In the House of Representatives, U. S., 

October 7, 2009. 

Resolved, That the House agree to the amendment of the 

Senate to the bill (H.R. 1016) entitled ‘‘An Act to amend 

title 38, United States Code, to provide advance appropriations authority for certain accounts of the Department of 

Veterans Affairs, and for other purposes.’’, with the following 

AMENDMENT: 

In lieu of the matter proposed to be inserted by the 

amendment of the Senate, insert the following: 

1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Veterans Health Care 

3 Budget Reform and Transparency Act of 2009’’. 

4 SEC. 2. PRESIDENT’S BUDGET SUBMISSION. 

5 Section 1105(a) of title 31, United States Code, is 

6 amended by adding at the end the following new paragraph: 

7 ‘‘(36) information on estimates of appropriations 

8 for the fiscal year following the fiscal year for which 

9 the budget is submitted for the following medical care 

10 accounts of the Veterans Health Administration, De11 partment of Veterans Affairs account: 

12 ‘‘(A) Medical Services. 

13 ‘‘(B) Medical Support and Compliance. 

14 ‘‘(C) Medical Facilities.’’. 
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1 SEC. 3. ADVANCE APPROPRIATIONS FOR CERTAIN MEDICAL 

2 CARE ACCOUNTS OF THE DEPARTMENT OF 

3 VETERANS AFFAIRS. 

4 (a) IN GENERAL.—Chapter 1 of title 38, United States 

5 Code, is amended by inserting after section 116 the fol6 lowing new section: 

7 ‘‘§ 117. Advance appropriations for certain medical 

8 care accounts 

9 ‘‘(a) IN GENERAL.—For each fiscal year, beginning 

10 with fiscal year 2011, discretionary new budget authority 

11 provided in an appropriations Act for the medical care ac12 counts of the Department shall— 

13 ‘‘(1) be made available for that fiscal year; and 

14 ‘‘(2) include, for each such account, advance dis15 cretionary new budget authority that first becomes 

16 available for the first fiscal year after the budget year. 

17 ‘‘(b) ESTIMATES REQUIRED.—The Secretary shall in18 clude in documents submitted to Congress in support of the 

19 President’s budget submitted pursuant to section 1105 of 

20 title 31, United States Code, detailed estimates of the funds 

21 necessary for the medical care accounts of the Department 

22 for the fiscal year following the fiscal year for which the 

23 budget is submitted. 

24 ‘‘(c) MEDICAL CARE ACCOUNTS.—For purposes of this 

25 section, the term ‘medical care accounts of the Department’ 

26 means the following medical care accounts of the Veterans 
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1 Health Administration, Department of Veterans Affairs ac2 count: 

3 ‘‘(1) Medical Services. 

4 ‘‘(2) Medical Support and Compliance. 

5 ‘‘(3) Medical Facilities. 

6 ‘‘(d) ANNUAL REPORT.—Not later than July 31 of each 

7 year, the Secretary shall submit to Congress an annual re8 port on the sufficiency of the Department’s resources for the 

9 next fiscal year beginning after the date of the submittal 

10 of the report for the provision of medical care. Such report 

11 shall also include estimates of the workload and demand 

12 data for that fiscal year.’’. 

13 (b) CLERICAL AMENDMENT.—The table of sections at 

14 the beginning of such chapter is amended by inserting after 

15 the item relating to section 113 the following new line: 

‘‘117. Advance appropriations for certain medical care accounts.’’. 

16 SEC. 4. COMPTROLLER GENERAL REVIEW OF THE ACCU17 RACY OF VA MEDICAL CARE BUDGET SUBMIS18 SION IN RELATION TO BASELINE HEALTH 

19 CARE MODEL PROJECTION. 

20 (a) REVIEW OF ACCURACY OF MEDICAL CARE BUDGET

21 SUBMISSION.—The Comptroller General shall conduct a re22 view of each budget of the President for a fiscal year that 

23 is submitted to Congress pursuant to section 1105(a) of title 

24 31 in order to assess whether or not the relevant components 

25 of the amounts requested in such budget for such fiscal year 
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1 for the medical care accounts of the Department of Veterans 

2 Affairs specified in section 117(c) of title 38, United States 

3 Code, as added by section 3, are consistent with estimates 

4 of the resources required by the Department for the provi5 sion of medical care and services in such fiscal year, as 

6 forecast using the Enrollee Health Care Projection Model, 

7 or other methodologies used by the Department. 

8 (b) REPORTS.— 

9 (1) IN GENERAL.—Not later than 120 days after 

10 the date of each year in 2011, 2012, and 2013, on 

11 which the President submits the budget request for the 

12 next fiscal year under section 1105 of title 31, United 

13 States Code, the Comptroller General shall submit to 

14 the Committees on Veterans’ Affairs, Appropriations, 

15 and the Budget of the Senate and the Committees on 

16 Veterans’ Affairs, Appropriations, and the Budget of 

17 the House of Representatives and to the Secretary a 

18 report on the review conducted under subsection (a). 

19 (2) ELEMENTS.—Each report under this para20 graph shall include, for the fiscal year beginning in 

21 the year in which such report is submitted, the fol22 lowing: 

23 (A) An assessment of the review conducted 

24 under subsection (a). 

25 (B) The basis for such assessment. 
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1 (C) Such additional information as the 

2 Comptroller General determines appropriate. 

3 (3) AVAILABILITY TO THE PUBLIC.—Each report 

4 submitted under this subsection shall also be made 

5 available to the public. 

Attest: 

Clerk. 
111TH CONGRESS 

1ST SESSION H.R. 1016 

AMENDMENT