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SECTION 1. SHORT TITLE.

This Act shall be cited as the ''VA State Health-Care Reform Pilot
Programs Act''.

SEC. 2. DEFINITIONS.

For purposes of this Act--
(1) The term ''Department'' means the Department of
Veterans Affairs.
(2) The term ''family'' means the spouse of a veteran or a
child of a veteran as those terms are defined in section 101 of
title 38, United States Code.
(3) The term ''pilot program'' means a program authorized
by section 5(a) of this Act.
(4) The term ''reformed health-care system'' means a State
program which is statutorily established by a State that the
Secretary determines was established to assure that residents
of the State have access to health-care services.
(5) The term ''Secretary'' means the Secretary of Veterans
Affairs.
(6) The term ''veteran'' has meaning given such term in
section 101(2) of title 38, United States Code.

SEC. 3. PILOT PROGRAMS AUTHORITY.

(a) Authority To Conduct Programs.--In up to five States that have
reformed health-care systems, the Secretary may conduct pilot programs
under which the Department may provide health care services, directly
or by contract, to persons identified in subsection (b) on the same or
similar basis as the State plan mandates for residents in the State.
(b) Persons Eligible for Services Under Programs.--Persons eligible
to receive services under a pilot program are any residents of the
State in which the pilot program is being conducted who are--
(1) veterans;
(2) individuals eligible for benefits under section 1713 of
title 38, United States Code; or
(3) members of the family of any veteran who participates
in a pilot program.
(c) Authority To Comply With State Health Plan Requirements.--In
conducting pilot programs, the Secretary may comply with such
requirements of State law applicable to the establishment and operation
of a health plan under a State reform plan, or to functioning as a
participant in, member of, or contractor to, such a health plan, as the
Secretary considers appropriate for application to a department or
agency of the Federal Government.
(d) Catchment Areas.--In conducting pilot programs in a State, the
Secretary may--
(1) conduct the programs in some or all health care
facilities of the Department located in the State; and
(2) establish such catchment areas within the State as the
Secretary determines appropriate.

SEC. 4. CONDITIONS OF PARTICIPATION.

(a) Condition on Establishment of Programs.--The Secretary may
establish and operate a pilot program in a State only after
determining, based on such factors as the Secretary considers relevant
(including the factors referred to in subsection (b)), that, in the
absence of an enrollment option through a Department plan in that
State, the projected workload in one or more Department health care
facilities in the State would decline to a level that--
(1) would threaten to impair the capability of such
facilities to meet one or more assigned mission of such
facilities; or
(2) would result in a deterioration in the quality of the
service delivered by such facilities to an extent that it would
not be reasonable to continue to provide needed services in
such facilities and satisfactory alternative arrangements could
not feasibly be provided.
(b) Factors.--In making a determination under subsection (a), the
Secretary shall consider the following:
(1) The relative universality of coverage provided to State
residents under the State reform plan.
(2) The scope of benefits offered under the plan.
(3) The extent of financing supporting the plan.
(4) The extent to which the State may serve as a model for
the Department in determining how to compete with other health
care providers in other States when Congress enacts National
health care reform.
(5) Such other matters as the Secretary determines
appropriate.
(c) Notice and Wait Requirement.--(1) The Secretary may establish
and operate a pilot program in a State not earlier than 30 days after
submitting to the Committees on Veterans' Affairs of the Senate and the
House of Representatives a report on the pilot program.
(2) Each report submitted under paragraph (1) shall include the
following:
(A) The rationale for proposed participation in the State
reform plan.
(B) A description of the extent to which applicable
provisions of State law specifically accommodate and facilitate
participation of the Department in the State reform plan.
(C) A detailed business plan for the participation of the
Department under the State reform plan.
(D) A description of the actions the Secretary has taken to
consult with veterans on the proposed participation of the
Department in the State reform plan.
(d) Requirement for Regulations.--The Secretary may operate a pilot
program in a State only after prescribing implementing regulations.
(e) Copayments.--(1) Except as provided in paragraph (2), the
Secretary shall require persons receiving health care services under a
pilot program to pay all premiums, copayments, deductibles, and
coinsurance amounts required by State law in the State where the pilot
program is undertaken.
(2) The Secretary may not collect premiums, copayments,
deductibles, and coinsurance amounts under this subsection from the
following individuals:
(A) Any veteran with a service-connected disability.
(B) any veteran whose discharge or release from the active
military, naval or air service was for a disability incurred or
aggravated in the line of duty.
(C) Any veteran who is in receipt of, or who, but for a
suspension pursuant to section 1151 of title 38, United States
Code (or both such a suspension and the receipt of retired
pay), would be entitled to disability compensation, but only to
the extent that such a veteran's continuing eligibility for
such care is provided for in the judgment or settlement
provided for in such section.
(D) Any veteran who is a former prisoner of war.
(E) Any veteran of the Mexican border period or World War
I.
(F) Any veteran who is unable to defray the expenses of
necessary care as determined under section 1722(a) of title 38,
United States Code.

