SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Veterans Health Care 
Budget Reform and Transparency Act of 2009’’. 
SEC. 2. SENSE OF CONGRESS. 
It is the sense of Congress that the provision of 
health care services to veterans could be more effectively 
and efficiently planned and managed if funding was pro-
vided for the management and provision of such services 
in the form of advance appropriations. 
SEC. 3. PRESIDENTS’ BUDGET SUBMISSIONS. 
Section 1105(a) of title 31, United States Code, is 
amended by adding at the end the following new para-
graph: 
‘‘(36) information on estimates of appropria-
tions for the fiscal year following the fiscal year for 
which the budget is submitted for the following ac-
counts of the Department of Veterans Affairs: 
‘‘(A) Medical Services. 
‘‘(B) Medical Support and Compliance. 
‘‘(C) Medical Facilities. 
‘‘(D) Information Technology Systems. 
‘‘(E) Medical and Prosthetic Research.’’.
SEC. 4. ADVANCE APPROPRIATIONS FOR CERTAIN AC-
COUNTS OF THE DEPARTMENT OF VETERANS 
AFFAIRS. 
(a) ADVANCE APPROPRIATIONS FOR CERTAIN AC-
COUNTS.— 
(1) IN GENERAL.—Chapter 1 of title 38, United 
States Code, is amended by inserting after section 
116 the following new section: 
‘‘§ 117. Advance appropriations for certain accounts 
‘‘(a) IN GENERAL.—For each fiscal year, beginning 
with fiscal year 2011, discretionary new budget authority 
provided in an appropriations Act for the appropriations 
accounts of the Department specified in subsection (c) 
shall— 
‘‘(1) be made available for that fiscal year; and 
‘‘(2) include, for each such appropriations ac-
count, advance discretionary new budget authority 
that first becomes available for the first fiscal year 
after the budget year. 
‘‘(b) ESTIMATES REQUIRED.—The Secretary shall in-
clude in documents submitted to Congress in support of 
the President’s budget submitted pursuant to section 1105 
of title 31, United States Code, detailed estimates of the 
funds necessary for the accounts of the Department speci-
fied in subsection (c) for the fiscal year following the fiscal 
year for which the budget is submitted.
‘‘(c) ACCOUNTS SPECIFIED.—The accounts specified 
in this subsection are the following accounts of the De-
partment of Veterans Affairs: 
‘‘(1) Medical Services. 
‘‘(2) Medical Support and Compliance. 
‘‘(3) Medical Facilities. 
‘‘(4) Information Technology Systems. 
‘‘(5) Medical and Prosthetic Research. 
‘‘(d) ANNUAL REPORT.—Not later than July 31 of 
each year, the Secretary shall submit to Congress an an-
nual report on the sufficiency of the Department’s re-
sources for the next fiscal year beginning after the date 
of the submittal of the report for the provision of medical 
care. Such report shall also include estimates of the work-
load and demand data for that fiscal year.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of such chapter is amended 
by inserting after the item relating to section 116 
the following new item: 
‘‘117. Advance appropriations for certain accounts.’’.
SEC. 5. COMPTROLLER GENERAL STUDY ON ADEQUACY 
AND ACCURACY OF BASELINE MODEL PRO-
JECTIONS OF THE DEPARTMENT OF VET-
ERANS AFFAIRS FOR HEALTH CARE EXPENDI-
TURES. 
(a) STUDY OF ADEQUACY AND ACCURACY OF BASE 
LINE MODEL PROJECTIONS.—The Comptroller General 
shall conduct a study of the adequacy and accuracy of the 
budget projections made by the Enrollee Health Care Pro-
jection Model (in this section referred to as the ‘‘Model’’), 
its equivalent, or other methodologies utilized for the pur-
pose of estimating and projecting health care expenditures 
of the Department of Veterans Affairs with respect to the 
fiscal year involved and the subsequent four fiscal years. 
(b) REPORTS.— 
(1) IN GENERAL.—Not later than the date of 
each year in 2011, 2012, and 2013, on which the 
President submits the budget request for the next 
fiscal year under section 1105 of title 31, United 
States Code, the Comptroller General shall submit to 
the appropriate committees of Congress and to the 
Secretary of Veterans Affairs a report. 
(2) ELEMENTS.—Each report under this para-
graph shall include, for the fiscal year concerning 
the year for which the budget is submitted, the fol-
lowing:
(A) A statement whether the amount re-
quested in the budget of the President for ex-
penditures of the Department for health care in 
such fiscal year is consistent with anticipated 
expenditures of the Department for health care 
in such fiscal year as determined utilizing the 
Model. 
(B) The basis for such statement. 
(C) Such additional information as the 
Comptroller General determines appropriate. 
(3) AVAILABILITY TO THE PUBLIC.—Each re-
port submitted under this subsection shall be made 
available to the public by the Comptroller General. 
(4) APPROPRIATE COMMITTEES OF CONGRESS 
DEFINED.—In this subsection, the term ‘‘appro-
priate committees of Congress’’ means— 
(A) the Committees on Veterans’ Affairs, 
Appropriations, and the Budget of the Senate; 
and 
(B) the Committees on Veterans’ Affairs, 
Appropriations, and the Budget of the House of 
Representatives. 
SEC. 6. REPORT TO CONGRESS. 
Not later than 90 days after the date of the enact-
ment of this Act, the Secretary of Veterans Affairs, shall
submit to the Committees on Veterans’ Affairs, Appro-
priations, and the Budget of the Senate and House of 
Representatives a report on the requirements of this Act 
and the amendments made by this Act. Such report shall 
include— 
(1) the Secretary’s plans for improving the ca-
pability of the Department of Veterans Affairs to 
better and more accurately estimate future health 
care costs and demands; and 
(2) a description of impediments, statutory or 
otherwise, to providing future year estimates and ad-
vance appropriations for the Medical Services, Med-
ical Support and Compliance, Medical Facilities, In-
formation Technology Systems, and Medical and 
Prosthetic Research accounts of the Department. 
Passed the House of Representatives June 23, 2009. 
Attest: 
Clerk.