#aae? ,,congress #b;d ,session ,9 ! ,h\se ( ,repres5tatives1 ,u4 ,s41 ,may #af1 #bjah ,,am5dm5t3 ,t ! bill f ! ,s5ate 7,s4 #bcgb7 entitl$ ,an ,act to am5d title #ch1 ,unit$ ,/ates ,code1 to provide out] burial receptacles = rema9s buri$ 9 ,national ,p>ks1 & = o!r purposes41 d pass ) ! foll[+ ,/rike out all aft] ! enact+ clause & ins]t3 #a4 ,%ort title2 table ( cont5ts 7a7 ,%ort title ,?is ,act may be cit$ z ! ,john ,s4 ,mc,cain ,,iii1 ,daniel ,k4 ,akaka1 & ,samuel ,r4 ,johnson ,,va ,ma9ta9+ ,int]nal ,sy/ems & ,/r5g!n+ ,integrat$ ,outside ,networks ,act ( #bjah or ! ,,va ,,mission ,act ( #bjah4 7b7 ,table ( cont5ts ,! table ( cont5ts = ?is ,act is z foll[s3 ,sec4 #a4 ,%ort title2 table ( cont5ts4 ,title ,i--,c>+ = our ,vet]ans ,sec4 #ajj4 ,%ort title2 ref]5ces to title #ch1 ,unit$ ,/ates ,code4 ,subtitle ,a--,develop+ an ,integrat$ ,high-,p]=m+ ,network ,*apt] #a--;,e/abli%+ ,community ,c>e ,programs ,sec4 #aja4 ,e/abli%m5t ( ,vet]ans ,community ,c>e ,program4 ,sec4 #ajb4 ,au?orization ( agreem5ts betwe5 ,dep>tm5t ( ,vet]ans ,affairs & non-,dep>tm5t provid]s4 ,sec4 #ajc4 ,con=m+ am5dm5ts = ,/ate vet]ans homes4 ,sec4 #ajd4 ,access /&>ds & /&>ds = quality4 ,sec4 #aje4 ,access to walk-9 c>e4 ,sec4 #ajf4 ,/rategy reg>d+ ! ,dep>tm5t ( ,vet]ans ,affairs ,high-,p]=m+ ,integrat$ ,heal? ,c>e ,network4 ,sec4 #ajg4 ,applicability ( ,directive ( ,(fice ( ,f$]al ,contract ,compliance ,programs4 ,sec4 #ajh4 ,prev5tion ( c]ta9 heal? c>e provid]s f provid+ non-,dep>tm5t heal? c>e s]vices to vet]ans4 ,sec4 #aji4 ,rem$iation ( m$ical s]vice l9es4 ,*apt] #b--,pay+ ,provid]s & ,improv+ ,collections ,sec4 #aaa4 ,prompt paym5t to provid]s4 ,sec4 #aab4 ,au?ority to pay = au?oriz$ c>e n subject to an agreem5t4 ,sec4 #aac4 ,improvem5t ( au?ority to recov] ! co/ ( s]vices furni%$ = non-s]vice-connect$ disabilities4 ,sec4 #aad4 ,process+ ( claims = reimbursem5t ?r\gh electronic int]face4 ,*apt] #c--;,education & ,tra9+ ,programs ,sec4 #aba4 ,education program on heal? c>e options4 ,sec4 #abb4 ,tra9+ program = adm9i/ration ( non-,dep>tm5t ( ,vet]ans ,affairs heal? c>e4 ,sec4 #abc4 ,cont9u+ m$ical education = non-,dep>tm5t m$ical pr(essionals4 ,*apt] #d--,o!r ,matt]s ,relat+ to ,non-,dep>tm5t ( ,vet]ans ,affairs ,provid]s ,sec4 #aca4 ,e/abli%m5t ( processes to ensure safe opioid prescrib+ practices by non-,dep>tm5t ( ,vet]ans ,affairs heal? c>e provid]s4 ,sec4 #acb4 ,improv+ in=mation %>+ ) community provid]s4 ,sec4 #acc4 ,compet5cy /&>ds = non-,dep>tm5t ( ,vet]ans ,affairs heal? c>e provid]s4 ,sec4 #acd4 ,dep>tm5t ( ,vet]ans ,affairs p>ticipation 9 national network ( ,/ate-bas$ prescription drug monitor+ programs4 ,*apt] #e--,o!r ,non-,dep>tm5t ,heal? ,c>e ,matt]s ,sec4 #ada4 ,plans = ,use ( ,supplem5tal ,appropriations ,requir$4 ,sec4 #adb4 ,vet]ans ,*oice ,fund flexibility4 ,sec4 #adc4 ,sunset ( ,vet]ans ,*oice ,program4 ,sec4 #add4 ,con=m+ am5dm5ts4 ,subtitle ,b--,improv+ ,dep>tm5t ( ,vet]ans ,affairs ,heal? ,c>e ,deliv]y ,sec4 #aea4 ,lic5sure ( heal? c>e pr(essionals ( ! ,dep>tm5t ( ,vet]ans ,affairs provid+ treatm5t via telem$ic9e4 ,sec4 #aeb4 ,au?ority = ,dep>tm5t ( ,vet]ans ,affairs ,c5t] = ,innovation = ,c>e & ,paym5t4 ,sec4 #aec4 ,au?orization to provide = op]ations on live donors = purposes ( conduct+ transplant proc$ures = vet]ans4 ,subtitle ,c--,family ,c>egiv]s ,sec4 #afa4 ,expansion ( family c>egiv] program ( ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #afb4 ,implem5tation ( in=mation te*nology sy/em ( ,dep>tm5t ( ,vet]ans ,affairs to assess & improve ! family c>egiv] program4 ,sec4 #afc4 ,modifications to annual evaluation report on c>egiv] program ( ,dep>tm5t ( ,vet]ans ,affairs4 ,title ,,ii--,,va ,asset & ,infra/ructure ,review ,subtitle ,a--,asset & ,infra/ructure ,review ,sec4 #bja4 ,%ort title4 ,sec4 #bjb4 ,! ,commission4 ,sec4 #bjc4 ,proc$ure = mak+ recomm5dations4 ,sec4 #bjd4 ,actions reg>d+ infra/ructure & facilities ( ! ,vet]ans ,heal? ,adm9i/ration4 ,sec4 #bje4 ,implem5tation4 ,sec4 #bjf4 ,dep>tm5t ( ,vet]ans ,affairs ,asset & ,infra/ructure ,review ,acc\nt4 ,sec4 #bjg4 ,congressional consid]ation ( ,commission report4 ,sec4 #bjh4 ,o!r matt]s4 ,sec4 #bji4 ,def9itions4 ,subtitle ,b--,o!r ,infra/ructure ,matt]s ,sec4 #baa4 ,improvem5t to tra9+ ( con/ruction p]sonnel4 ,sec4 #bab4 ,review ( enhanc$ use leases4 ,sec4 #bac4 ,assessm5t ( heal? c>e furni%$ by ! ,dep>tm5t to vet]ans :o live 9 ! ,pacific t]ritories4 ,title ,,iii--,improvem5ts to ,recruitm5t ( ,heal? ,c>e ,pr(essionals ,sec4 #cja4 ,designat$ s*ol>%ips = physicians & d5ti/s "u ,dep>tm5t ( ,vet]ans ,affairs ,heal? ,pr(essional ,s*ol>%ip ,program4 ,sec4 #cjb4 ,increase 9 maximum am\nt ( debt t may be r$uc$ "u ,education ,debt ,r$uction ,program ( ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #cjc4 ,e/abli%+ ! ,dep>tm5t ( ,vet]ans ,affairs ,specialty ,education ,loan ,repaym5t ,program4 ,sec4 #cjd4 ,vet]ans heal+ vet]ans m$ical access & s*ol>%ip program4 ,sec4 #cje4 ,bonuses = recruitm5t1 relocation1 & ret5tion4 ,sec4 #cjf4 ,inclusion ( ,vet ,c5t] employees 9 ,education ,debt ,r$uction ,program ( ,dep>tm5t ( ,vet]ans ,affairs4 ,title ,,iv--,heal? ,c>e 9 ,und]s]v$ ,areas ,sec4 #dja4 ,developm5t ( crit]ia = designation ( c]ta9 m$ical facilities ( ! ,dep>tm5t ( ,vet]ans ,affairs z und]s]v$ facilities & plan to address problem ( und]s]v$ facilities4 ,sec4 #djb4 ,pilot program to furni% mobile deploym5t teams to und]s]v$ facilities4 ,sec4 #djc4 ,pilot program on graduate m$ical education & resid5cy4 ,title ,v--,o!r ,matt]s ,sec4 #eja4 ,annual report on p]=mance aw>ds & bonuses aw>d$ to c]ta9 high-level employees ( ! dep>tm5t4 ,sec4 #ejb4 ,role ( podiatri/s 9 ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #ejc4 ,def9ition ( major m$ical facility project4 ,sec4 #ejd4 ,au?orization ( c]ta9 major m$ical facility projects ( ! ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #eje4 ,dep>tm5t ( ,vet]ans ,affairs p]sonnel transp>5cy4 ,sec4 #ejf4 ,program on e/abli%m5t ( pe] speciali/s 9 pati5t align$ c>e team sett+s )9 m$ical c5t]s ( ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #ejg4 ,dep>tm5t ( ,vet]ans ,affairs m$ical scribe pilot program4 ,sec4 #ejh4 ,ext5sion ( requirem5t to collect fees = h\s+ loans gu>ante$ by ,secret>y ( ,vet]ans ,affairs4 ,sec4 #eji4 ,ext5sion ( r$uction 9 am\nt ( p5sion furni%$ by ,dep>tm5t ( ,vet]ans ,affairs = c]ta9 vet]ans cov]$ by ,m$icaid plans = s]vices furni%$ by nurs+ facilities4 ,sec4 #eaj4 ,appropriation ( am\nts4 ,sec4 #eaa4 ,te*nical correction4 ,sec4 #eab4 ,budget>y effects4 ,i ,c>+ = our ,vet]ans #ajj4 ,%ort title2 ref]5ces to title #ch1 ,unit$ ,/ates ,code 7a7 ,%ort title ,?is title may be cit$ z ! ,c>+ = ,our ,vet]ans ,act ( #bjah4 7b7 ,ref]5ces to title #ch1 ,unit$ ,/ates ,code ,except z o!rwise expressly provid$1 :5ev] 9 ?is title an am5dm5t or repeal is express$ 9 t]ms ( an am5dm5t to1 or repeal (1 a section or o!r provision1 ! ref]5ce %all be consid]$ to be made to a section or o!r provision ( title #ch1 ,unit$ ,/ates ,code4 ,a ,develop+ an ,integrat$ ,high-,p]=m+ ,network #a ,e/abli%+ ,community ,c>e ,programs #aja4 ,e/abli%m5t ( ,vet]ans ,community ,c>e ,program 7a7 ,e/abli%m5t ( program 7#a7 ,9 g5]al ,section #agjc is am5d$ to read z foll[s3 #agjc4 ,vet]ans ,community ,c>e ,program 7a7 ,9 g5]al 7#a7 ,!re is e/abli%$ a program to furni% hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices to cov]$ vet]ans ?r\gh heal? c>e provid]s specifi$ 9 subsection 7c74 7#b7 ,! ,secret>y %all coord9ate ! furni%+ ( hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices "u ?is section to cov]$ vet]ans1 includ+ coord9ation (1 at a m9imum1 ! foll[+3 7,a7 ,ensur+ ! s*$ul+ ( m$ical appo9tm5ts 9 a timely mann] & ! e/abli%m5t ( a me*anism to receive m$ical records f non-,dep>tm5t provid]s4 7,b7 ,ensur+ cont9uity ( c>e & s]vices4 7,c7 ,ensur+ coord9ation among regional networks if ! cov]$ vet]an accesses c>e & s]vices 9 a diff]5t network ?an ! regional network 9 :i* ! cov]$ vet]an resides4 7,d7 ,ensur+ t cov]$ vet]ans d n exp]i5ce a lapse 9 c>e result+ f errors or delays by ! ,dep>tm5t or its contractors or an unusual or excessive burd5 9 access+ hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices4 7#c7 ,a cov]$ vet]an may only receive c>e or s]vices "u ?is section ^u ! au?orization ( su* c>e or s]vices by ! ,secret>y4 7b7 ,cov]$ vet]ans ,= purposes ( ?is section1 a cov]$ vet]an is any vet]an :o-- 7#a7 is enroll$ 9 ! sy/em ( annual pati5t enrollm5t e/abli%$ & op]at$ "u section #agje ( ?is title2 or 7#b7 is n enroll$ 9 su* sy/em b is o!rwise entitl$ to hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices "u subsection 7c77#b7 ( su* section4 7c7 ,heal? c>e provid]s specifi$ ,heal? c>e provid]s specifi$ 9 ?is subsection are ! foll[+3 7#a7 ,any heal? c>e provid] t is p>ticipat+ 9 ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq471 includ+ any physician furni%+ s]vices "u su* a program4 7#b7 ,! ,dep>tm5t ( ,def5se4 7#c7 ,! ,indian ,heal? ,s]vice4 7#d7 ,any ,f$]ally-qualifi$ heal? c5t] 7z def9$ 9 section #aije7l77#b77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7l77#b77;,b7774 7#e7 ,any heal? c>e provid] n o!rwise cov]$ "u any ( p>agraphs 7#a7 ?r\gh 7#d7 t meets crit]ia e/abli%$ by ! ,secret>y = purposes ( ?is section4 7d7 ,conditions "u :i* c>e is requir$ ,to be furni%$ ?r\gh non-,dep>tm5t provid]s 7#a7 ,! ,secret>y %all1 subject to ! availability ( appropriations1 furni% hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices to a cov]$ vet]an ?r\gh heal? c>e provid]s specifi$ 9 subsection 7c7 if-- 7,a7 ! ,dep>tm5t does n (f] ! c>e or s]vices ! vet]an requires2 7,b7 ! ,dep>tm5t does n op]ate a full-s]vice m$ical facility 9 ! ,/ate 9 :i* ! cov]$ vet]an resides2 7,c7 7i7 ! cov]$ vet]an 0 an eligible vet]an "u section #aja7;b77#b77;,b7 ( ! ,vet]ans ,access1 ,*oice1 & ,acc\ntability ,act ( #bjad 7,public ,law #aac-adf2 #ch ,u4,s4,c4 #agja note7 z ( ! day be=e ! date ( ! enactm5t ( ! ,c>+ = ,our ,vet]ans ,act ( #bjah2 7ii7 cont9ues to reside 9 a location t w\ld qualify ! vet]an = eligibility "u su* section2 & 7iii7 ei!r-- 7,i7 resides 9 "o ( ! five ,/ates ) ! l[e/ population d5sity z det]m9$ by data f ! #bjaj dec5nial c5sus2 or 7,,ii7 resides 9 a ,/ate n describ$ 9 subclause 7,i7 &-- 7aa7 receiv$ c>e or s]vices "u ?is title 9 ! ye> prec$+ ! enactm5t ( ! ,c>+ = ,our ,vet]ans ,act ( #bjah2 & 7bb7 is seek+ c>e or s]vices )9 #b ye>s ( ! date ( ! enactm5t ( ! ,c>+ = ,our ,vet]ans ,act ( #bjah2 7,d7 ! cov]$ vet]an has contact$ ! ,dep>tm5t to reque/ c>e or s]vices & ! ,dep>tm5t is n able to furni% su* c>e or s]vices 9 a mann] t complies ) designat$ access /&>ds develop$ by ! ,secret>y "u section #agjc;,b ( ?is title2 or 7,e7 ! cov]$ vet]an & ! cov]$ vet]an's ref]r+ cl9ician agree t furni%+ c>e & s]vices ?r\gh a non-,dep>tm5t entity or provid] w\ld be 9 ! be/ m$ical int]e/ ( ! cov]$ vet]an bas$ ^u crit]ia develop$ by ! ,secret>y4 7#b7 ,! ,secret>y %all ensure t ! crit]ia develop$ "u p>agraph 7#a77;,e7 include consid]ation ( ! foll[+3 7,a7 ,! di/ance betwe5 ! cov]$ vet]an & ! facility t provides ! hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices ! vet]an ne$s4 7,b7 ,! nature ( ! hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices requir$4 7,c7 ,! frequ5cy t ! hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices ne$s to be furni%$4 7,d7 ,! timel9ess ( available appo9tm5ts = ! hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices ! vet]an ne$s4 7,e7 ,:e!r ! cov]$ vet]an faces an unusual or excessive burd5 to access hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices f ! ,dep>tm5t m$ical facility :]e a cov]$ vet]an seeks hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices1 :i* %all include consid]ation ( ! foll[+3 7i7 ,:e!r ! cov]$ vet]an faces an excessive driv+ di/ance1 geographical *all5ge1 or environm5tal factor t imp$es ! access ( ! cov]$ vet]an4 7ii7 ,:e!r ! hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices s\ght by ! vet]an is provid$ by a m$ical facility ( ! ,dep>tm5t t is reasonably accessible to a cov]$ vet]an4 7iii7 ,:e!r a m$ical condition ( ! cov]$ vet]an affects ! ability ( ! cov]$ vet]an to travel4 7iv7 ,:e!r !re is compell+ reason1 z det]m9$ by ! ,secret>y1 t ! vet]an ne$s to receive hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices f a m$ical facility o!r ?an a m$ical facility ( ! ,dep>tm5t4 7v7 ,su* o!r consid]ations z ! ,secret>y consid]s appropriate4 7#c7 ,if ! ,secret>y has det]m9$ t ! ,dep>tm5t does n (f] ! c>e or s]vices ! cov]$ vet]an requires "u subp>agraph 7,a7 ( p>agraph 7#a71 t ! ,dep>tm5t does n op]ate a full-s]vice m$ical facility 9 ! ,/ate 9 :i* ! cov]$ vet]an resides "u subp>agraph 7,b7 ( su* p>agraph1 t ! cov]$ vet]an is describ$ "u subp>agraph 7,c7 ( su* p>agraph1 or t ! ,dep>tm5t is n able to furni% c>e or s]vices 9 a mann] t complies ) designat$ access /&>ds develop$ by ! ,secret>y "u section #agjc;,b ( ?is title "u subp>agraph 7,d7 ( su* p>agraph1 ! decision to receive hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices "u su* subp>agraphs f a heal? c>e provid] specifi$ 9 subsection 7c7 %all be at ! election ( ! vet]an4 7e7 ,conditions "u :i* c>e is au?oriz$ ,to be furni%$ ?r\gh non-,dep>tm5t provid]s 7#a7 7,a7 ,! ,secret>y may furni% hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices ?r\gh a heal? c>e provid] specifi$ 9 subsection 7c7 to a cov]$ vet]an s]v$ by a m$ical s]vice l9e ( ! ,dep>tm5t t ! ,secret>y has det]m9$ is n provid+ c>e t complies ) ! /&>ds = quality ! ,secret>y %all e/abli% "u section #agjc;,c4 7,b7 ,9 c>ry+ out subp>agraph 7,a71 ! ,secret>y %all-- 7i7 measure timel9ess ( ! m$ical s]vice l9e at a facility ( ! ,dep>tm5t :5 comp>$ ) ! same m$ical s]vice l9e at diff]5t ,dep>tm5t facilities2 & 7ii7 measure quality at a m$ical s]vice l9e ( a facility ( ! ,dep>tm5t by comp>+ x ) two or m di/9ct & appropriate quality measures at non-,dep>tm5t m$ical s]vice l9es4 7,c7 7i7 ,! ,secret>y may n concurr5tly furni% hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices "u subp>agraph 7,a7 ) respect to m ?an ?ree m$ical s]vice l9es describ$ 9 su* subp>agraph at any "o heal? c>e facility ( ! ,dep>tm5t4 7ii7 ,! ,secret>y may n concurr5tly furni% hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices "u subp>agraph 7,a7 ) respect to m ?an #cf m$ical s]vice l9es nationally describ$ 9 su* subp>agraph4 7#b7 ,! ,secret>y may limit ! types ( hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices cov]$ vet]ans may receive "u p>agraph 7#a7 9 t]ms ( ! l5g? ( "t su* c>e & s]vices w be available1 ! location at :i* su* c>e & s]vices w be available1 & ! cl9ical c>e & s]vices t w be available4 7#c7 7,a7 ,except z provid$ = 9 subp>agraph 7,b71 ! hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices au?oriz$ "u p>agraph 7#a7 ) respect to a m$ical s]vice l9e %all cease :5 ! rem$iation describ$ 9 section #agjf;,a ) respect to su* m$ical s]vice l9e is complete4 7,b7 ,! ,secret>y %all ensure cont9uity & coord9ation ( c>e = any vet]an :o elects to receive c>e or s]vices "u p>agraph 7#a7 f a heal? c>e provid] specifi$ 9 subsection 7c7 ?r\gh ! completion ( an episode ( c>e4 7#d7 ,! ,secret>y %all publi% 9 ! ,f$]al ,regi/]1 & %all take all reasonable /eps to provide direct notice to cov]$ vet]ans affect$ "u ?is subsection1 at lea/ once ea* ye> /at+ ! "t p]iod dur+ :i* su* c>e & s]vices w be available1 ! location or locations :]e su* c>e & s]vices w be available1 & ! cl9ical s]vices available at ea* location "u ?is subsection 9 accordance ) regulations ! ,secret>y %all prescribe4 7#e7 ,:5 ! ,secret>y ex]cises ! au?ority "u p>agraph 7#a71 ! decision to receive c>e or s]vices "u su* p>agraph f a heal? c>e provid] specifi$ 9 subsection 7c7 %all be at ! election ( ! cov]$ vet]an4 7f7 ,review ( decisions ,! review ( any decision "u subsection 7d7 or 7e7 %all be subject to ! ,dep>tm5t's cl9ical appeals process1 & su* decisions may n be appeal$ to ! ,bo>d ( ,vet]ans' ,appeals4 7g7 ,ti]$ network 7#a7 ,to promote ! provision ( high-quality & high-value hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices "u ?is section1 ! ,secret>y may develop a ti]$ provid] network ( eligible provid]s bas$ on crit]ia e/abli%$ by ! ,secret>y = purposes ( ?is section4 7#b7 ,9 develop+ a ti]$ provid] network ( eligible provid]s "u p>agraph 7#a71 ! ,secret>y %all n prioritize provid]s 9 a ti] ov] provid]s 9 any o!r ti] 9 a mann] t limits ! *oice ( a cov]$ vet]an 9 select+ a heal? c>e provid] specifi$ 9 subsection 7c7 = receipt ( hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices "u ?is section4 7h7 ,contracts ,to e/abli% networks ( heal? c>e provid]s 7#a7 ,! ,secret>y %all ent] into consolidat$1 competitively bid contracts to e/abli% networks ( heal? c>e provid]s specifi$ 9 p>agraphs 7#a7 & 7#e7 ( subsection 7c7 = purposes ( provid+ suffici5t access to hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices "u ?is section4 7#b7 7,a7 ,! ,secret>y %all1 to ! ext5t practicable1 ensure t cov]$ vet]ans are able to make _! own appo9tm5ts us+ advanc$ te*nology4 7,b7 ,to ! ext5t practicable1 ! ,secret>y %all be responsible = ! s*$ul+ ( appo9tm5ts = hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices "u ?is section4 7#c7 7,a7 ,! ,secret>y may t]m9ate a contract ) an entity ent]$ into "u p>agraph 7#a7 at su* "t & ^u su* notice to ! entity z ! ,secret>y may specify = purposes ( ?is section1 if ! ,secret>y notifies ! appropriate committees ( ,congress t1 at a m9imum-- 7i7 ! entity-- 7,i7 fail$ to comply sub/antially ) ! provisions ( ! contract or ) ! provisions ( ?is section & ! regulations prescrib$ "u ?is section2 7,,ii7 fail$ to comply ) ! access /&>ds or ! /&>ds = quality e/abli%$ by ! ,secret>y2 7,,iii7 is 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 7,,iv7 is id5tifi$ z an exclud$ s\rce on ! li/ ma9ta9$ 9 ! ,sy/em = ,aw>d ,managem5t1 or any successor sy/em2 or 7,v7 has be5 convict$ ( a felony or o!r s]i\s (f5se "u ,f$]al or ,/ate law & ! cont9u$ p>ticipation ( ! entity w\ld be detrim5tal to ! be/ int]e/s ( vet]ans or ! ,dep>tm5t2 7ii7 x is reasonable to t]m9ate ! contract bas$ on ! heal? c>e ne$s ( vet]ans2 or 7iii7 x is reasonable to t]m9ate ! contract bas$ on cov]age provid$ by contracts or %>+ agreem5ts ent]$ into "u au?orities o!r ?an ?is section4 7,b7 ,no?