‘‘(A) an Aging and Disability Resource 
Center, an area agency on aging, or a State 
agency (as defined in section 102 of the Older 
Americans Act of 1965 (42 U.S.C. 3002)); or 
‘‘(B) a center for independent living (as 
defined in section 702 of the Rehabilitation Act 
of 1973 (29 U.S.C. 796a)). 
‘‘(5) Such other health care providers as the 
Secretary considers appropriate for purposes of this 
section. 
‘‘(c) CERTIFICATION OF ELIGIBLE PROVIDERS.—(1) 
The Secretary shall establish a process for the certification 
of eligible providers under this section that shall, at a min-
imum, set forth the following: 
‘‘(A) Procedures for the submittal of applica-
tions for certification and deadlines for actions taken 
by the Secretary with respect to such applications. 
‘‘(B) Standards and procedures for approval 
and denial of certification, duration of certification, 
revocation of certification, and recertification. 
‘‘(C) Procedures for assessing eligible providers 
based on the risk of fraud, waste, and abuse of such 
providers similar to the level of screening under sec-
tion 1866(j)(2)(B) of the Social Security Act (42 
U.S.C. 1395cc(j)(2)(B)) and the standards set forth 
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under section 9.104 of title 48, Code of Federal 
Regulations, or any successor regulation. 
‘‘(2) The Secretary shall deny or revoke certification 
to an eligible provider under this subsection if the Sec-
retary determines that the eligible provider is currently— 
‘‘(A) excluded from participation in a Federal 
health care program (as defined in section 1128B(f) 
of the Social Security Act (42 U.S.C. 1320a–7b(f))) 
under section 1128 or 1128A of the Social Security 
Act (42 U.S.C. 1320a–7 and 1320a–7a); or 
‘‘(B) identified as an excluded source on the list 
maintained in the System for Award Management, 
or any successor system. 
‘‘(d) TERMS OF AGREEMENTS.—Each agreement en-
tered into with an eligible provider under this section shall 
include provisions requiring the eligible provider to do the 
following: 
‘‘(1) To accept payment for care and services 
furnished under this section at rates established by 
the Secretary for purposes of this section, which 
shall be, to the extent practicable, the rates paid by 
the United States for such care and services to pro-
viders of services and suppliers under the Medicare 
program under title XVIII of the Social Security Act 
(42 U.S.C. 1395 et seq.). 
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‘‘(2) To accept payment under paragraph (1) as 
payment in full for care and services furnished 
under this section and to not seek any payment for 
such care and services from the recipient of such 
care and services. 
‘‘(3) To furnish under this section only the care 
and services authorized by the Department under 
this section unless the eligible provider receives prior 
written consent from the Department to furnish care 
or services outside the scope of such authorization. 
‘‘(4) To bill the Department for care and serv-
ices furnished under this section in accordance with 
a methodology established by the Secretary for pur-
poses of this section. 
‘‘(5) Not to seek to recover or collect from a 
health-plan contract or third party, as those terms 
are defined in section 1729 of this title, for any care 
or services for which payment is made by the De-
partment under this section. 
‘‘(6) To provide medical records for veterans 
furnished care or services under this section to the 
Department in a timeframe and format specified by 
the Secretary for purposes of this section. 
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‘‘(7) To meet such other terms and conditions, 
including quality of care assurance standards, as the 
Secretary may specify for purposes of this section. 
‘‘(e) TERMINATION OF AGREEMENTS.—(1) An eligi-
ble provider may terminate an agreement with the Sec-
retary under this section at such time and upon such no-
tice to the Secretary as the Secretary may specify for pur-
poses of this section. 
‘‘(2) The Secretary may terminate an agreement with 
an eligible provider under this section at such time and 
upon such notice to the eligible provider as the Secretary 
may specify for purposes of this section, if the Secretary— 
‘‘(A) determines that the eligible provider failed 
to comply substantially with the provisions of the 
agreement or with the provisions of this section and 
the regulations prescribed thereunder; 
‘‘(B) determines that the eligible provider is— 
‘‘(i) excluded from participation in a Fed-
eral health care program (as defined in section 
1128B(f) of the Social Security Act (42 U.S.C. 
1320a–7b(f))) under section 1128 or 1128A of 
the Social Security Act (42 U.S.C. 1320a–7 
and 1320a–7a); or 
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‘‘(ii) identified as an excluded source on 
the list maintained in the System for Award 
Management, or any successor system; 
‘‘(C) ascertains that the eligible provider has 
been convicted of a felony or other serious offense 
under Federal or State law and determines that the 
continued participation of the eligible provider would 
be detrimental to the best interests of veterans or 
the Department; or 
‘‘(D) determines that it is reasonable to termi-
nate the agreement based on the health care needs 
of a veteran or veterans. 
‘‘(f) PERIODIC
REVIEW
OF
CERTAIN
AGREE-
MENTS.—(1) Not less frequently than once every two 
years, the Secretary shall review each Veterans Care 
Agreement of material size entered into during the two- 
year period preceding the review to determine whether it 
is feasible and advisable to furnish the hospital care, med-
ical services, or extended care furnished under such agree-
ment at facilities of the Department or through contracts 
or sharing agreements entered into under authorities other 
than this section. 
‘‘(2)(A) Subject to subparagraph (B), a Veterans 
Care Agreement is of material size as determined by the 
Secretary for purposes of this section. 
