H. R. 1625—461 
of prescription drugs from Veterans Health Administration facilities 
to enrolled veterans with privately written prescriptions based on 
requirements established by the Secretary: Provided further, That 
the implementation of the program described in the previous proviso 
shall incur no additional cost to the Department of Veterans Affairs: 
Provided further, That the Secretary of Veterans Affairs shall 
ensure that sufficient amounts appropriated under this heading 
for medical supplies and equipment are available for the acquisition 
of prosthetics designed specifically for female veterans. 
MEDICAL COMMUNITY CARE 
For necessary expenses for furnishing health care to individuals 
pursuant to chapter 17 of title 38, United States Code, at non- 
Department facilities, $419,176,000, which shall be in addition to 
funds previously appropriated under this heading that became 
available on October 1, 2017; and, in addition, $8,384,704,000, 
plus reimbursements, shall become available on October 1, 2018, 
and shall remain available until September 30, 2019: Provided, 
That, of the amount made available on October 1, 2018, under 
this heading, $2,000,000,000 shall remain available until September 
30, 2022. 
MEDICAL SUPPORT AND COMPLIANCE 
For necessary expenses in the administration of the medical, 
hospital, nursing home, domiciliary, construction, supply, and 
research activities, as authorized by law; administrative expenses 
in support of capital policy activities; and administrative and legal 
expenses of the Department for collecting and recovering amounts 
owed the Department as authorized under chapter 17 of title 38, 
United States Code, and the Federal Medical Care Recovery Act 
(42 U.S.C. 2651 et seq.), $100,000,000, which shall be in addition 
to funds previously appropriated under this heading that became 
available on October 1, 2017; and, in addition, $7,239,156,000, 
plus reimbursements, shall become available on October 1, 2018, 
and shall remain available until September 30, 2019: Provided, 
That, of the amount made available on October 1, 2018, under 
this heading, $100,000,000 shall remain available until September 
30, 2020. 
MEDICAL FACILITIES 
For necessary expenses for the maintenance and operation of 
hospitals, nursing homes, domiciliary facilities, and other necessary 
facilities of the Veterans Health Administration; for administrative 
expenses in support of planning, design, project management, real 
property acquisition and disposition, construction, and renovation 
of any facility under the jurisdiction or for the use of the Depart-
ment; for oversight, engineering, and architectural activities not 
charged to project costs; for repairing, altering, improving, or pro-
viding facilities in the several hospitals and homes under the juris-
diction of the Department, not otherwise provided for, either by 
contract or by the hire of temporary employees and purchase of 
materials; for leases of facilities; and for laundry services; 
$707,000,000, to remain available until September 30, 2019, which 
shall be in addition to funds previously appropriated under this 
heading that became available on October 1, 2017; and, in addition,
H. R. 1625—462 
$5,914,288,000, plus reimbursements, shall become available on 
October 1, 2018, and shall remain available until September 30, 
2019: Provided, That, of the amount made available on October 
1, 2018, under this heading, $250,000,000 shall remain available 
until September 30, 2020. 
MEDICAL AND PROSTHETIC RESEARCH 
For necessary expenses in carrying out programs of medical 
and prosthetic research and development as authorized by chapter 
73 of title 38, United States Code, $722,262,000, plus reimburse-
ments, shall remain available until September 30, 2019: Provided, 
That the Secretary of Veterans Affairs shall ensure that sufficient 
amounts appropriated under this heading are available for pros-
thetic research specifically for female veterans, and for toxic expo-
sure research. 
NATIONAL CEMETERY ADMINISTRATION 
For necessary expenses of the National Cemetery Administra-
tion for operations and maintenance, not otherwise provided for, 
including uniforms or allowances therefor; cemeterial expenses as 
authorized by law; purchase of one passenger motor vehicle for 
use in cemeterial operations; hire of passenger motor vehicles; and 
repair, alteration or improvement of facilities under the jurisdiction 
of the National Cemetery Administration, $306,193,000, of which 
not to exceed 10 percent shall remain available until September 
30, 2019. 
DEPARTMENTAL ADMINISTRATION 
GENERAL ADMINISTRATION 
(INCLUDING TRANSFER OF FUNDS) 
For necessary operating expenses of the Department of Vet-
erans Affairs, not otherwise provided for, including administrative 
expenses in support of Department-wide capital planning, manage-
ment and policy activities, uniforms, or allowances therefor; not 
to exceed $25,000 for official reception and representation expenses; 
hire of passenger motor vehicles; and reimbursement of the General 
Services Administration for security guard services, $335,891,000, 
of which not to exceed 10 percent shall remain available until 
September 30, 2019: Provided, That funds provided under this 
heading may be transferred to ‘‘General Operating Expenses, Vet-
erans Benefits Administration’’. 
BOARD OF VETERANS APPEALS 
For necessary operating expenses of the Board of Veterans 
Appeals, $161,048,000, of which not to exceed 10 percent shall 
remain available until September 30, 2019. 
