Title: Care Veterans Deserve Act of 2019
Policy area: Armed Forces and National Security

Summary:
Care Veterans Deserve Act of 2019
This bill expands and makes permanent the Veterans Choice Program. The program allows eligible veterans to receive health care in their communities rather than at a Department of Veterans Affairs (VA) facility when certain hardships exist (e.g., when a veteran resides more than 40 miles from a VA facility).
The bill expands program eligibility to include veterans with a service-connected disability rated at 50% or more.
Additionally, the bill requires the VA to contract with a national chain of walk-in clinics to provide hospital care and medical services in such clinics to veterans who are in the annual patient enrollment system. The clinics may not require a preauthorization or a co-payment for treatment.
Under the bill, an authorized health care professional may provide treatment via telemedicine at any location in any state, regardless of where such health care professional or the patient is located.
The bill requires the VA to extend the operating hours for VA pharmacies and medical facilities.
Finally, the VA may provide for a nongovernmental hospital organization best-practices peer review of each VA medical center.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 23 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                 H. R. 23

  To eliminate the sunset date for the Veterans Choice Program of the 
Department of Veterans Affairs, to expand eligibility for such program, 
   and to extend certain operating hours for pharmacies and medical 
         facilities of the Department, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 3, 2019

  Mr. Hudson introduced the following bill; which was referred to the 
                     Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
  To eliminate the sunset date for the Veterans Choice Program of the 
Department of Veterans Affairs, to expand eligibility for such program, 
   and to extend certain operating hours for pharmacies and medical 
         facilities of the Department, 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 ``Care Veterans Deserve Act of 2019''.

SEC. 2. EXPANSION OF VETERANS CHOICE PROGRAM.

    (a) Elimination of Sunset.--
            (1) In general.--Section 101 of the Veterans Access, 
        Choice, and Accountability Act of 2014 (Public Law 113-146; 38 
        U.S.C. 1701 note) is amended--
                    (A) by striking subsection (p); and
                    (B) by redesignating subsections (q), (r), (s), and 
                (t) as subsections (p), (q), (r), and (s), 
                respectively.
            (2) Conforming amendments.--Such section is amended--
                    (A) in subsection (i)(2), by striking ``during the 
                period in which the Secretary is authorized to carry 
                out this section pursuant to subsection (p)''; and
                    (B) in subsection (p)(2), as redesignated by 
                paragraph (1)(B), by striking subparagraph (F).
    (b) Expansion of Eligibility for Program.--
            (1) In general.--Subsection (b)(2) of such section is 
        amended--
                    (A) in subparagraph (C)(ii), by striking ``or'';
                    (B) in subparagraph (D)(ii)(II), by striking the 
                period at the end and inserting ``; or''; and
                    (C) by adding at the end the following new 
                subparagraph:
                    ``(E) has a service-connected disability rated at 
                50 percent or more.''.
            (2) Conforming amendment.--Subsection (g)(3) of such 
        section is amended by striking ``or (D)'' and inserting ``, 
        (D), or (E)''.

SEC. 3. ACCESS OF VETERANS TO WALK-IN CLINICS.

    (a) In General.--Subchapter I of chapter 17 of title 38, United 
States Code, is amended by inserting after section 1703 the following 
new section:
``Sec. 1703A. Hospital care and medical services at walk-in clinics
    ``(a) In General.--The Secretary shall enter into a contract with a 
national chain of walk-in clinics to provide the hospital care and 
medical services offered in such clinics to veterans enrolled in the 
system of annual patient enrollment established and operated under 
section 1705 of this title.
    ``(b) No Authorization or Copayment Required.--In receiving 
hospital care or medical services at a walk-in clinic under subsection 
(a), a veteran is not required--
            ``(1) to obtain authorization before receiving such care or 
        services at the clinic; or
            ``(2) to pay a copayment to the clinic or the Department in 
        connection with the receipt of such care or services.
    ``(c) Locations.--The Secretary may not require a national chain of 
walk-in clinics to expand their locations as a condition of a contract 
entered into under subsection (a).
    ``(d) Transmittal of Information.--(1) The national chain of walk-
in clinics with which the Secretary has entered into a contract under 
subsection (a) shall establish an automated system that transmits to 
the Secretary on a weekly basis information regarding the hospital care 
or medical services provided to veterans under this section during such 
week.
    ``(2) The automated system under paragraph (1) shall be established 
in a manner that allows the system to securely transmit information to 
the electronic health record of a veteran regarding the hospital care 
and medical services provided to the veteran under this section.
    ``(3) Transmittal of information under paragraph (1) may not be 
required as a condition of payment for hospital care or medical 
services provided under this section.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 of such title is amended by inserting after the item 
relating to section 1703 the following new item:

``1703A. Hospital care and medical services at walk-in clinics.''.

SEC. 4. LICENSURE OF HEALTH CARE PROFESSIONALS OF THE DEPARTMENT OF 
              VETERANS AFFAIRS PROVIDING TREATMENT VIA TELEMEDICINE.

