I 114th CONGRESS 2d Session H. R. 5936 IN THE HOUSE OF REPRESENTATIVES September 6, 2016 Mr. Miller of Florida (for himself and Mr. Ted Lieu of California ) introduced the following bill; which was referred to the Committee on Veterans' 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.

1. Short title This Act may be cited as the Veterans Care Agreement and West Los Angeles Leasing Act of 2016 . 2. Veterans Care Agreements (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: 1703A. Veterans Care Agreements with certain health care providers (a) Veterans Care Agreements (1) In addition to furnishing hospital care, medical services, or extended care under this chapter at facilities of the Department 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 eligible 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 furnishing such care and services at facilities of the Department or under contracts or sharing agreements under provisions of law other than this section is impracticable or inadvisable because of the medical condition of the veteran, the travel involved, or the nature of the care or services 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 available to be furnished by a non-Department health care provider 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 determined as if such care or services were furnished in a facility of the Department, and provisions of this title applicable 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 certification process pursuant to subsection (d)(1), a provider of hospital care, medical services, or extended care is eligible 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 exceed $11,000,000 (as adjusted in a manner similar 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 contract entered into with a department or agency of the Federal Government. (3) The provider is— (A) a provider of services that has enrolled 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 enrolled and entered into a participation agreement under section 1842(h) of such Act ( 42 U.S.C. 1395u(h) ); (C) a provider of items and services receiving 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 agency (as defined in section 102 of the Older Americans Act of 1965 ( 42 U.S.C. 3002 )); or (E) a center for independent living (as defined in section 702 of the Rehabilitation Act of 1973 ( 29 U.S.C. 796a )). (4) Any additional criteria determined appropriate by the Secretary. (d) Provider certification (1) The Secretary shall establish a process for the certification of eligible providers to enter into Veterans Care Agreements under this section that shall, at a minimum, set forth the following: (A) Procedures for the submission of applications for certification and deadlines for actions taken by the Secretary with respect to such applications. (B) Standards and procedures for the approval and denial of certifications and the revocation of certifications. (C) Procedures for assessing eligible providers based on the risk of fraud, waste, and abuse of such providers similar to the level of screening under section 1866(j)(2)(B) of the Social Security Act ( 42 U.S.C. 1395(j)(2)(B) ) and the standards set forth under section 9.104 of title 48, Code of Federal Regulations, or any successor regulation. (D) Requirement for denial or revocation of certification if the Secretary determines that the otherwise eligible provider is— (i) excluded from participation in a Federal 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 certification is denied or revoked under the procedures established under this subsection will be identified as an excluded source on the list maintained in the System for Award Management, or successor system, if the Secretary determines that such exclusion is appropriate. (2) To the extent practicable, the Secretary shall establish the procedures under paragraph (1) in a manner that takes into account any certification process administered by another department or agency of the Federal Government that an eligible provider has completed by reason of being a provider described in any of subparagraphs (A) through (E) of subsection (c)(3). (e) Terms of Agreements (1) The Secretary shall ensure that each Veterans Care Agreement include provisions requiring the eligible provider to do the following: (A) To accept payment for care and services furnished under this section in accordance with paragraph (2). (B) To accept payment under subparagraph (A) as payment in full for care and services furnished under this section and to not seek any payment for such care and services from the recipient of such care. (C) To furnish under this section only the care and services authorized by the Department under this section unless the eligible provider receives prior written consent from the Department to furnish care and services outside the scope of such authorization. (D) To bill the Department for care and services furnished under this section in accordance with a methodology established by the Secretary for purposes of this section. (E) Not to seek to recover or collect from a health-plan contract or third party (as those terms are defined in section 1729 of this title) for any care or services for which payment is made by the Department 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 