H. R. 5404—6 
SEC. 408. HEALTH PROFESSIONALS EDUCATION DEBT REDUCTION. 
Section 7683 is amended— 
(1) by striking subsection (a) and inserting the following 
new subsection: 
‘‘(a) IN GENERAL.—Education debt reduction payments under 
the Education Debt Reduction Program shall consist of— 
‘‘(1) payments to individuals selected to participate in the 
program of principal and interest on loans described in section 
7682(a)(2) of this title; or 
‘‘(2) payments for the principal and interest on such loans 
of such individuals to the holders of such loans.’’; 
(2) in subsections (b) and (c), by striking ‘‘payments to’’ 
both places it appears and inserting ‘‘payments to or for’’; 
and 
(3) in subsection (d)— 
(A) in paragraph (1), by striking ‘‘made to’’ and 
inserting ‘‘made to or for’’; and 
(B) in paragraph (2)(A), by striking ‘‘payable to that’’ 
and inserting ‘‘payable to or for that’’. 
SEC. 
409. 
AMENDMENTS 
TO 
VETERANS 
ACCESS, 
CHOICE, 
AND 
ACCOUNTABILITY ACT OF 2014. 
(a) EXPANDED AVAILABILITY OF HOSPITAL CARE AND MEDICAL 
SERVICES.—Section 101 of the Veterans Access, Choice, and 
Accountability Act of 2014 (Public Law 113–146; 38 U.S.C. 1701 
note) is amended— 
(1) in subsection (c)— 
(A) in paragraph (1)(A), by inserting ‘‘provide the vet-
eran an appointment that exceeds the wait-time goals 
described in such subsection or’’ before ‘‘place such’’; and 
(B) in paragraph (2), by inserting ‘‘(or other digital 
channel)’’ after ‘‘website’’; 
(2) in subsection (d)(1)(A), by adding at the end the fol-
lowing new sentences: ‘‘An agreement entered into pursuant 
to this subparagraph may not be treated as a Federal contract 
for the acquisition of goods or services and is not subject to 
any provision of law governing Federal contracts for the acquisi-
tion of goods or services. Before entering into an agreement 
pursuant to this subparagraph, the Secretary shall, to the 
maximum extent practicable and consistent with the require-
ments of this section, furnish such care and services to such 
veterans under this section with such entities pursuant to 
sharing agreements, existing contracts entered into by the Sec-
retary, or other processes available at medical facilities of the 
Department.’’; 
(3) in subsection (l)(1), by inserting ‘‘a copy of’’ before ‘‘any 
medical record’’; and 
(4) by adding at the end the following new subsection: 
‘‘(t) WAIVER OF CERTAIN PRINTING REQUIREMENTS.—Section 501 
of title 44, United States Code, shall not apply in carrying out 
this section.’’. 
(b) COLLABORATION
BETWEEN
VA 
AND
INDIAN
HEALTH 
SERVICE.—Section 102 of the Veterans Access, Choice, and Account-
ability Act of 2014 (Public Law 113–146; 38 U.S.C. 1701 note) 
is amended—
H. R. 5404—7 
(1) in subsection (b), by striking ‘‘The Secretary of Veterans 
Affairs shall establish’’ and inserting the following: ‘‘The Sec-
retary of Veterans Affairs and the Director of the Indian Health 
Service shall jointly establish and implement’’; 
(2) in subsection (c), by adding at the end the following 
new paragraph: 
‘‘(3) Entering into an agreement between the Department 
and the Indian Health Service described in paragraph (2)(A) 
with respect to the effect of such agreement on the priority 
access of any Indian to health care services provided through 
the Indian Health Service, the eligibility of any Indian to 
receive health services through the Indian Health Service, and 
the quality of health care services provided to any Indian 
through the Indian Health Service.’’; and 
(3) by striking subsection (d). 
(c) PROMPT PAYMENT.—Section 105 of the Veterans Access, 
Choice, and Accountability Act of 2014 (Public Law 113–146; 38 
U.S.C. 1701 note) is amended— 
(1) in subsection (a), by striking ‘‘section 1315’’ and 
inserting ‘‘part 1315’’; 
(2) in subsection (b)(2), by striking ‘‘chapter 39’’ and 
inserting ‘‘chapter 39 of title 31’’; and 
(3) in subsection (d), by striking ‘‘required by subsection 
(b)’’ and inserting ‘‘required by subsection (c)’’. 