    (a) In General.--Subchapter III of chapter 17 of title 38, United 
States Code, is amended by inserting after section 1730C the following 
new section:
``Sec. 1730D. Licensure of health care professionals providing 
              treatment via telemedicine
    ``(a) In General.--Notwithstanding any provision of law regarding 
the licensure of health care professionals, a covered health care 
professional may practice the health care profession of the health care 
professional at any location in any State, regardless of where such 
health care professional or the patient is located, if the health care 
professional is using telemedicine to provide treatment to an 
individual under this chapter.
    ``(b) Location of Care.--Subsection (a) shall apply to a covered 
health care professional providing treatment to a patient regardless of 
whether such health care professional or patient is located in a 
facility owned by the Federal Government during such treatment.
    ``(c) Rule of Construction.--Nothing in this section may be 
construed to remove, limit, or otherwise affect any obligation of a 
covered health care professional under the Controlled Substances Act 
(21 U.S.C. 801 et seq.).
    ``(d) Definitions.--In this section:
            ``(1) The term `covered health care professional' means a 
        health care professional who is--
                    ``(A) authorized by the Secretary to provide health 
                care under this chapter, including a private health 
                care professional who provides such care under a 
                contract or agreement entered into with the Secretary, 
                including a contract entered into under section 1703 of 
                this title; and
                    ``(B) licensed, registered, or certified in a State 
                to practice the health care profession of the health 
                care professional.
            ``(2) The term `telemedicine' means the use of 
        telecommunication technology and information technology to 
        provide health care or support the provision of health care in 
        situations in which the patient and health care professional 
        are separated by geographic distance.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 of such title is amended by inserting after the item 
relating to section 1730C the following new item:

``1730D. Licensure of health care professionals providing treatment via 
                            telemedicine.''.
    (c) Report on Telemedicine.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs 
        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 effectiveness of the use of 
        telemedicine by the Department of Veterans Affairs.
            (2) Elements.--The report required by paragraph (1) shall 
        include an assessment of the following:
                    (A) The satisfaction of veterans with telemedicine 
                furnished by the Department.
                    (B) The satisfaction of health care providers in 
                providing telemedicine furnished by the Department.
                    (C) The effect of telemedicine furnished by the 
                Department on the following:
                            (i) The ability of veterans to access 
                        health care, whether from the Department or 
                        from non-Department health care providers.
                            (ii) The frequency of use by veterans of 
                        telemedicine.
                            (iii) The productivity of health care 
                        providers.
                            (iv) Wait times for an appointment for the 
                        receipt of health care from the Department.
                            (v) The reduction, if any, in the use by 
                        veterans of services at Department facilities 
                        and non-Department facilities.
                    (D) The types of appointments for the receipt of 
                telemedicine furnished by the Department that were 
                provided during the one-year period preceding the 
                submittal of the report.
                    (E) The number of appointments for the receipt of 
                telemedicine furnished by the Department that were 
                requested during such period, disaggregated by Veterans 
                Integrated Service Network.
                    (F) Savings by the Department, if any, including 
                travel costs, of furnishing health care through the use 
                of telemedicine during such period.
            (3) Telemedicine defined.--In this subsection, the term 
        ``telemedicine'' has the meaning given that term in section 
        1730D(d)(2) of title 38, United States Code, as added by 
        subsection (a).

SEC. 5. EXTENSION OF OPERATING HOURS FOR PHARMACIES AND MEDICAL 
              FACILITIES OF THE DEPARTMENT OF VETERANS AFFAIRS.

    (a) Extension of Operating Hours for Pharmacies.--The Secretary of 
Veterans Affairs shall extend the operating hours for each pharmacy of 
the Department of Veterans Affairs during which the pharmacy offers 
services comparable to retail pharmacies to include--
            (1) operation on Saturday, Sunday, and Federal holidays; 
        and
            (2) operation until 8:00 p.m. on weekdays that are not 
        Federal holidays.
    (b) Contracts With Providers During Nights and Weekends.--The 
Secretary shall enter into contracts, including through locum tenens 
arrangements, with physicians and nurses that meet qualifications set 
forth by the Secretary for purposes of this section under which such 
physicians and nurses work at medical facilities of the Department 
during nights and weekends.
    (c) Support Staff.--The Secretary may obtain additional support 
staff as necessary to carry out this section, including by hiring 
employees or contracting for services.

SEC. 6. CONDUCT OF BEST-PRACTICES PEER REVIEW OF EACH MEDICAL CENTER OF 
              THE DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--The Secretary of Veterans Affairs may provide for 
the conduct by a nongovernmental hospital organization of a best-
practices peer review of each medical center of the Department of 
Veterans Affairs to evaluate the efficacy of health care delivered at 
each such medical center.
    (b) Priority.--The Secretary shall give priority for peer review 
conducted under subsection (a) to the medical centers of the Department 
with the longest wait times for an appointment or the worst health 
outcomes, as determined by the Secretary.
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