I 116th CONGRESS 1st Session H. R. 2628 IN THE HOUSE OF REPRESENTATIVES May 9, 2019 Mr. Bilirakis (for himself, Mr. Ferguson , Mr. Van Drew , Mr. Mast , Mr. Hastings , and Miss González-Colón of Puerto Rico ) 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 provide administrative support to providers of dental care who provide such care to veterans that is not furnished under such title, to direct the Secretary of Veterans Affairs to establish a pilot program for the provision of dental care to certain veterans, and for other purposes.

1. Short title This Act may be cited as the Veterans Early Treatment for Chronic Ailment Resurgence through Examinations Act of 2019 or the VET CARE Act of 2019 . 2. Administrative support for community providers of dental care Section 1712 of title 38, United States Code, is amended— (1) by redesignating subsections (d) and (e) as subsections (e) and (f), respectively; and (2) by inserting after subsection (c) the following new subsection (d): (d) (1) The Secretary may furnish, to a provider of dental care described in paragraph (2), administrative support (including information for the provider to share with veterans regarding the dental insurance plan under section 1712C of this title) related to dental care described in paragraph (2). (2) Dental care described in this paragraph is— (A) provided to a veteran; (B) not furnished under a law administered by the Secretary; and . 3. Pilot program for the provision of dental care to certain veterans (a) Pilot program The Secretary of Veterans Affairs shall carry out a pilot program to provide outpatient dental services and treatment, and related dental appliances, to eligible veterans enrolled under subsection (c)(3), at no cost to such veterans. Under the pilot program, the Secretary shall determine whether there is a correlation between veterans receiving such services and treatment, and the veterans suffering fewer complications of chronic ailments, thereby yielding a lower cost of care. (b) Eligible veteran defined For purposes of this section, the term eligible veteran means a veteran who— (1) is enrolled in the system of annual patient enrollment under section 1705 of title 38, United States Code; (2) is not eligible for dental care under section 1712 of title 38, United States Code; (3) the Secretary determines does not receive regular periodontal care; (4) is between 40 and 70 years of age; and (5) has been diagnosed with type 2 diabetes. (c) Application; evaluation; disqualification; enrollment; categorization (1) Application An eligible veteran may elect to apply for the pilot program. (2) Evaluation; disqualification An eligible veteran who applies for the pilot program shall receive an initial periodontal evaluation, including vertical bitewing radiographs. Any eligible veteran diagnosed with periodontal disease that requires surgery shall be disqualified from the pilot program. (3) Enrollment; categorization The Secretary shall enroll at least 1,500 eligible veterans who apply for the pilot program, giving preference to veterans with service-connected disabilities that increases in accordance with the veterans’ disability ratings under chapter 11 of title 38, United States Code, in a manner that ensures the following: (A) One-third of eligible veterans enrolled in the pilot program shall have been diagnosed with no or mild periodontitis under paragraph (2). (B) Two-thirds of eligible veterans enrolled in the pilot program shall have been diagnosed with moderate to severe periodontitis under paragraph (2). (d) Duration of program The Secretary shall carry out the pilot program during the four-year period beginning on the date that is 180 days after the effective date of this section. (e) Locations The pilot program shall be carried out in five facilities of the Veterans Health Administration, with one such facility in each of five Veterans Integrated Services Networks that the Secretary considers appropriate for the pilot program. (f) Patient distribution Each facility shall serve not more than one-fourth and not fewer than one-sixth of the veterans enrolled in the pilot program, in approximately even proportions of veterans categorized under subsection (c)(3). (g) Course of program (1) Periodontal therapy The Secretary shall make timely and appropriate periodontal therapy available to veterans described in subsection (c)(3)(B). (2) Election of treatment Such veterans who elect to receive treatment shall be classified as treated . (3) Annual evaluations Each treated veteran shall receive an annual dental evaluation, during which the periodontal health of the treated veteran shall be reassessed and recorded exactly as at the initial evaluation under subsection (c)(2). (4) Health outcome reporting For the duration of the pilot program, the Secretary shall collect and record data regarding the health of treated veterans, including events, treatments, and outcomes, and make such data available for analysis by qualified researchers. (h) Education (1) Health care providers The Secretary shall provide standardized instructions to all physicians and dentists who work in facilities described in subsection (e) to ensure consistent evaluation and care for veterans enrolled in the pilot program in all such facilities. (2) Enrolled veterans The Secretary shall provide each veteran enrolled in the pilot program with an orientation, information before any care is provided under the pilot program, and an exit interview that includes information regarding how such veteran may obtain dental services and treatment after the end of the pilot program. (i) Educational outreach The Secretary shall notify those institutions of higher education (as that term is defined in section 102 of the Higher Education Act of 1965 ( 20 U.S.C. 1002 )) that offer degrees in peri­odon­tol­o­gy of the pilot program so that such institutions may engage in similar studies regarding private periodontal care for veterans. (j) Report Not later than 18 months after the conclusion of the pilot program, the Secretary shall submit a report of findings to the Congress. (k) Regulations The Secretary shall administer the pilot program under such regulations as the Secretary shall prescribe, including best practices regarding informed consent and study registration.