,i  #aae? ,,congress  #a/ ,session  ,h4 
,r4 #ddeg  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,novemb] #ba1         
#bjag,mr4 ,lamborn 7= himself1 ,mr4     
,mead[s1 & ,mr4 ,franks ( ,arizona7     
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,vet]ans' ,affairs1 & 9
 addition to ! ,committees on ,ways &   
,means1 ,ov]sight & ,gov]nm5t ,re=m1    
,en]gy & ,comm]ce1 & ,arm$ ,s]vices1 = a
 p]iod to be subsequ5tly det]m9$ by !   
,speak]1 9 ea* case = consid]ation ( su*
 provisions z fall )9 ! jurisdiction ( !
 committee conc]n$  ,a ,,bill  ,to am5d 
title #ch1 ,unit$ ,/ates ,code1 to      
e/abli% ! ,vet]ans ,acc\ntable ,c>e     
,organization & to provide vet]ans      
access to private heal? insurance plans1
 & = o!r purposes4  #a4 ,%ort title2    
table ( cont5ts  ,?is ,act may be cit$ z
 ! ,vet]ans ,emp[]m5t ,act4  #b4        
,e/abli%m5t ( ,vet]ans ,acc\ntable ,c>e 
,organization  7a7 ,e/abli%m5t  7#a7 ,9 
g5]al ,*apt] #c ( title #ch1 ,unit$     
,/ates ,code1 is am5d$ by add+ at ! end 

! foll[+ new section3  #cbc4 ,vet]ans   
,acc\ntable ,c>e ,organization  7a7     
,e/abli%m5t  7#a7 ,!re is e/abli%$ !    
,vet]ans ,acc\ntable ,c>e ,organization 
79 ?is section ref]r$ to z !            
,corporation74  7#b7 ,! ,corporation is 
a f$]ally *>t]$ corporation4  7#c7 ,!   
,corporation %all be incorporat$ &      
domicil$ 9 ! ,di/rict ( ,columbia1 or   
ano!r ne>by ,/ate1 z det]m9$ by ! bo>d (
 directors ( ! ,corporation4  7#d7 ,!   
,corporation %all be a *>itable &       
nonpr(it corporation4  7#e7 ,except z   
o!rwise provid$1 ! ,corporation %all h  
p]petual exi/5ce4  7b7 ,purpose ,!      
purpose ( ! ,corporation is to furni%   
high-quality hospital c>e1 m$ical       
s]vices1 & o!r heal? c>e 7exclud+ nurs+ 
home c>e & domicili>y c>e7 to           
individuals eligible = su* c>e & s]vices
 "u laws adm9i/]$ by ! ,secret>y4  7c7  
,bo>d ( ,directors  7#a7 ,! p[]s ( !    
,corporation %all be ve/$ 9 a ,bo>d (   
,directors t gov]ns ! ,corporation4     
7#b7 ,! ,bo>d ( ,directors %all be      

compos$ ( ! foll[+ memb]s3  7,a7 ,!     
,secret>y ( ,vet]ans ,affairs4  7,b7    
,two memb]s appo9t$ by ! ,speak] ( !    
,h\se ( ,repres5tatives1 at lea/ "o (   
:om %all be a vet]an4  7,c7 ,two memb]s 
appo9t$ by ! ,m9ority ,lead] ( ! ,h\se (
 ,repres5tatives1 at lea/ "o ( :om %all 
be a vet]an4  7,d7 ,two memb]s appo9t$  
by ! ,majority ,lead] ( ! ,s5ate1 at    
lea/ "o ( :om %all be a vet]an4  7,e7   
,two memb]s appo9t$ by ! ,m9ority ,lead]
 ( ! ,s5ate1 at lea/ "o ( :om %all be a 
vet]an4  7,f7 ,two memb]s appo9t$ by !  
,presid5t1 at lea/ "o ( :om %all be     
vet]ans4  7#c7 ,! ,presid5t %all        
designate a memb] ( ! ,bo>d ( ,directors
 to s]ve z ,*airp]son ( ! ,bo>d4 ,!     
,bo>d %all select a ,vice ,*airp]son f  
among its memb]s4  7#d7  7,a7 ,a memb] (
 ! ,bo>d ( ,directors %all s]ve = a t]m 
( five ye>s1 except t ! memb]s fir/     
appo9t$ %all be appo9t$ = /agg]$ t]ms z 
! ,presid5t consid]s appropriate to     
ensure t ! t]ms ( no m ?an ?ree memb]s  
expire 9 ! same ye>4  7,b7 ,any memb]   

appo9t$ to fill a vacancy occurr+ be=e !
 expiration ( ! t]m = :i* ! memb]'s     
pr$ecessor 0 appo9t$ %all be appo9t$    
only = ! rema9d] ( t t]m4 ,a memb] may  
s]ve aft] ! expiration ( t memb]'s t]m  
until a successor has tak5 (fice4 ,a    
vacancy on ! ,bo>d %all n affect its    
p[]s1 b %all be fill$ 9 ! same mann] 9  
:i* ! orig9al appo9tm5t 0 made4  7,c7 ,!
 t]m ( ea* memb] may be r5ew$ = an      
additional t]m1 except t 9 no case %all 
any memb] s]ve m ?an two consecutive    
t]ms exce$+ t5 ye>s4  7,d7 ,dur+ !      
abs5ce or disability ( ! ,secret>y (    
,vet]ans ,affairs or 9 ! ev5t ( a       
vacancy 9 ! (fice ( ,secret>y1 ! ,act+  
,secret>y ( ,vet]ans ,affairs %all s]ve 
z ! memb] ( ! ,bo>d ( ,directors        
specifi$ 9 p>agraph 7#b77;,a74  7d7     
,duties ,9 c>ry+ out subsection 7b71 !  
,corporation %all-- 7#a7 transf]        
p]sonnel & assets ( ! ,dep>tm5t (       
,vet]ans ,affairs to ! ,corporation     
pursuant to subsection 7b7 ( section #b 
( ! ,vet]ans ,emp[]m5t ,act2  7#b7      

e/abli% priorities1 mile/ones1 & "tl9es1
 9 consultation ) ! ,secret>y ( ,vet]ans
 ,affairs1 = ! t]m9ation ( functions ( !
 ,vet]ans ,heal? ,adm9i/ration directly 
relat$ to ! furni%+ ( hospital c>e1     
m$ical s]vices1 & o!r heal? c>e 7exclud+
 nurs+ home c>e & domicili>y c>e7       
pursuant to subsection 7c7 ( su* section
 #b2  7#c7 ) respect to c5t]s (         
excell5ce relat+ to s]vice-connect$     
injuries & o!r m$ical issues--  7,a7    
cont9ue to adm9i/] su* c5t]s previ\sly  
e/abli%$ by ! ,secret>y2 &  7,b7 e/abli%
 & adm9i/] additional su* c5t]s z !     
,bo>d ( ,directors det]m9es appropriate4
  7#d7 9 consultation ) ! ,secret>y1    
c>ry out su* o!r actions necess>y to    
c>ry out ?is section4  7e7 ,p[]s ,!     
,corporation %all-- 7#a7 appo9t         
employees2 &  7#b7 adopt a ,con/itution 
& bylaws consi/5t ) ! purpose set =? "u 
subsection 7b74  7f7 ,duty ,to ma9ta9   
corporate & tax-,exempt /atus  7#a7 ,!  
,corporation %all ma9ta9 its /atus z a  
corporation incorporat$ "u ! laws ( !   

