SEC. 2. AGREEMENTS. 
(a) IN GENERAL.—Subchapter I of chapter 17 of title 
38, United States Code, is amended by inserting after sec-
tion 1703 the following new section: 
‘‘§ 1703A. Veterans Care Agreements with certain 
health care providers 
‘‘(a) VETERANS CARE AGREEMENTS.—(1) In addi-
tion to furnishing hospital care, medical services, or ex-
tended care under this chapter at facilities of the Depart-
ment or under contracts or sharing agreements entered 
into pursuant to provisions of law other than this section, 
the Secretary may furnish such care and services to eligi-
ble veterans through the use of agreements entered into 
under this section by the Secretary with eligible providers. 
‘‘(2) The Secretary may enter into Veterans Care 
Agreements under this section with eligible providers to 
furnish hospital care, medical services, and extended care 
to veterans whom the Secretary determines that fur-
nishing such care and services at facilities of the Depart-
ment or under contracts or sharing agreements under pro-
visions of law other than this section is impracticable or 
inadvisable because of the medical condition of the vet-
eran, the travel involved, or the nature of the care or serv-
ices required, or a combination of such factors. 
‘‘(b) VETERAN ELIGIBILITY.—Eligibility of a veteran 
for care and services under this section shall be deter-
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mined as if such care or services were furnished in a facil-
ity of the Department, and provisions of this title applica-
ble to veterans receiving such care and services in a facility 
of the Department shall apply to veterans receiving care 
and services under this section. 
‘‘(c) PROVIDER ELIGIBILITY.—Subject to the certifi-
cation process pursuant to subsection (d)(1), a provider 
of hospital care, medical services, or extended care is eligi-
ble to enter into a Veterans Care Agreement under this 
section if the Secretary determines that the provider meets 
each of the following criteria: 
‘‘(1) The gross annual revenue of the provider 
in the year preceding the year in which the provider 
enters into the Veterans Care Agreement does not 
exceed $11,000,000 (as adjusted in a manner simi-
lar to amounts adjusted pursuant to section 5312 of 
this title). 
‘‘(2) The provider does not otherwise provide 
such care or services to patients pursuant to a con-
tract entered into with a department or agency of 
the Federal Government. 
‘‘(3) The provider is— 
‘‘(A) a provider of services that has en-
rolled and entered into a provider agreement 
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under section 1866(a) of the Social Security 
Act (42 U.S.C. 1395cc(a)); 
‘‘(B) a physician or supplier that has en-
rolled and entered into a participation agree-
ment under section 1842(h) of such Act (42 
U.S.C. 1395u(h)); 
‘‘(C) a provider of items and services re-
ceiving payment under a State plan under title 
XIX of such Act (42 U.S.C. 1396 et seq.) or 
a waiver of such a plan; 
‘‘(D) an Aging and Disability Resource 
Center, an area agency on aging, or a State 
agency (as defined in section 102 of the Older 
Americans Act of 1965 (42 U.S.C. 3002)); or 
‘‘(E) a center for independent living (as 
defined in section 702 of the Rehabilitation Act 
of 1973 (29 U.S.C. 796a)). 
‘‘(4) Any additional criteria determined appro-
priate by the Secretary. 
‘‘(d) PROVIDER CERTIFICATION.—(1) The Secretary 
shall establish a process for the certification of eligible 
providers to enter into Veterans Care Agreements under 
this section that shall, at a minimum, set forth the fol-
lowing: 
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‘‘(A) Procedures for the submission of applica-
tions for certification and deadlines for actions taken 
by the Secretary with respect to such applications. 
‘‘(B) Standards and procedures for the ap-
proval and denial of certifications and the revocation 
of certifications. 
‘‘(C) Procedures for assessing eligible providers 
based on the risk of fraud, waste, and abuse of such 
providers similar to the level of screening under sec-
tion 1866(j)(2)(B) of the Social Security Act (42 
U.S.C. 1395(j)(2)(B)) and the standards set forth 
under section 9.104 of title 48, Code of Federal 
Regulations, or any successor regulation. 
‘‘(D) Requirement for denial or revocation of 
certification if the Secretary determines that the 
otherwise eligible provider is— 
‘‘(i) excluded from participation in a Fed-
eral health care program (as defined in section 
1128B(f) of the Social Security Act (42 U.S.C. 
1320a–7b(f))) under section 1128 or 1128A of 
the Social Security Act (42 U.S.C. 1320a–7 
and 1320a–7a); or 
‘‘(ii) identified as an excluded source on 
the list maintained in the System for Award 
Management, or any successor system. 
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‘‘(E) Procedures by which a provider whose cer-
tification is denied or revoked under the procedures 
established under this subsection will be identified as 
an excluded source on the list maintained in the Sys-
tem for Award Management, or successor system, if 
the Secretary determines that such exclusion is ap-
propriate. 
