Veterans Access, Choice, and Accountability Act of 2014
PL 113-146 (H.R.3230), enacted 08/07/2014

[113th Congress Public Law 146]
[From the U.S. Government Publishing Office]



[[Page 1753]]

         VETERANS ACCESS, CHOICE, AND ACCOUNTABILITY ACT OF 2014

[[Page 128 STAT. 1754]]

Public Law 113-146
113th Congress

                                 An Act


 
     To improve the access of veterans to medical services from the 
Department of Veterans Affairs, and for other purposes. <<NOTE: Aug. 7, 
                         2014 -  [H.R. 3230]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, <<NOTE: Veterans Access, 
Choice, and Accountability Act of 2014. 38 USC 101 note.>> 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Veterans Access, 
Choice, and Accountability Act of 2014''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Definitions.

 TITLE I--IMPROVEMENT OF ACCESS TO CARE FROM NON-DEPARTMENT OF VETERANS 
                            AFFAIRS PROVIDERS

Sec. 101. Expanded availability of hospital care and medical services 
           for veterans through the use of agreements with non-
           Department of Veterans Affairs entities.
Sec. 102. Enhancement of collaboration between Department of Veterans 
           Affairs and Indian Health Service.
Sec. 103. Enhancement of collaboration between Department of Veterans 
           Affairs and Native Hawaiian health care systems.
Sec. 104. Reauthorization and modification of pilot program of enhanced 
           contract care authority for health care needs of veterans.
Sec. 105. Prompt payment by Department of Veterans Affairs.
Sec. 106. Transfer of authority for payments for hospital care, medical 
           services, and other health care from non-Department of 
           Veterans Affairs providers to the chief business office of 
           the Veterans Health Administration.

              TITLE II--HEALTH CARE ADMINISTRATIVE MATTERS

Sec. 201. Independent assessment of the health care delivery systems and 
           management processes of the Department of Veterans Affairs.
Sec. 202. Commission on Care.
Sec. 203. Technology task force on review of scheduling system and 
           software of the Department of Veterans Affairs.
Sec. 204. Improvement of access of veterans to mobile vet centers and 
           mobile medical centers of the Department of Veterans Affairs.
Sec. 205. Improved performance metrics for health care provided by 
           Department of Veterans Affairs.
Sec. 206. Improved transparency concerning health care provided by 
           Department of Veterans Affairs.
Sec. 207. Information for veterans on the credentials of Department of 
           Veterans Affairs physicians.
Sec. 208. Information in annual budget of the President on hospital care 
           and medical services furnished through expanded use of 
           contracts for such care.
Sec. 209. Prohibition on falsification of data concerning wait times and 
           quality measures at Department of Veterans Affairs.

   TITLE III--HEALTH CARE STAFFING, RECRUITMENT, AND TRAINING MATTERS

Sec. 301. Treatment of staffing shortage and biennial report on staffing 
           of medical facilities of the Department of Veterans Affairs.

[[Page 128 STAT. 1755]]

Sec. 302. Extension and modification of certain programs within the 
           Department of Veterans Affairs Health Professionals 
           Educational Assistance Program.
Sec. 303. Clinic management training for employees at medical facilities 
           of the Department of Veterans Affairs.

             TITLE IV--HEALTH CARE RELATED TO SEXUAL TRAUMA

Sec. 401. Expansion of eligibility for sexual trauma counseling and 
           treatment to veterans on inactive duty training.
Sec. 402. Provision of counseling and treatment for sexual trauma by the 
           Department of Veterans Affairs to members of the Armed 
           Forces.
Sec. 403. Reports on military sexual trauma.

                   TITLE V--OTHER HEALTH CARE MATTERS

Sec. 501. Extension of pilot program on assisted living services for 
           veterans with traumatic brain injury.

                 TITLE VI--MAJOR MEDICAL FACILITY LEASES

Sec. 601. Authorization of major medical facility leases.
Sec. 602. Budgetary treatment of Department of Veterans Affairs major 
           medical facilities leases.

                    TITLE VII--OTHER VETERANS MATTERS

Sec. 701. Expansion of Marine Gunnery Sergeant John David Fry 
           Scholarship.
Sec. 702. Approval of courses of education provided by public 
           institutions of higher learning for purposes of All-Volunteer 
           Force Educational Assistance Program and Post-9/11 
           Educational Assistance conditional on in-State tuition rate 
           for veterans.
Sec. 703. Extension of reduction in amount of pension furnished by 
           Department of Veterans Affairs for certain veterans covered 
           by Medicaid plans for services furnished by nursing 
           facilities.
Sec. 704. Extension of requirement for collection of fees for housing 
           loans guaranteed by Secretary of Veterans Affairs.
Sec. 705. Limitation on awards and bonuses paid to employees of 
           Department of Veterans Affairs.
Sec. 706. Extension of authority to use income information.
Sec. 707. Removal of senior executives of the Department of Veterans 
           Affairs for performance or misconduct.

                        TITLE VIII--OTHER MATTERS

Sec. 801. Appropriation of amounts.
Sec. 802. Veterans Choice Fund.
Sec. 803. Emergency designations.

SEC. 2. <<NOTE: 38 USC 1701 note.>>  DEFINITIONS.

    In this Act:
            (1) The term ``facility of the Department'' has the meaning 
        given the term ``facilities of the Department'' in section 1701 
        of title 38, United States Code.
            (2) The terms ``hospital care'' and ``medical services'' 
        have the meanings given such terms in section 1701 of title 38, 
        United States Code.

TITLE I--IMPROVEMENT OF <<NOTE: 38 USC 1701 note.>>  ACCESS TO CARE FROM 
NON-DEPARTMENT OF VETERANS AFFAIRS PROVIDERS
SEC. 101. EXPANDED AVAILABILITY OF HOSPITAL CARE AND MEDICAL 
                        SERVICES FOR VETERANS THROUGH THE USE OF 
                        AGREEMENTS WITH NON-DEPARTMENT OF VETERANS 
                        AFFAIRS ENTITIES.

    (a) Expansion of Available Care and Services.--
            (1) Furnishing of care.--
                    (A) In general.--Hospital care and medical services 
                under chapter 17 of title 38, United States Code, shall

[[Page 128 STAT. 1756]]

                be furnished to an eligible veteran described in 
                subsection (b), at the election of such veteran, through 
                agreements authorized under subsection (d), or any other 
                law administered by the Secretary of Veterans Affairs, 
                with entities specified in subparagraph (B) for the 
                furnishing of such care and services to veterans.
                    (B) Entities specified.--The entities specified in 
                this subparagraph are the following:
                          (i) Any health care provider that is 
                      participating in the Medicare program under title 
                      XVIII of the Social Security Act (42 U.S.C. 1395 
                      et seq.), including any physician furnishing 
                      services under such program.
                          (ii) Any Federally-qualified health center (as 
                      defined in section 1905(l)(2)(B) of the Social 
                      Security Act (42 U.S.C. 1396d(l)(2)(B))).
                          (iii) The Department of Defense.
                          (iv) The Indian Health Service.
            (2) Choice of provider.--An eligible veteran who makes an 
        election under subsection (c) to receive hospital care or 
        medical services under this section may select a provider of 
        such care or services from among the entities specified in 
        paragraph (1)(B) that are accessible to the veteran.
            (3) Coordination of care and services.--The Secretary shall 
        coordinate, through the Non-VA Care Coordination Program of the 
        Department of Veterans Affairs, the furnishing of care and 
        services under this section to eligible veterans, including by 
        ensuring that an eligible veteran receives an appointment for 
        such care and services within the wait-time goals of the 
        Veterans Health Administration for the furnishing of hospital 
        care and medical services.

    (b) Eligible Veterans.--A veteran is an eligible veteran for 
purposes of this section if--
            (1)(A) <<NOTE: Eligibility date.>>  as of August 1, 2014, 
        the veteran is enrolled in the patient enrollment system of the 
        Department of Veterans Affairs established and operated under 
        section 1705 of title 38, United States Code, including any such 
        veteran who has not received hospital care or medical services 
        from the Department and has contacted the Department seeking an 
        initial appointment from the Department for the receipt of such 
        care or services; or
            (B) the veteran is eligible for hospital care and medical 
        services under section 1710(e)(1)(D) of such title and is a 
        veteran described in section 1710(e)(3) of such title; and
            (2) the veteran--
                    (A) attempts, or has attempted, to schedule an 
                appointment for the receipt of hospital care or medical 
                services under chapter 17 of title 38, United States 
                Code, but is unable to schedule an appointment within 
                the wait-time goals of the Veterans Health 
                Administration for the furnishing of such care or 
                services;
                    (B) resides more than 40 miles from the medical 
                facility of the Department, including a community-based 
                outpatient clinic, that is closest to the residence of 
                the veteran;
                    (C) resides--
                          (i) in a State without a medical facility of 
                      the Department that provides--
                                    (I) hospital care;

[[Page 128 STAT. 1757]]

                                    (II) emergency medical services; and
                                    (III) surgical care rated by the 
                                Secretary as having a surgical 
                                complexity of standard; and
                          (ii) more than 20 miles from a medical 
                      facility of the Department described in clause 
                      (i); or
                    (D)(i) resides in a location, other than a location 
                in Guam, American Samoa, or the Republic of the 
                Philippines, that is 40 miles or less from a medical 
                facility of the Department, including a community-based 
                outpatient clinic; and
                    (ii)(I) is required to travel by air, boat, or ferry 
                to reach each medical facility described in clause (i) 
                that is 40 miles or less from the residence of the 
                veteran; or
                    (II) faces an unusual or excessive burden in 
                accessing each medical facility described in clause (i) 
                that is 40 miles or less from the residence of the 
                veteran due to geographical challenges, as determined by 
                the Secretary.

    (c) Election and Authorization.--
            (1) In general.--In the case of an eligible veteran 
        described in subsection (b)(2)(A), the Secretary shall, at the 
        election of the eligible veteran--
                    (A) place such eligible veteran on an electronic 
                waiting list described in paragraph (2) for an 
                appointment for hospital care or medical services the 
                veteran has elected to receive under this section; or
                    (B)(i) authorize that such care or services be 
                furnished to the eligible veteran under this section for 
                a period of time specified by the Secretary; and
                    (ii) <<NOTE: Notification.>>  notify the eligible 
                veteran by the most effective means available, including 
                electronic communication or notification in writing, 
                describing the care or services the eligible veteran is 
                eligible to receive under this section.
            (2) Electronic waiting list.--The electronic waiting list 
        described in this paragraph shall be maintained by the 
        Department and allow access by each eligible veteran via 
        www.myhealth.va.gov or any successor website for the following 
        purposes:
                    (A) To determine the place of such eligible veteran 
                on the waiting list.
                    (B) To determine the average length of time an 
                individual spends on the waiting list, disaggregated by 
                medical facility of the Department and type of care or 
                service needed, for purposes of allowing such eligible 
                veteran to make an informed election under paragraph 
                (1).

    (d) Care and Services Through Agreements.--
            (1) Agreements.--
                    (A) In general.--The Secretary shall enter into 
                agreements for furnishing care and services to eligible 
                veterans under this section with entities specified in 
                subsection (a)(1)(B).
                    (B) Agreement defined.--In this paragraph, the term 
                ``agreement'' includes contracts, intergovernmental 
                agreements, and provider agreements, as appropriate.
            (2) Rates and reimbursement.--

[[Page 128 STAT. 1758]]

                    (A) In general.--In entering into an agreement under 
                paragraph (1) with an entity specified in subsection 
                (a)(1)(B), the Secretary shall--
                          (i) negotiate rates for the furnishing of care 
                      and services under this section; and
                          (ii) reimburse the entity for such care and 
                      services at the rates negotiated pursuant to 
                      clause (i) as provided in such agreement.
                    (B) Limit on rates.--
                          (i) In general.--Except as provided in clause 
                      (ii), rates negotiated under subparagraph (A)(i) 
                      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.
                          (ii) Exception.--
                                    (I) In general.--The Secretary may 
                                negotiate a rate that is more than the 
                                rate paid by the United States as 
                                described in clause (i) with respect to 
                                the furnishing of care or services under 
                                this section to an eligible veteran who 
                                resides in a highly rural area.
                                    (II) Highly rural area defined.--In 
                                this clause, the term ``highly rural 
                                area'' means an area located in a county 
                                that has fewer than seven individuals 
                                residing in that county per square mile.
                    (C) Limit on collection.--For the furnishing of care 
                or services pursuant to an agreement under paragraph 
                (1), an entity specified in subsection (a)(1)(B) may not 
                collect any amount that is greater than the rate 
                negotiated pursuant to subparagraph (A)(i).
            (3) Certain procedures.--
                    (A) In general.--In entering into an agreement under 
                paragraph (1) with an entity described in subparagraph 
                (B), the Secretary may use the procedures, including 
                those procedures relating to reimbursement, available 
                for entering into provider agreements under section 
                1866(a) of the Social Security Act (42 U.S.C. 1395cc(a)) 
                and participation agreements under section 1842(h) of 
                such Act (42 U.S.C. 1395u(h)). During the period in 
                which such entity furnishes care or services pursuant to 
                this section, such entity may not be treated as a 
                Federal contractor or subcontractor by the Office of 
                Federal Contract Compliance Programs of the Department 
                of Labor by virtue of furnishing such care or services.
                    (B) Entities described.--The entities described in 
                this subparagraph are the following:
                          (i) In the case of the Medicare program, any 
                      provider of services that has entered into a 
                      provider agreement under section 1866(a) of the 
                      Social Security Act (42 U.S.C. 1395cc(a)) and any 
                      physician or other supplier who has entered into a 
                      participation agreement under section 1842(h) of 
                      such Act (42 U.S.C. 1395u(h)); and

[[Page 128 STAT. 1759]]

                          (ii) In the case of the Medicaid program, any 
                      provider participating under a State plan under 
                      title XIX of such Act (42 U.S.C. 1396 et seq.).
            (4) Information on policies and procedures.--The Secretary 
        shall provide to any entity with which the Secretary has entered 
        into an agreement under paragraph (1) the following:
                    (A) Information on applicable policies and 
                procedures for submitting bills or claims for authorized 
                care or services furnished to eligible veterans under 
                this section.
                    (B) Access to a telephone hotline maintained by the 
                Department that such entity may call for information on 
                the following:
                          (i) Procedures for furnishing care and 
                      services under this section.
                          (ii) Procedures for submitting bills or claims 
                      for authorized care and services furnished to 
                      eligible veterans under this section and being 
                      reimbursed for furnishing such care and services.
                          (iii) Whether particular care or services 
                      under this section are authorized, and the 
                      procedures for authorization of such care or 
                      services.

