A bill to amend title 38, United States Code, to authorize advance appropriations for certain medical care accounts of the Department of Veterans Affairs by providing two-fiscal year budget authority, and for other purposes.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Veterans Health Care Budget Reform 
and Transparency Act of 2009''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Title 38, United States Code, authorizes the Secretary 
        of Veterans Affairs to furnish hospital and domiciliary care, 
        medical services, nursing home care, and related services to 
        eligible and enrolled veterans, but only to the extent that 
        appropriated resources and facilities are available for such 
        purposes.
            (2) For 19 of the past 22 fiscal years, funds have not been 
        appropriated for the Department of Veterans Affairs for the 
        provision of health care as of the commencement of the new 
        fiscal year, causing the Department great challenges in 
        planning and managing care for enrolled veterans, to the 
        detriment of veterans.
            (3) The cumulative effect of insufficient, late, and 
        unpredictable funding for the Department for health care 
        endangers the viability of the health care system of the 
        Department and impairs the specialized health care resources 
        the Department requires to maintain and improve the health of 
        sick and disabled veterans.
            (4) Appropriations for the health care programs of the 
        Department have too often proven insufficient over the past 
        decade, requiring the Secretary to ration health care and 
        Congress to approve supplemental appropriations for those 
        programs.
            (5) Providing sufficient, timely, and predictable funding 
        would ensure the Government meets its obligation to provide 
        health care to sick and disabled veterans and ensure that all 
        veterans enrolled for health care through the Department have 
        ready access to timely and high quality care.
            (6) Providing sufficient, timely, and predictable funding 
        would allow the Department to properly plan for and meet the 
        needs of veterans.

SEC. 3. TWO-FISCAL YEAR BUDGET AUTHORITY FOR CERTAIN MEDICAL CARE 
              ACCOUNTS OF THE DEPARTMENT OF VETERANS AFFAIRS.

    (a) Two-fiscal Year Budget Authority.--
            (1) In general.--Chapter 1 of title 38, United States Code, 
        is amended by inserting after section 113 the following new 
        section:
``Sec. 113A. Two-fiscal year budget authority for certain medical care 
              accounts
    ``(a) In General.--Beginning with fiscal year 2011, new 
discretionary budget authority provided in an appropriations Act for 
the appropriations accounts of the Department specified in subsection 
(b) shall be made available for the fiscal year involved, and shall 
include new discretionary budget authority for such appropriations 
accounts that first become available for the first fiscal year after 
such fiscal year.
    ``(b) Medical Care Accounts.--The medical care accounts of the 
Department specified in this subsection are the medical care accounts 
of the Veterans Health Administration as follows:
            ``(1) Medical Services.
            ``(2) Medical Support and Compliance.
            ``(3) Medical Facilities.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 1 of such title is amended by inserting 
        after the item relating to section 113 the following new item:

``113A. Two-fiscal year budget authority for certain medical care 
                            accounts.''.

SEC. 4. COMPTROLLER GENERAL OF THE UNITED STATES STUDY ON ADEQUACY AND 
              ACCURACY OF BASELINE MODEL PROJECTIONS OF THE DEPARTMENT 
              OF VETERANS AFFAIRS FOR HEALTH CARE EXPENDITURES.

    (a) Study of Adequacy and Accuracy of Baseline Model Projections.--
The Comptroller General of the United States shall conduct a study of 
the adequacy and accuracy of the budget projections made by the 
Enrollee Health Care Projection Model, its equivalent, or other 
methodologies, as utilized for the purpose of estimating and projecting 
health care expenditures of the Department of Veterans Affairs (in this 
section referred to as the ``Model'') with respect to the fiscal year 
involved and the subsequent four fiscal years.
    (b) Reports.--
            (1) In general.--Not later than 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 appropriate committees of Congress and to the Secretary a 
        report.
            (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) A statement whether the amount requested in the 
                budget of the President for expenditures of the 
                Department for health care in such fiscal year is 
                consistent with anticipated expenditures of the 
                Department for health care in such fiscal year as 
                determined utilizing the Model.
                    (B) The basis for such statement.
                    (C) Such additional information as the Comptroller 
                General determines appropriate.
            (3) Availability to the public.--Each report submitted 
        under this subsection shall also be made available to the 
        public.
            (4) Appropriate committees of congress defined.--In this 
        subsection, the term ``appropriate committees of Congress'' 
        means--
                    (A) the Committees on Veterans' Affairs, 
                Appropriations, and the Budget of the Senate; and
                    (B) the Committees on Veterans' Affairs, 
                Appropriations, and the Budget of the House of 
                Representatives.

Summary: Veterans Health Care Budget Reform and Transparency Act of 2009 - Requires, beginning with FY2011, a two-fiscal-year new discretionary budget authority for the following accounts of the Department of Veterans Affairs (VA): (1) Medical Services; (2) Medical Support and Compliance; and (3) Medical Facilities.

Requires the Comptroller General to: (1) conduct a study on the adequacy and accuracy of VA baseline model projections for health care expenditures; and (2) report during 2011-2013 to the Secretary of Veterans Affairs and the congressional veterans, appropriations, and budget committees on the sufficiency of budget requests for VA health expenditures in relation to the baseline model projections.