,di/rict ( ,columbia or ano!r ne>by     
,/ate1 z det]m9$ by ! ,bo>d (           
,directors4  7#b7 ,! ,corporation %all  
ma9ta9 its /atus z an organization      
exempt f ! ,int]nal ,rev5ue ,code (     
#aihf4  7g7 ,vet]ans ,acc\ntable ,c>e   
,organization ,fund  7#a7 ,!re is 9 !   
,treasury a fund to be kn[n z ! ,vet]ans
 ,acc\ntable ,c>e ,organization ,fund 79
 ?is subsection ref]r$ to z ! ,fund74   
7#b7 ,am\nts recov]$ or collect$ "u     
*apt] #bf ( ?is title %all be deposit$ 9
 ! ,fund4  7#c7 ,am\nts 9 ! ,fund %all  
be available1 )\t fur!r appropriation & 
)\t fiscal ye> limitation1 to e/abli% & 
adm9i/] c5t]s ( excell5ce describ$ 9    
subsection 7d77#c7 & = heal? c>e or     
m$ical s]vices furni%$ to a vet]an at a 
facility op]at$ by ! ,corporation4  4   
7#b7 ,cl]ical am5dm5t ,! table (        
sections at ! beg9n+ ( *apt] #c ( su*   
title is am5d$ by ins]t+ aft] ! item    
relat+ to section #cbb ! foll[+ new     
item3  #cbc4 ,vet]ans ,acc\ntable ,c>e  
,organization4  4  7b7 ,transf] (       

p]sonnel & assets  7#a7 ,transf] ,all ( 
! p]sonnel1 prop]ty1 records1 & unexp5d$
 balances ( appropriations1 allocations1
 & o!r funds employ$1 us$1 held1        
available1 or to be made available 9    
connection ) ! direct furni%+ ( hospital
 c>e1 m$ical s]vices1 & o!r heal? c>e   
7exclud+ nurs+ home c>e & domicili>y    
c>e7 to individuals eligible = su* c>e &
 s]vices "u laws adm9i/]$ by ! ,secret>y
 ( ,vet]ans ,affairs are transf]r$ to ! 
,vet]ans ,acc\ntable ,c>e ,organization 
e/abli%$ "u section #cbc ( title #ch1   
,unit$ ,/ates ,code1 z add$ by          
subsection 7a74  7#b7 ,r$uction 9 =ce ,!
 ,secret>y may implem5t a r$uction 9 =ce
 9 c>ry+ out p>agraph 7#a74  7c7        
,t]m9ation ( functions  7#a7 ,9 g5]al   
,except z provid$ by p>agraph 7#b71 all 
( ! functions ( ! ,vet]ans ,heal?       
,adm9i/ration directly relat+ to !      
furni%+ ( hospital c>e1 m$ical s]vices1 
& o!r heal? c>e 7exclud+ nurs+ home c>e 
& domicili>y c>e7 to individuals        
eligible = su* c>e & s]vices "u laws    

adm9i/]$ by ! ,secret>y %all t]m9ate "o 
ye> aft] ! date ( ! enactm5t ( ?is ,act4
  7#b7 ,ext5sions ,! ,secret>y (        
,vet]ans ,affairs may make n m ?an two  
#ij-;day ext5sions to ! t]m9ation date  
specifi$ 9 p>agraph 7#a7 if ! ,secret>y 
notifies ,congress ( su* ext5sions4     
7#c7 ,c]tification ( t]m9ation date ,!  
,secret>y %all c]tify to ,congress !    
date on :i* p>agraph 7#a7 is c>ri$ out4 
7d7 ,recomm5dations = /atutory am5dm5ts 
,n lat] ?an #ahj days aft] ! date ( !   
enactm5t ( ?is ,act1 ! ,secret>y %all   
submit to ,congress a report t conta9s  
recomm5dations = te*nical & con=m+      
am5dm5ts to ,f$]al /atutes to c>ry out  
?is ,act4  #c4 ,e/abli%m5t ( ,vet]ans   
,heal? ,insurance ,program  7a7         
,e/abli%m5t ,*apt] #gc ( title #ch1     
,unit$ ,/ates ,code1 is am5d$ by add+ at
 ! end ! foll[+ new section3  #gcji;,a4 
,vet]ans ,heal? ,insurance ,program  7a7
 ,e/abli%m5t ,!re is e/abli%$ 9 !       
,vet]ans ,heal? ,adm9i/ration ! ,vet]ans
 ,heal? ,insurance ,program 79 ?is      

section ref]r$ to z ! ,program74  7b7   
,duties ,"u ! ,program1 ! ,secret>y %all
 adm9i/] ! provision ( heal? insurance  
support to vet]ans "u *apt] #bf ( ?is   
title4  4  7b7 ,cl]ical am5dm5t ,! table
 ( sections at ! beg9n+ ( *apt] #gc (   
su* title is am5d$ by ins]t+ aft] ! item
 relat+ to section #gcji ! foll[+ new   
item3  #gcji;,a4 ,vet]ans ,heal?        
,insurance ,program4  4  #d4            
,designation ( exi/+ au?orities =       
hospital c>e1 m$ical s]vices1 & o!r     
heal? c>e  7a7 ,designation ,sub*apt] ,i
 ( *apt] #ag ( title #ch1 ,unit$ ,/ates 
,code1 is am5d$ by ins]t+ aft] section  
#agja ! foll[+ new section3  #agja;,a4  
,vets,care ,f$]al program3 designation (
 au?orities = hospital c>e1 m$ical      
s]vices1 & o!r heal? c>e z program  7a7 
,9 g5]al ,effective z ( ! date describ$ 
9 section #b7;c77#c7 ( ! ,vet]ans       
,emp[]m5t ,act1 ! au?orities = !        
provision ( hospital c>e1 m$ical        
s]vices1 & o!r heal? c>e 7o!r ?an nurs+ 
home c>e & domicili>y c>e7 9 sub*apt]   

