,,ii #aac? ,,congress #a/ ,session ,s4 #afjd ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,octob] #bi1 #bjac,mr4 ,s&]s introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,vet]ans' ,affairs ,a ,,bill ,to am5d title #ch1 ,unit$ ,/ates ,code1 to exp& & enhance eligibility = heal? c>e & s]vices ?r\gh ! ,dep>tm5t ( ,vet]ans ,affairs1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,vet]ans ,heal? ,c>e ,eligibility ,expansion & ,enhancem5t ,act ( #bjac4 #b4 ,enhancem5t ( nature ( eligibility = c>e ( c]ta9 vet]ans ,section #agaj7;a77#c7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by /rik+ may1 to ! ext5t res\rces & facilities are available & & ins]t+ %all14 #c4 ,requirem5t = enrollm5t 9 pati5t enrollm5t sy/em ( ,dep>tm5t ( ,vet]ans ,affairs ( c]ta9 vet]ans eligible = enrollm5t by law b n curr5tly p]mitt$ to enroll 7a7 ,requirem5t = enrollm5t ,section #agje ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new subsection3 7d7 7#a7 ,! ,secret>y %all provide = ! enrollm5t 9 ! pati5t enrollm5t sy/em ( vet]ans specifi$ 9 p>agraph 7#b7 by n lat] ?an ,decemb] #ca1 #bjad4 7#b7 ,vet]ans specifi$ 9 ?is p>agraph are z foll[s3 7,a7 ,vet]ans ) noncomp5sable s]vice-connect$ disabilities rat$ z z]o p]c5t disabl+ :o-- 7i7 are n o!rwise p]mitt$ to enroll 9 ! sy/em z ( ! date ( ! enactm5t ( ! ,vet]ans ,heal? ,c>e ,eligibility ,expansion & ,enhancem5t ,act ( #bjac2 & 7ii7 z ( ! date ( enrollm5t "u ?is section1 d n h access to heal? insurance except ?r\gh a heal? ex*ange e/abli%$ pursuant to section #acaa ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahjca74 7,b7 ,vet]ans )\t s]vice-connect$ disability :o-- 7i7 are n o!rwise p]mitt$ to enroll 9 ! sy/em z ( ! date ( ! enactm5t ( ! ,vet]ans ,heal? ,c>e ,eligibility ,expansion & ,enhancem5t ,act ( #bjac2 & 7ii7 z ( ! date ( enrollm5t "u ?is section1 d n h access to heal? insurance except ?r\gh a heal? ex*ange e/abli%$ pursuant to section #acaa ( ! ,pati5t ,protection & ,af=dable ,c>e ,act4 7#c7 ,! ,secret>y %all det]m9e :e!r a vet]an does n h access to heal? insurance except ?r\gh a heal? ex*ange = purposes ( p>agraph 7#b7 us+ in=mation obta9$ by ! ,secret>y ( ,heal? & ,human ,s]vices & ! ,secret>y ( ! ,treasury = purposes ( det]m9+ :e!r ! vet]an ma9ta9s m9imum ess5tial cov]age z requir$ by section #ejjj;,a ( ! ,int]nal ,rev5ue ,code ( #aihf & report$ z requir$ by section #fjee ( ! ,int]nal ,rev5ue ,code ( #aihf4 7#d7 ,a vet]an :o1 aft] enroll+ 9 ! pati5t enrollm5t sy/em pursuant to ?is subsection1 obta9s access to heal? insurance o!r ?an ?r\gh a heal? ex*ange %all rema9 enroll$ 9 ! pati5t enrollm5t sy/em not)/&+ obta9+ access to su* heal? insurance4 7#e7 ,a vet]an enroll$ 9 ! pati5t enrollm5t sy/em pursuant to ?is subsection %all ma9ta9 ! priority = c>e ( ! vet]an at ! "t ( enrollm5t unless & until a *ange 9 circum/ances ( ! vet]an results 9 a high] priority = c>e ( ! vet]an "u subsection 7a74 4 7b7 ,public notice ( comm5cem5t ( enrollm5t ,! ,secret>y ( ,vet]ans ,affairs %all publi% 9 ! ,f$]al ,regi/]1 & %all make available to ! public on an ,int]net website ( ! ,dep>tm5t ( ,vet]ans ,affairs1 a notice reg>d+ ! date on :i* vet]ans cov]$ by subsection 7d7 ( section #agje ( title #ch1 ,unit$ ,/ates ,code 7z add$ by subsection 7a7 ( ?is section71 may comm5ce enrollm5t 9 ! pati5t enrollm5t sy/em requir$ by t section4 #d4 ,fur!r ext5sion ( p]iod ( eligibility = heal? c>e = vet]ans ( combat s]vice dur+ c]ta9 p]iods ( ho/ilities & w> ,section #agaj7;e77#c7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 subp>agraph 7,a71 by /rik+ ! date t is five ye>s be=e ! date ( ! enactm5t ( ! ,national ,def5se ,au?orization ,act = ,fiscal ,ye> #bjjh1 aft] a p]iod ( five ye>s & ins]t+ ,janu>y #bg1 #bjjc1 aft] a p]iod ( #aj ye>s2 & 7#b7 9 subp>agraph 7,b71 by /rik+ m ?an five ye>s & all t foll[s & ins]t+ be=e ,janu>y #bh1 #bjjc1 & :o did n enroll 9 ! pati5t enrollm5t sy/em "u section #agje ( ?is title be=e ,janu>y #bh1 #bjjh1 aft] ,janu>y #bg1 #bjah44 #e4 ,relocation & re/atem5t ( limitation on requirem5ts to furni% c]ta9 c>e & s]vices cont+5t on ! availability ( appropriations 7a7 ,relocation & re/atem5t ,section #agjg ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new subsection3 7c7 7#a7 ,! requirem5ts specifi$ 9 p>agraph 7#b7 %all be effective 9 any fiscal ye> only to ! ext5t & 9 ! am\nt provid$ 9 advance 9 appropriations ,acts = su* purposes4 7#b7 ,! requirem5ts specifi$ 9 ?is p>agraph are z foll[s3 7,a7 ,! requirem5t 9 p>agraphs 7#a71 7#b71 & 7#c7 ( section #agaj7;a7 ( ?is title t ! ,secret>y provide hospital c>e & m$ical s]vices4 7,b7 ,! requirem5t 9 section #agaj;,a7a7 ( ?is title t ! ,secret>y provide nurs+ home c>e4 7,c7 ,! requirem5t 9 section #agaj;,b ( ?is title t ! ,secret>y provide a program ( ext5d$ c>e s]vices4 7,d7 ,! requirem5t 9 section #agde ( ?is title t ! ,secret>y provide nurs+ home c>e & prescription m$ic9es to vet]ans ) s]vice-connect$ disabilities 9 ,/ate homes4 4 7b7 ,con=m+ repeal ( sup]s$$ limitation ,section #agaj7;a7 ( su* title is am5d$-- 7#a7 by /rik+ p>agraph 7#d72 & 7#b7 by r$esignat+ p>agraph 7#e7 z p>agraph 7#d74 #f4 ,modification ( det]m9ation ( eligibility ( vet]ans = treatm5t z a l[-income family = purposes ( enrollm5t 9 ! pati5t enrollm5t sy/em ( ! ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,areas ( resid5ce ,! ,secret>y ( ,vet]ans ,affairs %all modify ! areas 9 :i* vet]ans reside z specifi$ = purposes ( det]m9+ :e!r vet]ans qualify = treatm5t z l[-income families = enrollm5t 9 ! pati5t enrollm5t sy/em ( ! ,dep>tm5t ( ,vet]ans ,affairs "u section #agje7;a77#g7 ( title #ch1 ,unit$ ,/ates ,code1 to meet ! requirem5ts z foll[s3 7#a7 ,any area s specifi$ %all be )9 only "o ,/ate4 7#b7 ,any area s specifi$ %all be co-ext5sive ) "o or m c\nties 7or simil> political subdivisions7 9 ! ,/ate conc]n$4 7b7 ,v>iable income ?re%olds ,! ,secret>y %all modify ! ?re%olds = income z specifi$ = purposes ( det]m9+ :e!r vet]ans qualify = treatm5t z l[-income families = enrollm5t 9 ! pati5t enrollm5t sy/em ref]r$ to 9 subsection 7a7 to meet ! requirem5ts z foll[s3 7#a7 ,!re %all be "o income ?re%old = ea* ,/ate1 equal to ! highe/ income ?re%old among ! c\nties )9 su* ,/ate4 7#b7 ,! calculation ( ! highe/ income ?re%old ( a c\nty %all be consi/5t ) ! calculation us$ = purposes ( section #c7;b7 ( ! ,unit$ ,/ates ,h\s+ ,act ( #aicg 7#db ,u4,s4,c4 #adcg;a7b774 7#c7 ,! tim+ & me?odology = implem5t+ any modifications 9 geographic income ?re%olds pursuant to p>agraph 7#a7 %all be det]m9$ by ! ,secret>y 9 su* a mann] z to p]mit ! ,dep>tm5t to build capacity = enroll+ su* additional vet]ans 9 ! pati5t enrollm5t sy/em ( ! ,dep>tm5t z become eligible = enrollm5t z a result ( su* modifications1 except t all requir$ modifications %all be complet$ n lat] ?an five ye>s aft] date ( ! enactm5t ( ?is ,act4 #g4 ,contract+ = heal? c>e 7a7 ,use ( capitation-,bas$ res\rce allocation 9 entry into contracts ,9 ent]+ into contracts = ! furni%+ ( heal? c>e s]vices "u ! laws adm9i/]$ by ! ,secret>y ( ,vet]ans ,affairs 7includ+ "u ?is ,act & ! am5dm5ts made by ?is ,act71 ! ,secret>y %all use ! capitation-bas$ res\rce allocation model ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7b7 ,priority = contracts ) c]ta9 entities ,9 ent]+ into contracts = ! furni%+ ( heal? c>e s]vices "u ! laws adm9i/]$ by ! ,secret>y1 ! ,secret>y %all af=d a priority = entry into contracts = ,f$]ally ,qualifi$ ,heal? ,c5t]s 7,f,q,h,cs7 & ,community ,heal? ,c5t]s 7,c,h,cs71 :5ev] appropriate4 7c7 ,be/ practices ,! ,secret>y %all modify ! guidance ( ! ,dep>tm5t ( ,vet]ans ,affairs on contracts = heal? c>e s]vices 9 ord] to provide = ! incorporation into su* contracts ( /&>diz$ requirem5ts = su* be/ practices "u su* contracts1 includ+ ! foll[+3 7#a7 ,requirem5ts t contracts provide ! ,dep>tm5t on a regul> basis in=mation on s*$ul+ & appe>ance = appo9tm5ts = heal? c>e on a p]-pati5t basis4 7#b7 ,su* o!r be/ practices requirem5ts z ! ,secret>y consid]s appropriate4