program, including by seeking to enter into 
memoranda of understanding with States to 
allow shared access of such information between 
States and the Department; 
(B) include such information in the Opioid 
Therapy Risk Report; and 
(C) require health care providers of the De-
partment to submit to the prescription drug 
monitoring program of each State information 
on prescriptions of controlled substances received 
by veterans in that State under the laws admin-
istered by the Secretary. 
(2) REPORT ON TRACKING OF DATA ON OPIOID 
USE.—Not later than 18 months after the date of the 
enactment of this Act, the Secretary shall submit to 
the Committee on Veterans’ Affairs of the Senate and 
the Committee on Veterans’ Affairs of the House of 
Representatives a report on the feasibility and advis-
ability of improving the Opioid Therapy Risk Report 
tool of the Department to allow for more advanced 
real-time tracking of and access to data on— 
(A) the key clinical indicators with respect 
to the totality of opioid use by veterans; 
(B) concurrent prescribing by health care 
providers of the Department of opioids in dif-
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ferent health care settings, including data on 
concurrent prescribing of opioids to treat mental 
health disorders other than opioid use disorder; 
and 
(C) mail-order prescriptions of opioid pre-
scribed to veterans under the laws administered 
by the Secretary. 
(e) AVAILABILITY
OF OPIOID RECEPTOR ANTAGO-
NISTS.— 
(1) INCREASED AVAILABILITY AND USE.— 
(A) IN
GENERAL.—The Secretary shall 
maximize the availability of opioid receptor an-
tagonists approved by the Food and Drug Ad-
ministration, including naloxone, to veterans. 
(B) AVAILABILITY, TRAINING, AND DISTRIB-
UTING.—In carrying out subparagraph (A), not 
later than 90 days after the date of the enact-
ment of this Act, the Secretary shall— 
(i) equip each pharmacy of the Depart-
ment with opioid receptor antagonists ap-
proved by the Food and Drug Administra-
tion to be dispensed to outpatients as need-
ed; and 
(ii) expand the Overdose Education 
and Naloxone Distribution program of the 
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Department to ensure that all veterans in 
receipt of health care under laws adminis-
tered by the Secretary who are at risk of 
opioid overdose may access such opioid re-
ceptor antagonists and training on the 
proper administration of such opioid recep-
tor antagonists. 
(C) VETERANS
WHO
ARE
AT
RISK.—For 
purposes of subparagraph (B), veterans who are 
at risk of opioid overdose include— 
(i) veterans receiving long-term opioid 
therapy; 
(ii) veterans receiving opioid therapy 
who have a history of substance use disorder 
or prior instances of overdose; and 
(iii) veterans who are at risk as deter-
mined by a health care provider who is 
treating the veteran. 
(2) REPORT.—Not later than 120 days after the 
date of the enactment of this Act, the Secretary shall 
submit to the Committee on Veterans’ Affairs of the 
Senate and the Committee on Veterans’ Affairs of the 
House of Representatives a report on carrying out 
paragraph (1), including an assessment of any re-
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maining steps to be carried out by the Secretary to 
carry out such paragraph. 
(f) INCLUSION OF CERTAIN INFORMATION AND CAPA-
BILITIES IN OPIOID THERAPY RISK REPORT TOOL OF THE 
DEPARTMENT.— 
(1) INFORMATION.—The Secretary shall include 
in the Opioid Therapy Risk Report tool of the De-
partment— 
(A) information on the most recent time the 
tool was accessed by a health care provider of the 
Department with respect to each veteran; and 
(B) information on the results of the most 
recent urine drug test for each veteran. 
(2) CAPABILITIES.—The Secretary shall include 
in the Opioid Therapy Risk Report tool the ability of 
the health care providers of the Department to deter-
mine whether a health care provider of the Depart-
ment prescribed opioids to a veteran without checking 
the information in the tool with respect to the vet-
eran. 
(g) NOTIFICATIONS
OF
RISK
IN
COMPUTERIZED 
HEALTH RECORD.—The Secretary shall modify the com-
puterized patient record system of the Department to ensure 
that any health care provider that accesses the record of 
a veteran, regardless of the reason the veteran seeks care 
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from the health care provider, will be immediately notified 
whether the veteran— 
(1) is receiving opioid therapy and has a history 
of substance use disorder or prior instances of over-
dose; 
(2) has a history of opioid abuse; or 
(3) is at risk of becoming an opioid abuser as de-
termined by a health care provider who is treating 
the veteran. 
(h) DEFINITIONS.—In this section: 
(1) The term ‘‘controlled substance’’ has the 
meaning given that term in section 102 of the Con-
trolled Substances Act (21 U.S.C. 802). 
(2) The term ‘‘State’’ means each of the several 
States, territories, and possessions of the United 
States, the District of Columbia, and the Common-
wealth of Puerto Rico. 
SEC. 103. STRENGTHENING OF JOINT WORKING GROUP ON 
PAIN MANAGEMENT OF THE DEPARTMENT OF 
VETERANS AFFAIRS AND THE DEPARTMENT 
OF DEFENSE. 
