I 
114TH CONGRESS 
2D SESSION 
H. R. 5936 
To amend title 38, United States Code, to authorize the Secretary of Veterans 
Affairs to enter into agreements with certain health care providers to 
furnish health care to veterans, to authorize the Secretary to enter 
into certain leases at the Department of Veterans Affairs West Los 
Angeles Campus in Los Angeles, California, to make certain improve-
ments to the enhanced-use lease authority of the Department, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 6, 2016 
Mr. MILLER of Florida (for himself and Mr. TED LIEU of California) intro-
duced the following bill; which was referred to the Committee on Vet-
erans’ Affairs 
A BILL 
To amend title 38, United States Code, to authorize the 
Secretary of Veterans Affairs to enter into agreements 
with certain health care providers to furnish health care 
to veterans, to authorize the Secretary to enter into 
certain leases at the Department of Veterans Affairs 
West Los Angeles Campus in Los Angeles, California, 
to make certain improvements to the enhanced-use lease 
authority of the Department, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
VerDate Sep 11 2014 
05:40 Sep 08, 2016
Jkt 059200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H5936.IH
H5936
SSpencer on DSK4SPTVN1PROD with BILLS
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Veterans Care Agree-
ment and West Los Angeles Leasing Act of 2016’’. 
SEC. 2. VETERANS CARE AGREEMENTS. 
(a) IN GENERAL.—Subchapter I of chapter 17 of title 
38, United States Code, is amended by inserting after sec-
tion 1703 the following new section: 
‘‘§ 1703A. Veterans Care Agreements with certain 
health care providers 
‘‘(a) VETERANS CARE AGREEMENTS.—(1) In addi-
tion to furnishing hospital care, medical services, or ex-
tended care under this chapter at facilities of the Depart-
ment or under contracts or sharing agreements entered 
into pursuant to provisions of law other than this section, 
the Secretary may furnish such care and services to eligi-
ble veterans through the use of agreements entered into 
under this section by the Secretary with eligible providers. 
‘‘(2) The Secretary may enter into Veterans Care 
Agreements under this section with eligible providers to 
furnish hospital care, medical services, and extended care 
to veterans whom the Secretary determines that fur-
nishing such care and services at facilities of the Depart-
ment or under contracts or sharing agreements under pro-
visions of law other than this section is impracticable or 
inadvisable because of the medical condition of the vet-
VerDate Sep 11 2014 
05:40 Sep 08, 2016
Jkt 059200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H5936.IH
H5936
SSpencer on DSK4SPTVN1PROD with BILLS
eran, the travel involved, or the nature of the care or serv-
ices required, or a combination of such factors. 
‘‘(3) The Secretary may enter into Veterans Care 
Agreements under this section with eligible providers if the 
Secretary determines that the hospital care or medical 
services to be furnished under the agreement is not avail-
able to be furnished by a non-Department health care pro-
vider under a contract or sharing agreement entered into 
pursuant to provisions of law other than this section. 
‘‘(b) VETERAN ELIGIBILITY.—Eligibility of a veteran 
for care and services under this section shall be deter-
mined as if such care or services were furnished in a facil-
ity of the Department, and provisions of this title applica-
ble to veterans receiving such care and services in a facility 
of the Department shall apply to veterans receiving care 
and services under this section. 
‘‘(c) PROVIDER ELIGIBILITY.—Subject to the certifi-
cation process pursuant to subsection (d)(1), a provider 
of hospital care, medical services, or extended care is eligi-
ble to enter into a Veterans Care Agreement under this 
section if the Secretary determines that the provider meets 
each of the following criteria: 
‘‘(1) The gross annual revenue of the provider 
in the year preceding the year in which the provider 
enters into the Veterans Care Agreement does not 
VerDate Sep 11 2014 
05:40 Sep 08, 2016
Jkt 059200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H5936.IH
H5936
SSpencer on DSK4SPTVN1PROD with BILLS
exceed $11,000,000 (as adjusted in a manner simi-
lar to amounts adjusted pursuant to section 5312 of 
this title) or, with respect to a provider that is a 
nursing care facility (skilled nursing facility), 
$27,500,000 (as so adjusted). 
‘‘(2) The provider does not otherwise provide 
such care or services to patients pursuant to a con-
tract entered into with a department or agency of 
the Federal Government. 
