H. R. 1016 
One Hundred Eleventh Congress 
of the 
United States of America 
AT THE FIRST SESSION 
Begun and held at the City of Washington on Tuesday, 
the sixth day of January, two thousand and nine 
An Act 
To amend title 38, United States Code, to provide advance appropriations authority 
for certain accounts of the Department of Veterans Affairs, and for other purposes. 
Be it enacted by the Senate and House of Representatives of 
the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Veterans Health Care Budget 
Reform and Transparency Act of 2009’’. 
SEC. 2. PRESIDENT’S BUDGET SUBMISSION. 
Section 1105(a) of title 31, United States Code, is amended 
by adding at the end the following new paragraph: 
‘‘(36) information on estimates of appropriations for the 
fiscal year following the fiscal year for which the budget is 
submitted for the following medical care accounts of the Vet-
erans Health Administration, Department of Veterans Affairs 
account: 
‘‘(A) Medical Services. 
‘‘(B) Medical Support and Compliance. 
‘‘(C) Medical Facilities.’’. 
SEC. 3. ADVANCE APPROPRIATIONS FOR CERTAIN MEDICAL CARE 
ACCOUNTS OF THE DEPARTMENT OF VETERANS AFFAIRS. 
(a) IN GENERAL.—Chapter 1 of title 38, United States Code, 
is amended by inserting after section 116 the following new section: 
‘‘§ 117. Advance appropriations for certain medical care 
accounts 
‘‘(a) IN GENERAL.—For each fiscal year, beginning with fiscal 
year 2011, discretionary new budget authority provided in an appro-
priations Act for the medical care accounts of the Department 
shall— 
‘‘(1) be made available for that fiscal year; and 
‘‘(2) include, for each such account, advance discretionary 
new budget authority that first becomes available for the first 
fiscal year after the budget year. 
‘‘(b) ESTIMATES REQUIRED.—The Secretary shall include in docu-
ments submitted to Congress in support of the President’s budget 
submitted pursuant to section 1105 of title 31, United States Code, 
detailed estimates of the funds necessary for the medical care 
accounts of the Department for the fiscal year following the fiscal 
year for which the budget is submitted. 
‘‘(c) MEDICAL CARE ACCOUNTS.—For purposes of this section, 
the term ‘medical care accounts of the Department’ means the
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following medical care accounts of the Veterans Health Administra-
tion, Department of Veterans Affairs account: 
‘‘(1) Medical Services. 
‘‘(2) Medical Support and Compliance. 
‘‘(3) Medical Facilities. 
‘‘(d) ANNUAL REPORT.—Not later than July 31 of each year, 
the Secretary shall submit to Congress an annual report on the 
sufficiency of the Department’s resources for the next fiscal year 
beginning after the date of the submittal of the report for the 
provision of medical care. Such report shall also include estimates 
of the workload and demand data for that fiscal year.’’. 
(b) CLERICAL AMENDMENT.—The table of sections at the begin-
ning of such chapter is amended by inserting after the item relating 
to section 113 the following new line: 
‘‘117. Advance appropriations for certain medical care accounts.’’. 
SEC. 4. COMPTROLLER GENERAL REVIEW OF THE ACCURACY OF VA 
MEDICAL CARE BUDGET SUBMISSION IN RELATION TO BASE-
LINE HEALTH CARE MODEL PROJECTION. 
(a) REVIEW OF ACCURACY OF MEDICAL CARE BUDGET SUBMIS-
SION.—The Comptroller General shall conduct a review of each 
budget of the President for a fiscal year that is submitted to 
Congress pursuant to section 1105(a) of title 31 in order to assess 
whether or not the relevant components of the amounts requested 
in such budget for such fiscal year for the medical care accounts 
of the Department of Veterans Affairs specified in section 117(c) 
of title 38, United States Code, as added by section 3, are consistent 
with estimates of the resources required by the Department for 
the provision of medical care and services in such fiscal year, 
as forecast using the Enrollee Health Care Projection Model, or 
other methodologies used by the Department. 
(b) REPORTS.— 
(1) IN GENERAL.—Not later than 120 days after the date 
of each year in 2011, 2012, and 2013, on which the President 
submits the budget request for the next fiscal year under section 
1105 of title 31, United States Code, the Comptroller General 
shall submit to the Committees on Veterans’ Affairs, Appropria-
tions, and the Budget of the Senate and the Committees on 
Veterans’ Affairs, Appropriations, and the Budget of the House 
of Representatives and to the Secretary a report on the review 
conducted under subsection (a). 
(2) ELEMENTS.—Each report under this paragraph shall 
include, for the fiscal year beginning in the year in which 
such report is submitted, the following: 
(A) An assessment of the review conducted under sub-
section (a). 
(B) The basis for such assessment. 
(C) Such additional information as the Comptroller 
General determines appropriate.
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(3) AVAILABILITY TO THE PUBLIC.—Each report submitted 
under this subsection shall also be made available to the public. 
Speaker of the House of Representatives. 
Vice President of the United States and
President of the Senate.