H. R. 4546—139
(A) one or more military treatment facilities and one or
more VA health care facilities are situated in relative proximity
to each other, including facilities engaged in joint ventures
as of the date of the enactment of this Act; and
(B) for which an agreement to coordinate care and programs
for patients at those facilities could be implemented not later
than October 1, 2004.
(c) CONDUCT OF PROJECT.—(1) At sites at which the project
is conducted, the Secretaries shall provide a test of a coordinated
management system for the military treatment facilities and VA
health care facilities participating in the project. Such a coordinated
management system for a site shall include at least one of the
elements specified in paragraph (2), and each of the elements speci-
fied in that paragraph must be included in the coordinated manage-
ment system for at least one of the participating sites.
(2) Elements of a coordinated management system referred
to in paragraph (1) are the following:
(A) A budget and financial management system for those
facilities that—
(i) provides managers with information about the costs
of providing health care by both Departments at the site;
and
(ii) allows managers to assess the advantages and dis-
advantages (in terms of relative costs, benefits, and
opportunities) of using resources of either Department to
provide or enhance health care to beneficiaries of either
Department.
(B) A coordinated staffing and assignment system for the
personnel (including contract personnel) employed at or
assigned to those facilities, including clinical practitioners of
either Department.
(C) Medical information and information technology sys-
tems for those facilities that—
(i) are compatible with the purposes of the project;
(ii) 
communicate 
with 
medical 
information 
and
information technology systems of corresponding elements
of those facilities; and
(iii) incorporate minimum standards of information
quality that are at least equivalent to those adopted for
the Departments at large in their separate health care
systems.
(d) AUTHORITY TO WAIVE CERTAIN ADMINISTRATIVE POLICIES.—
(1)(A) In order to carry out subsection (c), the Secretary of Defense
may, in the Secretary’s discretion, waive any administrative policy
of the Department of Defense otherwise applicable to that sub-
section that specifically conflicts with the purposes of the project,
in instances in which the Secretary determines that the waiver
is necessary for the purposes of the project.
(B) In order to carry out subsection (c), the Secretary of Vet-
erans Affairs may, in the Secretary’s discretion, waive any adminis-
trative policy of the Department of Veterans Affairs otherwise
applicable to that subsection that specifically conflicts with the
purposes of the project, in instances in which the Secretary deter-
mines that the waiver is necessary for the purposes of the project.
(C) The two Secretaries shall establish procedures for resolving
disputes that may arise from the effects of policy changes that
are not covered by other agreements or existing procedures.
H. R. 4546—140
(2) No waiver under paragraph (1) may alter any labor-manage-
ment agreement in effect as of the date of the enactment of this
Act or adopted by either Department during the period of the
project.
(e) USE BY DOD OF CERTAIN TITLE 38 PERSONNEL AUTHORI-
TIES.—(1) In order to carry out subsection (c), the Secretary of
Defense may apply to civilian personnel of the Department of
Defense assigned to or employed at a military treatment facility
participating in the project any of the provisions of subchapters
I, III, and IV of chapter 74 of title 38, United States Code, deter-
mined appropriate by the Secretary.
(2) For purposes of paragraph (1), any reference in chapter
74 of title 38, United States Code—
(A) to the ‘‘Secretary’’ or the ‘‘Under Secretary for Health’’
shall be treated as referring to the Secretary of Defense; and
(B) to the ‘‘Veterans Health Administration’’ shall be
treated as referring to the Department of Defense.
(f) FUNDING.—From amounts available for health care for a
fiscal year, each Secretary shall make available to carry out the
project not less than—
(1) $3,000,000 for fiscal year 2003;
(2) $6,000,000 for fiscal year 2004; and
(3) $9,000,000 for each succeeding year during which the
project is in effect.
(g) DEFINITIONS.—For purposes of this section:
(1) The term ‘‘military treatment facility’’ means a medical
facility under the jurisdiction of the Secretary of a military
department.
(2) The term ‘‘VA health care facility’’ means a facility
under the jurisdiction of the Veterans Health Administration
of the Department of Veterans Affairs.
(h) PERFORMANCE REVIEW.—(1) The Comptroller General shall
provide for an annual on-site review at each of the project locations
selected by the Secretaries under this section.
(2) Not later than 90 days after completion of the annual
review under paragraph (1), the Comptroller General shall submit
a report on such review to the Committees on Armed Services
and Veterans’ Affairs of the Senate and House of Representatives.
(3) Each such report shall include the following:
(A) The strategic mission coordination between shared
activities.
(B) The accuracy and validity of performance data used
to evaluate sharing performance and changes in standards
of care or services at the shared facilities.
(C) A statement that all appropriated funds designated
for sharing activities are being used for direct support of
sharing initiatives.
(D) Recommendations concerning continuance of the project
at each site for the succeeding 12-month period.
(4) Whenever there is a recommendation under paragraph
(3)(D) to discontinue a resource sharing project under this section,
the two Secretaries shall act upon that recommendation as soon
as practicable.
(5) In the initial report under this subsection, the Comptroller
General shall validate the baseline information used for compara-
tive analysis.
H. R. 4546—141
(i) TERMINATION.—(1) The project, and the authority provided
by this section, shall terminate on September 30, 2007.
(2) The two Secretaries jointly may terminate the performance
of the project at any site when the performance of the project
at that site fails to meet performance expectations of the Secre-
taries, based on recommendations from the Comptroller General
under subsection (h) or on other information available to the Secre-
taries to warrant such action.