furnished under a Veterans Care Agreement shall not be more than the rates paid by the United States to a provider of services (as defined in section 1861(u) of the Social 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 services under this section to an eligible veteran who resides in a highly rural area (as defined under the rural-urban commuting area codes developed by the Secretary of Agriculture 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 calculated 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 appropriate, the Secretary may negotiate such an adjusted rate. (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 Secretary shall establish a schedule of fees for such care or services. (f) Exclusion of certain Federal contracting 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 provider 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 Security Act ( 42 U.S.C. 1395 et seq. ) or the Medicaid program 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, ethics, 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 filing requirements under subsection (b) of such section. (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 Care Agreement shall not be treated as a Federal contractor 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 agreement (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 section, 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 be detrimental to the best interests of veterans of the Department; or (D) determines that it is reasonable to terminate 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 arising 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 appropriate congressional committees an annual report that includes— (1) a list of all Veterans Care Agreements entered into as of the date of the report; and (2) summaries of each determination made by the Secretary under subsection (h)(2) during the fiscal year covered by the report. (j) Quality of care In carrying out this section, the Secretary shall use the quality of care standards set forth or used by the Centers for Medicare & Medicaid Services. (k) Delegation The Secretary may delegate the authority to enter into or terminate a Veterans Care Agreement, or to make a determination described in subsection (h)(2), at a level not below the Assistant Deputy Under Secretary for Health for Community Care. (l) Sunset The Secretary may not enter into or renew a Veterans Care Agreement under this section after September 30, 2017. (m) Definitions In this section: (1) The term appropriate congressional committees means— (A) the Committees on Veterans’ Affairs of the House of Representatives and the Senate; and (B) the Committees on Appropriations of the House of Representatives and the Senate. (2) The term eligible provider means a provider of hospital care, medical services, or extended care that the Secretary determines is eligible to enter into Veterans Care Agreements under subsection (c). (3) The term Veterans Care Agreement means an agreement entered into by the Secretary with an eligible provider under subsection (a)(1). . (b) Clerical amendment The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 1703 the following new item: 1703A. Veterans Care Agreements with certain health care providers. . 3. Authority to enter into certain leases at the Department of Veterans Affairs West Los Angeles Campus (a) In general The Secretary of Veterans Affairs may carry out leases described in subsection (b) at the Department of Veterans Affairs West Los Angeles Campus in Los Angeles, California (hereinafter in this section referred to as the Campus ). (b) Leases described Leases described in this subsection are the following: (1) Any enhanced-use lease of real property under subchapter V of chapter 81 of title 38, United States Code, for purposes of providing supportive housing, as that term is defined in section 8161(3) of such title, that principally benefit veterans and their families. (2) Any lease of real property for a term not to exceed 50 years to a third party to provide services that principally benefit veterans and their families and that are limited to one or more of the following purposes: (A) The promotion of health and wellness, including nutrition and spiritual wellness. (B) Education. (C) Vocational training, skills building, or other training related to employment. (D) Peer activities, socialization, or physical recreation. (E) Assistance with legal issues and Federal benefits. (F) Volunteerism. (G) Family support services, including child care. (H) Transportation. (I) Services in support of one or more of the purposes specified in subparagraphs (A) through (H). (3) A lease of real property for a term not to exceed 10 years to The Regents of the University of California, a corporation organized under the laws of the State of California, on behalf of its University of California, Los Angeles (UCLA) campus (hereinafter in this section referred to as The Regents ), if— (A) the lease is consistent with the master plan described in subsection (g); (B) the provision of services to veterans is the predominant focus of the activities of The Regents at the Campus during the term of the lease; (C) The Regents expressly agrees to provide, during the term of the lease and