IIB 

111TH CONGRESS 

1ST SESSION H. R. 3219 

IN THE SENATE OF THE UNITED STATES 

JULY 28, 2009 

Received; read twice and referred to the Committee on Veterans’ Affairs 

AN ACT 

To amend title 38, United States Code, to make certain 

improvements in the laws administered by the Secretary 

of Veterans Affairs relating to insurance and health care, 

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, 


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1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

3 ‘‘Veterans’ Insurance and Health Care Improvements Act 

4 of 2009’’. 

5 (b) TABLE OF CONTENTS.—The table of contents for 

6 this Act is as follows: 

Sec. 1. Short title; table of contents. 

TITLE I—MATTERS RELATING TO INSURANCE 

Sec. 101. Permanent extension of duration of Servicemembers’ Group Life Insurance coverage for totally disabled veterans. 

Sec. 102. Increased amount of Veterans’ Group Life Insurance. 

Sec. 103. Elimination of reduction in amount of accelerated death benefit for 

terminally-ill persons insured under Servicemembers’ Group 

Life Insurance and Veterans’ Group Life Insurance. 

TITLE II—MATTERS RELATING TO HEALTH CARE 

Sec. 201. Higher priority status for certain veterans who are medal of honor 

recipients. 

Sec. 202. Provision of hospital care, medical services, and nursing home care 

for certain Vietnam-era veterans exposed to herbicide and veterans of the Persian Gulf War. 

Sec. 203. Prohibition on collection of copayments from catastrophically disabled 

veterans. 

Sec. 204. Establishment of Director of Physician Assistant Services at Veterans 

Health Administration of Department of Veterans Affairs. 

Sec. 205. Committee on Care of Veterans with Traumatic Brain Injury. 

Sec. 206. Revision of certain requirements for the pilot program of enhanced 

contract care authority for health care needs of veterans in 

highly rural areas. 

TITLE III—MATTERS RELATING TO BENEFITS 

Sec. 301. Benefits for qualified World War II veterans. 

Sec. 302. Waiver of housing loan fee for certain veterans with service-connected 

disabilities called to active service. 


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1 TITLE I—MATTERS RELATING 

2 TO INSURANCE 

3 SEC. 101. PERMANENT EXTENSION OF DURATION OF 

4 SERVICEMEMBERS’ GROUP LIFE INSURANCE 

5 COVERAGE FOR TOTALLY DISABLED VET6 ERANS. 

7 (a) EXTENSION.—Section 1968(a) of title 38, United 

8 States Code, is amended— 

9 (1) in paragraph (1)(A), by striking clause (ii) 

10 and inserting the following new clause (ii): 

11 ‘‘(ii) The date that is two years after 

12 the date of separation or release from such 

13 active duty or active duty for training.’’; 

14 and 

15 (2) in paragraph (4), by striking subparagraph 

16 (B) and inserting the following new subparagraph 

17 (B): 

18 ‘‘(B) The date that is two years after the 

19 date of separation or release from such assign20 ment.’’. 

21 (b) EFFECTIVE DATE.—The amendments made by 

22 subsection (a) shall apply with respect to a person who 

23 is separated or released on or after June 15, 2005. 


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1 SEC. 102. INCREASED AMOUNT OF VETERANS’ GROUP LIFE 

2 INSURANCE. 

3 (a) INCREASED AMOUNT.—Section 1977(a) of title 

4 38, United States Code, is amended— 

5 (1) in paragraph (1), by inserting ‘‘Except as 

6 provided in paragraph (3),’’ before ‘‘Veterans’ Group 

7 Life Insurance shall be’’; and 

8 (2) by adding after paragraph (2) the following 

9 new paragraph: 

10 ‘‘(3) Not more than once in each five-year period be11 ginning on the one-year anniversary of the date a person 

12 becomes insured under Veterans’ Group Life Insurance, 

13 such person may elect in writing to increase the amount 

14 for which the person is insured if— 

15 ‘‘(A) the person is under the age of 60; 

16 ‘‘(B) the increased amount is $25,000; and 

17 ‘‘(C) the amount for which the person is in18 sured does not exceed the amount provided for 

19 under section 1967(a)(3)(A)(i) of this title.’’. 