(a) IN GENERAL.—Not later than 90 days after the 
date of enactment of this Act, the Secretary of Veterans Af-
fairs and the Secretary of Defense shall ensure that the Pain 
Management Working Group of the Health Executive Com-
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mittee of the Department of Veterans Affairs–Department 
of Defense Joint Executive Committee established under sec-
tion 320 of title 38, United States Code, includes a focus 
on the following: 
(1) The opioid prescribing practices of health 
care providers of each Department. 
(2) The ability of each Department to manage 
acute and chronic pain among individuals receiving 
health care from the Department, including training 
health care providers with respect to pain manage-
ment. 
(3) The use by each Department of complemen-
tary and integrative health and complementary alter-
native medicines in treating such individuals. 
(4) The concurrent use by health care providers 
of each Department of opioids and prescription drugs 
to 
treat 
mental 
health 
disorders, 
including 
benzodiazepines. 
(5) The practice by health care providers of each 
Department of prescribing opioids to treat mental 
health disorders. 
(6) The coordination in coverage of and con-
sistent access to medications prescribed for patients 
transitioning from receiving health care from the De-
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partment of Defense to receiving health care from the 
Department of Veterans Affairs. 
(7) The ability of each Department to identify 
and treat substance use disorders among individuals 
receiving health care from that Department. 
(b) COORDINATION
AND CONSULTATION.—The Sec-
retary of Veterans Affairs and the Secretary of Defense shall 
ensure that the working group described in subsection (a)— 
(1) coordinates the activities of the working 
group with other relevant working groups established 
under section 320 of title 38, United States Code, in-
cluding the working groups on evidence-based prac-
tice, patient safety, pharmacy, psychological health, 
and psychological health; 
(2) consults with other relevant Federal agencies, 
including the Centers for Disease Control and Preven-
tion, with respect to the activities of the working 
group; and 
(3) consults with the Department of Veterans Af-
fairs and the Department of Defense with respect to, 
reviews, and comments on the VA/DOD Clinical 
Practice Guideline for Management of Opioid Ther-
apy for Chronic Pain, or any successor guideline, be-
fore any update to the guideline is released. 
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(c) CONSULTATIONS.—The Secretary of Veterans Af-
fairs and the Secretary of Defense shall ensure that the 
working group described in subsection (a) is able to mean-
ingfully consult with respect to the updated guideline re-
quired under subsection (a) of section 101, as required by 
subsection (b) of such section, not later than 1 year after 
the date of enactment of this Act. 
SEC. 104. REVIEW, INVESTIGATION, AND REPORT ON USE 
OF OPIOIDS IN TREATMENT BY DEPARTMENT 
OF VETERANS AFFAIRS. 
(a) COMPTROLLER GENERAL REPORT.— 
(1) IN GENERAL.—Not later than two years after 
the date of the enactment of this Act, the Comptroller 
General of the United States shall submit to the Com-
mittee on Veterans’ Affairs of the Senate and the 
Committee on Veterans’ Affairs of the House of Rep-
resentatives a report on the Opioid Safety Initiative 
of the Department of Veterans Affairs and the opioid 
prescribing practices of health care providers of the 
Department. 
(2) ELEMENTS.—The report submitted under 
paragraph (1) shall include the following: 
(A) Recommendations on such improve-
ments to the Opioid Safety Initiative of the De-
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partment as the Comptroller General considers 
appropriate. 
(B) Information with respect to— 
(i) deaths resulting from sentinel 
events involving veterans prescribed opioids 
by a health care provider of the Depart-
ment; 
(ii) overall prescription rates and pre-
scriptions indications of opioids to treat 
non-cancer, non-palliative, and non-hospice 
care patients; 
(iii) the prescription rates and pre-
scriptions indications of benzodiazepines 
and opioids concomitantly by health care 
providers of the Department; 
(iv) the practice by health care pro-
viders of the Department of prescribing 
opioids to treat patients without any pain, 
including to treat patients with mental 
health disorders other than opioid use dis-
order; and 
(v) the effectiveness of opioid therapy 
for patients receiving such therapy, includ-
ing the effectiveness of long-term opioid 
therapy. 
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(C) An evaluation of processes of the De-
partment in place to oversee opioid use among 
veterans, including procedures to identify and 
remedy potential over-prescribing of opioids by 
health care providers of the Department. 
(D) An assessment of the implementation by 
the Secretary of the VA/DOD Clinical Practice 
Guideline for Management of Opioid Therapy 
for Chronic Pain. 
(b) QUARTERLY PROGRESS REPORT ON IMPLEMENTA-
TION OF COMPTROLLER GENERAL RECOMMENDATIONS.— 
Not later than two years after the date of the enactment 
of this Act, and not later than 30 days after the end of 
each quarter thereafter, the Secretary of Veterans Affairs 
shall submit to the Committee on Veterans’ Affairs of the 
Senate and the Committee on Veterans’ Affairs of the House 
of Representatives a progress report detailing the actions 
by the Secretary during the period covered by the report 
to address any outstanding findings and recommendations 
by the Comptroller General of the United States under sub-
section (a) with respect to the Veterans Health Administra-
tion. 
