I 
118TH CONGRESS 
1ST SESSION H. R. 4150 
To improve the provision of health care furnished by the Department of 
Veterans Affairs for veterans diagnosed with diabetes and heart disease, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 15, 2023 
Ms. BROWNLEY introduced the following bill; which was referred to the 
Committee on Veterans’ Affairs 
A BILL 
To improve the provision of health care furnished by the 
Department of Veterans Affairs for veterans diagnosed 
with diabetes and heart disease, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Improving Whole 
Health for Veterans with Chronic Conditions Act’’. 
SEC. 2. SENSE OF CONGRESS. 
It is the sense of Congress that— 
(1) the Department of Veterans Affairs has pio-
neered a whole health approach to health care that 
VerDate Sep 11 2014 
23:26 Jul 07, 2023
Jkt 039200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H4150.IH
H4150
kjohnson on DSK79L0C42PROD with BILLS
provides access to alternative medicines, delivers a 
holistic approach to health and well-being, and re-
peatedly demonstrates better health outcomes than 
the private sector at a low cost to taxpayers in the 
United States; 
(2) the effects of poor dental care are shown to 
worsen the symptoms of diabetes and heart disease; 
(3) diabetes and heart disease are shown to in-
crease risk of periodontal disease; 
(4) the combination of diabetes, heart disease, 
and periodontal disease can be fatal; and 
(5) to best achieve a whole health model for the 
provision of health care to veterans with diabetes 
and heart disease and reduce long-term costs, the 
Department must furnish preventative and com-
prehensive dental care to veterans diagnosed with di-
abetes and heart disease. 
SEC. 3. DEFINITIONS. 
In this Act: 
(1) COVERED CARE.—The term ‘‘covered care’’ 
means dental care that is comprehensive in nature 
and consistent with the dental services and treat-
ment furnished by the Secretary of Veterans Affairs 
to veterans pursuant to section 1712(a)(1)(G) of 
title 38, United States Code. 
VerDate Sep 11 2014 
23:26 Jul 07, 2023
Jkt 039200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H4150.IH
H4150
kjohnson on DSK79L0C42PROD with BILLS
(2) COVERED
VETERAN.—The term ‘‘covered 
veteran’’ means a veteran who— 
(A) is enrolled in the system of annual pa-
tient enrollment of the Department of Veterans 
Affairs established and operated under sub-
section (a) of section 1705 of title 38, United 
States Code, pursuant to paragraph (1) or (2) 
of such subsection or is not enrolled in such 
system but is otherwise entitled to hospital care 
and medical services under subsection (c)(2) of 
such section; 
(B) is not eligible for dental services and 
treatment and related dental appliances under 
the laws administered by the Secretary of Vet-
erans Affairs as of the date of the enactment of 
this Act; and 
(C) has a diagnosis of— 
(i) type 1 or type 2 diabetes; or 
(ii) ischemic heart disease. 
SEC. 4. PILOT PROGRAM TO FURNISH DENTAL CARE FROM 
THE DEPARTMENT OF VETERANS AFFAIRS 
TO CERTAIN VETERANS DIAGNOSED WITH DI-
ABETES OR ISCHEMIC HEART DISEASE. 
(a) IN GENERAL.—Commencing not later than one 
year after the date of the enactment of this Act, the Sec-
VerDate Sep 11 2014 
23:26 Jul 07, 2023
Jkt 039200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H4150.IH
H4150
kjohnson on DSK79L0C42PROD with BILLS
retary of Veterans Affairs shall carry out a pilot program 
(in this section referred to as the ‘‘pilot program’’) under 
which the Secretary shall furnish covered care to covered 
veterans for the duration of the pilot program. 
(b) DURATION.—The pilot program shall be carried 
out during the four-year period beginning on the date of 
the commencement of the pilot program. 
(c) LOCATIONS.— 
(1) IN
GENERAL.—The Secretary shall carry 
out the pilot program at the following locations: 
(A) Each medical center of the Depart-
ment with an established dental clinic. 
(B) Each community-based outpatient clin-
ic with an established dental clinic. 
(2) MOBILE DENTAL CLINICS.—In carrying out 
the pilot program, the Secretary shall test the effi-
cacy of mobile dental clinics to service rural areas 
that do not have a population base to warrant a full- 
time clinic but where there are covered veterans in 
need of dental care. 
(3) HOME-BASED DENTAL CARE.—In carrying 
out the pilot program, the Secretary shall test the 
efficacy of portable dental care units to service rural 
veteran in their homes, as the Secretary considers 
medically appropriate. 
VerDate Sep 11 2014 
23:26 Jul 07, 2023
Jkt 039200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H4150.IH
H4150
kjohnson on DSK79L0C42PROD with BILLS
(d) DENTAL THERAPISTS AND TELE-DENTISTRY.— 
(1) IN
GENERAL.—In carrying out the pilot 
program, The Secretary shall test the efficacy of the 
use of dental therapists and tele-dentistry to service 
the dental care needs of covered veterans. 
(2) USE OF TELE-DENTISTRY.—When providing 
tele-dentistry under paragraph (1), the Secretary 
shall use Federal employees to the maximum extent 
possible. 
(e) ADMINISTRATION.— 
(1) NOTICE TO COVERED VETERANS.—In car-
rying out the pilot program, the Secretary shall in-
form all covered veterans of the covered care avail-
able under the pilot program. 
(2) COPAYMENTS.—The Secretary may collect 
copayments for covered care furnished under the 
pilot program in accordance with authorities on the 
collection of copayments for medical care of veterans 
under chapter 17 of title 38, United States Code. 
