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[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[S. 2309 Placed on Calendar Senate (PCS)]

                                                       Calendar No. 530

103d CONGRESS

  2d Session

                                S. 2309

_______________________________________________________________________

                                 A BILL

  To amend title 38, United States Code, to provide for reform of the 
 health care benefits furnished by the Department of Veterans Affairs 
 and the administration of health care benefits by the Department, and 
                          for other purposes.

_______________________________________________________________________

                July 21 (legislative day, July 20), 1994

                         Placed on the calendar

                                                       Calendar No. 530
103d CONGRESS
  2d Session
                                S. 2309

  To amend title 38, United States Code, to provide for reform of the 
 health care benefits furnished by the Department of Veterans Affairs 
 and the administration of health care benefits by the Department, and 
                          for other purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                July 21 (legislative day, July 20), 1994

Mr. Rockefeller, from the Committee on Veterans' Affairs, reported the 
    following original bill; which was read twice and placed on the 
                                calendar

_______________________________________________________________________

                                 A BILL

 
  To amend title 38, United States Code, to provide for reform of the 
 health care benefits furnished by the Department of Veterans Affairs 
 and the administration of health care benefits by the Department, and 
                          for other purposes.

    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 ``Veterans Health Care Reform Act of 
1994''.

SEC. 2. BENEFITS AND ELIGIBILITY THROUGH DEPARTMENT OF VETERANS AFFAIRS 
              MEDICAL SYSTEM.

    (a) Department of Veterans Affairs As a Participant in Health Care 
Reform.--
            (1) In general.--Title 38, United States Code, is amended 
        by inserting after chapter 17 the following new chapter:

    ``CHAPTER 18--ELIGIBILITY AND BENEFITS UNDER HEALTH SECURITY ACT

                        ``SUBCHAPTER I--GENERAL

``1801. Definitions.
                      ``SUBCHAPTER II--ENROLLMENT

``1811. Enrollment: veterans.
``1812. Enrollment: CHAMPVA eligibles.
``1813. Enrollment: family members.
                       ``SUBCHAPTER III--BENEFITS

``1821. Benefits for VA enrollees.
``1822. Chapter 17 benefits.
``1823. Supplemental benefits packages and policies.
``1824. Limitation regarding veterans enrolled with health plans 
                            outside Department.
                   ``SUBCHAPTER IV--FINANCIAL MATTERS

``1831. Premiums, copayments, and other charges.
``1832. Medicare coverage and reimbursement.
``1833. Recovery of cost of certain care and services.
``1834. Health Plan Fund.

                        ``SUBCHAPTER I--GENERAL

``Sec. 1801. Definitions
    ``For purposes of this chapter:
            ``(1) The term `health plan' means an entity that has been 
        certified under the Health Security Act as a health plan.
            ``(2) The term `VA health plan' means a health plan that is 
        operated by the Secretary under section 7341 of this title.
            ``(3) The term `VA enrollee' means an individual enrolled 
        under the Health Security Act in a VA health plan.
            ``(4) The term `comprehensive benefit package' means the 
        package of benefits required to be provided by a health plan 
        under the Health Security Act.

                      ``SUBCHAPTER II--ENROLLMENT

``Sec. 1811. Enrollment: veterans
    ``Each veteran who is an eligible individual within the meaning of 
section 1001 of the Health Security Act (including a veteran who is a 
medicare-eligible individual as defined in section 1902 of that Act) 
may enroll with a VA health plan. A veteran who wants to receive the 
comprehensive benefit package through the Department shall enroll with 
a VA health plan.
``Sec. 1812. Enrollment: CHAMPVA eligibles
    ``An individual who is eligible for benefits under section 1713 of 
this title and who is eligible to enroll in a health plan pursuant to 
section 1001 of the Health Security Act may enroll under that Act with 
a VA health plan in the same manner as a veteran.
``Sec. 1813. Enrollment: family members
    ``(a) The Secretary may authorize a VA health plan to enroll 
members of the family of an enrollee under section 1811 or 1812 of this 
title, subject to payment of premiums, deductibles, copayments, and 
coinsurance as required under the Health Security Act.
    ``(b) For purposes of subsection (a), an enrollee's family is those 
individuals (other than the enrollee) included within the term `family' 
as defined in section 1011(b) of the Health Security Act.

