#aadth ,,congress #b;d ,session ,h4 ,r4 #cihi ,,an ,,act ,to amend title #ch1 ,united ,states ,code1 to improve the process for determining the eligibility of caregivers of veterans to certain benefits administered by the ,secretary of ,veterans ,affairs1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,support ,our ,military ,caregivers ,act4 #b4 ,external clinical review of denied applications by caregivers of veterans 7a7 ,in general ,section #agbj;,g of title #ch1 ,united ,states ,code1 is amended-- 7#a7 by redesignating subsections 7d7 and 7e7 as subsections 7e7 and 7f71 respectively2 and 7#b7 by inserting after subsection 7c7 the following new subsection 7d73 7d7 ,external clinical review of applications 7#a7 ,using amounts otherwise appropriated to carry out this section1 an individual may elect to have an independent contractor described in paragraph 7#b7 perform an external clinical review of any of the following3 7,a7 ,the denial by the ,secretary of an application by an individual to be a caregiver or family caregiver eligible for the program of comprehensive assistance administered by the ,secretary pursuant to this section4 7,b7 ,with respect to such an application that the ,secretary has granted1 a determination by the ,secretary of the level or amount of personal care services that a veteran requires4 7,c7 ,a request by a caregiver or family caregiver for a reconsideration of the level or amount of personal care services that a veteran requires based on changes to the health or abilities of the veteran occurring since the ,secretary granted such an application4 7,d7 ,the revocation by the ,secretary of assistance administered by the ,secretary pursuant to this section4 7#b7 ,an independent contractor described in this paragraph is an independent contractor that-- 7,a7 is awarded a contract by the ,secretary to carry out this section pursuant to full and open competition under the ,federal ,acquisition ,regulation2 7,b7 has no direct or indirect financial relationship with any non-,department provider of services to caregivers and family caregivers pursuant to this title2 7,c7 has not otherwise conducted an external clinical review of benefits administered by the ,secretary pursuant to this title other than this section2 7,d7 has sufficient training and expertise in medical science and other appropriate health1 educational1 and vocational training and legal matters to perform the reviews described in paragraph 7#a72 and 7,e7 employs a panel of physicians or other appropriate health care professionals who do not provide health care to the individual who makes an election under paragraph 7#a74 7#c7 ,each external clinical review conducted pursuant to paragraph 7#a7 shall-- 7,a7 be based on applicable information included in the application for assistance described in such paragraph1 including clinical expertise1 medical1 technical1 and scientific evidence2 7,b7 include an opportunity for both the individual who elects for such review and1 to the extent possible1 the veteran for whom care is being provided to offer opinions and supporting data as to the level of care required2 and 7,c7 include a review of the initial clinical review of such veteran and any other review made by the ,secretary4 7#d7 ,in carrying out the external clinical reviews pursuant to paragraph 7#a71 the independent contractor shall1 as determined appropriate by the ,secretary-- 7,a7 collect and maintain information required2 and 7,b7 share such information with the ,secretary4 7#e7 ,the ,secretary shall take into account1 but is not bound by1 any determination made by the independent contractor pursuant to paragraph 7#a7 in determining the final decision with respect to the application for assistance4 ,the ,secretary may make a final decision that is contrary to such a determination if the ,secretary includes clinically supported documentation with the decision4 7#f7 ,the ,secretary shall ensure that each external clinical review conducted by the independent contractor pursuant to paragraph 7#a7 is completed and the ,department is notified in writing of the results of the review by not later than #abj days after the date on which the individual makes the election under such paragraph4 ,not later than #cj days after the delivery of the determination recommended by the independent contractors1 the ,secretary shall ensure that the veteran and the individual making the election under such paragraph is notified in writing of the final decision of the ,secretary4 ,in accordance with paragraph 7#e71 such notification shall include an explanation of the recommended decision1 a discussion of the facts and applicable regulations1 and an explanation of the clinical rationale for the final decision4 7#g7 ,the ,secretary shall notify individuals who submit an application to be a caregiver or family caregiver eligible for the program of comprehensive assistance administered by the ,secretary pursuant to this section of the ability of the individual to make an election under paragraph 7#a74 7#h7 ,nothing in this subsection may be construed to affect claims made by veterans for disability compensation under chapter #aa of this title4 4 7b7 ,application ,the amendments made by subsection 7a7 shall apply with respect to elections under subsection 7d7 of section #agbj;,g of title #ch1 ,united ,states ,code1 as added by subsection 7a77#b71 that are for applications or revocations for assistance for caregivers and family caregivers pursuant to such section for which the ,secretary of ,veterans ,affairs has not made a final decision as of the date of the enactment of this ,act4 #c4 ,process to determine eligibility for caregivers of veterans 7a7 ,directives ,the ,secretary of ,veterans ,affairs shall issue directives regarding the policies1 procedures1 and operational requirements for the ,family ,caregiver ,program1 including with respect to determining the eligibility of an individual to participate in the ,family ,caregiver ,program4 7b7 ,,gao ,report ,the ,comptroller ,general of the ,united ,states shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report on the processes of the ,secretary of ,veterans ,affairs with respect to-- 7#a7 determining the eligibility of an individual to participate in the ,family ,caregiver ,program2 7#b7 adjudicating appeals to such determinations2 and 7#c7 the periodic eligibility reevaluation of an individual participating in such program and the communication of any changes as a result of such reevaluations to the veteran and caregiver4 7c7 ,family ,caregiver ,program defined ,in this section1 the term ,family ,caregiver ,program either the program of comprehensive assistance for family caregivers or the program of general caregiver support services established by section #agbj;,g of title #ch1 ,united ,states ,code4 #d4 ,modification to limitation on awards and bonuses ,section #gje of the ,veterans ,access1 ,choice1 and ,accountability ,act of #bjad 7,public ,law #aac-adf2 #ch ,u4,s4,c4 #gjc note7 is amended to read as follows3 #gje4 ,limitation on awards and bonuses paid to employees of ,department of ,veterans ,affairs ,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 #de or #ec of title #e1 ,united ,states ,code1 or any other awards or bonuses authorized under such title or title #ch1 ,united ,states ,code1 does not exceed the following amounts3 7#a7 ,with respect to each of fiscal years #bjag through #bjba1 #bcj1jjj1jjj4 7#b7 ,with respect to each of fiscal years #bjbb through #bjbd1 #cfj1jjj1jjj4 4 ,passed the ,house of ,representatives ,may #bc1 #bjaf4;,clerk4