,i  #aadth ,,congress  #ast ,session    
,h4 ,r4 #cihi  ,,in ,,the ,,house ,,of  
,,representatives  ,november #e1 #bjae  
,ms4 ,stefanik introduced the following 
bill2 which was referred to the         
,committee on ,veterans' ,affairs  ,a   
,,bill  ,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 ,affairs4  #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 benefits 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 benefits 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 benefits described in   
such paragraph1 including clinical      
expertise1 medical1 technical1 and      
scientific evidence2  7,b7 include an   
opportunity for the individual who      
elects for such review to provide the   
opinions of the individual and the      
veteran for whom care is provided2 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 determination made by the     
independent contractor pursuant to      
paragraph 7#a7 shall be final4  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     
individual 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 ,such notification shall    
include an explanation of the decision1 
a discussion of the facts and applicable
 regulations1 and an explanation of the 
clinical rationale for the decision4    
7#g7 ,the ,secretary shall notify       
individuals who submit an application to
 be a caregiver or family caregiver     
eligible for benefits 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  7#a7 ,in general ,except 

as provided by paragraph 7#b71 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     
benefits by 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  7#b7 ,special rule ,a caregiver  
or family caregiver may make an election
 for an external clinical review under  
subsection 7d77#a77;,c7 of section      
#agbj;,g of title #ch1 ,united ,states  
,code1 as added by subsection 7a77#b71  
regardless of whether the ,secretary of 
,veterans ,affairs made the final       
decision with respect to the application
 for benefits by the caregiver or family
 caregiver before the date of the       
enactment of this ,act4