,,ii ( ?is *apt] & "u any o!r law       
adm9i/]$ by ! ,secret>y may be ref]r$ to
 z ! ,vets,care ,f$]al program4  7b7    
,designation ( recipi5ts ,effective z ( 
! date describ$ 9 section #b7;c77#c7 ( !
 ,vet]ans ,emp[]m5t ,act1 any eligible  
individual :o receives hospital c>e1    
m$ical s]vices1 & o!r heal? c>e 7exclud+
 nurs+ home c>e & domicili>y c>e7 9     
accordance ) ! au?orities ref]r$ to 9   
subsection 7a7 aft] su* date may be     
ref]r$ to 9 ! receipt ( su* c>e or      
s]vices z p>ticipat+ 9 ! ,vets,care     
,f$]al program4  7c7 ,second>y pay]     
7#a7 ,9 g5]al ,not)/&+ any o!r provision
 ( law1 any heal? plan 7includ+ !       
,m$ic>e program "u title ,,xviii ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#acie et seq47 or a ,/ate plan "u title 
,,xix ( su* ,act 7#db ,u4,s4,c4 #acif et
 seq47 & ! ,,tric>e program "u *apt] #ee
 ( title #aj7 "u :i* an eligible        
individual is cov]$ %all be responsible 
= ! paym5t ( co/s = any heal? c>e       
receiv$ by an eligible individual = a   

non-s]vice connect$ disability up to !  
maximum am\nt all[able "u su* plan be=e 
! ,vets,care ,f$]al program is          
responsible = any su* co/s1 if          
applicable4  7#b7 ,notification ,!      
,secret>y ( ,heal? & ,human ,s]vices1 ! 
,secret>y ( ,def5se1 or any o!r head ( a
 relevant dep>tm5t or ag5cy ( ! ,f$]al  
,gov]nm5t %all notify ! ,secret>y (     
,vet]ans ,affairs ( an eligible         
individual be+ cov]$ "u a heal? plan    
describ$ 9 p>agraph 7#a74  7d7 ,treatm5t
 ( employ]-,sponsor$ heal? plans  7#a7  
,9 g5]al ,! provisions ( section        
#ahfb7;b77#c77;,c7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #aciey7b77#c77;,c77
 %all apply ) respect to f9ancial or o!r
 inc5tives = an employee :o is an       
eligible individual n to enroll 7or to  
t]m9ate enrollm5t7 "u a heal? plan t    
w\ld 79 ! case ( su* enrollm5t7 be      
responsible "u subsection 7c7 = ! paym5t
 ( co/s = hospital c>e1 m$ical s]vices1 
or o!r heal? c>e receiv$ by ! eligible  
individual = a non-s]vice connect$      

disability 9 ! same mann] z su* section 
#ahfb7;b77#c77;,c7 applies to f9ancial  
or o!r inc5tives = an individual entitl$
 to b5efits "u title ,,xviii ( ! ,social
 ,security ,act 7#db ,u4,s4,c4 #acie et 
seq47 n to enroll 7or to t]m9ate        
enrollm5t7 "u a gr\p heal? plan or a    
l>ge gr\p heal? plan :i* w\ld 79 ! case 
( enrollm5t7 be a prim>y plan 7z def9$ 9
 section #ahfb7;b77#b77;,a7 ( su* ,act74
  7#b7 ,regulations ,! ,secret>y may by 
regulation adopt su* additional         
exceptions to ! prohibition describ$ 9  
p>agraph 7#a7 z ! ,secret>y consid]s    
appropriate & su* p>agraph %all be      
implem5t$ tak+ into acc\nt ! adoption ( 
su* exceptions4  7#c7 ,agreem5ts ,!     
,vet]ans ,acc\ntable ,c>e ,organization 
& ! ,secret>y ( ,heal? & ,human ,s]vices
 may ent] into agreem5ts to c>ry out ?is
 subsection4 ,any su* agreem5t %all     
provide t any exp5ses incurr$ by !      
,secret>y ( ,heal? & ,human ,s]vices    
p]ta9+ to c>ry+ out ?is subsection %all 
be reimburs$ by ! ,vet]ans ,acc\ntable  

,c>e ,organization4  7#d7 ,gr\p heal?   
plan def9$ ,9 ?is subsection1 ! t]m gr\p
 heal? plan means a gr\p heal? plan 7z t
 t]m is def9$ 9 section #ejjj7;b77#a7 ( 
! ,int]nal ,rev5ue ,code ( #aihf )\t    
reg>d to section #ejjj7;d7 ( ! ,int]nal 
,rev5ue ,code ( #aihf74  7e7 ,eligible  
individuals ,an individual is eligible  
to p>ticipate 9 ! ,vets,care ,f$]al     
program if su* individual 0 enroll$ 9 ! 
sy/em ( annual pati5t enrollm5t e/abli%$
 & op]at$ by ! ,secret>y "u section     
#agje7;a7 ( ?is title z ( ! date        
describ$ 9 section #b7;c77#c7 ( !       
,vet]ans ,emp[]m5t ,act4  4  7b7        
,cl]ical am5dm5t ,! table ( sections at 
! beg9n+ ( su* *apt] is am5d$ by ins]t+ 
aft] ! item relat+ to section #agja !   
foll[+ new item3  #agja;,a4 ,vets,care  
,f$]al program3 designation ( au?orities
 = hospital c>e1 m$ical s]vices1 & o!r  
heal? c>e z program4  4  #e4 ,heal?     
insurance support = new vet]ans &       
vet]ans elect+ heal? insurance support 9
 lieu ( eligibility = hospital c>e1     

m$ical s]vices1 & o!r heal? c>e "u exi/+
 au?orities  7a7 ,9 g5]al ,"p ,,ii (    
title #ch1 ,unit$ ,/ates ,code1 is am5d$
 by ins]t+ aft] *apt] #bd ! foll[+ new  
*apt]3  #bf ,vet]ans ,indep5d5ce 9      
,heal? ,c>e  ,sub*apt] ,i--,vet]ans     
,g5]ally #bfja4 ,vets,care ,*oice       
program3 designation ( recipi5ts4 #bfjb4
 ,eligibility4 #bfjc4 ,qualify+ heal?   
insurance4 #bfjd4 ,heal? insurance      
support4 #bfje4 ,treatm5t ( o!r heal?   
plans4 #bfjf4 ,receipt ( heal? c>e ?r\gh
 ! ,dep>tm5t4 #bfjg4 ,ph>macy b5efits4  
,sub*apt] ,,ii--,m$ic>e-,eligible       
,vet]ans #bfaa4 ,vets,care ,s5ior       
program3 designation ( recipi5ts4 #bfab4
 ,m$ic>e support4  ,i ,vet]ans ,g5]ally 
#bfja4 ,vets,care ,*oice program3       
designation ( recipi5ts  7a7 ,9 g5]al ,!
 au?orities = ! provision ( heal?       
insurance support "u ?is sub*apt] may be
 ref]r$ to z ! ,vets,care ,*oice        
program4  7b7 ,designation ( recipi5ts  
,any vet]an :o receives heal? insurance 
support "u ?is sub*apt] may be ref]r$ to

