,i  #aad? ,,congress  #b;d ,session  ,h4
 ,r4 #deia  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,febru>y #bc1 #bjaf   
,mr4 ,mill] ( ,florida introduc$ !      
foll[+ bill2 :i* 0 ref]r$ to !          
,committee on ,vet]ans' ,affairs  ,a    
,,bill  ,to am5d title #ch1 ,unit$      
,/ates ,code1 to au?orize ! ,secret>y ( 
,vet]ans ,affairs to ent] into agreem5ts
 ) c]ta9 heal? c>e provid]s to furni%   
hospital c>e1 m$ical s]vices1 & ext5d$  
c>e to vet]ans4  #a4 ,%ort title ,?is   
,act may be cit$ z ! ,dep>tm5t (        
,vet]ans ,affairs ,pur*as$ ,heal? ,c>e  
,/reaml9+ & ,mod]nization ,act4  #b4    
,agreem5ts  7a7 ,9 g5]al ,sub*apt] ,i ( 
*apt] #ag ( title #ch1 ,unit$ ,/ates    
,code1 is am5d$ by ins]t+ aft] section  
#agjc ! foll[+ new section3  #agjc;,a4  
,vet]ans ,c>e ,agreem5ts ) c]ta9 heal?  
c>e provid]s  7a7 ,vet]ans ,c>e         
,agreem5ts  7#a7 ,9 addition to furni%+ 
hospital c>e1 m$ical s]vices1 or ext5d$ 
c>e "u ?is *apt] at facilities ( !      
,dep>tm5t or "u contracts or %>+        

agreem5ts ent]$ into pursuant to        
provisions ( law o!r ?an ?is section1 ! 
,secret>y may furni% su* c>e & s]vices  
to eligible vet]ans ?r\gh ! use (       
agreem5ts ent]$ into "u ?is section by !
 ,secret>y ) eligible provid]s4  7#b7 ,!
 ,secret>y may ent] into ,vet]ans ,c>e  
,agreem5ts "u ?is section ) eligible    
provid]s to furni% hospital c>e1 m$ical 
s]vices1 & ext5d$ c>e to vet]ans :om !  
,secret>y det]m9es t furni%+ su* c>e &  
s]vices at facilities ( ! ,dep>tm5t or  
"u contracts or %>+ agreem5ts "u        
provisions ( law o!r ?an ?is section is 
impracticable or inadvisable because ( !
 m$ical condition ( ! vet]an1 ! travel  
involv$1 or ! nature ( ! c>e or s]vices 
requir$1 or a comb9ation ( su* factors4 
7b7 ,vet]an eligibility ,eligibility ( a
 vet]an = c>e & s]vices "u ?is section  
%all be det]m9$ z if su* c>e or s]vices 
7 furni%$ 9 a facility ( ! ,dep>tm5t1 & 
provisions ( ?is title applicable to    
vet]ans receiv+ su* c>e & s]vices 9 a   
facility ( ! ,dep>tm5t %all apply to    

vet]ans receiv+ c>e & s]vices "u ?is    
section4  7c7 ,provid] eligibility      
,subject to ! c]tification process      
pursuant to subsection 7d77#a71 a       
provid] ( hospital c>e1 m$ical s]vices1 
or ext5d$ c>e is eligible to ent] into a
 ,vet]ans ,c>e ,agreem5t "u ?is section 
if ! ,secret>y det]m9es t ! provid]     
meets ea* ( ! foll[+ crit]ia3  7#a7 ,!  
gross annual rev5ue ( ! provid] 9 ! ye> 
prec$+ ! ye> 9 :i* ! provid] ent]s into 
! ,vet]ans ,c>e ,agreem5t does n exce$  
#aa1jjj1jjj 7z adju/$ 9 a mann] simil>  
to am\nts adju/$ pursuant to section    
#ecab ( ?is title74  7#b7 ,! provid]    
does n o!rwise provide su* c>e or       
s]vices to pati5ts pursuant to a        
contract ent]$ into ) a dep>tm5t or     
ag5cy ( ! ,f$]al ,gov]nm5t4  7#c7 ,!    
provid] is-- 7,a7 a provid] ( s]vices t 
has enroll$ & ent]$ into a provid]      
agreem5t "u section #ahff7;a7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#acie;cc7a772  7,b7 a physician or      
suppli] t has enroll$ & ent]$ into a    