INFORMATION TECHNOLOGY SYSTEMS 
(INCLUDING TRANSFER OF FUNDS) 
For necessary expenses for information technology systems and 
telecommunications support, including developmental information
H. R. 1625—463 
systems and operational information systems; for pay and associated 
costs; and for the capital asset acquisition of information technology 
systems, including management and related contractual costs of 
said acquisitions, including contractual costs associated with oper-
ations authorized by section 3109 of title 5, United States Code, 
$4,055,500,000, 
plus 
reimbursements: 
Provided, 
That 
$1,230,320,000 shall be for pay and associated costs, of which not 
to exceed 5 percent shall remain available until September 30, 
2019: Provided further, That $2,496,650,000 shall be for operations 
and maintenance, of which not to exceed 5 percent shall remain 
available until September 30, 2019: Provided further, That 
$328,530,000 shall be for information technology systems develop-
ment, and shall remain available until September 30, 2019: Pro-
vided further, That amounts made available for information tech-
nology systems development may not be obligated or expended 
until the Secretary of Veterans Affairs or the Chief Information 
Officer of the Department of Veterans Affairs submits to the 
Committees on Appropriations of both Houses of Congress a certifi-
cation of the amounts, in parts or in full, to be obligated and 
expended for each development project: Provided further, That 
amounts made available for salaries and expenses, operations and 
maintenance, and information technology systems development may 
be transferred among the three subaccounts after the Secretary 
of Veterans Affairs requests from the Committees on Appropriations 
of both Houses of Congress the authority to make the transfer 
and an approval is issued: Provided further, That amounts made 
available for the ‘‘Information Technology Systems’’ account for 
development may be transferred among projects or to newly defined 
projects: Provided further, That no project may be increased or 
decreased by more than $1,000,000 of cost prior to submitting 
a request to the Committees on Appropriations of both Houses 
of Congress to make the transfer and an approval is issued, or 
absent a response, a period of 30 days has elapsed: Provided further, 
That the funds made available under this heading for information 
technology systems development shall be for the projects, and in 
the amounts, specified under this heading in the explanatory state-
ment described in section 4 (in the matter preceding division A 
of this consolidated Act). 
VETERANS ELECTRONIC HEALTH RECORD 
For activities related to implementation, preparation, develop-
ment, interface, management, rollout, and maintenance of a Vet-
erans Electronic Health Record system, including contractual costs 
associated with operations authorized by section 3109 of title 5, 
United States Code, and salaries and expenses of employees hired 
under titles 5 and 38, United States Code, $782,000,000, to remain 
available until September 30, 2020: Provided, That the Secretary 
of Veterans Affairs shall submit to the Committees on Appropria-
tions of both Houses of Congress quarterly reports detailing obliga-
tions, expenditures, and deployment implementation by facility: 
Provided further, That the funds provided in this account shall 
only be available to the Office of the Deputy Secretary, to be 
administered by that Office.
H. R. 1625—464 
OFFICE OF INSPECTOR GENERAL 
For necessary expenses of the Office of Inspector General, to 
include information technology, in carrying out the provisions of 
the Inspector General Act of 1978 (5 U.S.C. App.), $164,000,000, 
of which not to exceed 10 percent shall remain available until 
September 30, 2019. 
CONSTRUCTION, MAJOR PROJECTS 
For constructing, altering, extending, and improving any of 
the facilities, including parking projects, under the jurisdiction or 
for the use of the Department of Veterans Affairs, or for any 
of the purposes set forth in sections 316, 2404, 2406 and chapter 
81 of title 38, United States Code, not otherwise provided for, 
including 
planning, 
architectural 
and 
engineering 
services, 
construction management services, maintenance or guarantee 
period services costs associated with equipment guarantees provided 
under the project, services of claims analysts, offsite utility and 
storm drainage system construction costs, and site acquisition, 
where the estimated cost of a project is more than the amount 
set forth in section 8104(a)(3)(A) of title 38, United States Code, 
or where funds for a project were made available in a previous 
major project appropriation, $512,430,000, of which $432,430,000 
shall remain available until September 30, 2022, and of which 
$80,000,000 shall remain available until expended: Provided, That 
except for advance planning activities, including needs assessments 
which may or may not lead to capital investments, and other 
capital asset management related activities, including portfolio 
development and management activities, and investment strategy 
studies funded through the advance planning fund and the planning 
and design activities funded through the design fund, including 
needs assessments which may or may not lead to capital invest-
ments, and salaries and associated costs of the resident engineers 
who oversee those capital investments funded through this account 
and contracting officers who manage specific major construction 
projects, and funds provided for the purchase, security, and mainte-
nance of land for the National Cemetery Administration through 
the land acquisition line item, none of the funds made available 
under this heading shall be used for any project that has not 
been notified to Congress through the budgetary process or that 
has not been approved by the Congress through statute, joint resolu-
tion, or in the explanatory statement accompanying such Act and 
presented to the President at the time of enrollment: Provided 
further, That funds made available under this heading for fiscal 
year 2018, for each approved project shall be obligated: (1) by 
the awarding of a construction documents contract by September 
30, 2018; and (2) by the awarding of a construction contract by 
September 30, 2019: Provided further, That the Secretary of Vet-
erans Affairs shall promptly submit to the Committees on Appro-
priations of both Houses of Congress a written report on any 
approved major construction project for which obligations are not 
incurred within the time limitations established above: Provided 
further, That, of the amount made available under this heading, 
$117,300,000 for Veterans Health Administration major construc-
tion projects shall not be available until the Department of Veterans 
Affairs—
H. R. 1625—465 
(1) enters into an agreement with an appropriate non- 
Department of Veterans Affairs Federal entity to serve as the 
design and/or construction agent for any Veterans Health 
Administration major construction project with a Total Esti-
mated Cost of $100,000,000 or above by providing full project 
management services, including management of the project 
design, acquisition, construction, and contract changes, con-
sistent with section 502 of Public Law 114–58; and 
(2) certifies in writing that such an agreement is executed 
and intended to minimize or prevent subsequent major 
construction project cost overruns and provides a copy of the 
agreement entered into and any required supplementary 
information to the Committees on Appropriations of both 
Houses of Congress. 