to an extent and in a manner that the Secretary considers appropriate, additional services and support (for which The Regents is either not compensated by the Secretary or is compensated through an existing medical affiliation agreement) that— (i) principally benefit veterans and their families, including veterans that are severely disabled, women, aging, or homeless; and (ii) may consist of activities relating to the medical, clinical, therapeutic, dietary, rehabilitative, legal, mental, spiritual, physical, recreational, research, and counseling needs of veterans and their families or any of the purposes specified in any of subparagraphs (A) through (I) of paragraph (1); and (D) The Regents maintains records documenting the value of the additional services and support that The Regents provides pursuant to subparagraph (C) for the duration of the lease and makes such records available to the Secretary. (c) Limitation on Land-Sharing Agreements The Secretary may not carry out any land-sharing agreement pursuant to section 8153 of title 38, United States Code, at the Campus unless such agreement— (1) provides additional health-care resources to the Campus; and (2) benefits veterans and their families other than from the generation of revenue for the Department of Veterans Affairs. (d) Revenues from leases at the Campus Any funds received by the Secretary under a lease described in subsection (b) shall be credited to the applicable Department medical facilities account and shall be available, without fiscal year limitation and without further appropriation, exclusively for the renovation and maintenance of the land and facilities at the Campus. (e) Easements (1) In general Notwithstanding any other provision of law (other than Federal laws relating to environmental and historic preservation), pursuant to section 8124 of title 38, United States Code, the Secretary may grant easements or rights-of-way on, above, or under lands at the Campus to— (A) any local or regional public transportation authority to access, construct, use, operate, maintain, repair, or reconstruct public mass transit facilities, including, fixed guideway facilities and transportation centers; and (B) the State of California, County of Los Angeles, City of Los Angeles, or any agency or political subdivision thereof, or any public utility company (including any company providing electricity, gas, water, sewage, or telecommunication services to the public) for the purpose of providing such public utilities. (2) Improvements Any improvements proposed pursuant to an easement or right-of-way authorized under paragraph (1) shall be subject to such terms and conditions as the Secretary considers appropriate. (3) Termination Any easement or right-of-way authorized under paragraph (1) shall be terminated upon the abandonment or nonuse of the easement or right-of-way and all right, title, and interest in the land covered by the easement or right-of-way shall revert to the United States. (f) Prohibition on sale of property Notwithstanding section 8164 of title 38, United States Code, the Secretary may not sell or otherwise convey to a third party fee simple title to any real property or improvements to real property made at the Campus. (g) Consistency with master plan The Secretary shall ensure that each lease carried out under this section is consistent with the draft master plan approved by the Secretary on January 28, 2016, or successor master plans. (h) Compliance with certain laws (1) Laws relating to leases and land use If the Inspector General of the Department of Veterans Affairs determines, as part of an audit report or evaluation conducted by the Inspector General, that the Department is not in compliance with all Federal laws relating to leases and land use at the Campus, or that significant mismanagement has occurred with respect to leases or land use at the Campus, the Secretary may not enter into any lease or land-sharing agreement at the Campus, or renew any such lease or land-sharing agreement that is not in compliance with such laws, until the Secretary certifies to the Committee on Veterans’ Affairs of the Senate, the Committee on Veterans’ Affairs of the House of Representatives, and each Member of the Senate and the House of Representatives who represents the area in which the Campus is located that all recommendations included in the audit report or evaluation have been implemented. (2) Compliance of particular leases Except as otherwise expressly provided by this section, no lease may be entered into or renewed under this section unless the lease complies with chapter 33 of title 41, United States Code, and all Federal laws relating to environmental and historic preservation. (i) Community veterans engagement board (1) In general Not later than 180 days after the date of the enactment of this Act, the Secretary shall establish a Community Veterans Engagement Board (in this subsection referred to as the Board ) for the Campus to coordinate locally with the Department of Veterans Affairs to— (A) identify the goals of the community; and (B) provide advice and recommendations to the Secretary to improve services and outcomes for veterans, members of the Armed Forces, and the families of such veterans and members. (2) Members The Board