20 (b) EFFECTIVE DATE.—Paragraph (3) of section 

21 1977(a) of title 38, United States Code, shall take effect 

22 on the date that is 180 days after the date of the enact23 ment of this Act. 


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1 SEC. 103. ELIMINATION OF REDUCTION IN AMOUNT OF AC2 CELERATED DEATH BENEFIT FOR TERMI3 NALLY-ILL PERSONS INSURED UNDER 

4 SERVICEMEMBERS’ GROUP LIFE INSURANCE 

5 AND VETERANS’ GROUP LIFE INSURANCE. 

6 (a) ELIMINATION OF REDUCTION.—Section 

7 1980(b)(1) of title 38, United States Code, is amended 

8 by striking ‘‘reduced by’’ and all that follows through ‘‘the 

9 Secretary’’. 

10 (b) EFFECTIVE DATE.—The amendment made by 

11 subsection (a) shall apply with respect to a payment of 

12 an accelerated death benefit under section 1980 of title 

13 38, United States Code, made on or after the date of the 

14 enactment of this Act. 

15 TITLE II—MATTERS RELATING 

16 TO HEALTH CARE 

17 SEC. 201. HIGHER PRIORITY STATUS FOR CERTAIN VET18 ERANS WHO ARE MEDAL OF HONOR RECIPI19 ENTS. 

20 Section 1705(a)(3) of title 38, United States Code, 

21 is amended by inserting ‘‘veterans who were awarded the 

22 medal of honor under section 3741, 6241, or 8741 of title 

23 10 or section 491 of title 14,’’ after ‘‘Veterans who are 

24 former prisoners of war or who were awarded the Purple 

25 Heart,’’. 


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1 SEC. 202. PROVISION OF HOSPITAL CARE, MEDICAL SERV2 ICES, AND NURSING HOME CARE FOR CER3 TAIN VIETNAM-ERA VETERANS EXPOSED TO 

4 HERBICIDE AND VETERANS OF THE PERSIAN 

5 GULF WAR. 

6 Section 1710(e) of title 38, United States Code, is 

7 amended— 

8 (1) in paragraph (3)— 

9 (A) by striking ‘‘subsection (a)(2)(F)—’’ 

10 and all that follows through ‘‘(C) in the case’’ 

11 and inserting ‘‘subsection (a)(2)(F) in the 

12 case’’; and 

13 (B) by redesignating clauses (i) and (ii) of 

14 the former subparagraph (C) as subparagraphs 

15 (A) and (B) of such paragraph (3) and by mov16 ing such new subparagraphs two ems to the 

17 left; and 

18 (2) in paragraph (1)(C)— 

19 (A) by striking ‘‘paragraphs (2) and (3)’’ 

20 and inserting ‘‘paragraph (2)’’; and 

21 (B) by inserting after ‘‘on active duty’’ the 

22 following: ‘‘between August 2, 1990, and No23 vember 11, 1998,’’. 


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1 SEC. 203. PROHIBITION ON COLLECTION OF COPAYMENTS 

2 FROM CATASTROPHICALLY DISABLED VET3 ERANS. 

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

5 title 38, United States Code, is amended by adding at the 

6 end the following new section: 

7 ‘‘§ 1730A. Prohibition on collection of copayments 

8 from catastrophically disabled veterans 

9 ‘‘Notwithstanding subsections (f) and (g) of section 

10 1710 of this title, subsection (a) of section 1722A of this 

11 title, and any other provision of law, the Secretary may 

12 not require a veteran who is catastrophically disabled to 

13 make any copayment for the receipt of hospital care or 

14 medical services under the laws administered by the Sec15 retary.’’. 