+ 9 subp>agraph 7,a7 may be con/ru$ to re/rict ! au?ority ( ! ,secret>y to t]m9ate a contract ent]$ into "u p>agraph 7#a7 "u any o!r provision ( law4 7#d7 ,:5ev] ! ,secret>y provides notice to an entity t ! entity is fail+ to meet contractual obligations ent]$ into "u p>agraph 7#a71 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on su* failure4 ,su* report %all include ! foll[+3 7,a7 ,an explanation ( ! reasons = provid+ su* notice4 7,b7 ,a description ( ! effect ( su* failure1 includ+ ) respect to co/1 s*$ule1 & requirem5ts4 7,c7 ,a description ( ! actions tak5 by ! ,secret>y to mitigate su* failure4 7,d7 ,a description ( ! actions tak5 by ! contractor to address su* failure4 7,e7 ,a description ( any effect on ! community provid] m>ket = vet]ans 9 ! affect$ area4 7#e7 7,a7 ,! ,secret>y %all in/ruct ea* entity aw>d$ a contract "u p>agraph 7#a7 to recognize & accept1 on an int]im basis1 ! cr$5tials & qualifications ( heal? c>e provid]s :o are au?oriz$ to furni% hospital c>e & m$ical s]vices to vet]ans "u a community c>e program ( ! ,dep>tm5t 9 effect z ( ! day be=e ! date ( ! enactm5t ( ! ,c>+ = ,our ,vet]ans ,act ( #bjah1 includ+ "u ! ,pati5t-,c5t]$ ,community ,c>e ,program & ! ,vet]ans ,*oice ,program "u section #aja ( ! ,vet]ans ,access1 ,*oice1 & ,acc\ntability ,act ( #bjad 7,public ,law #aac-adf2 #ch ,u4,s4,c4 #agja note71 z qualifi$ provid]s "u ! program e/abli%$ "u ?is section4 7,b7 ,! int]im acceptance p]iod "u subp>agraph 7,a7 %all be det]m9$ by ! ,secret>y bas$ on ! foll[+ crit]ia3 7i7 ,) respect to a heal? c>e provid]1 :5 ! curr5t c]tification agreem5t = ! heal? c>e provid] expires4 7ii7 ,:e!r ! ,dep>tm5t has enact$ c]tification & eligibility crit]ia & regulatory proc$ures by :i* non-,dep>tm5t provid]s w be au?oriz$ "u ?is section4 7#f7 ,! ,secret>y %all e/abli% a sy/em or sy/ems = monitor+ ! quality ( c>e provid$ to cov]$ vet]ans ?r\gh a network "u ?is subsection & = assess+ ! quality ( hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices furni%$ ?r\gh su* network be=e ! r5ewal ( ! contract = su* network4 7i7 ,paym5t rates = c>e & s]vices 7#a7 ,except z provid$ 9 p>agraph 7#b71 & to ! ext5t practicable1 ! rate paid = hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices "u any provision 9 ?is title may n exce$ ! rate paid by ! ,unit$ ,/ates to a provid] ( s]vices 7z def9$ 9 section #ahfa7u7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciex7u777 or a suppli] 7z def9$ 9 section #ahfa7;d7 ( su* ,act 7#db ,u4,s4,c4 #aciex7d777 "u ! ,m$ic>e program "u title ,,xi or title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acja et seq471 includ+ section #ahcd ( su* ,act 7#db ,u4,s4,c4 #aciem71 = ! same c>e or s]vices4 7#b7 7,a7 ,a high] rate ?an ! rate paid by ! ,unit$ ,/ates z describ$ 9 p>agraph 7#a7 may be negotiat$ ) respect to ! furni%+ ( c>e or s]vices to a cov]$ vet]an :o resides 9 a highly rural area4 7,b7 ,9 ?is p>agraph1 ! t]m highly rural area means an area locat$ 9 a c\nty t has few] ?an sev5 individuals resid+ 9 t c\nty p] squ>e mile4 7#c7 ,) respect to furni%+ c>e or s]vices "u ?is section 9 ,alaska1 ! ,alaska ,fee ,s*$ule ( ! ,dep>tm5t ( ,vet]ans ,affairs %all be foll[$1 except = :5 ano!r paym5t agreem5t1 includ+ a contract or provid] agreem5t1 is 9 effect4 7#d7 ,) respect to furni%+ hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices "u ?is section 9 a ,/ate ) an ,all-,pay] ,model ,agreem5t "u section #ahad7;b77#c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;f7b77#c77 t became effective on or aft] ,janu>y #a1 #bjad1 ! ,m$ic>e paym5t rates "u p>agraph 7#b77;,a7 %all be calculat$ bas$ on ! paym5t rates "u su* agreem5t4 7#e7 ,not)/&+ p>agraph 7#a71 ! ,secret>y may incorporate1 to ! ext5t practicable1 ! use ( value-bas$ reimbursem5t models to promote ! provision ( high-quality c>e4 7#f7 ,) respect to hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices = :i* !re is n a rate paid "u ! ,m$ic>e program z describ$ 9 p>agraph 7#a71 ! rate paid = su* c>e or s]vices %all be det]m9$ by ! ,secret>y4 7j7 ,treatm5t ( o!r heal? plan contracts ,9 any case 9 :i* a cov]$ vet]an is furni%$ hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices "u ?is section = a non-s]vice-connect$ disability describ$ 9 subsection 7a77#b7 ( section #agbi ( ?is title1 ! ,secret>y %all recov] or collect reasonable *>ges = su* c>e or s]vices f a heal? plan contract describ$ 9 section #agbi 9 accordance ) su* section4 7k7 ,paym5t by vet]an ,a cov]$ vet]an %all n pay a great] am\nt = receiv+ c>e or s]vices "u ?is section ?an ! am\nt ! vet]an w\ld pay = receiv+ ! same or comp>able c>e or s]vices at a m$ical facility ( ! ,dep>tm5t or f a heal? c>e provid] ( ! ,dep>tm5t4 7l7 ,transplant au?ority = improv$ access 7#a7 ,9 ! case ( a cov]$ vet]an describ$ 9 p>agraph 7#b71 ! ,secret>y %all det]m9e :e!r to au?orize an organ or bone m>r[ transplant = t cov]$ vet]an at a non-,dep>tm5t facility4 7#b7 ,a cov]$ vet]an describ$ 9 ?is p>agraph-- 7,a7 requires an organ or bone m>r[ transplant2 & 7,b7 has1 9 ! op9ion ( ! prim>y c>e provid] ( ! vet]an1 a m$ically compell+ reason to travel outside ! region ( ! ,organ ,procurem5t & ,transplantation ,network1 e/abli%$ "u section #cgb ( ! ,national ,organ ,transplantation ,act 7,public ,law #ih-ejg2 #db ,u4,s4,c4 #bgd71 9 :i* ! vet]an resides1 to receive su* transplant4 7m7 ,monitor+ ( c>e provid$ 7#a7 7,a7 ,n lat] ?an #edj days aft] ! date ( ! enactm5t ( ! ,c>+ = ,our ,vet]ans ,act ( #bjah1 & n less frequ5tly ?an annually !reaft]1 ! ,secret>y %all submit to appropriate committees ( ,congress a review ( ! types & frequ5cy ( c>e s\ght "u subsection 7d74 7,b7 ,! review submitt$ "u subp>agraph 7,a7 %all include an assessm5t ( ! foll[+3 7i7 ,! top #be p]c5t ( types ( c>e & s]vices mo/ frequ5tly provid$ "u subsection 7d7 due to ! ,dep>tm5t n (f]+ su* c>e & s]vices4 7ii7 ,! frequ5cy su* c>e & s]vices 7 s\ght by cov]$ vet]ans "u ?is section4 7iii7 ,an analysis ( ! reasons ! ,dep>tm5t 0 unable to provide su* c>e & s]vices4 7iv7 ,any /eps ! ,dep>tm5t took to provide su* c>e & s]vices at a m$ical facility ( ! ,dep>tm5t4 7v7 ,! co/ ( su* c>e & s]vices4 7#b7 ,9 monitor+ ! hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices furni%$ "u ?is section1 ! ,secret>y %all d ! foll[+3 7,a7 ,) respect to hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices furni%$ ?r\gh provid] networks e/abli%$ "u subsection 7i7-- 7i7 compile data on ! types ( hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices furni%$ ?r\gh su* networks & h[ _m pati5ts us$ ea* type ( c>e & s]vice2 7ii7 id5tify gaps 9 hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices furni%$ ?r\gh su* networks2 7iii7 id5tify h[ su* gaps may be fix$ ?r\gh new contracts )9 su* networks or *anges 9 ! mann] 9 :i* hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices are furni%$ ?r\gh su* networks2 7iv7 assess ! total am\nts sp5t by ! ,dep>tm5t on hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices furni%$ ?r\gh su* networks2 7v7 assess ! timel9ess ( ! ,dep>tm5t 9 ref]r+ hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices to su* networks2 & 7vi7 assess ! timel9ess ( su* networks 9-- 7,i7 accept+ ref]rals2 & 7,,ii7 s*$ul+ & complet+ appo9tm5ts4 7,b7 ,report ! numb] ( m$ical s]vice l9es ! ,secret>y has det]m9$ "u subsection 7e77#a7 n to be provid+ hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices t comply ) ! /&>ds = quality e/abli%$ by ! ,secret>y4 7,c7 ,assess ! use ( academic affiliates & c5t]s ( excell5ce ( ! ,dep>tm5t to furni% hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices to cov]$ vet]ans "u ?is section4 7,d7 ,assess ! hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices furni%$ to cov]$ vet]ans "u ?is section by m$ical facilities op]at$ by ,f$]al ag5cies o!r ?an ! ,dep>tm5t4 7#c7 ,n lat] ?an #edj days aft] ! date ( ! enactm5t ( ! ,c>+ = ,our ,vet]ans ,act ( #bjah & n less frequ5tly ?an once ea* ye> !reaft]1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! in=mation ga!r$ "u p>agraph 7#b74 7n7 ,prohibition on c]ta9 limitations 7#a7 ,! ,secret>y %all n limit ! types ( hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices cov]$ vet]ans may receive "u ?is section if x is 9 ! be/ m$ical int]e/ ( ! vet]an to receive su* hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices1 z det]m9$ by ! vet]an & ! vet]an's heal? c>e provid]4 7#b7 ,no provision 9 ?is section may be con/ru$ to alt] or modify any o!r provision ( law e/abli%+ specific eligibility crit]ia = c]ta9 hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices4 7o7 ,def9itions ,9 ?is section3 7#a7 ,! t]m appropriate committees ( ,congress means-- 7,a7 ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,appropriations ( ! ,s5ate2 & 7,b7 ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,appropriations ( ! ,h\se ( ,repres5tatives4 7#b7 ,! t]m m$ical s]vice l9e means a cl9ic )9 a ,dep>tm5t m$ical c5t]4 4 7#b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( *apt] #ag is am5d$ by /rik+ ! item relat+ to section #agjc & ins]t+ ! foll[+ new item3 #agjc4 ,vet]ans ,community ,c>e ,program4 4 7b7 ,effective date ,section #agjc ( title #ch1 ,unit$ ,/ates ,code1 z am5d$ by subsection 7a71 %all take effect on ! lat] (-- 7#a7 ! date t is #cj days aft] ! date on :i* ! ,secret>y ( ,vet]ans ,affairs submits ! report requir$ "u section #aja7q77#b7 ( ! ,vet]ans ,access1 ,*oice1 & ,acc\ntability ,act ( #bjad 7,public ,law #aac-adf2 #ch ,u4,s4,c4 #agja note72 or 7#b7 ! date on :i* ! ,secret>y promulgates regulations pursuant to subsection 7c74 7c7 ,regulations 7#a7 ,9 g5]al ,n lat] ?an #a ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all promulgate regulations to c>ry out section #agjc ( title #ch1 ,unit$ ,/ates ,code1 z am5d$ by subsection 7a7 ( ?is section4 7#b7 ,updates 7,a7 ,p]iodic ,be=e promulgat+ ! regulations requir$ "u p>agraph 7#a71 ! ,secret>y %all provide to ! appropriate committees ( ,congress p]iodic updates to confirm ! progress ( ! ,secret>y t[>d develop+ su* regulations4 7,b7 ,fir/ update ,! fir/ update "u subp>agraph 7,a7 %all occur no lat] ?an #abj days f ! date ( ! enactm5t ( ?is ,act4 7,c7 ,appropriate committees ( ,congress def9$ ,9 ?is p>agraph1 ! t]m appropriate committees ( ,congress means-- 7i7 ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,appropriations ( ! ,s5ate2 & 7ii7 ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,appropriations ( ! ,h\se ( ,repres5tatives4 7d7 ,cont9uity ( exi/+ agreem5ts 7#a7 ,9 g5]al ,not)/&+ section #agjc ( title #ch1 ,unit$ ,/ates ,code1 z am5d$ by subsection 7a71 ! ,secret>y ( ,vet]ans ,affairs %all cont9ue all contracts1 memor&ums ( und]/&+1 memor&ums ( agreem5ts1 & o!r arrangem5ts t 7 9 effect on ! day be=e ! date ( ! enactm5t ( ?is ,act betwe5 ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,am]ican ,indian & ,alaska ,native heal? c>e sy/ems z e/abli%$ "u ! t]ms ( ! ,dep>tm5t ( ,vet]ans ,affairs & ,indian ,heal? ,s]vice ,memor&um ( ,und]/&+1 sign$ ,octob] #a1 #bjaj1 ! ,national ,reimbursem5t ,agreem5t1 sign$ ,decemb] #e1 #bjab1 arrangem5ts "u section #dje ( ! ,indian ,heal? ,c>e ,improvem5t ,act 7#be ,u4,s4,c4 #afde71 & agreem5ts ent]$ into "u sections #ajb & #ajc ( ! ,vet]ans ,access1 ,*oice1 & ,acc\ntability ,act ( #bjad 7,public ,law #aac-adf74 7#b7 ,modifications ,p>agraph 7#a7 %all n be con/ru$ to prohibit ! ,secret>y & ! p>ties to ! contracts1 memor&ums ( und]/&+1 memor&ums ( agreem5ts1 & o!r arrangem5ts describ$ 9 su* p>agraph f mak+ su* *anges to su* contracts1 memor&ums ( und]/&+1 memor&ums ( agreem5ts1 & o!r arrangem5ts z may be o!rwise au?oriz$ pursuant to o!r provisions ( law or ! t]ms ( ! contracts1 memor&ums ( und]/&+1 memor&ums ( agreem5ts1 & o!r arrangem5ts4 #ajb4 ,au?orization ( agreem5ts betwe5 ,dep>tm5t ( ,vet]ans ,affairs & non-,dep>tm5t provid]s 7a7 ,9 g5]al ,sub*apt] ,i ( *apt] #ag is am5d$ by ins]t+ aft] section #agjc ! foll[+ new section3 #agjc;,a4 ,agreem5ts ) eligible entities or provid]s2 c]tification processes 7a7 ,agreem5ts au?oriz$ 7#a7 7,a7 ,:5 hospital c>e1 a m$ical s]vice1 or an ext5d$ c>e s]vice requir$ by a vet]an :o is entitl$ to su* c>e or s]vice "u ?is *apt] is n feasibly available to ! vet]an f a facility ( ! ,dep>tm5t or ?r\gh a contract or %>+ agreem5t ent]$ into pursuant to ano!r provision ( law1 ! ,secret>y may furni% su* c>e or s]vice to su* vet]an ?r\gh an agreem5t "u ?is section ) an eligible entity or provid] to provide su* hospital c>e1 m$ical s]vice1 or ext5d$ c>e s]vice4 7,b7 ,an agreem5t ent]$ into "u ?is section to provide hospital c>e1 a m$ical s]vice1 or an ext5d$ c>e s]vice %all be kn[n z a ,vet]ans ,c>e ,agreem5t4 7,c7 ,= purposes ( subp>agraph 7,a71 hospital c>e1 a m$ical s]vice1 or an ext5d$ c>e s]vice may be consid]$ n feasibly available to a vet]an f a facility ( ! ,dep>tm5t or ?r\gh a contract or %>+ agreem5t describ$ 9 su* subp>agraph :5 ! ,secret>y det]m9es ! vet]an's m$ical condition1 ! travel involv$1 ! nature ( ! c>e or s]vices requir$1 or a comb9ation ( ^! factors make ! use ( a facility ( ! ,dep>tm5t or a contract or %>+ agreem5t describ$ 9 su* subp>agraph impracticable or inadvisable4 7,d7 ,a ,vet]ans ,c>e ,agreem5t may be ent]$ into by ! ,secret>y or any ,dep>tm5t (ficial au?oriz$ by ! ,secret>y4 7#b7 7,a7 ,subject to subp>agraph 7,b71 ! ,secret>y %all review ea* ,vet]ans ,c>e ,agreem5t ( mat]ial size1 z det]m9$ by ! ,secret>y or set =? 9 p>agraph 7#c71 = hospital c>e1 a m$ical s]vice1 or an ext5d$ c>e s]vice to det]m9e :e!r x is feasible & advisable to provide su* c>e or s]vice )9 a facility ( ! ,dep>tm5t or by contract or %>+ agreem5t ent]$ into pursuant to ano!r provision ( law &1 if s1 take action to d s4 7,b7 7i7 ,! ,secret>y %all review ea* ,vet]ans ,c>e ,agreem5t ( mat]ial size t has be5 9 effect = at lea/ #f mon?s )9 ! fir/ #b ye>s ( its tak+ effect1 & n less frequ5tly ?an once e #d ye>s !reaft]4 7ii7 ,if a ,vet]ans ,c>e ,agreem5t has n be5 9 effect = at lea/ #f mon?s by ! date ( ! review requir$ by subp>agraph 7,a71 ! agreem5t %all be review$ dur+ ! next cycle requir$ by subp>agraph 7,a71 & su* review %all s]ve z its review )9 ! fir/ #b ye>s ( its tak+ effect = purposes ( clause 7i74 7#c7 7,a7 ,9 fiscal ye> #bjai & 9 ea* fiscal ye> !reaft]1 9 addition to su* o!r ,vet]ans ,c>e ,agreem5ts z ! ,secret>y may det]m9e are ( mat]ial size1 a ,vet]ans ,c>e ,agreem5t = ! pur*ase ( ext5d$ c>e s]vices t exce$s #e1jjj1jjj annually %all be consid]$ ( mat]ial size4 7,b7 ,f "t to "t1 ! ,secret>y may publi% a notice 9 ! ,f$]al ,regi/] to adju/ ! doll> am\nt specifi$ 9 subp>agraph 7,a7 to acc\nt = *anges 9 ! co/ ( heal? c>e bas$ ^u recogniz$ heal? c>e m>ket surveys & o!r available data4 7b7 ,eligible entities & provid]s ,= purposes ( ?is section1 an eligible entity or provid] is-- 7#a7 any provid] ( s]vices t has enroll$ & ent]$ into a provid] agreem5t "u section #ahff7;a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;cc7a77 & any physician or o!r suppli] :o has enroll$ & ent]$ into a p>ticipation agreem5t "u section #ahdb7;h7 ( su* ,act 7#db ,u4,s4,c4 #acieu7h772 7#b7 any provid] p>ticipat+ "u a ,/ate plan "u title ,,xix ( su* ,act 7#db ,u4,s4,c4 #acif et seq472 7#c7 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 7#d7 a c5t] = indep5d5t liv+ 7z def9$ 9 section #gjb ( ! ,rehabilitation ,act ( #aigc 7#bi ,u4,s4,c4 #gif;a772 or 7#e7 any entity or provid] n describ$ 9 p>agraph 7#a7 or 7#b7 ( ?is subsection t ! ,secret>y det]m9es to be eligible pursuant to ! c]tification process describ$ 9 subsection 7c74 7c7 ,eligible entity or provid] c]tification process ,! ,secret>y %all e/abli% by regulation a process = ! c]tification ( eligible entities or provid]s or rec]tification ( eligible entities or provid]s "u ?is section4 ,su* a process %all1 at a m9imum-- 7#a7 e/abli% deadl9es = actions on applications = c]tification2 7#b7 set =? /&>ds = an approval or d5ial ( c]tification1 duration ( c]tification1 revocation ( an eligible entity or provid]'s c]tification1 & rec]tification ( eligible entities or provid]s2 7#c7 require ! d5ial ( c]tification if ! ,secret>y det]m9es ! eligible entity or provid] is exclud$ f p>ticipation 9 a ,f$]al heal? c>e program "u section #aabh or section #aabh;,a ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g or #acbj;a-#g;a7 or is curr5tly id5tifi$ z an exclud$ s\rce on ! ,sy/em = ,aw>d ,managem5t ,exclusions li/ describ$ 9 "p #i ( title #dh1 ,code ( ,f$]al ,regulations1 & "p #ahj ( title #b ( su* ,code1 or successor regulations2 7#d7 e/abli% proc$ures = scre5+ eligible entities or provid]s accord+ to ! risk ( fraud1 wa/e1 & abuse t are simil> to ! /&>ds "u section #ahff7;j77#b77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;cc7j77#b77;,b77 & section #i4ajd ( title #dh1 ,code ( ,f$]al ,regulations1 or successor regulations2 & 7#e7 incorporate & apply ! re/rictions & p5alties set =? 9 *apt] #ba ( title #da & treat ?is section z a procurem5t program only = purposes ( apply+ su* provisions4 7d7 ,rates ,to ! ext5t practicable1 ! rates paid by ! ,secret>y = hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices provid$ "u a ,vet]ans ,c>e ,agreem5t %all be 9 accordance ) ! rates paid by ! ,unit$ ,/ates "u section #agjc7;i7 ( ?is title4 7e7 ,t]ms ( ,vet]ans ,c>e ,agreem5ts 7#a7 ,pursuant to regulations promulgat$ "u subsection 7k71 ! ,secret>y may def9e ! requirem5ts = provid]s & entities ent]+ into agreem5ts "u ?is section bas$ ^u su* factors z ! numb] ( pati5ts receiv+ c>e or s]vices1 ! numb] ( employees employ$ by ! entity or provid] furni%+ su* c>e or s]vices1 ! am\nt paid by ! ,secret>y to ! provid] or entity1 or o!r factors z det]m9$ by ! ,secret>y4 7#b7 ,to furni% hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices "u ?is section1 an eligible entity or provid] %all agree-- 7,a7 to accept paym5t at ! rates e/abli%$ 9 regulations prescrib$ "u ?is section2 7,b7 t paym5t by ! ,secret>y "u ?is section on behalf ( a vet]an to a provid] ( s]vices or c>e %all1 unless reject$ & refund$ by ! provid] )9 #cj days ( receipt1 con/itute paym5t 9 full & ext+ui% any liability on ! "p ( ! vet]an = ! treatm5t or c>e provid$1 & no provision ( a contract1 agreem5t1 or assignm5t to ! contr>y %all op]ate to modify1 limit1 or negate ?is requirem5t2 7,c7 to provide only ! c>e & s]vices au?oriz$ by ! ,dep>tm5t "u ?is section & to obta9 ! prior writt5 cons5t ( ! ,dep>tm5t to furni% c>e or s]vices outside ! scope ( su* au?orization2 7,d7 to bill ! ,dep>tm5t 9 accordance ) ! me?odology outl9$ 9 regulations prescrib$ "u ?is section2 7,e7 to n seek to recov] or collect f a heal? plan contract or ?ird p>ty1 z ^? t]ms are def9$ 9 section #agbi ( ?is title1 = any c>e or s]vice t is furni%$ or paid = by ! ,dep>tm5t2 7,f7 to provide m$ical records to ! ,dep>tm5t 9 ! "t frame & =mat specifi$ by ! ,dep>tm5t2 & 7,g7 to meet su* o!r t]ms & conditions1 includ+ quality ( c>e assurance /&>ds1 z ! ,secret>y may specify 9 regulation4 7f7 ,discont9uation or nonr5ewal ( a ,vet]ans ,c>e ,agreem5t 7#a7 ,an eligible entity or provid] may discont9ue a ,vet]ans ,c>e ,agreem5t at su* "t & ^u su* notice to ! ,secret>y z may be provid$ 9 regulations prescrib$ "u ?is section4 7#b7 ,! ,secret>y may discont9ue a ,vet]ans ,c>e ,agreem5t ) an eligible entity or provid] at su* "t & ^u su* reasonable notice to ! eligible entity or provid] z may be specifi$ 9 regulations prescrib$ "u ?is section1 if an (ficial designat$ by ! ,secret>y-- 7,a7 has det]m9$ t ! eligible entity or provid] fail$ to comply sub/antially ) ! provisions ( ! ,vet]ans ,c>e ,agreem5t1 or ) ! provisions ( ?is section or regulations prescrib$ "u ?is section2 7,b7 has det]m9$ ! eligible entity or provid] is exclud$ f p>ticipation 9 a ,f$]al heal? c>e program "u section #aabh or section #aabh;,a ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g or #acbj;a-#g;a7 or is id5tifi$ on ! ,sy/em = ,aw>d ,managem5t ,exclusions li/ z provid$ 9 "p #i ( title #dh1 ,code ( ,f$]al ,regulations1 & "p #ahj ( title #b ( su* ,code1 or successor regulations2 7,c7 has asc]ta9$ t ! eligible entity or provid] has be5 convict$ ( a felony or o!r s]i\s (f5se "u ,f$]al or ,/ate law & det]m9es ! eligible entity or provid]'s cont9u$ p>ticipation w\ld be detrim5tal to ! be/ int]e/s ( vet]ans or ! ,dep>tm5t2 or 7,d7 has det]m9$ t x is reasonable to t]m9ate ! agreem5t bas$ on ! heal? c>e ne$s ( a vet]an4 7g7 ,quality ( c>e ,! ,secret>y %all e/abli% a sy/em or sy/ems = monitor+ ! quality ( c>e provid$ to vet]ans ?r\gh ,vet]ans ,c>e ,agreem5ts & = assess+ ! quality ( hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices furni%$ by eligible entities & provid]s be=e ! r5ewal ( ,vet]ans ,c>e ,agreem5ts4 7h7 ,disputes 7#a7 ,! ,secret>y %all promulgate adm9i/rative proc$ures = eligible entities & provid]s to pres5t all disputes aris+ "u or relat$ to ,vet]ans ,c>e ,agreem5ts4 7#b7 ,su* proc$ures con/itute ! eligible entities' & provid]s' exhau/ive & exclusive adm9i/rative rem$ies4 7#c7 ,eligible entities or provid]s mu/ fir/ exhau/ su* adm9i/rative proc$ures be=e seek+ any judicial review "u section #acdf ( title #bh 7kn[n z ! ,tuck] ,act74 7#d7 ,disputes "u ?is section mu/ p]ta9 to ei!r ! scope ( au?orization "u ! ,vet]ans ,c>e ,agreem5t or claims = paym5t subject to ! ,vet]ans ,c>e ,agreem5t & are n claims = ! purposes ( su* laws t w\ld o!rwise require application ( sections #gaja ?r\gh #gaji ( title #da1 ,unit$ ,/ates ,code4 7i7 ,applicability ( o!r provisions ( law 7#a7 ,a ,vet]ans ,c>e ,agreem5t may be au?oriz$ by ! ,secret>y or any ,dep>tm5t (ficial au?oriz$ by ! ,secret>y1 & su* action %all n be treat$ z-- 7,a7 an aw>d = ! purposes ( su* laws t w\ld o!rwise require ! use ( competitive proc$ures = ! furni%+ ( c>e & s]vices2 or 7,b7 a ,f$]al contract = ! acquisition ( goods or s]vices = purposes ( any provision ( ,f$]al law gov]n+ ,f$]al contracts = ! acquisition ( goods or s]vices except section #dgjf7;d7 ( title #da4 7#b7 7,a7 ,except z provid$ 9 ! agreem5t itself1 9 subp>agraph 7,b71 & unless o!rwise provid$ 9 ?is section or regulations prescrib$ pursuant to ?is section1 an eligible entity or provid] t ent]s into an agreem5t "u ?is section is n subject to1 9 ! c>ry+ out ( ! agreem5t1 any law to :i* provid]s ( s]vices & suppli]s "u ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq47 are n subject4 7,b7 ,an eligible entity or provid] t ent]s into an agreem5t "u ?is section is subject to-- 7i7 all laws reg>d+ integrity1 e?ics1 or fraud1 or t subject a p]son to civil or crim9al p5alties2 & 7ii7 all laws t protect aga9/ employm5t discrim9ation or t o!rwise ensure equal employm5t opportunities4 7#c7 ,not)/&+ p>agraph 7#b77;,b77i71 an eligible entity or provid] t ent]s into an agreem5t "u ?is section %all n be treat$ z a ,f$]al contractor or subcontractor = purposes ( *apt] #fg ( title #da 7commonly kn[n z ! ,mc,namara-,o',h>a ,s]vice ,contract ,act ( #aife74 7j7 ,p>ity ( treatm5t ,eligibility = hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices furni%$ to any vet]an pursuant to a ,vet]ans ,c>e ,agreem5t %all be subject to ! same t]ms z ?