I 

113TH CONGRESS 

2D SESSION H. R. 3858 

To amend title 38, United States Code, to direct the Secretary of Veterans 

Affairs to enter into contracts with health care providers to improve 

health care access and care coordination for veterans, and for other 

purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 13, 2014 

Mr. KINZINGER of Illinois introduced the following bill; which was referred to 

the Committee on Veterans’ Affairs 

A BILL 

To amend title 38, United States Code, to direct the Secretary of Veterans Affairs to enter into contracts with 

health care providers to improve health care access and 

care coordination for veterans, 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; SENSE OF CONGRESS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Veteran-Centered Access to Coordinated Health Care Act 

6 of 2014’’. 

7 (b) SENSE OF CONGRESS.—It is the sense of Con8 gress that— 


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1 (1) veterans who are authorized by the Sec2 retary of Veterans Affairs to receive health care in 

3 the community must not lose the high quality, safe4 ty, care coordination, and other veteran-centric ele5 ments that the health care system of the Depart6 ment of Veterans Affairs provides; 

7 (2) many veterans receive health care from both 

8 the Department and community providers but the 

9 lack of care coordination among the Department and 

10 community providers when veterans receive pur11 chased care places veterans at risk for poor health 

12 outcomes and results in inefficient use of finite 

13 health care resources; 

14 (3) veteran-centric care coordination is associ15 ated with improved patient outcomes, as Department 

16 and non-Department health care teams coordinate 

17 and collaborate to provide the best care for veterans; 

18 and 

19 (4) if the Secretary purchases care for veterans 

20 from the private sector, such care must be secured 

21 in a cost-effective manner, in a way that com22 plements the larger health care system of the De23 partment by using industry standards for care and 

24 costs. 


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1 SEC. 2. COMPREHENSIVE CONTRACT CARE COORDINATION 

2 PROGRAM FOR VETERANS. 

3 (a) IN GENERAL.— 

4 (1) TYPE OF CARE.—Subsection (a) of section 

5 1703 of title 38, United States Code, is amended to 

6 read as follows: 

7 ‘‘(a)(1) The Secretary shall provide an eligible vet8 eran with covered health services that are provided by a 

9 non-Department entity whom the Secretary enters into a 

10 contract with under this section if the Secretary deter11 mines that facilities of the Department are not capable 

12 of— 

13 ‘‘(A) economically furnishing covered health 

14 services to such veteran because of geographical in15 accessibility; or 

16 ‘‘(B) furnishing covered health services to such 

17 veteran because such facilities lack— 

18 ‘‘(i) the required personnel who are appro19 priately trained and experienced; or 

20 ‘‘(ii) the ability to provide timely and rea21 sonable access. 

22 ‘‘(2) Except as otherwise provided by this chapter or 

23 other law, the Secretary shall ensure that health care pro24 vided to a veteran under this title by a non-Department 

25 entity, including under the Patient-Centered Community 


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1 Care program or any other care-coordination program, is 

2 provided in accordance with this section. 

3 ‘‘(3) The Secretary shall provide covered health serv4 ices pursuant to this chapter at a location that is in ac5 cordance with the following priority: 

6 ‘‘(A) A facility of the Department. 

7 ‘‘(B) A facility of a department or agency of 

8 the Federal Government, or of a university, that the 

9 Secretary has entered into a sharing agreement with 

10 respect to providing such health services. 

11 ‘‘(C) A non-Department facility in accordance 

12 with this section. 

13 ‘‘(D) A non-Department facility in accordance 

14 with a provision of law other than this section. 

15 ‘‘(4) The Secretary shall ensure that veterans who re16 ceive health care under this title from a non-Department 

17 entity are able to efficiently reenter the health care system 

18 of the Department, including by coordinating care. 

19 ‘‘(5) In this subsection: 

20 ‘‘(A) The term ‘covered health services’ means, 

21 with respect to an eligible veteran, any hospital care, 

22 medical service, rehabilitative service, or preventative 

23 health service that is authorized to be provided by 

24 the Secretary to the veteran under this chapter or 

25 any other provision of law. 


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1 ‘‘(B) The term ‘eligible veteran’ means a vet2 eran enrolled in the health care system established 

3 under section 1705(a) of this title who elects to re4 ceive care under this section.’’. 

5 (2) QUALIFIED ENTITIES; CARE COORDINA6 TION.—Such section is amended by adding at the 

7 end the following new subsections: 

8 ‘‘(e) The Secretary shall enter into a contract with 

9 a non-Department entity under this section. The Secretary 

10 shall ensure that the resources of the Department are not 

11 used to duplicate administrative functions and information 

12 technology systems that are provided by the non-Depart13 ment entity under such a contract. A non-Department en14 tity shall be eligible for such a contract if the entity dem15 onstrates experience with respect to— 

16 ‘‘(1) the ability to provide non-Department 

17 health care services to veterans; 

18 ‘‘(2) meeting or exceeding internal credentialing 

19 standards of the Department and standards of the 

20 Utilization Review Accreditation Commission; 

21 ‘‘(3) having care coordinators who help veterans 

22 make, confirm, and keep medical appointments; 

23 ‘‘(4) having the ability to obtain clinical infor24 mation from non-Department entities and submit 

25 such information to the Department; 


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1 ‘‘(5) having— 

2 ‘‘(A) experience using an information tech3 nology system that— 

4 ‘‘(i) has the ability to track and mon5 itor veterans that is accessible by employ6 ees of the Department using a portal on an 

7 Internet website; and 

8 ‘‘(ii) allows veterans to file com9 plaints; and 

10 ‘‘(B) the ability to respond to potential 

11 quality indicators and patient safety events; and 

12 ‘‘(6) having the experience and ability to— 

13 ‘‘(A) process claims in the provider net14 work; 

15 ‘‘(B) bill a third party (as defined in sec16 tion 1725(f)(2) of this title) for care provided 

17 under this section, as appropriate; and 

18 ‘‘(C) transmit directly to the Secretary any 

19 amounts received pursuant to subparagraph 

20 (B). 