‘‘(2) To the extent practicable, the Secretary shall es-
tablish the procedures under paragraph (1) in a manner 
that takes into account any certification process adminis-
tered by another department or agency of the Federal 
Government that an eligible provider has completed by 
reason of being a provider described in any of subpara-
graphs (A) through (E) of subsection (c)(3). 
‘‘(e) TERMS OF AGREEMENTS.—The Secretary shall 
ensure that each Veterans Care Agreement include provi-
sions requiring the eligible provider to do the following: 
‘‘(1) To accept payment for care and services 
furnished under this section at rates established by 
the Secretary for purposes of this section, which 
shall be, to the extent practicable— 
‘‘(A) the rates paid by the United States 
for such care to providers of services and sup-
pliers under the Medicare program under title 
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XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.); 
‘‘(B) the rates paid by the United States 
pursuant to the Alaska Fee Schedule of the De-
partment of Veterans Affairs; 
‘‘(C) the rates paid by the United States 
pursuant to an All-Payer Model Agreement 
under the Social Security Act; or 
‘‘(D) the rates paid by the United States 
in a highly rural area pursuant to section 
101(d)(2)(B)(ii)(I) of the Veterans Access, 
Choice, and Accountability Act of 2014 (38 
U.S.C. 1701 note). 
‘‘(2) To accept payment under paragraph (1) as 
payment in full for care and services furnished 
under this section and to not seek any payment for 
such care and services from the recipient of such 
care. 
‘‘(3) To furnish under this section only the care 
and services authorized by the Department under 
this section unless the eligible provider receives prior 
written consent from the Department to furnish care 
and services outside the scope of such authorization. 
‘‘(4) To bill the Department for care and serv-
ices furnished under this section in accordance with 
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a methodology established by the Secretary for pur-
poses of this section. 
‘‘(5) Not to seek to recover or collect from a 
health-plan contract or third party (as those terms 
are defined in section 1729 of this title) for any care 
or services for which payment is made by the De-
partment under this section. 
‘‘(6) To provide medical records for veterans 
furnished care and services under this section to the 
Department in a timeframe and format specified by 
the Secretary for purposes of this section, except the 
Secretary may not require that any payment by the 
Secretary to the eligible provider be contingent on 
such provision of medical records. 
‘‘(7) To meet other such terms and conditions, 
including quality of care assurance standards, as the 
Secretary may specify for purposes of this section. 
‘‘(f) EXCLUSION
OF
CERTAIN
FEDERAL
CON-
TRACTING PROVISIONS.—(1) Notwithstanding any other 
provision of law, the Secretary may enter into a Veterans 
Care Agreement using procedures other than competitive 
procedures. 
‘‘(2)(A) Except as provided in subparagraph (B) and 
unless otherwise provided in this section, an eligible pro-
vider that enters into a Veterans Care Agreement under 
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this section is not subject to, in the carrying out of the 
agreement, any provision of law that providers of services 
and suppliers under the original Medicare fee-for-service 
program under parts A and B of title XVIII of the Social 
Security Act (42 U.S.C. 1395 et seq.) or the Medicaid pro-
gram under title XIX of such Act (42 U.S.C. 1396 et seq.) 
are not subject to. 
‘‘(B) In addition to the provisions of laws covered by 
subparagraph (A), an eligible provider shall be subject to 
the following provisions of law: 
‘‘(i) Any applicable law regarding integrity, eth-
ics, or fraud, or that subject a person to civil or 
criminal penalties. 
‘‘(ii) Section 431 of title 18. 
‘‘(iii) Section 1352 of title 31, except for the fil-
ing requirements under subsection (b) of such sec-
tion. 
‘‘(iv) Section 4705 or 4712 of title 41, and any 
other applicable law regarding the protection of 
whistleblowers. 
‘‘(v) Section 4706(d) of title 41. 
‘‘(vi) Title VII of the Civil Rights Act of 1964 
(42 U.S.C. 2000e et seq.) to the same extent as 
such title applies with respect to the eligible provider 
in providing care or services through an agreement 
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or arrangement other than under a Veterans Care 
Agreement. 
‘‘(C) An eligible provider that receives a payment 
from the Federal Government pursuant to a Veterans 
Care Agreement shall not be treated as a Federal con-
tractor or subcontractor by the Office of Federal Contract 
Compliance Programs of the Department of Labor based 
on the work performed or actions taken by such eligible 
provider that resulted in the receipt of such payments. 
‘‘(g) TERMINATION
OF VETERANS CARE AGREE-
MENT.—(1) An eligible provider may terminate a Veterans 
Care Agreement with the Secretary under this section at 
such time and upon such notice to the Secretary as the 
Secretary may specify for purposes of this section. 
