IB 
Union Calendar No. 505 
110TH CONGRESS 
2D SESSION 
H. R. 6445 
[Report No. 110–786] 
To amend title 38, United States Code, to prohibit the Secretary of Veterans 
Affairs from collecting certain copayments from veterans who are cata-
strophically disabled. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 9, 2008 
Mr. CAZAYOUX (for himself, Ms. CORRINE BROWN of Florida, Mr. FILNER, 
Mr. HARE, and Mr. MICHAUD) introduced the following bill; which was 
referred to the Committee on Veterans’ Affairs 
JULY 29, 2008 
Additional sponsors: Mr. SALAZAR, Ms. BERKLEY, Mr. SPACE, and Mr. 
BUYER 
JULY 29, 2008 
Reported with amendments, committed to the Committee of the Whole House 
on the State of the Union, and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in italic] 
A BILL 
To amend title 38, United States Code, to prohibit the Sec-
retary of Veterans Affairs from collecting certain copay-
ments from veterans who are catastrophically disabled. 
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. PROHIBITION ON COLLECTION OF CERTAIN 
COPAYMENTS
FROM
VETERANS
WHO
ARE 
CATASTROPHICALLY DISABLED. 
(a) PROHIBITION ON COLLECTION OF COPAYMENTS 
AND OTHER FEES FOR HOSPITAL OR NURSING HOME 
CARE.—Section 1710 of title 38, United States Code, is 
amended— 
(1) by redesignating subsection (h) as sub-
section (i); and 
(2) by inserting after subsection (g) the fol-
lowing new subsection (h): 
‘‘(h) Notwithstanding any other provision of this sec-
tion, a veteran who is catastrophically disabled shall not 
be required to make any payment otherwise required 
under subsection (f) or (g) for the receipt of hospital care 
or nursing home care under this section.’’. 
(b) EFFECTIVE DATE.—Subsection (h) of section 
1710 of title 38, United States Code, as added by sub-
section (a), shall apply with respect to hospital care or 
nursing home care provided after the date of the enact-
ment of this Act. 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Veterans’ Health Care 
Policy Enhancement Act of 2008’’. 
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SEC. 2. PROHIBITION ON COLLECTION OF CERTAIN COPAY-
MENTS FROM VETERANS WHO ARE CATA-
STROPHICALLY DISABLED. 
(a) PROHIBITION ON COLLECTION OF COPAYMENTS 
AND OTHER FEES FOR HOSPITAL OR NURSING HOME 
CARE.—Section 1710 of title 38, United States Code, is 
amended— 
(1) by redesignating subsection (h) as subsection 
(i); and 
(2) by inserting after subsection (g) the following 
new subsection (h): 
‘‘(h) Notwithstanding any other provision of this sec-
tion, a veteran who is catastrophically disabled shall not 
be required to make any payment otherwise required under 
subsection (f) or (g) for the receipt of hospital care or nurs-
ing home care under this section.’’. 
(b) EFFECTIVE DATE.—Subsection (h) of section 1710 
of title 38, United States Code, as added by subsection (a), 
shall apply with respect to hospital care or nursing home 
care provided after the date of the enactment of this Act. 
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SEC. 3. EXPANSION OF AUTHORITY OF SECRETARY OF VET-
ERANS AFFAIRS TO PROVIDE COUNSELING 
FOR FAMILY MEMBERS OF VETERANS RECEIV-
ING NONSERVICE-CONNECTED TREATMENT. 
Section 1782(b) of title 38, United States Code, is 
amended by striking ‘‘if—’’ and all that follows and insert-
ing a period. 
SEC. 4. COMPREHENSIVE POLICY ON PAIN MANAGEMENT. 
(a) COMPREHENSIVE POLICY REQUIRED.—Not later 
than October 1, 2008, the Secretary of Veterans Affairs shall 
develop and implement a comprehensive policy on the man-
agement of pain experienced by veterans enrolled for health 
care services provided by the Department of Veterans Af-
fairs. 
(b) SCOPE OF POLICY.—The policy required by sub-
section (a) shall cover each of the following: 
(1) The systemwide management of acute and 
chronic pain experienced by veterans. 
(2) The standard of care for pain management 
to be used throughout the Department. 
(3) The consistent application of pain assess-
ments to be used throughout the Department. 
(4) The assurance of prompt and appropriate 
pain care treatment and management by the Depart-
ment, systemwide, when medically necessary. 
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(5) The Department’s program of research re-
lated to acute and chronic pain suffered by veterans, 
including pain attributable to central and peripheral 
nervous system damage characteristic of injuries in-
curred in modern warfare. 
(6) The Department’s program of pain care edu-
cation and training for health care personnel of the 
Department. 
