I 
111TH CONGRESS 
2D SESSION 
H. R. 4568 
To direct the Secretary of Defense and the Secretary of Veterans Affairs 
to carry out a pilot program under which the Secretaries make payments 
for certain treatments of traumatic brain injury and post-traumatic stress 
disorder. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 2, 2010 
Mr. SESSIONS (for himself, Mr. PASCRELL, and Mr. PLATTS) introduced the 
following bill; which was referred to the Committee on Armed Services, 
and in addition to the Committee on Veterans’ Affairs, for a period to 
be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee 
concerned 
A BILL 
To direct the Secretary of Defense and the Secretary of 
Veterans Affairs to carry out a pilot program under 
which the Secretaries make payments for certain treat-
ments of traumatic brain injury and post-traumatic 
stress disorder. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘TBI Treatment Act’’. 
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SEC. 2. PILOT PROGRAM ON PAYMENT FOR TREATMENT OF 
MEMBERS OF THE ARMED FORCES AND VET-
ERANS FOR TRAUMATIC BRAIN INJURY AND 
POST-TRAUMATIC STRESS DISORDER. 
(a) PAYMENT PROCESS.—The Secretary of Defense 
and the Secretary of Veterans Affairs shall carry out a 
five-year pilot program under which each such Secretary 
shall establish a process through which each Secretary 
shall provide payment for treatments (including diagnostic 
testing) of traumatic brain injury or post-traumatic stress 
disorder received by members of the Armed Forces and 
veterans in health care facilities other than military treat-
ment facilities or Department of Veterans Affairs medical 
facilities. Such process shall provide that payment be 
made directly to the health care facility furnishing the 
treatment. 
(b) CONDITIONS FOR PAYMENT.—The approval by a 
Secretary for payment for a treatment pursuant to sub-
section (a) shall be subject to the following conditions: 
(1) Any drug or device used in the treatment 
must be approved or cleared by the Food and Drug 
Administration for any purpose. 
(2) The treatment or study protocol used in 
treating the member or veteran must have been ap-
proved by an institutional review board operating in 
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accordance with regulations issued by the Secretary 
of Health and Human Services. 
(3) The approved treatment or study protocol 
(including any patient disclosure requirements) must 
be used by the health care provider delivering the 
treatment. 
(4) The patient receiving the treatment or 
study protocol must demonstrate an improvement as 
a result of the treatment on one or more of the fol-
lowing: 
(A) Standardized independent pre-treat-
ment and post-treatment neuropsychological 
testing. 
(B) Accepted survey instruments. 
(C) Neurological imaging. 
(D) Clinical examination. 
(5) The patient receiving the treatment or 
study protocol must be receiving the treatment vol-
untarily. 
(c) ADDITIONAL RESTRICTIONS PROHIBITED.—Ex-
cept as provided in this subsection (b), no restriction or 
condition for reimbursement may be placed on any health 
care provider that is operating lawfully under the laws of 
the State in which the provider is located with respect to 
the receipt of payment under this Act. 
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(d) PAYMENT DEADLINE.—The Secretary of Defense 
and the Secretary of Veterans Affairs shall make a pay-
ment for a treatment or study protocol pursuant to sub-
section (a) not later than 30 days after a member of the 
Armed Forces or veteran (or health care provider on be-
half of such member or veteran) submits to the Secretary 
documentation regarding the treatment or study protocol. 
The Secretary of Defense and the Secretary of Veterans 
Affairs shall ensure that the documentation required 
under this subsection may not be an undue burden on the 
member of the Armed Forces or veteran or on the health 
care provider. 
(e) PAYMENT SOURCE.—Subsection (c)(1) of section 
1074 of title 10, United States Code, shall apply with re-
spect to the payment by the Secretary of Defense for 
treatment or study protocols pursuant to subsection (a) 
of traumatic brain injury and post-traumatic stress dis-
order received by members of the Armed Forces. 
(f) PAYMENT AMOUNT.—A payment under this Act 
shall be made at the equivalent Centers for Medicare and 
Medicaid Services reimbursement rate in effect for appro-
priate treatment codes for the State or territory in which 
the treatment or study protocol is received. If no such rate 
is in effect, payment shall be made at a fair market rate, 
as determined by the Secretary of Defense, in consultation 
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with the Secretary of Health and Human Services, with 
respect to a patient who is a member of the Armed Forces 
or the Secretary of Veterans Affairs with respect to a pa-
tient who is a veteran. 
(g) DATA COLLECTION AND AVAILABILITY.— 
(1) IN
GENERAL.—The Secretary of Defense 
and the Secretary of Veterans Affairs shall jointly 
develop and maintain a database containing data 
from each patient case involving the use of a treat-
ment under this section. The Secretaries shall en-
sure that the database preserves confidentiality and 
be made available only— 
(A) for third-party payer examination; 
(B) to the appropriate congressional com-
mittees and employees of the Department of 
Defense, the Department of Veterans Affairs, 
the Department of Health and Human Services, 
and appropriate State agencies; and 
(C) to the primary investigator of the insti-
tutional review board that approved the treat-
ment or study protocol, in the case of data re-
lating to a patient case involving the use of 
such treatment or study protocol. 