    (e) Other Health-Care Plan.--
            (1) Submittal of information to secretary.--Before receiving 
        hospital care or medical services under this section, an 
        eligible veteran shall provide to the Secretary information on 
        any health-care plan described in paragraph (4) under which the 
        eligible veteran is covered.
            (2) Disclosure of information to non-department entity.--
        Notwithstanding section 5701 of title 38, United States Code, 
        for purposes of furnishing hospital care or medical services to 
        an eligible veteran under this section, the Secretary shall 
        disclose to the entity specified in paragraph (1)(B) of 
        subsection (a) with which the Secretary has entered into an 
        agreement described in such subsection--
                    (A) whether the eligible veteran is covered under a 
                health-care plan described in paragraph (4); and
                    (B) whether the hospital care or medical services 
                sought by the eligible veteran is for a medical 
                condition that is related to a non-service-connected 
                disability described in paragraph (3)(C).
            (3) Care for which the department is secondarily 
        responsible.--
                    (A) In general.--If an eligible veteran is covered 
                under a health-care plan described in paragraph (4) and 
                receives hospital care or medical services for a non-
                service-connected disability described in subparagraph 
                (C), such health-care plan shall be primarily 
                responsible for paying for such care or services, to the 
                extent such care or services is covered by such health-
                care plan, and the Secretary shall be secondarily 
                responsible for paying for such care or services in 
                accordance with subparagraph (B)(ii).
                    (B) Responsibility for costs of care.--In a case in 
                which the Secretary is secondarily responsible for 
                paying for hospital care or medical services as 
                described in subparagraph (A)--

[[Page 128 STAT. 1760]]

                          (i) the health care provider that furnishes 
                      such care or services pursuant to an agreement 
                      described in subsection (a) shall be responsible 
                      for seeking reimbursement for the cost of such 
                      care or services from the health-care plan 
                      described in paragraph (4) under which the 
                      eligible veteran is covered; and
                          (ii) the Secretary shall be responsible for 
                      promptly paying only the amount that is not 
                      covered by such health-care plan, except that such 
                      responsibility for payment may not exceed the rate 
                      determined for such care or services pursuant to 
                      subsection (d)(2).
                    (C) Non-service-connected disability described.--A 
                non-service-connected disability described in this 
                subsection is a non-service-connected disability (as 
                defined in section 101 of title 38, United States 
                Code)--
                          (i) that is incurred incident to a veteran's 
                      employment and that is covered under a workers' 
                      compensation law or plan that provides for payment 
                      for the cost of health care and services provided 
                      to the veteran by reason of the disability;
                          (ii) that is incurred as the result of a motor 
                      vehicle accident to which applies a State law that 
                      requires the owners or operators of motor vehicles 
                      registered in that State to have in force 
                      automobile accident reparations insurance;
                          (iii) that is incurred as the result of a 
                      crime of personal violence that occurred in a 
                      State, or a political subdivision of a State, in 
                      which a person injured as the result of such a 
                      crime is entitled to receive health care and 
                      services at such State's or subdivision's expense 
                      for personal injuries suffered as the result of 
                      such crime;
                          (iv) that is incurred by a veteran--
                                    (I) who does not have a service-
                                connected disability; and
                                    (II) who is entitled to care (or 
                                payment of the expenses of care) under a 
                                health-care plan; or
                          (v) for which care and services are furnished 
                      under this section to a veteran who--
                                    (I) has a service-connected 
                                disability; and
                                    (II) is entitled to care (or payment 
                                of the expenses of care) under a health-
                                care plan.
            (4) Health-care plan.--A health-care plan described in this 
        paragraph--
                    (A) is an insurance policy or contract, medical or 
                hospital service agreement, membership or subscription 
                contract, or similar arrangement not administered by the 
                Secretary of Veterans Affairs, under which health 
                services for individuals are provided or the expenses of 
                such services are paid; and
                    (B) does not include any such policy, contract, 
                agreement, or similar arrangement pursuant to title 
                XVIII or XIX of the Social Security Act (42 U.S.C. 1395 
                et seq.) or chapter 55 of title 10, United States Code.

    (f) Veterans Choice Card.--

[[Page 128 STAT. 1761]]

            (1) <<NOTE: Deadline.>>  In general.--For purposes of 
        receiving care and services under this section, the Secretary 
        shall, not later than 90 days after the date of the enactment of 
        this Act, issue to each veteran described in subsection (b)(1) a 
        card that may be presented to a health care provider to 
        facilitate the receipt of care or services under this section.
            (2) Name of card.--Each card issued under paragraph (1) 
        shall be known as a ``Veterans Choice Card''.
            (3) Details of card.--Each Veterans Choice Card issued to a 
        veteran under paragraph (1) shall include the following:
                    (A) The name of the veteran.
                    (B) An identification number for the veteran that is 
                not the social security number of the veteran.
                    (C) The contact information of an appropriate office 
                of the Department for health care providers to confirm 
                that care or services under this section are authorized 
                for the veteran.
                    (D) Contact information and other relevant 
                information for the submittal of claims or bills for the 
                furnishing of care or services under this section.
                    (E) The following statement: ``This card is for 
                qualifying medical care outside the Department of 
                Veterans Affairs. Please call the Department of Veterans 
                Affairs phone number specified on this card to ensure 
                that treatment has been authorized.''.
            (4) Information on use of card.--Upon issuing a Veterans 
        Choice Card to a veteran, the Secretary shall provide the 
        veteran with information clearly stating the circumstances under 
        which the veteran may be eligible for care or services under 
        this section.

    (g) Information on Availability of Care.--The Secretary shall 
provide information to a veteran about the availability of care and 
services under this section in the following circumstances:
            (1) In the case of a veteran described in subsection 
        (b)(1)(B), when the veteran enrolls in the patient enrollment 
        system of the Department under section 1705 of title 38, United 
        States Code.
            (2) When the veteran attempts to schedule an appointment for 
        the receipt of hospital care or medical services from the 
        Department but is unable to schedule an appointment within the 
        wait-time goals of the Veterans Health Administration for the 
        furnishing of such care or services.
            (3) When the veteran becomes eligible for hospital care or 
        medical services under this section under subparagraph (B), (C), 
        or (D) of subsection (b)(2).

    (h) <<NOTE: Time period.>>  Follow-Up Care.--In carrying out this 
section, the Secretary shall ensure that, at the election of an eligible 
veteran who receives hospital care or medical services from a health 
care provider in an episode of care under this section, the veteran 
receives such hospital care and medical services from such health care 
provider through the completion of the episode of care (but for a period 
not exceeding 60 days), including all specialty and ancillary services 
deemed necessary as part of the treatment recommended in the course of 
such hospital care or medical services.

    (i) Providers.--To be eligible to furnish care or services under 
this section, a health care provider must--

[[Page 128 STAT. 1762]]

            (1) maintain at least the same or similar credentials and 
        licenses as those credentials and licenses that are required of 
        health care providers of the Department, as determined by the 
        Secretary for purposes of this section; and
            (2) submit, not less frequently than once each year during 
        the period in which the Secretary is authorized to carry out 
        this section pursuant to subsection (p), verification of such 
        licenses and credentials maintained by such health care 
        provider.

    (j) Cost-Sharing.--
            (1) <<NOTE: Requirement.>>  In general.--The Secretary shall 
        require an eligible veteran to pay a copayment for the receipt 
        of care or services under this section only if such eligible 
        veteran would be required to pay a copayment for the receipt of 
        such care or services at a medical facility of the Department or 
        from a health care provider of the Department pursuant to 
        chapter 17 of title 38, United States Code.
            (2) Limitation.--The amount of a copayment charged under 
        paragraph (1) may not exceed the amount of the copayment that 
        would be payable by such eligible veteran for the receipt of 
        such care or services at a medical facility of the Department or 
        from a health care provider of the Department pursuant to 
        chapter 17 of title 38, United States Code.
            (3) Collection of copayment.--A health care provider that 
        furnishes care or services to an eligible veteran under this 
        section shall collect the copayment required under paragraph (1) 
        from such eligible veteran at the time of furnishing such care 
        or services.

    (k) Claims Processing System.--
            (1) In general.--The Secretary shall provide for an 
        efficient nationwide system for processing and paying bills or 
        claims for authorized care and services furnished to eligible 
        veterans under this section.
            (2) <<NOTE: Deadline.>>  Regulations.--Not later than 90 
        days after the date of the enactment of this Act, the Secretary 
        of Veterans Affairs shall prescribe regulations for the 
        implementation of such system.
            (3) Oversight.--The Chief Business Office of the Veterans 
        Health Administration shall oversee the implementation and 
        maintenance of such system.
            (4) Accuracy of payment.--
                    (A) In general.--The Secretary shall ensure that 
                such system meets such goals for accuracy of payment as 
                the Secretary shall specify for purposes of this 
                section.
                    (B) Quarterly report.--
                          (i) In general.--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 quarterly report on the 
                      accuracy of such system.
                          (ii) Elements.--Each report required by clause 
                      (i) shall include the following:
                                    (I) A description of the goals for 
                                accuracy for such system specified by 
                                the Secretary under subparagraph (A).

[[Page 128 STAT. 1763]]

                                    (II) An assessment of the success of 
                                the Department in meeting such goals 
                                during the quarter covered by the 
                                report.
                          (iii) Deadline.--The Secretary shall submit 
                      each report required by clause (i) not later than 
                      20 days after the end of the quarter covered by 
                      the report.

    (l) Medical Records.--
            (1) In general.--The Secretary shall ensure that any health 
        care provider that furnishes care or services under this section 
        to an eligible veteran submits to the Department any medical 
        record related to the care or services provided to such eligible 
        veteran by such health care provider for inclusion in the 
        electronic medical record of such eligible veteran maintained by 
        the Department upon the completion of the provision of such care 
        or services to such eligible veteran.
            (2) Electronic format.--Any medical record submitted to the 
        Department under paragraph (1) shall, to the extent possible, be 
        in an electronic format.

    (m) Tracking of Missed Appointments.--The Secretary shall implement 
a mechanism to track any missed appointments for care or services under 
this section by eligible veterans to ensure that the Department does not 
pay for such care or services that were not furnished to an eligible 
veteran.
    (n) <<NOTE: Deadline. Regulations. Federal Register, publication.>>  
Implementation.--Not later than 90 days after the date of the enactment 
of this Act, the Secretary shall prescribe interim final regulations on 
the implementation of this section and publish such regulations in the 
Federal Register.

    (o) <<NOTE: Determination.>>  Inspector General Report.--Not later 
than 30 days after the date on which the Secretary determines that 75 
percent of the amounts deposited in the Veterans Choice Fund established 
by section 802 have been exhausted, the Inspector General of the 
Department shall submit to the Secretary a report on the results of an 
audit of the care and services furnished under this section to ensure 
the accuracy and timeliness of payments by the Department for the cost 
of such care and services, including any findings and recommendations of 
the Inspector General.

    (p) Authority To Furnish Care and Services.--
            (1) In general.--The Secretary may not use the authority 
        under this section to furnish care and services after the date 
        specified in paragraph (2).
            (2) Date specified.--The date specified in this paragraph is 
        the date on which the Secretary has exhausted all amounts 
        deposited in the Veterans Choice Fund established by section 
        802, or the date that is 3 years after the date of the enactment 
        of this Act, whichever occurs first.
            (3) <<NOTE: Federal Register, publication. Web 
        posting. Public information. Deadline.>>  Publication.--The 
        Secretary shall publish such date in the Federal Register and on 
        an Internet website of the Department available to the public 
        not later than 30 days before such date.

    (q) Reports.--
            (1) Initial report.--Not later than 90 days after the 
        publication of the interim final regulations under subsection 
        (n), 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 furnishing of care 
        and services under this section that includes the following:

[[Page 128 STAT. 1764]]

                    (A) The number of eligible veterans who have 
                received care or services under this section.
                    (B) A description of the types of care and services 
                furnished to eligible veterans under this section.
            (2) <<NOTE: Determination.>>  Final report.--Not later than 
        30 days after the date on which the Secretary determines that 75 
        percent of the amounts deposited in the Veterans Choice Fund 
        established by section 802 have been exhausted, 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 furnishing of care and services 
        under this section that includes the following:
                    (A) The total number of eligible veterans who have 
                received care or services under this section, 
                disaggregated by--
                          (i) eligible veterans described in subsection 
                      (b)(2)(A);
                          (ii) eligible veterans described in subsection 
                      (b)(2)(B);
                          (iii) eligible veterans described in 
                      subsection (b)(2)(C); and
                          (iv) eligible veterans described in subsection 
                      (b)(2)(D).
                    (B) A description of the types of care and services 
                furnished to eligible veterans under this section.
                    (C) An accounting of the total cost of furnishing 
                care and services to eligible veterans under this 
                section.
                    (D) The results of a survey of eligible veterans who 
                have received care or services under this section on the 
                satisfaction of such eligible veterans with the care or 
                services received by such eligible veterans under this 
                section.
                    (E) An assessment of the effect of furnishing care 
                and services under this section on wait times for 
                appointments for the receipt of hospital care and 
                medical services from the Department.
                    (F) An assessment of the feasibility and 
                advisability of continuing furnishing care and services 
                under this section after the termination date specified 
                in subsection (p).

    (r) Rule of Construction.--Nothing in this section shall be 
construed to alter the process of the Department for filling and paying 
for prescription medications.
    (s) Wait-Time Goals of the Veterans Health Administration.--
            (1) <<NOTE: Definition.>>  In general.--Except as provided 
        in paragraph (2), in this section, the term ``wait-time goals of 
        the Veterans Health Administration'' means not more than 30 days 
        from the date on which a veteran requests an appointment for 
        hospital care or medical services from the Department.
            (2) <<NOTE: Deadline. Reports.>>  Alternate goals.--If the 
        Secretary submits to Congress, not later than 60 days after the 
        date of the enactment of this Act, a report stating that the 
        actual wait-time goals of the Veterans Health Administration are 
        different from the wait-time goals specified in paragraph (1)--
                    (A) for purposes of this section, the wait-time 
                goals of the Veterans Health Administration shall be the 
                wait-time goals submitted by the Secretary under this 
                paragraph; and

[[Page 128 STAT. 1765]]

                    (B) <<NOTE: Federal Register, publication. Web 
                posting. Public information.>>  the Secretary shall 
                publish such wait-time goals in the Federal Register and 
                on an Internet website of the Department available to 
                the public.
SEC. 102. ENHANCEMENT OF COLLABORATION BETWEEN DEPARTMENT OF 
                        VETERANS AFFAIRS AND INDIAN HEALTH 
                        SERVICE.

    (a) <<NOTE: Consultation.>>  Outreach to Tribal-Run Medical 
Facilities.--The Secretary of Veterans Affairs shall, in consultation 
with the Director of the Indian Health Service, conduct outreach to each 
medical facility operated by an Indian tribe or tribal organization 
through a contract or compact with the Indian Health Service under the 
Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et 
seq.) to raise awareness of the ability of such facilities, Indian 
tribes, and tribal organizations to enter into agreements with the 
Department of Veterans Affairs under which the Secretary reimburses such 
facilities, Indian tribes, or tribal organizations, as the case may be, 
for health care provided to veterans who are--
            (1) eligible for health care at such facilities; and
            (2)(A) enrolled in the patient enrollment system of the 
        Department established and operated under section 1705 of title 
        38, United States Code; or
            (B) eligible for hospital care and medical services pursuant 
        to subsection (c)(2) of such section.

    (b) Performance Metrics for Memorandum of Understanding.--The 
Secretary of Veterans Affairs shall establish performance metrics for 
assessing the performance by the Department of Veterans Affairs and the 
Indian Health Service under the memorandum of understanding entitled 
``Memorandum of Understanding between the Department of Veterans Affairs 
(VA) and the Indian Health Service (IHS)'' in increasing access to 
health care, improving quality and coordination of health care, 
promoting effective patient-centered collaboration and partnerships 
between the Department and the Service, and ensuring health-promotion 
and disease-prevention services are appropriately funded and available 
for beneficiaries under both health care systems.
    (c) Report.--Not later than 180 days after the date of the enactment 
of this Act, the Secretary of Veterans Affairs and the Director of the 
Indian Health Service shall jointly submit to Congress a report on the 
feasibility and advisability of the following:
            (1) Entering into agreements for the reimbursement by the 
        Secretary of the costs of direct care services provided through 
        organizations receiving amounts pursuant to grants made or 
        contracts entered into under section 503 of the Indian Health 
        Care Improvement Act (25 U.S.C. 1653) to veterans who are 
        otherwise eligible to receive health care from such 
        organizations.
            (2) Including the reimbursement of the costs of direct care 
        services provided to veterans who are not Indians in agreements 
        between the Department and the following:
                    (A) The Indian Health Service.
                    (B) An Indian tribe or tribal organization operating 
                a medical facility through a contract or compact with 
                the Indian Health Service under the Indian Self-
                Determination and Education Assistance Act (25 U.S.C. 
                450 et seq.).
                    (C) A medical facility of the Indian Health Service.

[[Page 128 STAT. 1766]]

    (d) Definitions.--In this section:
            (1) Indian.--The terms ``Indian'' and ``Indian tribe'' have 
        the meanings given those terms in section 4 of the Indian Health 
        Care Improvement Act (25 U.S.C. 1603).
            (2) Medical facility of the indian health service.--The term 
        ``medical facility of the Indian Health Service'' includes a 
        facility operated by an Indian tribe or tribal organization 
        through a contract or compact with the Indian Health Service 
        under the Indian Self-Determination and Education Assistance Act 
        (25 U.S.C. 450 et seq.).
            (3) Tribal organization.--The term ``tribal organization'' 
        has the meaning given the term in section 4 of the Indian Self-
        Determination and Education Assistance Act (25 U.S.C. 450b).
SEC. 103. ENHANCEMENT OF COLLABORATION BETWEEN DEPARTMENT OF 
                        VETERANS AFFAIRS AND NATIVE HAWAIIAN 
                        HEALTH CARE SYSTEMS.

    (a) <<NOTE: Consultation. Contracts.>>  In General.--The Secretary 
of Veterans Affairs shall, in consultation with Papa Ola Lokahi and such 
other organizations involved in the delivery of health care to Native 
Hawaiians as the Secretary considers appropriate, enter into contracts 
or agreements with Native Hawaiian health care systems that are in 
receipt of funds from the Secretary of Health and Human Services 
pursuant to grants awarded or contracts entered into under section 6(a) 
of the Native Hawaiian Health Care Improvement Act (42 U.S.C. 11705(a)) 
for the reimbursement of direct care services provided to eligible 
veterans as specified in such contracts or agreements.