(f) REPORTS.— 
(1) IN GENERAL.—Not later than 90 days be-
fore the completion of the pilot program, and not 
later than 180 days after the completion of the pilot 
program, the Secretary shall submit to the Com-
mittee on Veterans’ Affairs and the Committee on 
VerDate Sep 11 2014 
23:26 Jul 07, 2023
Jkt 039200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H4150.IH
H4150
kjohnson on DSK79L0C42PROD with BILLS
Armed Services of the Senate and the Committee on 
Veterans’ Affairs and the Committee on Armed 
Services of the House of Representatives a report on 
the pilot program. 
(2) CONTENTS.—Each report under paragraph 
(1) shall include the following: 
(A) A description of the implementation 
and operation of the provision of covered care 
under the pilot program. 
(B) The number of covered veterans re-
ceiving covered care under the pilot program 
and a description of the covered care furnished 
to such veterans. 
(C) An analysis of the costs and benefits 
of covered care provided under the pilot pro-
gram, including a comparison of costs and ben-
efits by location type. 
(D) An assessment of the impact of the 
pilot program on appointments for care, pre-
scriptions, hospitalizations, emergency room vis-
its, wellness, employability, satisfaction, and 
perceived quality of life of covered veterans re-
lated to their diagnosis of diabetes or ischemic 
heart disease. 
VerDate Sep 11 2014 
23:26 Jul 07, 2023
Jkt 039200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H4150.IH
H4150
kjohnson on DSK79L0C42PROD with BILLS
(E) An analysis and assessment of the effi-
cacy of mobile clinics and portable dental care 
units, to the extent such modalities are used, to 
service the needs of covered veterans under the 
pilot program. 
(F) An analysis and assessment of the effi-
cacy of dental therapists and tele-dentistry to 
service the needs of covered veterans under the 
pilot program, to include a cost benefit analysis 
of such services. 
(G) The findings and conclusions of the 
Secretary with respect to the pilot program. 
(H) Such recommendations as the Sec-
retary considers appropriate for the expansion 
of dental care to all veterans eligible for health 
care from the Department. 
(g) IMPACT ON COMMUNITY CARE.—Nothing in this 
section limits a covered veteran from accessing care or 
services pursuant to section 1703 of title 38, United 
States Code. 
VerDate Sep 11 2014 
23:26 Jul 07, 2023
Jkt 039200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H4150.IH
H4150
kjohnson on DSK79L0C42PROD with BILLS
SEC. 
5. 
STUDENT 
LOAN 
REPAYMENT 
PROGRAM 
TO 
INCENTIVIZE DENTAL TRAINING AND EN-
SURE THE DENTAL WORKFORCE OF THE DE-
PARTMENT OF VETERANS AFFAIRS. 
(a) PROGRAM REQUIRED.—The Secretary of Vet-
erans Affairs, to ensure that the Department of Veterans 
Affairs has sufficient staff to provide covered care to cov-
ered veterans, shall implement a loan reimbursement pro-
gram for qualified dentists, dental hygienists, and oral 
surgeons who agree— 
(1) to be appointed by the Secretary as a den-
tist, dental hygienist, or oral surgeon, as the case 
may be, under section 7401 of title 38, United 
States Code; and 
(2) to serve as a dentist, dental hygienist, or 
oral surgeon, as the case may be, of the Department 
pursuant to such appointment at a dental clinic of 
the Department selected under subsection (c) for a 
period that is not less than the duration of the pilot 
program under section 4. 
(b) MAXIMUM AMOUNT.— 
(1) IN GENERAL.—Except as provided in para-
graph (2), the Secretary may reimburse not more 
than— 
(A) $100,000 for each dentist participating 
in the program under subsection (a); 
VerDate Sep 11 2014 
23:26 Jul 07, 2023
Jkt 039200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H4150.IH
H4150
kjohnson on DSK79L0C42PROD with BILLS
(B) $25,000 for each dental hygienist par-
ticipating in such program; and 
(C) $40,000 for each credentialed doctor of 
medicine in dentistry serving as an oral surgeon 
and participating in such program. 
(2) DUAL ELIGIBILITY.—The Secretary may re-
imburse an individual serving in multiple positions 
described in subparagraphs (A) through (C) of para-
graph (1) not more than $140,000. 
(c) SELECTION OF LOCATIONS.—The Secretary shall 
monitor demand among covered veterans for covered care 
and require participants in the program under subsection 
(a) to choose from dental clinics of the Department with 
the greatest need for dentists, dental hygienists, or oral 
surgeons, as the case may be, according to facility enroll-
ment and patient demand. 
SEC. 6. AUTHORIZATION OF APPROPRIATIONS. 
(a) IN GENERAL.—There is authorized to be appro-
priated for the Department of Veterans Affairs for fiscal 
year 2024 such sums as may be necessary to carry out 
this Act. 
(b) AVAILABILITY.—The amount authorized to be ap-
propriated under subsection (a) shall be available for obli-
VerDate Sep 11 2014 
23:26 Jul 07, 2023
Jkt 039200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H4150.IH
H4150
kjohnson on DSK79L0C42PROD with BILLS
gation for the eight-year period beginning on the date that 
is one year after the date of the enactment of this Act. 
Æ 
VerDate Sep 11 2014 
23:26 Jul 07, 2023
Jkt 039200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6301
E:\BILLS\H4150.IH
H4150
kjohnson on DSK79L0C42PROD with BILLS