CONSTRUCTION, MINOR PROJECTS 
For constructing, altering, extending, and improving any of 
the facilities, including parking projects, under the jurisdiction or 
for the use of the Department of Veterans Affairs, including plan-
ning and assessments of needs which may lead to capital invest-
ments, architectural and engineering services, maintenance or guar-
antee period services costs associated with equipment guarantees 
provided under the project, services of claims analysts, offsite utility 
and storm drainage system construction costs, and site acquisition, 
or for any of the purposes set forth in sections 316, 2404, 2406 
and chapter 81 of title 38, United States Code, not otherwise 
provided for, where the estimated cost of a project is equal to 
or less than the amount set forth in section 8104(a)(3)(A) of title 
38, United States Code, $342,570,000, to remain available until 
September 30, 2022, along with unobligated balances of previous 
‘‘Construction, Minor Projects’’ appropriations which are hereby 
made available for any project where the estimated cost is equal 
to or less than the amount set forth in such section: Provided, 
That funds made available under this heading shall be for: (1) 
repairs to any of the nonmedical facilities under the jurisdiction 
or for the use of the Department which are necessary because 
of loss or damage caused by any natural disaster or catastrophe; 
and (2) temporary measures necessary to prevent or to minimize 
further loss by such causes. 
GRANTS FOR CONSTRUCTION OF 
STATE EXTENDED CARE FACILITIES 
For grants to assist States to acquire or construct State nursing 
home and domiciliary facilities and to remodel, modify, or alter 
existing hospital, nursing home, and domiciliary facilities in State 
homes, for furnishing care to veterans as authorized by sections 
8131 through 8137 of title 38, United States Code, $110,000,000, 
to remain available until expended. 
GRANTS FOR CONSTRUCTION OF VETERANS CEMETERIES 
For grants to assist States and tribal organizations in estab-
lishing, expanding, or improving veterans cemeteries as authorized 
by section 2408 of title 38, United States Code, $45,000,000, to 
remain available until expended.
H. R. 1625—466 
ADMINISTRATIVE PROVISIONS 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 201. Any appropriation for fiscal year 2018 for ‘‘Compensa-
tion and Pensions’’, ‘‘Readjustment Benefits’’, and ‘‘Veterans Insur-
ance and Indemnities’’ may be transferred as necessary to any 
other of the mentioned appropriations: Provided, That, before a 
transfer may take place, the Secretary of Veterans Affairs shall 
request from the Committees on Appropriations of both Houses 
of Congress the authority to make the transfer and such Committees 
issue an approval, or absent a response, a period of 30 days has 
elapsed. 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 202. Amounts made available for the Department of Vet-
erans Affairs for fiscal year 2018, in this or any other Act, under 
the ‘‘Medical Services’’, ‘‘Medical Community Care’’, ‘‘Medical Sup-
port and Compliance’’, and ‘‘Medical Facilities’’ accounts may be 
transferred among the accounts: Provided, That any transfers 
among the ‘‘Medical Services’’, ‘‘Medical Community Care’’, and 
‘‘Medical Support and Compliance’’ accounts of 1 percent or less 
of the total amount appropriated to the account in this or any 
other Act may take place subject to notification from the Secretary 
of Veterans Affairs to the Committees on Appropriations of both 
Houses of Congress of the amount and purpose of the transfer: 
Provided further, That any transfers among the ‘‘Medical Services’’, 
‘‘Medical Community Care’’, and ‘‘Medical Support and Compliance’’ 
accounts in excess of 1 percent, or exceeding the cumulative 1 
percent for the fiscal year, may take place only after the Secretary 
requests from the Committees on Appropriations of both Houses 
of Congress the authority to make the transfer and an approval 
is issued: Provided further, That any transfers to or from the 
‘‘Medical Facilities’’ account may take place only after the Secretary 
requests from the Committees on Appropriations of both Houses 
of Congress the authority to make the transfer and an approval 
is issued. 