    (b) Definitions.--In this section, the terms ``Native Hawaiian'', 
``Native Hawaiian health care system'', and ``Papa Ola Lokahi'' have the 
meanings given those terms in section 12 of the Native Hawaiian Health 
Care Improvement Act (42 U.S.C. 11711).
SEC. 104. REAUTHORIZATION AND MODIFICATION OF PILOT PROGRAM OF 
                        ENHANCED CONTRACT CARE AUTHORITY FOR 
                        HEALTH CARE NEEDS OF VETERANS.

    Section 403 of the Veterans' Mental Health and Other Care 
Improvements Act of 2008 (Public Law 110-387; 38 U.S.C. 1703 note) is 
amended--
            (1) in subsection (a)--
                    (A) in paragraph (3), by striking ``only during 
                the'' and all that follows through the period at the end 
                and inserting ``only during the period beginning on the 
                date of the commencement of the pilot program under 
                paragraph (2) and ending on the date that is two years 
                after the date of the enactment of the Veterans Access, 
                Choice, and Accountability Act of 2014.''; and
                    (B) by amending paragraph (4) to read as follows:
            ``(4) Program locations.--The Secretary shall carry out the 
        pilot program at locations in the following Veterans Integrated 
        Service Networks (and such other locations as the Secretary 
        considers appropriate):
                    ``(A) Veterans Integrated Service Network 1.
                    ``(B) Veterans Integrated Service Network 6.
                    ``(C) Veterans Integrated Service Network 15.
                    ``(D) Veterans Integrated Service Network 18.
                    ``(E) Veterans Integrated Service Network 19.'';

[[Page 128 STAT. 1767]]

            (2) in subsection (b)(1)(A), by striking ``as of the date of 
        the commencement of the pilot program under subsection (a)(2)'' 
        and inserting ``as of August 1, 2014'';
            (3) by redesignating subsection (h) as subsection (k);
            (4) by inserting after subsection (g) the following new 
        subsections:

    ``(h) Appointments.--In carrying out the pilot program under this 
section, the Secretary shall ensure that medical appointments for 
covered veterans--
            ``(1) are scheduled not later than 5 days after the date on 
        which the appointment is requested; and
            ``(2) occur not later than 30 days after such date.

    ``(i) Outreach.--The Secretary shall ensure that covered veterans 
are informed about the pilot program under this section.
    ``(j) Use of Existing Contracts.--In carrying out the pilot program 
under this section after the date of the enactment of the Veterans 
Access, Choice, and Accountability Act of 2014, the Secretary shall make 
use of contracts entered into before such date or may enter into new 
contracts.''; and
            (5) in paragraph (2)(B) of subsection (k), as redesignated 
        by paragraph (3) of this section, by striking the semicolon at 
        the end and inserting ``; and''.
SEC. 105. PROMPT PAYMENT BY DEPARTMENT OF VETERANS AFFAIRS.

    (a) Sense of Congress on Prompt Payment by Department.--It is the 
sense <<NOTE: Compliance.>>  of Congress that the Secretary of Veterans 
Affairs shall comply with section 1315 of title 5, Code of Federal 
Regulations (commonly known as the ``prompt payment rule''), or any 
corresponding similar regulation or ruling, in paying for health care 
pursuant to contracts entered into with non-Department of Veterans 
Affairs providers to provide health care under the laws administered by 
the Secretary.

    (b) Establishment of Claims Processing System.--
            (1) Claims processing system.--The Secretary of Veterans 
        Affairs shall establish and implement a system to process and 
        pay claims for payment for hospital care, medical services, and 
        other health care furnished by non-Department of Veterans 
        Affairs health care providers under the laws administered by the 
        Secretary.
            (2) Compliance with prompt payment act.--The system 
        established and implemented under paragraph (1) shall comply 
        with all requirements of chapter 39, United States Code 
        (commonly referred to as the ``Prompt Payment Act'').

    (c) Report.--Not later than 1 year after the date of the enactment 
of this Act, the Comptroller General of the United States shall submit 
to Congress a report on the timeliness of payments by the Secretary for 
hospital care, medical services, and other health care furnished by non-
Department of Veterans Affairs health care providers under the laws 
administered by the Secretary.
    (d) Elements.--The report required by subsection (b) shall include 
the following:
            (1) The results of a survey of non-Department health care 
        providers who have submitted claims to the Department for 
        hospital care, medical services, or other health care furnished 
        to veterans for which payment is authorized under the laws

[[Page 128 STAT. 1768]]

        administered by the Secretary during the one-year period 
        preceding the submittal of the report, which survey shall 
        include the following:
                    (A) The amount of time it took for such health care 
                providers, after submitting such claims, to receive 
                payment from the Department for such care or services.
                    (B) A comparison of the amount of time under 
                subparagraph (A) and the amount of time it takes such 
                health care providers to receive payments from the 
                United States for similar care or services provided to 
                the following, if applicable:
                          (i) Beneficiaries under the Medicare program 
                      under title XVIII of the Social Security Act (42 
                      U.S.C. 1395 et seq.).
                          (ii) Covered beneficiaries under the TRICARE 
                      program under chapter 55 of title 10, United 
                      States Code.
            (2) Such recommendations for legislative or administrative 
        action as the Comptroller General considers appropriate.

    (e) Survey Elements.--In carrying out the survey, the Comptroller 
General shall seek responses from non-Department health care providers 
in a manner that ensures that the survey reflects the responses of such 
providers that--
            (1) are located in different geographic areas;
            (2) furnish a variety of different hospital care, medical 
        services, and other health care; and
            (3) furnish such care and services in a variety of different 
        types of medical facilities.
SEC. 106. TRANSFER OF AUTHORITY FOR PAYMENTS FOR HOSPITAL CARE, 
                        MEDICAL SERVICES, AND OTHER HEALTH CARE 
                        FROM NON-DEPARTMENT OF VETERANS AFFAIRS 
                        PROVIDERS TO THE CHIEF BUSINESS OFFICE OF 
                        THE VETERANS HEALTH ADMINISTRATION.

    (a) Transfer of Authority.--
            (1) <<NOTE: Effective date.>>  In general.--Effective as of 
        October 1, 2014, the Secretary of Veterans Affairs shall 
        transfer the authority to pay for hospital care, medical 
        services, and other health care furnished through non-Department 
        of Veterans Affairs providers from--
                    (A) the Veterans Integrated Service Networks and 
                medical centers of the Department of Veterans Affairs, 
                to
                    (B) the Chief Business Office of the Veterans Health 
                Administration of the Department of Veterans Affairs.
            (2) <<NOTE: Consultation.>>  Manner of care.--The Chief 
        Business Office shall work in consultation with the Office of 
        Clinical Operations and Management of the Department to ensure 
        that care and services described in paragraph (1) are provided 
        in a manner that is clinically appropriate and in the best 
        interest of the veterans receiving such care and services.
            (3) No delay in payment.--The transfer of authority under 
        paragraph (1) shall be carried out in a manner that does not 
        delay or impede any payment by the Department for hospital care, 
        medical services, or other health care furnished through a non-
        Department provider under the laws administered by the 
        Secretary.

    (b) Budget Matters.--The budget of the Department of Veterans 
Affairs for any fiscal year beginning after the date of the

[[Page 128 STAT. 1769]]

enactment of this Act (as submitted to Congress pursuant to section 
1105(a) of title 31, United States Code) shall specify funds for the 
payment for hospital care, medical services, and other health care 
furnished through non-Department of Veterans Affairs providers, 
including any administrative costs associated with such payment, as 
funds for the Chief Business Office of the Veterans Health 
Administration rather than as funds for the Veterans Integrated Service 
Networks or medical centers of the Department.

   TITLE <<NOTE: 38 USC 1701 note.>>  II--HEALTH CARE ADMINISTRATIVE 
MATTERS
SEC. 201. INDEPENDENT ASSESSMENT OF THE HEALTH CARE DELIVERY 
                        SYSTEMS AND MANAGEMENT PROCESSES OF THE 
                        DEPARTMENT OF VETERANS AFFAIRS.

    (a) Independent Assessment.--
            (1) <<NOTE: Deadline. Contracts.>>  Assessment.--Not later 
        than 90 days after the date of the enactment of this Act, the 
        Secretary of Veterans Affairs shall enter into one or more 
        contracts with a private sector entity or entities described in 
        subsection (b) to conduct an independent assessment of the 
        hospital care, medical services, and other health care furnished 
        in medical facilities of the Department. Such assessment shall 
        address each of the following:
                    (A) Current and projected demographics and unique 
                health care needs of the patient population served by 
                the Department.
                    (B) Current and projected health care capabilities 
                and resources of the Department, including hospital 
                care, medical services, and other health care furnished 
                by non-Department facilities under contract with the 
                Department, to provide timely and accessible care to 
                veterans.
                    (C) The authorities and mechanisms under which the 
                Secretary may furnish hospital care, medical services, 
                and other health care at non-Department facilities, 
                including whether the Secretary should have the 
                authority to furnish such care and services at such 
                facilities through the completion of episodes of care.
                    (D) The appropriate system-wide access standard 
                applicable to hospital care, medical services, and other 
                health care furnished by and through the Department, 
                including an identification of appropriate access 
                standards for each individual specialty and post-care 
                rehabilitation.
                    (E) The workflow process at each medical facility of 
                the Department for scheduling appointments for veterans 
                to receive hospital care, medical services, or other 
                health care from the Department.
                    (F) The organization, workflow processes, and tools 
                used by the Department to support clinical staffing, 
                access to care, effective length-of-stay management and 
                care transitions, positive patient experience, accurate 
                documentation, and subsequent coding of inpatient 
                services.
                    (G) The staffing level at each medical facility of 
                the Department and the productivity of each health care 
                provider at such medical facility, compared with health 
                care

[[Page 128 STAT. 1770]]

                industry performance metrics, which may include an 
                assessment of any of the following:
                          (i) The case load of, and number of patients 
                      treated by, each health care provider at such 
                      medical facility during an average week.
                          (ii) The time spent by such health care 
                      provider on matters other than the case load of 
                      such health care provider, including time spent by 
                      such health care provider as follows:
                                    (I) At a medical facility that is 
                                affiliated with the Department.
                                    (II) Conducting research.
                                    (III) Training or supervising other 
                                health care professionals of the 
                                Department.
                    (H) The information technology strategies of the 
                Department with respect to furnishing and managing 
                health care, including an identification of any 
                weaknesses and opportunities with respect to the 
                technology used by the Department, especially those 
                strategies with respect to clinical documentation of 
                episodes of hospital care, medical services, and other 
                health care, including any clinical images and 
                associated textual reports, furnished by the Department 
                in Department or non-Department facilities.
                    (I) Business processes of the Veterans Health 
                Administration, including processes relating to 
                furnishing non-Department health care, insurance 
                identification, third-party revenue collection, and 
                vendor reimbursement, including an identification of 
                mechanisms as follows:
                          (i) To avoid the payment of penalties to 
                      vendors.
                          (ii) To increase the collection of amounts 
                      owed to the Department for hospital care, medical 
                      services, or other health care provided by the 
                      Department for which reimbursement from a third 
                      party is authorized and to ensure that such 
                      amounts collected are accurate.
                          (iii) To increase the collection of any other 
                      amounts owed to the Department with respect to 
                      hospital care, medical services, and other health 
                      care and to ensure that such amounts collected are 
                      accurate.
                          (iv) To increase the accuracy and timeliness 
                      of Department payments to vendors and providers.
                    (J) The purchasing, distribution, and use of 
                pharmaceuticals, medical and surgical supplies, medical 
                devices, and health care related services by the 
                Department, including the following:
                          (i) The prices paid for, standardization of, 
                      and use by the Department of the following:
                                    (I) Pharmaceuticals.
                                    (II) Medical and surgical supplies.
                                    (III) Medical devices.
                          (ii) The use by the Department of group 
                      purchasing arrangements to purchase 
                      pharmaceuticals, medical and surgical supplies, 
                      medical devices, and health care related services.
                          (iii) The strategy and systems used by the 
                      Department to distribute pharmaceuticals, medical 
                      and surgical supplies, medical devices, and health 
                      care related

[[Page 128 STAT. 1771]]

                      services to Veterans Integrated Service Networks 
                      and medical facilities of the Department.
                    (K) The process of the Department for carrying out 
                construction and maintenance projects at medical 
                facilities of the Department and the medical facility 
                leasing program of the Department.
                    (L) The competency of leadership with respect to 
                culture, accountability, reform readiness, leadership 
                development, physician alignment, employee engagement, 
                succession planning, and performance management.
            (2) Particular elements of certain assessments.--
                    (A) Scheduling assessment.--In carrying out the 
                assessment required by paragraph (1)(E), the private 
                sector entity or entities shall do the following:
                          (i) Review all training materials pertaining 
                      to scheduling of appointments at each medical 
                      facility of the Department.
                          (ii) Assess whether all employees of the 
                      Department conducting tasks related to scheduling 
                      are properly trained for conducting such tasks.
                          (iii) Assess whether changes in the technology 
                      or system used in scheduling appointments are 
                      necessary to limit access to the system to only 
                      those employees that have been properly trained in 
                      conducting such tasks.
                          (iv) Assess whether health care providers of 
                      the Department are making changes to their 
                      schedules that hinder the ability of employees 
                      conducting such tasks to perform such tasks.
                          (v) Assess whether the establishment of a 
                      centralized call center throughout the Department 
                      for scheduling appointments at medical facilities 
                      of the Department would improve the process of 
                      scheduling such appointments.
                          (vi) Assess whether booking templates for each 
                      medical facility or clinic of the Department would 
                      improve the process of scheduling such 
                      appointments.
                          (vii) Assess any interim technology changes or 
                      attempts by Department to internally develop a 
                      long-term scheduling solutions with respect to the 
                      feasibility and cost effectiveness of such 
                      internally developed solutions compared to 
                      commercially available solutions.
                          (viii) Recommend actions, if any, to be taken 
                      by the Department to improve the process for 
                      scheduling such appointments, including the 
                      following:
                                    (I) Changes in training materials 
                                provided to employees of the Department 
                                with respect to conducting tasks related 
                                to scheduling such appointments.
                                    (II) Changes in monitoring and 
                                assessment conducted by the Department 
                                of wait times of veterans for such 
                                appointments.
                                    (III) Changes in the system used to 
                                schedule such appointments, including 
                                changes to improve how the Department--
                                            (aa) measures wait times of 
                                        veterans for such appointments;

[[Page 128 STAT. 1772]]

                                            (bb) monitors the 
                                        availability of health care 
                                        providers of the Department; and
                                            (cc) provides veterans the 
                                        ability to schedule such 
                                        appointments.
                                    (IV) Such other actions as the 
                                private sector entity or entities 
                                considers appropriate.
                    (B) Medical construction and maintenance project and 
                leasing program assessment.--In carrying out the 
                assessment required by paragraph (1)(K), the private 
                sector entity or entities shall do the following:
                          (i) Review the process of the Department for 
                      identifying and designing proposals for 
                      construction and maintenance projects at medical 
                      facilities of the Department and leases for 
                      medical facilities of the Department.
                          (ii) Assess the process through which the 
                      Department determines the following:
                                    (I) That a construction or 
                                maintenance project or lease is 
                                necessary with respect to a medical 
                                facility or proposed medical facility of 
                                the Department.
                                    (II) The proper size of such medical 
                                facility or proposed medical facility 
                                with respect to treating veterans in the 
                                catchment area of such medical facility 
                                or proposed medical facility.
                          (iii) Assess the management processes of the 
                      Department with respect to the capital management 
                      programs of the Department, including processes 
                      relating to the methodology for construction and 
                      design of medical facilities of the Department, 
                      the management of projects relating to the 
                      construction and design of such facilities, and 
                      the activation of such facilities.
                          (iv) Assess the medical facility leasing 
                      program of the Department.
            (3) <<NOTE: Deadline.>>  Timing.--The private sector entity 
        or entities carrying out the assessment required by paragraph 
        (1) shall complete such assessment not later than 240 days after 
        entering into the contract described in such paragraph.

