I 

116TH CONGRESS 

1ST SESSION H. R. 23 

To eliminate the sunset date for the Veterans Choice Program of the Department of Veterans Affairs, to expand eligibility for such program, and 

to extend certain operating hours for pharmacies and medical facilities 

of the Department, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 3, 2019 

Mr. HUDSON introduced the following bill; which was referred to the 

Committee on Veterans’ Affairs 

A BILL 

To eliminate the sunset date for the Veterans Choice Program of the Department of Veterans Affairs, to expand 

eligibility for such program, and to extend certain operating hours for pharmacies and medical facilities of the 

Department, 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 ‘‘Care Veterans Deserve 

5 Act of 2019’’. 

6 SEC. 2. EXPANSION OF VETERANS CHOICE PROGRAM. 

7 (a) ELIMINATION OF SUNSET.— 


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1 (1) IN GENERAL.—Section 101 of the Veterans 

2 Access, Choice, and Accountability Act of 2014 

3 (Public Law 113–146; 38 U.S.C. 1701 note) is 

4 amended— 

5 (A) by striking subsection (p); and 

6 (B) by redesignating subsections (q), (r), 

7 (s), and (t) as subsections (p), (q), (r), and (s), 

8 respectively. 

9 (2) CONFORMING AMENDMENTS.—Such section 

10 is amended— 

11 (A) in subsection (i)(2), by striking ‘‘dur12 ing the period in which the Secretary is author13 ized to carry out this section pursuant to sub14 section (p)’’; and 

15 (B) in subsection (p)(2), as redesignated 

16 by paragraph (1)(B), by striking subparagraph 

17 (F). 

18 (b) EXPANSION OF ELIGIBILITY FOR PROGRAM.— 

19 (1) IN GENERAL.—Subsection (b)(2) of such 

20 section is amended— 

21 (A) in subparagraph (C)(ii), by striking 

22 ‘‘or’’; 

23 (B) in subparagraph (D)(ii)(II), by strik24 ing the period at the end and inserting ‘‘; or’’; 

25 and 


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1 (C) by adding at the end the following new 

2 subparagraph: 

3 ‘‘(E) has a service-connected disability 

4 rated at 50 percent or more.’’. 

5 (2) CONFORMING AMENDMENT.—Subsection 

6 (g)(3) of such section is amended by striking ‘‘or 

7 (D)’’ and inserting ‘‘, (D), or (E)’’. 

8 SEC. 3. ACCESS OF VETERANS TO WALK-IN CLINICS. 

9 (a) IN GENERAL.—Subchapter I of chapter 17 of title 

10 38, United States Code, is amended by inserting after sec11 tion 1703 the following new section: 

12 ‘‘§ 1703A. Hospital care and medical services at walk13 in clinics 

14 ‘‘(a) IN GENERAL.—The Secretary shall enter into 

15 a contract with a national chain of walk-in clinics to pro16 vide the hospital care and medical services offered in such 

17 clinics to veterans enrolled in the system of annual patient 

18 enrollment established and operated under section 1705 

19 of this title. 

20 ‘‘(b) NO AUTHORIZATION OR COPAYMENT RE21 QUIRED.—In receiving hospital care or medical services at 

22 a walk-in clinic under subsection (a), a veteran is not re23 quired— 

24 ‘‘(1) to obtain authorization before receiving 

25 such care or services at the clinic; or 


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1 ‘‘(2) to pay a copayment to the clinic or the De2 partment in connection with the receipt of such care 

3 or services. 

4 ‘‘(c) LOCATIONS.—The Secretary may not require a 

5 national chain of walk-in clinics to expand their locations 

6 as a condition of a contract entered into under subsection 

7 (a). 

8 ‘‘(d) TRANSMITTAL OF INFORMATION.—(1) The na9 tional chain of walk-in clinics with which the Secretary 

10 has entered into a contract under subsection (a) shall es11 tablish an automated system that transmits to the Sec12 retary on a weekly basis information regarding the hos13 pital care or medical services provided to veterans under 

14 this section during such week. 

15 ‘‘(2) The automated system under paragraph (1) 

16 shall be established in a manner that allows the system 

17 to securely transmit information to the electronic health 

18 record of a veteran regarding the hospital care and med19 ical services provided to the veteran under this section. 

20 ‘‘(3) Transmittal of information under paragraph (1) 

21 may not be required as a condition of payment for hospital 

22 care or medical services provided under this section.’’. 

23 (b) CLERICAL AMENDMENT.—The table of sections 

24 at the beginning of chapter 17 of such title is amended 


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1 by inserting after the item relating to section 1703 the 

2 following new item: 

‘‘1703A. Hospital care and medical services at walk-in clinics.’’. 

3 SEC. 4. LICENSURE OF HEALTH CARE PROFESSIONALS OF 

4 THE DEPARTMENT OF VETERANS AFFAIRS 

5 PROVIDING TREATMENT VIA TELEMEDICINE. 

6 (a) IN GENERAL.—Subchapter III of chapter 17 of 

7 title 38, United States Code, is amended by inserting after 

8 section 1730C the following new section: 

9 ‘‘§ 1730D. Licensure of health care professionals pro10 viding treatment via telemedicine 

11 ‘‘(a) IN GENERAL.—Notwithstanding any provision 

12 of law regarding the licensure of health care professionals, 

13 a covered health care professional may practice the health 

14 care profession of the health care professional at any loca15 tion in any State, regardless of where such health care 

16 professional or the patient is located, if the health care 

17 professional is using telemedicine to provide treatment to 

18 an individual under this chapter. 