(c) ANNUAL REVIEW OF PRESCRIPTION RATES.—Not 
later than one year after the date of the enactment of this 
Act, and not less frequently than annually for the following 
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five years, the Secretary shall submit to the Committee on 
Veterans’ Affairs of the Senate and the Committee on Vet-
erans’ Affairs of the House of Representatives a report, with 
respect to each medical facility of the Department of Vet-
erans Affairs, to collect and review information on opioids 
prescribed by health care providers at the facility to treat 
non-cancer, non-palliative, and non-hospice care patients 
that contains, for the one-year period preceding the submis-
sion of the report, the following: 
(1) The number of patients and the percentage of 
the patient population of the Department who were 
prescribed benzodiazepines and opioids concurrently 
by a health care provider of the Department. 
(2) The number of patients and the percentage of 
the patient population of the Department without any 
pain who were prescribed opioids by a health care 
provider of the Department, including those who were 
prescribed benzodiazepines and opioids concurrently. 
(3) The number of non-cancer, non-palliative, 
and non-hospice care patients and the percentage of 
such patients who were treated with opioids by a 
health care provider of the Department on an inpa-
tient-basis and who also received prescription opioids 
by mail from the Department while being treated on 
an inpatient-basis. 
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(4) The number of non-cancer, non-palliative, 
and non-hospice care patients and the percentage of 
such patients who were prescribed opioids concur-
rently by a health care provider of the Department 
and a health care provider that is not health care 
provider of the Department. 
(5) With respect to each medical facility of the 
Department, information on opioids prescribed by 
health care providers at the facility to treat non-can-
cer, non-palliative, and non-hospice care patients, in-
cluding information on— 
(A) the prescription rate at which each 
health care provider at the facility prescribed 
benzodiazepines and opioids concurrently to such 
patients and the aggregate such prescription rate 
for all health care providers at the facility; 
(B) the prescription rate at which each 
health care provider at the facility prescribed 
benzodiazepines or opioids to such patients to 
treat conditions for which benzodiazepines or 
opioids are not approved treatment and the ag-
gregate such prescription rate for all health care 
providers at the facility; 
(C) the prescription rate at which each 
health care provider at the facility prescribed or 
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dispensed mail-order prescriptions of opioids to 
such patients while such patients were being 
treated with opioids on an inpatient-basis and 
the aggregate of such prescription rate for all 
health care providers at the facility; and 
(D) the prescription rate at which each 
health care provider at the facility prescribed 
opioids to such patients who were also concur-
rently prescribed opioids by a health care pro-
vider that is not a health care provider of the 
Department and the aggregate of such prescrip-
tion rates for all health care providers at the fa-
cility. 
(6) With respect to each medical facility of the 
Department, the number of times a pharmacist at the 
facility overrode a critical drug interaction warning 
with respect to an interaction between opioids and 
another medication before dispensing such medication 
to a veteran. 
(d) INVESTIGATION OF PRESCRIPTION RATES.—If the 
Secretary determines that a prescription rate with respect 
to a health care provider or medical facility of the Depart-
ment conflicts with or is otherwise inconsistent with the 
standards of appropriate and safe care, the Secretary 
shall— 
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(1) immediately notify the Committee on Vet-
erans’ Affairs of the Senate and the Committee on 
Veterans’ Affairs of the House of Representatives of 
such determination, including information relating to 
such determination, prescription rate, and health care 
provider or medical facility, as the case may be; and 
(2) through the Office of the Medical Inspector of 
the Veterans Health Administration, conduct a full 
investigation of the health care provider or medical 
facility, as the case may be. 
(e) PRESCRIPTION RATE DEFINED.—In this section, 
the term ‘‘prescription rate’’ means, with respect to a health 
care provider or medical facility of the Department, each 
of the following: 
(1) The number of patients treated with opioids 
by the health care provider or at the medical facility, 
as the case may be, divided by the total number of 
pharmacy users of that health care provider or med-
ical facility. 
(2) The average number of morphine equivalents 
per day prescribed by the health care provider or at 
the medical facility, as the case may be, to patients 
being treated with opioids. 
(3) Of the patients being treated with opioids by 
the health care provider or at the medical facility, as 
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the case may be, the average number of prescriptions 
of opioids per patient. 
SEC. 105. MANDATORY DISCLOSURE OF CERTAIN VETERAN 
INFORMATION TO STATE CONTROLLED SUB-
STANCE MONITORING PROGRAMS. 
Section 5701(l) of title 38, United States Code, is 
amended by striking ‘‘may’’ and inserting ‘‘shall’’. 
TITLE II—PATIENT ADVOCACY 
SEC. 201. COMMUNITY MEETINGS ON IMPROVING CARE 
FURNISHED BY DEPARTMENT OF VETERANS 
AFFAIRS. 
(a) COMMUNITY MEETINGS.— 
(1) MEDICAL CENTERS.—Not later than 90 days 
after the date of the enactment of this Act, and not 
less frequently than once every 90 days thereafter, the 
Secretary shall ensure that each medical facility of 
the Department of Veterans Affairs hosts a commu-
nity meeting open to the public on improving health 
care furnished by the Secretary. 
(2) COMMUNITY BASED OUTPATIENT CLINICS.— 
Not later than one year after the date of the enact-
ment of this Act, and not less frequently than annu-
ally thereafter, the Secretary shall ensure that each 
community based outpatient clinic of the Department 
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hosts a community meeting open to the public on im-
proving health care furnished by the Secretary. 