(d) IMPROVEMENT OF ACCESS TO MOBILE VET CENTERS.—Section 
204 of the Veterans Access, Choice, and Accountability Act of 2014 
(Public Law 113–146; 38 U.S.C. 1701 note) is amended— 
(1) in subsection (a)— 
(A) in paragraph (1), by inserting ‘‘and readjustment 
counseling services’’ after ‘‘other health care’’; and 
(B) in paragraph (2)— 
(i) in subparagraph (B), by inserting ‘‘and events’’ 
after ‘‘locations’’; and 
(ii) in subparagraph (C), by inserting ‘‘and outreach 
contacts’’ after ‘‘appointments’’; and 
(2) in subsection (b)(2)— 
(A) in subparagraph (A)— 
(i) in the matter preceding clause (i), by inserting 
‘‘and readjustment counseling’’ after ‘‘telemedicine 
services’’; and 
(ii) in clause (iii), by inserting ‘‘and outreach con-
tacts’’ after ‘‘appointments’’; 
(B) in subparagraph (B), by inserting ‘‘and readjust-
ment counseling’’ after ‘‘health care services’’; and 
(C) in subparagraph (E), by striking ‘‘mobile vet centers 
and’’. 
(e) IMPROVED TRANSPARENCY.—Section 206(b) of the Veterans 
Access, Choice, and Accountability Act of 2014 (Public Law 113– 
146; 38 U.S.C. 1701 note) is amended— 
(1) in paragraph (1), by striking ‘‘comprehensive database’’ 
and inserting ‘‘comprehensive, machine-readable data set’’; 
(2) in paragraph (3), by striking ‘‘notice in the database 
of the reason’’ and inserting ‘‘notice of the reason’’; and 
(3) in paragraphs (2), (3), and (4), by striking ‘‘database’’ 
each place it appears and inserting ‘‘data’’. 
(f) INFORMATION ON CREDENTIALS.—Section 207 of the Veterans 
Access, Choice, and Accountability Act of 2014 (Public Law 113–
H. R. 5404—8 
146; 38 U.S.C. 1701 note) is amended by striking ‘‘successor data-
base’’ each place it appears and inserting ‘‘successor data set’’. 
(g) REPORT ON STAFFING SHORTAGES.—Section 301(b)(3) of the 
Veterans Access, Choice, and Accountability Act of 2014 (Public 
Law 113–146) is amended— 
(1) in subparagraph (A), by striking ‘‘Not later’’ and all 
that follows through ‘‘2019’’ and inserting the following: ‘‘On 
October 1 of each year beginning in 2015 and ending in 2019’’; 
and 
(2) in subparagraph (B)— 
(A) in clause (iii), by striking ‘‘at each’’ and all that 
follows through the period at the end and inserting the 
following: ‘‘or guidelines of the Department with respect 
to determining the ratio of residents to staff supervising 
residents.’’; and 
(B) by striking clause (v) and inserting the following 
new clause: 
‘‘(v) Efforts of the Department, as of the date of 
the submittal of the report, to recruit and retain med-
ical residents to work for the Veterans Health Adminis-
tration as full-time employees.’’. 
(h) PROJECT ARCH.—Section 403(j) of the Veterans’ Mental 
Health and Other Care Improvements Act of 2008 (Public Law 
110–387; 38 U.S.C. 1703 note) is amended— 
(1) by striking ‘‘In carrying out’’ and inserting ‘‘Notwith-
standing any provision of law relating to the use of competitive 
procedures in entering into contracts, in carrying out’’; and 
(2) by inserting ‘‘under this section’’ after ‘‘make use of 
contracts entered into’’. 
(i) CLARIFICATION OF APPROVAL OF COURSES OF EDUCATION 
PROVIDED BY PUBLIC INSTITUTIONS OF HIGHER LEARNING AND IN- 
STATE TUITION RATE
FOR VETERANS.—Paragraph (1) of section 
3679(c) is amended to read as follows: 
‘‘(1) Notwithstanding any other provision of this chapter and 
subject to paragraphs (3) through (6), the Secretary shall disapprove 
a course of education provided by a public institution of higher 
learning if the institution charges tuition and fees for that course 
for covered individuals who are pursuing the course with edu-
cational assistance under chapter 30 or 33 of this title while living 
in the State in which the institution is located at a rate that 
is higher than the rate the institution charges for tuition and
H. R. 5404—9 
fees for that course for residents of the State in which the institution 
is located, regardless of the covered individual’s State of residence.’’. 
Speaker of the House of Representatives. 
Vice President of the United States and
President of the Senate.