I 

111TH CONGRESS 

1ST SESSION H. R. 1016 

To amend title 38, United States Code, to provide advance appropriations 

authority for certain medical care accounts of the Department of Veterans Affairs, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 12, 2009 

Mr. FILNER (for himself, Mr. MICHAUD, Ms. HERSETH SANDLIN, Mr. MITCHELL, Mr. HALL of New York, Mr. MCNERNEY, Mr. WALZ, Mr. HARE, 

Mrs. TAUSCHER, Mr. HODES, and Mr. SESTAK) introduced the following 

bill; which was referred to the Committee on Veterans’ Affairs 

A BILL 

To amend title 38, United States Code, to provide advance 

appropriations authority for certain medical care accounts of the Department of Veterans Affairs, 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 ‘‘Veterans Health Care 

5 Budget Reform and Transparency Act of 2009’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 


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1 (1) Title 38, United States Code, authorizes the 

2 Secretary of Veterans Affairs to furnish hospital and 

3 domiciliary care, medical services, nursing home 

4 care, and related services to eligible and enrolled vet5 erans, but only to the extent that appropriated re6 sources and facilities are available for such purposes. 

7 (2) For 19 out of the past 22 fiscal years, ap8 propriated funds for medical care were not provided 

9 to the Department of Veterans Affairs before the 

10 commencement of its new fiscal year, causing the 

11 Department great challenges in planning and man12 aging care for enrolled veterans, to the detriment of 

13 veterans. 

14 (3) The cumulative effect of insufficient, late, 

15 and unpredictable funding endangers the viability of 

16 the system and the specialized health care resources 

17 of the Department to maintain and improve the 

18 health of the Nation’s sick and disabled veterans. 

19 (4) Appropriation levels for the health care pro20 grams of the Department have too often proven in21 sufficient over the past decade, requiring the Sec22 retary of Veterans Affairs to ration health care and 

23 Congress to approve supplemental appropriations. 

24 (5) Providing sufficient, timely, and predictable 

25 funding would ensure the Government meets its obliVerDate Nov 24 2008 03:23 Feb 14, 2009 Jkt 079200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1016.IH H1016

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1 gation to provide health care to sick and disabled 

2 veterans and ensure that all veterans enrolled for 

3 care in the Department of Veterans Affairs have 

4 ready access to timely and high quality care. 

5 (6) Providing sufficient, timely, and predictable 

6 funding would allow the Department of Veterans Af7 fairs to properly plan for and meet the needs of vet8 erans. 

9 SEC. 3. ADVANCE APPROPRIATIONS FOR CERTAIN MED10 ICAL CARE ACCOUNTS OF THE DEPARTMENT 

11 OF VETERANS AFFAIRS. 

12 (a) ADVANCE APPROPRIATIONS FOR CERTAIN MED13 ICAL CARE ACCOUNTS.— 

14 (1) IN GENERAL.—Chapter 1 of title 38, United 

15 States Code, is amended by inserting after section 

16 113 the following new section: 

17 ‘‘§ 113A. Advance appropriations for certain medical 

18 care accounts 

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

20 with fiscal year 2011, discretionary new budget authority 

21 provided in an appropriations Act for the appropriations 

22 accounts of the Department specified in subsection (b) 

23 shall— 

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


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1 ‘‘(2) include, for each such appropriations ac2 count, advance discretionary new budget authority 

3 that first becomes available for the first fiscal year 

4 after the budget year. 

5 ‘‘(b) MEDICAL CARE ACCOUNTS AFFECTED.—The 

6 appropriations accounts subject to subsection (a) of this 

7 section are the following medical care accounts of the ‘Vet8 erans Health Administration, Department of Veterans Af9 fairs’ account: 

10 ‘‘(1) Medical Services. 

11 ‘‘(2) Medical Support and Compliance. 

12 ‘‘(3) Medical Facilities.’’. 

13 (2) CLERICAL AMENDMENT.—The table of sec14 tions at the beginning of such chapter is amended 

15 by inserting after the item relating to section 113 

16 the following new line: 

‘‘113A. Advance appropriations for certain medical care accounts.’’. 

17 SEC. 4. COMPTROLLER GENERAL STUDY ON ADEQUACY 

18 AND ACCURACY OF BASELINE MODEL PRO19 JECTIONS OF THE DEPARTMENT OF VET20 ERANS AFFAIRS FOR HEALTH CARE EXPENDI21 TURES. 

22 (a) STUDY OF ADEQUACY AND ACCURACY OF BASE

23 LINE MODEL PROJECTIONS.—The Comptroller General 

24 shall conduct a study of the adequacy and accuracy of the 

25 budget projections made by the Enrollee Health Care ProVerDate Nov 24 2008 03:23 Feb 14, 2009 Jkt 079200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1016.IH H1016

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1 jection Model (in this section referred to as the ‘‘Model’’), 

2 its equivalent, or other methodologies utilized for the pur3 pose of estimating and projecting health care expenditures 

4 of the Department of Veterans Affairs with respect to the 

5 fiscal year involved and the subsequent four fiscal years. 

6 (b) REPORTS.— 

7 (1) IN GENERAL.—Not later than the date of 

8 each year in 2011, 2012, and 2013, on which the 

9 President submits the budget request for the next 

10 fiscal year under section 1105 of title 31, United 

11 States Code, the Comptroller General shall submit to 

12 the appropriate committees of Congress and to the 

13 Secretary of Veterans Affairs a report. 

14 (2) ELEMENTS.—Each report under this para15 graph shall include, for the fiscal year concerning 

16 the year for which the budget is submitted, the fol17 lowing: 

18 (A) A statement whether the amount re19 quested in the budget of the President for ex20 penditures of the Department for health care in 

21 such fiscal year is consistent with anticipated 

22 expenditures of the Department for health care 

23 in such fiscal year as determined utilizing the 

24 Model. 

25 (B) The basis for such statement. 


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1 (C) Such additional information as the 

2 Comptroller General determines appropriate. 

3 (3) AVAILABILITY TO THE PUBLIC.—Each re4 port submitted under this subsection shall be made 

5 available to the public by the Comptroller General. 

6 (4) APPROPRIATE COMMITTEES OF CONGRESS

7 DEFINED.—In this subsection, the term ‘‘appro8 priate committees of Congress’’ means— 

9 (A) the Committees on Veterans’ Affairs, 

10 Appropriations, and the Budget of the Senate; 

11 and 

12 (B) the Committees on Veterans’ Affairs, 

13 Appropriations, and the Budget of the House of 

14 Representatives. 

Æ 


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