\gh provid$ 9 a facility ( ! ,dep>tm5t1 & provisions ( ?is *apt] applicable to vet]ans receiv+ su* c>e & s]vices 9 a facility ( ! ,dep>tm5t %all apply to vet]ans treat$ "u ?is section4 7k7 ,rulemak+ ,! ,secret>y %all promulgate regulations to c>ry out ?is section4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat+ to section #agjc ! foll[+ new item3 #agjc;,a4 ,agreem5ts ) eligible entities or provid]s2 c]tification processes4 4 #ajc4 ,con=m+ am5dm5ts = ,/ate vet]ans homes 7a7 ,9 g5]al ,section #agde7;a7 is am5d$-- 7#a7 9 p>agraph 7#a71 by /rik+ 7or agreem5t "u section #agbj7;c77#a7 ( ?is title7 & ins]t+ 7or an agreem5t72 & 7#b7 by add+ at ! end ! foll[+ new p>agraph3 7#d7 7,a7 ,an agreem5t "u ?is section may be au?oriz$ by ! ,secret>y or any ,dep>tm5t (ficial au?oriz$ by ! ,secret>y1 & any su* action is n an aw>d = purposes ( su* laws t w\ld o!rwise require ! use ( competitive proc$ures = ! furni%+ ( hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices4 7,b7 7i7 ,except z provid$ 9 ! agreem5t itself1 9 clause 7ii71 & unless o!rwise provid$ 9 ?is section or regulations prescrib$ pursuant to ?is section1 a ,/ate home t ent]s into an agreem5t "u ?is section is n subject to1 9 ! c>ry+ out ( ! agreem5t1 any provision ( law to :i* provid]s ( s]vices & suppli]s "u ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq47 are n subject4 7ii7 ,a ,/ate home t ent]s into an agreem5t "u ?is section is subject to-- 7,i7 all provisions ( law reg>d+ integrity1 e?ics1 or fraud1 or t subject a p]son to civil or crim9al p5alties2 7,,ii7 all provisions ( law t protect aga9/ employm5t discrim9ation or t o!rwise ensure equal employm5t opportunities2 & 7,,iii7 all provisions 9 sub*apt] ,v ( *apt] #ag ( ?is title4 7iii7 ,not)/&+ subp>agraph 7,b77ii77,i71 a ,/ate home t ent]s into an agreem5t "u ?is section may n be treat$ z a ,f$]al contractor or subcontractor = purposes ( *apt] #fg ( title #da 7kn[n z ! ,mc,namara-,o',h>a ,s]vice ,contract ,act ( #aife74 4 7b7 ,effective date ,! am5dm5t made by subsection 7a7 %all apply to c>e provid$ on or aft] ! effective date ( regulations issu$ by ! ,secret>y ( ,vet]ans ,affairs to c>ry out ?is section4 #ajd4 ,access /&>ds & /&>ds = quality 7a7 ,9 g5]al ,sub*apt] ,i ( *apt] #ag1 z am5d$ by section #ajb1 is fur!r am5d$ by ins]t+ aft] section #agjc;,a ! foll[+ new sections3 #agjc;,b4 ,access /&>ds 7a7 7#a7 ,! ,secret>y %all e/abli% access /&>ds = furni%+ hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices to cov]$ vet]ans = ! purposes ( section #agjc7;d74 7#b7 ,! ,secret>y %all ensure t ! access /&>ds e/abli%$ "u p>agraph 7#a7 def9e su* categories ( c>e to cov] all c>e & s]vices )9 ! m$ical b5efits package ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7b7 ,! ,secret>y %all ensure t ! access /&>ds provide cov]$ vet]ans1 employees ( ! ,dep>tm5t1 & heal? c>e provid]s 9 ! network e/abli%$ "u section #agjc7;h7 ) relevant comp>ative in=mation t is cle>1 useful1 & timely1 s t cov]$ vet]ans c make in=m$ decisions reg>d+ _! heal? c>e4 7c7 ,! ,secret>y %all consult ) all p]t95t ,f$]al entities 7includ+ ! ,dep>tm5t ( ,def5se1 ! ,dep>tm5t ( ,heal? & ,human ,s]vices1 & ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices71 entities 9 ! private sector1 & o!r nongov]nm5tal entities 9 e/abli%+ access /&>ds4 7d7 7#a7 ,n lat] ?an #bgj days aft] ! date ( ! enactm5t ( ! ,c>+ = ,our ,vet]ans ,act ( #bjah1 ! ,secret>y %all submit to ! appropriate committees ( ,congress a report detail+ ! access /&>ds4 7#b7 7,a7 ,be=e submitt+ ! report requir$ "u p>agraph 7#a71 ! ,secret>y %all provide p]iodic updates to ! appropriate committees ( ,congress to confirm ! ,dep>tm5t's progress t[>ds develop+ ! access /&>ds requir$ by ?is section4 7,b7 ,! fir/ update "u subp>agraph 7,a7 %all occur no lat] ?an #abj days f ! date ( ! enactm5t ( ! ,c>+ = ,our ,vet]ans ,act ( #bjah4 7#c7 ,n lat] ?an #edj days aft] ! date on :i* ! ,secret>y implem5ts ! access /&>ds e/abli%$ "u subsection 7a71 ! ,secret>y %all submit to ! appropriate committees ( ,congress a report detail+ ! implem5tation ( & compliance ) su* access /&>ds by ,dep>tm5t & non-,dep>tm5t entities or provid]s4 7e7 ,n lat] ?an #c ye>s aft] ! date on :i* ! ,secret>y e/abli%es access /&>ds "u subsection 7a7 & n less frequ5tly ?an once e #c ye>s !reaft]1 ! ,secret>y %all-- 7#a7 conduct a review ( su* /&>ds2 & 7#b7 submit to ! appropriate committees ( ,congress a report on ! f9d+s & any modification to ! access /&>ds ) respect to ! review conduct$ "u p>agraph 7#a74 7f7 ,! ,secret>y %all ensure heal? c>e provid]s specifi$ "u section #agjc7;c7 are able to comply ) ! applicable access /&>ds e/abli%$ by ! ,secret>y4 7g7 ,! ,secret>y %all publi% 9 ! ,f$]al ,regi/] & on an int]net website ( ! ,dep>tm5t ! designat$ access /&>ds e/abli%$ "u ?is section = purposes ( section #agjc7;d77#a77;,d74 7h7 7#a7 ,consi/5t ) p>agraphs 7#a77;,d7 & 7#c7 ( section #agjc7;d71 cov]$ vet]ans may contact ! ,dep>tm5t at any "t to reque/ a det]m9ation reg>d+ :e!r !y are eligible to receive c>e & s]vices f a non-,dep>tm5t entity or provid] bas$ on ! ,dep>tm5t be+ unable to furni% su* c>e & s]vices 9 a mann] t complies ) ! designat$ access /&>ds e/abli%$ "u ?is section4 7#b7 ,! ,secret>y %all e/abli% a process to review su* reque/s f cov]$ vet]ans to det]m9e :e!r-- 7,a7 ! reque/$ c>e is cl9ically necess>y2 & 7,b7 ! ,dep>tm5t is able to provide su* c>e 9 a mann] t complies ) designat$ access /&>ds e/abli%$ "u ?is section4 7#c7 ,! ,secret>y %all promptly respond to any su* reque/ by a cov]$ vet]an4 7i7 7#a7 ,! t]m appropriate committees ( ,congress means-- 7,a7 ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,appropriations ( ! ,s5ate2 & 7,b7 ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,appropriations ( ! ,h\se ( ,repres5tatives4 7#b7 ,! t]m cov]$ vet]ans ref]s to vet]ans describ$ 9 section #agjc7;b7 ( ?is title4 #agjc;,c4 ,/&>ds = quality 7a7 ,9 g5]al 7#a7 ,! ,secret>y %all e/abli% /&>ds = quality reg>d+ hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices furni%$ by ! ,dep>tm5t pursuant to ?is title1 includ+ ?r\gh non-,dep>tm5t heal? c>e provid]s pursuant to section #agjc ( ?is title4 7#b7 ,9 e/abli%+ /&>ds = quality "u p>agraph 7#a71 ! ,secret>y %all consid] exi/+ heal? quality measures t are appli$ to public & privately sponsor$ heal? c>e sy/ems ) ! purpose ( provid+ cov]$ vet]ans relevant comp>ative in=mation to make in=m$ decisions reg>d+ _! heal? c>e4 7#c7 ,! ,secret>y %all collect & consid] data = purposes ( e/abli%+ ! /&>ds "u p>agraph 7#a74 ,su* data collection %all include-- 7,a7 aft] consultation ) vet]ans s]vice organizations & o!r key /akehold]s on survey developm5t or modification ( an exi/+ survey1 a survey ( vet]ans :o h us$ hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices furni%$ by ! ,vet]ans ,heal? ,adm9i/ration dur+ ! mo/ rec5t #b-ye> p]iod to assess ! satisfaction ( ! vet]ans ) s]vice & quality ( c>e2 & 7,b7 datasets t include1 at a m9imum1 elem5ts relat+ to ! foll[+3 7i7 ,timely c>e4 7ii7 ,effective c>e4 7iii7 ,safety1 includ+1 at a m9imum1 complications1 readmissions1 & dea?s4 7iv7 ,effici5cy4 7#d7 ,! ,secret>y %all consult ) all p]t95t ,f$]al entities 7includ+ ! ,dep>tm5t ( ,def5se1 ! ,dep>tm5t ( ,heal? & ,human ,s]vices1 & ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices71 entities 9 ! private sector1 & o!r nongov]nm5tal entities 9 e/abli%+ /&>ds = quality4 7#e7 7,a7 ,n lat] ?an #bgj days aft] ! date ( ! enactm5t ( ! ,c>+ = ,our ,vet]ans ,act ( #bjah1 ! ,secret>y %all submit to ! appropriate committees ( ,congress a report detail+ ! /&>ds = quality4 7,b7 7i7 ,be=e submitt+ ! report requir$ "u subp>agraph 7,a71 ! ,secret>y %all provide p]iodic updates to ! appropriate committees ( ,congress to confirm ! ,dep>tm5t's progress t[>ds develop+ ! /&>ds = quality requir$ by ?is section4 7ii7 ,! fir/ update "u clause 7i7 %all occur no lat] ?an #abj days f ! date ( ! enactm5t ( ! ,c>+ = ,our ,vet]ans ,act ( #bjah4 7b7 ,publication & consid]ation ( public comm5ts 7#a7 ,n lat] ?an #a ye> aft] ! date on :i* ! ,secret>y e/abli%es /&>ds = quality "u subsection 7a71 ! ,secret>y %all publi% ! quality rat+ ( m$ical facilities ( ! ,dep>tm5t 9 ! publicly available ,hospital ,comp>e website ?r\gh ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices = ! purpose ( provid+ vet]ans ) in=mation t all[s !m to comp>e p]=mance measure in=mation among ,dep>tm5t & non-,dep>tm5t heal? c>e provid]s4 7#b7 ,n lat] ?an #b ye>s aft] ! date on :i* ! ,secret>y e/abli%es /&>ds = quality "u subsection 7a71 ! ,secret>y %all consid] & solicit public comm5t on pot5tial *anges to ! measures us$ 9 su* /&>ds to ensure t !y include ! mo/ up-to-date & applicable indu/ry measures = vet]ans4 7c7 7#a7 ,! t]m appropriate committees ( ,congress means-- 7,a7 ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,appropriations ( ! ,s5ate2 & 7,b7 ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,appropriations ( ! ,h\se ( ,repres5tatives4 7#b7 ,! t]m cov]$ vet]ans ref]s to vet]ans describ$ 9 section #agjc7;b7 ( ?is title4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( *apt] #ag1 z am5d$ by section #ajb1 is fur!r am5d$ by ins]t+ aft] ! item relat+ to section #agjc;,a ! foll[+ new items3 #agjc;,b4 ,access /&>ds4 #agjc;,c4 ,/&>ds = quality4 4 #aje4 ,access to walk-9 c>e 7a7 ,9 g5]al ,*apt] #ag is am5d$ by ins]t+ aft] section #agbe ! foll[+ new section3 #agbe;,a4 ,access to walk-9 c>e 7a7 ,proc$ures ,to ensure access to walk-,9 c>e ,! ,secret>y %all develop proc$ures to ensure t eligible vet]ans are able to access walk-9 c>e f qualify+ non-,dep>tm5t entities or provid]s4 7b7 ,eligible vet]ans ,= purposes ( ?is section1 an eligible vet]an is any individual :o-- 7#a7 is enroll$ 9 ! heal? c>e sy/em e/abli%$ "u section #agje7;a7 ( ?is title2 & 7#b7 has receiv$ c>e "u ?is *apt] )9 ! #bd-mon? p]iod prec$+ ! furni%+ ( walk-9 c>e "u ?is section4 7c7 ,qualify+ non-,dep>tm5t entities or provid]s ,= purposes ( ?is section1 a qualify+ non-,dep>tm5t entity or provid] is a non-,dep>tm5t entity or provid] t has ent]$ into a contract or o!r agreem5t ) ! ,secret>y to furni% s]vices "u ?is section4 7d7 ,f$]ally-,qualifi$ heal? c5t]s ,:5ev] practicable1 ! ,secret>y may use a ,f$]ally-qualifi$ heal? c5t] 7z def9$ 9 section #aije7l77#b77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7l77#b77;,b777 to c>ry out ?is section4 7e7 ,cont9uity ( c>e ,! ,secret>y %all ensure cont9uity ( c>e = ^? eligible vet]ans :o receive walk-9 c>e s]vices "u ?is section1 includ+ ?r\gh ! e/abli%m5t ( a me*anism to receive m$ical records f walk-9 c>e provid]s & provide p]t95t pati5t m$ical records to provid]s ( walk-9 c>e4 7f7 ,copaym5ts 7#a7 7,a7 ,! ,secret>y may require an eligible vet]an to pay ! ,unit$ ,/ates a copaym5t = ea* episode ( hospital c>e or m$ical s]vices provid$ "u ?is section if ! eligible vet]an w\ld be requir$ to pay a copaym5t "u ?is title4 7,b7 ,an eligible vet]an n requir$ to pay a copaym5t "u ?is title may access walk-9 c>e )\t a copaym5t = ! fir/ two visits 9 a cal5d> ye>4 ,= any additional visits1 a copaym5t at an am\nt det]m9$ by ! ,secret>y may be requir$4 7,c7 ,an eligible vet]an requir$ to pay a copaym5t "u ?is title may be requir$ to pay a regul> copaym5t = ! fir/ two walk-9 c>e visits 9 a cal5d> ye>4 ,= any additional visits1 a high] copaym5t at an am\nt det]m9$ by ! ,secret>y may be requir$4 7#b7 ,aft] ! fir/ two episodes ( c>e furni%$ to an eligible vet]an "u ?is section1 ! ,secret>y may adju/ ! copaym5t requir$ ( ! vet]an "u ?is subsection bas$ ^u ! priority gr\p ( enrollm5t ( ! eligible vet]an1 ! numb] ( episodes ( c>e furni%$ to ! eligible vet]an dur+ a ye>1 & o!r factors ! ,secret>y consid]s appropriate "u ?is section4 7#c7 ,! am\nt or am\nts ( ! copaym5ts requir$ "u ?is subsection %all be prescrib$ by ! ,secret>y by rule4 7#d7 ,section #haec7;c7 ( ?is title %all n apply to ?is subsection4 7g7 ,regulations ,n lat] ?an #a ye> aft] ! date ( ! enactm5t ( ! ,c>+ = ,our ,vet]ans ,act ( #bjah1 ! ,secret>y %all promulgate regulations to c>ry out ?is section4 7h7 ,walk-,9 c>e def9$ ,9 ?is section1 ! t]m walk-9 c>e means non-em]g5t c>e provid$ by a qualify+ non-,dep>tm5t entity or provid] t furni%es episodic c>e & n longitud9al managem5t ( conditions & is o!rwise def9$ ?r\gh regulations ! ,secret>y %all promulgate4 4 7b7 ,effective date ,section #agbe;,a ( title #ch1 ,unit$ ,/ates ,code1 z add$ by subsection 7a7 %all take effect on ! date ^u :i* f9al regulations implem5t+ su* section take effect4 7c7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat+ to section #agbe ! foll[+ new item3 #agbe;,a4 ,access to walk-9 c>e4 4 #ajf4 ,/rategy reg>d+ ! ,dep>tm5t ( ,vet]ans ,affairs ,high-,p]=m+ ,integrat$ ,heal? ,c>e ,network 7a7 ,9 g5]al ,sub*apt] ,,ii ( *apt] #gc is am5d$ by ins]t+ aft] section #gccj;,b ! foll[+ new section3 #gccj;,c4 ,quadr5nial ,vet]ans ,heal? ,adm9i/ration review 7a7 ,m>ket area assessm5ts 7#a7 ,n less frequ5tly ?an e #d ye>s1 ! ,secret>y ( ,vet]ans ,affairs %all p]=m m>ket area assessm5ts reg>d+ ! heal? c>e s]vices furni%$ "u ! laws adm9i/]$ by ! ,secret>y4 7#b7 ,ea* m>ket area assessm5t e/abli%$ "u p>agraph 7#a7 %all include ! foll[+3 7,a7 ,an assessm5t ( ! dem& = heal? c>e f ! ,dep>tm5t1 disaggregat$ by geographic m>ket areas z det]m9$ by ! ,secret>y1 includ+ ! numb] ( reque/s = heal? c>e s]vices "u ! laws adm9i/]$ by ! ,secret>y4 7,b7 ,an inv5tory ( ! heal? c>e capacity ( ! ,dep>tm5t ( ,vet]ans ,affairs across ! ,dep>tm5t's sy/em ( facilities4 7,c7 ,an assessm5t ( ! heal? c>e capacity to be provid$ ?r\gh contract$ community c>e provid]s & provid]s :o ent]$ into a provid] agreem5t ) ! ,dep>tm5t "u section #agjc;,a ( title #ch1 z add$ by section #ajb1 includ+ ! numb] ( provid]s1 ! geographic location ( ! provid]s1 & categories or types ( heal? c>e s]vices provid$ by ! provid]s4 7,d7 ,an assessm5t obta9$ f o!r ,f$]al direct deliv]y sy/ems ( _! capacity to provide heal? c>e to vet]ans4 7,e7 ,an assessm5t ( ! heal? c>e capacity ( non-contract$ provid]s :]e !re is insuffici5t network supply4 7,f7 ,an assessm5t ( ! heal? c>e capacity ( academic affiliates & o!r collaborations ( ! ,dep>tm5t z x relates to provid+ heal? c>e to vet]ans4 7,g7 ,an assessm5t ( ! effects on heal? c>e capacity ( ! access /&>ds & /&>ds = quality e/abli%$ "u sections #agjc;,b & #agjc;,c ( ?is title4 7,h7 ,! numb] ( appo9tm5ts = heal? c>e s]vices "u ! laws adm9i/]$ by ! ,secret>y1 disaggregat$ by-- 7i7 appo9tm5ts at facilities ( ! ,dep>tm5t ( ,vet]ans ,affairs2 & 7ii7 appo9tm5ts ) non-,dep>tm5t heal? c>e provid]s4 7#c7 7,a7 ,! ,secret>y %all submit to ! appropriate committees ( ,congress ! m>ket area assessm5ts e/abli%$ 9 p>agraph 7#a74 7,b7 ,! ,secret>y also %all submit to ! appropriate committees ( ,congress ! m>ket area assessm5ts complet$ by or be+ p]=m$ on ! day be=e ! date ( ! enactm5t ( ! ,c>+ = ,our ,vet]ans ,act ( #bjah4 7#d7 7,a7 ,! ,secret>y %all use ! m>ket area assessm5ts e/abli%$ "u p>agraph 7#a7 to-- 7i7 det]m9e ! capacity ( ! heal? c>e provid] networks e/abli%$ "u section #agjc7;h7 ( ?is title2 7ii7 in=m ! ,dep>tm5t budget1 9 accordance ) subp>agraph 7,b72 & 7iii7 in=m & assess ! appropriat5ess ( ! access /&>ds e/abli%$ "u section #agjc;,b ( ?is title & /&>ds = quality "u section #agjc;,c & to make recomm5dations = any *anges to su* /&>ds4 7,b7 ,! ,secret>y %all ensure t ! ,dep>tm5t budget = any fiscal ye> 7z submitt$ ) ! budget ( ! ,presid5t "u section #aaje7;a7 ( title #ca7 reflects ! f9d+s ( ! ,secret>y ) respect to ! mo/ rec5t m>ket area assessm5ts "u p>agraph 7#a7 & heal? c>e utilization data f ! ,dep>tm5t & non-,dep>tm5t entities or provid]s furni%+ c>e & s]vices to cov]$ vet]ans z describ$ 9 section #agjc7;b74 7b7 ,/rategic plan ,to meet heal? c>e dem& 7#a7 ,n lat] ?an #a ye> aft] ! date ( ! enactm5t ( ! ,c>+ = ,our ,vet]ans ,act ( #bjah & n less frequ5tly ?an once e #d ye>s !reaft]1 ! ,secret>y %all submit to ! appropriate committees ( ,congress a /rategic plan t specifies a #d-ye> =eca/ (-- 7,a7 ! dem& = heal? c>e f ! ,dep>tm5t1 disaggregat$ by geographic area z det]m9$ by ! ,secret>y2 7,b7 ! heal? c>e capacity to be provid$ at ea* m$ical c5t] ( ! ,dep>tm5t2 & 7,c7 ! heal? c>e capacity to be provid$ ?r\gh community c>e provid]s4 7#b7 ,9 prep>+ ! /rategic plan "u p>agraph 7#a71 ! ,secret>y %all-- 7,a7 assess ! access /&>ds & /&>ds = quality e/abli%$ "u sections #agjc;,b & #agjc;,c ( ?is title2 7,b7 assess ! m>ket area assessm5ts e/abli%$ "u subsection 7a72 7,c7 assess ! ne$s ( ! ,dep>tm5t bas$ on id5tifi$ s]vices t provide managem5t ( conditions or disord]s relat$ to milit>y s]vice = :i* !re is limit$ exp]i5ce or access 9 ! national m>ket1 ! ov]all heal? ( vet]ans ?r\gh\t _! lifespan1 or o!r s]vices z ! ,secret>y det]m9es appropriate2 7,d7 consult ) key /akehold]s )9 ! ,dep>tm5t1 ! heads ( o!r ,f$]al ag5cies1 & o!r relevant gov]nm5tal & nongov]nm5tal entities1 includ+ ,/ate1 local1 & tribal gov]nm5t (ficials1 memb]s ( ,congress1 vet]ans s]vice organizations1 private sector repres5tatives1 academics1 & o!r policy exp]ts2 7,e7 id5tify em]g+ issues1 tr5ds1 problems1 & opportunities t c\ld affect heal? c>e s]vices furni%$ "u ! laws adm9i/]$ by ! ,secret>y2 7,f7 develop recomm5dations reg>d+ bo? %ort- & long-t]m priorities = heal? c>e s]vices furni%$ "u ! laws adm9i/]$ by ! ,secret>y2 7,g7 aft] consultation ) vet]ans s]vice organizations & o!r key /akehold]s on survey developm5t or modification ( an exi/+ survey1 consid] a survey ( vet]ans :o h us$ hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices furni%$ by ! ,vet]ans ,heal? ,adm9i/ration dur+ ! mo/ rec5t #b-ye> p]iod to assess ! satisfaction ( ! vet]ans ) s]vice & quality ( c>e2 7,h7 conduct a compreh5sive exam9ation ( programs & policies ( ! ,dep>tm5t reg>d+ ! deliv]y ( heal? c>e s]vices & ! dem& ( heal? c>e s]vices = vet]ans 9 future ye>s2 7,i7 assess ! rem$iation ( m$ical s]vice l9es ( ! ,dep>tm5t z describ$ 9 section #agjf;,a 9 conjunction ) ! utilization ( non-,dep>tm5t entities or provid]s to (fset rem$iation2 & 7,j7 consid] su* o!r matt]s z ! ,secret>y consid]s appropriate4 7c7 ,responsibilities ,! ,secret>y %all be responsible =-- 7#a7 ov]see+ ! trans=mation & organizational *ange across ! ,dep>tm5t to a*ieve su* high p]=m+ integrat$ heal? c>e network2 7#b7 develop+ ! capital infra/ructure plann+ & procurem5t processes1 :e!r m9or or major con/ruction projects or leases2 & 7#c7 develop+ a multi-ye> budget process t is capable ( =eca/+ future ye> budget requirem5ts & project+ ! co/ ( deliv]+ heal? c>e s]vices "u a high-p]=m+ integrat$ heal? c>e network4 7d7 ,appropriate committees ( ,congress def9$ ,9 ?is section1 ! t]m appropriate committees ( ,congress means-- 7#a7 ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,appropriations ( ! ,s5ate2 & 7#b7 ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,appropriations ( ! ,h\se ( ,repres5tatives4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat+ to section #gccj;,b ! foll[+ new item3 #gccj;,c4 ,quadr5nial ,vet]ans ,heal? ,adm9i/ration review4 4 #ajg4 ,applicability ( ,directive ( ,(fice ( ,f$]al ,contract ,compliance ,programs 7a7 ,9 g5]al ,not)/&+ ! treatm5t ( c]ta9 laws "u subsection 7i7 ( section #agjc;,a ( title #ch1 ,unit$ ,/ates ,code1 z add$ by section #ajb ( ?is title1 ,directive #bjad-ja ( ! ,(fice ( ,f$]al ,contract ,compliance ,programs ( ! ,dep>tm5t ( ,labor 7effective z ( ,may #g1 #bjad7 %all apply to any entity ent]+ into an agreem5t "u su* section #agjc;,a