SEC. 5. EXPIRATION OF AUTHORITY.

The authority to conduct pilot programs under this Act shall expire
on December 31, 1997.

SEC. 6. FUNDING.

(a) Revolving Fund.--There is established in the Treasury of the
United States a revolving fund for conducting pilot programs authorized
by section 3(a).
(b) Authorization of Appropriations.--There is authorized to be
appropriated to the revolving fund for fiscal years 1995, 1996, and
1997 such sums as may be necessary to carry out the purposes of this
Act.
(c) Availability of Funds.--(1) Amounts in the revolving fund
established under subsection (a) shall be available without fiscal year
limitation for payment of all expenses necessary to carry out the pilot
programs, including--
(A) expenses of furnishing medical care and services;
(B) expenses of consumer surveys;
(C) expenses of printing, marketing, and advertising
services (including contracts for such services); and
(D) expenses for the acquisition, construction, repair, or
renovation of facilities (including the land on which
facilities are located or to be constructed).
(2) Funds in the revolving fund shall not be available for a major
medical facility project, or a major medical facility lease, under
section 8104(a)(3) of title 38, United States Code, unless specifically
authorized by law.
(d) Collection of Funds.--(1) The Secretary may recover or collect
funds which result from participation by the Department in a pilot
program authorized under section 3(a) for care provided to veterans or
their dependents. The Secretary may recover or collect such funds
(including amounts received as premiums, copayments, deductibles or
third-party reimbursements) from an individual, another agency or
department of the Federal Government, an agency of State or local
government, or a health-care provider, health care plan, insurer, or
other entity.
(2) The Secretary shall, in consultation with the Director of the
Office of Management and Budget, estimate the collection of funds to be
received for services to be provided to veterans by each Department
facility participating in a State pilot program during each fiscal
year. Such estimates shall be based upon and consistent with the higher
of--
(A) the fiscal year baseline for third-party recoveries,
copayments, and other medical collections for the fiscal year
included in the budget submitted to Congress by the President;
or
(B) the fiscal year baseline for such collections for the
fiscal year as reestimated by the Congressional Budget Office.
(3)(A) Amounts collected for services provided to dependents shall
be deposited in the revolving fund established in subsection (a).
(B) Amounts collected for services provided to veterans in excess
of the estimate determined under paragraph (2) shall be deposited in
the revolving fund established under subsection (a).
(C) An amount up to the estimate determined under paragraph (2)
shall be deposited in the Medical-Care Cost Recovery Fund established
under section 1729(g) of title 38, United States Code.

SEC. 7. ADMINISTRATIVE FLEXIBILITY.