 9 ! receipt ( support z p>ticipat+ 9 ! 
,vets,care ,*oice program4  7c7         
,relation%ip to c>e by ,vet]ans         
,acc\ntable ,c>e ,organization ,heal?   
insurance support "u ?is sub*apt] is 9  
addition to any heal? c>e or m$ical     
s]vices furni%$ to a vet]an at a        
facility op]at$ by ! ,vet]ans           
,acc\ntable ,c>e ,organization4  #bfjb4 
,eligibility  7a7 ,9 g5]al ,except z    
provid$ 9 subsections 7c7 & 7d71 !      
foll[+ vet]ans %all be provid$ heal?    
insurance support "u ?is sub*apt]3  7#a7
 ,vet]ans :o fir/ enroll 9 ! sy/em (    
annual pati5t enrollm5t e/abli%$ &      
op]at$ by ! ,secret>y "u section        
#agje7;a7 ( ?is title on or aft] ! date 
describ$ 9 section #b7;c77#c7 ( !       
,vet]ans ,emp[]m5t ,act4  7#b7 ,vet]ans 
enroll$ 9 su* sy/em z ( ! date describ$ 
9 section #b7;c77#c7 ( ! ,vet]ans       
,emp[]m5t ,act :o elect heal? insurance 
support "u ?is sub*apt] 9 lieu (        
eligibility = hospital c>e1 m$ical      
s]vices1 & o!r heal? c>e 7exclud+ nurs+ 

home c>e & domicili>y c>e7 "u !         
,vets,care ,f$]al program "u *apt] #ag (
 ?is title or any o!r law adm9i/]$ by ! 
,secret>y4  7b7 ,enrollm5t ,! ,secret>y 
%all adm9i/]-- 7#a7 an op5 enrollm5t    
p]iod = ! ,vets,care ,*oice program t   
corresponds to ! op5 enrollm5t p]iod = !
 ,f$]al ,employees ,heal? ,b5efits      
program describ$ 9 section #hije7;g72 & 
7#b7 special enrollm5t p]iods bas$ on   
qualify+ life ev5ts ( vet]ans simil> to 
su* ev5ts "u ! ,f$]al ,employees ,heal? 
,b5efits ,program1 except t ! *ange (   
priority gr\p %all also be treat$ z a   
qualify+ life ev5t4  7c7 ,effect (      
election ,:ile an election "u subsection
 7a77#b7 ( a vet]an describ$ 9 t        
subsection is 9 effect1 ! vet]an is n   
eligible = hospital c>e1 m$ical s]vices1
 & o!r heal? c>e 7exclud+ nurs+ home c>e
 & domicili>y c>e7 "u *apt] #ag ( ?is   
title or any o!r law adm9i/]$ by !      
,secret>y4  7d7 ,exceptions ,! foll[+   
vet]ans are n eligible = heal? insurance
 support "u ?is sub*apt]3 7#a7 ,any     

vet]an eligible = c>e "u ! ,m$ic>e      
program "u title ,,xviii ( ! ,social    
,security ,act 7#db ,u4,s4,c4 #acie et  
seq474  7#b7 ,any vet]an :o-- 7,a7 fir/ 
enrolls 9 ! sy/em ( annual pati5t       
enrollm5t e/abli%$ & op]at$ by !        
,secret>y "u section #agje7;a7 ( ?is    
title on or aft] ! date describ$ 9      
section #b7;c77#c7 ( ! ,vet]ans ,act2 & 
7,b7 is 9 priority gr\p #g or priority  
gr\p #h4  7e7 ,comm5cem5t ( availability
 ( support ,heal? insurance support "u  
?is sub*apt] %all comm5ce be+ available 
z foll[s3  7#a7 ,) respect to vet]ans 9 
priority gr\p #a1 #b1 or #c1 on ! fir/  
day ( ! fir/ mon? t beg9s on or aft] !  
date describ$ 9 section #b7;c77#c7 ( !  
,vet]ans ,emp[]m5t ,act4  7#b7 ,)       
respect to vet]ans 9 a priority gr\p o!r
 ?an #a1 #b1 or #c1 on ! fir/ day ( !   
fir/ mon? t beg9s on or aft] ! date t is
 #ahj days aft] ! comm5cem5t date "u    
p>agraph 7#a74  7f7 ,priority gr\p def9$
 ,9 ?is section1 ! t]m priority gr\p    
means ! priority gr\ps e/abli%$ by !    

,secret>y = purposes ( ! enrollm5t (    
vet]ans 9 ! pati5t enrollm5t sy/em "u   
section #agje7;a7 ( ?is title4  #bfjc4  
,qualify+ heal? insurance ,heal?        
insurance support may be provid$ "u ?is 
sub*apt] only = heal? plans t-- 7#a7    
include ! types ( heal? c>e au?oriz$ "u 
section #ajgi ( title #aj1 ,unit$ ,/ates
 ,code2 &  7#b7 provide su* additional  
elem5ts ( cov]age z ! ,secret>y %all    
prescribe = purposes ( ?is sub*apt]4    
#bfjd4 ,heal? insurance support  7a7 ,9 
g5]al ,! ,secret>y %all provide heal?   
insurance support to vet]ans eligible = 
su* support "u ?is sub*apt] ?r\gh       
premium support "u subsections 7b7 &    
7c71 co/-%>+ support "u subsection 7d71 
& alt]native support "u subsection 7e7  
by pay+ or reimburs+ su* vet]ans = !    
co/s associat$ ) su* heal? insurance    
support4 ,! ,secret>y %all make su*     
paym5ts or reimbursem5ts 9 a mann]      
simil> to ! mann] 9 :i* ! ,c5t]s =      
,m$ic>e  ,m$icaid ,s]vices make simil>  
paym5ts & reimbursem5ts4  7b7 ,premium  