or section #agde ( su* title1 z am5d$ by section #ajc1 9 ! same mann] z su* directive applies to subcontractors "u ! ,,tric>e program = ! duration ( ! moratorium provid$ "u su* directive4 7b7 ,applicability p]iod ,! directive describ$ 9 subsection 7a71 & ! moratorium provid$ "u su* directive1 %all n be alt]$ or resc9d$ be=e ,may #g1 #bjai4 7c7 ,,tric>e program def9$ ,9 ?is section1 ! t]m ,,tric>e program has ! mean+ giv5 t t]m 9 section #ajgb ( title #aj1 ,unit$ ,/ates ,code4 #ajh4 ,prev5tion ( c]ta9 heal? c>e provid]s f provid+ non-,dep>tm5t heal? c>e s]vices to vet]ans 7a7 ,9 g5]al ,on & aft] ! date t is #a ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all d5y or revoke ! eligibility ( a heal? c>e provid] to provide non-,dep>tm5t heal? c>e s]vices to vet]ans if ! ,secret>y det]m9es t ! heal? c>e provid]-- 7#a7 0 remov$ f employm5t ) ! ,dep>tm5t ( ,vet]ans ,affairs due to conduct t violat$ a policy ( ! ,dep>tm5t relat+ to ! deliv]y ( safe & appropriate heal? c>e2 or 7#b7 violat$ ! requirem5ts ( a m$ical lic5se ( ! heal? c>e provid] t result$ 9 ! loss ( su* m$ical lic5se4 7b7 ,p]missive action ,on & aft] ! date t is #a ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y may d5y1 revoke1 or susp5d ! eligibility ( a heal? c>e provid] to provide non-,dep>tm5t heal? c>e s]vices if ! ,secret>y det]m9es su* action is necess>y to imm$iately protect ! heal?1 safety1 or welf>e ( vet]ans & ! heal? c>e provid] is "u inve/igation by ! m$ical lic5s+ bo>d ( a ,/ate 9 :i* ! heal? c>e provid] is lic5s$ or practices4 7c7 ,susp5sion ,! ,secret>y %all susp5d ! eligibility ( a heal? c>e provid] to provide non-,dep>tm5t heal? c>e s]vices to vet]ans if ! heal? c>e provid] is susp5d$ f s]v+ z a heal? c>e provid] ( ! ,dep>tm5t4 7d7 ,comptroll] ,g5]al report ,n lat] ?an #b ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ,congress a report on ! implem5tation by ! ,secret>y ( ?is section1 includ+ ! foll[+3 7#a7 ,! aggregate numb] ( heal? c>e provid]s d5i$ or susp5d$ "u ?is section f p>ticipation 9 provid+ non-,dep>tm5t heal? c>e s]vices4 7#b7 ,an evaluation ( any impact on access to heal? c>e = pati5ts or /aff+ %ortages 9 programs ( ! ,dep>tm5t provid+ non-,dep>tm5t heal? c>e s]vices4 7#c7 ,an explanation ( ! coord9ation ( ! ,dep>tm5t ) ! m$ical lic5s+ bo>ds ( ,/ates 9 implem5t+ ?is section1 ! am\nt ( involvem5t ( su* bo>ds 9 su* implem5tation1 & ef=ts by ! ,dep>tm5t to address any conc]ns rais$ by su* bo>ds ) respect to su* implem5tation4 7#d7 ,su* recomm5dations z ! ,comptroll] ,g5]al consid]s appropriate reg>d+ h>moniz+ eligibility crit]ia betwe5 heal? c>e provid]s ( ! ,dep>tm5t & heal? c>e provid]s eligible to provide non-,dep>tm5t heal? c>e s]vices4 7e7 ,non-,dep>tm5t heal? c>e s]vices def9$ ,9 ?is section1 ! t]m non-,dep>tm5t heal? c>e s]vices means s]vices-- 7#a7 provid$ "u sub*apt] ,i ( *apt] #ag ( title #ch1 ,unit$ ,/ates ,code1 at non-,dep>tm5t facilities 7z def9$ 9 section #agja ( su* title72 7#b7 provid$ "u section #aja ( ! ,vet]ans ,access1 ,*oice1 & ,acc\ntability ,act ( #bjad 7,public ,law #aac-adf2 #ch ,u4,s4,c4 #agja note72 7#c7 pur*as$ ?r\gh ! ,m$ical ,community ,c>e acc\nt ( ! ,dep>tm5t2 or 7#d7 pur*as$ ) am\nts deposit$ 9 ! ,vet]ans ,*oice ,fund "u section #hjb ( ! ,vet]ans ,access1 ,*oice1 & ,acc\ntability ,act ( #bjad4 #aji4 ,rem$iation ( m$ical s]vice l9es 7a7 ,9 g5]al ,sub*apt] ,i ( *apt] #ag is am5d$ by ins]t+ aft] section #agjf ! foll[+ new section3 #agjf;,a4 ,rem$iation ( m$ical s]vice l9es 7a7 ,9 g5]al ,n lat] ?an #cj days aft] det]m9+ "u section #agjc7;e77#a7 t a m$ical s]vice l9e ( ! ,dep>tm5t is provid+ hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices t does n comply ) ! /&>ds = quality e/abli%$ by ! ,secret>y1 ! ,secret>y %all submit to ,congress an assessm5t ( ! factors t l$ ! ,secret>y to make su* det]m9ation & a plan ) specific actions1 & ! "t to complete !m1 to be tak5 to comply ) su* /&>ds = quality1 includ+ ! foll[+3 7#a7 ,increas+ p]sonnel or tempor>y p]sonnel assi/ance1 includ+ mobile deploym5t teams4 7#b7 ,special hir+ inc5tives1 includ+ ! ,education ,debt ,r$uction ,program "u sub*apt] ,,vii ( *apt] #gf ( ?is title & recruitm5t1 relocation1 & ret5tion inc5tives4 7#c7 ,utiliz+ direct hir+ au?ority4 7#d7 ,provid+ improv$ tra9+ opportunities = /aff4 7#e7 ,acquir+ improv$ equipm5t4 7#f7 ,mak+ /ructural modifications to ! facility us$ by ! m$ical s]vice l9e4 7#g7 ,su* o!r actions z ! ,secret>y consid]s appropriate4 7b7 ,responsible p>ties ,9 ea* assessm5t submitt$ "u subsection 7a7 ) respect to a m$ical s]vice l9e1 ! ,secret>y %all id5tify ! individuals at ! ,c5tral ,(fice ( ! ,vet]ans ,heal? ,adm9i/ration1 ! facility us$ by ! m$ical s]vice l9e1 & ! c5tral (fice ( ! relevant ,vet]ans ,integrat$ ,s]vice ,network :o are responsible = ov]see+ ! progress ( t m$ical s]vice l9e 9 comply+ ) ! /&>ds = quality e/abli%$ by ! ,secret>y4 7c7 ,int]im reports ,n lat] ?an #ahj days aft] submitt+ an assessm5t "u subsection 7a7 ) respect to a m$ical s]vice l9e1 ! ,secret>y %all submit to ,congress a report on ! progress ( t m$ical s]vice l9e 9 comply+ ) ! /&>ds = quality e/abli%$ by ! ,secret>y & any o!r measures ! ,secret>y w take to assi/ ! m$ical s]vice l9e 9 comply+ ) su* /&>ds = quality4 7d7 ,annual reports ,n less frequ5tly ?an once ea* ye>1 ! ,secret>y %all-- 7#a7 submit to ,congress an analysis ( ! rem$iation actions & co/s ( su* actions tak5 ) respect to ea* m$ical s]vice l9e ) respect to :i* ! ,secret>y submitt$ an assessm5t & plan "u p>agraph 7#a7 9 ! prec$+ ye>1 includ+ an update on ! progress ( ea* su* m$ical s]vice l9e 9 comply+ ) ! /&>ds = quality & timel9ess e/abli%$ by ! ,secret>y & any o!r actions ! ,secret>y is und]tak+ to assi/ ! m$ical s]vice l9e 9 comply+ ) /&>ds = quality z e/abli%$ by ! ,secret>y2 & 7#b7 publi% su* analysis on ! int]net website ( ! ,dep>tm5t4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat+ to section #agjf ! foll[+ new item3 #agjf;,a4 ,rem$iation ( m$ical s]vice l9es4 4 #b ,pay+ ,provid]s & ,improv+ ,collections #aaa4 ,prompt paym5t to provid]s 7a7 ,9 g5]al ,sub*apt] ,i ( *apt] #ag is am5d$ by ins]t+ aft] section #agjc;,c1 z add$ by section #ajd ( ?is title1 ! foll[+ new section3 #agjc;,d4 ,prompt paym5t /&>d 7a7 ,9 g5]al 7#a7 ,not)/&+ any o!r provision ( ?is title or ( any o!r provision ( law1 ! ,secret>y %all pay = hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices furni%$ by heal? c>e entities or provid]s "u ?is *apt] )9 #de cal5d> days ^u receipt ( a clean pap] claim or #cj cal5d> days ^u receipt ( a clean electronic claim4 7#b7 ,if a claim is d5i$1 ! ,secret>y %all1 )9 #de cal5d> days ( d5ial = a pap] claim & #cj cal5d> days ( d5ial = an electronic claim1 notify ! heal? c>e entity or provid] ( ! reason = d5y+ ! claim & :at1 if any1 additional in=mation is requir$ to process ! claim4 7#c7 ,^u ! receipt ( ! additional in=mation1 ! ,secret>y %all ensure t ! claim is paid1 d5i$1 or o!rwise adjudicat$ )9 #cj cal5d> days f ! receipt ( ! reque/$ in=mation4 7#d7 ,?is section %all only apply to paym5ts made on an invoice basis & %all n apply to capitation or o!r =ms ( p]iodic paym5t to entities or provid]s4 7b7 ,submittal ( claims by heal? c>e entities & provid]s ,a heal? c>e entity or provid] t furni%es hospital c>e1 a m$ical s]vice1 or an ext5d$ c>e s]vice "u ?is *apt] %all submit to ! ,secret>y a claim = paym5t = furni%+ ! hospital c>e1 m$ical s]vice1 or ext5d$ c>e s]vice n lat] ?an #ahj days aft] ! date on :i* ! entity or provid] furni%$ ! hospital c>e1 m$ical s]vice1 or ext5d$ c>e s]vice4 7c7 ,fraudul5t claims 7#a7 ,sections #cgbi ?r\gh #cgcc ( title #ca %all apply to fraudul5t claims = paym5t submitt$ to ! ,secret>y by a heal? c>e entity or provid] "u ?is *apt]4 7#b7 ,pursuant to regulations prescrib$ by ! ,secret>y1 ! ,secret>y %all b> a heal? c>e entity or provid] f furni%+ hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices "u ?is *apt] :5 ! ,secret>y det]m9es ! entity or provid] has submitt$ to ! ,secret>y fraudul5t heal? c>e claims = paym5t by ! ,secret>y4 7d7 ,ov]due claims 7#a7 ,any claim t has n be5 d5i$ ) notice1 made p5d+ ) notice1 or paid to ! heal? c>e entity or provid] by ! ,secret>y %all be ov]due if ! notice or paym5t is n receiv$ by ! entity provid] )9 ! "t p]iods specifi$ 9 subsection 7a74 7#b7 7,a7 ,if a claim is ov]due "u ?is subsection1 ! ,secret>y may1 "u ! requirem5ts e/abli%$ by subsection 7a7 & consi/5t ) ! provisions ( *apt] #ci ( title #ca 7commonly ref]r$ to z ! ,prompt ,paym5t ,act71 require t int]e/ be paid on clean claims4 7,b7 ,int]e/ paid "u subp>agraph 7,a7 %all be comput$ at ! rate ( int]e/ e/abli%$ by ! ,secret>y ( ! ,treasury "u section #cijb ( title #ca & publi%$ 9 ! ,f$]al ,regi/]4 7#c7 ,n less frequ5tly ?an annually1 ! ,secret>y %all submit to ,congress a report on paym5t ( ov]due claims "u ?is subsection1 disaggregat$ by pap] & electronic claims1 t includes ! foll[+3 7,a7 ,! am\nt paid 9 ov]due claims describ$ 9 ?is subsection1 disaggregat$ by ! am\nt ( ! ov]due claim & ! am\nt ( int]e/ paid on su* ov]due claim4 7,b7 ,! numb] ( su* ov]due claims & ! av]age numb] ( days late ea* claim 0 paid1 disaggregat$ by facility ( ! ,dep>tm5t & ,vet]ans ,integrat$ ,s]vice ,network region4 7e7 ,ov]paym5t 7#a7 ,! ,secret>y %all d$uct ! am\nt ( any ov]paym5t f paym5ts due a heal? c>e entity or provid] "u ?is *apt]4 7#b7 ,d$uctions may n be made "u ?is subsection unless ! ,secret>y has made reasonable ef=ts to notify a heal? c>e entity or provid] ( ! "r to dispute ! exi/5ce or am\nt ( su* indebt$ness & ! "r to reque/ a compromise ( su* indebt$ness4 7#c7 ,! ,secret>y %all make a det]m9ation ) respect to any su* dispute or reque/ prior to d$uct+ any ov]paym5t unless ! "t requir$ to make su* a det]m9ation be=e mak+ any d$uctions w\ld jeop>dize ! ,secret>y's ability to recov] ! full am\nt ( su* indebt$ness4 7f7 ,in=mation & docum5tation requir$ 7#a7 ,! ,secret>y %all provide to all heal? c>e entities & provid]s p>ticipat+ 9 a program to furni% hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices "u ?is *apt] a li/ ( in=mation & docum5tation t is requir$ to e/abli% a clean claim "u ?is section4 7#b7 ,! ,secret>y %all consult ) entities 9 ! heal? c>e indu/ry1 9 ! public & private sector1 to det]m9e ! in=mation & docum5tation to include 9 ! li/ "u p>agraph 7#a74 7#c7 ,if ! ,secret>y modifies ! in=mation & docum5tation includ$ 9 ! li/ "u p>agraph 7#a71 ! ,secret>y %all notify all heal? c>e entities & provid]s describ$ 9 p>agraph 7#a7 n lat] ?an #cj days be=e su* modifications take effect4 7g7 ,process+ ( claims 7#a7 ,9 process+ a claim = comp5sation = hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices furni%$ by a non-,dep>tm5t heal? c>e entity or provid] "u ?is *apt]1 ! ,secret>y may act ?r\gh-- 7,a7 a non-,dep>tm5t entity t is "u contract or agreem5t = ! program e/abli%$ "u section #agjc7;a7 ( ?is title2 or 7,b7 a non-,dep>tm5t entity t specializes 9 su* process+ = o!r ,f$]al ag5cy heal? c>e sy/ems4 7#b7 ,! ,secret>y %all seek to contract ) a ?ird p>ty to conduct a review ( claims describ$ 9 p>agraph 7#c7 t includes-- 7,a7 a feasibility assessm5t to det]m9e ! capacity ( ! ,dep>tm5t to process su* claims 9 a timely mann]2 & 7,b7 a co/ b5efit analysis comp>+ ! capacity ( ! ,dep>tm5t to a ?ird p>ty entity capable ( process+ su* claims4 7#c7 ,! review requir$ "u p>agraph 7#b7 %all apply to claims = hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices furni%$ "u section #agjc ( ?is ,act1 z am5d$ by ! ,c>+ = ,our ,vet]ans ,act ( #bjah1 t are process$ by ! ,dep>tm5t4 7h7 ,report on enc\nt] data sy/em 7#a7 ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ! ,c>+ = ,our ,vet]ans ,act ( #bjah1 ! ,secret>y %all submit to ! appropriate committees ( ,congress a report on ! feasibility & advisability ( adopt+ a fund+ me*anism simil> to :at is utiliz$ by o!r ,f$]al ag5cies to all[ a contract$ entity to act z a fiscal int]m$i>y = ! ,f$]al ,gov]nm5t to di/ribute1 or pass ?r\gh1 ,f$]al ,gov]nm5t funds = c]ta9 non-und]writt5 hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices4 7#b7 ,! ,secret>y may coord9ate ) ! ,dep>tm5t ( ,def5se1 ! ,dep>tm5t ( ,heal? & ,human ,s]vices1 & ! ,dep>tm5t ( ! ,treasury 9 develop+ ! report requir$ by p>agraph 7#a74 7i7 ,def9itions ,9 ?is section3 7#a7 ,! t]m appropriate committees ( ,congress means-- 7,a7 ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,appropriations ( ! ,s5ate2 & 7,b7 ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,appropriations ( ! ,h\se ( ,repres5tatives4 7#b7 ,! t]m clean electronic claim means ! transmission ( data = purposes ( paym5t ( cov]$ heal? c>e exp5ses t is submitt$ to ! ,secret>y :i* conta9s sub/antially all ( ! requir$ data elem5ts necess>y = accurate adjudication1 )\t obta9+ additional in=mation f ! entity or provid] t furni%$ ! c>e or s]vice1 submitt$ 9 su* =mat z prescrib$ by ! ,secret>y 9 regulations = ! purpose ( pay+ claims = c>e or s]vices4 7#c7 ,! t]m clean pap] claim means a pap] claim = paym5t ( cov]$ heal? c>e exp5ses t is submitt$ to ! ,secret>y :i* conta9s sub/antially all ( ! requir$ data elem5ts necess>y = accurate adjudication1 )\t obta9+ additional in=mation f ! entity or provid] t furni%$ ! c>e or s]vice1 submitt$ 9 su* =mat z prescrib$ by ! ,secret>y 9 regulations = ! purpose ( pay+ claims = c>e or s]vices4 7#d7 ,! t]m fraudul5t claims means ! kn[+ misrepres5tation ( a mat]ial fact or facts by a heal? c>e entity or provid] made to induce ! ,secret>y to pay a claim t 0 n legally payable to t provid]4 7#e7 ,! t]m heal? c>e entity or provid] includes any non-,dep>tm5t heal? c>e entity or provid]1 b does n include any ,f$]al heal? c>e entity or provid]4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat+ to section #agjc;,c1 z add$ by section #ajd ( ?is title1 ! foll[+ new item3 #agjc;,d4 ,prompt paym5t /&>d4 4 #aab4 ,au?ority to pay = au?oriz$ c>e n subject to an agreem5t 7a7 ,9 g5]al ,sub*apt] ,,iv ( *apt] #ha is am5d$ by add+ at ! end ! foll[+ new section3 #haei4 ,au?ority to pay = s]vices au?oriz$ b n subject to an agreem5t 7a7 ,9 g5]al ,if1 9 ! c\rse ( furni%+ hospital c>e1 a m$ical s]vice1 or an ext5d$ c>e s]vice au?oriz$ by ! ,secret>y & pursuant to a contract1 agreem5t1 or o!r arrangem5t ) ! ,secret>y1 a provid] :o is n a p>ty to ! contract1 agreem5t1 or o!r arrangem5t furni%es hospital c>e1 a m$ical s]vice1 or an ext5d$ c>e s]vice t ! ,secret>y consid]s necess>y1 ! ,secret>y may comp5sate ! provid] = ! co/ ( su* c>e or s]vice4 7b7 ,new contracts & agreem5ts ,! ,secret>y %all take reasonable ef=ts to ent] into a contract1 agreem5t1 or o!r arrangem5t ) a provid] describ$ 9 subsection 7a7 to ensure t future c>e & s]vices au?oriz$ by ! ,secret>y & furni%$ by ! provid] are subject to su* a contract1 agreem5t1 or o!r arrangem5t4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat+ to section #haeh ! foll[+ new item3 #haei4 ,au?ority to pay = s]vices au?oriz$ b n subject to an agreem5t4 4 #aac4 ,improvem5t ( au?ority to recov] ! co/ ( s]vices furni%$ = non-s]vice-connect$ disabilities 7a7 ,broad5+ scope ( applicability ,section #agbi is am5d$-- 7#a7 9 subsection 7a7-- 7,a7 9 p>agraph 7#b77;,a7-- 7i7 by /rik+ ! vet]an's & ins]t+ ! individual's2 & 7ii7 by /rik+ ! vet]an & ins]t+ ! individual2 & 7,b7 9 p>agraph 7#c7-- 7i7 9 ! matt] prec$+ subp>agraph 7,a71 by /rik+ ! vet]an & ins]t+ ! individual2 & 7ii7 9 subp>agraph 7,a71 by /rik+ ! vet]an's & ins]t+ ! individual's2 7#b7 9 subsection 7b7-- 7,a7 9 p>agraph 7#a7-- 7i7 by /rik+ ! vet]an & ins]t+ ! individual2 & 7ii7 by /rik+ ! vet]an's & ins]t+ ! individual's2 & 7,b7 9 p>agraph 7#b7-- 7i7 9 subp>agraph 7,a7-- 7,i7 by /rik+ ! vet]an & ins]t+ ! individual2 & 7,,ii7 by /rik+ ! vet]an's & ins]t+ ! individual's2 & 7ii7 9 subp>agraph 7,b7-- 7,i7 9 clause 7i71 by /rik+ ! vet]an & ins]t+ ! individual2 & 7,,ii7 9 clause 7ii7-- 7aa7 by /rik+ ! vet]an & ins]t+ ! individual2 & 7bb7 by /rik+ ! vet]an's ea* place x appe>s & ins]t+ ! individual's2 7#c7 9 subsection 7e71 by /rik+ ,a vet]an & ins]t+ ,an individual2 & 7#d7 9 subsection 7h7-- 7,a7 9 p>agraph 7#a7-- 7i7 9 ! matt] prec$+ subp>agraph 7,a71 by /rik+ a vet]an & ins]t+ an individual2 7ii7 9 subp>agraph 7,a71 by /rik+ ! vet]an & ins]t+ ! individual2 & 7iii7 9 subp>agraph 7,b71 by /rik+ ! vet]an & ins]t+ ! individual2 & 7,b7 9 p>agraph 7#b7-- 7i7 by /rik+ ,a vet]an & ins]t+ ,an individual2 7ii7 by /rik+ a vet]an & ins]t+ an individual2 & 7iii7 by /rik+ ! vet]an & ins]t+ ! individual4 7b7 ,modification ( au?ority ,subsection 7a77#a7 ( su* section is am5d$ by /rik+ 7#a7 ,subject & all t foll[s ?r\gh ! p]iod & ins]t+ ! foll[+3 7#a7 ,subject to ! provisions ( ?is section1 9 any case 9 :i* ! ,unit$ ,/ates is requir$ by law to furni% or pay = c>e or s]vices "u ?is *apt] = a non-s]vice-connect$ disability describ$ 9 p>agraph 7#b7 ( ?is subsection1 ! ,unit$ ,/ates has ! "r to recov] or collect f a ?ird p>ty ! reasonable *>ges ( c>e or s]vices s furni%$ or paid = to ! ext5t t ! recipi5t or provid] ( ! c>e or s]vices w\ld be eligible to receive paym5t = su* c>e or s]vices f su* ?ird p>ty if ! c>e or s]vices _h n be5 furni%$ or paid = by a dep>tm5t or ag5cy ( ! ,unit$ ,/ates44 7c7 ,modification ( eligible individuals ,subp>agraph 7,d7 ( subsection 7a77#b7 ( su* section is am5d$ to read z foll[s3 7,d7 t is incurr$ by an individual :o is entitl$ to c>e 7or paym5t ( ! exp5ses ( c>e7 "u a heal?