p>ticipation agreem5t "u section        
#ahdb7;h7 ( su* ,act 7#db ,u4,s4,c4     
#acieu7h772  7,c7 a provid] ( items &   
s]vices receiv+ paym5t "u a ,/ate plan  
"u title ,,xix ( su* ,act 7#db ,u4,s4,c4
 #acif et seq47 or a waiv] ( su* a plan2
  7,d7 an ,ag+ & ,disability ,res\rce   
,c5t]1 an area ag5cy on ag+1 or a ,/ate 
ag5cy 7z def9$ 9 section #ajb ( ! ,old] 
,am]icans ,act ( #aife 7#db ,u4,s4,c4   
#cjjb772 or  7,e7 a c5t] = indep5d5t    
liv+ 7z def9$ 9 section #gjb ( !        
,rehabilitation ,act ( #aigc 7#bi       
,u4,s4,c4 #gif;a774  7#d7 ,any          
additional crit]ia det]m9$ appropriate  
by ! ,secret>y4  7d7 ,provid]           
c]tification  7#a7 ,! ,secret>y %all    
e/abli% a process = ! c]tification (    
eligible provid]s to ent] into ,vet]ans 
,c>e ,agreem5ts "u ?is section t %all1  
at a m9imum1 set =? ! foll[+3  7,a7     
,proc$ures = ! submission ( applications
 = c]tification & deadl9es = actions    
tak5 by ! ,secret>y ) respect to su*    
applications4  7,b7 ,/&>ds & proc$ures =

 ! approval & d5ial ( c]tifications & ! 
revocation ( c]tifications4  7,c7       
,proc$ures = assess+ eligible provid]s  
bas$ on ! risk ( fraud1 wa/e1 & abuse ( 
su* provid]s simil> to ! level ( scre5+ 
"u section #ahff7;j77#b77;,b7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#acie7;j77#b77;,b77 & ! /&>ds set =? "u 
section #i4ajd ( title #dh1 ,code (     
,f$]al ,regulations1 or any successor   
regulation4  7,d7 ,requirem5t = d5ial or
 revocation ( c]tification if !         
,secret>y det]m9es t ! o!rwise eligible 
provid] is--  7i7 exclud$ f p>ticipation
 9 a ,f$]al heal? c>e program 7z def9$ 9
 section #aabh;,b7f7 ( ! ,social        
,security ,act 7#db ,u4,s4,c4           
#acbj;a-#g;b7f777 "u section #aabh or   
#aabh;,a ( ! ,social ,security ,act 7#db
 ,u4,s4,c4 #acbj;a-#g & #acbj;a-#g;a72  
or  7ii7 id5tifi$ z an exclud$ s\rce on 
! li/ ma9ta9$ 9 ! ,sy/em = ,aw>d        
,managem5t1 or any successor sy/em4     
7,e7 ,proc$ures by :i* a provid] ^:     
c]tification is d5i$ or revok$ "u !     

proc$ures e/abli%$ "u ?is subsection w  
be id5tifi$ z an exclud$ s\rce on ! li/ 
ma9ta9$ 9 ! ,sy/em = ,aw>d ,managem5t1  
or successor sy/em1 if ! ,secret>y      
det]m9es t su* exclusion is appropriate4
  7#b7 ,to ! ext5t practicable1 !       
,secret>y %all e/abli% ! proc$ures "u   
p>agraph 7#a7 9 a mann] t takes into    
acc\nt any c]tification process adm9i/]$
 by ano!r dep>tm5t or ag5cy ( ! ,f$]al  
,gov]nm5t t an eligible provid] has     
complet$ by reason ( be+ a provid]      
describ$ 9 any ( subp>agraphs 7,a7 ?r\gh
 7,e7 ( subsection 7c77#c74  7e7 ,t]ms (
 ,agreem5ts ,! ,secret>y %all ensure t  
ea* ,vet]ans ,c>e ,agreem5t include     
provisions requir+ ! eligible provid] to
 d ! foll[+3  7#a7 ,to accept paym5t =  
c>e & s]vices furni%$ "u ?is section at 
rates e/abli%$ by ! ,secret>y = purposes
 ( ?is section1 :i* %all be1 to ! ext5t 
practicable--  7,a7 ! rates paid by !   
,unit$ ,/ates = su* c>e to provid]s (   
s]vices & suppli]s "u ! ,m$ic>e program 
"u title ,,xviii ( ! ,social ,security  