shall be comprised of a number of members that the Secretary determines appropriate, of which not less than 50 percent shall be veterans. The nonveteran members shall be family members of veterans, veteran advocates, service providers, or stakeholders. (3) Community input In carrying out subparagraphs (A) and (B) of paragraph (1), the Board shall— (A) provide the community opportunities to collaborate and communicate with the Board, including by conducting public forums on the Campus; and (B) focus on local issues regarding the Department that are identified by the community, including with respect to health care, benefits, and memorial services at the Campus. (j) Notification and reports (1) Congressional notification With respect to each lease or land-sharing agreement intended to be entered into or renewed at the Campus, the Secretary shall notify the Committee on Veterans’ Affairs of the Senate, the Committee on Veterans’ Affairs of the House of Representatives, and each Member of the Senate and the House of Representatives who represents the area in which the Campus is located of the intent of the Secretary to enter into or renew the lease or land-sharing agreement not later than 45 days before entering into or renewing the lease or land-sharing agreement. (2) Annual report Not later than one year after the date of the enactment of this Act, and not less frequently than annually thereafter, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate, the Committee on Veterans’ Affairs of the House of Representatives, and each Member of the Senate and the House of Representatives who represents the area in which the Campus is located an annual report evaluating all leases and land-sharing agreements carried out at the Campus, including— (A) an evaluation of the management of the revenue generated by the leases; and (B) the records described in subsection (b)(3)(D). (3) Inspector General report (A) In general Not later than each of two years and five years after the date of the enactment of this Act, and as determined necessary by the Inspector General of the Department of Veterans Affairs thereafter, the Inspector General shall submit to the Committee on Veterans’ Affairs of the Senate, the Committee on Veterans’ Affairs of the House of Representatives, and each Member of the Senate and the House of Representatives who represents the area in which the Campus is located a report on all leases carried out at the Campus and the management by the Department of the use of land at the Campus, including an assessment of the efforts of the Department to implement the master plan described in subsection (g) with respect to the Campus. (B) Consideration of annual report In preparing each report required by subparagraph (A), the Inspector General shall take into account the most recent report submitted to Congress by the Secretary under paragraph (2). (k) Rule of construction Nothing in this section shall be construed as a limitation on the authority of the Secretary to enter into other agreements regarding the Campus that are authorized by law and not inconsistent with this section. (l) Principally benefit veterans and their families defined In this section the term principally benefit veterans and their families , with respect to services provided by a person or entity under a lease of property or land-sharing agreement— (1) means services— (A) provided exclusively to veterans and their families; or (B) that are designed for the particular needs of veterans and their families, as opposed to the general public, and any benefit of those services to the general public is distinct from the intended benefit to veterans and their families; and (2) excludes services in which the only benefit to veterans and their families is the generation of revenue for the Department of Veterans Affairs. (m) Conforming amendments (1) Prohibition on disposal of property Section 224(a) of the Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2008 ( Public Law 110–161 ; 121 Stat. 2272) is amended by striking The Secretary of Veterans Affairs and inserting Except as authorized under the Los Angeles Homeless Veterans Leasing Act of 2016, the Secretary of Veterans Affairs . (2) Enhanced-use leases Section 8162(c) of title 38, United States Code, is amended by inserting , other than an enhanced-use lease under the Los Angeles Homeless Veterans Leasing Act of 2016, before shall be considered . 4. Improvements to enhanced-use lease authority of Department of Veterans Affairs (a) Prohibition on waiver of obligation of lessee Paragraph (3) of section 8162(b) of title 38, United States Code, is amended by adding at the following new subparagraph: (D) The Secretary may not waive or postpone the obligation of a lessee to pay any consideration under an enhanced-use lease, including monthly rent. . (b) Clarification of liability of Federal Government to third parties Section 8162 of such title is amended by adding at the end the following new subsection: (d) (1) Nothing in this subchapter authorizes the Secretary to enter into an enhanced-use lease that provides for, is contingent upon, or otherwise authorizes the Federal Government to guarantee a loan made by a third party to a lessee for purposes of the enhanced-use lease. (2) Nothing in this subchapter