                       ``SUBCHAPTER III--BENEFITS

``Sec. 1821. Benefits for VA enrollees
    ``The Secretary shall ensure that each VA health plan provides to 
each individual enrolled with it the items and services in the 
comprehensive benefit package under the Health Security Act.
``Sec. 1822. Chapter 17 benefits
    ``The Secretary shall provide to a veteran the care and services 
not included in the comprehensive benefits package that are authorized 
to be provided under chapter 17 of this title in accordance with the 
terms and conditions applicable to that veteran and that care under 
such chapter.
``Sec. 1823. Supplemental benefits packages and policies
    ``(a) As part of a VA health plan, the Secretary may offer to 
veterans--
            ``(1) supplemental health benefits policies for the care 
        and services described in subsection (b); and
            ``(2) cost-sharing policies consistent with the 
        requirements of part 2 of subtitle E of title I of the Health 
        Security Act.
    ``(b) The care and services referred to in subsection (a) are care 
and services that--
            ``(1) are not available under the comprehensive benefit 
        package; and
            ``(2) can be provided by the Secretary at reasonable cost.
``Sec. 1824. Limitation regarding veterans enrolled with health plans 
              outside Department
    ``A veteran who is residing in a regional alliance area in which 
the Department operates a health plan and who is enrolled in a health 
plan that is not operated by the Department may be provided the items 
and services in the comprehensive benefit package by a VA health plan 
only if the plan is reimbursed for the care provided.