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

17 at the beginning of such chapter is amended by inserting 

18 after the item relating to section 1730 the following new 

19 item: 

‘‘1730A. Prohibition on collection of copayments from catastrophically disabled 

veterans.’’. 


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1 SEC. 204. ESTABLISHMENT OF DIRECTOR OF PHYSICIAN 

2 ASSISTANT SERVICES AT VETERANS HEALTH 

3 ADMINISTRATION OF DEPARTMENT OF VET4 ERANS AFFAIRS. 

5 (a) IN GENERAL.—Section 7306(a) of title 38, 

6 United States Code, is amended by striking paragraph (9) 

7 and inserting the following new paragraph (9): 

8 ‘‘(9) The Director of Physician Assistant Serv9 ices, who shall serve in a full-time capacity at the 

10 Central Office of the Department and who shall be 

11 a qualified physician assistant, who shall be respon12 sible to and report directly to the Under Secretary 

13 for Health on all matters relating to the education 

14 and training, employment, appropriate utilization, 

15 and optimal participation of physician assistants 

16 within the programs and initiatives of the Adminis17 tration.’’. 

18 (b) DEADLINE FOR IMPLEMENTATION.—The Sec19 retary of Veterans Affairs shall ensure that an individual 

20 is serving as the Director of Physician Assistant Services 

21 under section 7306(a)(9) of title 38, United States Code, 

22 as added by subsection (a), by not later than 120 days 

23 after the date of the enactment of this Act. 


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1 SEC. 205. COMMITTEE ON CARE OF VETERANS WITH TRAU2 MATIC BRAIN INJURY. 

3 (a) ESTABLISHMENT OF COMMITTEE.—Subchapter 

4 II of chapter 73 of title 38, United States Code, is amend5 ed by inserting after section 7321 the following new sec6 tion: 

7 ‘‘§ 7321A. Committee on Care of Veterans with Trau8 matic Brain Injury 

9 ‘‘(a) ESTABLISHMENT.—The Secretary shall estab10 lish in the Veterans Health Administration a committee 

11 to be known as the ‘Committee on Care of Veterans with 

12 Traumatic Brain Injury’. The Under Secretary for Health 

13 shall appoint employees of the Department with expertise 

14 in the care of veterans with traumatic brain injury to serve 

15 on the committee. 

16 ‘‘(b) RESPONSIBILITIES OF COMMITTEE.—The com17 mittee shall assess, and carry out a continuing assessment 

18 of, the capability of the Veterans Health Administration 

19 to meet effectively the treatment and rehabilitation needs 

20 of veterans with traumatic brain injury. In carrying out 

21 that responsibility, the committee shall— 

22 ‘‘(1) evaluate the care provided to such veterans 

23 through the Veterans Health Administration; 

24 ‘‘(2) identify systemwide problems in caring for 

25 such veterans in facilities of the Veterans Health 

26 Administration; 


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1 ‘‘(3) identify specific facilities within the Vet2 erans Health Administration at which program en3 richment is needed to improve treatment and reha4 bilitation of such veterans; and 

5 ‘‘(4) identify model programs which the com6 mittee considers to have been successful in the treat7 ment and rehabilitation of such veterans and which 

8 should be implemented more widely in or through fa9 cilities of the Veterans Health Administration. 

10 ‘‘(c) ADVICE AND RECOMMENDATIONS.—The com11 mittee shall— 

12 ‘‘(1) advise the Under Secretary regarding the 

13 development of policies for the care and rehabilita14 tion of veterans with traumatic brain injury; and 

15 ‘‘(2) make recommendations to the Under Sec16 retary— 

17 ‘‘(A) for improving programs of care of 

18 such veterans at specific facilities and through19 out the Veterans Health Administration; 

20 ‘‘(B) for establishing special programs of 

21 education and training relevant to the care of 

22 such veterans for employees of the Veterans 

23 Health Administration; 

24 ‘‘(C) regarding research needs and prior25 ities relevant to the care of such veterans; and 


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1 ‘‘(D) regarding the appropriate allocation 

2 of resources for all such activities. 