SEC. 723. REPORT ON IMPROVED COORDINATION AND SHARING OF
HEALTH CARE AND HEALTH CARE RESOURCES FOL-
LOWING DOMESTIC ACTS OF TERRORISM OR DOMESTIC
USE OF WEAPONS OF MASS DESTRUCTION.
(a) JOINT REVIEW.—The Secretary of Defense and the Secretary
of Veterans Affairs shall jointly review the adequacy of current
processes and existing statutory authorities and policy governing
the capability of the Department of Defense and the Department
of Veterans Affairs to provide health care to members of the Armed
Forces following domestic acts of terrorism or domestic use of
weapons of mass destruction, both before and after any declaration
of national emergency. Such review shall include a determination
of the adequacy of current authorities in providing for the coordina-
tion and sharing of health care resources between the two Depart-
ments in such cases, particularly before the declaration of a national
emergency.
(b) REPORT TO CONGRESS.—The two Secretaries shall include
a joint report on the review under subsection (a), including any
recommended legislative changes, shall be submitted to Congress
as part of the fiscal year 2004 budget submission to Congress.
SEC. 724. INTEROPERABILITY OF DEPARTMENT OF VETERANS AFFAIRS
AND DEPARTMENT OF DEFENSE PHARMACY DATA SYS-
TEMS.
(a) INTEROPERABILITY.—The Secretary of Veterans Affairs and
the Secretary of Defense shall seek to ensure that on or before
October 1, 2004, the Department of Veterans Affairs pharmacy
data system and the Department of Defense pharmacy data system
(known as the ‘‘Pharmacy Data Transaction System’’) are interoper-
able for both Department of Defense beneficiaries and Department
of Veterans Affairs beneficiaries by achieving real-time interface,
data exchange, and checking of prescription drug data of out-
patients, and using national standards for the exchange of out-
patient medication information.
(b) ALTERNATIVE REQUIREMENT.—If the interoperability speci-
fied in subsection (a) is not achieved by October 1, 2004, as deter-
mined jointly by the Secretary of Defense and the Secretary of
Veterans Affairs, the Secretary of Veterans Affairs shall adopt
the Department of Defense Pharmacy Data Transaction System
for use by the Department of Veterans Affairs health care system.
Such system shall be fully operational not later than October 1,
2005.
(c) IMPLEMENTATION
FUNDING
FOR
ALTERNATIVE
REQUIRE-
MENT.—The Secretary of Defense shall transfer to the Secretary
of Veterans Affairs, or shall otherwise bear the cost of, an amount
sufficient to cover three-fourths of the cost to the Department
H. R. 4546—142
of Veterans Affairs for computer programming activities and rel-
evant staff training expenses related to implementation of sub-
section (b). Such amount shall be determined in such manner as
agreed to by the two Secretaries.
SEC. 725. JOINT PILOT PROGRAM FOR PROVIDING GRADUATE MED-
ICAL EDUCATION AND TRAINING FOR PHYSICIANS.
(a) IN GENERAL.—The Secretary of Defense and the Secretary
of Veterans Affairs shall jointly carry out a pilot program under
which graduate medical education and training is provided to mili-
tary physicians and physician employees of the Department of
Defense and the Department of Veterans Affairs through one or
more programs carried out in military medical treatment facilities
of the Department of Defense and medical centers of the Depart-
ment of Veterans Affairs. The pilot program shall begin not later
than January 1, 2003.
(b) COST-SHARING AGREEMENT.—The Secretaries shall enter
into an agreement for carrying out the pilot program. The agree-
ment shall establish means for each Secretary to assist in paying
the costs, with respect to individuals under the jurisdiction of
that Secretary, incurred by the other Secretary in providing medical
education and training under the pilot program.
(c) USE OF EXISTING AUTHORITIES.—To carry out the pilot pro-
gram, the Secretary of Defense and the Secretary of Veterans
Affairs may use authorities provided to them under this subtitle,
section 8111 of title 38, United States Code (as amended by section
721(a)), and other laws relating to the furnishing or support of
medical education and the cooperative use of facilities.
(d) TERMINATION OF PROGRAM.—The pilot program under this
section shall terminate on July 31, 2008.
(e) REPEAL
OF SUPERSEDED PROVISION.—Section 738 of the
National Defense Authorization Act for Fiscal Year 2002 (Public
Law 107–107; 10 U.S.C. 1094 note; 115 Stat.1173) is repealed.
SEC. 726. REPEAL OF CERTAIN LIMITS ON DEPARTMENT OF VETERANS
AFFAIRS RESOURCES.
(a) REPEAL OF VA BED LIMITS.—Section 8110(a)(1) of title 38,
United States Code, is amended—
(1) in the first sentence, by striking ‘‘at not more than
125,000 and not less than 100,000’’;
(2) in the third sentence, by striking ‘‘shall operate and
maintain a total of not less than 90,000 hospital beds and
nursing home beds and’’; and
(3) in the fourth sentence, by striking ‘‘to enable the Depart-
ment to operate and maintain a total of not less than 90,000
hospital and nursing home beds in accordance with this para-
graph and’’.
(b) EFFECTIVE DATE.—The amendments made by subsection
(a) shall take effect on October 1, 2003.
TITLE VIII—ACQUISITION POLICY, AC-
QUISITION MANAGEMENT, AND RE-
LATED MATTERS
Subtitle A—Acquisition Policy and Management
Sec. 801. Buy-to-budget acquisition of end items.