                   ``SUBCHAPTER IV--FINANCIAL MATTERS

``Sec. 1831. Premiums, copayments, and other charges
    ``(a)(1) Except as provided in paragraph (2), the Secretary may not 
impose on or collect from a veteran described in subsection (b) who is 
a VA enrollee a cost-share charge of any kind (whether a premium, 
copayment, deductible, coinsurance charge, or other charge) for items 
and services in the comprehensive benefit package that a VA health plan 
provides. The Secretary shall make such arrangements as necessary with 
health alliances in order to carry out this subsection.
    ``(2) The Secretary shall collect from a veteran referred to in 
paragraph (1) an appropriate cost-share charge for any items and 
services that are available to the veteran through the VA health plan 
but which the veteran obtains from a health care provider other than a 
VA health plan network provider.
    ``(b) The veterans referred to in subsection (a) are the following:
            ``(1) Any veteran with a compensable service-connected 
        disability.
            ``(2) Any veteran whose discharge or release from the 
        active military, naval or air service was for a disability 
        incurred or aggravated in the line of duty.
            ``(3) Any veteran who is in receipt of, or who, but for a 
        suspension pursuant to section 1151 of this title (or both such 
        a suspension and the receipt of retired pay), would be entitled 
        to disability compensation, but only to the extent that such a 
        veteran's continuing eligibility for such care is provided for 
        in the judgment or settlement provided for in such section.
            ``(4) Any veteran who is a former prisoner of war.
            ``(5) Any veteran of the Mexican border period or World War 
        I.
            ``(6) Any veteran who is unable to defray the expenses of 
        necessary care as determined under section 1722(a) of this 
        title.
            ``(7) Any veteran referred to in subparagraph (A), (B), or 
        (C) of section 1710(e) of this title.
    ``(c)(1) Except as provided in paragraph (2), in the case of a VA 
enrollee who is not described in subsection (b), the Secretary shall 
charge premiums and establish copayments, deductibles, and coinsurance 
amounts for care and services provided under this chapter. The premium 
rate, and the rates for deductibles and copayments, for each VA health 
plan shall be established by that health plan based on rules 
established by the health alliance under which it is operating.
    ``(2) The Secretary may not charge a veteran referred to in 
paragraph (1) a premium for any care or service that the Secretary 
provides the veteran under a supplemental benefits policy offered under 
section 1823 of this title if the Secretary is required to provide such 
care or service under chapter 17 of this title.
    ``(d) In the case of a veteran with a compensable service-connected 
disability who is enrolled in a VA health plan and who has net earnings 
from self-employment, the Secretary shall, under regulations prescribed 
by the Secretary, provide for a reduction in any premium payment (or 
alliance credit repayment) owed by the veteran under section 6126 or 
6111 of the Health Security Act by virtue of the veteran's net earnings 
from self-employment.
``Sec. 1832. Medicare coverage and reimbursement
    ``(a) For purposes of any program administered by the Secretary of 
Health and Human Services under title XVIII of the Social Security Act 
(42 U.S.C. 1395 et seq.), a Department facility shall be deemed to be a 
Medicare provider.
    ``(b)(1) A VA health plan shall be considered to be a Medicare HMO.
    ``(2) For purposes of this section, the term `Medicare HMO' means 
an eligible organization under section 1876 of the Social Security Act.
    ``(c) In the case of care provided under this chapter to a veteran 
(other than a veteran described in section 1831(b) of this title), or 
to a family member of a veteran, who is eligible for benefits under the 
Medicare program under title XVIII of the Social Security Act, the 
Secretary of Health and Human Services shall reimburse a VA health plan 
or Department health-care facility providing services as a Medicare 
provider or Medicare HMO in the same amounts and under the same terms 
and conditions as that Secretary reimburses other Medicare providers or 
Medicare HMOs, respectively. The Secretary of Health and Human Services 
shall include with each such reimbursement a Medicare explanation of 
benefits.
    ``(d) When the Secretary provides care to a veteran, or a family 
member of a veteran, for which the Secretary receives reimbursement 
under this section, the Secretary shall require the veteran to pay to 
the Department any applicable deductible or copayment that is not 
covered by Medicare.
``Sec. 1833. Recovery of cost of certain care and services
    ``(a) In the case of an individual provided care or services 
through a VA health plan who has coverage under a supplemental health 
insurance policy pursuant to part 2 of subtitle E of title I of the 
Health Security Act, a Medicare supplemental health insurance plan (as 
defined in the Health Security Act), or any other provision of law, the 
Secretary has the right to recover or collect charges for care or 
services (as determined by the Secretary, but not including care or 
services for a service-connected disability) from the party providing 
that coverage to the extent that the individual (or the provider of the 
care or services) would be eligible to receive payment for such care or 
services from such party if the care or services had not been furnished 
by a department or agency of the United States.
    ``(b) In the case of a veteran referred to in section 1831(b) of 
this title who is enrolled in a health plan other than a VA health plan 
and who is provided care or services for a service-connected disability 
by a VA health plan, the Secretary has the right to recover or collect 
charges for such care and services from the party operating the health 
plan to the extent that the veteran (or the provider of the care or 
services) would be eligible to receive payment for such care or 
services from such party if the care or services had not been furnished 
by a department or agency of the United States.
    ``(c) The provisions of subsections (b) through (f) of section 1729 
of this title shall apply with respect to claims by the United States 
under subsection (a) or (b) in the same manner as they apply to claims 
under subsection (a) of that section.
``Sec. 1834. Health Plan Fund
    ``(a) There is hereby established in the Treasury a revolving fund 
to be known as the `Department of Veterans Affairs Health Plan Fund'.
    ``(b)(1) Subject to paragraphs (2) and (3), amounts collected or 
recovered by the Department under this subchapter by reason of the 
furnishing of care and services to an individual by a VA health plan or 
the enrollment of an individual with a VA health plan (including 
amounts received as premiums, premium discount payments, copayments or 
coinsurance, and deductibles, amounts received as third-party 
reimbursements, and amounts received as reimbursements from another 
health plan for care furnished to one of its enrollees) shall be 
credited to the revolving fund.
    ``(2) Premiums collected by the Department under this subchapter 
during fiscal year 1996 or 1997 by reason of the furnishing of care and 
services under a VA health plan to a veteran referred to in section 
1831(b) of this title shall be credited to the revolving fund 
established under subsection (a) only if the amount of funds 
appropriated to the Veterans Health Care Investment Fund established 
under subsection (a)(1) of section 7346 of this title for the fiscal 
year concerned is less than the amount specified to be credited to that 
fund for that fiscal year under subsection (c) of such section 7346.
    ``(3) Premiums received by the Department under this subchapter in 
any fiscal year after fiscal year 1997 by reason of the furnishing of 
care and services under a VA health plan to a veteran referred to in 
paragraph (2) shall be credited to the revolving fund established under 
subsection (a) only if the cost of providing such care and services is 
not covered by appropriations. The amount so credited shall be the 
amount of such premiums received that is necessary to cover the 
difference between the cost of such care and services and such 
appropriations.
    ``(c) The Secretary shall establish in the revolving fund a 
separate account for each VA health plan. The Secretary shall credit 
any amount received under subsection (b) by reason of the furnishing of 
care and services in or through a VA health plan or the enrollment of 
an individual with a VA health plan.
    ``(d) Amounts credited to the account of the revolving fund for a 
VA health plan under subsection (b) are hereby made available to the VA 
health plan for the expenses of the delivery by the VA health plan of 
the items and services in the comprehensive benefit package and any 
supplemental benefits package or policy offered by the VA health 
plan.''.
            (2) The table of chapters at the beginning of title 38, 
        United States Code, and at the beginning of part II of such 
        title, is amended by inserting after the item relating to 
        chapter 17 the following new item:

``18. Benefits and Eligibility Under Health Security Act....   1801.''.
    (b) Preservation of Existing Benefits for Facilities Not Operating 
as Health Plans.--(1) Chapter 17 of title 38, United States Code, is 
amended by inserting after section 1704 the following new section:
``Sec. 1705. Facilities not operating within health plans; veterans not 
              eligible to enroll in health plans
    ``The provisions of this chapter shall apply with respect to the 
furnishing of care and services--
            ``(1) by any facility of the Department when it is not 
        operating as or within a health plan certified as a health plan 
        under the Health Security Act; and
            ``(2) by any facility of the Department (whether or not 
        operating as or within a health plan certified as a health plan 
        under the Health Security Act) in the case of a veteran who is 
        not an eligible individual with the meaning of section 1001 of 
        the Health Security Act.''.
    (2) The table of sections at the beginning of such chapter is 
amended by inserting after the item relating to section 1704 the 
following new item:

``1705. Facilities not operating within health plans; veterans not 
                            eligible to enroll in health plans.''.

SEC. 3. ORGANIZATION OF DEPARTMENT OF VETERANS AFFAIRS FACILITIES AS 
              HEALTH PLANS.

    (a) In General.--Chapter 73 of title 38, United States Code, is 
amended--
            (1) by redesignating subchapter IV as subchapter V; and
            (2) by inserting after subchapter III the following new 
        subchapter IV:

 ``SUBCHAPTER IV--PARTICIPATION AS PART OF NATIONAL HEALTH CARE REFORM

``Sec. 7341. Organization of health care facilities as health plans
    ``(a)(1) The Secretary shall organize health plans and operate 
Department facilities as or within health plans under the Health 
Security Act.
    ``(2)(A) The Secretary shall prescribe regulations establishing 
standards for the operation of Department health care facilities as or 
within health plans under that Act. In prescribing such standards, the 
Secretary shall ensure that they conform, to the maximum extent 
practicable, to the requirements for health plans generally set forth 
in part 1 of subtitle E of title I of the Health Security Act.
    ``(B) Not later than 30 days after prescribing such standards, the 
Secretary shall submit to the Committees on Veterans' Affairs of the 
Senate and the House of Representatives a report describing the 
differences, if any, between such standards and the requirements for 
health plans generally referred to in subparagraph (A).
    ``(b) Health care facilities of the Department located within an 
area or region may be organized to operate as a single health plan 
encompassing all Department facilities within that area or region or 
may be organized to operate as several health plans.
    ``(c) In carrying out responsibilities under the Health Security 
Act, a State (or a State-established entity)--
            ``(1) may not impose any standard or requirement on a VA 
        health plan that is inconsistent with this chapter or any 
        regulation prescribed under this chapter or other Federal laws 
        regarding the operation of this chapter; and
            ``(2) may not deny certification of a VA health plan under 
        the Health Security Act on the basis of a conflict between a 
        rule of a State or health alliance and this chapter or 
        regulations prescribed under this chapter or other Federal laws 
        regarding the operation of this chapter.
``Sec. 7342. Contract authority for facilities operating as or within 
              health plans
    ``(a) The Secretary shall designate a health plan director for each 
VA health plan organized and operated under this subchapter.
    ``(b) The health plan director of a VA health plan may enter into 
contracts and agreements for the provision of care and services to be 
provided under the VA health plan and contracts and agreements for 
other services (including procurement of equipment, maintenance and 
repair services, and other services related to the provision of health 
care services) that are necessary for the provision of care and 
services under the VA health plan.
    ``(c) Contracts and agreements (including leases) under subsection 
(a) shall not be subject to the following provisions of law:
            ``(1) Section 8110(c) of this title, relating to the 
        contracting of services at Department health-care facilities.
            ``(2) Section 8122(a)(1) of this title, relating to the 
        lease of Department property.
            ``(3) Section 8125 of this title, relating to local 
        contracts for the procurement of health-care items.
            ``(4) Section 702 of title 5, relating to the right of 
        review of agency wrongs by courts of the United States.
            ``(5) Sections 1346(a)(2) and 1491 of title 28, relating to 
        the jurisdiction of the district courts of the United States 
        and the United States Court of Federal Claims, respectively, 
        for the actions enumerated in such sections.
            ``(6) Subchapter V of chapter 35 of title 31, relating to 
        adjudication of protests of violations of procurement statutes 
        and regulations.
            ``(7) Sections 3526 and 3702 of such title, relating to the 
        settlement of accounts and claims, respectively, of the United 
        States.
            ``(8) Subsections (b)(7), (e), (f), (g), and (h) of section 
        8 of the Small Business Act (15 U.S.C. 637(b)(7), (e), (f), 
        (g), and (h)), relating to requirements with respect to small 
        businesses for contracts for property and services.
            ``(9) The provisions of law assembled for purposes of 
        codification of the United States Code as section 471 through 
        544 of title 40 that relate to the authority of the 
        Administrator of General Services over the lease and disposal 
        of Federal Government property.
            ``(10) The provisions of the Office of Federal Procurement 
        Policy Act (41 U.S.C. 401 et seq.), relating to the procurement 
        of property and services by the Federal Government.
            ``(11) Chapter 3 of the Federal Property and Administrative 
        Services Act of 1949 (41 U.S.C. 251 et seq.), relating to the 
        procurement of property and services by the Federal Government.
            ``(12) Office of Management and Budget Circular A-76.
    ``(d)(1) Contracts and agreements for the provision of care and 
services under subsection (a) may include any contract or other 
agreement that the health plan director of a VA health plan determines 
appropriate in order to provide care and services under the VA health 
plan.
    ``(2) Contracts and agreements under this subsection may be entered 
into without prior review by the Central Office of the Department.
    ``(e)(1) The entry into a contract or agreement under this section 
for services other than the services referred to in subsection (c) 
(including contracts and agreements for procurement of equipment, 
maintenance and repair services, and other services related to the 
provision of health care services) shall not be subject to prior review 
by the Central Office if the amount of the contract or agreement is 
less than $250,000.
    ``(2)(A) The Central Office may conduct a prior review of a 
contract or agreement referred to in paragraph (1) if the amount of the 
contract or agreement is $250,000 or greater.
    ``(B) If the Central Office fails to approve or reject a contract 
or agreement referred to under subparagraph (A) within 30 days of its 
submittal to the Central Office, such contract or agreement shall be 
deemed approved by the Central Office.
``Sec. 7343. Resource sharing authority
    ``(a) The Secretary may enter into agreements under section 8153 of 
this title with other health care plans, with health care providers, 
and with other health industry organizations, and with individuals, for 
the sharing of resources of the Department under a VA health plan.
    ``(b) The Secretary may enter into agreements with other 
departments and agencies of the Federal Government for the sharing of 