19 ‘‘(b) LOCATION OF CARE.—Subsection (a) shall apply 

20 to a covered health care professional providing treatment 

21 to a patient regardless of whether such health care profes22 sional or patient is located in a facility owned by the Fed23 eral Government during such treatment. 

24 ‘‘(c) RULE OF CONSTRUCTION.—Nothing in this sec25 tion may be construed to remove, limit, or otherwise affect 


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1 any obligation of a covered health care professional under 

2 the Controlled Substances Act (21 U.S.C. 801 et seq.). 

3 ‘‘(d) DEFINITIONS.—In this section: 

4 ‘‘(1) The term ‘covered health care professional’ 

5 means a health care professional who is— 

6 ‘‘(A) authorized by the Secretary to pro7 vide health care under this chapter, including a 

8 private health care professional who provides 

9 such care under a contract or agreement en10 tered into with the Secretary, including a con11 tract entered into under section 1703 of this 

12 title; and 

13 ‘‘(B) licensed, registered, or certified in a 

14 State to practice the health care profession of 

15 the health care professional. 

16 ‘‘(2) The term ‘telemedicine’ means the use of 

17 telecommunication technology and information tech18 nology to provide health care or support the provi19 sion of health care in situations in which the patient 

20 and health care professional are separated by geo21 graphic distance.’’. 

22 (b) CLERICAL AMENDMENT.—The table of sections 

23 at the beginning of chapter 17 of such title is amended 

24 by inserting after the item relating to section 1730C the 

25 following new item: 


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‘‘1730D. Licensure of health care professionals providing treatment via telemedicine.’’. 

1 (c) REPORT ON TELEMEDICINE.— 

2 (1) IN GENERAL.—Not later than one year 

3 after the date of the enactment of this Act, the Sec4 retary of Veterans Affairs shall submit to the Com5 mittee on Veterans’ Affairs of the Senate and the 

6 Committee on Veterans’ Affairs of the House of 

7 Representatives a report on the effectiveness of the 

8 use of telemedicine by the Department of Veterans 

9 Affairs. 

10 (2) ELEMENTS.—The report required by para11 graph (1) shall include an assessment of the fol12 lowing: 

13 (A) The satisfaction of veterans with tele14 medicine furnished by the Department. 

15 (B) The satisfaction of health care pro16 viders in providing telemedicine furnished by 

17 the Department. 

18 (C) The effect of telemedicine furnished by 

19 the Department on the following: 

20 (i) The ability of veterans to access 

21 health care, whether from the Department 

22 or from non-Department health care pro23 viders. 


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1 (ii) The frequency of use by veterans 

2 of telemedicine. 

3 (iii) The productivity of health care 

4 providers. 

5 (iv) Wait times for an appointment 

6 for the receipt of health care from the De7 partment. 

8 (v) The reduction, if any, in the use 

9 by veterans of services at Department fa10 cilities and non-Department facilities. 

11 (D) The types of appointments for the re12 ceipt of telemedicine furnished by the Depart13 ment that were provided during the one-year 

14 period preceding the submittal of the report. 

15 (E) The number of appointments for the 

16 receipt of telemedicine furnished by the Depart17 ment that were requested during such period, 

18 disaggregated by Veterans Integrated Service 

19 Network. 

20 (F) Savings by the Department, if any, in21 cluding travel costs, of furnishing health care 

22 through the use of telemedicine during such pe23 riod. 

24 (3) TELEMEDICINE DEFINED.—In this sub25 section, the term ‘‘telemedicine’’ has the meaning 


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1 given that term in section 1730D(d)(2) of title 38, 

2 United States Code, as added by subsection (a). 

3 SEC. 5. EXTENSION OF OPERATING HOURS FOR PHAR4 MACIES AND MEDICAL FACILITIES OF THE 

5 DEPARTMENT OF VETERANS AFFAIRS. 

6 (a) EXTENSION OF OPERATING HOURS FOR PHAR7 MACIES.—The Secretary of Veterans Affairs shall extend 

8 the operating hours for each pharmacy of the Department 

9 of Veterans Affairs during which the pharmacy offers 

10 services comparable to retail pharmacies to include— 

11 (1) operation on Saturday, Sunday, and Fed12 eral holidays; and 

13 (2) operation until 8:00 p.m. on weekdays that 

14 are not Federal holidays. 

15 (b) CONTRACTS WITH PROVIDERS DURING NIGHTS

16 AND WEEKENDS.—The Secretary shall enter into con17 tracts, including through locum tenens arrangements, with 

18 physicians and nurses that meet qualifications set forth 

19 by the Secretary for purposes of this section under which 

20 such physicians and nurses work at medical facilities of 

21 the Department during nights and weekends. 

22 (c) SUPPORT STAFF.—The Secretary may obtain ad23 ditional support staff as necessary to carry out this sec24 tion, including by hiring employees or contracting for serv25 ices. 


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1 SEC. 6. CONDUCT OF BEST-PRACTICES PEER REVIEW OF 

2 EACH MEDICAL CENTER OF THE DEPART3 MENT OF VETERANS AFFAIRS. 

4 (a) IN GENERAL.—The Secretary of Veterans Affairs 

5 may provide for the conduct by a nongovernmental hos6 pital organization of a best-practices peer review of each 

7 medical center of the Department of Veterans Affairs to 

8 evaluate the efficacy of health care delivered at each such 

9 medical center. 

10 (b) PRIORITY.—The Secretary shall give priority for 

11 peer review conducted under subsection (a) to the medical 

12 centers of the Department with the longest wait times for 

13 an appointment or the worst health outcomes, as deter14 mined by the Secretary. 

Æ 


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