support g5]ally ,! premium support      
provid$ by ! ,secret>y "u ?is subsection
 is z foll[s3 7#a7 ,ti] #a ,to any      
vet]an ) a s]vice-connect$ disability   
rat$ z #ajj p]c5t disabl+1 heal?        
insurance support suffici5t to provide  
b5efits to ! vet]an "u a heal? plan t   
are actu>ially equival5t to #ajj p]c5t (
 ! full actu>ial value ( ! b5efits      
provid$ "u ! heal? plan4 ,a heal? plan  
"u ?is p>agraph may be ref]r$ to z a    
,ti] #a ,plan4  7#b7 ,ti] #b ,to any    
vet]an 9 priority gr\p #a n cov]$ by    
p>agraph 7#a7 & any vet]an 9 priority   
gr\p #b1 heal? insurance support        
suffici5t to provide b5efits to ! vet]an
 "u a heal? plan t are actu>ially       
equival5t to #ij p]c5t ( ! full actu>ial
 value ( ! b5efits provid$ "u ! heal?   
plan4 ,a heal? plan "u ?is p>agraph may 
be ref]r$ to z a ,ti] #b ,plan4  7#c7   
,ti] #c ,to any vet]an 9 priority gr\p  
#c or priority gr\p #d1 heal? insurance 
support suffici5t to provide b5efits to 
! vet]an "u a heal? plan t are          

actu>ially equival5t to #hj p]c5t ( !   
full actu>ial value ( ! b5efits provid$ 
"u ! heal? plan4 ,a heal? plan "u ?is   
p>agraph may be ref]r$ to z a ,ti] #c   
,plan4  7#d7 ,ti] #d ,to any vet]an 9   
priority gr\p #e or priority gr\p #f1   
heal? insurance support suffici5t to    
provide b5efits to ! vet]an "u a heal?  
plan t are actu>ially equival5t to #gj  
p]c5t ( ! full actu>ial value ( !       
b5efits provid$ "u ! heal? plan4 ,a     
heal? plan "u ?is p>agraph may be ref]r$
 to z a ,ti] #d ,plan4  7#e7 ,ti] #e ,to
 any vet]an n 9 a priority gr\p cov]$ by
 p>agraphs 7#a7 ?r\gh 7#d7 & n          
ineligible = su* support "u section     
#bfjb7;d77#b7 ( ?is title1 heal?        
insurance support suffici5t to provide  
b5efits to ! vet]an "u a heal? plan t   
are actu>ially equival5t to #fj p]c5t ( 
! full actu>ial value ( ! b5efits       
provid$ "u ! heal? plan4 ,a heal? plan  
"u ?is p>agraph may be ref]r$ to z a    
,ti] #e ,plan4  7c7 ,additional premium 
support bas$ on ne$ ,! premium support  

provid$ by ! ,secret>y "u ?is subsection
 is z foll[s3 7#a7 ,to any vet]an ) an  
annual gross h\sehold income t is less  
?an #acc p]c5t ( ! pov]ty l9e1 heal?    
insurance support suffici5t to cov] any 
co/s ( su* mon?ly premium t are m ?an #b
 p]c5t ( ! mon?ly gross h\sehold income 
( ! vet]an4  7#b7 ,to any vet]an ) an   
annual gross h\sehold income t is betwe5
 #acc p]c5t & #aej p]c5t ( ! pov]ty l9e1
 heal? insurance support suffici5t to   
cov] any co/s ( su* mon?ly premium t are
 m ?an #c p]c5t ( ! mon?ly gross        
h\sehold income ( ! vet]an4  7#c7 ,to   
any vet]an ) an annual gross h\sehold   
income t is betwe5 #aej p]c5t & #bjj    
p]c5t ( ! pov]ty l9e1 heal? insurance   
support suffici5t to cov] any co/s ( su*
 mon?ly premium t are m ?an #d p]c5t ( !
 mon?ly gross h\sehold income ( !       
vet]an4  7#d7 ,to any vet]an ) an annual
 gross h\sehold income t is betwe5 #bjj 
p]c5t & #bej p]c5t ( ! pov]ty l9e1 heal?
 insurance support suffici5t to cov] any
 co/s ( su* mon?ly premium t are m ?an  

#f4c p]c5t ( ! mon?ly gross h\sehold    
income ( ! vet]an4  7#e7 ,to any vet]an 
) an annual gross h\sehold income t is  
betwe5 #bej p]c5t & #cjj p]c5t ( !      
pov]ty l9e1 heal? insurance support     
suffici5t to cov] any co/s ( su* mon?ly 
premium t are m ?an #h4je p]c5t ( !     
mon?ly gross h\sehold income ( ! vet]an4
  7#f7 ,to any vet]an ) an annual gross 
h\sehold income t is betwe5 #cjj p]c5t &
 #djj p]c5t ( ! pov]ty l9e1 heal?       
insurance support suffici5t to cov] any 
co/s ( su* mon?ly premium t are m ?an   
#i4e p]c5t ( ! mon?ly gross h\sehold    
income ( ! vet]an4  7d7 ,co/-,%>+       
support ,! co/-%>+ support provid$ by ! 
,secret>y "u ?is subsection is z foll[s3
 7#a7 ,to any vet]an ) an annual gross  
h\sehold income t is less ?an #aej p]c5t
 ( ! pov]ty l9e1 heal? insurance support
 suffici5t to cov] co/-%>+ 9 ord] to    
ensure t ! effective m9imum actu>ial    
value ( ! b5efits provid$ "u ! heal?    
plan ( ! vet]an is n less ?an #id p]c5t4
  7#b7 ,to any vet]an ) an annual gross 

h\sehold income t is betwe5 #aej p]c5t &
 #bjj p]c5t ( ! pov]ty l9e1 heal?       
insurance support suffici5t to cov]     
co/-%>+ 9 ord] to ensure t ! effective  
m9imum actu>ial value ( ! b5efits       
provid$ "u ! heal? plan ( ! vet]an is n 
less ?an #hg p]c5t4  7#c7 ,to any vet]an
 ) an annual gross h\sehold income t is 
betwe5 #bjj p]c5t & #bej p]c5t ( !      
pov]ty l9e1 heal? insurance support     
suffici5t to cov] co/-%>+ 9 ord] to     
ensure t ! effective m9imum actu>ial    
value ( ! b5efits provid$ "u ! heal?    
plan ( ! vet]an is n less ?an #gc p]c5t4
  7e7 ,alt]native support = vet]ans )   
c]ta9 heal? insurance  7#a7 ,9 g5]al    
,not)/&+ any o!r provision ( ?is        
section1 ^u ! election ( a vet]an       
eligible = heal? insurance support "u   
?is sub*apt] :o obta9s a high d$uctible 
heal? plan t includes a heal? sav+s     
acc\nt "u section #bbc ( ! ,int]nal     
,rev5ue ,code ( #aihf1 ! ,secret>y %all 
contribute an am\nt calculat$ "u        
p>agraph 7#b7 into su* heal? sav+s      