3 ‘‘(d) ANNUAL REPORT.—Not later than June 1 of 

4 2010, and each subsequent year, the Secretary shall sub5 mit to the Committees on Veterans’ Affairs of the Senate 

6 and House of Representatives a report on the implementa7 tion of this section. Each such report shall include the fol8 lowing for the calendar year preceding the year in which 

9 the report is submitted: 

10 ‘‘(1) A list of the members of the committee. 

11 ‘‘(2) The assessment of the Under Secretary for 

12 Health, after review of the initial findings of the 

13 committee, regarding the capability of the Veterans 

14 Health Administration, on a systemwide and facility15 by-facility basis, to meet effectively the treatment 

16 and rehabilitation needs of veterans with traumatic 

17 brain injury. 

18 ‘‘(3) The plans of the committee for further as19 sessments. 

20 ‘‘(4) The findings and recommendations made 

21 by the committee to the Under Secretary for Health 

22 and the views of the Under Secretary on such find23 ings and recommendations. 

24 ‘‘(5) A description of the steps taken, plans 

25 made (and a timetable for the execution of such 


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1 plans), and resources to be applied toward improving 

2 the capability of the Veterans Health Administration 

3 to meet effectively the treatment and rehabilitation 

4 needs of veterans with traumatic brain injury.’’. 

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

6 at the beginning of such chapter is amended by inserting 

7 after the item relating to section 7321 the following new 

8 item: 

‘‘7321A. Committee on Care of Veterans with Traumatic Brain Injury.’’. 

9 SEC. 206. REVISION OF CERTAIN REQUIREMENTS FOR THE 

10 PILOT PROGRAM OF ENHANCED CONTRACT 

11 CARE AUTHORITY FOR HEALTH CARE NEEDS 

12 OF VETERANS IN HIGHLY RURAL AREAS. 

13 Subsection (b) of section 403 of the Veterans’ Mental 

14 Health and Other Care Improvements Act of 2008 (Public 

15 Law 110–387; 38 U.S.C. 1703 note) is amended to read 

16 as follows: 

17 ‘‘(b) COVERED VETERANS.—For purposes of the 

18 pilot program under this section, a covered veteran is any 

19 veteran who— 

20 ‘‘(1) is— 

21 ‘‘(A) enrolled in the system of patient en22 rollment established under section 1705(a) of 

23 title 38, United States Code, as of the date of 

24 the commencement of the pilot program under 

25 subsection (a)(2); or 


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1 ‘‘(B) eligible for health care under section 

2 1710(e)(3)(C) of title 38, United States Code; 

3 and 

4 ‘‘(2) resides in a location that is— 

5 ‘‘(A) more than 60 minutes’ driving dis6 tance, as determined by the Secretary, from the 

7 nearest Department health care facility pro8 viding primary care services, in the case of a 

9 veteran seeking such services; 

10 ‘‘(B) more than 120 minutes’ driving dis11 tance, as determined by the Secretary, from the 

12 nearest Department health care facility pro13 viding acute hospital care, in the case of a vet14 eran seeking such care; or 

15 ‘‘(C) more than 240 minutes’ driving dis16 tance, as determined by the Secretary, from the 

17 nearest Department health care facility pro18 viding tertiary care, in the case of a veteran 

19 seeking such care.’’. 


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1 TITLE III—MATTERS RELATING 

2 TO BENEFITS 

3 SEC. 301. BENEFITS FOR QUALIFIED WORLD WAR II VET4 ERANS. 

5 (a) ESTABLISHMENT OF COMPENSATION FUND.— 

6 Subchapter II of chapter 5 of title 38, United States Code, 

7 is amended by adding at the end the following new section: 

8 ‘‘§ 533. Qualified World War II Veterans Equity Com9 pensation Fund 

10 ‘‘(a) COMPENSATION FUND.—(1) There is in the gen11 eral fund of the Treasury a fund to be known as the 

12 ‘Qualified World War II Veterans Equity Compensation 

13 Fund’ (in this section referred to as the ‘compensation 

14 fund’). 