resources of the Department and such departments and agencies in order 
to provide care and services under a VA health plan.
``Sec. 7344. Administrative and personnel flexibility
    ``(a) Notwithstanding any other provision of law, the Secretary 
may--
            ``(1) appoint health care personnel to positions in any 
        facility of the Department operating as or within a VA health 
        plan in accordance with such qualifications for such positions 
        as the Secretary may establish; and
            ``(2) promote and advance personnel serving in such 
        positions in accordance with such qualifications as the 
        Secretary may establish.
    ``(b) Subject to the provisions of section 1404 of the Health 
Security Act, the Secretary may carry out appropriate promotional, 
advertising, and marketing activities to inform individuals of the 
availability of VA health plans.
``Sec. 7345. Expenditure authority
    ``(a)(1) Except as provided in subsection (b) and notwithstanding 
any other provision of law, the director of a VA health plan may expend 
funds available to a VA health plan (including funds available under 
section 1834(c) of this title, funds available under section 
7346(d)(2)(B) of this title, and funds otherwise made available to the 
VA health plan by the Secretary) for any purpose, and in any amount, 
that the director determines appropriate in order to ensure that the VA 
health plan meets the requirements and the requirements of furnishing 
care and services to veterans under chapter 17 of this title.
    ``(2) Funds may be expended under this subsection in order to cover 
the following costs:
            ``(A) The costs of marketing and advertising under a VA 
        health plan.
            ``(B) The costs of legal services provided to a VA health 
        plan by the General Counsel of the Department.
            ``(C) The costs of acquisition (including acquisition of 
        land), construction, repair, or renovation of facilities.
    ``(3) The exercise by a health plan director of the authority 
provided in paragraph (1) shall not be subject to prior review by the 
Central Office of the Department.
    ``(b) Subsection (a) shall not apply to expenditures of funds 
provided to a facility by the Central Office of the Department 
exclusively for the purpose of the provision of the following services:
            ``(1) Services relating to post-traumatic stress disorder.
            ``(2) Services relating to spinal-cord injuries.
            ``(3) Services relating to substance abuse.
            ``(4) Services relating to the rehabilitation of blind 
        veterans.
``Sec. 7346. Veterans Health Care Investment Fund
    ``(a)(1) There is hereby established in the Treasury of the United 
States a fund to be known as the Veterans Health Care Investment Fund 
(in this section referred to as the `Fund').
    ``(2) The Fund shall be added to the list of accounts that are 
considered mandatory for the purposes of scoring appropriations bills.
    ``(b) There is hereby authorized to be appropriated to the 
Department, in addition to amounts otherwise authorized to be 
appropriated to the Department for VA health plans, such amounts as are 
necessary for the Secretary of the Treasury to fulfill the requirement 
of subsection (c).
    ``(c) For each of fiscal years 1995, 1996, and 1997, the Secretary 
of the Treasury shall, subject to the availability of appropriated 
funds, credit to the Fund an amount in that fiscal year as follows:
            ``(1) For fiscal year 1995, $1,225,000,000.
            ``(2) For fiscal year 1996, $600,000,000.
            ``(3) For fiscal year 1997, $1,700,000,000.
    ``(d)(1) Subject to paragraph (2), amounts in the Fund shall be 
available to the Secretary only for the VA health plans organized and 
operated under this subchapter.
    ``(2)(A) For each of fiscal years 1996 and 1997, the Secretary 
shall estimate the total amount to be collected or recovered under 
sections 1831, 1832, and 1833 of this title by reason of the provision 
of care and services through VA health plans under chapter 18 of this 
title or the enrollment of individuals in such plans under that 
chapter. The Secretary shall estimate the amount to be so collected or 
recovered with respect to each VA health plan and with respect to all 
VA health plans.
    ``(B) For each such fiscal year, the Secretary shall make available 
to each VA health plan an amount that bears the same relationship to 
the total amount available in the Fund for the fiscal year as the 
amount estimated to be collected or recovered by the VA health plan 
during the fiscal year bears to the total amount estimated to be 
collected or recovered by all VA health plans during that fiscal year.
    ``(e) Not later than March 1, 1997, the Secretary shall submit to 
Congress a report concerning the operation of the Department of 
Veterans Affairs health care system in preparing for, and operating 
under, national health care reform under the Health Security Act during 
fiscal years 1995 and 1996. The report shall include a discussion of--
            ``(1) the adequacy of amounts in the Fund for the operation 
        of VA health plans;
            ``(2) the quality of care provided by such plans;
            ``(3) the ability of such plans to attract patients; and
            ``(4) the need (if any) for additional funds for the Fund 
        in fiscal years after fiscal year 1997.
``Sec. 7347. Funding provisions: grants and other sources of assistance
    ``The Secretary may apply for and accept, if awarded, any grant or 
other source of funding that is intended to meet the needs of special 
populations and that but for this section is unavailable to facilities 
of the Department or to health plans operated by the Government if 
funds obtained through the grant or other source of funding will be 
used through a facility of the Department operating as or within a 
health plan.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 73 is amended by striking out the item relating to the heading 
for subchapter IV and inserting in lieu thereof the following:

 ``Subchapter IV--Participation as Part of National Health Care Reform

``7341. Organization of health care facilities as health plans.
``7342. Contract authority for facilities operating as or within health 
                            plans.
``7343. Resource sharing authority.
``7344. Administrative and personnel flexibility.
``7345. Expenditure authority.
``7346. Veterans Health Care Investment Fund.
``7347. Funding provisions: grants and other sources of assistance.
                ``Subchapter V--Research Corporations''.

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