(2) ENROLLMENT IN INSTITUTIONAL REVIEW 
BOARD STUDY.—In the case of a patient enrolled in 
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a registered institutional review board study, results 
may be publically distributable in accordance with 
the regulations prescribed pursuant to the Health 
Insurance Portability and Accountability Act of 
1996 (Public Law 104–191) and other regulations 
and practices in effect as of the date of the enact-
ment of this Act. 
(3) 
QUALIFIED
INSTITUTIONAL
REVIEW 
BOARDS.—The Secretary of Defense and the Sec-
retary of Veterans Affairs shall each ensure that the 
Internet website of their respective departments in-
cludes a list of all civilian institutional review board 
studies that have received a payment under this Act. 
(h) ASSISTANCE FOR MEMBERS TO OBTAIN TREAT-
MENT.— 
(1) ASSIGNMENT TO TEMPORARY DUTY.—The 
Secretary of a military department may assign a 
member of the Armed Forces under the jurisdiction 
of the Secretary to temporary duty or allow the 
member a permissive temporary duty in order to 
permit the member to receive treatment or study 
protocol for traumatic brain injury or post-traumatic 
stress disorder, for which payments shall be made 
under subsection (a), at a location beyond reason-
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able commuting distance of the member’s permanent 
duty station. 
(2) PAYMENT OF PER DIEM.—A member who is 
away from the member’s permanent station may be 
paid a per diem in lieu of subsistence in an amount 
not more than the amount to which the member 
would be entitled if the member were performing 
travel in connection with a temporary duty assign-
ment. 
(3) GIFT RULE WAIVER.—Notwithstanding any 
rule of any department or agency with respect to 
ethics or the receipt of gifts, any assistance provided 
to a member of the Armed Forces with a service- 
connected injury or disability for travel, meals, or 
entertainment incidental to receiving treatment or 
study protocol under this Act, or for the provision 
of such treatment or study protocol, shall not be 
subject to or covered by any such rule. 
(i) RETALIATION PROHIBITED.—No retaliation may 
be made against any member of the Armed Forces or vet-
eran who receives treatment or study protocol as part of 
registered institutional review board study carried out by 
a civilian health care practitioner. 
(j) TREATMENT OF UNIVERSITY AND NATIONALLY 
ACCREDITED
INSTITUTIONAL
REVIEW
BOARDS.—For 
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purposes of this Act, a university-affiliated or nationally 
accredited institutional review board shall be treated in the 
same manner as a Government institutional review board. 
(k) MEMORANDA OF UNDERSTANDING.—The Sec-
retary of Defense and the Secretary of Veterans Affairs 
shall seek to expeditiously enter into memoranda of under-
standings with civilian institutional review boards de-
scribed in subsection (j) for the purpose of providing for 
members of the Armed Forces and veterans to receive 
treatment carried out by civilian health care practitioners 
under a treatment or study protocol approved by and 
under the oversight of civilian institutional review boards 
that would qualify for payment under this Act. 
(l) OUTREACH REQUIRED.— 
(1) OUTREACH TO VETERANS.—The Secretary 
of Veterans Affairs shall notify each veteran with a 
service-connected injury or disability of the oppor-
tunity to receive treatment or study protocol pursu-
ant to this Act. 
(2) OUTREACH TO MEMBERS OF THE ARMED 
FORCES.—The Secretary of Defense shall notify 
each member of the Armed Forces with a service- 
connected injury or disability of the opportunity to 
receive treatment or study protocol pursuant to this 
Act. 
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(m) REPORT TO CONGRESS.—Not later than 30 days 
after the last day of each fiscal year during which the Sec-
retary of Defense and the Secretary of Veterans Affairs 
are authorized to make payments under this Act, the Sec-
retaries shall jointly submit to Congress an annual report 
on the implementation of this Act. Such report shall in-
clude each of the following for that fiscal year: 
(1) The number of individuals for whom the 
Secretary has provided payments under this Act. 
(2) The condition for which each such indi-
vidual receives treatment for which payment is pro-
vided under this Act and the success rate of each 
such treatment. 
(3) Treatment methods that are used by enti-
ties receiving payment provided under this Act and 
the respective rate of success of each such method. 
(4) The recommendations of the Secretaries 
with respect to the integration of treatment methods 
for which payment is provided under this Act into 
facilities of the Department of Defense and Depart-
ment of Veterans Affairs. 
(n) TERMINATION.—The authority to make a pay-
ment under this Act shall terminate on the date that is 
five years after the date of the enactment of this Act. 
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(o) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this Act 
$10,000,000 for each fiscal year during which the Sec-
retary of Veterans Affairs and the Secretary of Defense 
are authorized to make payments under this Act. 
Æ 
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