(b) ATTENDANCE BY DIRECTOR OF VETERANS INTE-
GRATED SERVICE NETWORK OR DESIGNEE.— 
(1) IN
GENERAL.—Each community meeting 
hosted by a medical facility or community based out-
patient clinic under subsection (a) shall be attended 
by the Director of the Veterans Integrated Service 
Network in which the medical facility or community 
based outpatient clinic, as the case may be, is located. 
Subject to paragraph (2), the Director may delegate 
such attendance only to an employee who works in the 
Office of the Director. 
(2) ATTENDANCE BY DIRECTOR.—Each Director 
of a Veterans Integrated Service Network shall person-
ally attend not less than one community meeting 
under subsection (a) hosted by each medical facility 
located in the Veterans Integrated Service Network 
each year. 
(c) NOTICE.—The Secretary shall notify the Committee 
on Veterans’ Affairs of the Senate, the Committee on Vet-
erans’ Affairs of the House of Representatives, and each 
Member of Congress (as defined in section 104) who rep-
resents the area in which the medical facility is located of 
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a community meeting under subsection (a) by not later 
than 10 days before such community meeting occurs. 
SEC. 202. IMPROVEMENT OF AWARENESS OF PATIENT AD-
VOCACY PROGRAM AND PATIENT BILL OF 
RIGHTS OF DEPARTMENT OF VETERANS AF-
FAIRS. 
Not later than 90 days after the date of the enactment 
of this Act, the Secretary of Veterans Affairs shall, in as 
many prominent locations as the Secretary determines ap-
propriate to be seen by the largest percentage of patients 
and family members of patients at each medical facility 
of the Department of Veterans Affairs— 
(1) display the purposes of the Patient Advocacy 
Program of the Department and the contact informa-
tion for the patient advocate at such medical facility; 
and 
(2) display the rights and responsibilities of— 
(A) patients and family members and pa-
tients at such medical facility; and 
(B) with respect to community living cen-
ters and other residential facilities of the Depart-
ment, residents and family members of residents 
at such medical facility. 
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SEC. 203. COMPTROLLER GENERAL REPORT ON PATIENT 
ADVOCACY PROGRAM OF DEPARTMENT OF 
VETERANS AFFAIRS. 
(a) IN GENERAL.—Not later than two years after the 
date of the enactment of this Act, the Comptroller General 
of the United States shall submit to the Committee on Vet-
erans’ Affairs of the Senate and the Committee on Veterans’ 
Affairs of the House of Representatives a report on the Pa-
tient Advocacy Program of the Department of Veterans Af-
fairs (in this section referred to as the ‘‘Program’’). 
(b) ELEMENTS.—The report required by subsection (a) 
shall include the following: 
(1) A description of the Program, including— 
(A) the purpose of the Program; 
(B) the activities carried out under the Pro-
gram; and 
(C) the sufficiency of the Program in 
achieving the purpose of the Program. 
(2) An assessment of the sufficiency of staffing of 
employees of the Department responsible for carrying 
out the Program. 
(3) An assessment of the sufficiency of the train-
ing of such employees. 
(4) An assessment of— 
(A) the awareness of the Program among 
veterans and family members of veterans; and 
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(B) the use of the Program by veterans and 
family members of veterans. 
(5) Such recommendations and proposals for im-
proving or modifying the Program as the Comptroller 
General considers appropriate. 
(6) Such other information with respect to the 
Program as the Comptroller General considers appro-
priate. 
TITLE III—COMPLEMENTARY 
AND INTEGRATIVE HEALTH 
SEC. 301. EXPANSION OF RESEARCH AND EDUCATION ON 
AND DELIVERY OF COMPLEMENTARY AND IN-
TEGRATIVE HEALTH TO VETERANS. 
(a) ESTABLISHMENT.—There is established a commis-
sion to be known as the ‘‘Creating Options for Veterans’ 
Expedited Recovery’’ or the ‘‘COVER Commission’’ (in this 
Act referred to as the ‘‘Commission’’). The Commission shall 
examine the evidence-based therapy treatment model used 
by the Secretary of Veterans Affairs for treating mental 
health conditions of veterans and the potential benefits of 
incorporating complementary alternative treatments avail-
able in non-Department facilities (as defined in section 
1701 of title 38, United States Code). 
(b) DUTIES.—The Commission shall perform the fol-
lowing duties: 
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(1) Examine the efficacy of the evidence-based 
therapy model used by the Secretary for treating men-
tal health illnesses of veterans and identify areas to 
improve wellness-based outcomes. 
(2) Conduct a patient-centered survey within 
each of the Veterans Integrated Service Networks to 
examine— 
(A) the experience of veterans with the De-
partment of Veterans Affairs when seeking med-
ical assistance for mental health issues through 
the health care system of the Department; 
(B) the experience of veterans with non-De-
partment facilities and health professionals for 
treating mental health issues; 
(C) the preference of veterans regarding 
available treatment for mental health issues and 
which methods the veterans believe to be most ef-
fective; 
(D) the experience, if any, of veterans with 
respect to the complementary alternative treat-
ment therapies described in paragraph (3); 
(E) the prevalence of prescribing prescrip-
tion medication among veterans seeking treat-
ment through the health care system of the De-
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partment as remedies for addressing mental 
health issues; and 
(F) the outreach efforts of the Secretary re-
garding the availability of benefits and treat-
ments for veterans for addressing mental health 
issues, including by identifying ways to reduce 
barriers to gaps in such benefits and treatments. 