21 ‘‘(f) In carrying out this section, the Secretary shall 

22 ensure the following: 

23 ‘‘(1) With respect to each medical center of the 

24 Department, the Secretary is consistent in deterVerDate Mar 15 2010 03:57 Jan 14, 2014 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H3858.IH H3858

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1 mining the eligibility of veterans under subsection 

2 (a). 

3 ‘‘(2) The Secretary requires care coordinators 

4 of a non-Department entity described in subsection 

5 (e)(3) who will coordinate care of a veteran by the 

6 entity with a care coordinator of the Department. 

7 ‘‘(3) The Department and a non-Department 

8 entity under this section exchange clinical informa9 tion to improve both clinical decisionmaking and the 

10 care a veteran receives. 

11 ‘‘(4) Both non-Department facilities under this 

12 section and Department facilities meet performance 

13 metrics regarding— 

14 ‘‘(A) the quality of health care provided; 

15 ‘‘(B) the satisfaction of veterans; 

16 ‘‘(C) clinical information return within 30 

17 days of a health care visit of a patient; 

18 ‘‘(D) a no-show rate at a rate less than the 

19 industry standard; 

20 ‘‘(E) claims being paid within 30 days; 

21 ‘‘(F) timely access to health care, including 

22 initial appointments occurring less than 30 days 

23 after being requested; 

24 ‘‘(G) cost effectiveness; and 


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1 ‘‘(H) sufficient volume and case mix to en2 sure cost-effective vendor prices. 

3 ‘‘(g)(1) Not later than October 31 of each year, the 

4 Secretary shall submit to the Committee on Veterans’ Af5 fairs of the Senate and the Committee on Veterans’ Af6 fairs of the House of Representatives a report on care pro7 vided under this section, including— 

8 ‘‘(A) the cost to the Department; 

9 ‘‘(B) the number of veterans receiving care 

10 under this section as compared to the number of vet11 erans receiving care from non-Department facilities 

12 under other provisions of law; 

13 ‘‘(C) the quality of such care and the satisfac14 tion of such veterans; 

15 ‘‘(D) the performance metrics under subsection 

16 (f)(4); and 

17 ‘‘(E) other matters the Secretary considers ap18 propriate. 

19 ‘‘(2) Not later than March 1 of each odd-numbered 

20 year, the Secretary shall submit to the Committee on Vet21 erans’ Affairs of the Senate and the Committee on Vet22 erans’ Affairs of the House of Representatives a report 

23 on the allocation of resources with respect to care provided 

24 by the Department and by non-Department facilities.’’. 


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1 (3) EFFECTIVE DATE.—The amendments made 

2 by this subsection shall take effect 180 days after 

3 the date of the enactment of this Act. 

4 (b) REAUTHORIZATION OF PROJECT ARCH.—Section 

5 403 of the Veterans’ Mental Health and Other Care Im6 provements Act of 2008 (Public Law 110–387; 38 U.S.C. 

7 1703 note) is amended— 

8 (1) in subsection (a)(3), by striking ‘‘A vet9 eran’’ and inserting ‘‘Except as provided by sub10 section (i), a veteran’’; and 

11 (2) by adding at the end the following new sub12 section: 

13 ‘‘(i) REAUTHORIZATION.— 

14 ‘‘(1) RECOMMENCEMENT.—Not later than 90 

15 days after the date of the enactment of the Veteran16 Centered Collaborative Health Care Act of 2014, the 

17 Secretary shall again commence the conduct of the 

18 pilot program under subsection (a)(1). 

19 ‘‘(2) PROGRAM LOCATIONS.—Notwithstanding 

20 subsection (a)(4), the Secretary shall carry out the 

21 pilot program pursuant to paragraph (1) within each 

22 Veterans Integrated Service Network. 

23 ‘‘(3) APPOINTMENTS.—In carrying out the pilot 

24 program pursuant to paragraph (1), the Secretary 

25 shall ensure that medical appointments for veterans 


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1 occur during the 30-day period beginning on the 

2 date that is 15 days after the date on which the ap3 pointment is requested. 

4 ‘‘(4) OUTREACH.—The Secretary shall ensure 

5 that a veteran eligible for the pilot program carried 

6 out pursuant to paragraph (1) is informed of such 

7 program. 

8 ‘‘(5) TERMINATION.—The authority of the Sec9 retary to carry out the pilot program pursuant to 

10 paragraph (1) shall terminate on the date that is 

11 three years after the date on which the Secretary 

12 commences such program under such paragraph.’’. 

Æ 


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