    (b) Private Sector Entities Described.--A private entity described 
in this subsection is a private entity that--
            (1) has experience and proven outcomes in optimizing the 
        performance of the health care delivery systems of the Veterans 
        Health Administration and the private sector and in health care 
        management; and
            (2) specializes in implementing large-scale organizational 
        and cultural transformations, especially with respect to health 
        care delivery systems.

    (c) Program Integrator.--
            (1) In general.--If the Secretary enters into contracts with 
        more than one private sector entity under subsection (a), the 
        Secretary shall designate one such entity that is predominately 
        a health care organization as the program integrator.
            (2) Responsibilities.--The program integrator designated 
        pursuant to paragraph (1) shall be responsible for coordinating 
        the outcomes of the assessments conducted by the private 
        entities pursuant to such contracts.

[[Page 128 STAT. 1773]]

    (d) Report on Assessment.--
            (1) In general.--Not later than 60 days after completing the 
        assessment required by subsection (a), the private sector entity 
        or entities carrying out such assessment shall submit to the 
        Secretary of Veterans Affairs, the Committee on Veterans' 
        Affairs of the Senate, the Committee on Veterans' Affairs of the 
        House of Representatives, and the Commission on Care established 
        under section 202 a report on the findings and recommendations 
        of the private sector entity or entities with respect to such 
        assessment.
            (2) <<NOTE: Deadline. Federal Register, publication. Web 
        posting. Public information.>>  Publication.--Not later than 30 
        days after receiving the report under paragraph (1), the 
        Secretary shall publish such report in the Federal Register and 
        on an Internet website of the Department of Veterans Affairs 
        that is accessible to the public.

    (e) Non-Department Facilities Defined.--In this section, the term 
``non-Department facilities'' has the meaning given that term in section 
1701 of title 38, United States Code.
SEC. 202. COMMISSION ON CARE.

    (a) Establishment of Commission.--
            (1) In general.--There is established a commission, to be 
        known as the ``Commission on Care'' (in this section referred to 
        as the ``Commission''), to examine the access of veterans to 
        health care from the Department of Veterans Affairs and 
        strategically examine how best to organize the Veterans Health 
        Administration, locate health care resources, and deliver health 
        care to veterans during the 20-year period beginning on the date 
        of the enactment of this Act.
            (2) Membership.--
                    (A) Voting members.--The Commission shall be 
                composed of 15 voting members who are appointed as 
                follows:
                          (i) Three members appointed by the Speaker of 
                      the House of Representatives, at least one of whom 
                      shall be a veteran.
                          (ii) Three members appointed by the Minority 
                      Leader of the House of Representatives, at least 
                      one of whom shall be a veteran.
                          (iii) Three members appointed by the Majority 
                      Leader of the Senate, at least one of whom shall 
                      be a veteran.
                          (iv) Three members appointed by the Minority 
                      Leader of the Senate, at least one of whom shall 
                      be a veteran.
                          (v) Three members appointed by the President, 
                      at least two of whom shall be veterans.
                    (B) Qualifications.--Of the members appointed under 
                subparagraph (A)--
                          (i) at least one member shall represent an 
                      organization recognized by the Secretary of 
                      Veterans Affairs for the representation of 
                      veterans under section 5902 of title 38, United 
                      States Code;
                          (ii) at least one member shall have experience 
                      as senior management for a private integrated 
                      health care system with an annual gross revenue of 
                      more than $50,000,000;

[[Page 128 STAT. 1774]]

                          (iii) at least one member shall be familiar 
                      with government health care systems, including 
                      those systems of the Department of Defense, the 
                      Indian Health Service, 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)));
                          (iv) at least one member shall be familiar 
                      with the Veterans Health Administration but shall 
                      not be currently employed by the Veterans Health 
                      Administration; and
                          (v) at least one member shall be familiar with 
                      medical facility construction and leasing projects 
                      carried out by government entities and have 
                      experience in the building trades, including 
                      construction, engineering, and architecture.
                    (C) <<NOTE: Deadline.>>  Date.--The appointments of 
                members of the Commission shall be made not later than 1 
                year after the date of the enactment of this Act.
            (3) Period of appointment.--
                    (A) In general.--Members shall be appointed for the 
                life of the Commission.
                    (B) Vacancies.--Any vacancy in the Commission shall 
                not affect its powers, but shall be filled in the same 
                manner as the original appointment.
            (4) <<NOTE: Deadline.>>  Initial meeting.--Not later than 15 
        days after the date on which eight voting members of the 
        Commission have been appointed, the Commission shall hold its 
        first meeting.
            (5) Meetings.--The Commission shall meet at the call of the 
        Chairperson.
            (6) Quorum.--A majority of the members of the Commission 
        shall constitute a quorum, but a lesser number of members may 
        hold hearings.
            (7) <<NOTE: President.>>  Chairperson and vice 
        chairperson.--The President shall designate a member of the 
        commission to serve as Chairperson of the Commission. The 
        Commission shall select a Vice Chairperson from among its 
        members.

    (b) Duties of Commission.--
            (1) Evaluation and assessment.--The Commission shall 
        undertake a comprehensive evaluation and assessment of access to 
        health care at the Department of Veterans Affairs.
            (2) Matters evaluated and assessed.--In undertaking the 
        comprehensive evaluation and assessment required by paragraph 
        (1), the Commission shall evaluate and assess the results of the 
        assessment conducted by the private sector entity or entities 
        under section 201, including any findings, data, or 
        recommendations included in such assessment.
            (3) Reports.--The Commission shall submit to the President, 
        through the Secretary of Veterans Affairs, reports as follows:
                    (A) Not later than 90 days after the date of the 
                initial meeting of the Commission, an interim report 
                on--
                          (i) the findings of the Commission with 
                      respect to the evaluation and assessment required 
                      by this subsection; and
                          (ii) such recommendations as the Commission 
                      may have for legislative or administrative action 
                      to improve

[[Page 128 STAT. 1775]]

                      access to health care through the Veterans Health 
                      Administration.
                    (B) Not later than 180 days after the date of the 
                initial meeting of the Commission, a final report on--
                          (i) the findings of the Commission with 
                      respect to the evaluation and assessment required 
                      by this subsection; and
                          (ii) such recommendations as the Commission 
                      may have for legislative or administrative action 
                      to improve access to health care through the 
                      Veterans Health Administration.

    (c) Powers of the Commission.--
            (1) Hearings.--The Commission may hold such hearings, sit 
        and act at such times and places, take such testimony, and 
        receive such evidence as the Commission considers advisable to 
        carry out this section.
            (2) Information from federal agencies.--The Commission may 
        secure directly from any Federal agency such information as the 
        Commission considers necessary to carry out this section. Upon 
        request of the Chairperson of the Commission, the head of such 
        agency shall furnish such information to the Commission.

    (d) Commission Personnel Matters.--
            (1) Compensation of members.--
                    (A) In general.--Each member of the Commission who 
                is not an officer or employee of the Federal Government 
                shall be compensated at a rate equal to the daily 
                equivalent of the annual rate of basic pay prescribed 
                for level IV of the Executive Schedule under section 
                5315 of title 5, United States Code, for each day 
                (including travel time) during which such member is 
                engaged in the performance of the duties of the 
                Commission.
                    (B) Officers or employees of the united states.--All 
                members of the Commission who are officers or employees 
                of the United States shall serve without compensation in 
                addition to that received for their services as officers 
                or employees of the United States.
            (2) Travel expenses.--The members of the Commission shall be 
        allowed travel expenses, including per diem in lieu of 
        subsistence, at rates authorized for employees of agencies under 
        subchapter I of chapter 57 of title 5, United States Code, while 
        away from their homes or regular places of business in the 
        performance of services for the Commission.
            (3) Staff.--
                    (A) In general.--The Chairperson of the Commission 
                may, without regard to the civil service laws and 
                regulations, appoint and terminate an executive director 
                and such other additional personnel as may be necessary 
                to enable the Commission to perform its duties. The 
                employment of an executive director shall be subject to 
                confirmation by the Commission.
                    (B) Compensation.--The Chairperson of the Commission 
                may fix the compensation of the executive director and 
                other personnel without regard to chapter 51 and 
                subchapter III of chapter 53 of title 5, United States 
                Code, relating to classification of positions and 
                General Schedule pay rates, except that the rate of pay 
                for the executive

[[Page 128 STAT. 1776]]

                director and other personnel may not exceed the rate 
                payable for level V of the Executive Schedule under 
                section 5316 of such title.
            (4) Detail of government employees.--Any Federal Government 
        employee may be detailed to the Commission without 
        reimbursement, and such detail shall be without interruption or 
        loss of civil service status or privilege.
            (5) Procurement of temporary and intermittent services.--The 
        Chairperson of the Commission may procure temporary and 
        intermittent services under section 3109(b) of title 5, United 
        States Code, at rates for individuals that do not exceed the 
        daily equivalent of the annual rate of basic pay prescribed for 
        level V of the Executive Schedule under section 5316 of such 
        title.

    (e) Termination of the Commission.--The Commission shall terminate 
30 days after the date on which the Commission submits the report under 
subsection (b)(3)(B).
    (f) Funding.--The Secretary of Veterans Affairs shall make available 
to the Commission from amounts appropriated or otherwise made available 
to the Secretary such amounts as the Secretary and the Chairperson of 
the Commission jointly consider appropriate for the Commission to 
perform its duties under this section.
    (g) <<NOTE: President.>>  Executive Action.--
            (1) Action on recommendations.--The President shall require 
        the Secretary of Veterans Affairs and such other heads of 
        relevant Federal departments and agencies to implement each 
        recommendation set forth in a report submitted under subsection 
        (b)(3) that the President--
                    (A) considers feasible and advisable; and
                    (B) determines can be implemented without further 
                legislative action.
            (2) Reports.--Not later than 60 days after the date on which 
        the President receives a report under subsection (b)(3), the 
        President shall submit to the Committee on Veterans' Affairs of 
        the Senate and the Committee on Veterans' Affairs of the House 
        of Representatives and such other committees of Congress as the 
        President considers appropriate a report setting forth the 
        following:
                    (A) An assessment of the feasibility and 
                advisability of each recommendation contained in the 
                report received by the President.
                    (B) For each recommendation assessed as feasible and 
                advisable under subparagraph (A) the following:
                          (i) Whether such recommendation requires 
                      legislative action.
                          (ii) If such recommendation requires 
                      legislative action, a recommendation concerning 
                      such legislative action.
                          (iii) A description of any administrative 
                      action already taken to carry out such 
                      recommendation.
                          (iv) A description of any administrative 
                      action the President intends to be taken to carry 
                      out such recommendation and by whom.

[[Page 128 STAT. 1777]]

SEC. 203. TECHNOLOGY TASK FORCE ON REVIEW OF SCHEDULING SYSTEM AND 
                        SOFTWARE OF THE DEPARTMENT OF VETERANS 
                        AFFAIRS.

    (a) Task Force Review.--
            (1) <<NOTE: Establishment.>>  In general.--The Secretary of 
        Veterans Affairs shall, through the use of a technology task 
        force, conduct a review of the needs of the Department of 
        Veterans Affairs with respect to the scheduling system and 
        scheduling software of the Department of Veterans Affairs that 
        is used by the Department to schedule appointments for veterans 
        for hospital care, medical services, and other health care from 
        the Department.
            (2) Agreement.--
                    (A) In general.--The Secretary shall seek to enter 
                into an agreement with a technology organization or 
                technology organizations to carry out the review 
                required by paragraph (1).
                    (B) Prohibition on use of funds.--Notwithstanding 
                any other provision of law, no Federal funds may be used 
                to assist the technology organization or technology 
                organizations under subparagraph (A) in carrying out the 
                review required by paragraph (1).

    (b) Report.--
            (1) In general.--Not later than 45 days after the date of 
        the enactment of this Act, the technology task force required 
        under subsection (a)(1) shall submit to the Secretary, the 
        Committee on Veterans' Affairs of the Senate, and the Committee 
        on Veterans' Affairs of the House of Representatives a report 
        setting forth the findings and recommendations of the technology 
        task force regarding the needs of the Department with respect to 
        the scheduling system and scheduling software of the Department 
        described in such subsection.
            (2) Elements.--The report required by paragraph (1) shall 
        include the following:
                    (A) Proposals for specific actions to be taken by 
                the Department to improve the scheduling system and 
                scheduling software of the Department described in 
                subsection (a)(1).
                    (B) A determination as to whether one or more 
                existing off-the-shelf systems would--
                          (i) meet the needs of the Department to 
                      schedule appointments for veterans for hospital 
                      care, medical services, and other health care from 
                      the Department; and
                          (ii) improve the access of veterans to such 
                      care and services.
            (3) <<NOTE: Deadline. Federal Register, publication. Web 
        posting. Public information. Deadline.>>  Publication.--Not 
        later than 30 days after the receipt of the report required by 
        paragraph (1), the Secretary shall publish such report in the 
        Federal Register and on an Internet website of the Department 
        accessible to the public.

    (c) Implementation of Task Force Recommendations.--Not later than 1 
year after the receipt of the report required by subsection (b)(1), the 
Secretary shall implement the recommendations set forth in such report 
that the Secretary considers are feasible, advisable, and cost 
effective.

[[Page 128 STAT. 1778]]

SEC. 204. IMPROVEMENT OF ACCESS OF VETERANS TO MOBILE VET CENTERS 
                        AND MOBILE MEDICAL CENTERS OF THE 
                        DEPARTMENT OF VETERANS AFFAIRS.

    (a) Improvement of Access.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        improve the access of veterans to telemedicine and other health 
        care through the use of mobile vet centers and mobile medical 
        centers of the Department of Veterans Affairs by providing 
        standardized requirements for the operation of such centers.
            (2) Requirements.--The standardized requirements required by 
        paragraph (1) shall include the following:
                    (A) The number of days each mobile vet center and 
                mobile medical center of the Department is expected to 
                travel per year.
                    (B) The number of locations each center is expected 
                to visit per year.
                    (C) The number of appointments each center is 
                expected to conduct per year.
                    (D) The method and timing of notifications given by 
                each center to individuals in the area to which the 
                center is traveling, including notifications informing 
                veterans of the availability to schedule appointments at 
                the center.
            (3) Use of telemedicine.--The Secretary shall ensure that 
        each mobile vet center and mobile medical center of the 
        Department has the capability to provide telemedicine services.

    (b) Reports.--
            (1) In general.--Not later than 1 year after the date of the 
        enactment of this Act, and not later than September 30 each year 
        thereafter, the Secretary of Veterans Affairs 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 access to health care through the use of mobile vet 
        centers and mobile medical centers of the Department that 
        includes statistics on each of the requirements set forth in 
        subsection (a)(2) for the year covered by the report.
            (2) Elements.--Each report required by paragraph (1) shall 
        include the following:
                    (A) A description of the use of mobile vet centers 
                and mobile medical centers to provide telemedicine 
                services to veterans during the year preceding the 
                submittal of the report, including the following:
                          (i) The number of days each mobile vet center 
                      and mobile medical center was open to provide such 
                      services.
                          (ii) The number of days each center traveled 
                      to a location other than the headquarters of the 
                      center to provide such services.
                          (iii) The number of appointments each center 
                      conducted to provide such services on average per 
                      month and in total during such year.
                    (B) An analysis of the effectiveness of using mobile 
                vet centers and mobile medical centers to provide health 
                care services to veterans through the use of 
                telemedicine.
                    (C) Any recommendations for an increase in the 
                number of mobile vet centers and mobile medical centers 
                of the Department.

[[Page 128 STAT. 1779]]

                    (D) Any recommendations for an increase in the 
                telemedicine capabilities of each mobile vet center and 
                mobile medical center.
                    (E) The feasibility and advisability of using 
                temporary health care providers, including locum tenens, 
                to provide direct health care services to veterans at 
                mobile vet centers and mobile medical centers.
                    (F) Such other recommendations on improvement of the 
                use of mobile vet centers and mobile medical centers by 
                the Department as the Secretary considers appropriate.
SEC. 205. IMPROVED PERFORMANCE METRICS FOR HEALTH CARE PROVIDED BY 
                        DEPARTMENT OF VETERANS AFFAIRS.

    (a) Prohibition on Use of Scheduling and Wait-Time Metrics in 
Determination of Performance Awards.--The Secretary of Veterans Affairs 
shall ensure that scheduling and wait-time metrics or goals are not used 
as factors in determining the performance of the following employees for 
purposes of determining whether to pay performance awards to such 
employees:
            (1) Directors, associate directors, assistant directors, 
        deputy directors, chiefs of staff, and clinical leads of medical 
        centers of the Department of Veterans Affairs.
            (2) Directors, assistant directors, and quality management 
        officers of Veterans Integrated Service Networks of the 
        Department of Veterans Affairs.