SEC. 203. Appropriations available in this title for salaries 
and expenses shall be available for services authorized by section 
3109 of title 5, United States Code; hire of passenger motor vehicles; 
lease of a facility or land or both; and uniforms or allowances 
therefore, as authorized by sections 5901 through 5902 of title 
5, United States Code. 
SEC. 204. No appropriations in this title (except the appropria-
tions for ‘‘Construction, Major Projects’’, and ‘‘Construction, Minor 
Projects’’) shall be available for the purchase of any site for or 
toward the construction of any new hospital or home. 
SEC. 205. No appropriations in this title shall be available 
for hospitalization or examination of any persons (except bene-
ficiaries entitled to such hospitalization or examination under the 
laws providing such benefits to veterans, and persons receiving 
such treatment under sections 7901 through 7904 of title 5, United 
States Code, or the Robert T. Stafford Disaster Relief and Emer-
gency Assistance Act (42 U.S.C. 5121 et seq.)), unless reimburse-
ment of the cost of such hospitalization or examination is made 
to the ‘‘Medical Services’’ account at such rates as may be fixed 
by the Secretary of Veterans Affairs.
H. R. 1625—467 
SEC. 206. Appropriations available in this title for ‘‘Compensa-
tion and Pensions’’, ‘‘Readjustment Benefits’’, and ‘‘Veterans Insur-
ance and Indemnities’’ shall be available for payment of prior year 
accrued obligations required to be recorded by law against the 
corresponding prior year accounts within the last quarter of fiscal 
year 2017. 
SEC. 207. Appropriations available in this title shall be available 
to pay prior year obligations of corresponding prior year appropria-
tions accounts resulting from sections 3328(a), 3334, and 3712(a) 
of title 31, United States Code, except that if such obligations 
are from trust fund accounts they shall be payable only from ‘‘Com-
pensation and Pensions’’. 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 208. Notwithstanding any other provision of law, during 
fiscal year 2018, the Secretary of Veterans Affairs shall, from the 
National Service Life Insurance Fund under section 1920 of title 
38, United States Code, the Veterans’ Special Life Insurance Fund 
under section 1923 of title 38, United States Code, and the United 
States Government Life Insurance Fund under section 1955 of 
title 38, United States Code, reimburse the ‘‘General Operating 
Expenses, Veterans Benefits Administration’’ and ‘‘Information 
Technology Systems’’ accounts for the cost of administration of 
the insurance programs financed through those accounts: Provided, 
That reimbursement shall be made only from the surplus earnings 
accumulated in such an insurance program during fiscal year 2018 
that are available for dividends in that program after claims have 
been paid and actuarially determined reserves have been set aside: 
Provided further, That if the cost of administration of such an 
insurance program exceeds the amount of surplus earnings accumu-
lated in that program, reimbursement shall be made only to the 
extent of such surplus earnings: Provided further, That the Sec-
retary shall determine the cost of administration for fiscal year 
2018 which is properly allocable to the provision of each such 
insurance program and to the provision of any total disability 
income insurance included in that insurance program. 
SEC. 209. Amounts deducted from enhanced-use lease proceeds 
to reimburse an account for expenses incurred by that account 
during a prior fiscal year for providing enhanced-use lease services, 
may be obligated during the fiscal year in which the proceeds 
are received. 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 210. Funds available in this title or funds for salaries 
and other administrative expenses shall also be available to 
reimburse the Office of Resolution Management, the Office of 
Employment Discrimination Complaint Adjudication, the Office of 
Accountability and Whistleblower Protection, and the Office of 
Diversity and Inclusion for all services provided at rates which 
will recover actual costs but not to exceed $47,668,000 for the 
Office of Resolution Management, $3,932,000 for the Office of 
Employment Discrimination Complaint Adjudication, $17,620,000 
for the Office of Accountability and Whistleblower Protection, and 
$2,973,000 for the Office of Diversity and Inclusion: Provided, That 
payments may be made in advance for services to be furnished 
based on estimated costs: Provided further, That amounts received
H. R. 1625—468 
shall be credited to the ‘‘General Administration’’ and ‘‘Information 
Technology Systems’’ accounts for use by the office that provided 
the service. 
