Title: Tribal Veterans Health Care Enhancement Act
Policy area: Native Americans

Summary:
Tribal Veterans Health Care Enhancement Act
This bill authorizes the Indian Health Service (IHS) to pay copayments owed to the Department of Veterans Affairs (VA) by Indian veterans for medical services authorized under the Purchased/Referred Care program and administered at a VA facility.
The IHS, the VA, and tribal health programs, in consultation with impacted tribes, must enter into a memorandum of understanding that authorizes the IHS or a tribal health program to pay such copayments unless it would decrease the quality of, or access to, health care for individuals receiving care from the IHS or the VA.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 1001 Introduced in Senate (IS)]

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116th CONGRESS
  1st Session
                                S. 1001

  To amend the Indian Health Care Improvement Act to allow the Indian 
Health Service to cover the cost of a copayment of an Indian or Alaska 
 Native veteran receiving medical care or services from the Department 
              of Veterans Affairs, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 3, 2019

 Mr. Thune (for himself and Mr. Rounds) introduced the following bill; 
  which was read twice and referred to the Committee on Indian Affairs

_______________________________________________________________________

                                 A BILL


 
  To amend the Indian Health Care Improvement Act to allow the Indian 
Health Service to cover the cost of a copayment of an Indian or Alaska 
 Native veteran receiving medical care or services from 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 ``Tribal Veterans Health Care 
Enhancement Act''.

SEC. 2. LIABILITY FOR PAYMENT.

    Section 222 of the Indian Health Care Improvement Act (25 U.S.C. 
1621u) is amended by adding at the end the following:
    ``(d) Veterans Affairs Copayments.--The Service may pay, in 
accordance with section 412, the cost of a copayment assessed by the 
Department of Veterans Affairs to an eligible Indian veteran (as 
defined in section 412) for covered medical care (as defined in such 
section).''.

SEC. 3. COPAYMENTS FOR TRIBAL VETERANS RECEIVING CERTAIN MEDICAL 
              SERVICES.

    Title IV of the Indian Health Care Improvement Act (25 U.S.C. 1641 
et seq.) is amended by adding at the end the following:

``SEC. 412. PAYMENTS FOR ELIGIBLE INDIAN VETERANS RECEIVING COVERED 
              MEDICAL CARE AT VA FACILITIES.

    ``(a) Definitions.--In this section:
            ``(1) Appropriate committees of congress.--The term 
        `appropriate committees of Congress' means--
                    ``(A) in the Senate--
                            ``(i) the Committee on Veterans' Affairs; 
                        and
                            ``(ii) the Committee on Indian Affairs; and
                    ``(B) in the House of Representatives--
                            ``(i) the Committee on Veterans' Affairs; 
                        and
                            ``(ii) the Committee on Natural Resources.
            ``(2) Covered medical care.--The term `covered medical 
        care' means any medical care or service that is--
                    ``(A) authorized for an eligible Indian veteran 
                under the contract health service and referred by the 
                Service; and
                    ``(B) administered at a facility of the Department 
                of Veterans Affairs, including any services rendered 
                under a contract with a non-Department of Veterans 
                Affairs health care provider.
            ``(3) Eligible indian veteran.--The term `eligible Indian 
        veteran' means an Indian or Alaska Native veteran who is 
        eligible for assistance from the Service.
    ``(b) Memorandum of Understanding.--
            ``(1) In general.--Notwithstanding any other provision of 
        law, except as provided in paragraph (3), the Secretary (or a 
        designee, including the director of any area office of the 
        Service), the Secretary of Veterans Affairs (or a designee), 
        and any tribal health program, as applicable, shall enter into 
        a memorandum of understanding, in consultation with Indian 
        tribes to be impacted by the memorandum of understanding (on a 
        national or regional basis), that authorizes the Secretary or 
        tribal health program, as applicable, to pay to the Secretary 
        of Veterans Affairs any copayments owed to the Department of 
        Veterans Affairs by eligible Indian veterans for covered 
        medical care.
            ``(2) Factors for consideration.--In entering into a 
        memorandum of understanding under paragraph (1), the Secretary, 
        the Secretary of Veterans Affairs, and any tribal health 
        program, as applicable, shall take into consideration any 
        findings contained in the report under subsection (e).
            ``(3) Exception.--The Secretary, the Secretary of Veterans 
        Affairs, and any tribal health program, as applicable, shall 
        not be required to enter into a memorandum of understanding 
        under paragraph (1) if the Secretary, the Secretary of Veterans 
        Affairs, and any tribal health program, as applicable, jointly 
        certify to the appropriate committees of Congress that such a 
        memorandum of understanding would--
                    ``(A) decrease the quality of health care provided 
                to eligible Indian veterans;
                    ``(B) impede the access of those veterans to health 
                care; or
                    ``(C) substantially decrease the quality of, or 
                access to, health care by individuals receiving health 
                care from the Department of Veterans Affairs or 
                beneficiaries of the Service.
    ``(c) Payment by Service.--Notwithstanding any other provision of 
law and in accordance with the relevant memorandum of understanding 
described in subsection (b), the Service may cover the cost of any 
copayment assessed by the Department of Veterans Affairs to an eligible 
Indian veteran receiving covered medical care.
    ``(d) Authorization To Accept Funds.--Notwithstanding section 
407(c), section 2901(b) of the Patient Protection and Affordable Care 
Act (25 U.S.C. 1623(b)), or any other provision of law, and in 
accordance with the relevant memorandum of understanding described in 
subsection (b), the Secretary of Veterans Affairs may accept a payment 
from the Service under subsection (c).
    ``(e) Report.--Not later than 90 days after the date of enactment 
of this section, the Secretary and the Secretary of Veterans Affairs 
shall submit to the appropriate committees of Congress a report that 
describes--
            ``(1) the number of veterans, disaggregated by State, who--
                    ``(A) are eligible for assistance from the Service; 
                and
                    ``(B) have received health care at a medical 
                facility of the Department of Veterans Affairs;
            ``(2) the number of veterans, disaggregated by State and 
        calendar year, who--
                    ``(A) are eligible for assistance from the Service; 
                and
                    ``(B) were referred to a medical facility of the 
                Department of Veterans Affairs from a facility of the 
                Service during the period--
                            ``(i) beginning on January 1, 2013; and
                            ``(ii) ending on December 31, 2018; and
            ``(3) an update regarding efforts of the Secretary and the 
        Secretary of Veterans Affairs to streamline health care for 
        veterans who are eligible for assistance from the Service and 
        have received health care at a medical facility of the 
        Department of Veterans Affairs and at a facility of the 
        Service, including a description of--
                    ``(A) any changes to the provision of health care 
                required under this Act; and
                    ``(B) any barriers to efficiently streamline the 
                provision of health care to veterans who are eligible 
                for assistance from the Service.''.
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