,act 7#db ,u4,s4,c4 #acie et seq472     
7,b7 ! rates paid by ! ,unit$ ,/ates    
pursuant to ! ,alaska ,fee ,s*$ule ( !  
,dep>tm5t ( ,vet]ans ,affairs2  7,c7 !  
rates paid by ! ,unit$ ,/ates pursuant  
to an ,all-,pay] ,model ,agreem5t "u !  
,social ,security ,act2 or  7,d7 ! rates
 paid by ! ,unit$ ,/ates 9 a highly     
rural area pursuant to section          
#aja7;d77#b77;,b77ii77,i7 ( ! ,vet]ans  
,access1 ,*oice1 & ,acc\ntability ,act (
 #bjad 7#ch ,u4,s4,c4 #agja note74  7#b7
 ,to accept paym5t "u p>agraph 7#a7 z   
paym5t 9 full = c>e & s]vices furni%$ "u
 ?is section & to n seek any paym5t =   
su* c>e & s]vices f ! recipi5t ( su*    
c>e4  7#c7 ,to furni% "u ?is section    
only ! c>e & s]vices au?oriz$ by !      
,dep>tm5t "u ?is section unless !       
eligible provid] receives prior writt5  
cons5t f ! ,dep>tm5t to furni% c>e &    
s]vices outside ! scope ( su*           
au?orization4  7#d7 ,to bill ! ,dep>tm5t
 = c>e & s]vices furni%$ "u ?is section 
9 accordance ) a me?odology e/abli%$ by 

! ,secret>y = purposes ( ?is section4   
7#e7 ,n to seek to recov] or collect f a
 heal?-plan contract or ?ird p>ty 7z ^? 
t]ms are def9$ 9 section #agbi ( ?is    
title7 = any c>e or s]vices = :i* paym5t
 is made by ! ,dep>tm5t "u ?is section4 
7#f7 ,to provide m$ical records =       
vet]ans furni%$ c>e & s]vices "u ?is    
section to ! ,dep>tm5t 9 a timeframe &  
=mat specifi$ by ! ,secret>y = purposes 
( ?is section1 except ! ,secret>y may n 
require t any paym5t by ! ,secret>y to !
 eligible provid] be cont+5t on su*     
provision ( m$ical records4  7#g7 ,to   
meet o!r su* t]ms & conditions1 includ+ 
quality ( c>e assurance /&>ds1 z !      
,secret>y may specify = purposes ( ?is  
section4  7f7 ,exclusion ( c]ta9 ,f$]al 
contract+ provisions  7#a7 ,not)/&+ any 
o!r provision ( law1 ! ,secret>y may    
ent] into a ,vet]ans ,c>e ,agreem5t us+ 
proc$ures o!r ?an competitive proc$ures4
  7#b7  7,a7 ,except z provid$ 9        
subp>agraph 7,b7 & unless o!rwise       
provid$ 9 ?is section1 an eligible      

provid] t ent]s into a ,vet]ans ,c>e    
,agreem5t "u ?is section is n subject   
to1 9 ! c>ry+ out ( ! agreem5t1 any     
provision ( law t provid]s ( s]vices &  
suppli]s "u ! orig9al ,m$ic>e           
fee-=-s]vice program "u p>ts ,a & ,b (  
title ,,xviii ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acie et seq47 or !     
,m$icaid program "u title ,,xix ( su*   
,act 7#db ,u4,s4,c4 #acif et seq47 are n
 subject to4  7,b7 ,9 addition to !     
provisions ( laws cov]$ by subp>agraph  
7,a71 an eligible provid] %all be       
subject to ! foll[+ provisions ( law3   
7i7 ,any applicable law reg>d+          
integrity1 e?ics1 or fraud1 or t subject
 a p]son to civil or crim9al p5alties4  
7ii7 ,section #dca ( title #ah4  7iii7  
,section #aceb ( title #ca1 except = !  
fil+ requirem5ts "u subsection 7b7 ( su*
 section4  7iv7 ,section #dgje or #dgab 
( title #da1 & any o!r applicable law   
reg>d+ ! protection ( :i/lebl[]s4  7v7  
,section #dgjf7;d7 ( title #da4  7vi7   
,title ,,vii ( ! ,civil ,rights ,act (  