    (b) Modification of Performance Plans.--
            (1) <<NOTE: Deadline.>>  In general.--Not later than 30 days 
        after the date of the enactment of this Act, the Secretary shall 
        modify the performance plans of the directors of the medical 
        centers of the Department and the directors of the Veterans 
        Integrated Service Networks to ensure that such plans are based 
        on the quality of care received by veterans at the health care 
        facilities under the jurisdictions of such directors.
            (2) Factors.--In modifying performance plans under paragraph 
        (1), the Secretary shall ensure that assessment of the quality 
        of care provided at health care facilities under the 
        jurisdiction of a director described in paragraph (1) includes 
        consideration of the following:
                    (A) Recent reviews by the Joint Commission (formerly 
                known as the ``Joint Commission on Accreditation of 
                Healthcare Organizations'') of such facilities.
                    (B) The number and nature of recommendations 
                concerning such facilities by the Inspector General of 
                the Department in reviews conducted through the Combined 
                Assessment Program, in the reviews by the Inspector 
                General of community-based outpatient clinics and 
                primary care clinics, and in reviews conducted through 
                the Office of Healthcare Inspections during the two most 
                recently completed fiscal years.
                    (C) The number of recommendations described in 
                subparagraph (B) that the Inspector General of the 
                Department determines have not been carried out 
                satisfactorily with respect to such facilities.
                    (D) Reviews of such facilities by the Commission on 
                Accreditation of Rehabilitation Facilities.

[[Page 128 STAT. 1780]]

                    (E) The number and outcomes of administrative 
                investigation boards, root cause analyses, and peer 
                reviews conducted at such facilities during the fiscal 
                year for which the assessment is being conducted.
                    (F) The effectiveness of any remedial actions or 
                plans resulting from any Inspector General 
                recommendations in the reviews and analyses described in 
                subparagraphs (A) through (E).
            (3) <<NOTE: Assessment.>>  Additional leadership 
        positions.--To the degree practicable, the Secretary shall 
        assess the performance of other employees of the Department in 
        leadership positions at Department medical centers, including 
        associate directors, assistant directors, deputy directors, 
        chiefs of staff, and clinical leads, and in Veterans Integrated 
        Service Networks, including assistant directors and quality 
        management officers, using factors and criteria similar to those 
        used in the performance plans modified under paragraph (1).

    (c) Removal of Certain Performance Goals.--For each fiscal year that 
begins after the date of the enactment of this Act, the Secretary shall 
not include in the performance goals of any employee of a Veterans 
Integrated Service Network or medical center of the Department any 
performance goal that might disincentivize the payment of Department 
amounts to provide hospital care, medical services, or other health care 
through a non-Department provider.
SEC. 206. IMPROVED TRANSPARENCY CONCERNING HEALTH CARE PROVIDED BY 
                        DEPARTMENT OF VETERANS AFFAIRS.

    (a) <<NOTE: Deadline. Federal Register, publication. Web 
posting. Public information.>>  Publication of Wait Times.--Not later 
than 90 days after the date of the enactment of this Act, the Secretary 
of Veterans Affairs shall publish in the Federal Register, and on a 
publicly accessible Internet website of each medical center of the 
Department of Veterans Affairs, the wait-times for the scheduling of an 
appointment in each Department facility by a veteran for the receipt of 
primary care, specialty care, and hospital care and medical services 
based on the general severity of the condition of the veteran. Whenever 
the wait-times for the scheduling of such an appointment changes, the 
Secretary shall publish the revised wait-times--
            (1) on a publicly accessible Internet website of each 
        medical center of the Department by not later than 30 days after 
        such change; and
            (2) in the Federal Register by not later than 90 days after 
        such change.

    (b) Publicly Available Database of Patient Safety, Quality of Care, 
and Outcome Measures.--
            (1) <<NOTE: Deadline.>>  In general.--Not later than 180 
        days after the date of the enactment of this Act, the Secretary 
        shall develop and make available to the public a comprehensive 
        database containing all applicable patient safety, quality of 
        care, and outcome measures for health care provided by the 
        Department that are tracked by the Secretary.
            (2) Update frequency.--The Secretary shall update the 
        database required by paragraph (1) not less frequently than once 
        each year.
            (3) <<NOTE: Notice.>>  Unavailable measures.--For all 
        measures that the Secretary would otherwise publish in the 
        database required

[[Page 128 STAT. 1781]]

        by paragraph (1) but has not done so because such measures are 
        not available, the Secretary shall publish notice in the 
        database of the reason for such unavailability and a timeline 
        for making such measures available in the database.
            (4) Accessibility.--The Secretary shall ensure that the 
        database required by paragraph (1) is accessible to the public 
        through the primary Internet website of the Department and 
        through each primary Internet website of a Department medical 
        center.

    (c) Hospital Compare Website of Department of Health and Human 
Services.--
            (1) <<NOTE: Deadline. Public information.>>  Agreement 
        required.--Not later than 180 days after the date of the 
        enactment of this Act, the Secretary of Veterans Affairs shall 
        enter into an agreement with the Secretary of Health and Human 
        Services for the provision by the Secretary of Veterans Affairs 
        of such information as the Secretary of Health and Human 
        Services may require to report and make publicly available 
        patient quality and outcome information concerning Department of 
        Veterans Affairs medical centers through the Hospital Compare 
        Internet website of the Department of Health and Human Services 
        or any successor Internet website.
            (2) Information provided.--The information provided by the 
        Secretary of Veterans Affairs to the Secretary of Health and 
        Human Services under paragraph (1) shall include the following:
                    (A) Measures of timely and effective health care.
                    (B) Measures of readmissions, complications of 
                death, including with respect to 30-day mortality rates 
                and 30-day readmission rates, surgical complication 
                measures, and health care related infection measures.
                    (C) Survey data of patient experiences, including 
                the Hospital Consumer Assessment of Healthcare Providers 
                and Systems or any similar successor survey developed by 
                the Department of Health and Human Services.
                    (D) Any other measures required of or reported with 
                respect to hospitals participating in the Medicare 
                program under title XVIII of the Social Security Act (42 
                U.S.C. 1395 et seq.).
            (3) <<NOTE: Notice.>>  Unavailable information.--For any 
        applicable metric collected by the Department of Veterans 
        Affairs or required to be provided under paragraph (2) and 
        withheld from or unavailable in the Hospital Compare Internet 
        website or any successor Internet website, the Secretary of 
        Veterans Affairs shall publish a notice on such Internet website 
        stating the reason why such metric was withheld from public 
        disclosure and a timeline for making such metric available, if 
        applicable.

    (d) Comptroller General Review of Publicly Available Safety and 
Quality Metrics.--Not later <<NOTE: Deadline.>>  than 3 years after the 
date of the enactment of this Act, the Comptroller General of the United 
States shall conduct a review of the safety and quality metrics made 
publicly available by the Secretary of Veterans Affairs under this 
section to assess the degree to which the Secretary is complying with 
the provisions of this section.

[[Page 128 STAT. 1782]]

SEC. 207. INFORMATION FOR VETERANS ON THE CREDENTIALS OF 
                        DEPARTMENT OF VETERANS AFFAIRS PHYSICIANS.

    (a) Improvement of ``Our Doctors'' Internet Website Links.--
            (1) Availability through department of veterans affairs 
        homepage.--A link to the ``Our Doctors'' health care providers 
        database of the Department of Veterans Affairs, or any successor 
        database, shall be available on and through the homepage of the 
        Internet website of the Department that is accessible to the 
        public.
            (2) Information on location of residency training.--The 
        Internet website of the Department that is accessible to the 
        public shall include under the link to the ``Our Doctors'' 
        health care providers database of the Department, or any 
        successor database, the name of the facility at which each 
        licensed physician of the Department underwent residency 
        training.
            (3) Information on physicians at particular facilities.--The 
        ``Our Doctors'' health care providers database of the 
        Department, or any successor database, shall identify whether 
        each licensed physician of the Department is a physician in 
        residency.

    (b) Information on Credentials of Physicians for Veterans Undergoing 
Surgical Procedures.--
            (1) In general.--Each veteran who is undergoing a surgical 
        procedure by or through the Department shall be provided 
        information described in paragraph (2) with respect to the 
        surgeon to be performing such procedure at such time in advance 
        of the procedure as is appropriate to permit such veteran to 
        evaluate such information.
            (2) Information described.--The information described in 
        this paragraph with respect to a surgeon described in paragraph 
        (1) is as follows:
                    (A) The education and training of the surgeon.
                    (B) The licensure, registration, and certification 
                of the surgeon by the State or national entity 
                responsible for such licensure, registration, or 
                certification.
            (3) Other individuals.--If a veteran is unable to evaluate 
        the information provided under paragraph (1) due to the health 
        or mental competence of the veteran, such information shall be 
        provided to an individual acting on behalf of the veteran.

    (c) Comptroller General Report and Plan.--
            (1) Report.--Not later than 2 years after the date of the 
        enactment of this Act, the Comptroller General of the United 
        States shall submit to the Committee on Veterans' Affairs of the 
        Senate and the Committee on Veterans' Affairs of the House of 
        Representatives a report setting forth an assessment by the 
        Comptroller General of the following:
                    (A) The manner in which contractors under the 
                Patient-Centered Community Care initiative of the 
                Department perform oversight of the credentials of 
                physicians within the networks of such contractors under 
                the initiative.
                    (B) The oversight by the Department of the contracts 
                under the Patient-Centered Community Care initiative.
                    (C) The verification by the Department of the 
                credentials and licenses of health care providers 
                furnishing hospital care and medical services under 
                section 101.

[[Page 128 STAT. 1783]]

            (2) <<NOTE: Deadlines.>>  Plan.--
                    (A) In general.--Not later than 30 days after the 
                submittal of the report under paragraph (1), the 
                Secretary shall submit to the Comptroller General, the 
                Committee on Veterans' Affairs of the Senate, and the 
                Committee on Veterans' Affairs of the House of 
                Representatives a plan to address any findings and 
                recommendations of the Comptroller General included in 
                such report.
                    (B) Implementation.--Not later than 90 days after 
                the submittal of the report under paragraph (1), the 
                Secretary shall carry out such plan.
SEC. 208. INFORMATION IN ANNUAL BUDGET OF THE PRESIDENT ON 
                        HOSPITAL CARE AND MEDICAL SERVICES 
                        FURNISHED THROUGH EXPANDED USE OF 
                        CONTRACTS FOR SUCH CARE.

    The materials on the Department of Veterans Affairs in the budget of 
the President for a fiscal year, as submitted to Congress pursuant to 
section 1105(a) of title 31, United States Code, shall set forth the 
following:
            (1) The number of veterans who received hospital care and 
        medical services under section 101 during the fiscal year 
        preceding the fiscal year in which such budget is submitted.
            (2) The amount expended by the Department on furnishing care 
        and services under such section during the fiscal year preceding 
        the fiscal year in which such budget is submitted.
            (3) The amount requested in such budget for the costs of 
        furnishing care and services under such section during the 
        fiscal year covered by such budget, set forth in aggregate and 
        by amounts for each account for which amounts are so requested.
            (4) The number of veterans that the Department estimates 
        will receive hospital care and medical services under such 
        section during the fiscal years covered by the budget 
        submission.
            (5) The number of employees of the Department on paid 
        administrative leave at any point during the fiscal year 
        preceding the fiscal year in which such budget is submitted.
SEC. 209. PROHIBITION ON FALSIFICATION OF DATA CONCERNING WAIT 
                        TIMES AND QUALITY MEASURES AT DEPARTMENT 
                        OF VETERANS AFFAIRS.

    Not <<NOTE: Deadline.>>  later than 60 days after the date of the 
enactment of this Act, and in accordance with title 5, United States 
Code, the Secretary of Veterans Affairs shall establish policies whereby 
any employee of the Department of Veterans Affairs who knowingly submits 
false data concerning wait times for health care or quality measures 
with respect to health care to another employee of the Department or 
knowingly requires another employee of the Department to submit false 
data concerning such wait times or quality measures to another employee 
of the Department is subject to a penalty the Secretary considers 
appropriate after notice and an opportunity for a hearing, including 
civil penalties, unpaid suspensions, or termination.

[[Page 128 STAT. 1784]]

   TITLE III--HEALTH CARE STAFFING, RECRUITMENT, AND TRAINING MATTERS

SEC. 301. TREATMENT OF STAFFING SHORTAGE AND BIENNIAL REPORT ON 
                        STAFFING OF MEDICAL FACILITIES OF THE 
                        DEPARTMENT OF VETERANS AFFAIRS.

    (a) Staffing Shortages.--
            (1) In general.--Subchapter I of chapter 74 of title 38, 
        United States Code, is amended by adding at the end the 
        following new section:
``Sec. 7412. <<NOTE: 38 USC 7412.>>  Annual determination of 
                  staffing shortages; recruitment and appointment 
                  for needed occupations

    ``(a) <<NOTE: Deadline. Federal Register, publication. Time 
period.>>  In General.--Not later than September 30 of each year, the 
Inspector General of the Department shall determine, and the Secretary 
shall publish in the Federal Register, the five occupations of personnel 
of this title of the Department covered under section 7401 of this title 
for which there are the largest staffing shortages throughout the 
Department as calculated over the five-year period preceding the 
determination.

    ``(b) Recruitment and Appointment.--Notwithstanding sections 3304 
and 3309 through 3318 of title 5, the Secretary may, upon a 
determination by the Inspector General under paragraph (1) that there is 
a staffing shortage throughout the Department with respect to a 
particular occupation, recruit and directly appoint, during the fiscal 
year after the fiscal year during which such determination is made, 
qualified personnel to serve in that particular occupation for the 
Department.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of such chapter is amended by inserting after the item 
        relating to section 7411 the following new item:

``7412. Annual determination of staffing shortages; recruitment and 
           appointment for needed occupations.''.

            (3) <<NOTE: Federal Register, publication. 38 USC 7412 
        note.>>  Deadline for first determination.--Notwithstanding the 
        deadline under section 7412 of title 38, United States Code, as 
        added by paragraph (1), for the annual determination of staffing 
        shortages in the Veterans Health Administration, the Inspector 
        General of the Department of Veterans Affairs shall make the 
        first determination required under such section, and the 
        Secretary of Veterans Affairs shall publish in the Federal 
        Register such determination, by not later than the date that is 
        180 days after the date of the enactment of this Act.

    (b) Increase of Graduate Medical Education Residency Positions.--
            (1) In general.--Section 7302 of title 38, United States 
        Code, is amended by adding at the end the following new 
        subsection:

    ``(e)(1) In carrying out this section, the Secretary shall establish 
medical residency programs, or ensure that already established medical 
residency programs have a sufficient number of residency positions, at 
any medical facility of the Department that the Secretary determines--

[[Page 128 STAT. 1785]]

            ``(A) is experiencing a shortage of physicians; and
            ``(B) is located in a community that is designated as a 
        health professional shortage area (as defined in section 332 of 
        the Public Health Service Act (42 U.S.C. 254e)).

    ``(2) In carrying out paragraph (1), the Secretary shall--
            ``(A) allocate the residency positions under such paragraph 
        among occupations included in the most current determination 
        published in the Federal Register pursuant to section 7412(a) of 
        this title; and
            ``(B) give priority to residency positions and programs in 
        primary care, mental health, and any other specialty the 
        Secretary determines appropriate.''.
            (2) Five-year increase.--
                    (A) <<NOTE: Time period. Effective date. 38 USC 7302 
                note.>>  In general.--In carrying out section 7302(e) of 
                title 38, United States Code, as added by paragraph (1), 
                during the 5-year period beginning on the day that is 1 
                year after the date of the enactment of this Act, the 
                Secretary of Veterans Affairs shall increase the number 
                of graduate medical education residency positions at 
                medical facilities of the Department by up to 1,500 
                positions.
                    (B) Priority.--In increasing the number of graduate 
                medical education residency positions at medical 
                facilities of the Department under subparagraph (A), the 
                Secretary shall give priority to medical facilities 
                that--
                          (i) as of the date of the enactment of this 
                      Act, do not have a medical residency program; and
                          (ii) are located in a community that has a 
                      high concentration of veterans.
            (3) Report.--
                    (A) In general.--Not later than 60 days after the 
                date of the enactment of this Act, and not later than 
                October 1 each year thereafter until 2019, 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 graduate medical 
                education residency positions at medical facilities of 
                the Department.
                    (B) Elements.--Each report required by subparagraph 
                (A) shall include the following:
                          (i) For the year preceding the submittal of 
                      the report, the number of graduate medical 
                      education residency positions at medical 
                      facilities of the Department as follows:
                                    (I) That were filled.
                                    (II) That were not filled.
                                    (III) That the Department 
                                anticipated filling.
                          (ii) With respect to each graduate medical 
                      education residency position specified in clause 
                      (i)--
                                    (I) the geographic location of each 
                                such position; and
                                    (II) if such position was filled, 
                                the academic affiliation of the medical 
                                resident that filled such position.
                          (iii) The policy at each medical facility of 
                      the Department with respect to the ratio of 
                      medical residents to staff supervising medical 
                      residents.