15 ‘‘(2) Subject to the availability of appropriations for 

16 such purpose, amounts in the compensation fund shall be 

17 available to the Secretary without fiscal year limitation to 

18 make payments to eligible individuals in accordance with 

19 this section. 

20 ‘‘(b) ELIGIBLE INDIVIDUALS.—(1) An eligible indi21 vidual is an individual who— 

22 ‘‘(A) during the 1-year period beginning on the 

23 date of the enactment of this section, submits to the 

24 Secretary an application containing such information 

25 and assurances as the Secretary may require; 


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1 ‘‘(B) has not received benefits under the Serv2 icemen’s Readjustment Act of 1944 (Public Law 

3 78–346); and 

4 ‘‘(C) has engaged in qualified service. 

5 ‘‘(2) For purposes of paragraph (1), a person has en6 gaged in qualified service if the service of the person has 

7 been determined to have been active duty service pursuant 

8 to section 1401 of the GI Bill Improvement Act of 1977 

9 (38 U.S.C. 106 note). 

10 ‘‘(c) AMOUNT OF PAYMENTS.—The Secretary shall 

11 make a monthly payment out of the compensation fund 

12 in the amount of $1,000 to an eligible individual. The Sec13 retary shall make such payments to eligible individuals in 

14 the order in which the Secretary receives the applications 

15 of the eligible individuals. 

16 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—(1) 

17 There are authorized to be appropriated to the compensa18 tion fund amounts as follows: 

19 ‘‘(A) For fiscal year 2010, $222,000,000. 

20 ‘‘(B) For fiscal year 2011, $193,000,000. 

21 ‘‘(C) For fiscal year 2012, $170,000,000. 

22 ‘‘(D) For fiscal year 2013, $146,000,000. 

23 ‘‘(E) For fiscal year 2014, $124,000,000. 

24 ‘‘(2) Funds appropriated to carry out this section 

25 shall remain available until expended. 


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1 ‘‘(e) REPORTS.—The Secretary shall include, in docu2 ments submitted to Congress by the Secretary in support 

3 of the President’s budget for each fiscal year, detailed in4 formation on the operation of the compensation fund, in5 cluding the number of applicants, the number of eligible 

6 individuals receiving benefits, the amounts paid out of the 

7 compensation fund, the administration of the compensa8 tion fund, and an estimate of the amounts necessary to 

9 fully fund the compensation fund for that fiscal year and 

10 each of the three subsequent fiscal years. 

11 ‘‘(f) REGULATIONS.—The Secretary shall prescribe 

12 regulations to carry out this section.’’. 

13 (b) REGULATIONS.—Not later than 180 days after 

14 the date of the enactment of this Act, the Secretary shall 

15 prescribe the regulations required under section 532(f) of 

16 title 38, United States Code, as added by subsection (a). 

17 (c) CLERICAL AMENDMENT.—The table of sections 

18 at the beginning of such chapter is amended by inserting 

19 after the item related to section 532 the following new 

20 item: 

‘‘533. Qualified World War II Veterans Equity Compensation Fund.’’. 


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1 SEC. 302. WAIVER OF HOUSING LOAN FEE FOR CERTAIN 

2 VETERANS WITH SERVICE-CONNECTED DIS3 ABILITIES CALLED TO ACTIVE SERVICE. 

4 Section 3729(c)(1) of title 38, United States Code, 

5 is amended by inserting after ‘‘retirement pay’’ the fol6 lowing: ‘‘or active service pay’’. 

Passed the House of Representatives July 27, 2009. 

Attest: LORRAINE C. MILLER, 

Clerk. 


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