I 
115TH CONGRESS 
1ST SESSION H. R. 4113 
To amend title 38, United States Code, to allow the Secretary of Veterans 
Affairs to enter into certain agreements with non-Department of Veterans 
Affairs health care providers if the Secretary is not feasibly able to 
provide health care in facilities of the Department or through contracts 
or sharing agreements, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 24, 2017 
Mr. POLIQUIN introduced the following bill; which was referred to the 
Committee on Veterans’ Affairs 
A BILL 
To amend title 38, United States Code, to allow the Sec-
retary of Veterans Affairs to enter into certain agree-
ments with non-Department of Veterans Affairs health 
care providers if the Secretary is not feasibly able to 
provide health care in facilities of the Department or 
through contracts or sharing agreements, and for other 
purposes. 
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 ‘‘Veterans Access to 
Long Term Care and Health Services Act’’. 
VerDate Sep 11 2014 
01:00 Oct 25, 2017
Jkt 079200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H4113.IH
H4113
lotter on DSKBCFDHB2PROD with BILLS
SEC. 2. PURPOSE. 
The purpose of this Act is— 
(1) to maintain the access of veterans to high- 
quality hospital care, medical services, and extended 
care if that care is not available directly from the 
Department of Veterans Affairs; 
(2) to continue to allow the use by the Depart-
ment of agreements covered by the Federal Acquisi-
tion Regulation and agreements that are not covered 
by such regulation, similar to those agreements used 
under the original Medicare fee-for-service program 
(Medicare Parts A and B), if it is not practicable to 
contract for the care needed by veterans through an 
agreement covered by such regulation; 
(3) to address the fact that individual health 
care providers, especially smaller providers in rural 
areas, may not be willing to accept veterans as pa-
tients when doing so would require the significant 
time and administrative requirements in connection 
with entering into agreements with the Department 
that are covered by such regulation; 
(4) to address the deficiencies in current law re-
garding agreements entered into by the Department 
that have raised legal issues; and 
(5) to ensure that agreements that are not cov-
ered by such regulation include robust terms and 
VerDate Sep 11 2014 
01:00 Oct 25, 2017
Jkt 079200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H4113.IH
H4113
lotter on DSKBCFDHB2PROD with BILLS
conditions that address the quality of health care for 
veterans, oversight of the provision of such health 
care, and protections for taxpayers. 
SEC. 3. AUTHORIZATION OF AGREEMENTS BETWEEN THE 
DEPARTMENT OF VETERANS AFFAIRS AND 
NON-DEPARTMENT 
HEALTH 
CARE 
PRO-
VIDERS. 
(a) IN GENERAL.—Subchapter I of chapter 17 of title 
38, United States Code, is amended by adding after sec-
tion 1703 the following new section: 
‘‘§ 1703A. Veterans Care Agreements with certain 
health care providers 
‘‘(a) AGREEMENTS TO FURNISH CARE.—(1) If the 
Secretary is not feasibly able to furnish hospital care, med-
ical services, or extended care under this chapter at facili-
ties of the Department or under contracts or sharing 
agreements entered into under authorities other than this 
section, the Secretary may furnish such care and services 
by entering into agreements under this section with eligi-
ble providers that are certified under subsection (c). An 
agreement entered into under this section may be referred 
to as a ‘Veterans Care Agreement’. 
‘‘(2) The Secretary is not feasibly able to furnish care 
or services as described in paragraph (1) if the Secretary 
determines that the medical condition of the veteran, the 
VerDate Sep 11 2014 
01:00 Oct 25, 2017
Jkt 079200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H4113.IH
H4113
lotter on DSKBCFDHB2PROD with BILLS
travel involved, the nature of the care or services required, 
or a combination of those factors make the use of facilities 
of the Department, contracts, or sharing agreements im-
practicable or inadvisable. 
‘‘(3) Eligibility of a veteran under this section for the 
care or services described in paragraph (1) shall be deter-
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 or services in a facility 
of the Department shall apply to veterans receiving such 
care or services under this section. 
‘‘(b) ELIGIBLE PROVIDERS.—For purposes of this 
section, an eligible provider is one of the following: 
‘‘(1) A provider of services that has enrolled 
and entered into a provider agreement under section 
1866(a) of the Social Security Act (42 U.S.C. 
1395cc(a)). 
‘‘(2) A physician or supplier that has enrolled 
and entered into a participation agreement under 
section 1842(h) of such Act (42 U.S.C. 1395u(h)). 
‘‘(3) A provider of items and services receiving 
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. 
‘‘(4) A provider that is— 
VerDate Sep 11 2014 
01:00 Oct 25, 2017
Jkt 079200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H4113.IH
H4113
lotter on DSKBCFDHB2PROD with BILLS