(3) Examine available research on complemen-
tary alternative treatment therapies for mental health 
issues and identify what benefits could be made with 
the inclusion of such treatments for veterans, includ-
ing with respect to— 
(A) music therapy; 
(B) equine therapy; 
(C) training and caring for service dogs; 
(D) yoga therapy; 
(E) acupuncture therapy; 
(F) meditation therapy; 
(G) outdoor sports therapy; 
(H) hyperbaric oxygen therapy; 
(I) accelerated resolution therapy; 
(J) art therapy; 
(K) magnetic resonance therapy; and 
(L) other therapies the Commission deter-
mines appropriate. 
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(4) Study the sufficiency of the resources of the 
Department to ensure the delivery of quality health 
care for mental health issues among veterans seeking 
treatment within the Department. 
(5) Study the current treatments and resources 
available within the Department and assess— 
(A) the effectiveness of such treatments and 
resources in decreasing the number of suicides 
per day by veterans; 
(B) the number of veterans who have been 
diagnosed with mental health issues; 
(C) the percentage of veterans using the re-
sources of the Department who have been diag-
nosed with mental health issues; 
(D) the percentage of veterans who have 
completed counseling sessions offered by the De-
partment; and 
(E) the efforts of the Department to expand 
complementary alternative treatments viable to 
the recovery of veterans with mental health issues 
as determined by the Secretary to improve the ef-
fectiveness of treatments offered with the Depart-
ment. 
(c) MEMBERSHIP.— 
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(1) IN GENERAL.—The Commission shall be com-
posed of 10 members, appointed as follows: 
(A) Two members appointed by the Speaker 
of the House of Representatives, at least one of 
whom shall be a veteran. 
(B) Two members appointed by the Minor-
ity Leader of the House of Representatives, at 
least one of whom shall be a veteran. 
(C) Two members appointed by the Major-
ity Leader of the Senate, at least one of whom 
shall be a veteran. 
(D) Two members appointed by the Minor-
ity Leader of the Senate, at least one of whom 
shall be a veteran. 
(E) Two members appointed by the Presi-
dent, at least one of whom shall be a veteran. 
(2) QUALIFICATIONS.—Members of the Commis-
sion shall be— 
(A) individuals who are of recognized 
standing and distinction within the medical 
community with a background in treating men-
tal health; 
(B) individuals with experience working 
with the military and veteran population; and 
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(C) individuals who do not have a financial 
interest in any of the complementary alternative 
treatments reviewed by the Commission. 
(3) CHAIRMAN.—The President shall designate a 
member of the Commission to be the Chairman. 
(4) PERIOD OF APPOINTMENT.—Members of the 
Commission shall be appointed for the life of the 
Commission. 
(5) VACANCY.—A vacancy in the Commission 
shall be filled in the manner in which the original 
appointment was made. 
(6) APPOINTMENT DEADLINE.—The appointment 
of members of the Commission in this section shall be 
made not later than 90 days after the date of the en-
actment of this Act. 
(d) POWERS OF COMMISSION.— 
(1) MEETINGS.— 
(A) INITIAL
MEETING.—The Commission 
shall hold its first meeting not later than 30 
days after a majority of members are appointed 
to the Commission. 
(B) MEETING.—The Commission shall regu-
larly meet at the call of the Chairman. Such 
meetings may be carried out through the use of 
telephonic or other appropriate telecommuni-
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cation technology if the Commission determines 
that such technology will allow the members to 
communicate simultaneously. 
(2) HEARINGS.—The Commission may hold such 
hearings, sit and act at such times and places, take 
such testimony, and receive evidence as the Commis-
sion considers advisable to carry out the responsibil-
ities of the Commission. 
(3) INFORMATION FROM FEDERAL AGENCIES.— 
The Commission may secure directly from any de-
partment or agency of the Federal Government such 
information as the Commission considers necessary to 
carry out the duties of the Commission. 
(4) INFORMATION FROM NONGOVERNMENTAL OR-
GANIZATIONS.—In carrying out its duties, the Com-
mission may seek guidance through consultation with 
foundations, veteran service organizations, nonprofit 
groups, faith-based organizations, private and public 
institutions of higher education, and other organiza-
tions as the Commission determines appropriate. 
(5) COMMISSION
RECORDS.—The Commission 
shall keep an accurate and complete record of the ac-
tions and meeting of the Commission. Such record 
shall be made available for public inspection and the 
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Comptroller General of the United States may audit 
and examine such record. 
(6) PERSONNEL
RECORDS.—The Commission 
shall keep an accurate and complete record of the ac-
tions and meetings of the Commission. Such record 
shall be made available for public inspection and the 
Comptroller General of the United States may audit 
and examine such records. 
(7) COMPENSATION OF MEMBERS; TRAVEL EX-
PENSES.—Each member shall serve without pay but 
shall receive travel expenses to perform the duties of 
the Commission, including per diem in lieu of sub-
stances, at rates authorized under subchapter I of 
chapter 57 of title 5, United States Code. 
