II 118th CONGRESS 1st Session S. 1545 IN THE SENATE OF THE UNITED STATES May 10, 2023 Mrs. Blackburn (for herself, Mr. Rounds , Mr. Cramer , and Mr. Tuberville ) introduced the following bill; which was read twice and referred to the Committee on Veterans' Affairs A BILL To direct the Secretary of Veterans Affairs to carry out a pilot program to improve the ability of veterans to access medical care in medical facilities of the Department of Veterans Affairs and in the community by providing veterans the ability to choose health care providers.

1. Short title This Act may be cited as the Veterans Health Care Freedom Act . 2. Pilot program on ability of veterans to choose health care providers (a) Pilot program (1) Requirement The Secretary of Veterans Affairs, acting through the Center for Innovation for Care and Payment of the Department of Veterans Affairs, shall carry out a pilot program to improve the ability of eligible veterans to access hospital care, medical services, and extended care services through the covered care system by providing eligible veterans the ability to choose health care providers. (2) Locations The Secretary shall select a minimum of four Veterans Integrated Service Networks in which to carry out the pilot program. (b) Removal of certain requirements To access care In carrying out the pilot program, the Secretary shall furnish hospital care, medical services, and extended care services to eligible veterans through the covered care system as follows: (1) At medical facilities of the Department of Veterans Affairs, regardless of whether the facility is in the same Veterans Integrated Service Network as the Network in which the veteran resides. (2) At non-Department facilities pursuant to, as appropriate— (A) section 1703 of title 38, United States Code, without regard to the requirements specified in subsection (d) of such section; or (B) section 1703A of such title, without regard to whether the care or service is not feasibly available to the eligible veteran from a facility of the Department or through a contract or sharing agreement entered into pursuant to a provision of law other than such section as required under subparagraphs (A) and (C) of subsection (a)(1) of such section. (c) Election of veteran In accordance with subsections (d) and (e), an eligible veteran participating in the pilot program may elect to receive hospital care, medical services, and extended care services at any provider in the covered care system. (d) Coordination of care (1) Selection Each eligible veteran participating in the pilot program shall select a primary care provider in the covered care system. (2) Coordination The primary care provider of an eligible veteran selected under paragraph (1) shall— (A) coordinate with the Secretary and other health care providers the hospital care, medical services, and extended care services furnished to the veteran under the pilot program; and (B) refer the veteran to specialty care providers in the covered care system, as clinically necessary. (3) Systems The Secretary shall establish systems as the Secretary determines appropriate to ensure that a primary care provider can effectively coordinate the hospital care, medical services, and extended care services furnished to a veteran under the pilot program. (e) Specialty care (1) Access Subject to subsection (d)(2)(B), an eligible veteran participating in the pilot program may select any specialty care provider in the covered care system from which to receive specialty care. (2) Designation The Secretary may designate a specialty care provider as a primary care provider of an eligible veteran participating in the pilot program if the Secretary determines that such designation is in the health interests of the veteran (such as an endocrinologist with respect to a veteran diagnosed with diabetes, a neurologist with respect to a veteran diagnosed with Parkinson’s disease, or an obstetrician-gynecologist with respect to a female veteran). (f) Mental health care An eligible veteran participating in the pilot program may select a mental health care provider in the covered care system from which to receive mental health care. (g) Information In carrying out the pilot program, the Secretary shall furnish to eligible veterans the information on eligibility, cost sharing, treatments, and providers required for veterans to make informed decisions with respect to— (1) selecting primary care providers and specialty care providers; and (2) treatments available to the veteran. (h) Duration (1) Phase in The Secretary shall carry out the pilot program during the three-year period beginning on the date that is one year after the date of the enactment of this Act. (2) Permanent requirement (A) Veterans Community Care Program Section 1703(d) of title 38, United States Code, is amended— (i) in paragraph (1), by striking The Secretary shall and inserting Except as provided by paragraph (4), the Secretary shall ; and (ii) by adding at the end the following new paragraph: (4) Beginning on the date that is four years after the date of the enactment of the Veterans Health Care Freedom Act — (A) the requirements under paragraphs (1), (2), and (3) shall not apply with respect to furnishing hospital care, medical services, and extended care services to a covered veteran under this section; and (B) the Secretary shall furnish hospital care, medical services, and extended care services to a covered veteran under this section with the same conditions on the ability of the veteran to choose health care providers as specified in the pilot program described in section 2 of such Act. . (B) Veterans Care Agreements Section 1703A(a)(1) of such title is amended— (i) in subparagraph (C), by striking For purposes and inserting Except as provided by subparagraph (E), for purposes ; and (ii) by adding at the end the following new subparagraph: (E) Beginning on the date that is four years after the date of the enactment of the Veterans Health Care Freedom Act — (i) the requirement under subparagraph (A) and (C) that care or services may only be furnished under this section to covered individuals when such care or services are not feasibly available to the covered individual from a facility of the Department or through a contract or sharing agreement entered into pursuant to a provision of law other than this section shall not apply with respect to furnishing hospital care, medical services, and extended care services to a covered individual under this section; and (ii) the Secretary shall furnish hospital care, medical services, and extended care services to a covered individual under this section with the same conditions on the ability of the individual to choose health care providers as specified in the pilot program described in section 2 of such Act. . (C) V ISN s Beginning on the date that is four years after the date of the enactment of this Act, the Secretary shall furnish hospital care, medical services, and extended care services to veterans under chapter 17 of title 38, United States Code, at medical facilities of the Department of Veterans Affairs, regardless of whether the facility is in the same Veterans Integrated Service Network as the Network in which the veteran resides. (i) Reports (1) Implementation (A) In general On a quarterly basis during the two-year period beginning on the date of the enactment of this Act, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the implementation of the pilot program. (B) Final design One of the reports required under subparagraph (A) shall contain a description of the final design of the pilot program. (2) Annual On an annual basis during the period beginning on the date that is one year after the date of the submission of the final report under paragraph (1) and ending on the date of the conclusion of the pilot program, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the results of the pilot program. (j) Regulations The Secretary, in consultation with the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives, may prescribe regulations to carry out this section. (k) No additional appropriations No additional funds are authorized to be appropriated to carry out this section and the amendments made by this section, and this section and the amendments made by this section shall be carried out using amounts otherwise made available to the Veterans Health Administration. (l) Definitions In this section: (1) Covered care system The term covered care system means each— (A) medical facility of the Department; (B) health care provider specified in subsection 1703(c) of title 38, United States Code; and (C) eligible entity or provider that has entered into a Veterans Care Agreement under section 1703A of such title. (2) Eligible veteran The term eligible veteran means a veteran who is enrolled in the patient enrollment system of the Department of Veterans Affairs under section 1705 of title 38, United States Code. (3) Hospital care; medical services; non-Department facilities The terms hospital care , medical services , and non-Department facilities have the meanings given those terms in section 1701 of title 38, United States Code.