SEC. 211. No funds of the Department of Veterans Affairs 
shall be available for hospital care, nursing home care, or medical 
services provided to any person under chapter 17 of title 38, United 
States Code, for a non-service-connected disability described in sec-
tion 1729(a)(2) of such title, unless that person has disclosed to 
the Secretary of Veterans Affairs, in such form as the Secretary 
may require, current, accurate third-party reimbursement informa-
tion for purposes of section 1729 of such title: Provided, That 
the Secretary may recover, in the same manner as any other debt 
due the United States, the reasonable charges for such care or 
services from any person who does not make such disclosure as 
required: Provided further, That any amounts so recovered for care 
or services provided in a prior fiscal year may be obligated by 
the Secretary during the fiscal year in which amounts are received. 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 212. Notwithstanding any other provision of law, proceeds 
or revenues derived from enhanced-use leasing activities (including 
disposal) may be deposited into the ‘‘Construction, Major Projects’’ 
and ‘‘Construction, Minor Projects’’ accounts and be used for 
construction (including site acquisition and disposition), alterations, 
and improvements of any medical facility under the jurisdiction 
or for the use of the Department of Veterans Affairs. Such sums 
as realized are in addition to the amount provided for in ‘‘Construc-
tion, Major Projects’’ and ‘‘Construction, Minor Projects’’. 
SEC. 213. Amounts made available under ‘‘Medical Services’’ 
are available— 
(1) for furnishing recreational facilities, supplies, and equip-
ment; and 
(2) for funeral expenses, burial expenses, and other 
expenses incidental to funerals and burials for beneficiaries 
receiving care in the Department. 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 214. Such sums as may be deposited to the Medical 
Care Collections Fund pursuant to section 1729A of title 38, United 
States Code, may be transferred to the ‘‘Medical Services’’ and 
‘‘Medical Community Care’’ accounts to remain available until 
expended for the purposes of these accounts. 
SEC. 215. The Secretary of Veterans Affairs may enter into 
agreements with Federally Qualified Health Centers in the State 
of Alaska and Indian tribes and tribal organizations which are 
party to the Alaska Native Health Compact with the Indian Health 
Service, to provide healthcare, including behavioral health and 
dental care, to veterans in rural Alaska. The Secretary shall require 
participating veterans and facilities to comply with all appropriate 
rules and regulations, as established by the Secretary. The term 
‘‘rural Alaska’’ shall mean those lands which are not within the 
boundaries of the municipality of Anchorage or the Fairbanks North 
Star Borough.
H. R. 1625—469 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 216. Such sums as may be deposited to the Department 
of Veterans Affairs Capital Asset Fund pursuant to section 8118 
of title 38, United States Code, may be transferred to the ‘‘Construc-
tion, Major Projects’’ and ‘‘Construction, Minor Projects’’ accounts, 
to remain available until expended for the purposes of these 
accounts. 
SEC. 217. Not later than 30 days after the end of each fiscal 
quarter, the Secretary of Veterans Affairs shall submit to the 
Committees on Appropriations of both Houses of Congress a report 
on the financial status of the Department of Veterans Affairs for 
the preceding quarter: Provided, That, at a minimum, the report 
shall include the direction contained in the paragraph entitled 
‘‘Quarterly reporting’’, under the heading ‘‘General Administration’’ 
in the joint explanatory statement accompanying Public Law 114– 
223. 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 218. Amounts made available under the ‘‘Medical Serv-
ices’’, ‘‘Medical Community Care’’, ‘‘Medical Support and Compli-
ance’’, ‘‘Medical Facilities’’, ‘‘General Operating Expenses, Veterans 
Benefits Administration’’, ‘‘Board of Veterans Appeals’’, ‘‘General 
Administration’’, and ‘‘National Cemetery Administration’’ accounts 
for fiscal year 2018 may be transferred to or from the ‘‘Information 
Technology Systems’’ account: Provided, That such transfers may 
not result in a more than 10 percent aggregate increase in the 
total amount made available by this Act for the ‘‘Information Tech-
nology Systems’’ account: Provided further, That, before a transfer 
may take place, the Secretary of Veterans Affairs shall request 
from the Committees on Appropriations of both Houses of Congress 
the authority to make the transfer and an approval is issued. 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 219. Of the amounts appropriated to the Department 
of Veterans Affairs for fiscal year 2018 for ‘‘Medical Services’’, 
‘‘Medical Community Care’’, ‘‘Medical Support and Compliance’’, 
‘‘Medical Facilities’’, ‘‘Construction, Minor Projects’’, and ‘‘Informa-
tion Technology Systems’’, up to $297,137,000, plus reimbursements, 
may be transferred to the Joint Department of Defense—Depart-
ment of Veterans Affairs Medical Facility Demonstration Fund, 
established by section 1704 of the National Defense Authorization 
Act for Fiscal Year 2010 (Public Law 111–84; 123 Stat. 3571) 
and may be used for operation of the facilities designated as com-
bined Federal medical facilities as described by section 706 of the 
Duncan Hunter National Defense Authorization Act for Fiscal Year 
2009 (Public Law 110–417; 122 Stat. 4500): Provided, That addi-
tional funds may be transferred from accounts designated in this 
section to the Joint Department of Defense—Department of Vet-
erans Affairs Medical Facility Demonstration Fund upon written 
notification by the Secretary of Veterans Affairs to the Committees 
on Appropriations of both Houses of Congress: Provided further, 
That section 222 of title II of division A of Public Law 114–223 
is repealed.