(8) STAFF.—The Chairman, in accordance with 
rules agreed upon the Commission, may appoint fix 
the compensation of a staff director and such other 
personnel as may be necessary to enable the Commis-
sion to carry out its functions, without regard to the 
provisions of title 5, United States Code, governing 
appointments in the competitive service, without re-
gard to the provision of chapter 51 and subchapter 
III of chapter 53 of such title relating to classification 
and General Schedule pay rates, except that no rate 
of pay fixed under this paragraph may exceed the 
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equivalent of that payable for a position at a level IV 
of the Executive Schedule under section 5316 of title 
5, United States Code. 
(9) PERSONNEL AS FEDERAL EMPLOYEES.— 
(A) IN
GENERAL.—The executive director 
and any personnel of the Commission are em-
ployees under section 2105 of title 5, United 
States Code, for purpose of chapters 63, 81, 83, 
84, 85, 87, 89, and 90 of such title. 
(B) MEMBERS OF THE COMMISSION.—Sub-
paragraph (A) shall not be construed to apply to 
members of the Commission. 
(10) CONTRACTING.—The Commission may, to 
such extent and in such amounts as are provided in 
appropriations Acts, enter into contracts to enable the 
Commission to discharge the duties of the Commission 
under this Act. 
(11) EXPERT AND CONSULTANT SERVICE.—The 
Commission may procure the services of experts and 
consultants in accordance with section 3109 or title 
5, United States Code, at rates not to exceed the daily 
rate paid to a person occupying a position at level IV 
of the Executive Schedule under section 3109 of title 
5, United States Code. 
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(12) POSTAL SERVICE.—The Commission may 
use the United States mails in the same manner and 
under the same conditions as departments and agen-
cies of the United States. 
(13) PHYSICAL FACILITIES AND EQUIPMENT.— 
Upon the request of the Commission, the Adminis-
trator of General Services shall provide to the Com-
mission, on a reimbursable basis, the administrative 
support services necessary for the Commission to 
carry out its responsibilities under this Act. These ad-
ministrative services may include human resource 
management, budget, leasing accounting, and payroll 
services. 
(e) REPORT.— 
(1) INTERIM REPORTS.— 
(A) IN GENERAL.—Not later than 60 days 
after the date on which the Commission first 
meets, and each 30-day period thereafter ending 
on the date on which the Commission submits 
the final report under paragraph (2), the Com-
mission shall submit to the Committees on Vet-
erans’ Affairs of the House of Representatives 
and the Senate and the President a report detail-
ing the level of cooperation the Secretary of Vet-
erans Affairs (and the heads of other depart-
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ments or agencies of the Federal Government) 
has provided to the Commission. 
(B) OTHER REPORTS.—In carrying out its 
duties, at times that the Commission determines 
appropriate, the Commission shall submit to the 
Committee on Veterans’ Affairs of the House of 
Representatives and the Senate and any other 
appropriate entities an interim report with re-
spect to the findings identified by the Commis-
sion. 
(2) FINAL REPORT.—Not later than 18 months 
after the first meeting of the Commission, the Com-
mission shall submit to the Committee on Veterans’ 
Affairs of the House of Representatives and the Sen-
ate, the President, and the Secretary of Veterans Af-
fairs a final report on the findings of the Commis-
sion. Such report shall include the following: 
(A) Recommendations to implement in a 
feasible, timely, and cost efficient manner the so-
lutions and remedies identified within the find-
ings of the Commission pursuant to subsection 
(b). 
(B) An analysis of the evidence-based ther-
apy model used by the Secretary of Veterans Af-
fairs for treating veterans with mental health 
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care issues, and an examination of the preva-
lence and efficacy of prescription drugs as a 
means for treatment. 
(C) The findings of the patient-centered sur-
vey conducted within each of the Veterans Inte-
grated Service Networks pursuant to subsection 
(b)(2). 
(D) An examination of complementary al-
ternative treatments described in subsection 
(b)(3) and the potential benefits of incorporating 
such treatments in the therapy models used by 
the Secretary for treating veterans with mental 
health issues. 
(3) PLAN.—Not later than 90 days after the date 
on which the Commission submits the final report 
under paragraph (2), the Secretary of Veterans Af-
fairs shall submit to the Committee on Veterans’ Af-
fairs of the House of Representatives and the Senate 
a report on the following: 
(A) An action plan for implementing the 
recommendations established by the Commission 
on such solutions and remedies for improving 
wellness-based outcomes for veterans with mental 
health care issues. 
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(B) A feasible timeframe on when the com-
plementary alternative treatments described in 
subsection (b)(3) can be implemented Depart-
ment-wide. 
(C) With respect to each recommendation 
established by the Commission, including any 
complementary alternative treatment, that the 
Secretary determines is not appropriate or fea-
sible to implement, a justification for such deter-
mination and an alternative solution to improve 
the efficacy of the therapy models used by the 
Secretary for treating veterans with mental 
health issues. 
(f) TERMINATION OF COMMISSION.—The Commission 
shall terminate 30 days after the Commission submits the 
final report under subsection (e)(2). 
SEC. 302. PILOT PROGRAM ON INTEGRATION OF COM-
PLEMENTARY ALTERNATIVE MEDICINES AND 
RELATED ISSUES FOR VETERANS AND FAM-
ILY MEMBERS OF VETERANS. 