[[Page 128 STAT. 1786]]

                          (iv) <<NOTE: Time period.>>  During the 1-year 
                      period preceding the submittal of the report, the 
                      number of individuals who declined an offer from 
                      the Department to serve as a medical resident at a 
                      medical facility of the Department and the reason 
                      why each such individual declined such offer.
                          (v) <<NOTE: Time period.>>  During the 1-year 
                      period preceding the submittal of the report, a 
                      description of--
                                    (I) challenges, if any, faced by the 
                                Department in filling graduate medical 
                                education residency positions at medical 
                                facilities of the Department; and
                                    (II) actions, if any, taken by the 
                                Department to address such challenges.
                          (vi) A description of efforts of the 
                      Department, as of the date of the submittal of the 
                      report, to recruit and retain medical residents to 
                      work for the Veterans Health Administration as 
                      full-time employees.

    (c) Priority in Scholarship Program of Health Professionals 
Educational Assistance Program to Certain Providers.--Section 7612(b)(5) 
of title 38, United States Code, is amended--
            (1) in subparagraph (A), by striking ``and'' at the end;
            (2) by redesignating subparagraph (B) as subparagraph (C); 
        and
            (3) by inserting after subparagraph (A) the following new 
        subparagraph (B):
            ``(B) shall give priority to applicants pursuing a course of 
        education or training toward a career in an occupation for which 
        the Inspector General of the Department has, in the most current 
        determination published in the Federal Register pursuant to 
        section 7412(a) of this title, determined that there is one of 
        the largest staffing shortages throughout the Department with 
        respect to such occupation; and''.

    (d) Reports.--
            (1) In general.--Not later than 180 days after the date of 
        the enactment of this Act, and not later than December 31 of 
        each even-numbered year thereafter until 2024, the Secretary of 
        Veterans Affairs shall submit to the Committees on Veterans' 
        Affairs of the Senate and House of Representatives a report 
        assessing the staffing of each medical facility of the 
        Department.
            (2) Elements.--Each report submitted under paragraph (1) 
        shall include the following:
                    (A) The results of a system-wide assessment of all 
                medical facilities of the Department to ensure the 
                following:
                          (i) Appropriate staffing levels for health 
                      care professionals to meet the goals of the 
                      Secretary for timely access to care for veterans.
                          (ii) Appropriate staffing levels for support 
                      personnel, including clerks.
                          (iii) Appropriate sizes for clinical panels.
                          (iv) Appropriate numbers of full-time staff, 
                      or full-time equivalents, dedicated to direct care 
                      of patients.
                          (v) Appropriate physical plant space to meet 
                      the capacity needs of the Department in that area.

[[Page 128 STAT. 1787]]

                          (vi) Such other factors as the Secretary 
                      considers necessary.
                    (B) A plan for addressing any issues identified in 
                the assessment described in subparagraph (A), including 
                a timeline for addressing such issues.
                    (C) A list of the current wait times and workload 
                levels for the following clinics in each medical 
                facility:
                          (i) Mental health.
                          (ii) Primary care.
                          (iii) Gastroenterology.
                          (iv) Women's health.
                          (v) Such other clinics as the Secretary 
                      considers appropriate.
                    (D) A description of the results of the most current 
                determination of the Inspector General under subsection 
                (a) of section 7412 of title 38, United States Code, as 
                added by subsection (a)(1) of this section, and a plan 
                to use direct appointment authority under subsection (b) 
                of such section 7412 to fill staffing shortages, 
                including recommendations for improving the speed at 
                which the credentialing and privileging process can be 
                conducted.
                    (E) The current staffing models of the Department 
                for the following clinics, including recommendations for 
                changes to such models:
                          (i) Mental health.
                          (ii) Primary care.
                          (iii) Gastroenterology.
                          (iv) Women's health.
                          (v) Such other clinics as the Secretary 
                      considers appropriate.
                    (F) A detailed analysis of succession planning at 
                medical facilities of the Department, including the 
                following:
                          (i) The number of positions in medical 
                      facilities throughout the Department that are not 
                      filled by a permanent employee.
                          (ii) The length of time each position 
                      described in clause (i) remained vacant or filled 
                      by a temporary or acting employee.
                          (iii) A description of any barriers to filling 
                      the positions described in clause (i).
                          (iv) A plan for filling any positions that are 
                      vacant or filled by a temporary or acting employee 
                      for more than 180 days.
                          (v) A plan for handling emergency 
                      circumstances, such as administrative leave or 
                      sudden medical leave for senior officials.
                    (G) <<NOTE: Time period.>>  The number of health 
                care providers of the Department who have been removed 
                from their positions, have retired, or have left their 
                positions for another reason, disaggregated by provider 
                type, during the 2-year period preceding the submittal 
                of the report.
                    (H) Of the health care providers specified in 
                subparagraph (G) who have been removed from their 
                positions, the following:
                          (i) The number of such health care providers 
                      who were reassigned to other positions in the 
                      Department.

[[Page 128 STAT. 1788]]

                          (ii) The number of such health care providers 
                      who left the Department.
                          (iii) The number of such health care providers 
                      who left the Department and were subsequently 
                      rehired by the Department.
SEC. 302. EXTENSION AND MODIFICATION OF CERTAIN PROGRAMS WITHIN 
                        THE DEPARTMENT OF VETERANS AFFAIRS HEALTH 
                        PROFESSIONALS EDUCATIONAL ASSISTANCE 
                        PROGRAM.

    (a) Extension of Scholarship Program.--Section 7619 of title 38, 
United States Code, is amended by striking ``December 31, 2014'' and 
inserting ``December 31, 2019''.
    (b) Modification of Education Debt Reduction Program.--
            (1) Modification of amount and duration of eligibility.--
        Paragraph (1) of section 7683(d) of such title is amended--
                    (A) by striking ``$60,000'' and inserting 
                ``$120,000''; and
                    (B) by striking ``$12,000 of such payments'' and all 
                that follows through the period at the end and inserting 
                ``$24,000 of such payments may be made in each year of 
                participation in the Program''.
            (2) Elimination of limitation.--
                    (A) In general.--Such section is further amended--
                          (i) by striking paragraph (2);
                          (ii) by redesignating paragraph (3) as 
                      paragraph (2); and
                          (iii) in paragraph (2), as redesignated by 
                      clause (ii), by striking ``paragraphs (1) and 
                      (2)'' and inserting ``paragraph (1)''.
                    (B) Conforming amendment.--Paragraph (1) of such 
                section, as amended by paragraph (1), is further amended 
                by striking ``Subject to paragraph (2), the amount'' and 
                inserting ``The amount''.
SEC. 303. <<NOTE: 38 USC 703 note.>>  CLINIC MANAGEMENT TRAINING 
                        FOR EMPLOYEES AT MEDICAL FACILITIES OF THE 
                        DEPARTMENT OF VETERANS AFFAIRS.

    (a) Clinic Management Training Program.--
            (1) <<NOTE: Deadline.>>  In general.--Not later than 180 
        days after the date of the enactment of this Act, the Secretary 
        of Veterans Affairs shall commence a role-specific clinic 
        management training program to provide in-person, standardized 
        education on systems and processes for health care practice 
        management and scheduling to all appropriate employees, as 
        determined by the Secretary, at medical facilities of the 
        Department.
            (2) Elements.--
                    (A) In general.--The clinic management training 
                program required by paragraph (1) shall include the 
                following:
                          (i) Training on how to manage the schedules of 
                      health care providers of the Department, including 
                      the following:
                                    (I) Maintaining such schedules in a 
                                manner that allows appointments to be 
                                booked at least eight weeks in advance.
                                    (II) Proper planning procedures for 
                                vacation, leave, and graduate medical 
                                education training schedules.

[[Page 128 STAT. 1789]]

                          (ii) Training on the appropriate number of 
                      appointments that a health care provider should 
                      conduct on a daily basis, based on specialty.
                          (iii) Training on how to determine whether 
                      there are enough available appointment slots to 
                      manage demand for different appointment types and 
                      mechanisms for alerting management of insufficient 
                      slots.
                          (iv) Training on how to properly use the 
                      appointment scheduling system of the Department, 
                      including any new scheduling system implemented by 
                      the Department.
                          (v) Training on how to optimize the use of 
                      technology, including the following:
                                    (I) Telemedicine.
                                    (II) Electronic mail.
                                    (III) Text messaging.
                                    (IV) Such other technologies as 
                                specified by the Secretary.
                          (vi) Training on how to properly use physical 
                      plant space at medical facilities of the 
                      Department to ensure efficient flow and privacy 
                      for patients and staff.
                    (B) Role-specific.--The Secretary shall ensure that 
                each employee of the Department included in the clinic 
                management training program required by paragraph (1) 
                receives education under such program that is relevant 
                to the responsibilities of such employee.
            (3) Sunset.--The clinic management training program required 
        by paragraph (1) shall terminate on the date that is 2 years 
        after the date on which the Secretary commences such program.

    (b) Training Materials.--
            (1) In general.--After the termination of the clinic 
        management training program required by subsection (a), the 
        Secretary shall provide training materials on health care 
        management to each of the following employees of the Department 
        that are relevant to the position and responsibilities of such 
        employee upon the commencement of employment of such employee:
                    (A) Any manager of a medical facility of the 
                Department.
                    (B) Any health care provider at a medical facility 
                of the Department.
                    (C) Such other employees of the Department as the 
                Secretary considers appropriate.
            (2) Update.--The Secretary shall regularly update the 
        training materials required under paragraph (1).

             TITLE IV--HEALTH CARE RELATED TO SEXUAL TRAUMA

SEC. 401. EXPANSION OF ELIGIBILITY FOR SEXUAL TRAUMA COUNSELING 
                        AND TREATMENT TO VETERANS ON INACTIVE DUTY 
                        TRAINING.

    Section 1720D(a)(1) of title 38, United States Code, is amended by 
striking ``or active duty for training'' and inserting ``, active duty 
for training, or inactive duty training''.

[[Page 128 STAT. 1790]]

SEC. 402. PROVISION OF COUNSELING AND TREATMENT FOR SEXUAL TRAUMA 
                        BY THE DEPARTMENT OF VETERANS AFFAIRS TO 
                        MEMBERS OF THE ARMED FORCES.

    (a) Expansion of Coverage to Members of the Armed Forces.--
Subsection (a) of section 1720D of title 38, United States Code, is 
amended--
            (1) by redesignating paragraph (2) as paragraph (3);
            (2) by inserting after paragraph (1) the following new 
        paragraph (2):

    ``(2)(A) <<NOTE: Consultation.>>  In operating the program required 
by paragraph (1), the Secretary may, in consultation with the Secretary 
of Defense, provide counseling and care and services to members of the 
Armed Forces (including members of the National Guard and Reserves) on 
active duty to overcome psychological trauma described in that 
paragraph.

    ``(B) A member described in subparagraph (A) shall not be required 
to obtain a referral before receiving counseling and care and services 
under this paragraph.''; and
            (3) in paragraph (3), as redesignated by paragraph (1)--
                    (A) by striking ``a veteran'' and inserting ``an 
                individual''; and
                    (B) by striking ``that veteran'' each place it 
                appears and inserting ``that individual''.

    (b) Information to Members on Availability of Counseling and 
Services.--Subsection (c) of such section is amended--
            (1) by striking ``to veterans'' each place it appears; and
            (2) in paragraph (3), by inserting ``members of the Armed 
        Forces and'' before ``individuals''.

    (c) Inclusion of Members in Reports on Counseling and Services.--
Subsection (e) of such section is amended--
            (1) in the matter preceding paragraph (1), by striking ``to 
        veterans'';
            (2) in paragraph (2)--
                    (A) by striking ``women veterans'' and inserting 
                ``individuals''; and
                    (B) by striking ``training under subsection (d).'' 
                and inserting ``training under subsection (d), 
                disaggregated by--
                    ``(A) veterans;
                    ``(B) members of the Armed Forces (including members 
                of the National Guard and Reserves) on active duty; and
                    ``(C) for each of subparagraphs (A) and (B)--
                          ``(i) men; and
                          ``(ii) women.'';
            (3) in paragraph (4), by striking ``veterans'' and inserting 
        ``individuals''; and
            (4) in paragraph (5)--
                    (A) by striking ``women veterans'' and inserting 
                ``individuals''; and
                    (B) by inserting ``, including specific 
                recommendations for individuals specified in 
                subparagraphs (A), (B), and (C) of paragraph (2)'' 
                before the period at the end.

    (d) <<NOTE: 38 USC 1720D.>>  Effective Date.--The amendments made by 
this section shall take effect on the date that is 1 year after the date 
of the enactment of this Act.

[[Page 128 STAT. 1791]]

SEC. 403. REPORTS ON MILITARY SEXUAL TRAUMA.

    (a) Report on Services Available for Military Sexual Trauma in the 
Department of Veterans Affairs.--Not later than 630 days after the date 
of the enactment of this Act, the Secretary of Veterans Affairs 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 treatment and services available from the Department of Veterans 
Affairs for male veterans who experience military sexual trauma compared 
to such treatment and services available to female veterans who 
experience military sexual trauma.
    (b) Reports on Transition of Military Sexual Trauma Treatment From 
Department of Defense to Department of Veterans Affairs.--Not later than 
630 days after the date of the enactment of this Act, and annually 
thereafter for 5 years, the Department of Veterans Affairs-Department of 
Defense Joint Executive Committee established by section 320(a) of title 
38, United States Code, shall submit to the appropriate committees of 
Congress a report on military sexual trauma that includes the following:
            (1) The processes and procedures utilized by the Department 
        of Veterans Affairs and the Department of Defense to facilitate 
        transition of treatment of individuals who have experienced 
        military sexual trauma from treatment provided by the Department 
        of Defense to treatment provided by the Department of Veterans 
        Affairs.
            (2) A description and assessment of the collaboration 
        between the Department of Veterans Affairs and the Department of 
        Defense in assisting veterans in filing claims for disabilities 
        related to military sexual trauma, including permitting veterans 
        access to information and evidence necessary to develop or 
        support such claims.

    (c) Definitions.--In this section:
            (1) Appropriate committees of congress.--The term 
        ``appropriate committees of Congress'' means--
                    (A) the Committee on Veterans' Affairs and the 
                Committee on Armed Services of the Senate; and
                    (B) the Committee on Veterans' Affairs and the 
                Committee on Armed Services of the House of 
                Representatives.
            (2) Military sexual trauma.--The term ``military sexual 
        trauma'' means psychological trauma, which in the judgment of a 
        mental health professional employed by the Department, resulted 
        from a physical assault of a sexual nature, battery of a sexual 
        nature, or sexual harassment which occurred while the veteran 
        was serving on active duty, active duty for training, or 
        inactive duty training.
            (3) Sexual harassment.--The term ``sexual harassment'' means 
        repeated, unsolicited verbal or physical contact of a sexual 
        nature which is threatening in character.
            (4) Sexual trauma.--The term ``sexual trauma'' shall have 
        the meaning given that term by the Secretary of Veterans Affairs 
        for purposes of this section.

    (d) Effective Date.--This section shall take effect on the date that 
is 270 days after the date of the enactment of this Act.

[[Page 128 STAT. 1792]]

                   TITLE V--OTHER HEALTH CARE MATTERS

SEC. 501. EXTENSION OF PILOT PROGRAM ON ASSISTED LIVING SERVICES 
                        FOR VETERANS WITH TRAUMATIC BRAIN INJURY.

    (a) In General.--Section 1705 of the National Defense Authorization 
Act for Fiscal Year 2008 (Public Law 110-181; 38 U.S.C. 1710C note) is 
amended by adding at the end the following:
    ``(g) Termination.--The pilot program shall terminate on October 6, 
2017.''.
    (b) Conforming Amendment.--Subsection (a) of such section is amended 
by striking ``five-year''.