(a) Applicability of Notice and Wait Requirement.--The Secretary
may carry out any reorganization necessary to carry out a pilot program
authorized by section 3(a) without regard to the provisions of section
510(b) of title 38, United States Code.
(b) Applicability of Other Provisions of Law.--The Director of a
Department health care facility participating in a pilot project
authorized by section 3(a) may enter into agreements with health care
plans, insurers, health care providers, or with any other entity or
individual to furnish or obtain any health care resource, as that term
is defined in section 8152 of title 38, United States Code, without
regard to the following:
(1) Chapter 7 of the Office of Federal Procurement Policy
Act (41 U.S.C. 410 et. seq.).
(2) Chapter 4 of the Federal Property and Administrative
Services Act of 1949 (41 U.S.C. 251 et seq.).
(3) Subsections (b)(7), (e), (f), (g), and (h) of section 8
of the Small Business Act (15 U.S.C. 637), relating to
certificate of competency, notice, and sole sourcing.
(4) Office of Management and Budget Circular A-76.
(5) Section 8110(c) of title 38, United States Code,
relating to contracting out at Department medical facilities.
(6) Subchapter V of chapter 35 of title 31, United States
Code, relating to Government Accounting Office protests.
(7) Sections 3526 and 3702 of title 31, United States Code,
relating to jurisdiction over Government Accounting Office
protests.
(8) Section 1491 of title 28, United States Code, relating
to protests to the United States Court of Federal Claims.
(9) Section 702 of title 5, United States Code, and section
1346(2) of title 28, United States Code, relating to protests
to United States district courts.
(10) Section 8125 of title 38, United States Code, relating
to local contracts for health care items.
(11) The provisions of law appearing as sections 471
through 544 of title 40, United States Code, for purposes of
the proposal of the Law Revision Counsel of a codification of
Federal law, relating to the authority of the General Services
Administration over leasing and disposal of property.
(12) Section 8122(a)(1) of title 38, United States Code,
relating to out-leasing by the Department.

SEC. 8. MARKETING.

The Secretary may carry out such promotional, advertising, and
marketing activities as the Secretary considers necessary to
effectively establish and operate a health plan pilot program.

SEC. 9. REPORTS.

Not later than November 30 of each of 1995 through 1998, the
Secretary shall submit to the Committees on Veterans' Affairs of the
Senate and the House of Representatives a report on the pilot programs
carried out by the Secretary under this Act.

SEC. 10. SAVINGS PROVISIONS.

(a) Benefits.--The Secretary shall provide the persons referred to
in section 3(b) with all benefits authorized to be provided to such
persons under title 38, United States Code, in accordance with the
terms and conditions applicable to such persons and such benefits,
notwithstanding that such benefits are not provided under the pilot
program.
(b) Utilization of Other Department Facilities.--Department
facilities not participating in pilot programs shall continue to
furnish health care benefits in accordance with the provisions of title
38, United States Code.
Output:
VA State Health-Care Reform Pilot Programs Act - Authorizes the Secretary of Veterans Affairs to conduct pilot programs in up to five States that have reformed health-care systems (a statutorily established system to assure residents access to health-care services) under which the Department of Veterans Affairs may provide, directly or by contract, health-care services on the same or a similar basis as the State plan mandates for residents. Makes eligible for such services veterans, survivors and dependents of disabled veterans or veterans who died in active service, and members of the family of any veteran participating in the pilot program. Outlines pilot program conditions, including a 30-day waiting period after notifying specified congressional committees of the intention to establish the program. Requires the payment of all applicable premiums, copayments, deductibles, and coinsurance payments by program participants. Terminates the authority to conduct the pilot programs as of December 31, 1990.
Establishes a revolving fund and authorizes appropriations to the fund for FY 1995 through 1997 for pilot program purposes. Provides for the collection of funds from program participants. Allows any required administrative reorganization necessary to carry out a pilot program without the required congressional notification and waiting period. Provides for: (1) marketing activities to promote the pilot programs; and (2) required reports.