IB Union Calendar No. 500 118th CONGRESS 2d Session H. R. 4424 [Report No. 118–600] IN THE HOUSE OF REPRESENTATIVES June 30, 2023 Mr. LaLota (for himself, Mr. Ryan , Mr. Fitzpatrick , Mr. Case , and Ms. Spanberger ) introduced the following bill; which was referred to the Committee on Veterans' Affairs July 22, 2024 Additional sponsors: Mr. Davis of North Carolina , Mr. Garbarino , Mr. Lawler , Mr. Kildee , Ms. Kuster , Mr. Deluzio , Mr. Kilmer , Ms. Lofgren , Ms. Perez , Ms. Blunt Rochester , Mr. Gottheimer , and Mr. Ciscomani July 22, 2024 Reported with an amendment, committed to the Committee of the Whole House on the State of the Union, and ordered to be printed Strike out all after the enacting clause and insert the part printed in italic For text of introduced bill, see copy of bill as introduced on June 30, 2023 A BILL To direct the Secretary of Veterans Affairs to study and report on the prevalence of cholangiocarcinoma in veterans who served in the Vietnam theater of operations during the Vietnam era, and for other purposes.

1. Short title This Act may be cited as the Vietnam Veterans Liver Fluke Cancer Study Act . 2. Study on the prevalence of cholangiocarcinoma in veterans who served in the Vietnam theater of operations during the Vietnam era (a) Epidemiological study Not later than 120 days after the date of enactment of this Act, the Secretary of Veterans Affairs, in consultation with the Director of the Centers for Disease Control and Prevention of the Department of Health and Human Services, shall commence an epidemiological study on the prevalence of cholangiocarcinoma in covered veterans of the Vietnam era, using data from the Veterans Affairs Central Cancer Registry and the National Program of Cancer Registries. The study shall— (1) identify the rate of incidence of cholangiocarcinoma in covered veterans of the Vietnam era and in residents of the United States, from the beginning of the Vietnam era to the date of enactment of this Act; and (2) for each of the groups specified in paragraph (1), identify the percentage of individuals with cholangiocarcinoma by various demographic characteristics, including by age, gender, race, ethnicity, and the geographic location of the patient at the time of diagnosis. (b) Report to Congress Not later than one year after the completion of the study under subsection (a), the Secretary shall submit to Congress a report containing— (1) the results of the study under subsection (a); and (2) recommendations for administrative or legislative actions required to address issues identified in the study under subsection (a). (c) Continued tracking of cholangiocarcinoma in covered veterans of the Vietnam era The Secretary shall track the prevalence of cholangiocarcinoma in covered veterans of the Vietnam era using the Veterans Affairs Central Cancer Registry, and provide such information to Congress as required under subsection (d). (d) Follow-Up reports The Secretary shall periodically submit to the Congress an updated report under subsection (b), as determined by the Secretary. (e) Definitions In this section: (1) The term Secretary means the Secretary of Veterans Affairs. (2) The term Vietnam era has the meaning given such term in section 101 of title 38, United States Code. (3) The term covered veterans of the Vietnam era means veterans who served in the Vietnam theater of operations during the Vietnam era. 3. Modification of certain housing loan fees The loan fee table in section 3729(b)(2) of title 38, United States Code, is amended by striking November 15, 2031 each place it appears and inserting November 29, 2031 .

July 22, 2024 Reported with an amendment, committed to the Committee of the Whole House on the State of the Union, and ordered to be printed