H. R. 1625—470 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 220. Of the amounts appropriated to the Department 
of Veterans Affairs which become available on October 1, 2018, 
for ‘‘Medical Services’’, ‘‘Medical Community Care’’, ‘‘Medical Sup-
port and Compliance’’, and ‘‘Medical Facilities’’, up to $306,378,000, 
plus reimbursements, may be transferred to the Joint Department 
of Defense—Department of Veterans Affairs Medical Facility Dem-
onstration Fund, established by section 1704 of the National 
Defense Authorization Act for Fiscal Year 2010 (Public Law 111– 
84; 123 Stat. 3571) and may be used for operation of the facilities 
designated as combined Federal medical facilities as described by 
section 706 of the Duncan Hunter National Defense Authorization 
Act for Fiscal Year 2009 (Public Law 110–417; 122 Stat. 4500): 
Provided, That additional funds may be transferred from accounts 
designated in this section to the Joint Department of Defense— 
Department of Veterans Affairs Medical Facility Demonstration 
Fund upon written notification by the Secretary of Veterans Affairs 
to the Committees on Appropriations of both Houses of Congress. 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 221. Such sums as may be deposited to the Medical 
Care Collections Fund pursuant to section 1729A of title 38, United 
States Code, for healthcare provided at facilities designated as 
combined Federal medical facilities as described by section 706 
of the Duncan Hunter National Defense Authorization Act for Fiscal 
Year 2009 (Public Law 110–417; 122 Stat. 4500) shall also be 
available: (1) for transfer to the Joint Department of Defense— 
Department of Veterans Affairs Medical Facility Demonstration 
Fund, established by section 1704 of the National Defense 
Authorization Act for Fiscal Year 2010 (Public Law 111–84; 123 
Stat. 3571); and (2) for operations of the facilities designated as 
combined Federal medical facilities as described by section 706 
of the Duncan Hunter National Defense Authorization Act for Fiscal 
Year 2009 (Public Law 110–417; 122 Stat. 4500): Provided, That, 
notwithstanding section 1704(b)(3) of the National Defense 
Authorization Act for Fiscal Year 2010 (Public Law 111–84; 123 
Stat. 2573), amounts transferred to the Joint Department of 
Defense—Department of Veterans Affairs Medical Facility Dem-
onstration Fund shall remain available until expended. 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 222. Of the amounts available in this title for ‘‘Medical 
Services’’, ‘‘Medical Community Care’’, ‘‘Medical Support and 
Compliance’’, and ‘‘Medical Facilities’’, a minimum of $15,000,000 
shall be transferred to the DOD–VA Health Care Sharing Incentive 
Fund, as authorized by section 8111(d) of title 38, United States 
Code, to remain available until expended, for any purpose author-
ized by section 8111 of title 38, United States Code. 
SEC. 223. None of the funds available to the Department of 
Veterans Affairs, in this or any other Act, may be used to replace 
the current system by which the Veterans Integrated Service Net-
works select and contract for diabetes monitoring supplies and 
equipment. 
SEC. 224. The Secretary of Veterans Affairs shall notify the 
Committees on Appropriations of both Houses of Congress of all
H. R. 1625—471 
bid savings in a major construction project that total at least 
$5,000,000, or 5 percent of the programmed amount of the project, 
whichever is less: Provided, That such notification shall occur within 
14 days of a contract identifying the programmed amount: Provided 
further, That the Secretary shall notify the Committees on Appro-
priations of both Houses of Congress 14 days prior to the obligation 
of such bid savings and shall describe the anticipated use of such 
savings. 
SEC. 225. None of the funds made available for ‘‘Construction, 
Major Projects’’ may be used for a project in excess of the scope 
specified for that project in the original justification data provided 
to the Congress as part of the request for appropriations unless 
the Secretary of Veterans Affairs receives approval from the 
Committees on Appropriations of both Houses of Congress. 
SEC. 226. Not later than 30 days after the end of each fiscal 
quarter, the Secretary of Veterans Affairs shall submit to the 
Committees on Appropriations of both Houses of Congress a quar-
terly report containing performance measures and data from each 
Veterans Benefits Administration Regional Office: Provided, That, 
at a minimum, the report shall include the direction contained 
in the section entitled ‘‘Disability claims backlog’’, under the heading 
‘‘General Operating Expenses, Veterans Benefits Administration’’ 
in the joint explanatory statement accompanying Public Law 114– 
223: Provided further, That the report shall also include information 
on the number of appeals pending at the Veterans Benefits Adminis-
tration as well as the Board of Veterans Appeals on a quarterly 
basis. 