(a) PILOT PROGRAM.— 
(1) IN GENERAL.—Not later than 180 days after 
the date on which the Secretary of Veterans Affairs 
receives the final report under section 301(e), the Sec-
retary shall commence a pilot program to assess the 
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feasibility and advisability of using wellness-based 
programs (as defined by the Secretary) to complement 
the provision of pain management and related health 
care services, including mental health care services, to 
veterans. 
(2) MATTERS ADDRESSED.—In carrying out the 
pilot program, the Secretary shall assess the fol-
lowing: 
(A) Means of improving coordination be-
tween Federal, State, local, and community pro-
viders of health care in the provision of pain 
management and related health care services to 
veterans. 
(B) Means of enhancing outreach, and co-
ordination of outreach, by and among providers 
of health care referred to in subparagraph (A) on 
the pain management and related health care 
services available to veterans. 
(C) Means of using wellness-based programs 
of providers of health care referred to in sub-
paragraph (A) as complements to the provision 
by the Department of pain management and re-
lated health care services to veterans. 
(D) Whether wellness-based programs de-
scribed in subparagraph (C)— 
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(i) are effective in enhancing the qual-
ity of life and well-being of veterans; 
(ii) are effective in increasing the ad-
herence of veterans to the primary pain 
management and related health care serv-
ices provided such veterans by the Depart-
ment; 
(iii) have an effect on the sense of well- 
being of veterans who receive primary pain 
management and related health care serv-
ices from the Department; and 
(iv) are effective in encouraging vet-
erans receiving health care from the Depart-
ment to adopt a more healthy lifestyle. 
(b) DURATION.—The Secretary shall carry out the 
pilot program under subsection (a)(1) for a period of three 
years. 
(c) LOCATIONS.— 
(1) FACILITIES.—The Secretary shall carry out 
the pilot program under subsection (a)(1) at facilities 
of the Department providing pain management and 
related health care services, including mental health 
care services, to veterans. In selecting such facilities 
to carry out the pilot program, the Secretary shall se-
lect not fewer than 15 medical centers of the Depart-
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ment, of which not fewer than two shall be 
polytrauma rehabilitation centers of the Department. 
(2) MEDICAL
CENTERS
WITH
PRESCRIPTION 
RATES
OF
OPIOIDS
THAT
CONFLICT
WITH
CARE 
STANDARDS.—In selecting the medical centers under 
paragraph (1), the Secretary shall give priority to 
medical centers of the Department at which there is 
a prescription rate of opioids that conflicts with or is 
otherwise inconsistent with the standards of appro-
priate and safe care. 
(d) PROVISION OF SERVICES.—Under the pilot pro-
gram under subsection (a)(1), the Secretary shall provide 
covered services to covered veterans by integrating com-
plementary and alternative medicines and integrative 
health services with other services provided by the Depart-
ment at the medical centers selected under subsection (c). 
(e) COVERED VETERANS.—For purposes of the pilot 
program under subsection (a)(1), a covered veteran is any 
veteran who— 
(1) has a mental health condition diagnosed by 
a clinician of the Department; 
(2) experiences chronic pain; 
(3) has a chronic condition being treated by a 
clinician of the Department; or 
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(4) is not described in paragraph (1), (2), or (3) 
and requests to participate in the pilot program or is 
referred by a clinician of the Department who is 
treating the veteran. 
(f) COVERED SERVICES.— 
(1) IN GENERAL.—For purposes of the pilot pro-
gram, covered services are services consisting of com-
plementary and integrative health services as selected 
by the Secretary. 
(2) ADMINISTRATION
OF
SERVICES.—Covered 
services shall be administered under the pilot pro-
gram as follows: 
(A) Covered services shall be administered 
by professionals or other instructors with appro-
priate training and expertise in complementary 
and integrative health services who are employ-
ees of the Department or with whom the Depart-
ment enters into an agreement to provide such 
services. 
(B) Covered services shall be included as 
part of the Patient Aligned Care Teams initia-
tive of the Office of Patient Care Services, Pri-
mary Care Program Office, in coordination with 
the Office of Patient Centered Care and Cultural 
Transformation. 
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(C) Covered services shall be made available 
to— 
(i) covered veterans who have received 
conventional treatments from the Depart-
ment for the conditions for which the cov-
ered veteran seeks complementary and inte-
grative health services under the pilot pro-
gram; and 
(ii) covered veterans who have not re-
ceived conventional treatments from the De-
partment for such conditions. 
(g) REPORTS.— 
(1) IN
GENERAL.—Not later than 30 months 
after the date on which the Secretary commences the 
pilot program under subsection (a)(1), the Secretary 
shall submit to the Committee on Veterans’ Affairs of 
the Senate and the Committee on Veterans’ Affairs of 
the House of Representatives a report on the pilot 
program. 
(2) ELEMENTS.—The report under paragraph 
(1) shall include the following: 
(A) The findings and conclusions of the Sec-
retary with respect to the pilot program under 
subsection (a)(1), including with respect to— 
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(i) the use and efficacy of the com-
plementary and integrative health services 
established under the pilot program; 
(ii) the outreach conducted by the Sec-
retary to inform veterans and community 
organizations about the pilot program; and 
(iii) an assessment of the benefit of the 
pilot program to covered veterans in mental 
health diagnoses, pain management, and 
treatment of chronic illness. 
