IIB 
110TH CONGRESS 
2D SESSION 
H. R. 6445 
IN THE SENATE OF THE UNITED STATES 
JULY 31, 2008 
Received; read twice and referred to the Committee on Veterans’ Affairs 
AN ACT 
To amend title 38, United States Code, to prohibit the Sec-
retary of Veterans Affairs from collecting certain copay-
ments from veterans who are catastrophically disabled, 
and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Veterans’ Health Care 
Policy Enhancement Act of 2008’’. 
SEC. 2. PROHIBITION ON COLLECTION OF CERTAIN COPAY-
MENTS FROM VETERANS WHO ARE CATA-
STROPHICALLY DISABLED. 
(a) PROHIBITION ON COLLECTION OF COPAYMENTS 
AND OTHER FEES FOR HOSPITAL OR NURSING HOME 
CARE.—Section 1710 of title 38, United States Code, is 
amended— 
(1) by redesignating subsection (h) as sub-
section (i); and 
(2) by inserting after subsection (g) the fol-
lowing new subsection (h): 
‘‘(h) Notwithstanding any other provision of this sec-
tion, a veteran who is catastrophically disabled shall not 
be required to make any payment otherwise required 
under subsection (f) or (g) for the receipt of hospital care 
or nursing home care under this section.’’. 
(b) EFFECTIVE DATE.—Subsection (h) of section 
1710 of title 38, United States Code, as added by sub-
section (a), shall apply with respect to hospital care or 
nursing home care provided after the date of the enact-
ment of this Act. 
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SEC. 3. EXPANSION OF AUTHORITY OF SECRETARY OF VET-
ERANS AFFAIRS TO PROVIDE COUNSELING 
FOR FAMILY MEMBERS OF VETERANS RE-
CEIVING NONSERVICE-CONNECTED TREAT-
MENT. 
Section 1782(b) of title 38, United States Code, is 
amended by striking ‘‘if—’’ and all that follows and insert-
ing a period. 
SEC. 4. COMPREHENSIVE POLICY ON PAIN MANAGEMENT. 
(a) COMPREHENSIVE POLICY REQUIRED.—Not later 
than October 1, 2008, the Secretary of Veterans Affairs 
shall develop and implement a comprehensive policy on the 
management of pain experienced by veterans enrolled for 
health care services provided by the Department of Vet-
erans Affairs. 
(b) SCOPE OF POLICY.—The policy required by sub-
section (a) shall cover each of the following: 
(1) The systemwide management of acute and 
chronic pain experienced by veterans. 
(2) The standard of care for pain management 
to be used throughout the Department. 
(3) The consistent application of pain assess-
ments to be used throughout the Department. 
(4) The assurance of prompt and appropriate 
pain care treatment and management by the Depart-
ment, systemwide, when medically necessary. 
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(5) The Department’s program of research re-
lated to acute and chronic pain suffered by veterans, 
including pain attributable to central and peripheral 
nervous system damage characteristic of injuries in-
curred in modern warfare. 
(6) The Department’s program of pain care 
education and training for health care personnel of 
the Department. 
(7) The Department’s program of patient edu-
cation for veterans suffering from acute or chronic 
pain and their families. 
(c) UPDATES.—The Secretary shall revise the policy 
developed under subsection (a) on a periodic basis in ac-
cordance with experience and evolving best practice guide-
lines. 
(d) CONSULTATION.—The Secretary shall develop the 
policy developed under subsection (a), and revise such pol-
icy under subsection (c), in consultation with veterans 
service organizations and organizations with expertise in 
the assessment, diagnosis, treatment, and management of 
pain. 
(e) ANNUAL REPORT.— 
(1) IN
GENERAL.—Not later than 180 days 
after the date of the completion and initial imple-
mentation of the policy under subsection (a) and on 
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October 1 of every fiscal year thereafter through fis-
cal year 2018, 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 implementation of 
the policy developed under subsection (a). 
(2) CONTENTS.—The report required by para-
graph (1) shall include the following: 
(A) A description of the policy developed 
and implemented under subsection (a) and any 
revisions to such policy under subsection (c). 
(B) A description of the performance 
measures used to determine the effectiveness of 
such policy in improving pain care for veterans 
systemwide. 
(C) An assessment of the adequacy of the 
Department’s pain management services based 
on a survey of patients managed in Department 
clinics. 
(D) An assessment of the Department’s re-
search programs relevant to the treatment of 
the types of acute and chronic pain suffered by 
veterans. 
(E) An assessment of the training provided 
to Department health care personnel with re-
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spect to the diagnosis, treatment, and manage-
ment of acute and chronic pain. 
(F) An assessment of the Department’s 
pain care-related patient education programs. 
(f) VETERANS SERVICE ORGANIZATION DEFINED.— 
In this section, the term ‘‘veterans service organization’’ 
means any organization recognized by the Secretary for 
the representation of veterans under section 5902 of title 
38, United States Code. 
SEC. 5. ESTABLISHMENT OF CONSOLIDATED PATIENT AC-
COUNTING CENTERS. 
(a) ESTABLISHMENT OF CENTERS.—Chapter 17 of 
title 38, United States Code, is amended by inserting after 
section 1729A the following: 
‘‘§ 1729B. Consolidated patient accounting centers 
‘‘(a) IN GENERAL.—Not later than 5 years after the 
date of enactment of this section, the Secretary of Vet-
erans Affairs shall establish not more than seven consoli-
dated patient accounting centers for conducting industry- 
modeled regionalized billing and collection activities of the 
Department. 
‘‘(b) FUNCTIONS.—The centers shall carry out the 
following functions: 
‘‘(1) Reengineer and integrate all business proc-
esses of the revenue cycle of the Department. 
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‘‘(2) Standardize and coordinate all activities of 
the Department related to the revenue cycle for all 
health care services furnished to veterans for non-
service-connected medical conditions. 
‘‘(3) Apply commercial industry standards for 
measures of access, timeliness, and performance 
metrics with respect to revenue enhancement of the 
Department. 
‘‘(4) Apply other requirements with respect to 
such revenue cycle improvement as the Secretary 
may specify.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of such chapter is amended by inserting 
after the item relating to section 1729A the following: 
‘‘1729B. Consolidated patient accounting centers.’’. 
SEC. 6. SIMPLIFYING AND UPDATING NATIONAL STAND-
ARDS TO ENCOURAGE TESTING OF THE 
HUMAN IMMUNODEFICIENCY VIRUS. 
Section 124 of the Veterans’ Benefits and Services 
Act of 1988 (38 U.S.C. 7333 note; 102 Stat. 505) and 
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the item relating to such section in the table of contents 
of such Act (102 Stat. 487) are repealed. 
Passed the House of Representatives July 30, 2008. 
Attest: 
LORRAINE C. MILLER, 
Clerk. 
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