SEC. 227. The Secretary of Veterans Affairs shall provide writ-
ten notification to the Committees on Appropriations of both Houses 
of Congress 15 days prior to organizational changes which result 
in the transfer of 25 or more full-time equivalents from one 
organizational unit of the Department of Veterans Affairs to 
another. 
SEC. 228. The Secretary of Veterans Affairs shall provide on 
a quarterly basis to the Committees on Appropriations of both 
Houses of Congress notification of any single national outreach 
and awareness marketing campaign in which obligations exceed 
$2,000,000. 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 229. The Secretary of Veterans Affairs, upon determination 
that such action is necessary to address needs of the Veterans 
Health Administration, may transfer to the ‘‘Medical Services’’ 
account any discretionary appropriations made available for fiscal 
year 2018 in this title (except appropriations made to the ‘‘General 
Operating Expenses, Veterans Benefits Administration’’ account) 
or any discretionary unobligated balances within the Department 
of Veterans Affairs, including those appropriated for fiscal year 
2018, that were provided in advance by appropriations Acts: Pro-
vided, That transfers shall be made only with the approval of 
the Office of Management and Budget: Provided further, That the 
transfer authority provided in this section is in addition to any 
other transfer authority provided by law: Provided further, That 
no amounts may be transferred from amounts that were designated 
by Congress as an emergency requirement pursuant to a concurrent 
resolution on the budget or the Balanced Budget and Emergency
H. R. 1625—472 
Deficit Control Act of 1985: Provided further, That such authority 
to transfer may not be used unless for higher priority items, based 
on emergent healthcare requirements, than those for which origi-
nally appropriated and in no case where the item for which funds 
are requested has been denied by Congress: Provided further, That, 
upon determination that all or part of the funds transferred from 
an appropriation are not necessary, such amounts may be trans-
ferred back to that appropriation and shall be available for the 
same purposes as originally appropriated: Provided further, That 
before a transfer may take place, the Secretary of Veterans Affairs 
shall request from the Committees on Appropriations of both Houses 
of Congress the authority to make the transfer and receive approval 
of that request. 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 230. Amounts made available for the Department of Vet-
erans Affairs for fiscal year 2018, under the ‘‘Board of Veterans 
Appeals’’ and the ‘‘General Operating Expenses, Veterans Benefits 
Administration’’ accounts may be transferred between such 
accounts: Provided, That before a transfer may take place, the 
Secretary of Veterans Affairs shall request from the Committees 
on Appropriations of both Houses of Congress the authority to 
make the transfer and receive approval of that request. 
SEC. 231. The Secretary of Veterans Affairs may not reprogram 
funds among major construction projects or programs if such 
instance of reprogramming will exceed $7,000,000, unless such re-
programming is approved by the Committees on Appropriations 
of both Houses of Congress. 
SEC. 232. (a) The Secretary of Veterans Affairs shall ensure 
that the toll-free suicide hotline under section 1720F(h) of title 
38, United States Code— 
(1) provides to individuals who contact the hotline imme-
diate assistance from a trained professional; and 
(2) adheres to all requirements of the American Association 
of Suicidology. 
(b)(1) None of the funds made available by this Act may be 
used to enforce or otherwise carry out any Executive action that 
prohibits the Secretary of Veterans Affairs from appointing an 
individual to occupy a vacant civil service position, or establishing 
a new civil service position, at the Department of Veterans Affairs 
with respect to such a position relating to the hotline specified 
in subsection (a). 
(2) In this subsection— 
(A) the term ‘‘civil service’’ has the meaning given such 
term in section 2101(1) of title 5, United States Code; and 
(B) the term ‘‘Executive action’’ includes— 
(i) any Executive order, presidential memorandum, or 
other action by the President; and 
(ii) any agency policy, order, or other directive. 
SEC. 233. None of the funds in this or any other Act may 
be used to close Department of Veterans Affairs (VA) hospitals, 
domiciliaries, or clinics, conduct an environmental assessment, or 
to diminish healthcare services at existing Veterans Health 
Administration medical facilities located in Veterans Integrated 
Service Network 23 as part of a planned realignment of VA services 
until the Secretary provides to the Committees on Appropriations
H. R. 1625—473 
of both Houses of Congress a report including the following ele-
ments: 
(1) a national realignment strategy that includes a detailed 
description of realignment plans within each Veterans 
Integrated Services Network (VISN), including an updated Long 
Range Capital Plan to implement realignment requirements; 
(2) an explanation of the process by which those plans 
were developed and coordinated within each VISN; 
(3) a cost versus benefit analysis of each planned realign-
ment, including the cost of replacing Veterans Health Adminis-
tration services with contract care or other outsourced services; 
(4) an analysis of how any such planned realignment of 
services will impact access to care for veterans living in rural 
or highly rural areas, including travel distances and transpor-
tation costs to access a VA medical facility and availability 
of local specialty and primary care; 
(5) an inventory of VA buildings with historic designation 
and the methodology used to determine the buildings’ condition 
and utilization; 
(6) a description of how any realignment will be consistent 
with requirements under the National Historic Preservation 
Act; and 
(7) consideration given for reuse of historic buildings within 
newly identified realignment requirements: Provided, That, this 
provision shall not apply to capital projects in VISN 23, or 
any other VISN, which have been authorized or approved by 
Congress. 