‘‘(3) The provider is— 
‘‘(A) a provider of services that has en-
rolled and entered into a provider agreement 
under section 1866(a) of the Social Security 
Act (42 U.S.C. 1395cc(a)); 
‘‘(B) a physician or supplier that has en-
rolled and entered into a participation agree-
ment under section 1842(h) of such Act (42 
U.S.C. 1395u(h)); 
‘‘(C) a provider of items and services re-
ceiving 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; 
‘‘(D) an Aging and Disability Resource 
Center, an area agency on aging, or a State 
VerDate Sep 11 2014 
05:40 Sep 08, 2016
Jkt 059200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H5936.IH
H5936
SSpencer on DSK4SPTVN1PROD with BILLS
‘‘(D) Requirement for denial or revocation of 
certification if the Secretary determines that the 
otherwise 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 
‘‘(ii) identified as an excluded source on 
the list maintained in the System for Award 
Management, or any successor system. 
‘‘(E) Procedures by which a provider whose cer-
tification is denied or revoked under the procedures 
established under this subsection will be identified as 
an excluded source on the list maintained in the Sys-
tem for Award Management, or successor system, if 
the Secretary determines that such exclusion is ap-
propriate. 
‘‘(2) To the extent practicable, the Secretary shall es-
tablish the procedures under paragraph (1) in a manner 
that takes into account any certification process adminis-
tered by another department or agency of the Federal 
Government that an eligible provider has completed by 
VerDate Sep 11 2014 
05:40 Sep 08, 2016
Jkt 059200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H5936.IH
H5936
SSpencer on DSK4SPTVN1PROD with BILLS
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. 
‘‘(F) To provide medical records for veterans 
furnished care and services under this section to the 
Department in a timeframe and format specified by 
the Secretary for purposes of this section, except the 
Secretary may not require that any payment by the 
Secretary to the eligible provider be contingent on 
such provision of medical records. 
‘‘(G) To meet other such terms and conditions, 
including quality of care assurance standards, as the 
Secretary may specify for purposes of this section. 
‘‘(2)(A) Except as provided in subparagraphs (B) 
through (G), rates negotiated for care and services fur-
nished under a Veterans Care Agreement shall not be 
more than the rates paid by the United States to a pro-
vider of services (as defined in section 1861(u) of the So-
cial Security Act (42 U.S.C. 1395x(u))) or a supplier (as 
defined in section 1861(d) of such Act (42 U.S.C. 
1395x(d))) under the Medicare program under title XVIII 
of the Social Security Act (42 U.S.C. 1395 et seq.) for 
the same care or services. 
‘‘(B) With respect to the furnishing of care or serv-
ices under this section to an eligible veteran who resides 
VerDate Sep 11 2014 
05:40 Sep 08, 2016
Jkt 059200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H5936.IH
H5936
SSpencer on DSK4SPTVN1PROD with BILLS
in a highly rural area (as defined under the rural-urban 
commuting area codes developed by the Secretary of Agri-
culture and the Secretary of Health and Human Services), 
the Secretary of Veterans Affairs may negotiate a rate 
that is more than the rate paid by the United States as 
described in subparagraph (B). 
‘‘(C) With respect to furnishing care or services 
under a Veterans Care Agreement in Alaska, the Alaska 
Fee Schedule of the Department of Veterans Affairs will 
be followed, except for when another payment agreement, 
including a contract or provider agreement, is in place. 
‘‘(D) With respect to furnishing care or services 
under a Veterans Care Agreement in a State with an All- 
Payer Model Agreement under the Social Security Act 
that became effective on or after January 1, 2014, the 
Medicare payment rates under clause (i) shall be cal-
culated based on the payment rates under such agreement, 
or any such successor agreement. 
‘‘(E) With respect to furnishing care or services 
under a Veterans Care Agreement in a region in which 
the Secretary determines that adjusting the rate paid by 
the United States as described in subparagraph (A) is ap-
propriate, the Secretary may negotiate such an adjusted 
rate. 
VerDate Sep 11 2014 
05:40 Sep 08, 2016
Jkt 059200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H5936.IH
H5936
SSpencer on DSK4SPTVN1PROD with BILLS
‘‘(F) With respect to furnishing care or services 
under a Veterans Care Agreement in a location or in a 
situation in which an exception to the rates paid by the 
United States under the Medicare program under title 
XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) 
for the same care or services applies, the Secretary shall 
follow such exception. 