(B) Identification of any unresolved bar-
riers that impede the ability of the Secretary to 
incorporate 
complementary 
and 
integrative 
health services with other health care services 
provided by the Department. 
(C) Such recommendations for the continu-
ation or expansion of the pilot program as the 
Secretary considers appropriate. 
(h) COMPLEMENTARY AND INTEGRATIVE HEALTH DE-
FINED.—In this section, the term ‘‘complementary and inte-
grative health’’ shall have the meaning given that term by 
the National Institutes of Health. 
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TITLE IV—FITNESS OF HEALTH 
CARE PROVIDERS 
SEC. 401. ADDITIONAL REQUIREMENTS FOR HIRING OF 
HEALTH CARE PROVIDERS BY DEPARTMENT 
OF VETERANS AFFAIRS. 
As part of the hiring process for each health care pro-
vider considered for a position at the Department of Vet-
erans Affairs after the date of the enactment of the Act, the 
Secretary of Veterans Affairs shall require from the medical 
board of each State in which the health care provider has 
a medical license— 
(1) information on any violation of the require-
ments of the medical license of the health care pro-
vider during the 20-year period preceding the consid-
eration of the health care provider by the Department; 
and 
(2) information on whether the health care pro-
vider has entered into any settlement agreement for 
the disciplinary charge relating to the practice of 
medicine by the health care provider. 
SEC. 402. PROVISION OF INFORMATION ON HEALTH CARE 
PROVIDERS OF DEPARTMENT OF VETERANS 
AFFAIRS TO STATE MEDICAL BOARDS. 
Notwithstanding section 552a of title 5, United States 
Code, with respect to each health care provider of the De-
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partment of Veterans Affairs who has violated a require-
ment of the medical license of the health care provider, the 
Secretary of Veterans Affairs shall provide to the medical 
board of each State in which the health care provider is 
licensed detailed information with respect to such violation, 
regardless of whether such board has formally requested such 
information. 
SEC. 403. REPORT ON COMPLIANCE BY DEPARTMENT OF 
VETERANS 
AFFAIRS 
WITH 
REVIEWS 
OF 
HEALTH CARE PROVIDERS LEAVING THE DE-
PARTMENT OR TRANSFERRING TO OTHER FA-
CILITIES. 
Not later than 180 days after the date of the enactment 
of this Act, the Secretary of Veterans Affairs shall submit 
to the Committee on Veterans’ Affairs of the Senate and 
the Committee on Veterans’ Affairs of the House of Rep-
resentatives a report on the compliance by the Department 
of Veterans Affairs with the policy of the Department— 
(1) to conduct a review of each health care pro-
vider of the Department who transfers to another 
medical facility of the Department, retires, or is ter-
minated to determine whether there are any concerns, 
complaints, or allegations of violations relating to the 
medical practice of the health care provider; and 
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(2) to take appropriate action with respect to 
any such concern, complaint, or allegation. 
TITLE V—OTHER VETERANS 
MATTERS 
SEC. 501. AUDIT OF VETERANS HEALTH ADMINISTRATION 
PROGRAMS OF DEPARTMENT OF VETERANS 
AFFAIRS. 
(a) AUDIT.—The Secretary of Veterans Affairs shall 
seek to enter into a contract with a nongovernmental entity 
under which the entity shall conduct a audits of the pro-
grams of the Veterans Health Administration of the Depart-
ment of Veterans Affairs to identify ways to improve the 
furnishing of benefits and health care administered by the 
Veterans Health Administration to veterans and families 
of veterans. 
(b) AUDIT REQUIREMENTS.—In carrying out each 
audit under subsection (a), the entity shall perform the fol-
lowing: 
(1) Five-year risk assessments to identify the 
functions, staff organizations, and staff offices of the 
Veterans Health Administration that would lead to-
wards the greatest improvement in furnishing of bene-
fits and health care to veterans and families of vet-
erans. 
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(2) Development of plans that are informed by 
the risk assessment under paragraph (1) to conduct 
audits of the functions, staff organizations, and staff 
offices identified under paragraph (1). 
(3) Conduct audits in accordance with the plans 
developed pursuant to paragraph (2). 
(c) REPORTS.—Not later than 90 days after the date 
on which each audit is completed under subsection (a), the 
Secretary shall submit to the Committees on Veterans’ Af-
fairs of the House of Representatives and the Senate a re-
port that includes— 
(1) a summary of the audit; 
(2) the findings of the entity that conducted the 
audit with respect to the audit; and 
(3) such recommendations as the Secretary deter-
mines appropriate for legislative or administrative 
action to improve the furnishing of benefits and 
health care to veterans and families of veterans. 
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Union Calendar No. 422 
114TH CONGRESS 
2D SESSION 
H. R. 4063 
[Report No. 114–546, Part I] 
A BILL 
To improve the use by the Secretary of Veterans 
Affairs of opioids in treating veterans, to improve 
patient advocacy by the Secretary, and to expand 
the availability of complementary and integrative 
health, and for other purposes. 
MAY 10, 2016 
Reported from the Committee on Veterans’ Affairs with 
an amendment 
MAY 10, 2016 
The Committee on Armed Services discharged; committed 
to the Committee of the Whole House on the State of 
the Union and ordered to be printed 
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