II 113th CONGRESS 1st Session S. 1165 IN THE SENATE OF THE UNITED STATES June 13, 2013 Mr. Tester (for himself, Mr. Pryor , Mr. Begich , and Mr. Wyden ) introduced the following bill; which was read twice and referred to the Committee on Veterans' Affairs A BILL To amend title 38, United States Code, to provide for certain requirements relating to the immunization of veterans, and for other purposes.

1. Short title This Act may be cited as the Access to Appropriate Immunizations for Veterans Act of 2013 . 2. Ensuring veteran access to appropriate immunizations (a) Inclusion of recommended adult vaccinations as medical services (1) Covered benefit Subparagraph (F) of section 1701(9) of title 38, United States Code, is amended to read as follows: (F) immunizations against infectious diseases, including each immunization on the recommended adult immunization schedule at the time such immunization is indicated on that schedule; . (2) Definition Section 1701 of such title is amended by adding after paragraph (9) the following new paragraph: (10) The term recommended adult immunization schedule means the schedule established (and periodically reviewed and, as appropriate, revised) by the Advisory Committee on Immunization Practices established by the Secretary of Health and Human Services and delegated to the Centers for Disease Control and Prevention. . (b) Report to Congress Section 1704(1)(A) of such title is amended— (1) in clause (i), by striking and at the end; (2) in clause (ii), by striking the period at the end and inserting ; and ; and (3) by inserting after clause (ii) the following new clause: (iii) to ensure that veterans have received each immunization on the recommended adult immunization schedule at the time such immunization is indicated on that schedule. . (c) Assurance that administration of vaccinations constitutes appropriate management and cost-Effective delivery of health care services (1) In general Section 1706(a) of such title is amended— (A) by striking In managing the provision and inserting (1) In managing the provision ; and (B) by adding at the end the following new paragraph: (2) (A) In managing the provision of medical services under such section, the Secretary shall develop and implement quality measures and metrics to ensure that veterans receiving medical services under this title receive each immunization on the recommended adult immunization schedule at the time such immunization is indicated on that schedule. (B) Quality measures and metrics developed and implemented under subparagraph (A) shall include targets for compliance. (C) The Secretary shall, to the maximum extent feasible, develop and implement measures and metrics required by subparagraph (A) concurrently and consistently with the metrics in place, as of the date of the enactment of this paragraph, with respect to influenza and pneumococcal vaccinations. . (2) Report to Congress Section 1704(1) of such title is amended by adding at the end the following new subparagraph: (H) Statistics related to the quality measures and metrics developed and implemented under section 1706(a)(2) of this title. . (3) Effective dates (A) Development of initial schedule The Secretary shall establish the quality measures and metrics described in paragraph (2) of section 1706(a) of such title, as added by paragraph (1), through notice and comment rulemaking. The Secretary shall publish in the Federal Register proposed measures and metrics by no later than July 1, 2013, and shall finalize such measures and metrics by no later than December 31, 2013. (B) Implementation of measures and metrics The Secretary shall implement paragraph (2) of such section on January 1, 2014. (C) Report to Congress Subparagraph (H) of paragraph (1) of section 1704 of such title, as added by paragraph (2), shall apply with respect to the first report submitted under such section after January 1, 2014.