                 TITLE VI--MAJOR MEDICAL FACILITY LEASES

SEC. 601. AUTHORIZATION OF MAJOR MEDICAL FACILITY LEASES.

    (a) In General.--The Secretary of Veterans Affairs may carry out the 
following major medical facility leases at the locations specified, and 
in an amount for each lease not to exceed the amount shown for such 
location (not including any estimated cancellation costs):
            (1) For a clinical research and pharmacy coordinating 
        center, Albuquerque, New Mexico, an amount not to exceed 
        $9,560,000.
            (2) For a community-based outpatient clinic, Brick, New 
        Jersey, an amount not to exceed $7,280,000.
            (3) For a new primary care and dental clinic annex, 
        Charleston, South Carolina, an amount not to exceed $7,070,250.
            (4) For a community-based outpatient clinic, Cobb County, 
        Georgia, an amount not to exceed $6,409,000.
            (5) For the Leeward Outpatient Healthcare Access Center, 
        Honolulu, Hawaii, including a co-located clinic with the 
        Department of Defense and the co-location of the Honolulu 
        Regional Office of the Veterans Benefits Administration and the 
        Kapolei Vet Center of the Department of Veterans Affairs, an 
        amount not to exceed $15,887,370.
            (6) For a community-based outpatient clinic, Johnson County, 
        Kansas, an amount not to exceed $2,263,000.
            (7) For a replacement community-based outpatient clinic, 
        Lafayette, Louisiana, an amount not to exceed $2,996,000.
            (8) For a community-based outpatient clinic, Lake Charles, 
        Louisiana, an amount not to exceed $2,626,000.
            (9) For outpatient clinic consolidation, New Port Richey, 
        Florida, an amount not to exceed $11,927,000.
            (10) For an outpatient clinic, Ponce, Puerto Rico, an amount 
        not to exceed $11,535,000.
            (11) For lease consolidation, San Antonio, Texas, an amount 
        not to exceed $19,426,000.
            (12) For a community-based outpatient clinic, San Diego, 
        California, an amount not to exceed $11,946,100.
            (13) For an outpatient clinic, Tyler, Texas, an amount not 
        to exceed $4,327,000.

[[Page 128 STAT. 1793]]

            (14) For the Errera Community Care Center, West Haven, 
        Connecticut, an amount not to exceed $4,883,000.
            (15) For the Worcester Community-Based Outpatient Clinic, 
        Worcester, Massachusetts, an amount not to exceed $4,855,000.
            (16) For the expansion of a community-based outpatient 
        clinic, Cape Girardeau, Missouri, an amount not to exceed 
        $4,232,060.
            (17) For a multispecialty clinic, Chattanooga, Tennessee, an 
        amount not to exceed $7,069,000.
            (18) For the expansion of a community-based outpatient 
        clinic, Chico, California, an amount not to exceed $4,534,000.
            (19) For a community-based outpatient clinic, Chula Vista, 
        California, an amount not to exceed $3,714,000.
            (20) For a new research lease, Hines, Illinois, an amount 
        not to exceed $22,032,000.
            (21) For a replacement research lease, Houston, Texas, an 
        amount not to exceed $6,142,000.
            (22) For a community-based outpatient clinic, Lincoln, 
        Nebraska, an amount not to exceed $7,178,400.
            (23) For a community-based outpatient clinic, Lubbock, 
        Texas, an amount not to exceed $8,554,000.
            (24) For a community-based outpatient clinic consolidation, 
        Myrtle Beach, South Carolina, an amount not to exceed 
        $8,022,000.
            (25) For a community-based outpatient clinic, Phoenix, 
        Arizona, an amount not to exceed $20,757,000.
            (26) For the expansion of a community-based outpatient 
        clinic, Redding, California, an amount not to exceed $8,154,000.
            (27) For the expansion of a community-based outpatient 
        clinic, Tulsa, Oklahoma, an amount not to exceed $13,269,200.

    (b) <<NOTE: Oklahoma.>>  Requirements for Clinic in Tulsa.--
            (1) In general.--In carrying out the expansion of the 
        community-based outpatient clinic in Tulsa, Oklahoma, authorized 
        by subsection (a)(27), the Secretary of Veterans Affairs shall 
        ensure that such clinic satisfies the following requirements:
                    (A) Consist of not more than 140,000 gross square 
                feet.
                    (B) Have an annual cost per square foot of not more 
                than the average market rate in Tulsa, Oklahoma, for an 
                equivalent medical facility plus 20 percent.
                    (C) Satisfy the mandate of the Department of 
                Veterans Affairs to provide veterans in Oklahoma with 
                access to quality and efficient care.
                    (D) Expand clinical capacity in the region in which 
                the clinic is located in a cost efficient manner based 
                upon regional cost comparisons, taking into account the 
                needs of current veterans and the potential demand by 
                veterans for care in the future.
                    (E) Be the most cost effective option for the 
                Department as predicted over a 30-year life cycle for 
                such clinic.
            (2) Cost effective determination.--
                    (A) In general.--If the Secretary determines that 
                the most cost effective option over a 30-year life cycle 
                would be to purchase or construct a facility in Tulsa, 
                Oklahoma, instead of entering into a major medical 
                facility lease in

[[Page 128 STAT. 1794]]

                such location as authorized by subsection (a)(27), the 
                Secretary shall not enter into such lease.
                    (B) Major medical facility project.--If the 
                Secretary makes the determination described in 
                subparagraph (A), the Secretary may request authority 
                for a major medical facility project in Tulsa, Oklahoma, 
                from Congress pursuant to section 8104(b) of title 38, 
                United States Code.
                    (C) <<NOTE: Deadline.>>  Cost-benefit analysis.--If 
                the Secretary requests authority for the major medical 
                facility project described in subparagraph (B), not 
                later than 90 days after making the determination 
                described in subparagraph (A), the Secretary shall 
                submit to Congress a detailed cost-benefit analysis of 
                such major medical facility project.
SEC. 602. <<NOTE: 38 USC 8104 note.>>  BUDGETARY TREATMENT OF 
                        DEPARTMENT OF VETERANS AFFAIRS MAJOR 
                        MEDICAL FACILITIES LEASES.

    (a) Findings.--Congress finds the following:
            (1) Title 31, United States Code, requires the Department of 
        Veterans Affairs to record the full cost of its contractual 
        obligation against funds available at the time a contract is 
        executed.
            (2) Office of Management and Budget Circular A-11 provides 
        guidance to agencies in meeting the statutory requirements under 
        title 31, United States Code, with respect to leases.
            (3) For operating leases, Office of Management and Budget 
        Circular A-11 requires the Department of Veterans Affairs to 
        record up-front budget authority in an ``amount equal to total 
        payments under the full term of the lease or [an] amount 
        sufficient to cover first year lease payments plus cancellation 
        costs''.

    (b) Requirement for Obligation of Full Cost.--
            (1) <<NOTE: Records.>>  In general.--Subject to the 
        availability of appropriations provided in advance, in 
        exercising the authority of the Secretary of Veterans Affairs to 
        enter into leases provided in this Act, the Secretary shall 
        record, pursuant to section 1501 of title 31, United States 
        Code, as the full cost of the contractual obligation at the time 
        a contract is executed either--
                    (A) an amount equal to total payments under the full 
                term of the lease; or
                    (B) if the lease specifies payments to be made in 
                the event the lease is terminated before its full term, 
                an amount sufficient to cover the first year lease 
                payments plus the specified cancellation costs.
            (2) Self-insuring authority.--The requirements of paragraph 
        (1) may be satisfied through the use of the self-insuring 
        authority identified in title 40, United States Code, consistent 
        with Office of Management and Budget Circular A-11.

    (c) Transparency.--
            (1) Compliance.--Subsection (b) of section 8104 of title 38, 
        United States Code, is amended by adding at the end the 
        following new paragraph:
            ``(7) In the case of a prospectus proposing funding for a 
        major medical facility lease, a detailed analysis of how the 
        lease is expected to comply with Office of Management and Budget 
        Circular A-11 and section 1341 of title 31 (commonly

[[Page 128 STAT. 1795]]

        referred to as the `Anti-Deficiency Act'). Any such analysis 
        shall include--
                    ``(A) an analysis of the classification of the lease 
                as a `lease-purchase', `capital lease', or `operating 
                lease' as those terms are defined in Office of 
                Management and Budget Circular A-11;
                    ``(B) an analysis of the obligation of budgetary 
                resources associated with the lease; and
                    ``(C) an analysis of the methodology used in 
                determining the asset cost, fair market value, and 
                cancellation costs of the lease.''.
            (2) Submittal to congress.--Such section 8104 is further 
        amended by adding at the end the following new subsection:

    ``(h)(1) <<NOTE: Deadline.>>  Not less than 30 days before entering 
into a major medical facility lease, the Secretary shall submit to the 
Committees on Veterans' Affairs of the Senate and the House of 
Representatives--
            ``(A) <<NOTE: Notice.>>  notice of the Secretary's intention 
        to enter into the lease;
            ``(B) a detailed summary of the proposed lease;
            ``(C) a description and analysis of any differences between 
        the prospectus submitted pursuant to subsection (b) and the 
        proposed lease; and
            ``(D) a scoring analysis demonstrating that the proposed 
        lease fully complies with Office of Management and Budget 
        Circular A-11.

    ``(2) <<NOTE: Confidentiality.>>  Each committee described in 
paragraph (1) shall ensure that any information submitted to the 
committee under such paragraph is treated by the committee with the same 
level of confidentiality as is required by law of the Secretary and 
subject to the same statutory penalties for unauthorized disclosure or 
use as the Secretary.

    ``(3) <<NOTE: Deadline. Reports.>>  Not more than 30 days after 
entering into a major medical facility lease, the Secretary shall submit 
to each committee described in paragraph (1) a report on any material 
differences between the lease that was entered into and the proposed 
lease described under such paragraph, including how the lease that was 
entered into changes the previously submitted scoring analysis described 
in subparagraph (D) of such paragraph.''.

    (d) Rule of Construction.--Nothing in this section, or the 
amendments made by this section, shall be construed to in any way 
relieve the Department of Veterans Affairs from any statutory or 
regulatory obligations or requirements existing prior to the enactment 
of this section and such amendments.

                    TITLE VII--OTHER VETERANS MATTERS

SEC. 701. EXPANSION OF MARINE GUNNERY SERGEANT JOHN DAVID FRY 
                        SCHOLARSHIP.

    (a) Expansion of Entitlement.--Subsection (b)(9) of section 3311 of 
title 38, United States Code, is amended by inserting ``or spouse'' 
after ``child''.
    (b) Limitation and Election on Certain Benefits.--Subsection (f) of 
such section is amended--
            (1) by redesignating paragraph (2) as paragraph (4); and

[[Page 128 STAT. 1796]]

            (2) by inserting after paragraph (1) the following new 
        paragraphs:
            ``(2) <<NOTE: Expiration date.>>  Limitation.--The 
        entitlement of an individual to assistance under subsection (a) 
        pursuant to paragraph (9) of subsection (b) because the 
        individual was a spouse of a person described in such paragraph 
        shall expire on the earlier of--
                    ``(A) the date that is 15 years after the date on 
                which the person died; or
                    ``(B) the date on which the individual remarries.
            ``(3) Election on receipt of certain benefits.--A surviving 
        spouse entitled to assistance under subsection (a) pursuant to 
        paragraph (9) of subsection (b) who is also entitled to 
        educational assistance under chapter 35 of this title may not 
        receive assistance under both this section and such chapter, but 
        shall make an irrevocable election (in such form and manner as 
        the Secretary may prescribe) under which section or chapter to 
        receive educational assistance.''.

    (c) Conforming Amendment.--Section 3321(b)(4) of such title is 
amended--
            (1) by striking ``an individual'' and inserting ``a child''; 
        and
            (2) by striking ``such individual's'' each time it appears 
        and inserting ``such child's''.

    (d) <<NOTE: Applicability. 38 USC 3311 note.>>  Effective Date.--The 
amendments made by this section shall apply with respect to a quarter, 
semester, or term, as applicable, commencing on or after January 1, 
2015.
SEC. 702. APPROVAL OF COURSES OF EDUCATION PROVIDED BY PUBLIC 
                        INSTITUTIONS OF HIGHER LEARNING FOR 
                        PURPOSES OF ALL-VOLUNTEER FORCE 
                        EDUCATIONAL ASSISTANCE PROGRAM AND POST-9/
                        11 EDUCATIONAL ASSISTANCE CONDITIONAL ON 
                        IN-STATE TUITION RATE FOR VETERANS.

    (a) In General.--Section 3679 of title 38, United States Code, is 
amended by adding at the end the following new subsection:
    ``(c)(1) Notwithstanding any other provision of this chapter and 
subject to paragraphs (3) through (6), the Secretary shall disapprove a 
course of education provided by a public institution of higher learning 
to a covered individual pursuing a course of education with educational 
assistance under chapter 30 or 33 of this title while living in the 
State in which the public institution of higher learning is located if 
the institution charges tuition and fees for that course for the covered 
individual at a rate that is higher than the rate the institution 
charges for tuition and fees for that course for residents of the State 
in which the institution is located, regardless of the covered 
individual's State of residence.
    ``(2) <<NOTE: Definition.>>  For purposes of this subsection, a 
covered individual is any individual as follows:
            ``(A) <<NOTE: Time period.>>  A veteran who was discharged 
        or released from a period of not fewer than 90 days of service 
        in the active military, naval, or air service less than three 
        years before the date of enrollment in the course concerned.
            ``(B) An individual who is entitled to assistance under 
        section 3311(b)(9) or 3319 of this title by virtue of such 
        individual's relationship to a veteran described in subparagraph 
        (A).

    ``(3) If after enrollment in a course of education that is subject 
to disapproval under paragraph (1) by reason of paragraph (2)(A)

[[Page 128 STAT. 1797]]

or (2)(B) a covered individual pursues one or more courses of education 
at the same public institution of higher learning while remaining 
continuously enrolled (other than during regularly scheduled breaks 
between courses, semesters or terms) at that institution of higher 
learning, any course so pursued by the covered individual at that 
institution of higher learning while so continuously enrolled shall also 
be subject to disapproval under paragraph (1).
    ``(4) It shall not be grounds to disapprove a course of education 
under paragraph (1) if a public institution of higher learning requires 
a covered individual pursuing a course of education at the institution 
to demonstrate an intent, by means other than satisfying a physical 
presence requirement, to establish residency in the State in which the 
institution is located, or to satisfy other requirements not relating to 
the establishment of residency, in order to be charged tuition and fees 
for that course at a rate that is equal to or less than the rate the 
institution charges for tuition and fees for that course for residents 
of the State.
    ``(5) <<NOTE: Waiver authority.>>  The Secretary may waive such 
requirements of paragraph (1) as the Secretary considers appropriate.

    ``(6) <<NOTE: Applicability.>>  Disapproval under paragraph (1) 
shall apply only with respect to educational assistance under chapters 
30 and 33 of this title.''.

    (b) <<NOTE: Applicability. 38 USC 3679 note.>>  Effective Date.--
Subsection (c) of section 3679 of title 38, United States Code (as added 
by subsection (a) of this section), shall apply with respect to 
educational assistance provided for pursuit of a program of education 
during a quarter, semester, or term, as applicable, that begins after 
July 1, 2015.
SEC. 703. EXTENSION OF REDUCTION IN AMOUNT OF PENSION FURNISHED BY 
                        DEPARTMENT OF VETERANS AFFAIRS FOR CERTAIN 
                        VETERANS COVERED BY MEDICAID PLANS FOR 
                        SERVICES FURNISHED BY NURSING FACILITIES.

    Section 5503(d)(7) of title 38, United States Code, is amended by 
striking ``November 30, 2016'' and inserting ``September 30, 2024''.
SEC. 704. EXTENSION OF REQUIREMENT FOR COLLECTION OF FEES FOR 
                        HOUSING LOANS GUARANTEED BY SECRETARY OF 
                        VETERANS AFFAIRS.