shall be construed to abrogate or constitute a waiver of the sovereign immunity of the United States with respect to any loan, financing, or other financial agreement entered into by the lessee and a third party relating to an enhanced-use lease. . (c) Transparency (1) Notice Section 8163(c)(1) of such title is amended— (A) by inserting and the Committees on the Budget of the House of Representatives and the Senate after congressional veterans’ affairs committees ; (B) by striking and shall publish and inserting , shall publish ; (C) by inserting before the period at the end the following: , and shall submit to the congressional veterans’ affairs committees a copy of the proposed lease ; and (D) by adding at the end the following new sentence: With respect to a major enhanced-use lease, upon the request of the congressional veterans’ affairs committees, not later than 30 days after the date of such notice, the Secretary shall testify before the committees on the major enhanced-use lease, including with respect to the status of the lease, the cost, and the plans to carry out the activities under the lease. The Secretary may not delegate such testifying below the level of the head of the Office of Asset Enterprise Management of the Department or any successor to such office. . (2) Annual reports Section 8168 of such title is amended— (A) by striking to Congress each place it appears and inserting to the congressional veterans’ affairs committees and the Committees on the Budget of the House of Representatives and the Senate ; (B) in subsection (a)— (i) by striking Not later and inserting (1) Not later ; (ii) by striking a report and all that follows through the period at the end and inserting a report on enhanced-use leases. ; and (iii) by adding at the end the following new paragraph: (2) Each report under paragraph (1) shall include the following: (A) Identification of the actions taken by the Secretary to implement and administer enhanced-use leases. (B) For the most recent fiscal year covered by the report, the amounts deposited into the Medical Care Collection Fund account that were derived from enhanced-use leases. (C) Identification of the actions taken by the Secretary using the amounts described in subparagraph (B). (D) Documents of the Department supporting the contents of the report described in subparagraphs (A) through (C). ; and (C) in subsection (b)— (i) by striking Each year and inserting (1) Each year ; (ii) by striking this subchapter, and all that follows through the period at the end and inserting this subchapter. ; and (iii) by adding at the end the following new paragraph: (2) Each report under paragraph (1) shall include the following with respect to each enhanced-use lease covered by the report: (A) An overview of how the Secretary is using consideration received by the Secretary under the lease to support veterans. (B) The amount of consideration received by the Secretary under the lease. (C) The amount of any revenues collected by the Secretary relating to the lease not covered by subparagraph (B), including a description of any in-kind assistance or services provided by the lessee to the Secretary or to veterans under an agreement entered into by the Secretary pursuant to any provision of law. (D) The costs to the Secretary of carrying out the lease. (E) Documents of the Department supporting the contents of the report described in subparagraphs (A) through (D). . (d) Additional definitions Section 8161 of such title is amended by adding at the end the following new paragraphs: (4) The term lessee means the party with whom the Secretary has entered into an enhanced-use lease under this subchapter. (5) The term major enhanced-use lease means an enhanced-use lease that includes consideration consisting of an average annual rent of more than $10,000,000. . (e) Comptroller General audit (1) Report Not later than 270 days after the date of the enactment of this Act, the Comptroller General of the United States shall submit to the appropriate congressional committees a report containing an audit of the enhanced-use lease program of the Department of Veterans Affairs under subchapter V of chapter 81 of title 38, United States Code. (2) Matters included The report under paragraph (1) shall include the following: (A) The financial impact of the enhanced-use lease authority on the Department of Veterans Affairs and whether the revenue realized from such authority and other financial benefits would have been realized without such authority. (B) The use by the Secretary of such authority and whether the arrangements made under such authority would have been made without such authority. (C) An identification of the controls that are in place to ensure accountability and transparency and to protect the Federal Government. (D) An overall assessment of the activities of the Secretary under such authority to ensure procurement cost avoidance, negotiated cost avoidance, in-contract cost avoidance, and rate reductions. (3) Appropriate congressional committees defined In this subsection, the term appropriate congressional committees means— (A) the Committees on Veterans’ Affairs of the House of Representatives and the Senate; and (B) the Committees on the Budget of the House of Representatives and the Senate.