-plan contract4 4 #aad4 ,process+ ( claims = reimbursem5t ?r\gh electronic int]face ,! ,secret>y ( ,vet]ans ,affairs may ent] into an agreem5t ) a ?ird-p>ty entity to process1 ?r\gh ! use ( an electronic int]face1 claims = reimbursem5t = heal? c>e provid$ "u ! laws adm9i/]$ by ! ,secret>y4 #c ,education & ,tra9+ ,programs #aba4 ,education program on heal? c>e options 7a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all develop & adm9i/] an education program t tea*es vet]ans ab\t _! heal? c>e options ?r\gh ! ,dep>tm5t ( ,vet]ans ,affairs4 7b7 ,elem5ts ,! program "u subsection 7a7 %all-- 7#a7 tea* vet]ans ab\t-- 7,a7 eligibility crit]ia = c>e f ! ,dep>tm5t set =? "u sections #agjc1 z am5d$ by section #aja ( ?is title1 & #agaj ( title #ch1 ,unit$ ,/ates ,code2 7,b7 priority gr\ps = enrollm5t 9 ! sy/em ( annual pati5t enrollm5t "u section #agje7;a7 ( su* title2 7,c7 ! copaym5ts & o!r f9ancial obligations1 if any1 requir$ ( c]ta9 individuals = c]ta9 s]vices2 & 7,d7 h[ to utilize ! access /&>ds & /&>ds = quality e/abli%$ "u sections #agjc;,b & #agjc;,c ( su* title2 7#b7 tea* vet]ans ab\t ! int]action betwe5 heal? insurance 7includ+ private insurance1 ,m$ic>e1 ,m$icaid1 ! ,,tric>e program1 ! ,indian ,heal? ,s]vice1 tribal heal? programs1 & o!r =ms ( insurance7 & heal? c>e f ! ,dep>tm5t2 & 7#c7 provide vet]ans ) in=mation on :at to d :5 !y h a compla9t ab\t heal? c>e receiv$ f ! ,dep>tm5t 7:e!r ab\t ! provid]1 ! ,dep>tm5t1 or any o!r type ( compla9t74 7c7 ,accessibility ,9 develop+ ! education program "u ?is section1 ! ,secret>y %all ensure t mat]ials "u su* program are accessible-- 7#a7 to vet]ans :o may n h access to ! int]net2 & 7#b7 to vet]ans 9 a mann] t complies ) ! ,am]icans ) ,disabilities ,act ( #aiij 7#db ,u4,s4,c4 #abaja et seq474 7d7 ,annual evaluation & report 7#a7 ,evaluation ,! ,secret>y %all develop a me?od to evaluate ! effectiv5ess ( ! education program "u ?is section & evaluate ! program us+ ! me?od n less frequ5tly ?an once ea* ye>4 7#b7 ,report ,n less frequ5tly ?an once ea* ye>1 ! ,secret>y %all submit to ,congress a report on ! f9d+s ( ! ,secret>y ) respect to ! mo/ rec5t evaluation conduct$ by ! ,secret>y "u p>agraph 7#a74 7e7 ,def9itions ,9 ?is section3 7#a7 ,m$icaid ,! t]m ,m$icaid means ! ,m$icaid program "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq474 7#b7 ,m$ic>e ,! t]m ,m$ic>e means ! ,m$ic>e program "u title ,,xviii ( su* ,act 7#db ,u4,s4,c4 #acie et seq474 7#c7 ,tric>e program ,! t]m ,,tric>e program has ! mean+ giv5 t t]m 9 section #ajgb ( title #aj1 ,unit$ ,/ates ,code4 #abb4 ,tra9+ program = adm9i/ration ( non-,dep>tm5t ( ,vet]ans ,affairs heal? c>e 7a7 ,e/abli%m5t ( program ,! ,secret>y ( ,vet]ans ,affairs %all develop & implem5t a tra9+ program to tra9 employees & contractors ( ! ,dep>tm5t ( ,vet]ans ,affairs on h[ to adm9i/] non-,dep>tm5t heal? c>e programs1 includ+ ! foll[+3 7#a7 ,reimbursem5t = non-,dep>tm5t em]g5cy room c>e4 7#b7 ,! ,vet]ans ,community ,c>e ,program "u section #agjc ( su* title1 z am5d$ by section #aja4 7#c7 ,managem5t ( prescriptions pursuant to improvem5ts "u section #aca4 7b7 ,annual evaluation & report ,! ,secret>y %all-- 7#a7 develop a me?od to evaluate ! effectiv5ess ( ! tra9+ program develop$ & implem5t$ "u subsection 7a72 7#b7 evaluate su* program n less frequ5tly ?an once ea* ye>2 & 7#c7 n less frequ5tly ?an once ea* ye>1 submit to ,congress ! f9d+s ( ! ,secret>y ) respect to ! mo/ rec5t evaluation c>ri$ out "u p>agraph 7#b74 #abc4 ,cont9u+ m$ical education = non-,dep>tm5t m$ical pr(essionals 7a7 ,e/abli%m5t ( program 7#a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all e/abli% a program to provide cont9u+ m$ical education mat]ial to non-,dep>tm5t m$ical pr(essionals4 7#b7 ,education provid$ ,! program e/abli%$ "u p>agraph 7#a7 %all include education on ! foll[+3 7,a7 ,id5tify+ & treat+ common m5tal & physical conditions ( vet]ans & family memb]s ( vet]ans4 7,b7 ,! heal? c>e sy/em ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7,c7 ,su* o!r matt]s z ! ,secret>y consid]s appropriate4 7b7 ,mat]ial provid$ ,! cont9u+ m$ical education mat]ial provid$ to non-,dep>tm5t m$ical pr(essionals "u ! program e/abli%$ "u subsection 7a7 %all be ! same mat]ial provid$ to m$ical pr(essionals ( ! ,dep>tm5t to ensure t all m$ical pr(essionals treat+ vet]ans h access to ! same mat]ials1 :i* supports core compet5cies ?r\gh\t ! community4 7c7 ,adm9i/ration ( program 7#a7 ,9 g5]al ,! ,secret>y %all adm9i/] ! program e/abli%$ "u subsection 7a7 to p>ticipat+ non-,dep>tm5t m$ical pr(essionals ?r\gh an int]net website ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7#b7 ,curriculum & cr$it provid$ ,! ,secret>y %all det]m9e ! curriculum ( ! program & ! numb] ( h\rs ( cr$it to provide to p>ticipat+ non-,dep>tm5t m$ical pr(essionals = cont9u+ m$ical education4 7#c7 ,accr$itation ,! ,secret>y %all ensure t ! program is accr$it$ 9 z _m ,/ates z practicable4 7#d7 ,consi/5cy ) exi/+ rules ,! ,secret>y %all ensure t ! program is consi/5t ) ! rules & regulations ( ! foll[+3 7,a7 ,! m$ical lic5s+ ag5cy ( ea* ,/ate 9 :i* ! program is accr$it$4 7,b7 ,su* m$ical cr$5tial+ organizations z ! ,secret>y consid]s appropriate4 7#e7 ,us] co/ ,! ,secret>y %all c>ry out ! program at no co/ to p>ticipat+ non-,dep>tm5t m$ical pr(essionals4 7#f7 ,monitor+1 evaluation1 & report ,! ,secret>y %all monitor ! utilization ( ! program e/abli%$ "u subsection 7a71 evaluate its effectiv5ess1 & report to ,congress on utilization & effectiv5ess n less frequ5tly ?an once ea* ye>4 7d7 ,non-,dep>tm5t m$ical pr(essional def9$ ,9 ?is section1 ! t]m non-,dep>tm5t m$ical pr(essional means any individual :o is lic5s$ by an appropriate m$ical au?ority 9 ! ,unit$ ,/ates & is 9 good /&+1 is n an employee ( ! ,dep>tm5t ( ,vet]ans ,affairs1 & provides c>e to vet]ans or family memb]s ( vet]ans "u ! laws adm9i/]$ by ! ,secret>y ( ,vet]ans ,affairs4 #d ,o!r ,matt]s ,relat+ to ,non-,dep>tm5t ( ,vet]ans ,affairs ,provid]s #aca4 ,e/abli%m5t ( processes to ensure safe opioid prescrib+ practices by non-,dep>tm5t ( ,vet]ans ,affairs heal? c>e provid]s 7a7 ,receipt & review ( guidel9es ,! ,secret>y ( ,vet]ans ,affairs %all ensure t all cov]$ heal? c>e provid]s are provid$ a copy ( & c]tify t !y h review$ ! evid5ce-bas$ guidel9es = prescrib+ opioids set =? by ! ,opioid ,safety ,initiative ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7b7 ,inclusion ( m$ical hi/ory & curr5t m$ications ,! ,secret>y %all implem5t a process to ensure t1 if c>e ( a vet]an by a cov]$ heal? c>e provid] is au?oriz$ "u ! laws adm9i/]$ by ! ,secret>y1 ! docum5t au?oriz+ su* c>e includes ! available & relevant m$ical hi/ory ( ! vet]an & a li/ ( all m$ications prescrib$ to ! vet]an z kn[n by ! ,dep>tm5t4 7c7 ,submittal ( m$ical records & prescriptions 7#a7 ,9 g5]al ,! ,secret>y %all1 consi/5t ) section #agjc7;a77#b77;,a71 z am5d$ by section #aja ( ?is title1 & section #agjc;,a7e77#b77;,f71 z add$ by section #ajb ( ?is title1 require ea* cov]$ heal? c>e provid] to submit m$ical records ( any c>e or s]vices furni%$1 includ+ records ( any prescriptions = opioids1 to ! ,dep>tm5t 9 ! timeframe & =mat specifi$ by ! ,secret>y4 7#b7 ,responsibility ( dep>tm5t = record+ & monitor+ ,9 c>ry+ out p>agraph 7#a7 & ^u ! receipt by ! ,dep>tm5t ( ! m$ical records describ$ 9 p>agraph 7#a71 ! ,secret>y %all-- 7,a7 ensure ! ,dep>tm5t is responsible = ! record+ ( ! prescription 9 ! electronic heal? record ( ! vet]an2 & 7,b7 enable o!r monitor+ ( ! prescription z outl9$ 9 ! ,opioid ,safety ,initiative ( ! ,dep>tm5t4 7#c7 ,report ,n less frequ5tly ?an annually1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report evaluat+ ! compliance ( cov]$ heal? c>e provid]s ) ! requirem5ts "u ?is section4 7d7 ,use ( opioid safety initiative guidel9es 7#a7 ,9 g5]al ,if ! ,secret>y det]m9es t ! opioid prescrib+ practices ( a cov]$ heal? c>e provid]1 :5 treat+ cov]$ vet]ans1 satisfy a condition describ$ 9 p>agraph 7#c71 ! ,secret>y %all take su* action z ! ,secret>y consid]s appropriate to ensure ! safety ( all vet]ans receiv+ c>e f t heal? c>e provid]1 includ+ remov+ or direct+ ! removal ( any su* heal? c>e provid] f provid] networks or o!rwise refus+ to au?orize c>e ( vet]ans by su* heal? c>e provid] 9 any program au?oriz$ "u ! laws adm9i/]$ by ! ,secret>y4 7#b7 ,inclusion 9 contracts ,! ,secret>y %all ensure t any contracts1 agreem5ts1 or o!r arrangem5ts ent]$ into by ! ,secret>y ) ?ird p>ties involv$ 9 adm9i/]+ programs t provide c>e 9 ! community to vet]ans "u ! laws adm9i/]$ by ! ,secret>y specifically grant ! au?ority set =? 9 p>agraph 7#a7 to su* ?ird p>ties & to ! ,secret>y1 z ! case may be4 7#c7 ,conditions = exclusion or limitation ,! ,secret>y %all take su* action z is consid]$ appropriate "u p>agraph 7#a7 :5 ! opioid prescrib+ practices ( a cov]$ heal? c>e provid] :5 treat+ cov]$ vet]ans-- 7,a7 conflict ) or are o!rwise inconsi/5t ) ! /&>ds ( appropriate & safe c>e2 7,b7 violate ! requirem5ts ( a m$ical lic5se ( ! heal? c>e provid]2 or 7,c7 may place at risk ! vet]ans receiv+ heal? c>e f ! provid]4 7e7 ,cov]$ heal? c>e provid] def9$ ,9 ?is section1 ! t]m cov]$ heal? c>e provid] means a non-,dep>tm5t ( ,vet]ans ,affairs heal? c>e provid] :o provides heal? c>e to vet]ans "u ! laws adm9i/]$ by ! ,secret>y ( ,vet]ans ,affairs1 b does n include a heal? c>e provid] employ$ by ano!r ag5cy ( ! ,f$]al ,gov]nm5t4 #acb4 ,improv+ in=mation %>+ ) community provid]s ,section #gccb7;b77#b7 is am5d$ by /rik+ subp>agraph 7,h7 & ins]t+ ! foll[+ new subp>agraphs3 7,h7 7i7 ,to a non-,dep>tm5t entity 7includ+ private entities & o!r ,f$]al ag5cies7 = purposes ( provid+ heal? c>e1 includ+ hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices1 to pati5ts or p]=m+ o!r heal? c>e-relat$ activities or functions4 7ii7 ,an entity to :i* a record is disclos$ "u ?is subp>agraph may n disclose or use su* record = a purpose o!r ?an t = :i* ! disclosure 0 made or z p]mitt$ by law4 7,i7 ,to a ?ird p>ty 9 ord] to recov] or collect reasonable *>ges = c>e furni%$ to1 or paid on behalf (1 a pati5t 9 connection ) a non-s]vice connect$ disability z p]mitt$ by section #agbi ( ?is title or = a condition = :i* recov]y is au?oriz$ or ) respect to :i* ! ,unit$ ,/ates is deem$ to be a ?ird p>ty b5efici>y "u ! ,act entitl$ ,an ,act to provide = ! recov]y f torti\sly liable ?ird p]sons ( ! co/ ( hospital & m$ical c>e & treatm5t furni%$ by ! ,unit$ ,/ates 7,public ,law #hg-fic2 #db ,u4,s4,c4 #bfea et seq42 commonly kn[n z ! ,f$]al ,m$ical ,c>e ,recov]y ,act74 4 #acc4 ,compet5cy /&>ds = non-,dep>tm5t ( ,vet]ans ,affairs heal? c>e provid]s 7a7 ,e/abli%m5t ( /&>ds & requirem5ts ,! ,secret>y ( ,vet]ans ,affairs %all e/abli% /&>ds & requirem5ts = ! provision ( c>e by non-,dep>tm5t ( ,vet]ans ,affairs heal? c>e provid]s 9 cl9ical areas = :i* ! ,dep>tm5t ( ,vet]ans ,affairs has special exp]tise1 includ+ po/-traumatic /ress disord]1 milit>y sexual trauma-relat$ conditions1 & traumatic bra9 injuries4 7b7 ,condition = eligibility ,to furni% c>e 7#a7 ,ea* non-,dep>tm5t ( ,vet]ans ,affairs heal? c>e provid] %all1 to ! ext5t practicable z det]m9$ by ! ,secret>y or o!rwise provid$ = 9 p>agraph 7#b71 meet ! /&>ds & requirem5ts e/abli%$ pursuant to subsection 7a7 be=e furni%+ c>e pursuant to a contract1 agreem5t1 or o!r arrangem5t ) ! ,dep>tm5t ( ,vet]ans ,affairs4 ,non-,dep>tm5t ( ,vet]ans ,affairs heal? c>e provid]s furni%+ c>e pursuant to a contract1 agreem5t1 or o!r arrangem5t %all1 to ! ext5t practicable z det]m9$ by ! ,secret>y1 fulfill tra9+ requirem5ts e/abli%$ by ! ,secret>y on h[ to deliv] evid5ce-bas$ treatm5ts 9 ! cl9ical areas = :i* ! ,dep>tm5t ( ,vet]ans ,affairs has special exp]tise4 7#b7 ,ea* non-,dep>tm5t ( ,vet]ans ,affairs heal? c>e provid] :o ent]s into a contract1 agreem5t1 or o!r arrangem5t aft] ! effective date id5tifi$ 9 subsection 7c7 %all1 to ! ext5t practicable1 meet ! /&>ds & requirem5ts e/abli%$ pursuant to subsection 7a7 )9 #f mon?s ( ! contract1 agreem5t1 or o!r arrangem5t tak+ effect4 7c7 ,effective date ,?is section %all take effect on ! day t is #a ye> aft] ! date ( ! enactm5t ( ?is ,act4 #acd4 ,dep>tm5t ( ,vet]ans ,affairs p>ticipation 9 national network ( ,/ate-bas$ prescription drug monitor+ programs 7a7 ,9 g5]al ,*apt] #ag is am5d$ by ins]t+ aft] section #agcj;,a ! foll[+ new section3 #agcj;,b4 ,access to ,/ate prescription drug monitor+ programs 7a7 ,access to programs 7#a7 ,any lic5s$ heal? c>e provid] or delegate ( su* a provid] %all be consid]$ an au?oriz$ recipi5t or us] = ! purpose ( qu]y+ & receiv+ data f ! national network ( ,/ate-bas$ prescription drug monitor+ programs to support ! safe & effective prescrib+ ( controll$ sub/ances to cov]$ pati5ts4 7#b7 ,"u ! au?ority grant$ by p>agraph 7#a7-- 7,a7 lic5s$ heal? c>e provid]s or delegates ( su* provid]s %all qu]y su* network 9 accordance ) applicable regulations & policies ( ! ,vet]ans ,heal? ,adm9i/ration2 & 7,b7 not)/&+ any g5]al or specific provision ( law1 rule1 or regulation ( a ,/ate1 no ,/ate may re/rict ! access ( lic5s$ heal? c>e provid]s or delegates ( su* provid]s f access+ t ,/ate's prescription drug monitor+ programs4 7#c7 ,no ,/ate %all d5y or revoke ! lic5se1 regi/ration1 or c]tification ( a lic5s$ heal? c>e provid] or delegate :o o!rwise meets t ,/ate's qualifications = hold+ ! lic5se1 regi/ration1 or c]tification on ! basis t ! lic5s$ heal? c>e provid] or delegate qu]i$ or receiv$ data1 or attempt$ to qu]y or receive data1 f ! national network ( ,/ate-bas$ prescription drug monitor+ programs "u ?is section4 7b7 ,cov]$ pati5ts ,= purposes ( ?is section1 a cov]$ pati5t is a pati5t :o-- 7#a7 receives a prescription = a controll$ sub/ance2 & 7#b7 is n receiv+ palliative c>e or enroll$ 9 hospice c>e4 7c7 ,def9itions ,9 ?is section3 7#a7 ,! t]m controll$ sub/ance has ! mean+ giv5 su* t]m 9 section #ajb7f7 ( ! ,controll$ ,sub/ances ,act 7#ba ,u4,s4,c4 #hjb7f774 7#b7 ,! t]m delegate means a p]son or automat$ sy/em access+ ! national network ( ,/ate-bas$ prescription monitor+ programs at ! direction or "u ! sup]vision ( a lic5s$ heal? c>e provid]4 7#c7 ,! t]m lic5s$ heal? c>e provid] means a heal? c>e provid] employ$ by ! ,dep>tm5t :o is lic5s$1 c]tifi$1 or regi/]$ )9 any ,/ate to fill or prescribe m$ications )9 ! scope ( 8 or h] practice z a ,dep>tm5t employee4 7#d7 ,! t]m national network ( ,/ate-bas$ prescription monitor+ programs means an int]connect$ nation-wide sy/em t facilitates ! transf] to ,/ate prescription drug monitor+ program data across ,/ate l9es4 7#e7 ,! t]m ,/ate means a ,/ate1 z def9$ 9 section #aja7bj7 ( ?is title1 or a political subdivision ( a ,/ate4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( *apt] #ag ( su* title is am5d$ by ins]t+ aft] ! item relat+ to section #agcj;,a ! foll[+ new item3 #agcj;,b4 ,access to ,/ate prescription drug monitor+ programs4 4 #e ,o!r ,non-,dep>tm5t ,heal? ,c>e ,matt]s #ada4 ,plans = ,use ( ,supplem5tal ,appropriations ,requir$ ,:5ev] ! ,secret>y submits to ,congress a reque/ = supplem5tal appropriations or any o!r appropriation outside ! /&>d budget process to address a budget>y issue affect+ ! ,dep>tm5t ( ,vet]ans ,affairs1 ! ,secret>y %all1 n lat] ?an #de days be=e ! date on :i* su* budget>y issue w\ld />t affect+ a program or s]vice1 submit to ,congress a ju/ification = ! reque/1 includ+ a plan t details h[ ! ,secret>y int5ds to use ! reque/$ appropriation & h[ long ! reque/$ appropriation is expect$ to meet ! ne$s ( ! ,dep>tm5t & c]tification t ! reque/ 0 made us+ an updat$ & s\nd actu>ial analysis4 #adb4 ,vet]ans ,*oice ,fund flexibility ,section #hjb ( ! ,vet]ans ,access1 ,*oice1 & ,acc\ntability ,act ( #bjad 7,public ,law #aac-adf2 #ch ,u4,s4,c4 #agja note7 is am5d$-- 7#a7 9 subsection 7c7-- 7,a7 9 p>agraph 7#a71 by /rik+ by p>agraph 7#c7 & ins]t+ 9 p>agraphs 7#c7 & 7#d72 & 7,b7 by add+ at ! end ! foll[+ new p>agraph3 7#d7 ,p]man5t au?ority = o!r uses ,beg9n+ on ,m>* #a1 #bjai1 am\nts rema9+ 9 ! ,vet]ans ,*oice ,fund may be us$ to furni% hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices to individuals pursuant to *apt] #ag ( title #ch1 ,unit$ ,/ates ,code1 at non-,dep>tm5t facilities1 includ+ pursuant to non-,dep>tm5t provid] programs o!r ?an ! program e/abli%$ by section #aja4 ,su* am\nts %all be available 9 addition to am\nts available 9 o!r appropriations acc\nts = su* purposes4 2 & 7#b7 9 subsection 7d77#a71 by /rik+ to subsection 7c77#c7 & ins]t+ to p>agraphs 7#c7 & 7#d7 ( subsection 7c74 #adc4 ,sunset ( ,vet]ans ,*oice ,program ,subsection 7p7 ( section #aja ( ! ,vet]ans ,access1 ,*oice1 & ,acc\ntability ,act ( #bjad 7,public ,law #aac-adf2 #ch ,u4,s4,c4 #agja note7 is am5d$ to read z foll[s3 7p7 ,au?ority ,to furni% c>e & s]vices ,! ,secret>y may n use ! au?ority "u ?is section to furni% c>e & s]vices aft] ! date t is #a ye> aft] ! date ( ! enactm5t ( ! ,c>+ = ,our ,vet]ans ,act ( #bjah4 4 #add4 ,con=m+ am5dm5ts 7a7 ,9 g5]al 7#a7 ,title #ch ,title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7,a7 9 section #agab7;a7-- 7i7 9 p>agraph 7#c71 by /rik+ "u clause 7#a71 7#b71 or 7#e7 ( section #agjc7;a7 ( ?is title & ins]t+ or ent]$ an agreem5t2 & 7ii7 9 p>agraph 7#d77;,a71 by /rik+ "u ! provisions ( ?is subsection & section #agjc ( ?is title2 7,b7 9 section #agab;,a7e77#a7-- 7i7 by ins]t+ or agreem5ts aft] contracts2 & 7ii7 by /rik+ 7"u sections #agjc7;a77#b7 & #agaj7;a77#a77;,b7 ( ?is title72 & 7,c7 9 section #bcjc7;a77#b77;,b77i71 by /rik+ ) section #agjc & ins]t+ ) sections #agjc;,a1 #haaa1 & #haec4 7#b7 ,social ,security ,act ,section #ahff7;a77#a77,l7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;cc7a77#a77,l77 is am5d$ by /rik+ "u section #fjc & ins]t+ "u *apt] #ag4 7#c7 ,vet]ans' ,b5efits ,improvem5ts ,act ( #aiid ,section #ajd7;a77#d77;,a7 ( ! ,vet]ans' ,b5efits ,improvem5ts ,act ( #aiid 7,public ,law #ajc-ddf2 #ch ,u4,s4,c4 #aaag note7 is am5d$ by /rik+ 9 section #agjc & ins]t+ 9 sections #agjc;,a1 #haaa1 & #haec4 7b7 ,effective date ,! am5dm5ts made by subsection 7a7 %all take effect on ! date describ$ 9 section #aja7;b74 ,b ,improv+ ,dep>tm5t ( ,vet]ans ,affairs ,heal? ,c>e ,deliv]y #aea4 ,lic5sure ( heal? c>e pr(essionals ( ! ,dep>tm5t ( ,vet]ans ,affairs provid+ treatm5t via telem$ic9e 7a7 ,9 g5]al ,*apt] #ag is am5d$ by ins]t+ aft] section #agcj;,b1 z add$ by section #acd1 ! foll[+ new section3 #agcj;,c4 ,lic5sure ( heal? c>e pr(essionals provid+ treatm5t via telem$ic9e 7a7 ,9 g5]al ,not)/&+ any provision ( law reg>d+ ! lic5sure ( heal? c>e pr(essionals1 a cov]$ heal? c>e pr(essional may practice ! heal? c>e pr(ession ( ! heal? c>e pr(essional at any location 9 any ,/ate1 reg>dless ( :]e ! cov]$ heal? c>e pr(essional or ! pati5t is locat$1 if ! cov]$ heal? c>e pr(essional is us+ telem$ic9e to provide treatm5t to an individual "u ?is *apt]4 7b7 ,cov]$ heal? c>e pr(essionals ,= purposes ( ?is section1 a cov]$ heal? c>e pr(essional is any heal? c>e pr(essional :o-- 7#a7 is an employee ( ! ,dep>tm5t appo9t$ "u ! au?ority "u section #gcjf1 #gdja1 #gdje1 #gdjf1 or #gdjh ( ?is title or title #e2 7#b7 is au?oriz$ by ! ,secret>y to provide heal? c>e "u ?is *apt]2 7#c7 is requir$ to adh]e to all /&>ds = quality relat+ to ! provision ( m$ic9e 9 accordance ) applicable policies ( ! ,dep>tm5t2 & 7#d7 has an active1 curr5t1 full1 & unre/rict$ lic5se1 regi/ration1 or c]tification 9 a ,/ate to practice ! heal? c>e pr(ession ( ! heal? c>e pr(essional4 7c7 ,prop]ty ( ,f$]al ,gov]nm5t ,subsection 7a7 %all apply to a cov]$ heal? c>e pr(essional provid+ treatm5t to a pati5t reg>dless ( :e!r ! cov]$ heal? c>e pr(essional or pati5t is locat$ 9 a facility own$ by ! ,f$]al ,gov]nm5t dur+ su* treatm5t4 7d7 ,relation to ,/ate law 7#a7 ,! provisions ( ?is section %all sup]s$e any provisions ( ! law ( any ,/ate to ! ext5t t su* provision ( ,/ate law are inconsi/5t ) ?is section4 7#b7 ,no ,/ate %all d5y or revoke ! lic5se1 regi/ration1 or c]tification ( a cov]$ heal? c>e pr(essional :o o!rwise meets ! qualifications ( ! ,/ate = hold+ ! lic5se1 regi/ration1 or c]tification on ! basis t ! cov]$ heal? c>e pr(essional has engag$ or int5ds to engage 9 activity cov]$ by subsection 7a74 7e7 ,rule ( con/ruction ,no?