I 

115TH CONGRESS 

1ST SESSION H. R. 1910 

To amend title 38, United States Code, to improve the process for determining 

the eligibility of caregivers of veterans to certain benefits administered 

by the Secretary of Veterans Affairs, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 5, 2017 

Ms. STEFANIK (for herself, Mr. CARTER of Texas, Mr. COOK, Mr. CRAMER, 

Mr. FASO, Mr. JONES, Mr. OLSON, Mr. RENACCI, Mr. ROYCE of California, Mr. WEBSTER of Florida, Mr. YOUNG of Iowa, and Mr. ZELDIN) 

introduced the following bill; which was referred to the Committee on 

Veterans’ Affairs 

A BILL 

To amend title 38, United States Code, to improve the 

process for determining the eligibility of caregivers of 

veterans to certain benefits administered by the Secretary 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 ‘‘Support Our Military 

5 Caregivers Act’’. 


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1 SEC. 2. EXTERNAL CLINICAL REVIEW OF DENIED APPLICA2 TIONS BY CAREGIVERS OF VETERANS. 

3 (a) IN GENERAL.—Section 1720G of title 38, United 

4 States Code, is amended— 

5 (1) by redesignating subsections (d) and (e) as 

6 subsections (e) and (f), respectively; and 

7 (2) by inserting after subsection (c) the fol8 lowing new subsection (d): 

9 ‘‘(d) EXTERNAL CLINICAL REVIEW OF APPLICA10 TIONS.—(1) Using amounts otherwise appropriated to 

11 carry out this section, an individual may elect to have an 

12 independent contractor described in paragraph (2) per13 form an external clinical review of any of the following: 

14 ‘‘(A) The denial by the Secretary of an applica15 tion by an individual to be a caregiver or family 

16 caregiver eligible for the program of comprehensive 

17 assistance administered by the Secretary pursuant to 

18 this section. 

19 ‘‘(B) With respect to such an application that 

20 the Secretary has granted, a determination by the 

21 Secretary of the level or amount of personal care 

22 services that a veteran requires. 

23 ‘‘(C) A request by a caregiver or family care24 giver for a reconsideration of the level or amount of 

25 personal care services that a veteran requires based 

26 on changes to the health or abilities of the veteran 


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1 occurring since the Secretary granted such an appli2 cation. 

3 ‘‘(D) The revocation by the Secretary of assist4 ance administered by the Secretary pursuant to this 

5 section. 

6 ‘‘(2) An independent contractor described in this 

7 paragraph is an independent contractor that— 

8 ‘‘(A) is awarded a contract by the Secretary to 

9 carry out this section pursuant to full and open com10 petition under the Federal Acquisition Regulation; 

11 ‘‘(B) has no direct or indirect financial relation12 ship with any non-Department provider of services 

13 to caregivers and family caregivers pursuant to this 

14 title; 

15 ‘‘(C) has not otherwise conducted an external 

16 clinical review of benefits administered by the Sec17 retary pursuant to this title other than this section; 

18 ‘‘(D) has sufficient training and expertise in 

19 medical science and other appropriate health, edu20 cational, and vocational training and legal matters 

21 to perform the reviews described in paragraph (1); 

22 and 

23 ‘‘(E) employs a panel of physicians or other ap24 propriate health care professionals who do not proVerDate Sep 11 2014 04:23 Apr 12, 2017 Jkt 069200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1910.IH H1910

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1 vide health care to the individual who makes an elec2 tion under paragraph (1). 

3 ‘‘(3) Each external clinical review conducted pursu4 ant to paragraph (1) shall— 

5 ‘‘(A) be based on applicable information in6 cluded in the application for assistance described in 

7 such paragraph, including clinical expertise, medical, 

8 technical, and scientific evidence; 

9 ‘‘(B) include an opportunity for both the indi10 vidual who elects for such review and, to the extent 

11 possible, the veteran for whom care is being provided 

12 to offer opinions and supporting data as to the level 

13 of care required; and 

14 ‘‘(C) include a review of the initial clinical re15 view of such veteran and any other review made by 

16 the Secretary. 

17 ‘‘(4) In carrying out the external clinical reviews pur18 suant to paragraph (1), the independent contractor shall, 

19 as determined appropriate by the Secretary— 

20 ‘‘(A) collect and maintain information required; 

21 and 

22 ‘‘(B) share such information with the Secretary. 

23 ‘‘(5) The Secretary shall take into account, but is not 

24 bound by, any determination made by the independent 

25 contractor pursuant to paragraph (1) in determining the 


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1 final decision with respect to the application for assist2 ance. The Secretary may make a final decision that is con3 trary to such a determination if the Secretary includes 

4 clinically supported documentation with the decision. 

5 ‘‘(6) The Secretary shall ensure that each external 

6 clinical review conducted by the independent contractor 

7 pursuant to paragraph (1) is completed and the Depart8 ment is notified in writing of the results of the review by 

9 not later than 120 days after the date on which the indi10 vidual makes the election under such paragraph. Not later 

11 than 30 days after the delivery of the determination rec12 ommended by the independent contractors, the Secretary 

13 shall ensure that the veteran and the individual making 

14 the election under such paragraph is notified in writing 

15 of the final decision of the Secretary. In accordance with 

16 paragraph (5), such notification shall include an expla17 nation of the recommended decision, a discussion of the 

18 facts and applicable regulations, and an explanation of the 

19 clinical rationale for the final decision. 

20 ‘‘(7) The Secretary shall notify individuals who sub21 mit an application to be a caregiver or family caregiver 

22 eligible for the program of comprehensive assistance ad23 ministered by the Secretary pursuant to this section of the 

24 ability of the individual to make an election under para25 graph (1). 


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1 ‘‘(8) Nothing in this subsection may be construed to 

2 affect claims made by veterans for disability compensation 

3 under chapter 11 of this title.’’. 

4 (b) APPLICATION.—The amendments made by sub5 section (a) shall apply with respect to elections under sub6 section (d) of section 1720G of title 38, United States 

7 Code, as added by subsection (a)(2), that are for applica8 tions or revocations for assistance for caregivers and fam9 ily caregivers pursuant to such section for which the Sec10 retary of Veterans Affairs has not made a final decision 

11 as of the date of the enactment of this Act. 

12 SEC. 3. PROCESS TO DETERMINE ELIGIBILITY FOR CARE13 GIVERS OF VETERANS. 

14 (a) DIRECTIVES.—The Secretary of Veterans Affairs 

15 shall issue directives regarding the policies, procedures, 

16 and operational requirements for the Family Caregiver 

17 Program, including with respect to determining the eligi18 bility of an individual to participate in the Family Care19 giver Program. 

20 (b) GAO REPORT.—The Comptroller General of the 

21 United States shall submit to the Committees on Vet22 erans’ Affairs of the House of Representatives and the 

23 Senate a report on the processes of the Secretary of Vet24 erans Affairs with respect to— 


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1 (1) determining the eligibility of an individual 

2 to participate in the Family Caregiver Program; 

3 (2) adjudicating appeals to such determina4 tions; and 

5 (3) the periodic eligibility reevaluation of an in6 dividual participating in such program and the com7 munication of any changes as a result of such re8 evaluations to the veteran and caregiver. 

9 (c) FAMILY CAREGIVER PROGRAM DEFINED.—In 

10 this section, the term ‘‘Family Caregiver Program’’ either 

11 the program of comprehensive assistance for family care12 givers or the program of general caregiver support services 

13 established by section 1720G of title 38, United States 

14 Code. 

Æ 


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