acc\nt on behalf ( ! vet]an4  7#b7      
,am\nt calculat$ ,! am\nt calculat$ "u  
?is p>agraph is an am\nt equal to !     
diff]5ce betwe5-- 7,a7 ! am\nt ( heal?  
insurance support ! vet]an w\ld o!rwise 
h receiv$ "u ! subsection ( ?is section 
applicable to ! vet]an2 &  7,b7 ! am\nt 
payable by ! vet]an 9 connection ) !    
high d$uctible heal? plan describ$ 9    
p>agraph 7#a74  7f7 ,det]m9ations bas$  
on co/ ( plans ,9 mak+ det]m9ations "u  
?is section ) respect to ! am\nt ( heal?
 insurance support to provide to a      
vet]an1 ! ,secret>y %all make su*       
det]m9ations bas$ on ! co/s associat$ ) 
! second-lea/-co/ly heal? plan available
 to ! vet]an 9 ! area 9 :i* ! vet]an    
resides4  7g7 ,def9itions ,9 ?is        
section3 7#a7 ,! t]m co/-%>+1 9         
connection ) ! receipt ( heal? c>e &    
treatm5t "u a heal? plan1 means any     
copaym5ts1 d$uctibles1 or o!r *>ges     
impos$1 collect$1 or o!rwise requir$ by 
a heal? insurance provid] or heal? c>e  
provid] 9 connection ) ! receipt ( heal?

 c>e & treatm5t "u su* heal? plan4  7#b7
 ,! t]m pov]ty l9e means ! pov]ty l9e 7z
 def9$ 9 section #fgc7b7 ( ! ,community 
,s]vices ,block ,grant ,act 7#db        
,u4,s4,c4 #iijb7b77 applicable to a     
family ( ! size involv$4  7#c7 ,! t]m   
high d$uctible heal? plan has ! mean+   
giv5 t t]m 9 section #bbc7;c77#b7 ( !   
,int]nal ,rev5ue ,code ( #aihf4  7#d7 ,!
 t]m priority gr\p means ! priority     
gr\ps e/abli%$ by ! ,secret>y = purposes
 ( ! enrollm5t ( vet]ans 9 ! pati5t     
enrollm5t sy/em "u section #agje7;a7 (  
?is title4  #bfje4 ,treatm5t ( o!r heal?
 plans  7a7 ,second>y pay]  7#a7 ,9     
g5]al ,not)/&+ any o!r provision ( law1 
any heal? plan 7includ+ a ,/ate plan "u 
title ,,xix ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #acif et seq47 & !       
,,tric>e program "u *apt] #ee ( title   
#aj7 "u :i* a vet]an is cov]$ t is n a  
heal? plan = :i* heal? insurance support
 is provid$ "u ?is sub*apt] %all be     
responsible = ! paym5t ( co/s = any     
heal? c>e receiv$ by an eligible        

individual = a non-s]vice connect$      
disability up to ! maximum am\nt        
all[able "u su* plan be=e any heal? plan
 = :i* heal? insurance support is       
provid$ "u ?is sub*apt] is responsible =
 any su* co/s1 if applicable4  7#b7     
,notification ,! ,secret>y ( ,heal? &   
,human ,s]vices1 ! ,secret>y ( ,def5se1 
or any o!r head ( a relevant dep>tm5t or
 ag5cy ( ! ,f$]al ,gov]nm5t %all notify 
! ,secret>y ( ,vet]ans ,affairs ( an    
eligible individual be+ cov]$ "u a heal?
 plan describ$ 9 p>agraph 7#a74  7b7    
,treatm5t ( employ]-,sponsor$ heal?     
plans  7#a7 ,9 g5]al ,! provisions (    
section #ahfb7;b77#c77;,c7 ( ! ,social  
,security ,act 7#db ,u4,s4,c4           
#aciey7b77#c77;,c77 %all apply ) respect
 to f9ancial or o!r inc5tives = an      
employee :o is a vet]an n to enroll 7or 
to t]m9ate enrollm5t7 "u a heal? plan t 
is n a heal? plan = :i* heal? insurance 
support is provid$ "u ?is sub*apt] & t  
w\ld 79 ! case ( su* enrollm5t7 be      
responsible "u subsection 7a7 = ! paym5t

 ( co/s = heal? c>e receiv$ by ! vet]an 
9 ! same mann] z su* section            
#ahfb7;b77#c77;,c7 applies to f9ancial  
or o!r inc5tives = an individual entitl$
 to b5efits "u title ,,xviii ( ! ,social
 ,security ,act 7#db ,u4,s4,c4 #acie et 
seq47 n to enroll 7or to t]m9ate        
enrollm5t7 "u a gr\p heal? plan or a    
l>ge gr\p heal? plan :i* w\ld 79 ! case 
( enrollm5t7 be a prim>y plan 7z def9$ 9
 section #ahfb7;b77#b77;,a7 ( su* ,act74
  7#b7 ,regulations ,! ,secret>y may by 
regulation adopt su* additional         
exceptions to ! prohibition describ$ 9  
p>agraph 7#a7 z ! ,secret>y consid]s    
appropriate & su* p>agraph %all be      
implem5t$ tak+ into acc\nt ! adoption ( 
su* exceptions4  7#c7 ,agreem5ts ,!     
,secret>y ( ,vet]ans ,affairs & !       
,secret>y ( ,heal? & ,human ,s]vices may
 ent] into agreem5ts to c>ry out ?is    
subsection4 ,any su* agreem5t %all      
provide t any exp5ses incurr$ by !      
,secret>y ( ,heal? & ,human ,s]vices    
p]ta9+ to c>ry+ out ?is subsection %all 

be reimburs$ by ! ,secret>y ( ,vet]ans  
,affairs4  7#d7 ,gr\p heal? plan def9$  
,9 ?is subsection1 ! t]m gr\p heal? plan
 means a gr\p heal? plan 7z t t]m is    
def9$ 9 section #ejjj7;b77#a7 ( !       
,int]nal ,rev5ue ,code ( #aihf )\t reg>d
 to section #ejjj7;d7 ( ! ,int]nal      
,rev5ue ,code ( #aihf74  #bfjf4 ,receipt
 ( heal? c>e ?r\gh ! ,dep>tm5t  7a7     
,contracts ,any heal? insurance provid] 
t provides a heal? plan = :i* heal?     
insurance support may be provid$ "u ?is 
sub*apt] or sub*apt] ,,ii may ent] into 
a contract ) ! ,vet]ans ,acc\ntable ,c>e
 ,organization "u :i* ! m$ical p]sonnel 
& facilities ( ! ,vet]ans ,acc\ntable   
,c>e ,organization may be treat$ z a    
designat$ provid] = purposes ( su* heal?
 plan4  7b7 ,co/ ( c>e ,! co/1 includ+  
any copaym5ts1 ( any heal? c>e or       
treatm5t provid$ to a vet]an by !       
,vet]ans ,acc\ntable ,c>e ,organization 
"u a contact "u subsection 7a7 %all be  
det]m9$ by ! ,vet]ans ,acc\ntable ,c>e  
,organization4  7c7 ,me*anism ,! ,bo>d (