#aifd 7#db ,u4,s4,c4 #bjjj;e et seq47 to
 ! same ext5t z su* title applies )     
respect to ! eligible provid] 9 provid+ 
c>e or s]vices ?r\gh an agreem5t or     
arrangem5t o!r ?an "u a ,vet]ans ,c>e   
,agreem5t4  7,c7 ,an eligible provid] t 
receives a paym5t f ! ,f$]al ,gov]nm5t  
pursuant to a ,vet]ans ,c>e ,agreem5t   
%all n be treat$ z a ,f$]al contractor  
or subcontractor by ! ,(fice ( ,f$]al   
,contract ,compliance ,programs ( !     
,dep>tm5t ( ,labor bas$ on ! "w p]=m$ or
 actions tak5 by su* eligible provid] t 
result$ 9 ! receipt ( su* paym5ts4  7g7 
,t]m9ation ( ,vet]ans ,c>e agreem5t     
7#a7 ,an eligible provid] may t]m9ate a 
,vet]ans ,c>e ,agreem5t ) ! ,secret>y "u
 ?is section at su* "t & ^u su* notice  
to ! ,secret>y z ! ,secret>y may specify
 = purposes ( ?is section4  7#b7 ,!     
,secret>y may t]m9ate a ,vet]ans ,c>e   
,agreem5t ) an eligible provid] "u ?is  
section at su* "t & ^u su* notice to !  
eligible provid] z ! ,secret>y may      
specify = ! purposes ( ?is section1 if !

 ,secret>y--  7,a7 det]m9es t ! eligible
 provid] fail$ to comply ) ! provisions 
( ! agreem5t or ?is section or o!r      
applicable provision ( law2  7,b7 makes 
a revocation pursuant to subsection     
7d77#a77d72  7,c7 asc]ta9s t ! eligible 
provid] has be5 convict$ ( a felony or  
o!r s]i\s (f5se "u ,f$]al or ,/ate law &
 det]m9es t ! cont9u$ p>ticipation ( !  
eligible provid] w\ld be detrim5tal to !
 be/ int]e/s ( vet]ans ( ! ,dep>tm5t2 or
  7,d7 det]m9es t x is reasonable to    
t]m9ate ! agreem5t bas$ on ! heal? c>e  
ne$s ( vet]ans4  7h7 ,duration2 m&atory 
reviews  7#a7 ,ea* ,vet]ans ,c>e        
,agreem5t ent]$ into "u ?is section %all
 be = a two-ye> p]iod unless ! ,secret>y
 ext5ds ! agreem5t pursuant to p>agraph 
7#b77;,b74  7#b7  7,a7 ,dur+ ! #ahj-;day
 p]iod beg9n+ #edj days aft] ! date on  
:i* a ,vet]ans ,c>e ,agreem5t is ent]$  
into or r5ew$1 ! ,secret>y %all review !
 agreem5t to det]m9e :e!r x is feasible 
& advisable to in/ead furni% ! hospital 
c>e1 m$ical s]vices1 or ext5d$ c>e      