    Section 3729(b)(2) of title 38, United States Code, is amended--
            (1) in subparagraph (A)--
                    (A) in clause (iii), by striking ``October 1, 2017'' 
                and inserting ``September 30, 2024''; and
                    (B) in clause (iv), by striking ``October 1, 2017'' 
                and inserting ``September 30, 2024'';
            (2) in subparagraph (B)--
                    (A) in clause (i), by striking ``October 1, 2017'' 
                and inserting ``September 30, 2024''; and
                    (B) in clause (ii), by striking ``October 1, 2017'' 
                and inserting ``September 30, 2024'';
            (3) in subparagraph (C)--
                    (A) in clause (i), by striking ``October 1, 2017'' 
                and inserting ``September 30, 2024''; and
                    (B) in clause (ii), by striking ``October 1, 2017'' 
                and inserting ``September 30, 2024''; and
            (4) in subparagraph (D)--
                    (A) in clause (i), by striking ``October 1, 2017'' 
                and inserting ``September 30, 2024''; and

[[Page 128 STAT. 1798]]

                    (B) in clause (ii), by striking ``October 1, 2017'' 
                and inserting ``September 30, 2024''.
SEC. 705. <<NOTE: 38 USC 703 note.>>  LIMITATION ON AWARDS AND 
                        BONUSES PAID TO EMPLOYEES OF DEPARTMENT OF 
                        VETERANS AFFAIRS.

    In each of fiscal years 2015 through 2024, the Secretary of Veterans 
Affairs shall ensure that the aggregate amount of awards and bonuses 
paid by the Secretary in a fiscal year under chapter 45 or 53 of title 
5, United States Code, or any other awards or bonuses authorized under 
such title does not exceed $360,000,000.
SEC. 706. EXTENSION OF AUTHORITY TO USE INCOME INFORMATION.

    Section 5317(g) of title 38, United States Code, is amended by 
striking ``September 30, 2016'' and inserting ``September 30, 2024''.
SEC. 707. REMOVAL OF SENIOR EXECUTIVES OF THE DEPARTMENT OF 
                        VETERANS AFFAIRS FOR PERFORMANCE OR 
                        MISCONDUCT.

    (a) Removal or Transfer.--
            (1) In general.--Chapter 7 of title 38, United States Code, 
        is amended by adding at the end the following new section:
``Sec. 713. <<NOTE: 38 USC 713.>>  Senior executives: removal 
                based on performance or misconduct

    ``(a) In General.--(1) The Secretary may remove an individual 
employed in a senior executive position at the Department of Veterans 
Affairs from the senior executive position if the Secretary determines 
the performance or misconduct of the individual warrants such removal. 
If the Secretary so removes such an individual, the Secretary may--
            ``(A) remove the individual from the civil service (as 
        defined in section 2101 of title 5); or
            ``(B) in the case of an individual described in paragraph 
        (2), transfer the individual from the senior executive position 
        to a General Schedule position at any grade of the General 
        Schedule for which the individual is qualified and that the 
        Secretary determines is appropriate.

    ``(2) An individual described in this paragraph is an individual 
who--
            ``(A) previously occupied a permanent position within the 
        competitive service (as that term is defined in section 2102 of 
        title 5);
            ``(B) previously occupied a permanent position within the 
        excepted service (as that term is defined in section 2103 of 
        title 5); or
            ``(C) prior to employment in a senior executive position at 
        the Department of Veterans Affairs, did not occupy any position 
        within the Federal Government.

    ``(b) Pay of Transferred Individual.--(1) Notwithstanding any other 
provision of law, including the requirements of section 3594 of title 5, 
any individual transferred to a General Schedule position under 
subsection (a)(2) shall, beginning on the date of such transfer, receive 
the annual rate of pay applicable to such position.
    ``(2) An individual so transferred may not be placed on 
administrative leave or any other category of paid leave during the 
period

[[Page 128 STAT. 1799]]

during which an appeal (if any) under this section is ongoing, and may 
only receive pay if the individual reports for duty. If an individual so 
transferred does not report for duty, such individual shall not receive 
pay or other benefits pursuant to subsection (e)(5).
    ``(c) <<NOTE: Deadline.>>  Notice to Congress.--Not later than 30 
days after removing or transferring an individual from a senior 
executive position under subsection (a), the Secretary shall submit to 
the Committees on Veterans' Affairs of the Senate and House of 
Representatives notice in writing of such removal or transfer and the 
reason for such removal or transfer.

    ``(d) Procedure.--(1) The procedures under section 7543(b) of title 
5 shall not apply to a removal or transfer under this section.
    ``(2)(A) Subject to subparagraph (B) and subsection (e), any removal 
or transfer under subsection (a) may be appealed to the Merit Systems 
Protection Board under section 7701 of title 5.
    ``(B) <<NOTE: Deadline.>>  An appeal under subparagraph (A) of a 
removal or transfer may only be made if such appeal is made not later 
than seven days after the date of such removal or transfer.

    ``(e) Expedited Review by Administrative Judge.--(1) Upon receipt of 
an appeal under subsection (d)(2)(A), the Merit Systems Protection Board 
shall refer such appeal to an administrative judge pursuant to section 
7701(b)(1) of title 5. <<NOTE: Deadline.>>  The administrative judge 
shall expedite any such appeal under such section and, in any such case, 
shall issue a decision not later than 21 days after the date of the 
appeal.

    ``(2) Notwithstanding any other provision of law, including section 
7703 of title 5, the decision of an administrative judge under paragraph 
(1) shall be final and shall not be subject to any further appeal.
    ``(3) In any case in which the administrative judge cannot issue a 
decision in accordance with the 21-day requirement under paragraph (1), 
the removal or transfer is final. <<NOTE: Deadline. Reports.>>  In such 
a case, the Merit Systems Protection Board shall, within 14 days after 
the date that such removal or transfer is final, submit to Congress and 
the Committees on Veterans' Affairs of the Senate and House of 
Representatives a report that explains the reasons why a decision was 
not issued in accordance with such requirement.

    ``(4) The Merit Systems Protection Board or administrative judge may 
not stay any removal or transfer under this section.
    ``(5) <<NOTE: Time period.>>  During the period beginning on the 
date on which an individual appeals a removal from the civil service 
under subsection (d) and ending on the date that the administrative 
judge issues a final decision on such appeal, such individual may not 
receive any pay, awards, bonuses, incentives, allowances, differentials, 
student loan repayments, special payments, or benefits.

    ``(6) To the maximum extent practicable, the Secretary shall provide 
to the Merit Systems Protection Board, and to any administrative judge 
to whom an appeal under this section is referred, such information and 
assistance as may be necessary to ensure an appeal under this subsection 
is expedited.
    ``(f) Relation to Title 5.--(1) The authority provided by this 
section is in addition to the authority provided by section 3592 or 
subchapter V of chapter 75 of title 5.
    ``(2) Section 3592(b)(1) of title 5 does not apply to an action to 
remove or transfer an individual under this section.
    ``(g) Definitions.--In this section:

[[Page 128 STAT. 1800]]

            ``(1) The term `individual' means--
                    ``(A) a career appointee (as that term is defined in 
                section 3132(a)(4) of title 5); or
                    ``(B) any individual who occupies an administrative 
                or executive position and who was appointed under 
                section 7306(a) or section 7401(1) of this title.
            ``(2) The term `misconduct' includes neglect of duty, 
        malfeasance, or failure to accept a directed reassignment or to 
        accompany a position in a transfer of function.
            ``(3) The term `senior executive position' means--
                    ``(A) with respect to a career appointee (as that 
                term is defined in section 3132(a)(4) of title 5), a 
                Senior Executive Service position (as such term is 
                defined in section 3132(a)(2) of title 5); and
                    ``(B) with respect to an individual appointed under 
                section 7306(a) or section 7401(1) of this title, an 
                administrative or executive position.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of such chapter is amended by adding at the end the 
        following new item:

``713. Senior executives: removal based on performance or misconduct.''.

    (b) <<NOTE: 38 USC 713 note.>>  Establishment of Expedited Review 
Process.--
            (1) <<NOTE: Deadline.>>  In general.--Not later than 14 days 
        after the date of the enactment of this Act, the Merit Systems 
        Protection Board shall establish and put into effect a process 
        to conduct expedited reviews in accordance with section 713(d) 
        of title 38, United States Code.
            (2) Inapplicability of certain regulations.--Section 1201.22 
        of title 5, Code of Federal Regulations, as in effect on the day 
        before the date of the enactment of this Act, shall not apply to 
        expedited reviews carried out under section 713(d) of title 38, 
        United States Code.
            (3) Waiver.--The Merit Systems Protection Board may waive 
        any other regulation in order to provide for the expedited 
        review required under section 713(d) of title 38, United States 
        Code.
            (4) Report by merit systems protection board.--Not later 
        than 14 days after the date of the enactment of this Act, the 
        Merit Systems Protection Board shall submit to the Committees on 
        Veterans' Affairs of the Senate and House of Representatives a 
        report on the actions the Board plans to take to conduct 
        expedited reviews under section 713(d) of title 38, United 
        States Code, as added by subsection (a). Such report shall 
        include a description of the resources the Board determines will 
        be necessary to conduct such reviews and a description of 
        whether any resources will be necessary to conduct such reviews 
        that were not available to the Board on the day before the date 
        of the enactment of this Act.

    (c) <<NOTE: Time period. Effective date. 38 USC 713 note.>>  
Temporary Exemption From Certain Limitation on Initiation of Removal 
From Senior Executive Service.--During the 120-day period beginning on 
the date of the enactment of this Act, an action to remove an individual 
from the Senior Executive Service at the Department of Veterans Affairs 
pursuant to section 7543 of title 5, United States Code, may be 
initiated, notwithstanding section 3592(b) of such title, or any other 
provision of law.

[[Page 128 STAT. 1801]]

    (d) <<NOTE: 38 USC 713 note.>>  Construction.--
            (1) <<NOTE: Applicability.>>  In general.--Nothing in this 
        section or section 713 of title 38, United States Code, as added 
        by subsection (a), shall be construed to apply to an appeal of a 
        removal, transfer, or other personnel action that was pending 
        before the date of the enactment of this Act.
            (2) Relation to title 5.--With respect to the removal or 
        transfer of an individual (as that term is defined in such 
        section 713) employed at the Department of Veterans Affairs, the 
        authority provided by such section 713 is in addition to the 
        authority provided by section 3592 or subchapter V of chapter 75 
        of title 5, United States Code.

TITLE <<NOTE: 38 USC 1701 note.>>  VIII--OTHER MATTERS
SEC. 801. APPROPRIATION OF AMOUNTS.

    (a) In General.--There is authorized to be appropriated, and is 
appropriated, to the Secretary of Veterans Affairs, out of any funds in 
the Treasury not otherwise appropriated $5,000,000,000 to carry out 
subsection (b). Such funds shall be available for obligation or 
expenditure without fiscal year limitation.
    (b) Use of Amounts.--The amount appropriated under subsection (a) 
shall be used by the Secretary as follows:
            (1) To increase the access of veterans to care as follows:
                    (A) To hire primary care and specialty care 
                physicians for employment in the Department of Veterans 
                Affairs.
                    (B) To hire other medical staff, including the 
                following:
                          (i) Physicians.
                          (ii) Nurses.
                          (iii) Social workers.
                          (iv) Mental health professionals.
                          (v) Other health care professionals as the 
                      Secretary considers appropriate.
                    (C) To carry out sections 301 and 302, including the 
                amendments made by such sections.
                    (D) To pay for expenses, equipment, and other costs 
                associated with the hiring of primary care, specialty 
                care physicians, and other medical staff under 
                subparagraphs (A), (B), and (C).
            (2) To improve the physical infrastructure of the Department 
        as follows:
                    (A) To maintain and operate hospitals, nursing 
                homes, domiciliary facilities, and other facilities of 
                the Veterans Health Administration.
                    (B) To enter into contracts or hire temporary 
                employees to repair, alter, or improve facilities under 
                the jurisdiction of the Department that are not 
                otherwise provided for under this paragraph.
                    (C) To carry out leases for facilities of the 
                Department.
                    (D) To carry out minor construction projects of the 
                Department.

    (c) Availability.--The amount appropriated under subsection (a) 
shall remain available until expended.
    (d) Report.--
            (1) In general.--Not later than 1 year after the date of the 
        enactment of this Act, the Secretary of Veterans Affairs

[[Page 128 STAT. 1802]]

        shall submit to the appropriate committees of Congress a report 
        on how the Secretary has obligated the amounts appropriated 
        under subsection (a) as of the date of the submittal of the 
        report.
            (2) Appropriate committees of congress defined.--In this 
        subsection, the term ``appropriate committees of Congress'' 
        means--
                    (A) the Committee on Veterans' Affairs and the 
                Committee on Appropriations of the Senate; and
                    (B) the Committee on Veterans' Affairs and the 
                Committee on Appropriations of the House of 
                Representatives.

    (e) Funding Plan.--The Secretary shall submit to Congress a funding 
plan describing how the Secretary intends to use the amounts provided 
under subsection (a).
SEC. 802. VETERANS CHOICE FUND.

    (a) In General.--There is established in the Treasury of the United 
States a fund to be known as the Veterans Choice Fund.
    (b) Administration of Fund.--The Secretary of Veterans Affairs shall 
administer the Veterans Choice Fund established by subsection (a).
    (c) Use of Amounts.--
            (1) In general.--Any amounts deposited in the Veteran Choice 
        Fund shall be used by the Secretary of Veterans Affairs to carry 
        out section 101, including, subject to paragraph (2), any 
        administrative requirements of such section.
            (2) Amount for administrative requirements.--
                    (A) Limitation.--Except as provided by subparagraph 
                (B), of the amounts deposited in the Veterans Choice 
                Fund, not more than $300,000,000 may be used for 
                administrative requirements to carry out section 101.
                    (B) Increase.--The Secretary may increase the amount 
                set forth in subparagraph (A) with respect to the 
                amounts used for administrative requirements if--
                          (i) <<NOTE: Determination.>>  the Secretary 
                      determines that the amount of such increase is 
                      necessary to carry out section 101;
                          (ii) <<NOTE: Reports. Time period.>>  the 
                      Secretary submits to the Committees on Veterans' 
                      Affairs and Appropriations of the House of 
                      Representatives and the Committees on Veterans' 
                      Affairs and Appropriations of the Senate a report 
                      described in subparagraph (C); and
                          (iii) a period of 60 days has elapsed 
                      following the date on which the Secretary submits 
                      the report under clause (ii).
                    (C) Report.--A report described in this subparagraph 
                is a report that contains the following:
                          (i) A notification of the amount of the 
                      increase that the Secretary determines necessary 
                      under subparagraph (B)(i).
                          (ii) The justifications for such increased 
                      amount.
                          (iii) The administrative requirements that the 
                      Secretary will carry out using such increased 
                      amount.

    (d) Appropriation and Deposit of Amounts.--
            (1) In general.--There is authorized to be appropriated, and 
        is appropriated, to the Secretary of Veterans Affairs, out of 
        any funds in the Treasury not otherwise appropriated 
        $10,000,000,000 to be deposited in the Veterans Choice Fund

[[Page 128 STAT. 1803]]

        established by subsection (a). Such funds shall be available for 
        obligation or expenditure without fiscal year limitation, and 
        only for the program created under section 101.
            (2) Availability.--The amount appropriated under paragraph 
        (1) shall remain available until expended.

    (e) Sense of Congress.--It is the sense of Congress that the 
Veterans Choice Fund is a supplement to but distinct from the Department 
of Veterans Affairs' current and expected level of non-Department care 
currently part of Department's medical care budget. Congress expects 
that the Department will maintain at least its existing obligations of 
non-Department care programs in addition to but distinct from the 
Veterans Choice Fund for each of fiscal years 2015 through 2017.
SEC. 803. EMERGENCY DESIGNATIONS.

    (a) In General.--This Act is designated as an emergency requirement 
pursuant to section 4(g) of the Statutory Pay-As-You-Go Act of 2010 (2 
U.S.C. 933(g)).
    (b) Designation in Senate.--In the Senate, this Act is designated as 
an emergency requirement pursuant to section 403(a) of S. Con. Res. 13 
(111th Congress), the concurrent resolution on the budget for fiscal 
year 2010.

    Approved August 7, 2014.

LEGISLATIVE HISTORY--H.R. 3230 (S. 2450):
---------------------------------------------------------------------------

HOUSE REPORTS: No. 113-564 (Comm. of Conference).
CONGRESSIONAL RECORD:
                                                        Vol. 159 (2013):
                                    Oct. 3, considered and passed House.
                                                        Vol. 160 (2014):
                                    June 11, considered and passed 
                                        Senate, amended, in lieu of S. 
                                        2450.
                                    June 18, House concurred in Senate 
                                        amendments with an amendment.
                                    July 30, House agreed to conference 
                                        report.
                                    July 31, Senate agreed to conference 
                                        report.
DAILY COMPILATION OF PRESIDENTIAL DOCUMENTS (2014):
            Aug. 7, Presidential remarks.

                                  <all>