 ,directors ( ! ,vet]ans ,acc\ntable    
,c>e ,organization %all e/abli% a       
me*anism ?r\gh :i* ! ,vet]ans           
,acc\ntable ,c>e ,organization ent]s    
into contracts ) heal? insurance        
provid]s "u subsection 7a74  #bfjg4     
,ph>macy b5efits ,a vet]an :o is enroll$
 9 ! ,vets,care ,*oice program or !     
,vets,care ,s5ior program may fill      
prescriptions at ph>macies ( !          
,dep>tm5t4  ,,ii ,m$ic>e-,eligible      
,vet]ans  #bfaa4 ,vets,care ,s5ior      
program3 designation ( recipi5ts  7a7 ,9
 g5]al ,! au?orities = ! provision (    
heal? insurance support "u ?is sub*apt] 
may be ref]r$ to z ! ,vets,care ,s5ior  
program4  7b7 ,designation ( recipi5ts  
,any vet]an :o receives heal? insurance 
support "u ?is sub*apt] may be ref]r$ to
 9 ! receipt ( support z p>ticipat+ 9 ! 
,vets,care ,s5ior program4  7c7         
,relation%ip to c>e by ,vet]ans         
,acc\ntable ,c>e ,organization ,heal?   
insurance support "u ?is sub*apt] is 9  
addition to any heal? c>e or m$ical     

s]vices furni%$ to a vet]an at a        
facility op]at$ by ! ,vet]ans           
,acc\ntable ,c>e ,organization4  #bfab4 
,m$ic>e support  7a7 ,9 g5]al ,!        
,secret>y %all provide heal? insurance  
support to ea* cov]$ vet]an equal to !  
co/s incurr$ by su* vet]an = ,m$ic>e    
premiums & co/-%>+ "u p>ts ,a1 ,b1 ,c1 &
 ,d ( title ,,xviii ( ! ,social         
,security ,act 7#db ,u4,s4,c4 #acie et  
seq47 & = premiums & co/-%>+ = ,m$ic>e  
supplem5tal policies "u section #ahhb ( 
su* ,act 7#db ,u4,s4,c4 #aciess74  7b7  
,relation%ip ) ,vets,care ,f$]al        
,not)/&+ any o!r provision ( law1 if a  
cov]$ vet]an is enroll$ 9 ! ,vets,care  
,f$]al program "u section #agja;,a ( ?is
 title1 ! ,m$ic>e program "u title      
,,xviii ( ! ,social ,security ,act 7#db 
,u4,s4,c4 #acie et seq47 7or a ,m$ic>e  
supplem5tal policy "u section #ahhb (   
su* ,act 7#db ,u4,s4,c4 #aciess77 %all  
be responsible = ! paym5t ( co/s = any  
heal? c>e receiv$ by an eligible        
individual = a non-s]vice connect$      

disability up to ! maximum am\nt        
all[able "u su* program 7or supplem5tal 
policy7 = su* heal? c>e be=e !          
,vets,care ,f$]al program is responsible
 = any su* co/s1 if applicable4  7c7    
,availability ( paym5t or reimbursem5t  
7#a7 ,comm5cem5t ,heal? insurance       
support "u ?is sub*apt] %all comm5ce be+
 available z foll[s3 7,a7 ,) respect to 
cov]$ vet]ans 9 priority gr\p #a1 #b1 or
 #c1 on ! fir/ day ( ! fir/ mon? t beg9s
 on or aft] ! date describ$ 9 section   
#b7;c77#c7 ( ! ,vet]ans ,emp[]m5t ,act4 
7,b7 ,) respect to cov]$ vet]ans 9 a    
priority gr\p o!r ?an #a1 #b1 or #c1 on 
! fir/ day ( ! fir/ mon? t beg9s on or  
aft] ! date t is #ahj days aft] !       
comm5cem5t date "u p>agraph 7#a74  7#b7 
,exclusion ( c]ta9 vet]ans ,a cov]$     
vet]an is n eligible = heal? insurance  
support "u ?is section if su* vet]an--  
7,a7 fir/ enrolls 9 ! sy/em ( annual    
pati5t enrollm5t e/abli%$ & op]at$ by ! 
,secret>y "u section #agje7;a7 ( ?is    
title on or aft] ! date ( ! enactm5t (  

?is ,act2 &  7,b7 is 9 priority gr\p #g 
or #h4  7d7 ,def9itions ,9 ?is section3 
7#a7 ,! t]m co/-%>+1 9 connection ) !   
receipt ( heal? c>e & treatm5t "u !     
,m$ic>e program "u title ,,xviii ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#acie et seq47 or ,m$ic>e supplem5tal   
policies "u section #ahhb ( su* ,act    
7#db ,u4,s4,c4 #aciess71 means any      
copaym5ts1 d$uctibles1 or o!r *>ges     
impos$1 collect$1 or o!rwise requir$ by 
a heal? insurance provid] or heal? c>e  
provid] 9 connection ) receipt ( heal?  
c>e & treatm5t "u su* program or        
supplem5tal policies4  7#b7 ,! t]m cov]$
 vet]an means a vet]an receiv+ b5efits  
"u ! ,m$ic>e program "u title ,,xviii ( 
! ,social ,security ,act4  7#c7 ,! t]m  
priority gr\p means ! priority gr\ps    
e/abli%$ by ! ,secret>y = purposes ( !  
enrollm5t ( vet]ans 9 ! pati5t enrollm5t
 sy/em "u section #agje7;a7 ( ?is title4
  4  7b7 ,cl]ical am5dm5t ,! table (    
*apt]s at ! beg9n+ title #ch1 ,unit$    
,/ates ,code1 is am5d$ by ins]t+ aft] ! 

item relat+ to *apt] #bd ! foll[+ new   
item3  ,*apt] #bf4,vet]ans ,indep5d5ce 9
 ,heal? ,c>e#bfja  4  7c7 ,con=m+       
am5dm5ts  7#a7 ,m9imum ess5tial cov]age 
,section #ejjj;,a7f77#a77;,a77v7 ( !    
,int]nal ,rev5ue ,code ( #aihf is am5d$ 
by /rik+ or #ah & ins]t+ 1 #ah1 or #bf4 
7#b7 ,m$ic>e "p ,b  7,a7                
,non-application ( late enrollm5t p5alty
 ,section #ahci7;b7 ( ! ,social         
,security ,act 7#db ,u4,s4,c4 #acier7b77
 is am5d$1 9 ! second s5t5ce1 by ins]t+ 
or mon?s = :i* ! individual c demon/rate
 t ! individual 0 enroll$ 9 ! ,vets,care
 ,s5ior program "u sub*apt] ,,ii ( *apt]
 #bf ( title #ch1 ,unit$ ,/ates ,code   
aft] an individual describ$ 9 section   
#ahcg7k77#c74  7,b7 ,special enrollm5t  
p]iod ,section #ahcg ( ! ,social        
,security ,act 7#db ,u4,s4,c4 #aciep7 is
 am5d$ by add+ at ! end ! foll[+ new    
subsection3  7m7  7#a7 ,9 ! case ( any  
individual :o is enroll$ 9 ! ,vets,care 
,s5ior program "u sub*apt] ,,ii ( *apt] 
#bf ( title #ch1 ,unit$ ,/ates ,code at 

