 
territory in which the treatment or study protocol is received. If no 
such rate is in effect, payment shall be made at a fair market rate, as 
determined by the Secretary of Defense, in consultation with the 
Secretary of Health and Human Services, with respect to a patient who 
is a member of the Armed Forces or the Secretary of Veterans Affairs 
with respect to a patient who is a veteran.
    (g) Data Collection and Availability.--
            (1) In general.--The Secretary of Defense and the Secretary 
        of Veterans Affairs shall jointly develop and maintain a 
        database containing data from each patient case involving the 
        use of a treatment under this section. The Secretaries shall 
        ensure that the database preserves confidentiality and be made 
        available only--
                    (A) for third-party payer examination;
                    (B) to the appropriate congressional committees and 
                employees of the Department of Defense, the Department 
                of Veterans Affairs, the Department of Health and Human 
                Services, and appropriate State agencies; and
                    (C) to the primary investigator of the 
                institutional review board that approved the treatment 
                or study protocol, in the case of data relating to a 
                patient case involving the use of such treatment or 
                study protocol.
            (2) Enrollment in institutional review board study.--In the 
        case of a patient enrolled in a registered institutional review 
        board study, results may be publically distributable in 
        accordance with the regulations prescribed pursuant to the 
        Health Insurance Portability and Accountability Act of 1996 
        (Public Law 104-191) and other regulations and practices in 
        effect as of the date of the enactment of this Act.
            (3) Qualified institutional review boards.--The Secretary 
        of Defense and the Secretary of Veterans Affairs shall each 
        ensure that the Internet website of their respective 
        departments includes a list of all civilian institutional 
        review board studies that have received a payment under this 
        Act.
    (h) Assistance for Members To Obtain Treatment.--
            (1) Assignment to temporary duty.--The Secretary of a 
        military department may assign a member of the Armed Forces 
        under the jurisdiction of the Secretary to temporary duty or 
        allow the member a permissive temporary duty in order to permit 
        the member to receive treatment or study protocol for traumatic 
        brain injury or post-traumatic stress disorder, for which 
        payments shall be made under subsection (a), at a location 
        beyond reasonable commuting distance of the member's permanent 
        duty station.
            (2) Payment of per diem.--A member who is away from the 
        member's permanent station may be paid a per diem in lieu of 
        subsistence in an amount not more than the amount to which the 
        member would be entitled if the member were performing travel 
        in connection with a temporary duty assignment.
            (3) Gift rule waiver.--Notwithstanding any rule of any 
        department or agency with respect to ethics or the receipt of 
        gifts, any assistance provided to a member of the Armed Forces 
        with a service-connected injury or disability for travel, 
        meals, or entertainment incidental to receiving treatment or 
        study protocol under this Act, or for the provision of such 
        treatment or study protocol, shall not be subject to or covered 
        by any such rule.
    (i) Retaliation Prohibited.--No retaliation may be made against any 
member of the Armed Forces or veteran who receives treatment or study 
protocol as part of a registered institutional review board study 
carried out by a civilian health care practitioner.
    (j) Treatment of University and Nationally Accredited Institutional 
Review Boards.--For purposes of this Act, a university-affiliated or 
nationally accredited institutional review board shall be treated in 
the same manner as a Government institutional review board.
    (k) Memoranda of Understanding.--The Secretary of Defense and the 
Secretary of Veterans Affairs shall seek to expeditiously enter into 
memoranda of understanding with civilian institutional review boards 
described in subsection (j) for the purpose of providing for members of 
the Armed Forces and veterans to receive treatment carried out by 
civilian health care practitioners under a treatment or study protocol 
approved by and under the oversight of civilian institutional review 
boards that would qualify for payment under this Act.
    (l) Outreach Required.--
            (1) Outreach to veterans.--The Secretary of Veterans 
        Affairs shall notify each veteran with a service-connected 
        injury or disability of the opportunity to receive treatment or 
        study protocol pursuant to this Act.
            (2) Outreach to members of the armed forces.--The Secretary 
        of Defense shall notify each member of the Armed Forces with a 
        service-connected injury or disability of the opportunity to 
        receive treatment or study protocol pursuant to this Act.
    (m) Report to Congress.--Not later than 30 days after the last day 
of each fiscal year during which the Secretary of Defense and the 
Secretary of Veterans Affairs are authorized to make payments under 
this Act, the Secretaries shall jointly submit to Congress an annual 
report on the implementation of this Act. Such report shall include 
each of the following for that fiscal year:
            (1) The number of individuals for whom the Secretary has 
        provided payments under this Act.
            (2) The condition for which each such individual receives 
        treatment for which payment is provided under this Act and the 
        success rate of each such treatment.
            (3) Treatment methods that are used by entities receiving 
        payment provided under this Act and the respective rate of 
        success of each such method.
            (4) The recommendations of the Secretaries with respect to 
        the integration of treatment methods for which payment is 
        provided under this Act into facilities of the Department of 
        Defense and Department of Veterans Affairs.
    (n) Termination.--The authority to make a payment under this Act 
shall terminate on the date that is five years after the date of the 
enactment of this Act.
    (o) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this Act $10,000,000 for each fiscal year 
during which the Secretary of Veterans Affairs and the Secretary of 
Defense are authorized to make payments under this Act.
                                 <all>
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