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‘‘(B) A Veterans Care Agreement entered into after 
September 30, 2018, for the purchase of extended care 
services is of material size if the purchase of such services 
under the agreement exceeds $1,000,000 annually. The 
Secretary may adjust such amount to account for changes 
in the cost of health care based upon recognized health 
care market surveys and other available data and shall 
publish any such adjustments in the Federal Register. 
‘‘(g) TREATMENT OF CERTAIN LAWS.—(1) An agree-
ment under this section may be entered into without re-
gard to any law that would require the Secretary to use 
competitive procedures in selecting the party with which 
to enter into the agreement. 
‘‘(2)(A) Except as provided in subparagraph (B) and 
unless otherwise provided in this section or regulations 
prescribed pursuant to this section, an eligible provider 
that enters into an agreement under this section is not 
subject to, in the carrying out of the agreement, any law 
that an eligible provider described in subsection (b)(1), 
(b)(2), or (b)(3) is not subject to under the original Medi-
care fee-for-service program under parts A and B of title 
XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) 
or the Medicaid program under title XIX of such Act (42 
U.S.C. 1396 et seq.). 
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‘‘(B) The exclusion under subparagraph (A) does not 
apply to laws regarding integrity, ethics, fraud, or that 
subject a person to civil or criminal penalties. 
‘‘(3) Title VII of the Civil Rights Act of 1964 (42 
U.S.C. 2000e et seq.) shall apply with respect to an eligi-
ble provider that enters into an agreement under this sec-
tion to the same extent as such title applies with respect 
to the eligible provider in providing care or services 
through an agreement or arrangement other than under 
this section. 
‘‘(h) MONITORING OF QUALITY OF CARE.—The Sec-
retary shall establish a system or systems, consistent with 
survey and certification procedures used by the Centers 
for Medicare & Medicaid Services and State survey agen-
cies to the extent practicable— 
‘‘(1) to monitor the quality of care and services 
furnished to veterans under this section; and 
‘‘(2) to assess the quality of care and services 
furnished by an eligible provider for purposes of de-
termining whether to renew an agreement under this 
section with the eligible provider. 
‘‘(i) DISPUTE RESOLUTION.—(1) The Secretary shall 
establish administrative procedures for eligible providers 
with which the Secretary has entered an agreement under 
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this section to present any dispute arising under or related 
to the agreement. 
‘‘(2) Before using any dispute resolution mechanism 
under chapter 71 of title 41 with respect to a dispute aris-
ing under an agreement under this section, an eligible pro-
vider must first exhaust the administrative procedures es-
tablished by the Secretary under paragraph (1).’’. 
(b) REGULATIONS.—The Secretary of Veterans Af-
fairs shall prescribe an interim final rule to carry out sec-
tion 1703A of such title, as added by subsection (a), not 
later than one year after the date of the enactment of this 
Act. 
(c) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 17 of such title is amended 
by inserting after the item related to section 1703 the fol-
lowing new item: 
‘‘1703A. Veterans Care Agreements with certain health care providers.’’. 
SEC. 4. MODIFICATION OF AUTHORITY TO ENTER INTO 
AGREEMENTS TO PROVIDE NURSING HOME 
CARE. 
(a) USE OF AGREEMENTS.— 
(1) IN
GENERAL.—Paragraph (1) of section 
1745(a) of title 38, United States Code, is amended, 
in the matter preceding subparagraph (A), by strik-
ing ‘‘a contract (or agreement under section 
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1720(c)(1) of this title)’’ and inserting ‘‘an agree-
ment’’. 
(2) PAYMENT.—Paragraph (2) of such section 
is amended by striking ‘‘contract (or agreement)’’ 
each place it appears and inserting ‘‘agreement’’. 
(b) EXCLUSION
OF
CERTAIN
FEDERAL
CON-
TRACTING PROVISIONS.—Such section is amended by add-
ing at the end the following new paragraph: 
‘‘(4)(A) An agreement under this section may be en-
tered into without regard to any law that would require 
the Secretary to use competitive procedures in selecting 
the party with which to enter into the agreement. 
‘‘(B)(i) Except as provided in clause (ii) and unless 
otherwise provided in this section or regulations prescribed 
pursuant to this section, a State home that enters into 
an agreement under this section is not subject to, in the 
carrying out of the agreement, any law that a provider 
described in subparagraph (D) is not subject to under the 
original Medicare fee-for-service program under parts A 
and B of title XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.) or the Medicaid program under title XIX 
of such Act (42 U.S.C. 1396 et seq.). 
‘‘(ii) The exclusion under clause (i) does not apply 
to laws regarding integrity, ethics, fraud, or that subject 
a person to civil or criminal penalties. 
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‘‘(C) Title VII of the Civil Rights Act of 1964 (42 
U.S.C. 2000e et seq.) shall apply with respect to any State 
home that enters into an agreement under this section. 
‘‘(D) A provider described in this subparagraph is 
one of the following: 
‘‘(i) A provider of services that has enrolled and 
entered into a provider agreement under section 
1866(a) of the Social Security Act (42 U.S.C. 
1395cc(a)). 
‘‘(ii) A physician or supplier that has enrolled 
and entered into a participation agreement under 
section 1842(h) of such Act (42 U.S.C. 1395u(h)). 
‘‘(iii) A provider of items and services receiving 
payment under a State plan under title XIX of such 
Act (42 U.S.C. 1396 et seq.) or a waiver of such a 
plan.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to agreements entered into under 
section 1745 of such title on and after the date that is 
30 days after the date of the enactment of this Act. 
Æ 
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