‘‘(2) The Secretary may terminate a Veterans Care 
Agreement with an eligible provider under this section at 
such time and upon such notice to the eligible provider 
as the Secretary may specify for the purposes of this sec-
tion, if the Secretary— 
‘‘(A) determines that the eligible provider failed 
to comply with the provisions of the agreement or 
this section or other applicable provision of law; 
‘‘(B) makes a revocation pursuant to subsection 
(d)(1)(4); 
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‘‘(C) ascertains that the eligible provider has 
been convicted of a felony or other serious offense 
under Federal or State law and determines that the 
continued participation of the eligible provider would 
be detrimental to the best interests of veterans of 
the Department; or 
‘‘(D) determines that it is reasonable to termi-
nate the agreement based on the health care needs 
of veterans. 
‘‘(h) DURATION; MANDATORY REVIEWS.—(1) Each 
Veterans Care Agreement entered into under this section 
shall be for a two-year period unless the Secretary extends 
the agreement pursuant to paragraph (2)(B). 
‘‘(2)(A) During the 180-day period beginning 540 
days after the date on which a Veterans Care Agreement 
is entered into or renewed, the Secretary shall review the 
agreement to determine whether it is feasible and advis-
able to instead furnish the hospital care, medical services, 
or extended care furnished under the agreement at facili-
ties of the Department or through contracts or sharing 
agreements entered into under authorities other than this 
section. 
‘‘(B) If the Secretary determines under subparagraph 
(A) that it is not feasible and advisable to instead furnish 
hospital care, medical services, or extended care furnished 
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under a Veterans Care Agreement at facilities of the De-
partment or through contracts or sharing agreements en-
tered into under authorities other than this section, the 
Secretary— 
‘‘(i) shall prepare a written memorandum of 
such determination; and 
‘‘(ii) may renew such agreement. 
‘‘(i) DISPUTES.—(1) The Secretary shall establish 
administrative procedures for eligible providers with which 
the Secretary has entered into a Veterans Care Agreement 
to present any dispute arising under or related to the 
agreement. 
‘‘(2) Before using any dispute resolution mechanism 
under chapter 71 of title 41 with respect to a dispute aris-
ing under a Veterans Care Agreement under this section, 
an eligible provider must first exhaust the administrative 
procedures established by the Secretary under paragraph 
(1). 
‘‘(j) ANNUAL REPORTS.—Not later than October 1 
of the year following the fiscal year in which the Secretary 
first enters into a Veterans Care Agreement, and each 
year thereafter, the Secretary shall submit to the appro-
priate congressional committees an annual report that in-
cludes— 
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‘‘(1) a list of all Veterans Care Agreements en-
tered into as of the date of the report; and 
‘‘(2) summaries of each determination made by 
the Secretary under subsection (h)(2) during the fis-
cal year covered by the report. 
‘‘(k) QUALITY OF CARE.—In carrying out this sec-
tion, the Secretary shall use the quality of care standards 
set forth or used by the Centers for Medicare & Medicaid 
Services. 
‘‘(l) DELEGATION.—The Secretary may delegate the 
authority to enter into or terminate a Veterans Care 
Agreement, or to make a determination described in sub-
section (h)(2), at a level not below the Assistant Deputy 
Under Secretary for Health for Community Care. 
‘‘(m) SUNSET.—The Secretary may not enter into or 
renew a Veterans Care Agreement under this section after 
the date that is five years after the enactment of this Act. 
‘‘(n) DEFINITIONS.—In this section: 
‘‘(1) The term ‘appropriate congressional com-
mittees’ means— 
‘‘(A) the Committees on Veterans’ Affairs 
of the House of Representatives and the Sen-
ate; and 
‘‘(B) the Committees on Appropriations of 
the House of Representatives and the Senate. 
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‘‘(2) The term ‘eligible provider’ means a pro-
vider of hospital care, medical services, or extended 
care that the Secretary determines is eligible to 
enter into Veterans Care Agreements under sub-
section (c). 
‘‘(3) The term ‘Veterans Care Agreement’ 
means an agreement entered into by the Secretary 
with an eligible provider under subsection (a)(1).’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 17 of such title is amended 
by inserting after the item related to section 1703 the fol-
lowing new item: 
‘‘1703A. Veterans Care Agreements with certain health care providers.’’. 
(c) REGULATIONS.—Not later than one year after the 
date of the enactment of this Act, the Secretary of Vet-
erans Affairs shall prescribe interim final regulations to 
implement section 1703A of title 38, United States Code, 
as added by subsection (a), and publish such regulations 
in the Federal Register. 
Æ 
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