II 118th CONGRESS 1st Session S. 1913 IN THE SENATE OF THE UNITED STATES June 8, 2023 Mr. Schatz (for himself, Ms. Murkowski , Ms. Hirono , and Mr. Boozman ) introduced the following bill; which was read twice and referred to the Committee on Veterans' Affairs A BILL To expand access to health care for veterans in the Freely Associated States, and for other purposes.

1. Short title This Act may be cited as the Care for COFA Veterans Act . 2. Expansion of existing authorities to provide health care to veterans in the Freely Associated States (a) Health care abroad Section 1724 of title 38, United States Code, is amended— (1) in subsection (a), by striking subsections (b) and (c) and inserting subsections (b), (c), and (f) ; and (2) by adding at the end the following new subsection: (f) (1) The Secretary may furnish hospital care and medical services in the Freely Associated States for any service-connected disability or non-service-connected disability. (2) In furnishing care and services under paragraph (1), the Secretary may furnish such care and services through contracts or other agreements, through reimbursement, or through the direct provision of care by health care personnel of the Department. (3) In this subsection, the term Freely Associated States means the Republic of Palau, the Republic of the Marshall Islands, and the Federated States of Micronesia, which have each entered into a Compact of Free Association with the United States. . (b) Beneficiary travel for treatment of service-Connected disabilities Section 111 of such title is amended by adding at the end the following new subsection: (h) (1) The Secretary may make payments provided for in this section to or for any person specified in subsection (b)(1)(A) for travel specified in that subsection to, from, or within the Freely Associated States. (2) In this subsection, the term Freely Associated States means the Republic of Palau, the Republic of the Marshall Islands, and the Federated States of Micronesia, which have each entered into a Compact of Free Association with the United States. . (c) Legal issues The Secretary of Veterans Affairs, in consultation with the Secretary of State, shall work with the governments of the Freely Associated States to facilitate the furnishing of health services, including telehealth, under the laws administered by the Secretary of Veterans Affairs to veterans in the Freely Associated States, such as by addressing— (1) licensure, certification, registration, and tort issues relating to health care personnel; and (2) matters relating to deliveries of pharmaceutical products and medical surgical products, including deliveries of such products through the pharmacy of the Department of Veterans Affairs, to the Freely Associated States. (d) Outreach and assessment of options During the one-year period beginning on the date of the enactment of this Act, the Secretary of Veterans Affairs shall— (1) conduct robust outreach to and engage with each government of the Freely Associated States; and (2) assess options about the best way to furnish care under section 1724(f) of title 38, United States Code, as added by subsection (a). (e) Report on provision of health care to veterans in the Freely Associated States Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to Congress a report on the implementation of the authorities provided pursuant to the amendments made by this section and any additional authorities and resources needed by the Secretary to carry out those authorities, including to carry out the following: (1) Reimbursement of care for non-service-connected disabilities in the Freely Associated States under section 1724(f) of title 38, United States Code, as added by subsection (a). (2) Contracts with local clinics and federally qualified health centers (as defined in section 1905(l)(2)(B) of the Social Security Act ( 42 U.S.C. 1396d(l)(2)(B) )) in the Freely Associated States to provide care and services such section 1724(f), as so added. (3) Furnishing of telehealth services and technologies to veterans in the Freely Associated States by providers of the Department under such section 1724(f), as so added. (4) Payment under section 111(h) of title 38, United States Code, as added by subsection (b), for travel to, from, or within the Freely Associated States for veterans seeking health care for service-connected disabilities. (5) Construction of clinics in the Freely Associated States or leasing of space at military installations, embassy compounds, or consulate facilities to provide care under section 1724(f) of title 38, United States Code, as added by subsection (a). (6) Such other matters as the Secretary considers appropriate. (f) Freely Associated States defined In this section, the term Freely Associated States means the Republic of Palau, the Republic of the Marshall Islands, and the Federated States of Micronesia, which have each entered into a Compact of Free Association with the United States.