+ 9 ?is section may be con/ru$ to remove1 limit1 or o!rwise affect any obligation ( a cov]$ heal? c>e pr(essional "u ! ,controll$ ,sub/ances ,act 7#ba ,u4,s4,c4 #hja et seq474 7f7 ,/ate def9$ ,9 ?is section1 ! t]m ,/ate means a ,/ate1 z def9$ 9 section #aja7bj7 ( ?is title1 or a political subdivision ( a ,/ate4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( *apt] #ag ( su* title is am5d$ by ins]t+ aft] ! item relat+ to section #agcj;,b1 z add$ by section #acd1 ! foll[+ new item3 #agcj;,c4 ,lic5sure ( heal? c>e pr(essionals provid+ treatm5t via telem$ic9e4 4 7c7 ,report on telem$ic9e 7#a7 ,9 g5]al ,n lat] ?an #a ye> aft] ! e>li] ( ! date on :i* s]vices provid$ "u section #agcj;,b ( title #ch1 ,unit$ ,/ates ,code1 z add$ by subsection 7a71 fir/ occur or regulations are promulgat$ to c>ry out su* section1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! effectiv5ess ( ! use ( telem$ic9e by ! ,dep>tm5t ( ,vet]ans ,affairs4 7#b7 ,elem5ts ,! report requir$ by p>agraph 7#a7 %all include an assessm5t ( ! foll[+3 7,a7 ,! satisfaction ( vet]ans ) telem$ic9e furni%$ by ! ,dep>tm5t4 7,b7 ,! satisfaction ( heal? c>e provid]s 9 provid+ telem$ic9e furni%$ by ! ,dep>tm5t4 7,c7 ,! effect ( telem$ic9e furni%$ by ! ,dep>tm5t on ! foll[+3 7i7 ,! ability ( vet]ans to access heal? c>e1 :e!r f ! ,dep>tm5t or f non-,dep>tm5t heal? c>e provid]s4 7ii7 ,! frequ5cy ( use by vet]ans ( telem$ic9e4 7iii7 ,! productivity ( heal? c>e provid]s4 7iv7 ,wait times = an appo9tm5t = ! receipt ( heal? c>e f ! ,dep>tm5t4 7v7 ,! use by vet]ans ( 9-p]son s]vices at ,dep>tm5t facilities & non-,dep>tm5t facilities4 7,d7 ,! types ( appo9tm5ts = ! receipt ( telem$ic9e furni%$ by ! ,dep>tm5t t 7 provid$ dur+ ! #a-ye> p]iod prec$+ ! submittal ( ! report4 7,e7 ,! numb] ( appo9tm5ts = ! receipt ( telem$ic9e furni%$ by ! ,dep>tm5t t 7 reque/$ dur+ su* p]iod1 disaggregat$ by m$ical facility4 7,f7 ,sav+s by ! ,dep>tm5t1 if any1 includ+ travel co/s1 f furni%+ heal? c>e ?r\gh ! use ( telem$ic9e dur+ su* p]iod4 #aeb4 ,au?ority = ,dep>tm5t ( ,vet]ans ,affairs ,c5t] = ,innovation = ,c>e & ,paym5t 7a7 ,9 g5]al ,sub*apt] ,i ( *apt] #ag1 z am5d$ by ?is title1 is fur!r am5d$ by ins]t+ aft] section #agjc;,d1 z add$ by section #aaa1 ! foll[+ new section3 #agjc;,e4 ,c5t] = ,innovation = ,c>e & ,paym5t 7a7 ,9 g5]al 7#a7 ,!re is e/abli%$ )9 ! ,dep>tm5t a ,c5t] = ,innovation = ,c>e & ,paym5t 79 ?is section ref]r$ to z ! ,c5t]74 7#b7 ,! ,secret>y1 act+ ?r\gh ! ,c5t]1 may c>ry out su* pilot programs ! ,secret>y det]m9es to be appropriate to develop innovative approa*es to te/+ paym5t & s]vice deliv]y models 9 ord] to r$uce exp5ditures :ile pres]v+ or enhanc+ ! quality ( c>e furni%$ by ! ,dep>tm5t4 7#c7 ,! ,secret>y1 act+ ?r\gh ! ,c5t]1 %all te/ paym5t & s]vice deliv]y models to det]m9e :e!r su* models-- 7,a7 improve access to1 & quality1 timel9ess1 & pati5t satisfaction ( c>e & s]vices2 & 7,b7 create co/ sav+s = ! ,dep>tm5t4 7#d7 7,a7 ,! ,secret>y %all te/ a model 9 a location :]e ! ,secret>y det]m9es t ! model w addresses deficits 9 c>e 7includ+ poor cl9ical outcomes or pot5tially avoidable exp5ditures7 = a def9$ population4 7,b7 ,! ,secret>y %all focus on models ! ,secret>y expects to r$uce program co/s :ile pres]v+ or enhanc+ ! quality ( c>e receiv$ by individuals receiv+ b5efits "u ?is *apt]4 7,c7 ,! models select$ may include ^? describ$ 9 section #aaae;,a7b77#b77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7b77#b77;,b774 7#e7 ,9 select+ a model = te/+1 ! ,secret>y may consid]1 9 addition to o!r factors id5tifi$ 9 ?is subsection1 ! foll[+ factors3 7,a7 ,:e!r ! model includes a regul> process = monitor+ & updat+ pati5t c>e plans 9 a mann] t is consi/5t ) ! ne$s & pref]5ces ( individuals receiv+ b5efits "u ?is *apt]4 7,b7 ,:e!r ! model places ! individual receiv+ b5efits "u ?is *apt] 7includ+ family memb]s & o!r c>egiv]s ( su* individual7 at ! c5t] ( ! c>e team ( su* individual4 7,c7 ,:e!r ! model uses te*nology or new sy/ems to coord9ate c>e ov] "t & across sett+s4 7,d7 ,:e!r ! model demon/rates effective l9kage ) o!r public sector pay]s1 private sector pay]s1 or /atewide paym5t models4 7#f7 7,a7 ,models te/$ "u ?is section may n be design$ 9 su* a way t w\ld all[ ! ,unit$ ,/ates to recov] or collect reasonable *>ges f a ,f$]al heal? c>e program = c>e or s]vices furni%$ by ! ,secret>y to a vet]an "u pilot programs c>ri$ out "u ?is section4 7,b7 ,9 ?is p>agraph1 ! t]m ,f$]al heal? c>e program means-- 7i7 an insurance program describ$ 9 section #ahaa ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;c7 or e/abli%$ by section #ahca ( su* ,act 7#db ,u4,s4,c4 #acie;j72 7ii7 a ,/ate plan = m$ical assi/ance approv$ "u title ,,xix ( su* ,act 7#db ,u4,s4,c4 #acif et seq472 or 7iii7 a ,,tric>e program op]at$ "u sections #ajge1 #ajge;a1 #ajgf1 #ajgf;a1 #ajgf;c1 #ajgf;d1 #ajgf;e1 or #ajgf;f ( title #aj4 7b7 ,duration ,ea* pilot program c>ri$ out by ! ,secret>y "u ?is section %all t]m9ate no lat] ?an #e ye>s aft] ! date ( ! comm5cem5t ( ! pilot program4 7c7 ,location ,! ,secret>y %all ensure t ea* pilot program c>ri$ out "u ?is section occurs 9 an area or areas appropriate = ! int5d$ purposes ( ! pilot program4 ,to ! ext5t practicable1 ! ,secret>y %all ensure t ! pilot programs are locat$ 9 geographically div]se areas ( ! ,unit$ ,/ates4 7d7 ,budget ,fund+ = ea* pilot program c>ri$ out by ! ,secret>y "u ?is section %all come f appropriations-- 7#a7 provid$ 9 advance 9 appropriations acts = ! ,vet]ans ,heal? ,adm9i/ration2 & 7#b7 provid$ = in=mation te*nology sy/ems4 7e7 ,notice ,! ,secret>y %all-- 7#a7 publi% in=mation ab\t ea* pilot program "u ?is section 9 ! ,f$]al ,regi/]2 & 7#b7 take reasonable actions to provide direct notice to vet]ans eligible to p>ticipate 9 su* pilot programs4 7f7 ,waiv] ( au?orities 7#a7 ,subject to report+ "u p>agraph 7#b7 & approval "u p>agraph 7#c71 9 implem5t+ a pilot program "u ?is section1 ! ,secret>y may waive su* requirem5ts 9 sub*apt]s ,i1 ,,ii1 & ,,iii ( ?is *apt] z ! ,secret>y det]m9es necess>y solely = ! purposes ( c>ry+ out ?is section ) respect to te/+ models describ$ 9 subsection 7a74 7#b7 ,be=e waiv+ any au?ority "u p>agraph 7#a71 ! ,secret>y %all submit to ! ,speak] ( ! ,h\se ( ,repres5tatives1 ! m9ority lead] ( ! ,h\se ( ,repres5tatives1 ! majority lead] ( ! ,s5ate1 ! m9ority lead] ( ! ,s5ate1 & ea* /&+ committee ) jurisdiction "u ! rules ( ! ,s5ate & ( ! ,h\se ( ,repres5tatives to report a bill to am5d ! provision or provisions ( law t w\ld be waiv$ by ! ,dep>tm5t1 a report on a reque/ = waiv] t describes 9 detail ! foll[+3 7,a7 ,! specific au?orities to be waiv$ "u ! pilot program4 7,b7 ,! /&>d or /&>ds to be us$ 9 ! pilot program 9 lieu ( ! waiv$ au?orities4 7,c7 ,! reasons = su* waiv] or waiv]s4 7,d7 ,a description ( ! metric or metrics ! ,secret>y w use to det]m9e ! effect ( ! waiv] or waiv]s ^u ! access to & quality1 timel9ess1 or pati5t satisfaction ( c>e & s]vices furni%$ ?r\gh ! pilot program4 7,e7 ,! anticipat$ co/ sav+s1 if any1 ( ! pilot program4 7,f7 ,! s*$ule = int]im reports on ! pilot program describ+ ! results ( ! pilot program s f> & ! feasibility & advisability ( cont9u+ ! pilot program4 7,g7 ,! s*$ule = ! t]m9ation ( ! pilot program & ! submission ( a f9al report on ! pilot program describ+ ! result ( ! pilot program & ! feasibility & advisability ( mak+ ! pilot program p]man5t4 7,h7 ,! e/imat$ budget ( ! pilot program4 7#c7 7,a7 ,^u receipt ( a report submitt$ "u p>agraph 7#b71 ea* ,h\se ( ,congress %all provide copies ( ! report to ! *airman & rank+ memb] ( ea* /&+ committee ) jurisdiction "u ! rules ( ! ,h\se ( ,repres5tatives or ! ,s5ate to report a bill to am5d ! provision or provisions ( law t w\ld be waiv$ by ! ,dep>tm5t "u ?is subsection4 7,b7 ,! waiv] reque/$ by ! ,secret>y "u p>agraph 7#b7 %all be consid]$ approv$ "u ?is p>agraph if !re is enact$ into law a jo9t resolution approv+ su* reque/ 9 its entirety4 7,c7 ,= purposes ( ?is p>agraph1 ! t]m jo9t resolution means only a jo9t resolution :i* is introduc$ )9 ! p]iod ( five legislative days beg9n+ on ! date on :i* ! ,secret>y transmits ! report to ! ,congress "u su* p>agraph 7#b71 &-- 7i7 :i* does n h a preamble2 & 7ii7 ! matt] aft] ! resolv+ clause ( :i* is z foll[s3 t ,congress approves ! reque/ = a waiv] "u section #agjc;,e7f7 ( title #ch1 ,unit$ ,/ates ,code1 z submitt$ by ! ,secret>y on 1 ! blank space be+ fill$ ) ! appropriate date4 7,d7 7i7 ,any committee ( ! ,h\se ( ,repres5tatives to :i* a jo9t resolution is ref]r$ %all report x to ! ,h\se )\t am5dm5t n lat] ?an #ae legislative days aft] ! date ( introduction !re(4 ,if a committee fails to report ! jo9t resolution )9 t p]iod1 ! committee %all be dis*>g$ f fur!r consid]ation ( ! jo9t resolution4 7ii7 ,x %all be 9 ord] at any "t aft] ! ?ird legislative day aft] ea* committee au?oriz$ to consid] a jo9t resolution has report$ or has be5 dis*>g$ f consid]ation ( a jo9t resolution1 to move to proce$ to consid] ! jo9t resolution 9 ! ,h\se4 ,all po9ts ( ord] aga9/ ! motion are waiv$4 ,su* a motion %all n be 9 ord] aft] ! ,h\se has dispos$ ( a motion to proce$ on a jo9t resolution address+ a p>ticul> submission4 ,! previ\s "q %all be consid]$ z ord]$ on ! motion to its adoption )\t int]v5+ motion4 ,! motion %all n be debatable4 ,a motion to reconsid] ! vote by :i* ! motion is dispos$ ( %all n be 9 ord]4 7iii7 ,! jo9t resolution %all be consid]$ z read4 ,all po9ts ( ord] aga9/ ! jo9t resolution & aga9/ its consid]ation are waiv$4 ,! previ\s "q %all be consid]$ z ord]$ on ! jo9t resolution to its passage )\t int]v5+ motion except two h\rs ( debate equally divid$ & controll$ by ! propon5t & an oppon5t4 ,a motion to reconsid] ! vote on passage ( ! jo9t resolution %all n be 9 ord]4 7,e7 7i7 ,a jo9t resolution introduc$ 9 ! ,s5ate %all be ref]r$ to ! ,committee on ,vet]ans' ,affairs4 7ii7 ,any committee ( ! ,s5ate to :i* a jo9t resolution is ref]r$ %all report x to ! ,s5ate )\t am5dm5t n lat] ?an #ae session days aft] ! date ( introduction ( a jo9t resolution describ$ 9 p>agraph 7,c74 ,if a committee fails to report ! jo9t resolution )9 t p]iod1 ! committee %all be dis*>g$ f fur!r consid]ation ( ! jo9t resolution & ! jo9t resolution %all be plac$ on ! cal5d>4 7iii7 7,i7 ,not)/&+ ,rule ,,xxii ( ! ,/&+ ,rules ( ! ,s5ate1 x is 9 ord] at any "t aft] ! ?ird session day on :i* ! ,committee on ,vet]ans' ,affairs has report$ or has be5 dis*>g$ f consid]ation ( a jo9t resolution describ$ 9 p>agraph 7,c7 7ev5 ?\gh a previ\s motion to ! same effect has be5 disagre$ to7 to move to proce$ to ! consid]ation ( ! jo9t resolution1 & all po9ts ( ord] aga9/ ! jo9t resolution 7& aga9/ consid]ation ( ! jo9t resolution7 are waiv$4 ,! motion to proce$ is n debatable4 ,! motion is n subject to a motion to po/pone4 ,a motion to reconsid] ! vote by :i* ! motion is agre$ to or disagre$ to %all n be 9 ord]4 ,if a motion to proce$ to ! consid]ation ( ! resolution is agre$ to1 ! jo9t resolution %all rema9 ! unf9i%$ bus9ess until dispos$ (4 7,,ii7 ,consid]ation ( ! jo9t resolution1 & on all debatable motions & appeals 9 connection !re)1 %all be limit$ to n m ?an two h\rs1 :i* %all be divid$ equally betwe5 ! majority & m9ority lead]s or _! designees4 ,a motion fur!r to limit debate is 9 ord] & n debatable4 ,an am5dm5t to1 or a motion to po/pone1 or a motion to proce$ to ! consid]ation ( o!r bus9ess1 or a motion to recommit ! jo9t resolution is n 9 ord]4 7,,iii7 ,if ! ,s5ate has vot$ to proce$ to a jo9t resolution1 ! vote on passage ( ! jo9t resolution %all occur imm$iately foll[+ ! conclusion ( consid]ation ( ! jo9t resolution1 & a s+le quorum call at ! conclusion ( ! debate if reque/$ 9 accordance ) ! rules ( ! ,s5ate4 7,,iv7 ,appeals f ! decisions ( ! ,*air relat+ to ! application ( ! rules ( ! ,s5ate1 z ! case may be1 to ! proc$ure relat+ to a jo9t resolution %all be decid$ )\t debate4 7,f7 ,a jo9t resolution consid]$ pursuant to ?is p>agraph %all n be subject to am5dm5t 9 ei!r ! ,h\se ( ,repres5tatives or ! ,s5ate4 7,g7 7i7 ,if1 be=e ! passage by "o ,h\se ( ! jo9t resolution ( t ,h\se1 t ,h\se receives ! jo9t resolution f ! o!r ,h\se1 !n ! foll[+ proc$ures %all apply3 7,i7 ,! jo9t resolution ( ! o!r ,h\se %all n be ref]r$ to a committee4 7,,ii7 ,) respect to ! jo9t resolution ( ! ,h\se receiv+ ! jo9t resolution-- 7aa7 ! proc$ure 9 t ,h\se %all be ! same z if no jo9t resolution _h be5 receiv$ f ! o!r ,h\se2 b 7bb7 ! vote on passage %all be on ! jo9t resolution ( ! o!r ,h\se4 7ii7 ,if ! ,s5ate fails to introduce or consid] a jo9t resolution "u ?is p>agraph1 ! jo9t resolution ( ! ,h\se %all be entitl$ to exp$it$ floor proc$ures "u ?is subp>agraph4 7iii7 ,if1 foll[+ passage ( ! jo9t resolution 9 ! ,s5ate1 ! ,s5ate !n receives ! companion measure f ! ,h\se ( ,repres5tatives1 ! companion measure %all n be debatable4 7,h7 ,?is subp>agraph is enact$ by ,congress-- 7i7 z an ex]cise ( ! rulemak+ p[] ( ! ,s5ate & ,h\se ( ,repres5tatives1 respectively1 & z su* x is deem$ a "p ( ! rules ( ea* ,h\se1 respectively1 b applicable only ) respect to ! proc$ure to be foll[$ 9 t ,h\se 9 ! case ( a jo9t resolution1 & x sup]s$es o!r rules only to ! ext5t t x is inconsi/5t ) su* rules2 & 7ii7 ) full recognition ( ! con/itutional "r ( ei!r ,h\se to *ange ! rules 7s f> z relat+ to ! proc$ure ( t ,h\se7 at any "t1 9 ! same mann]1 & to ! same ext5t z 9 ! case ( any o!r rule ( t ,h\se4 7g7 ,limitations 7#a7 ,! ,secret>y may n c>ry out m ?an #aj pilot programs concurr5tly4 7#b7 7,a7 ,subject to subp>agraph 7,b71 ! ,secret>y may n exp5d m ?an #ej1jjj1jjj 9 any fiscal ye> f am\nts "u subsection 7d74 7,b7 ,! ,secret>y may exp5d m ?an ! am\nt 9 subp>agraph 7,a7 if-- 7i7 ! ,secret>y det]m9es t ! additional exp5diture is necess>y to c>ry out pilot programs "u ?is section2 7ii7 ! ,secret>y submits to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ! ,h\se ( ,repres5tatives a report sett+ =? ! am\nt ( ! additional exp5diture & a ju/ification = ! additional exp5diture2 & 7iii7 ! ,*airm5 ( ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ! ,h\se ( ,repres5tatives transmit to ! ,secret>y a lett] approv+ ( ! additional exp5diture4 7#c7 ,! waiv] provisions 9 subsection 7f7 %all n apply unless ! ,secret>y1 9 accordance ) ! requirem5ts 9 subsection 7f71 submits ! fir/ proposal = a pilot program n lat] ?an #ah mon?s aft] ! date ( ! enactm5t ( ! ,c>+ = ,our ,vet]ans ,act ( #bjah4 7#d7 ,not)/&+ section #ejb ( ?is title1 decisions by ! ,secret>y "u ?is section %all1 consi/5t ) section #eaa ( ?is title1 be f9al & conclusive & may n be review$ by any o!r (ficial or by any c\rt1 :e!r by an action 9 ! nature ( m&amus or o!rwise4 7#e7 7,a7 ,if ! ,secret>y det]m9es t a pilot program is n improv+ ! quality ( c>e or produc+ co/ sav+s1 ! ,secret>y %all-- 7i7 propose a modification to ! pilot program 9 ! int]im report t %all also be consid]$ a report "u subsection 7f77#b7 & %all be subject to ! t]ms & conditions ( subsection 7f77#b72 or 7ii7 t]m9ate su* pilot program n lat] ?an #cj days aft] submitt+ ! int]im report to ,congress4 7,b7 ,if ! ,secret>y t]m9ates a pilot program "u subp>agraph 7,a77ii71 = purposes ( subp>agraphs 7,f7 & 7,g7 ( subsection 7f77#b71 su* int]im report w also s]ve z ! f9al report = t pilot program4 7h7 ,evaluation & report+ requirem5ts 7#a7 ,! ,secret>y %all conduct an evaluation ( ea* model te/$1 :i* %all include1 at a m9imum1 an analysis (-- 7,a7 ! quality ( c>e furni%$ "u ! model1 includ+ ! measurem5t ( pati5t-level outcomes & pati5t-c5t]$ness crit]ia det]m9$ appropriate by ! ,secret>y2 & 7,b7 ! *anges 9 sp5d+ by reason ( t model4 7#b7 ,! ,secret>y %all make ! results ( ea* evaluation "u ?is subsection available to ! public 9 a timely fa%ion & may e/abli% requirem5ts = o!r entities p>ticipat+ 9 ! te/+ ( models "u ?is section to collect & report in=mation t ! ,secret>y det]m9es is necess>y to monitor & evaluate su* models4 7i7 ,coord9ation & advice 7#a7 ,! ,secret>y %all obta9 advice f ! ,"u ,secret>y = ,heal? & ! ,special ,m$ical ,advisory ,gr\p e/abli%$ pursuant to section #gcab ( ?is title 9 ! developm5t & implem5tation ( any pilot program op]at$ "u ?is section4 7#b7 ,9 c>ry+ out ! duties "u ?is section1 ! ,secret>y %all consult repres5tatives ( relevant ,f$]al ag5cies1 & cl9ical & analytical exp]ts ) exp]tise 9 m$ic9e & heal? c>e managem5t4 ,! ,secret>y %all use appropriate me*anisms to seek input f int]e/$ p>ties4 7j7 ,expansion ( successful pilot programs ,tak+ into acc\nt ! evaluation "u subsection 7f71 ! ,secret>y may1 ?r\gh rulemak+1 exp& 7includ+ implem5tation on a nationwide basis7 ! duration & ! scope ( a model t is be+ te/$ "u subsection 7a7 to ! ext5t det]m9$ appropriate by ! ,secret>y1 if-- 7#a7 ! ,secret>y det]m9es t su* expansion is expect$ to-- 7,a7 r$uce sp5d+ )\t r$uc+ ! quality ( c>e2 or 7,b7 improve ! quality ( pati5t c>e )\t increas+ sp5d+2 & 7#b7 ! ,secret>y det]m9es t su* expansion w\ld n d5y or limit ! cov]age or provision ( b5efits = individuals receiv+ b5efits "u ?is *apt]4 4 7b7 ,con=m+ am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt]1 z am5d$ by ?is title1 is fur!r am5d$ by ins]t+ aft] ! item relat+ to section #agjc;,d ! foll[+ new item3 #agjc;,e4 ,c5t] = ,innovation = ,c>e & ,paym5t4 4 #aec4 ,au?orization to provide = op]ations on live donors = purposes ( conduct+ transplant proc$ures = vet]ans 7a7 ,9 g5]al ,sub*apt] ,,viii ( *apt] #ag is am5d$ by add+ at ! end ! foll[+ new section3 #aghh4 ,transplant proc$ures ) live donors & relat$ s]vices 7a7 ,9 g5]al ,subject to subsections 7b7 & 7c71 9 a case 9 :i* a vet]an is eligible = a transplant proc$ure f ! ,dep>tm5t1 ! ,secret>y may provide = an op]ation on a live donor to c>ry out su* proc$ure = su* vet]an1 not)/&+ t ! live donor may n be eligible = heal? c>e f ! ,dep>tm5t4 7b7 ,o!r s]vices ,subject to ! availability ( appropriations = su* purpose1 ! ,secret>y %all furni% to a live donor any c>e or s]vices be=e & aft] conduct+ ! transplant proc$ure "u subsection 7a7 t may be requir$ 9 connection ) su* proc$ure4 7c7 ,use ( non-,dep>tm5t facilities ,9 c>ry+ out ?is section1 ! ,secret>y may provide = ! op]ation describ$ 9 subsection 7a7 on a live donor & furni% to ! live donor ! c>e & s]vices describ$ 9 subsection 7b7 at a non-,dep>tm5t facility pursuant to an agreem5t ent]$ into by ! ,secret>y "u ?is *apt]4 ,! live donor %all be deem$ to be an individual eligible = hospital c>e & m$ical s]vices at a non-,dep>tm5t facility pursuant to su* an agreem5t solely = ! purposes ( receiv+ su* op]ation1 c>e1 & s]vices at ! non-,dep>tm5t facility4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( *apt] #ag is am5d$ by ins]t+ aft] ! item relat+ to section #aghg ! foll[+ new item3 #aghh4 ,transplant proc$ures ) live donors & relat$ s]vices4 4 ,c ,family ,c>egiv]s #afa4 ,expansion ( family c>egiv] program ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,family c>egiv] program 7#a7 ,expansion ( eligibility 7,a7 ,9 g5]al ,subp>agraph 7,b7 ( subsection 7a77#b7 ( section #agbj;,g is am5d$ to read z foll[s3 7,b7 = assi/ance provid$ "u ?is subsection-- 7i7 be=e ! date on :i* ! ,secret>y submits to ,congress a c]tification t ! ,dep>tm5t has fully implem5t$ ! in=mation te*nology sy/em requir$ by section #afb7;a7 ( ! ,c>+ = ,our ,vet]ans ,act ( #bjah1 has a s]i\s injury 7includ+ traumatic bra9 injury1 psy*ological trauma1 or o!r m5tal disord]7 incurr$ or aggravat$ 9 ! l9e ( duty 9 ! active milit>y1 naval1 or air s]vice on or aft] ,septemb] #aa1 #bjja2 7ii7 dur+ ! #b-ye> p]iod beg9n+ on ! date on :i* ! ,secret>y submitt$ to ,congress ! c]tification describ$ 9 clause 7i71 has a s]i\s injury 7includ+ traumatic bra9 injury1 psy*ological trauma1 or o!r m5tal disord]7 incurr$ or aggravat$ 9 ! l9e ( duty 9 ! active milit>y1 naval1 or air s]vice-- 7,i7 on or be=e ,may #g1 #aige2 or 7,,ii7 on or aft] ,septemb] #aa1 #bjja2 or 7iii7 aft] ! date t is #b ye>s aft] ! date on :i* ! ,secret>y submits to ,congress ! c]tification describ$ 9 clause 7i71 has a s]i\s injury 7includ+ traumatic bra9 injury1 psy*ological trauma1 or o!r m5tal disord]7 incurr$ or aggravat$ 9 ! l9e ( duty 9 ! active milit>y1 naval1 or air s]vice2 & 4 7,b7 ,publication 9 ,f$]al ,regi/] ,n lat] ?an #cj days aft] ! date on :i* ! ,secret>y ( ,vet]ans ,affairs submits to ,congress ! c]tification describ$ 9 subsection 7a77#b77;,b77i7 ( section #agbj;,g ( su* title1 z am5d$ by subp>agraph 7,a7 ( ?is p>agraph1 ! ,secret>y %all publi% ! date specifi$ 9 su* subsection 9 ! ,f$]al ,regi/]4 7#b7 ,expansion ( ne$$ s]vices 9 eligibility crit]ia ,subsection 7a77#b77;,c7 ( su* section is am5d$-- 7,a7 9 clause 7ii71 by /rik+ 2 or & ins]t+ a semicolon2 7,b7 by r$esignat+ clause 7iii7 z clause 7iv72 & 7,c7 by ins]t+ aft] clause 7ii7 ! foll[+ new clause 7iii73 7iii7 a ne$ = regul> or ext5sive in/ruction or sup]vision )\t :i* ! ability ( ! vet]an to function 9 daily life w\ld be s]i\sly impair$2 or 4 7#c7 ,expansion ( s]vices provid$ ,subsection 7a77#c77;,a77ii7 ( su* section is am5d$-- 7,a7 9 subclause 7,,iv71 by /rik+ 2 & & ins]t+ a semicolon2 7,b7 9 subclause 7,v71 by /rik+ ! p]iod at ! end & ins]t+ 2 &2 & 7,c7 by add+ at ! end ! foll[+ new subclause3 7,,vi7 ?r\gh ! use ( contracts )1 or ! provision ( grants to1 public or private entities-- 7aa7 f9ancial plann+ s]vices relat+ to ! ne$s ( injur$ vet]ans & _! c>egiv]s2 & 7bb7 legal s]vices1 includ+ legal advice & consultation1 relat+ to ! ne$s ( injur$ vet]ans & _! c>egiv]s4 4 7#d7 ,modification ( /ip5d calculation ,subsection 7a77#c77;,c7 ( su* section is am5d$-- 7,a7 by r$esignat+ clause 7iii7 z clause 7iv72 & 7,b7 by ins]t+ aft] clause 7ii7 ! foll[+ new clause 7iii73 7iii7 ,9 det]m9+ ! am\nt & degree ( p]sonal c>e s]vices provid$ "u clause 7i7 ) respect to an eligible vet]an ^: ne$ = p]sonal c>e s]vices is bas$ 9 :ole or 9 "p on a ne$ = sup]vision or protection "u p>agraph 7#b77;,c77ii7 or regul> in/ruction or sup]vision "u p>agraph 7#b77;,c77iii71 ! ,secret>y %all take into acc\nt ! foll[+3 7,i7 ,! assessm5t by ! family c>egiv] ( ! ne$s & limitations ( ! vet]an4 7,,ii7 ,! ext5t to :i* ! vet]an c function safely & indep5d5tly 9 ! abs5ce ( su* sup]vision1 protection1 or in/ruction4 7,,iii7 ,! am\nt ( "t requir$ = ! family c>egiv] to provide su* sup]vision1 protection1 or in/ruction to ! vet]an4 4 7#e7 ,p]iodic evaluation ( ne$ = c]ta9 s]vices ,subsection 7a77#c7 ( su* section is am5d$ by add+ at ! end ! foll[+ new subp>agraph3 7,d7 ,9 provid+ in/ruction1 prep>ation1 & tra9+ "u subp>agraph 7,a77i77,i7 & te*nical support "u subp>agraph 7,a77i77,,ii7 to ea* family c>egiv] :o is approv$ z a provid] ( p]sonal c>e s]vices = an eligible vet]an "u p>agraph 7#f71 ! ,secret>y %all p]iodically evaluate ! ne$s ( ! eligible vet]an & ! skills ( ! family c>egiv] ( su* vet]an to det]m9e if additional in/ruction1 prep>ation1 tra9+1 or te*nical support "u ^? subp>agraphs is necess>y4 4 7#f7 ,use ( prim>y c>e teams ,subsection 7a77#e7 ( su* section is am5d$1 9 ! matt] prec$+ subp>agraph 7,a71 by ins]t+ 79 collaboration ) ! prim>y c>e team = ! eligible vet]an to ! maximum ext5t practicable7 aft] evaluate4 7#g7 ,assi/ance = family c>egiv]s ,subsection 7a7 ( su* section is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#aa7 7,a7 ,9 provid+ assi/ance "u ?is subsection to family c>egiv]s ( eligible vet]ans1 ! ,secret>y may ent] into contracts1 provid] agreem5ts1 & memor&a ( und]/&+ ) ,f$]al ag5cies1 ,/ates1 & private1 nonpr(it1 & o!r entities to provide su* assi/ance to su* family c>egiv]s4 7,b7 ,! ,secret>y may provide assi/ance "u ?is p>agraph only if su* assi/ance is reasonably accessible to ! family c>egiv] & is sub/antially equival5t or bett] 9 quality to simil> s]vices provid$ by ! ,dep>tm5t4 7,c7 ,! ,secret>y may provide fair comp5sation to ,f$]al ag5cies1 ,/ates1 & o!r entities t provide assi/ance "u ?is p>agraph4 4 7b7 ,modification ( def9ition ( p]sonal c>e s]vices ,subsection 7d77#d7 ( su* section is am5d$-- 7#a7 9 subp>agraph 7,a71 by /rik+ indep5d5t2 7#b7 by r$esignat+ subp>agraph 7,b7 z subp>agraph 7,d72 & 7#c7 by ins]t+ aft] subp>agraph 7,a7 ! foll[+ new subp>agraphs3 7,b7 ,sup]vision or protection bas$ on symptoms or residuals ( neurological or o!r impairm5t or injury4 7,c7 ,regul> or ext5sive in/ruction or sup]vision )\t :i* ! ability ( ! vet]an to function 9 daily life w\ld be s]i\sly impair$4 4 #afb4 ,implem5tation ( in=mation te*nology sy/em ( ,dep>tm5t ( ,vet]ans ,affairs to assess & improve ! family c>egiv] program 7a7 ,implem5tation ( new sy/em 7#a7 ,9 g5]al ,n lat] ?an ,octob] #a1 #bjah1 ! ,secret>y ( ,vet]ans ,affairs %all implem5t an in=mation te*nology sy/em t fully supports ! ,program & all[s = data assessm5t & compreh5sive monitor+ ( ! ,program4 7#b7 ,elem5ts ( sy/em ,! in=mation te*nology sy/em requir$ to be implem5t$ "u p>agraph 7#a7 %all include ! foll[+3 7,a7 ,! ability to easily retrieve data t w all[ all aspects ( ! ,program 7at ! m$ical c5t] & aggregate levels7 & ! workload tr5ds = ! ,program to be assess$ & compreh5sively monitor$4 7,b7 ,! ability to manage data ) respect to a numb] ( c>egiv]s t is m ?an ! numb] ( c>egiv]s t ! ,secret>y expects to apply = ! ,program4 7,c7 ,! ability to integrate ! sy/em ) o!r relevant in=mation te*nology sy/ems ( ! ,vet]ans ,heal? ,adm9i/ration4 7b7 ,assessm5t ( ,program ,n lat] ?an #ahj days aft] implem5t+ ! sy/em describ$ 9 subsection 7a71 ! ,secret>y %all1 ?r\gh ! ,"u ,secret>y = ,heal?1 use data f ! sy/em & o!r relevant data to conduct an assessm5t ( h[ key aspects ( ! ,program are /ructur$ & c>ri$ out4 7c7 ,ongo+ monitor+ ( & modifications to ,program 7#a7 ,monitor+ ,! ,secret>y %all use ! sy/em implem5t$ "u subsection 7a7 to monitor & assess ! workload ( ! ,program1 includ+ monitor+ & assessm5t ( data on-- 7,a7 ! /atus ( applications1 appeals1 & home visits 9 connection ) ! ,program2 & 7,b7 ! use by c>egiv]s p>ticipat+ 9 ! ,program ( o!r support s]vices "u ! ,program su* z respite c>e4 7#b7 ,modifications ,bas$ on ! monitor+ & assessm5t conduct$ "u p>agraph 7#a71 ! ,secret>y %all id5tify & implem5t su* modifications to ! ,program z ! ,secret>y consid]s necess>y to ensure ! ,program is function+ z int5d$ & provid+ vet]ans & c>egiv]s p>ticipat+ 9 ! ,program ) s]vices 9 a timely mann]4 7d7 ,reports 7#a7 ,initial report 7,a7 ,9 g5]al ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate1 ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives1 & ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates a report t includes-- 7i7 ! /atus ( ! plann+1 developm5t1 & deploym5t ( ! sy/em requir$ to be implem5t$ "u subsection 7a71 includ+ any *anges 9 ! timel9e = ! implem5tation ( ! sy/em2 & 7ii7 an assessm5t ( ! ne$s ( family c>egiv]s ( vet]ans describ$ 9 subp>agraph 7,b71 ! res\rces ne$$ = ! inclusion ( su* family c>egiv]s 9 ! ,program1 & su* *anges to ! ,program z ! ,secret>y consid]s necess>y to ensure ! successful expansion ( ! ,program to include su* family c>egiv]s4 7,b7 ,vet]ans describ$ ,vet]ans describ$ 9 ?is subp>agraph are vet]ans :o are eligible = ! ,program "u clause 7ii7 or 7iii7 ( section #agbj;,g7a77#b77;,b7 ( title #ch1 ,unit$ ,/ates ,code1 z am5d$ by section #afa7;a77#a7 ( ?is title1 solely due to a s]i\s injury 7includ+ traumatic bra9 injury1 psy*ological trauma1 or o!r m5tal disord]7 incurr$ or aggravat$ 9 ! l9e ( duty 9 ! active milit>y1 naval1 or air s]vice be=e ,septemb] #aa1 #bjja4 7#b7 ,notification by ,comptroll] ,g5]al ,! ,comptroll] ,g5]al %all review ! report submitt$ "u p>agraph 7#a7 & notify ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives ) respect to ! progress ( ! ,secret>y 9-- 7,a7 fully implem5t+ ! sy/em requir$ "u subsection 7a72 & 7,b7 implem5t+ a process = us+ su* sy/em to monitor & assess ! ,program "u subsection 7c77#a7 & modify ! ,program z consid]$ necess>y "u subsection 7c77#b74 7#c7 ,f9al report 7,a7 ,9 g5]al ,n lat] ?an ,octob] #a1 #bjai1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate1 ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives1 & ! ,comptroll] ,g5]al a report on ! implem5tation ( subsections 7a7 ?r\gh 7c74 7,b7 ,elem5ts ,! report requir$ by subp>agraph 7,a7 %all include ! foll[+3 7i7 ,a c]tification by ! ,secret>y t ! in=mation te*nology sy/em describ$ 9 subsection 7a7 has be5 implem5t$4 7ii7 ,a description ( h[ ! ,secret>y has implem5t$ su* sy/em4 7iii7 ,a description ( ! modifications to ! ,program1 if any1 t 7 id5tifi$ & implem5t$ "u subsection 7c77#b74 7iv7 ,a description ( h[ ! ,secret>y is us+ su* sy/em to monitor ! workload ( ! ,program4 7e7 ,def9itions ,9 ?is section3 7#a7 ,active milit>y1 naval1 or air s]vice ,! t]m active milit>y1 naval1 or air s]vice has ! mean+ giv5 t t]m 9 section #aja ( title #ch1 ,unit$ ,/ates ,code4 7#b7 ,program ,! t]m ,program means ! program ( compreh5sive assi/ance = family c>egiv]s "u section #agbj;,g7a7 ( title #ch1 ,unit$ ,/ates ,code1 z am5d$ by section #afa ( ?is title4 #afc4 ,modifications to annual evaluation report on c>egiv] program ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,b>ri]s to c>e & s]vices ,subp>agraph 7,a77iv7 ( section #aja7;c77#b7 ( ! ,c>egiv]s & ,vet]ans ,omnibus ,heal? ,s]vices ,act ( #bjaj 7,public ,law #aaa-afc2 #ch ,u4,s4,c4 #agbj;,g note7 is am5d$ by ins]t+ 1 includ+ a description ( any b>ri]s to access+ & receiv+ c>e & s]vices "u su* programs be=e ! semicolon4 7b7 ,suffici5cy ( tra9+ = family c>egiv] program ,subp>agraph 7,b7 ( su* section is am5d$-- 7#a7 9 clause 7i71 by /rik+ 2 & & ins]t+ a semicolon2 7#b7 9 clause 7ii71 by /rik+ ! p]iod at ! end & ins]t+ 2 &2 & 7#c7 by add+ at ! end ! foll[+ new clause3 7iii7 an evaluation ( ! suffici5cy & consi/5cy ( ! tra9+ provid$ to family c>egiv]s "u su* program 9 prep>+ family c>egiv]s to provide c>e to vet]ans "u su* program4 4 ,,ii ,,va ,asset & ,infra/ructure ,review ,a ,asset & ,infra/ructure ,review #bja4 ,%ort title ,?is subtitle may be cit$ z ! ,,va ,asset & ,infra/ructure ,review ,act ( #bjah4 #bjb4 ,! ,commission 7a7 ,e/abli%m5t ,!re is e/abli%$ an indep5d5t commission to be kn[n z ! ,asset & ,infra/ructure ,review ,commission 79 ?is subtitle ref]r$ to z ! ,commission74 7b7 ,duties ,! ,commission %all c>ry out ! duties specifi$ = x 9 ?is subtitle4 7c7 ,appo9tm5t 7#a7 ,9 g5]al 7,a7 ,appo9tm5t ,! ,commission %all be compos$ ( n9e memb]s appo9t$ by ! ,presid5t1 by & ) ! advice & cons5t ( ! ,s5ate4 7,b7 ,transmission ( nom9ations ,! ,presid5t %all transmit to ! ,s5ate ! nom9ations = appo9tm5t to ! ,commission n lat] ?an ,may #ca1 #bjba4 7#b7 ,consultation 9 selection process ,9 select+ individuals = nom9ations = appo9tm5ts to ! ,commission1 ! ,presid5t %all consult )-- 7,a7 ! ,speak] ( ! ,h\se ( ,repres5tatives2 7,b7 ! majority lead] ( ! ,s5ate2 7,c7 ! m9ority lead] ( ! ,h\se ( ,repres5tatives2 7,d7 ! m9ority lead] ( ! ,s5ate2 & 7,e7 congressionally *>t]$1 memb]%ip bas$ vet]ans s]vice organizations conc]n+ ! appo9tm5t ( ?ree memb]s4 7#c7 ,designation ( ,*air ,at ! "t ! ,presid5t nom9ates individuals = appo9tm5t to ! ,commission "u p>agraph 7#a77;,b71 ! ,presid5t %all designate "o su* individual :o %all s]ve z ,*air ( ! ,commission & "o su* individual :o %all s]ve z ,vice ,*air ( ! ,commission4 7#d7 ,memb] repres5tation ,9 nom9at+ individuals "u ?is subsection1 ! ,presid5t %all ensure t-- 7,a7 vet]ans1 reflect+ curr5t demographics ( vet]ans enroll$ 9 ! sy/em ( annual pati5t enrollm5t "u section #agje ( title #ch1 ,unit$ ,/ates ,code1 are adequately repres5t$ 9 ! memb]%ip ( ! ,commission2 7,b7 at lea/ "o memb] ( ! ,commission has exp]i5ce work+ = a private integrat$ heal? c>e sy/em t has annual gross rev5ues ( m ?an #ej1jjj1jjj2 7,c7 at lea/ "o memb] has exp]i5ce z a s5ior manag] = an entity specifi$ 9 clause 7ii71 7iii71 or 7iv7 ( section #aja7;a77#a77;,b7 ( ! ,vet]ans ,access1 ,*oice1 & ,acc\ntability ,act ( #bjad 7,public ,law #aac-adf2 #ch ,u4,s4,c4 #agja note72 7,d7 at lea/ "o memb]-- 7i7 has exp]i5ce ) capital asset managem5t = ! ,f$]al ,gov]nm5t2 & 7ii7 is famili> ) trades relat$ to build+ & real prop]ty1 includ+ con/ruction1 eng9e]+1 ar*itecture1 leas+1 & /rategic p>tn]%ips2 & 7,e7 at lea/ ?ree memb]s repres5t congressionally *>t]$1 memb]%ip-bas$1 vet]ans s]vice organizations4 7d7 ,meet+s 7#a7 ,9 g5]al ,! ,commission %all meet only dur+ cal5d> ye>s #bjbb & #bjbc4 7#b7 ,public nature ( meet+s & proce$+s 7,a7 ,public meet+s ,ea* meet+ ( ! ,commission %all be op5 to ! public4 7,b7 ,op5 p>ticipation ,all ! proce$+s1 in=mation1 & delib]ations ( ! ,commission %all be available = review by ! public4 7e7 ,vacancies ,a vacancy 9 ! ,commission %all be fill$ 9 ! same mann] z ! orig9al appo9tm5t1 b ! individual appo9t$ to fill ! vacancy %all s]ve only = ! unexpir$ portion ( ! t]m = :i* ! individual's pr$ecessor 0 appo9t$4 7f7 ,pay 7#a7 ,9 g5]al ,memb]s ( ! ,commission %all s]ve )\t pay4 7#b7 ,(fic]s or employees ( ! ,unit$ ,/ates ,ea* memb] ( ! ,commission :o is an (fic] or employee ( ! ,unit$ ,/ates %all s]ve )\t comp5sation 9 addition to t receiv$ = s]vice z an (fic] or employee ( ! ,unit$ ,/ates4 7#c7 ,travel exp5ses ,memb]s %all receive travel exp5ses1 includ+ p] diem 9 lieu ( subsi/5ce1 9 accordance ) sections #egjb & #egjc ( title #e1 ,unit$ ,/ates ,code4 7g7 ,director ( /aff 7#a7 ,appo9tm5t ,! ,commission %all appo9t a ,director :o-- 7,a7 has n s]v$ z an employee ( ! ,dep>tm5t ( ,vet]ans ,affairs dur+ ! #a-ye> p]iod prec$+ ! date ( su* appo9tm5t2 & 7,b7 is n o!rwise b>r$ or prohibit$ f s]v+ z ,director "u ,f$]al e?ics laws & regulations1 by reason ( po/-employm5t conflict ( int]e/4 7#b7 ,rate ( pay ,! ,director %all be paid at ! rate ( basic pay payable = level ,,iv ( ! ,executive ,s*$ule "u section #ecae ( title #e1 ,unit$ ,/ates ,code4 7h7 ,/aff 7#a7 ,pay ( p]sonnel ,subject to p>agraphs 7#b7 & 7#c71 ! ,director1 ) ! approval ( ! ,commission1 may appo9t & fix ! pay ( additional p]sonnel4 7#b7 ,exemption f c]ta9 requirem5ts ,! ,director may make su* appo9tm5ts )\t reg>d to ! provisions ( title #e1 ,unit$ ,/ates ,code1 gov]n+ appo9tm5ts 9 ! competitive s]vice1 & any p]sonnel s appo9t$ may be paid )\t reg>d to ! provisions ( *apt] #ea & sub*apt] ,,iii ( *apt] #ec ( t title relat+ to classification & ,g5]al ,s*$ule pay rates1 except t an individual s appo9t$ may n receive pay 9 excess ( ! annual rate ( basic pay payable = ,,gs-#ae ( ! ,g5]al ,s*$ule4 7#c7 ,detailees 7,a7 ,limitation on numb] ,n m ?an two-?irds ( ! p]sonnel employ$ by or detail$ to ! ,commission may be on detail f ! ,dep>tm5t ( ,vet]ans ,affairs4 7,b7 ,pr(essional analy/s ,n m ?an half ( ! pr(essional analy/s ( ! ,commission /aff may be p]sons detail$ f ! ,dep>tm5t ( ,vet]ans ,affairs to ! ,commission4 7,c7 ,prohibition on detail ( c]ta9 p]sonnel ,a p]son may n be detail$ f ! ,dep>tm5t ( ,vet]ans ,affairs to ! ,commission if1 )9 #f mon?s be=e ! detail is to beg91 t p]son p>ticipat$ p]sonally & sub/antially 9 any matt] )9 ! ,dep>tm5t ( ,vet]ans ,affairs conc]n+ ! prep>ation ( recomm5dations reg>d+ facilities ( ! ,vet]ans ,heal? ,adm9i/ration4 7#d7 ,au?ority to reque/ detail$ p]sonnel ,subject to p>agraph 7#c71 ! head ( any ,f$]al dep>tm5t or ag5cy1 ^u ! reque/ ( ! ,director1 may detail any ( ! p]sonnel ( t dep>tm5t or ag5cy to ! ,commission to assi/ ! ,commission 9 c>ry+ out its duties "u ?is subtitle4 7#e7 ,in=mation f ,f$]al ag5cies ,! ,commission may secure directly f any ,f$]al ag5cy su* in=mation ! ,commission consid]s necess>y to c>ry out ?is subtitle4 ,^u reque/ ( ! ,*air1 ! head ( su* ag5cy %all furni% su* in=mation to ! ,commission4 7i7 ,o!r au?ority 7#a7 ,tempor>y & int]mitt5t s]vices ,! ,commission may procure by contract1 to ! ext5t funds are available1 ! tempor>y or int]mitt5t s]vices ( exp]ts or consultants pursuant to section #caji ( title #e1 ,unit$ ,/ates ,code4 7#b7 ,leas+ & acquisition ( prop]ty ,to ! ext5t funds are available1 ! ,commission may lease real prop]ty & acquire p]sonal prop]ty ei!r ( its own accord or 9 consultation ) ! ,g5]al ,s]vices ,adm9i/ration4 7j7 ,t]m9ation ,! ,commission %all t]m9ate on ,decemb] #ca1 #bjbc4 7k7 ,prohibition aga9/ re/rict+ communications 7#a7 ,9 g5]al ,except z provid$ 9 p>agraph 7#b71 no p]son may re/rict an employee ( ! ,dep>tm5t ( ,vet]ans ,affairs 9 communicat+ ) ! ,commission4 7#b7 ,unlawful communications ,p>agraph 7#a7 does n apply to a communication t is unlawful4 #bjc4 ,proc$ure = mak+ recomm5dations 7a7 ,selection crit]ia 7#a7 ,publication ,! ,secret>y %all1 n lat] ?an ,febru>y #a1 #bjba1 & aft] consult+ ) vet]ans s]vice organizations1 publi% 9 ! ,f$]al ,regi/] & transmit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ! ,h\se ( ,repres5tatives ! crit]ia propos$ to be us$ by ! ,dep>tm5t ( ,vet]ans ,affairs 9 assess+ & mak+ recomm5dations reg>d+ ! mod]nization or realignm5t ( facilities ( ! ,vet]ans ,heal? ,adm9i/ration "u ?is subtitle4 ,su* crit]ia %all include ! pref]5ces ( vet]ans reg>d+ heal? c>e furni%$ by ! ,dep>tm5t4 7#b7 ,public comm5t ,! ,secret>y %all provide an opportunity = public comm5t on ! propos$ crit]ia "u p>agraph 7#a7 = a p]iod ( at lea/ #ij days & %all include notice ( t opportunity 9 ! publication requir$ "u su* p>agraph4 7#c7 ,publication ( f9al crit]ia ,! ,secret>y %all1 n lat] ?an ,may #ca1 #bjba1 publi% 9 ! ,f$]al ,regi/] & transmit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ! ,h\se ( ,repres5tatives ! f9al crit]ia to be us$ 9 mak+ recomm5dations reg>d+ ! closure1 mod]nization1 or realignm5t ( facilities ( ! ,vet]ans ,heal? ,adm9i/ration "u ?is subtitle4 7b7 ,recomm5dations ( ! ,secret>y 7#a7 ,publication 9 ,f$]al ,regi/] ,! ,secret>y %all1 n lat] ?an ,janu>y #ca1 #bjbb1 & aft] consult+ ) vet]ans s]vice organizations1 publi% 9 ! ,f$]al ,regi/] & transmit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ! ,h\se ( ,repres5tatives & to ! ,commission a report detail+ ! recomm5dations reg>d+ ! mod]nization or realignm5t ( facilities ( ! ,vet]ans ,heal? ,adm9i/ration on ! basis ( ! f9al crit]ia ref]r$ to 9 subsection 7a77#b7 t are applicable4 7#b7 ,factors = consid]ation ,9 mak+ recomm5dations "u ?is subsection1 ! ,secret>y %all consid] ea* ( ! foll[+ factors3 7,a7 ,! degree to :i* any heal? c>e deliv]y or o!r site = provid+ s]vices to vet]ans reflect ! metrics ( ! ,dep>tm5t ( ,vet]ans ,affairs reg>d+ m>ket area heal? sy/em plann+4 7,b7 ,! provision ( effective & effici5t access to high-quality heal? c>e & s]vices = vet]ans4 7,c7 ,! ext5t to :i* ! real prop]ty t no long] meets ! ne$s ( ! ,f$]al ,gov]nm5t c\ld be reconfigur$1 repurpos$1 consolidat$1 realign$1 ex*ang$1 outleas$1 replac$1 sold1 or dispos$4 7,d7 ,! ne$ ( ! ,vet]ans ,heal? ,adm9i/ration to acquire infra/ructure or facilities t w be us$ = ! provision ( heal? c>e & s]vices to vet]ans4 7,e7 ,! ext5t to :i* ! op]at+ & ma9t5ance co/s are r$uc$ ?r\gh consolidat+1 colocat+1 & reconfigur+ space1 & ?r\gh realiz+ o!r op]ational effici5cies4 7,f7 ,! ext5t & tim+ ( pot5tial co/s & sav+s1 includ+ ! numb] ( ye>s su* co/s or sav+s w be incurr$1 beg9n+ ) ! date ( completion ( ! propos$ recomm5dation4 7,g7 ,! ext5t to :i* ! real prop]ty aligns ) ! mission ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7,h7 ,! ext5t to :i* any action w\ld impact o!r missions ( ! ,dep>tm5t 7includ+ education1 rese>*1 or em]g5cy prep>$ness74 7,i7 ,local /akehold] inputs & any factors id5tifi$ ?r\gh public field he>+s4 7,j7 ,! assessm5ts "u p>agraph 7#c74 7,k7 ,! ext5t to :i* ! ,vet]ans ,heal? ,adm9i/ration has appropriately /aff$ ! m$ical facility1 includ+ det]m9ations :e!r !re has be5 insuffici5t res\rce allocation or delib]ate und]/aff+4 7,l7 ,any o!r su* factors ! ,secret>y det]m9es appropriate4 7#c7 ,capacity & comm]cial m>ket assessm5ts 7,a7 ,assessm5ts ,! ,secret>y %all assess ! capacity ( ea* ,vet]ans ,integrat$ ,s]vice ,network & m$ical facility ( ! ,dep>tm5t to furni% hospital c>e or m$ical s]vices to vet]ans "u *apt] #ag ( title #ch1 ,unit$ ,/ates ,code4 ,ea* su* assessm5t %all-- 7i7 id5tify gaps 9 furni%+ su* c>e or s]vices at su* ,vet]ans ,integrat$ ,s]vice ,network or m$ical facility2 7ii7 id5tify h[ su* gaps c be fill$ by-- 7,i7 ent]+ into contracts or agreem5ts ) network provid]s "u ?is section or ) entities "u o!r provisions ( law2 7,,ii7 mak+ *anges 9 ! way su* c>e & s]vices are furni%$ at su* ,vet]ans ,integrat$ ,s]vice ,network or m$ical facility1 includ+-- 7aa7 ext5d+ h\rs ( op]ation2 7bb7 add+ p]sonnel2 or 7cc7 exp&+ space ?r\gh ! con/ruction1 leas+1 or %>+ ( heal? c>e facilities2 & 7,,iii7 ! build+ or realignm5t ( ,dep>tm5t res\rces or p]sonnel2 7iii7 =eca/1 bas$ on future projections & hi/orical tr5ds1 bo? ! %ort- & long-t]m dem& 9 furni%+ c>e or s]vices at su* ,vet]ans ,integrat$ ,s]vice ,network or m$ical facility & assess h[ su* dem& affects ! ne$s to use su* network provid]s2 7iv7 include a comm]cial heal? c>e m>ket assessm5t ( designat$ cat*m5t areas 9 ! ,unit$ ,/ates conduct$ by a non-gov]nm5tal entity2 & 7v7 consid] ! unique ability ( ! ,f$]al ,gov]nm5t to reta9 a pres5ce 9 an area o!rwise devoid ( comm]cial heal? c>e provid]s or f :i* su* provid]s are at risk ( leav+4 7,b7 ,consultation ,9 c>ry+ out ! assessm5ts "u subp>agraph 7,a71 ! ,secret>y %all consult ) vet]ans s]vice organizations & vet]ans s]v$ by ea* su* ,vet]ans ,integrat$ ,s]vice ,network & m$ical facility4 7,c7 ,submittal ,! ,secret>y %all submit su* assessm5ts to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate ) ! recomm5dations ( ! ,secret>y "u ?is subsection & make ! assessm5ts publicly available4 7#d7 ,summ>y ( selection process ,! ,secret>y %all include1 ) ! li/ ( recomm5dations publi%$ & transmitt$ pursuant to p>agraph 7#a71 a summ>y ( ! selection process t result$ 9 ! recomm5dation = ea* facility ( ! ,vet]ans ,heal? ,adm9i/ration1 includ+ a ju/ification = ea* recomm5dation4 ,! ,secret>y %all transmit ! matt]s ref]r$ to 9 ! prec$+ s5t5ce n lat] ?an #g days aft] ! date ( ! transmittal to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ! ,h\se ( ,repres5tatives & ! ,commission ( ! report ref]r$ to 9 p>agraph 7#a74 7#e7 ,treatm5t ( facilities ,9 assess+ facilities ( ! ,vet]ans ,heal? ,adm9i/ration1 ! ,secret>y %all consid] all su* facilities equally )\t reg>d to :e!r ! facility has be5 previ\sly consid]$ or propos$ = reuse1 closure1 mod]nization1 or realignm5t by ! ,dep>tm5t ( ,vet]ans ,affairs4 7#f7 ,availability ( in=mation to ,congress ,9 addition to mak+ all in=mation us$ by ! ,secret>y to prep>e ! recomm5dations "u ?is subsection available to ,congress 7includ+ any committee or ,memb] ( ,congress71 ! ,secret>y %all also make su* in=mation available to ! ,commission & ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates4 7#g7 ,c]tification ( accuracy 7,a7 ,9 g5]al ,ea* p]son ref]r$ to 9 subp>agraph 7,b71 :5 submitt+ in=mation to ! ,secret>y or ! ,commission conc]n+ ! mod]nization or realignm5t ( a facility ( ! ,vet]ans ,heal? ,adm9i/ration1 %all c]tify t su* in=mation is accurate & complete to ! be/ ( t p]son's k & belief4 7,b7 ,cov]$ p]sons ,subp>agraph 7,a7 applies to ! foll[+ p]sons3 7i7 ,ea* ,"u ,secret>y ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7ii7 ,ea* director ( a ,vet]ans ,integrat$ ,s]vice ,network4 7iii7 ,ea* director ( a m$ical c5t] ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7iv7 ,ea* director ( a program (fice ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7v7 ,ea* p]son :o is 9 a position ! duties ( :i* include p]sonal & sub/antial involvem5t 9 ! prep>ation & submission ( in=mation & recomm5dations conc]n+ ! mod]nization or realignm5t ( facilities ( ! ,vet]ans ,heal? ,adm9i/ration4 7c7 ,review & recomm5dations by ! ,commission 7#a7 ,public he>+s 7,a7 ,9 g5]al ,aft] receiv+ ! recomm5dations f ! ,secret>y pursuant to subsection 7b71 ! ,commission %all conduct