SEC. 234. Section 8109(b) of title 38, United States Code, is 
amended— 
(1) in paragraph (2), by striking ‘‘and’’ at the end; 
(2) in paragraph (3), by striking the period and inserting 
‘‘; and’’; and 
(3) by adding at the end the following new paragraph: 
‘‘(4) notwithstanding subsection (a) of section 1344 of title 31, 
may use a passenger carrier (as such term is defined in subsection 
(h)(1) of such section) to transport such an employee between a 
parking facility and the medical facility of the Department at which 
the employee works.’’. 
SEC. 235. None of the funds made available to the Secretary 
of Veterans Affairs by this or any other Act may be obligated 
or expended in contravention of the ‘‘Veterans Health Administra-
tion Clinical Preventive Services Guidance Statement on the Vet-
erans Health Administration’s Screening for Breast Cancer Guid-
ance’’ published on May 10, 2017, as issued by the Veterans Health 
Administration National Center for Health Promotion and Disease 
Prevention. 
SEC. 236. (a) Notwithstanding any other provision of law, the 
amounts appropriated or otherwise made available to the Depart-
ment of Veterans Affairs for the ‘‘Medical Services’’ account may 
be used to provide— 
(1) fertility counseling and treatment using assisted repro-
ductive technology to a covered veteran or the spouse of a 
covered veteran; or 
(2) adoption reimbursement to a covered veteran. 
(b) In this section: 
(1) The term ‘‘service-connected’’ has the meaning given 
such term in section 101 of title 38, United States Code.
H. R. 1625—474 
(2) The term ‘‘covered veteran’’ means a veteran, as such 
term is defined in section 101 of title 38, United States Code, 
who has a service-connected disability that results in the 
inability of the veteran to procreate without the use of fertility 
treatment. 
(3) The term ‘‘assisted reproductive technology’’ means 
benefits relating to reproductive assistance provided to a 
member of the Armed Forces who incurs a serious injury or 
illness on active duty pursuant to section 1074(c)(4)(A) of title 
10, United States Code, as described in the memorandum on 
the subject of ‘‘Policy for Assisted Reproductive Services for 
the Benefit of Seriously or Severely Ill/Injured (Category II 
or III) Active Duty Service Members’’ issued by the Assistant 
Secretary of Defense for Health Affairs on April 3, 2012, and 
the guidance issued to implement such policy, including any 
limitations on the amount of such benefits available to such 
a member except that— 
(A) the time periods regarding embryo cryopreservation 
and storage set forth in part III(G) and in part IV(H) 
of such memorandum shall not apply; and 
(B) such term includes embryo cryopreservation and 
storage without limitation on the duration of such 
cryopreservation and storage. 
(4) The term ‘‘adoption reimbursement’’ means reimburse-
ment for the adoption-related expenses for an adoption that 
is finalized after the date of the enactment of this Act under 
the same terms as apply under the adoption reimbursement 
program of the Department of Defense, as authorized in Depart-
ment of Defense Instruction 1341.09, including the reimburse-
ment limits and requirements set forth in such instruction. 
(c) Amounts made available for the purposes specified in sub-
section (a) of this section are subject to the requirements for funds 
contained in section 508 of division H of the Consolidated Appropria-
tions Act, 2017 (Public Law 115–31). 
(RESCISSION OF FUNDS) 
SEC. 237. Of the unobligated balance of funds made available 
in the sixth proviso under the heading ‘‘Department of Veterans 
Affairs—Veterans Health Administration—Medical Services’’ in title 
II of Division J of the Consolidated Appropriations Act, 2016 (Public 
Law 114–113), $751,000,000 is hereby rescinded. 
SEC. 238. None of the funds appropriated or otherwise made 
available by this Act or any other Act for the Department of Vet-
erans Affairs may be used in a manner that is inconsistent with: 
(1) section 842 of the Transportation, Treasury, Housing and Urban 
Development, the Judiciary, the District of Columbia, and Inde-
pendent Agencies Appropriations Act, 2006 (Public Law 109–115; 
119 Stat. 2506); or (2) section 8110(a)(5) of title 38, United States 
Code. 
SEC. 239. Section 842 of Public Law 109–115 shall not apply 
to conversion of an activity or function of the Veterans Health 
Administration, Veterans Benefits Administration, or National 
Cemetery Administration to contractor performance by a business 
concern that is at least 51 percent owned by one or more Indian 
tribes as defined in section 5304(e) of title 25, United States Code,