‘‘(G) With respect to furnishing care or services 
under a Veterans Care Agreement for care or services not 
covered under the Medicare program under title XVIII of 
the Social Security Act (42 U.S.C. 1395 et seq.), the Sec-
retary shall establish a schedule of fees for such care or 
services. 
‘‘(f) EXCLUSION
OF
CERTAIN
FEDERAL
CON-
TRACTING PROVISIONS.—(1) Notwithstanding any other 
provision of law, the Secretary may enter into a Veterans 
Care Agreement using procedures other than competitive 
procedures. 
‘‘(2)(A) Except as provided in subparagraph (B) and 
unless otherwise provided in this section, an eligible pro-
vider that enters into a Veterans Care Agreement under 
this section is not subject to, in the carrying out of the 
agreement, any provision of law that providers of services 
and suppliers under the original Medicare fee-for-service 
program under parts A and B of title XVIII of the Social 
VerDate Sep 11 2014 
05:40 Sep 08, 2016
Jkt 059200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H5936.IH
H5936
SSpencer on DSK4SPTVN1PROD with BILLS
Security Act (42 U.S.C. 1395 et seq.) or the Medicaid pro-
gram under title XIX of such Act (42 U.S.C. 1396 et seq.) 
are not subject to. 
‘‘(B) In addition to the provisions of laws covered by 
subparagraph (A), an eligible provider shall be subject to 
the following provisions of law: 
‘‘(i) Any applicable law regarding integrity, eth-
ics, or fraud, or that subject a person to civil or 
criminal penalties. 
‘‘(ii) Section 431 of title 18. 
‘‘(iii) Section 1352 of title 31, except for the fil-
ing requirements under subsection (b) of such sec-
tion. 
‘‘(iv) Section 4705 or 4712 of title 41, and any 
other applicable law regarding the protection of 
whistleblowers. 
‘‘(v) Section 4706(d) of title 41. 
‘‘(vi) Title VII of the Civil Rights Act of 1964 
(42 U.S.C. 2000e et seq.) 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 a Veterans Care 
Agreement. 
‘‘(C) An eligible provider that receives a payment 
from the Federal Government pursuant to a Veterans 
VerDate Sep 11 2014 
05:40 Sep 08, 2016
Jkt 059200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H5936.IH
H5936
SSpencer on DSK4SPTVN1PROD with BILLS
Care Agreement shall not be treated as a Federal con-
tractor or subcontractor by the Office of Federal Contract 
Compliance Programs of the Department of Labor based 
on the work performed or actions taken by such eligible 
provider that resulted in the receipt of such payments. 
‘‘(g) TERMINATION OF A VETERANS CARE AGREE-
MENT.—(1) An eligible provider may terminate a Veterans 
Care Agreement with the Secretary under this section at 
such time and upon such notice to the Secretary as the 
Secretary may specify for purposes of this section. 
‘‘(2) The Secretary may terminate a Veterans Care 
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 the purposes of this sec-
tion, if the Secretary— 
‘‘(A) determines that the eligible provider failed 
to comply with the provisions of the agreement or 
this section or other applicable provision of law; 
‘‘(B) makes a revocation pursuant to subsection 
(d)(1)(4); 
‘‘(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 
VerDate Sep 11 2014 
05:40 Sep 08, 2016
Jkt 059200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H5936.IH
H5936
SSpencer on DSK4SPTVN1PROD with BILLS
be detrimental to the best interests of veterans of 
the Department; or 
‘‘(D) determines that it is reasonable to termi-
nate the agreement based on the health care needs 
of veterans. 
‘‘(h) DISPUTES.—(1) The Secretary shall establish 
administrative procedures for eligible providers with which 
the Secretary has entered into a Veterans Care Agreement 
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 a Veterans Care Agreement under this section, 
an eligible provider must first exhaust the administrative 
procedures established by the Secretary under paragraph 
(1). 
‘‘(i) ANNUAL REPORTS.—Not later than October 1 
of the year following the fiscal year in which the Secretary 
first enters into a Veterans Care Agreement, and each 
year thereafter, the Secretary shall submit to the appro-
priate congressional committees an annual report that in-
cludes— 
‘‘(1) a list of all Veterans Care Agreements en-
tered into as of the date of the report; and 
VerDate Sep 11 2014 
05:40 Sep 08, 2016
Jkt 059200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H5936.IH
H5936
SSpencer on DSK4SPTVN1PROD with BILLS