224 
(B) seek to enter into contracts with ap-
propriate entities for the employment of 20 ad-
ditional medical scribes. 
(2) DISTRIBUTION.—The Secretary shall assign 
four medical scribes to each of the 10 medical cen-
ters of the Department where the Secretary carries 
out the pilot program as follows: 
(A) Two scribes shall be assigned to each 
of two physicians. 
(B) Thirty percent of the scribes shall be 
employed in the provision of emergency care. 
(C) Seventy percent of the scribes shall be 
employed in the provision of speciality care in 
specialties with the longest patient wait times 
or lowest efficiency ratings, as determined by 
the Secretary. 
(d) REPORTS.— 
(1) REPORTS TO CONGRESS.—Not later than 
180 days after the commencement of the pilot pro-
gram required under this section, and every 180 
days thereafter for the duration of the pilot pro-
gram, the Secretary of Veterans Affairs shall submit 
to Congress a report on the pilot program. Each 
such report shall include each of the following: 
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225 
(A) A separate analysis of each the fol-
lowing with respect to medical scribes employed 
by the Department of Veterans Affairs and 
medical scribes performing Department of Vet-
erans Affairs functions under a contract: 
(i) Provider efficiency. 
(ii) Patient satisfaction. 
(iii) Average wait time. 
(iv) The number of patients seen per 
day by each physician or practitioner. 
(v) The amount of time required to 
hire and train an employee to perform 
medical scribe functions under the pilot 
program. 
(B) Metrics and data for analyzing the ef-
fects of the pilot program, including an evalua-
tion of the each of the elements under clauses 
(i) through (iv) of subparagraph (A) at medical 
centers who employed scribes under the pilot 
program for an appropriate period preceding 
the hiring of such scribes. 
(2) COMPTROLLER
GENERAL
REPORT.—Not 
later than 90 days after the termination of the pilot 
program under this section, the Comptroller General 
of the United States shall submit to Congress a re-
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port on the pilot program. Such report shall include 
a comparison of the pilot program with similar pro-
grams carried out in the private sector. 
(e) DEFINITIONS.—In this section: 
(1) The term ‘‘medical scribe’’ means an unli-
censed individual hired to enter information into the 
electronic health record or chart at the direction of 
a physician or licensed independent practitioner 
whose responsibilities include the following: 
(A) Assisting the physician or practitioner 
in navigating the electronic health record. 
(B) Responding to various messages as di-
rected by the physician or practitioner. 
(C) Entering information into the elec-
tronic health record, as directed by the physi-
cian or practitioner. 
(2) The terms ‘‘urban’’ and ‘‘rural’’ have the 
meanings given such terms under the rural-urban 
commuting codes developed by the Secretary of Agri-
culture and the Secretary of Health and Human 
Services. 
(f) FUNDING.—The pilot program under this section 
shall be carried out using amounts otherwise authorized 
to be appropriated for the Department of Veterans Af-
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227 
fairs. No additional amounts are authorized to be appro-
priated to carry out such program. 
SEC. 508. EXTENSION OF REQUIREMENT TO COLLECT FEES 
FOR HOUSING LOANS GUARANTEED BY SEC-
RETARY OF VETERANS AFFAIRS. 
Section 3729(b)(2) of title 38, United States Code, 
is amended by striking ‘‘2027’’ each place it appears and 
inserting ‘‘2028’’. 
SEC. 509. EXTENSION OF REDUCTION IN AMOUNT OF PEN-
SION FURNISHED BY DEPARTMENT OF VET-
ERANS AFFAIRS FOR CERTAIN VETERANS 
COVERED BY MEDICAID PLANS FOR SERV-
ICES FURNISHED BY NURSING FACILITIES. 
Section 5503(d)(7) of title 38, United States Code, 
is amended by striking ‘‘September 30, 2027’’ and insert-
ing ‘‘September 30, 2028’’. 
SEC. 510. APPROPRIATION OF AMOUNTS. 
(a) VETERANS CHOICE PROGRAM.—There is author-
ized to be appropriated, and is appropriated, to the Sec-
retary of Veterans Affairs, out of any funds in the Treas-
ury not otherwise appropriated, $5,200,000,000 to be de-
posited in the Veterans Choice Fund under section 802 
of the Veterans Access, Choice, and Accountability Act of 
2014 (Public Law 113–146; 38 U.S.C. 1701 note). 
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(b) AVAILABILITY OF AMOUNTS.—The amounts ap-
propriated under subsection (a) shall be available for obli-
gation or expenditure without fiscal year limitation. 
SEC. 511. TECHNICAL CORRECTION. 
Section 1712I of title 38, United States Code, is re-
designated as section 1720I of such title. 
Æ 
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