IIB 
114TH CONGRESS 
2D SESSION 
H. R. 3989 
IN THE SENATE OF THE UNITED STATES 
MAY 24, 2016 
Received; read twice and referred to the Committee on Veterans’ Affairs 
AN ACT 
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 Sec-
retary of Veterans Affairs, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Support Our Military 
Caregivers Act’’. 
SEC. 2. EXTERNAL CLINICAL REVIEW OF DENIED APPLICA-
TIONS BY CAREGIVERS OF VETERANS. 
(a) IN GENERAL.—Section 1720G of title 38, United 
States Code, is amended— 
(1) by redesignating subsections (d) and (e) as 
subsections (e) and (f), respectively; and 
(2) by inserting after subsection (c) the fol-
lowing new subsection (d): 
‘‘(d) EXTERNAL CLINICAL REVIEW
OF APPLICA-
TIONS.—(1) Using amounts otherwise appropriated to 
carry out this section, an individual may elect to have an 
independent contractor described in paragraph (2) per-
form an external clinical review of any of the following: 
‘‘(A) The denial by the Secretary of an applica-
tion by an individual to be a caregiver or family 
caregiver eligible for the program of comprehensive 
assistance administered by the Secretary pursuant to 
this section. 
‘‘(B) With respect to such an application that 
the Secretary has granted, a determination by the 
Secretary of the level or amount of personal care 
services that a veteran requires. 
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‘‘(C) A request by a caregiver or family care-
giver for a reconsideration of the level or amount of 
personal care services that a veteran requires based 
on changes to the health or abilities of the veteran 
occurring since the Secretary granted such an appli-
cation. 
‘‘(D) The revocation by the Secretary of assist-
ance administered by the Secretary pursuant to this 
section. 
‘‘(2) An independent contractor described in this 
paragraph is an independent contractor that— 
‘‘(A) is awarded a contract by the Secretary to 
carry out this section pursuant to full and open com-
petition under the Federal Acquisition Regulation; 
‘‘(B) has no direct or indirect financial relation-
ship with any non-Department provider of services 
to caregivers and family caregivers pursuant to this 
title; 
‘‘(C) has not otherwise conducted an external 
clinical review of benefits administered by the Sec-
retary pursuant to this title other than this section; 
‘‘(D) has sufficient training and expertise in 
medical science and other appropriate health, edu-
cational, and vocational training and legal matters 
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to perform the reviews described in paragraph (1); 
and 
‘‘(E) employs a panel of physicians or other ap-
propriate health care professionals who do not pro-
vide health care to the individual who makes an elec-
tion under paragraph (1). 
‘‘(3) Each external clinical review conducted pursu-
ant to paragraph (1) shall— 
‘‘(A) be based on applicable information in-
cluded in the application for assistance described in 
such paragraph, including clinical expertise, medical, 
technical, and scientific evidence; 
‘‘(B) include an opportunity for both the indi-
vidual who elects for such review and, to the extent 
possible, the veteran for whom care is being provided 
to offer opinions and supporting data as to the level 
of care required; and 
‘‘(C) include a review of the initial clinical re-
view of such veteran and any other review made by 
the Secretary. 
‘‘(4) In carrying out the external clinical reviews pur-
suant to paragraph (1), the independent contractor shall, 
as determined appropriate by the Secretary— 
‘‘(A) collect and maintain information required; 
and 
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‘‘(B) share such information with the Secretary. 
‘‘(5) The Secretary shall take into account, but is not 
bound by, any determination made by the independent 
contractor pursuant to paragraph (1) in determining the 
final decision with respect to the application for assist-
ance. The Secretary may make a final decision that is con-
trary to such a determination if the Secretary includes 
clinically supported documentation with the decision. 
‘‘(6) The Secretary shall ensure that each external 
clinical review conducted by the independent contractor 
pursuant to paragraph (1) is completed and the Depart-
ment is notified in writing of the results of the review by 
not later than 120 days after the date on which the indi-
vidual makes the election under such paragraph. Not later 
than 30 days after the delivery of the determination rec-
ommended by the independent contractors, the Secretary 
shall ensure that the veteran and the individual making 
the election under such paragraph is notified in writing 
of the final decision of the Secretary. In accordance with 
paragraph (5), such notification shall include an expla-
nation of the recommended decision, a discussion of the 
facts and applicable regulations, and an explanation of the 
clinical rationale for the final decision. 
‘‘(7) The Secretary shall notify individuals who sub-
mit an application to be a caregiver or family caregiver 
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eligible for the program of comprehensive assistance ad-
ministered by the Secretary pursuant to this section of the 
ability of the individual to make an election under para-
graph (1). 
‘‘(8) Nothing in this subsection may be construed to 
affect claims made by veterans for disability compensation 
under chapter 11 of this title.’’. 
(b) APPLICATION.—The amendments made by sub-
section (a) shall apply with respect to elections under sub-
section (d) of section 1720G of title 38, United States 
Code, as added by subsection (a)(2), that are for applica-
tions or revocations for assistance for caregivers and fam-
ily caregivers pursuant to such section for which the Sec-
retary of Veterans Affairs has not made a final decision 
as of the date of the enactment of this Act. 
SEC. 3. PROCESS TO DETERMINE ELIGIBILITY FOR CARE-
GIVERS OF VETERANS. 
(a) DIRECTIVES.—The Secretary of Veterans Affairs 
shall issue directives regarding the policies, procedures, 
and operational requirements for the Family Caregiver 
Program, including with respect to determining the eligi-
bility of an individual to participate in the Family Care-
giver Program. 
(b) GAO REPORT.—The Comptroller General of the 
United States shall submit to the Committees on Vet-
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erans’ Affairs of the House of Representatives and the 
Senate a report on the processes of the Secretary of Vet-
erans Affairs with respect to— 
(1) determining the eligibility of an individual 
to participate in the Family Caregiver Program; 
(2) adjudicating appeals to such determina-
tions; and 
(3) the periodic eligibility reevaluation of an in-
dividual participating in such program and the com-
munication of any changes as a result of such re-
evaluations to the veteran and caregiver. 
(c) FAMILY CAREGIVER PROGRAM DEFINED.—In 
this section, the term ‘‘Family Caregiver Program’’ either 
the program of comprehensive assistance for family care-
givers or the program of general caregiver support services 
established by section 1720G of title 38, United States 
Code. 
SEC. 4. MODIFICATION TO LIMITATION ON AWARDS AND 
BONUSES. 
Section 705 of the Veterans Access, Choice, and Ac-
countability Act of 2014 (Public Law 113–146; 38 U.S.C. 
703 note) is amended to read as follows: 
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‘‘SEC. 705. LIMITATION ON AWARDS AND BONUSES PAID TO 
EMPLOYEES OF DEPARTMENT OF VETERANS 
AFFAIRS. 
‘‘The Secretary of Veterans Affairs shall ensure that 
the aggregate amount of awards and bonuses paid by the 
Secretary in a fiscal year under chapter 45 or 53 of title 
5, United States Code, or any other awards or bonuses 
authorized under such title or title 38, United States 
Code, does not exceed the following amounts: 
‘‘(1) With respect to each of fiscal years 2017 
through 2021, $230,000,000. 
‘‘(2) With respect to each of fiscal years 2022 
through 2024, $360,000,000.’’. 
Passed the House of Representatives May 23, 2016. 
Attest: 
KAREN L. HAAS, 
Clerk. 
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