! "t ! individual is entitl$ to "p ,a "u
 section #bbf or section #bbf;,a & :o is
 eligible to enroll b :o has elect$ n to
 enroll 7or to be deem$ enroll$7 dur+ ! 
individual's initial enrollm5t p]iod1   
!re %all be a special enrollm5t p]iod z 
specifi$ by ! ,secret>y4  7#b7 ,9 ! case
 ( an individual :o enrolls dur+ !      
special enrollm5t p]iod provid$ "u      
p>agraph 7#a71 ! cov]age p]iod "u ?is "p
 %all beg9 on su* date specifi$ by !    
,secret>y4  7#c7 ,an individual may only
 enroll dur+ ! special enrollm5t p]iod  
provid$ "u p>agraph 7#a7 "o "t dur+ !   
individual's lifetime4  7#d7 ,!         
,secret>y ( ,vet]ans ,affairs %all      
collaborate ) ! ,secret>y ( ,heal? &    
,human ,s]vices & ! ,commission] (      
,social ,security to provide = !        
accurate id5tification ( individuals    
describ$ 9 p>agraph 7#a74 ,! ,secret>y (
 ,vet]ans ,affairs %all provide su*     
individuals ) notification ) respect to 
?is subsection4 ,! ,secret>y ( ,vet]ans 
,affairs %all collaborate ) ! ,secret>y 

( ,heal? & ,human ,s]vices & !          
,commission] ( ,social ,security to     
ensure appropriate foll[ up pursuant to 
any notification provid$ "u ! prec$+    
s5t5ce4  4  #f4 ,coord9ation betwe5     
,vets,care ,*oice program & eligibility 
to make contributions to heal? sav+s    
acc\nts  7a7 ,9 g5]al ,section          
#bbc7;c77#a77;,b7 ( ! ,int]nal ,rev5ue  
,code ( #aihf is am5d$ by /rik+ & at !  
end ( clause 7ii71 by /rik+ ! p]iod at !
 end ( clause 7iii7 & ins]t+ 1 &1 & by  
add+ at ! end ! foll[+ new clause3  7iv7
 cov]age = heal? insurance support "u ! 
,vets,care ,*oice program "u sub*apt] ,i
 ( *apt] #bf ( title #ch1 ,unit$ ,/ates 
,code4  4  7b7 ,d5ial ( d$uction =      
am\nts n includible 9 gross income      
,subsection 7b7 ( section #bbc ( !      
,int]nal ,rev5ue ,code ( #aihf is am5d$ 
by add+ at ! end ! foll[+ new p>agraph3 
7#i7 ,am\nts n includible 9 gross income
 ,no am\nt paid to a heal? sav+s acc\nt 
( an individual %all be tak5 into acc\nt
 "u subsection 7a7 if 7)\t reg>d to ?is 

section7 su* am\nt1 :5 paid to or on    
behalf ( su* individual1 is exclud$ f   
gross income ( ! individual or exempt f 
taxation "u any provision ( ,f$]al law4 
4  7c7 ,effective date ,! am5dm5ts made 
by ?is section %all apply to am\nts paid
 to a heal? sav+s acc\nt 7z def9$ 9     
section #bbc7;d7 ( ! ,int]nal ,rev5ue   
,code ( #aihf7 aft] ! date ( ! enactm5t 
( ?is ,act4  #g4 ,publication ( heal?   
c>e in=mation  7a7 ,9 g5]al ,! ,secret>y
 ( ,vet]ans ,affairs %all make available
 to ! public on an ongo+ basis in=mation
 ab\t ! op]ations ( ! ,vet]ans ,heal?   
,adm9i/ration 9 a mann] simil> to       
publication ( in=mation "u ! ,m$ic>e    
,acc\ntable ,c>e ,organization program  
to bett] monitor & support cont9u\s     
improvem5t 9 ! ,vet]ans ,heal?          
,adm9i/ration4  7b7 ,elem5ts ,!         
in=mation publi%$ "u subsection 7a7 %all
 include in=mation ab\t ! op]ations ( ! 
,vet]ans ,heal? ,adm9i/ration1 includ+  
metrics reg>d+ quality1 safety1 pati5t  
exp]i5ce1 timel9ess1 & co/-effectiv5ess4

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c>e insurance  7a7 ,9 g5]al ,section    
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is am5d$-- 7#a7 by r$esignat+ p>agraphs 
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9 section #aja7b7 ( title #ch1 ,unit$   
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 or 7#e742  7,c7 9 subp>agraph 7,c71 by 
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7,d7 9 subp>agraph 7,d71 by /rik+ or    
7#d7 & ins]t+ 7#d71 or 7#e72  7#d7 9    
p>agraph 7#g71 z s r$esignat$1 by /rik+ 
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7#e7 9 p>agraph 7#aa71 z s r$esignat$-- 
7,a7 9 subp>agraph 7,c71 by /rik+       
,comm]ce2 & & ins]t+ ,comm]ce22  7,b7 9 
subp>agraph 7,d71 by /rik+ ,s]vices4 &  
ins]t+ ,s]vices2 &2 &  7,c7 by ins]t+   

aft] subp>agraph 7,d73  7,e7 ) respect  
to a vet]an1 ! ,secret>y ( ,vet]ans     
,affairs4  4  7b7 ,te*nical & con=m+    
am5dm5ts ,title #e1 ,unit$ ,/ates ,code1
 is am5d$ z foll[s3  7#a7 ,section #ijjb
 is am5d$-- 7,a7 9 subsection 7a71 by   
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7,b7 9 subsection 7e7-- 7i7 9 p>agraph  
7#b71 by /rik+ or 7#d7 & ins]t+ 7#d71 or
 7#e72 &  7ii7 9 p>agraph 7#d71 by /rik+
 section #ijja7i7 & ins]t+ section      
#ijja7aj74  7#b7 ,section #ijjd7;d7 is  
am5d$ by ins]t+ aft] )held "u subsection
 7b7 ! foll[+3 1 :o is an enrollee by   
virtue ( be+ a vet]an describ$ 9 section
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#ijjh7;c7 is am5d$ by /rik+ 7#c7 or 7#d7
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