furni%$ "u ! agreem5t at facilities ( ! 
,dep>tm5t or ?r\gh contracts or %>+     
agreem5ts ent]$ into "u au?orities o!r  
?an ?is section4  7,b7 ,if ! ,secret>y  
det]m9es "u subp>agraph 7,a7 t x is n   
feasible & advisable to in/ead furni%   
hospital c>e1 m$ical s]vices1 or ext5d$ 
c>e furni%$ "u a ,vet]ans ,c>e ,agreem5t
 at facilities ( ! ,dep>tm5t or ?r\gh   
contracts or %>+ agreem5ts ent]$ into "u
 au?orities o!r ?an ?is section1 !      
,secret>y--  7i7 %all prep>e a writt5   
memor&um ( su* det]m9ation2 &  7ii7 may 
r5ew su* agreem5t4  7i7 ,disputes  7#a7 
,! ,secret>y %all e/abli% adm9i/rative  
proc$ures = eligible provid]s ) :i* !   
,secret>y has ent]$ into a ,vet]ans ,c>e
 ,agreem5t to pres5t any dispute aris+  
"u or relat$ to ! agreem5t4  7#b7 ,be=e 
us+ any dispute resolution me*anism "u  
*apt] #ga ( title #da ) respect to a    
dispute aris+ "u a ,vet]ans ,c>e        
,agreem5t "u ?is section1 an eligible   
provid] mu/ fir/ exhau/ ! adm9i/rative  
proc$ures e/abli%$ by ! ,secret>y "u    

p>agraph 7#a74  7j7 ,annual reports ,n  
lat] ?an ,octob] #a ( ! ye> foll[+ !    
fiscal ye> 9 :i* ! ,secret>y fir/ ent]s 
into a ,vet]ans ,c>e ,agreem5t1 & ea*   
ye> !reaft]1 ! ,secret>y %all submit to 
! appropriate congressional committees  
an annual report t includes--  7#a7 a   
li/ ( all ,vet]ans ,c>e ,agreem5ts ent]$
 into z ( ! date ( ! report2 &  7#b7    
summ>ies ( ea* det]m9ation made by !    
,secret>y "u subsection 7h77#b7 dur+ !  
fiscal ye> cov]$ by ! report4  7k7      
,quality ( c>e ,9 c>ry+ out ?is section1
 ! ,secret>y %all use ! quality ( c>e   
/&>ds set =? or us$ by ! ,c5t]s =       
,m$ic>e  ,m$icaid ,s]vices4  7l7        
,delegation ,! ,secret>y may delegate ! 
au?ority to ent] into or t]m9ate a      
,vet]ans ,c>e ,agreem5t1 or to make a   
det]m9ation describ$ 9 subsection       
7h77#b71 at a level n bel[ ! ,assi/ant  
,deputy ,"u ,secret>y = ,heal? =        
,community ,c>e4  7m7 ,sunset ,!        
,secret>y may n ent] into or r5ew a     
,vet]ans ,c>e ,agreem5t "u ?is section  

aft] ! date t is five ye>s aft] !       
enactm5t ( ?is ,act4  7n7 ,def9itions ,9
 ?is section3 7#a7 ,! t]m appropriate   
congressional committees means--  7,a7 !
 ,committees on ,vet]ans' ,affairs ( !  
,h\se ( ,repres5tatives & ! ,s5ate2 &   
7,b7 ! ,committees on ,appropriations ( 
! ,h\se ( ,repres5tatives & ! ,s5ate4   
7#b7 ,! t]m eligible provid] means a    
provid] ( hospital c>e1 m$ical s]vices1 
or ext5d$ c>e t ! ,secret>y det]m9es is 
eligible to ent] into ,vet]ans ,c>e     
,agreem5ts "u subsection 7c74  7#c7 ,!  
t]m ,vet]ans ,c>e ,agreem5t means an    
agreem5t ent]$ into by ! ,secret>y ) an 
eligible provid] "u subsection 7a77#a74 
4  7b7 ,cl]ical am5dm5t ,! table (      
sections at ! beg9n+ ( *apt] #ag ( su*  
title is am5d$ by ins]t+ aft] ! item    
relat$ to section #agjc ! foll[+ new    
item3  #agjc;,a4 ,vet]ans ,c>e          
,agreem5ts ) c]ta9 heal? c>e provid]s4  
4  7c7 ,regulations ,n lat] ?an "o ye>  
aft] ! date ( ! enactm5t ( ?is ,act1 !  
,secret>y ( ,vet]ans ,affairs %all      

prescribe int]im f9al regulations to    
implem5t section #agjc;,a ( title #ch1  
,unit$ ,/ates ,code1 z add$ by          
subsection 7a71 & publi% su* regulations
 9 ! ,f$]al ,regi/]4