(7) The Department’s program of patient edu-
cation for veterans suffering from acute or chronic 
pain and their families. 
(c) UPDATES.—The Secretary shall revise the policy 
developed under subsection (a) on a periodic basis in ac-
cordance with experience and evolving best practice guide-
lines. 
(d) CONSULTATION.—The Secretary shall develop the 
policy developed under subsection (a), and revise such pol-
icy under subsection (c), in consultation with veterans serv-
ice organizations and organizations with expertise in the 
assessment, diagnosis, treatment, and management of pain. 
(e) ANNUAL REPORT.— 
(1) IN GENERAL.—Not later than 180 days after 
the date of the completion and initial implementation 
of the policy under subsection (a) and on October 1 
of every fiscal year thereafter through fiscal year 
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2018, the Secretary shall submit to the Committee on 
Veterans’ Affairs of the Senate and the Committee on 
Veterans’ Affairs of the House of Representatives a re-
port on the implementation of the policy developed 
under subsection (a). 
(2) CONTENTS.—The report required by para-
graph (1) shall include the following: 
(A) A description of the policy developed 
and implemented under subsection (a) and any 
revisions to such policy under subsection (c). 
(B) A description of the performance meas-
ures used to determine the effectiveness of such 
policy in improving pain care for veterans sys-
temwide. 
(C) An assessment of the adequacy of the 
Department’s pain management services based 
on a survey of patients managed in Department 
clinics. 
(D) An assessment of the Department’s re-
search programs relevant to the treatment of the 
types of acute and chronic pain suffered by vet-
erans. 
(E) An assessment of the training provided 
to Department health care personnel with respect 
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to the diagnosis, treatment, and management of 
acute and chronic pain. 
(F) An assessment of the Department’s pain 
care-related patient education programs. 
(f) VETERANS SERVICE ORGANIZATION DEFINED.—In 
this section, the term ‘‘veterans service organization’’ means 
any organization recognized by the Secretary for the rep-
resentation of veterans under section 5902 of title 38, 
United States Code. 
SEC. 5. ESTABLISHMENT OF CONSOLIDATED PATIENT AC-
COUNTING CENTERS. 
(a) ESTABLISHMENT OF CENTERS.—Chapter 17 of 
title 38, United States Code, is amended by inserting after 
section 1729A the following: 
‘‘§ 1729B. Consolidated patient accounting centers 
‘‘(a) IN GENERAL.—Not later than 5 years after the 
date of enactment of this section, the Secretary of Veterans 
Affairs shall establish not more than seven consolidated pa-
tient accounting centers for conducting industry-modeled 
regionalized billing and collection activities of the Depart-
ment. 
‘‘(b) FUNCTIONS.—The centers shall carry out the fol-
lowing functions: 
‘‘(1) Reengineer and integrate all business proc-
esses of the revenue cycle of the Department. 
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‘‘(2) Standardize and coordinate all activities of 
the Department related to the revenue cycle for all 
health care services furnished to veterans for non-
service-connected medical conditions. 
‘‘(3) Apply commercial industry standards for 
measures of access, timeliness, and performance 
metrics with respect to revenue enhancement of the 
Department. 
‘‘(4) Apply other requirements with respect to 
such revenue cycle improvement as the Secretary may 
specify.’’. 
(b) CLERICAL AMENDMENT.—The table of sections at 
the beginning of such chapter is amended by inserting after 
the item relating to section 1729A the following: 
‘‘1729B. Consolidated patient accounting centers.’’. 
SEC. 6. SIMPLIFYING AND UPDATING NATIONAL STAND-
ARDS 
TO 
ENCOURAGE 
TESTING 
OF 
THE 
HUMAN IMMUNODEFICIENCY VIRUS. 
Section 124 of the Veterans’ Benefits and Services Act 
of 1988 (38 U.S.C. 7333 note; 102 Stat. 505) and the item 
relating to such section in the table of contents of such Act 
(102 Stat. 487) are repealed. 
Amend the title so as to read: ‘‘A bill to amend title 
38, United States Code, to prohibit the Secretary of Vet-
erans Affairs from collecting certain copayments from 
veterans who are catastrophically disabled, and for other 
purposes.’’. 
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Union Calendar No. 505 
110TH CONGRESS 
2D SESSION 
H. R. 6445 
[Report No. 110–786] 
A BILL 
To amend title 38, United States Code, to prohibit 
the Secretary of Veterans Affairs from collecting 
certain copayments from veterans who are cata-
strophically disabled. 
JULY 29, 2008 
Reported with amendments, committed to the Committee 
of the Whole House on the State of the Union, and or-
dered to be printed 
VerDate Aug 31 2005 
22:55 Jul 29, 2008
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