public he>+s on ! recomm5dations4 7,b7 ,locations ,! ,commission %all conduct public he>+s 9 regions affect$ by a recomm5dation ( ! ,secret>y to close a facility ( ! ,vet]ans ,heal? ,adm9i/ration4 ,to ! greate/ ext5t practicable1 ! ,commission %all conduct public he>+s 9 regions affect$ by a recomm5dation ( ! ,secret>y to mod]nize or realign su* a facility4 7,c7 ,requir$ witnesses ,witnesses at ea* public he>+ %all include at a m9imum-- 7i7 a vet]an-- 7,i7 enroll$ "u section #agje ( title #ch1 ,unit$ ,/ates ,code2 & 7,,ii7 id5tifi$ by a local vet]ans s]vice organization2 & 7ii7 a local elect$ (ficial4 7#b7 ,transmittal to ,presid5t 7,a7 ,9 g5]al ,! ,commission %all1 n lat] ?an ,janu>y #ca1 #bjbc1 transmit to ! ,presid5t a report conta9+ ! ,commission's f9d+s & conclusions bas$ on a review & analysis ( ! recomm5dations made by ! ,secret>y1 toge!r ) ! ,commission's recomm5dations1 = mod]nizations & realignm5ts ( facilities ( ! ,vet]ans ,heal? ,adm9i/ration4 7,b7 ,au?ority to make *anges to recomm5dations ,subject to subp>agraph 7,c71 9 mak+ its recomm5dations1 ! ,commission may *ange any recomm5dation made by ! ,secret>y if ! ,commission-- 7i7 det]m9es t ! ,secret>y deviat$ sub/antially f ! f9al crit]ia ref]r$ to 9 subsection 7a77#b7 9 mak+ su* recomm5dation2 7ii7 det]m9es t ! *ange is consi/5t ) ! f9al crit]ia ref]r$ to 9 subsection 7a77#b72 7iii7 publi%es a notice ( ! propos$ *ange 9 ! ,f$]al ,regi/] n less ?an #de days be=e transmitt+ its recomm5dations to ! ,presid5t pursuant to subp>agraph 7,a72 & 7iv7 conducts public he>+s on ! propos$ *ange4 7#c7 ,ju/ification = *anges ,! ,commission %all expla9 & ju/ify 9 its report submitt$ to ! ,presid5t pursuant to p>agraph 7#b7 any recomm5dation made by ! ,commission t is diff]5t f ! recomm5dations made by ! ,secret>y pursuant to subsection 7b74 ,! ,commission %all transmit a copy ( su* report to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ! ,h\se ( ,repres5tatives on ! same date on :i* x transmits its recomm5dations to ! ,presid5t "u p>agraph 7#b74 7#d7 ,provision ( in=mation to ,congress ,aft] ! ,commission transmits its report to ! ,presid5t1 ! ,commission %all promptly provide1 ^u reque/1 to any ,memb] ( ,congress1 in=mation us$ by ! ,commission 9 mak+ its recomm5dations4 7d7 ,review by ! ,presid5t 7#a7 ,report ,! ,presid5t %all1 n lat] ?an ,febru>y #ae1 #bjbc1 transmit to ! ,commission & to ! ,congress a report conta9+ ! ,presid5t's approval or disapproval ( ! ,commission's recomm5dations4 7#b7 ,presid5tial approval ,if ! ,presid5t approves all ! recomm5dations ( ! ,commission1 ! ,presid5t %all transmit a copy ( su* recomm5dations to ! ,congress1 toge!r ) a c]tification ( su* approval4 7#c7 ,presid5tial disapproval ,if ! ,presid5t disapproves ! recomm5dations ( ! ,commission1 9 :ole or 9 "p1 ! ,presid5t %all transmit to ! ,commission & ! ,congress1 n lat] ?an ,m>* #a1 #bjbc1 ! reasons = t disapproval4 ,! ,commission1 aft] consid]ation ( ! ,presid5t's reasons = disapproval1 %all !n transmit to ! ,presid5t1 n lat] ?an ,m>* #ae1 #bjbc1 a report conta9+-- 7,a7 ! ,commission's f9d+s & conclusions bas$ on a review & analysis ( ^? reasons = disapproval provid$ by ! ,presid5t2 & 7,b7 recomm5dations t ! ,commission det]m9es are appropriate = mod]nizations & realignm5ts ( facilities ( ! ,vet]ans ,heal? ,adm9i/ration4 7#d7 ,transmittal ( recomm5dations to ,congress ,if ! ,presid5t approves all recomm5dations ( ! ,commission transmitt$ to ! ,presid5t "u p>agraph 7#c71 ! ,presid5t %all transmit a copy ( su* recomm5dations to ! ,congress1 toge!r ) a c]tification ( su* approval4 7#e7 ,failure to transmit ,if ! ,presid5t does n transmit to ! ,congress an approval & c]tification describ$ 9 p>agraph 7#b7 or 7#d7 by ,m>* #cj1 #bjbc1 ! process by :i* facilities ( ! ,vet]ans ,heal? ,adm9i/ration may be select$ = mod]nization or realignm5t "u ?is subtitle %all be t]m9at$4 #bjd4 ,actions reg>d+ infra/ructure & facilities ( ! ,vet]ans ,heal? ,adm9i/ration 7a7 ,9 g5]al ,subject to subsection 7b71 ! ,secret>y %all beg9 to implem5t ! recomm5d$ mod]nizations & realignm5ts 9 ! report "u section #bjc7;d7 n lat] ?an #c ye>s aft] ! date on :i* ! ,presid5t transmits su* report to ,congress4 ,9 any fiscal ye>1 su* implem5tation includes-- 7#a7 ! plann+ ( mod]nizations & realignm5ts ( facilities ( ! ,vet]ans ,heal? ,adm9i/ration z recomm5d$ 9 su* report2 & 7#b7 provid+ detail$ in=mation on ! budget = su* mod]nizations or realignm5ts 9 docum5ts submitt$ to ,congress by ! ,secret>y 9 support ( ! ,presid5t's budget = t fiscal ye>4 7b7 ,congressional disapproval 7#a7 ,9 g5]al ,! ,secret>y may n c>ry out any mod]nization or realignm5t recomm5d$ by ! ,commission 9 a report transmitt$ f ! ,presid5t pursuant to section #bjc7;d7 if a jo9t resolution is enact$1 9 accordance ) ! provisions ( section #bjg1 disapprov+ su* recomm5dations ( ! ,commission be=e ! e>li] (-- 7,a7 ! end ( ! #de-;day p]iod beg9n+ on ! date on :i* ! ,presid5t transmits su* report2 or 7,b7 ! adj\rnm5t ( ,congress s9e die = ! session dur+ :i* su* report is transmitt$4 7#b7 ,computation ( p]iod ,= purposes ( p>agraph 7#a7 & subsections 7a7 & 7c7 ( section #bjg1 ! days on :i* ei!r ,h\se ( ,congress is n 9 session because ( an adj\rnm5t ( m ?an ?ree days to a day c]ta9 %all be exclud$ 9 ! computation ( a p]iod4 #bje4 ,implem5tation 7a7 ,9 g5]al 7#a7 ,mod]niz+ & realign+ facilities ,9 mod]niz+ or realign+ any facility ( ! ,vet]ans ,heal? ,adm9i/ration "u ?is subtitle1 ! ,secret>y may-- 7,a7 take su* actions z may be necess>y to mod]nize or realign any su* facility1 includ+ ! alt]ation ( su* facilities1 ! acquisition ( su* l&1 ! leas+ or con/ruction ( su* replacem5t facilities1 ! disposition ( su* l& or facilities1 ! p]=mance ( su* activities1 & ! conduct ( su* advance plann+ & design z may be requir$ to transf] functions f a facility ( ! ,vet]ans ,heal? ,adm9i/ration to ano!r su* facility1 & may use = su* purpose funds 9 ! ,acc\nt or funds appropriat$ to ! ,dep>tm5t ( ,vet]ans ,affairs = su* purposes2 7,b7 c>ry out activities = ! purposes ( environm5tal mitigation1 abatem5t1 or re/oration at any su* facility1 & %all use = su* purposes funds 9 ! ,acc\nt2 7,c7 reimburse o!r ,f$]al ag5cies = actions p]=m$ at ! reque/ ( ! ,secret>y ) respect to any su* closure or realignm5t1 & may use = su* purpose funds 9 ! ,acc\nt or funds appropriat$ to ! ,dep>tm5t ( ,vet]ans ,affairs & available = su* purpose2 & 7,d7 ex]cise ! au?ority ( ! ,secret>y "u sub*apt] ,v ( *apt] #ha ( title #ch1 ,unit$ ,/ates ,code4 7#b7 ,environm5tal re/oration2 hi/oric pres]vation ,9 c>ry+ out any closure or realignm5t "u ?is subtitle1 ! ,secret>y1 ) reg>ds to any prop]ty made excess to ! ne$s ( ! ,dep>tm5t ( ,vet]ans ,affairs z a result ( su* closure or realignm5t1 %all c>ry out1 z soon z possible ) funds available = su* purpose1 any ( ! foll[+ = :i* ! ,secret>y is responsible3 7,a7 ,environm5tal mitigation4 7,b7 ,environm5tal abatem5t4 7,c7 ,environm5tal re/oration4 7,d7 ,compliance ) hi/oric pres]vation requirem5ts4 7b7 ,managem5t & disposal ( prop]ty 7#a7 ,exi/+ ,disposal ,au?orities ,to transf] or dispose ( surplus real prop]ty or infra/ructure locat$ at any facility ( ! ,vet]ans ,heal? ,adm9i/ration t is mod]niz$ or realign$ "u ?is title1 ! ,secret>y may ex]cise ! au?orities ( ! ,secret>y "u sub*apt]s ,i & ,,ii ( *apt] #ha ( title #ch1 ,unit$ ,/ates ,code1 or ! au?orities delegat$ to ! ,secret>y by ! ,adm9i/rator ( ,g5]al ,s]vices "u sub*apt] ,,iii ( *apt] #e ( title #dj1 ,unit$ ,/ates ,code4 7#b7 ,effects on local communities 7,a7 ,consultation ) ,/ate & local gov]nm5t ,be=e any action may be tak5 ) respect to ! disposal ( any surplus real prop]ty or infra/ructure locat$ at any facility ( ! ,vet]ans ,heal? ,adm9i/ration to be clos$ or realign$ "u ?is subtitle1 ! ,secret>y ( ,vet]ans ,affairs %all consult ) ! ,gov]nor ( ! ,/ate & ! heads ( ! local gov]nm5ts conc]n$ = ! purpose ( consid]+ any plan = ! use ( su* prop]ty by ! local community conc]n$4 7,b7 ,treatm5t ( roads ,if infra/ructure or a facility ( ! ,vet]ans ,heal? ,adm9i/ration to be clos$ or realign$ "u ?is subtitle includes a road us$ = public access ?r\gh1 into1 or ar\nd ! facility1 ! ,secret>y-- 7i7 %all consult ) ! ,gov]nm5t ( ! ,/ate & ! heads ( ! local gov]nm5ts conc]n$ = ! purpose ( consid]+ ! cont9u$ availability ( ! road = public use aft] ! recomm5d$ action is complete2 & 7ii7 may ex]cise ! au?ority ( ! ,secret>y "u section #hajh ( title #ch1 ,unit$ ,/ates ,code4 7#c7 ,leases2 ,,c]cla 7,a7 ,lease au?ority 7i7 ,transf] to r$evelopm5t au?ority = lease ,! ,secret>y may transf] title to a facility ( ! ,vet]ans ,heal? ,adm9i/ration approv$ = closure or realignm5t "u ?is subtitle 7includ+ prop]ty at a facility ( ! ,vet]ans ,heal? ,adm9i/ration approv$ = realignm5t :i* w be reta9$ by ! ,dep>tm5t ( ,vet]ans ,affairs or ano!r ,f$]al ag5cy aft] realignm5t7 to ! r$evelopm5t au?ority = ! facility if ! r$evelopm5t au?ority agrees to lease1 directly ^u transf]1 "o or m portions ( ! prop]ty transf]r$ "u ?is subp>agraph to ! ,secret>y or to ! head ( ano!r dep>tm5t or ag5cy ( ! ,f$]al ,gov]nm5t4 7ii7 ,t]m ( lease ,a lease "u clause 7i7 %all be = a t]m ( n to exce$ #ej ye>s1 b may provide = options = r5ewal or ext5sion ( ! t]m by ! dep>tm5t or ag5cy conc]n$4 7iii7 ,limitation ,a lease "u clause 7i7 may n require r5tal paym5ts by ! ,unit$ ,/ates4 7iv7 ,treatm5t ( rema9d]$ lease t]ms ,a lease "u clause 7i7 %all include a provision specify+ t if ! dep>tm5t or ag5cy conc]n$ ceases requir+ ! use ( ! leas$ prop]ty be=e ! expiration ( ! t]m ( ! lease1 ! rema9d] ( ! lease t]m may be satisfi$ by ! same or ano!r dep>tm5t or ag5cy ( ! ,f$]al ,gov]nm5t us+ ! prop]ty = a use simil> to ! use "u ! lease4 ,ex]cise ( ! au?ority provid$ by ?is clause %all be made 9 consultation ) ! r$evelopm5t au?ority conc]n$4 7v7 ,facility s]vices ,not)/&+ clause 7iii71 if a lease "u clause 7i7 involves a sub/antial portion ( ! facility1 ! dep>tm5t or ag5cy conc]n$ may obta9 facility s]vices = ! leas$ prop]ty & common area ma9t5ance f ! r$evelopm5t au?ority or ! r$evelopm5t au?ority's assignee z a provision ( ! lease4 ,! facility s]vices & common area ma9t5ance %all be provid$ at a rate no high] ?an ! rate *>g$ to non-,f$]al t5ants ( ! transf]r$ prop]ty4 ,facility s]vices & common area ma9t5ance cov]$ by ! lease %all n include-- 7,i7 municipal s]vices t a ,/ate or local gov]nm5t is requir$ by law to provide to all l&[n]s 9 its jurisdiction )\t direct *>ge2 or 7,,ii7 firefight+ or security-gu>d functions4 7,b7 ,application ( ,,c]cla ,! provisions ( section #abj7;h7 ( ! ,compreh5sive ,environm5tal ,response1 ,comp5sation1 & ,liability ,act ( #aihj 7#db ,u4,s4,c4 #ifbj7;h77 %all apply to any transf] ( real prop]ty "u ?is p>agraph4 7,c7 ,additional t]ms & conditions ,! ,secret>y may require any additional t]ms & conditions 9 connection ) a transf] "u ?is p>agraph z su* ,secret>y consid]s appropriate to protect ! int]e/s ( ! ,unit$ ,/ates4 7#d7 ,application ( ,mc,kinney-,v5to ,homeless ,assi/ance ,act ,no?+ 9 ?is subtitle %all limit or o!rwise affect ! application ( ! provisions ( ! ,mc,kinney-,v5to ,homeless ,assi/ance ,act 7#db ,u4,s4,c4 #aacja et seq47 to facilities ( ! ,vet]ans ,heal? ,adm9i/ration clos$ "u ?is subtitle4 7c7 ,applicability ( ,national ,environm5tal ,policy ,act ( #aifi 7#a7 ,9 g5]al ,! provisions ( ! ,national ,environm5tal ,policy ,act ( #aifi 7#db ,u4,s4,c4 #dcba et seq47 %all n apply to ! actions ( ! ,presid5t1 ! ,commission1 &1 except z provid$ 9 p>agraph 7#b71 ! ,dep>tm5t ( ,vet]ans ,affairs 9 c>ry+ out ?is subtitle4 7#b7 ,dep>tm5t ( ,vet]ans ,affairs 7,a7 ,cov]$ activities ,! provisions ( ! ,national ,environm5tal ,policy ,act ( #aifi %all apply to actions ( ! ,dep>tm5t ( ,vet]ans ,affairs "u ?is subtitle-- 7i7 dur+ ! process ( prop]ty disposal2 & 7ii7 dur+ ! process ( relocat+ functions f a facility ( ! ,vet]ans ,heal? ,adm9i/ration be+ clos$ or realign$ to ano!r facility aft] ! receiv+ facility has be5 select$ b be=e ! functions are relocat$4 7,b7 ,o!r activities ,9 apply+ ! provisions ( ! ,national ,environm5tal ,policy ,act ( #aifi to ! processes ref]r$ to 9 subp>agraph 7,a71 ! ,secret>y %all n h to consid]-- 7i7 ! ne$ = clos+ or realign+ ! facility ( ! ,vet]ans ,heal? ,adm9i/ration z recomm5d$ by ! ,commission2 7ii7 ! ne$ = transf]r+ functions to any facility ( ! ,vet]ans ,heal? ,adm9i/ration :i* has be5 select$ z ! receiv+ facility2 or 7iii7 facilities ( ! ,vet]ans ,heal? ,adm9i/ration alt]native to ^? recomm5d$ or select$4 7d7 ,waiv] 7#a7 ,re/rictions on use ( funds ,! ,secret>y may close or realign facilities ( ! ,vet]ans ,heal? ,adm9i/ration "u ?is subtitle )\t reg>d to any provision ( law re/rict+ ! use ( funds = clos+ or realign+ facilities ( ! ,vet]ans ,heal? ,adm9i/ration includ$ 9 any appropriation or au?orization ,act4 7#b7 ,re/rictions on au?orities ,! ,secret>y may close or realign facilities ( ! ,vet]ans ,heal? ,adm9i/ration "u ?is subtitle )\t reg>d to ! re/rictions ( section #haaj ( title #ch1 ,unit$ ,/ates ,code4 7e7 ,transf] au?ority 9 connection ) paym5t ( environm5tal rem$iation co/s 7#a7 ,9 g5]al 7,a7 ,transf] by de$ ,subject to p>agraph 7#b7 ( ?is subsection & section #abj7;h7 ( ! ,compreh5sive ,environm5tal ,response1 ,comp5sation1 & ,liability ,act ( #aihj 7#db ,u4,s4,c4 #ifbj7;h771 ! ,secret>y may ent] into an agreem5t to transf] by de$ a facility ( ! ,vet]ans ,heal? ,adm9i/ration ) any p]son :o agrees to p]=m all environm5tal re/oration1 wa/e managem5t1 & environm5tal compliance activities t are requir$ = ! prop]ty or facilities "u ,f$]al & ,/ate laws1 adm9i/rative decisions1 agreem5ts 7includ+ s*$ules & mile/ones71 & concurr5ces4 7,b7 ,additional t]ms or conditions ,! ,secret>y may require any additional t]ms & conditions 9 connection ) an agreem5t au?oriz$ by subp>agraph 7,a7 z ! ,secret>y consid]s appropriate to protect ! int]e/s ( ! ,unit$ ,/ates4 7#b7 ,limitation ,a transf] ( a facility ( ! ,vet]ans ,heal? ,adm9i/ration may be made "u p>agraph 7#a7 only if ! ,secret>y c]tifies to ,congress t-- 7,a7 ! co/s ( all environm5tal re/oration1 wa/e managem5t1 & environm5tal compliance activities o!rwise to be paid by ! ,secret>y ) respect to ! facility ( ! ,vet]ans ,heal? ,adm9i/ration are equal to or great] ?an ! fair m>ket value ( ! prop]ty or facilities to be transf]r$1 z det]m9$ by ! ,secret>y2 or 7,b7 if su* co/s are l[] ?an ! fair m>ket value ( ! facility ( ! ,vet]ans ,heal? ,adm9i/ration1 ! recipi5t ( su* transf] agrees to pay ! diff]5ce betwe5 ! fair m>ket value & su* co/s4 7#c7 ,paym5t by ! ,secret>y = c]ta9 transf]s ,9 ! case ( a facility ( ! ,vet]ans ,heal? ,adm9i/ration cov]$ by a c]tification "u p>agraph 7#b77;,a71 ! ,secret>y may pay ! recipi5t ( su* facility an am\nt equal to ! less] (-- 7,a7 ! am\nt by :i* ! co/s incurr$ by ! recipi5t ( ! facility ( ! ,vet]ans ,heal? ,adm9i/ration = all environm5tal re/oration1 wa/e1 managem5t1 & environm5tal compliance activities ) respect to su* facility exce$ ! fair m>ket value ( su* prop]ty z specifi$ 9 su* c]tification2 or 7,b7 ! am\nt by :i* ! co/s 7z det]m9$ by ! ,secret>y7 t w\ld o!rwise h be5 incurr$ by ! ,secret>y = su* re/oration1 managem5t1 & activities ) respect to su* facility ( ! ,vet]ans ,heal? ,adm9i/ration exce$ ! fair m>ket value ( prop]ty z s specifi$4 7#d7 ,disclosure ,z "p ( an agreem5t "u p>agraph 7#a71 ! ,secret>y %all disclose to ! p]son to :om ! facility ( ! ,vet]ans ,heal? ,adm9i/ration w be transf]r$ any in=mation ( ! ,secret>y reg>d+ ! environm5tal re/oration1 wa/e managem5t1 & environm5tal compliance activities describ$ 9 p>agraph 7#a7 t relate to ! facility ( ! ,vet]ans ,heal? ,adm9i/ration4 ,! ,secret>y %all provide su* in=mation be=e ent]+ into ! agreem5t4 7#e7 ,applicability ( c]ta9 environm5tal laws ,no?+ 9 ?is subsection %all be con/ru$ to modify1 alt]1 or am5d ! ,compreh5sive ,environm5tal ,response1 ,comp5sation1 & ,liability ,act ( #aihj 7#db ,u4,s4,c4 #ifja et seq47 or ! ,solid ,wa/e ,disposal ,act 7#db ,u4,s4,c4 #fija et seq474 #bjf4 ,dep>tm5t ( ,vet]ans ,affairs ,asset & ,infra/ructure ,review ,acc\nt 7a7 ,e/abli%m5t ,!re is h]eby e/abli%$ 9 ! l$g]s ( ! ,treasury an acc\nt to be kn[n z ! ,dep>tm5t ( ,vet]ans ,affairs ,asset & ,infra/ructure ,review ,acc\nt :i* %all be adm9i/]$ by ! ,secret>y z a s+le acc\nt4 7b7 ,cr$its to acc\nt ,!re %all be cr$it$ to ! ,acc\nt ! foll[+3 7#a7 ,funds au?oriz$ = & appropriat$ to ! ,acc\nt4 7#b7 ,proce$s receiv$ f ! lease1 transf]1 or disposal ( any prop]ty at a facility ( ! ,vet]ans ,heal? ,adm9i/ration clos$ or realign$ "u ?is subtitle4 7c7 ,use ( acc\nt ,! ,secret>y may use ! funds 9 ! ,acc\nt only = ! foll[+ purposes3 7#a7 ,to c>ry out ?is subtitle4 7#b7 ,to cov] prop]ty managem5t & disposal co/s incurr$ at facilities ( ! ,vet]ans ,heal? ,adm9i/ration clos$1 mod]niz$1 or realign$ "u ?is subtitle4 7#c7 ,to cov] co/s associat$ ) sup]vision1 inspection1 ov]head1 eng9e]+1 & design ( con/ruction projects und]tak5 "u ?is subtitle1 & subsequ5t claims1 if any1 relat$ to su* activities4 7#d7 ,o!r purposes t ! ,secret>y det]m9es support ! mission & op]ations ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7d7 ,consolidat$ budget ju/ification display = acc\nt 7#a7 ,consolidat$ budget in=mation requir$ ,! ,secret>y %all e/abli% a consolidat$ budget ju/ification display 9 support ( ! ,acc\nt t = ea* fiscal ye>-- 7,a7 details ! am\nt & nature ( cr$its to1 & exp5ditures f1 ! ,acc\nt dur+ ! prec$+ fiscal ye>2 7,b7 sep>ately details ! environm5tal rem$iation co/s associat$ ) facility ( ! ,vet]ans ,heal? ,adm9i/ration = :i* a budget reque/ is made2 7,c7 specifies ! transf]s into ! ,acc\nt & ! purposes = :i* ^! transf]r$ funds w be fur!r obligat$1 to include c>etak] & environm5t rem$iation co/s associat$ ) ea* facility ( ! ,vet]ans ,heal? ,adm9i/ration2 & 7,d7 details any intra-budget activity transf]s )9 ! ,acc\nt t exce$$ #a1jjj1jjj dur+ ! prec$+ fiscal ye> or t are propos$ = ! next fiscal ye> & w exce$ #a1jjj1jjj4 7#b7 ,submission ,! ,secret>y %all include ! in=mation requir$ by p>agraph 7#a7 9 ! mat]ials t ! ,secret>y submits to ,congress 9 support ( ! budget = a fiscal ye> submitt$ by ! ,presid5t pursuant to section #aaje ( title #ca1 ,unit$ ,/ates ,code4 7e7 ,closure ( acc\nt2 treatm5t ( rema9+ funds 7#a7 ,closure ,! ,acc\nt %all be clos$ at ! "t & 9 ! mann] provid$ = appropriation acc\nts "u section #aeee ( title #ca1 ,unit$ ,/ates ,code1 except t unobligat$ funds :i* rema9 9 ! ,acc\nt ^u closure %all be held by ! ,secret>y ( ! ,treasury until transf]r$ to ! ,secret>y ( ,vet]ans ,affairs by law aft] ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ! ,h\se ( ,repres5tatives receive ! f9al report transmitt$ "u p>agraph 7#b74 7#b7 ,f9al report ,no lat] ?an #fj days aft] ! closure ( ! ,acc\nt "u p>agraph 7#a71 ! ,secret>y %all transmit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ! ,h\se ( ,repres5tatives & ! ,committees on ,appropriations ( ! ,h\se ( ,repres5tatives & ! ,s5ate a report conta9+ an acc\nt+ (-- 7,a7 all ! funds cr$it$ to & exp5d$ f ! ,acc\nt or o!rwise exp5d$ "u ?is subtitle2 & 7,b7 any funds rema9+ 9 ! ,acc\nt4 #bjg4 ,congressional consid]ation ( ,commission report 7a7 ,disapproval resolution ,= purposes ( ?is subtitle1 ! t]m jo9t resolution means only a jo9t resolution :i* is introduc$ )9 ! #e-;day p]iod beg9n+ on ! date on :i* ! ,presid5t transmits ! report to ! ,congress "u section #bjc7;d71 &-- 7#a7 :i* does n h a preamble2 7#b7 ! matt] aft] ! resolv+ clause ( :i* is z foll[s3 t ,congress disapproves ! recomm5dations ( ! ,,vha ,asset & ,infra/ructure ,review ,commission z submitt$ by ! ,presid5t on 1 ! blank space be+ fill$ ) ! appropriate date2 & 7#c7 ! title ( :i* is z foll[s3 ,jo9t resolution disapprov+ ! recomm5dations ( ! ,,vha ,asset & ,infra/ructure ,review ,commission44 7b7 ,consid]ation 9 ! ,h\se ( ,repres5tatives 7#a7 ,report+ & dis*>ge ,any committee ( ! ,h\se ( ,repres5tatives to :i* a jo9t resolution is ref]r$ %all report x to ! ,h\se )\t am5dm5t n lat] ?an #ae legislative days aft] ! date ( introduction !re(4 ,if a committee fails to report ! jo9t resolution )9 t p]iod1 ! committee %all be dis*>g$ f fur!r consid]ation ( ! jo9t resolution4 7#b7 ,proce$+ to consid]ation ,x %all be 9 ord] at any "t aft] ! ?ird legislative day aft] ea* committee au?oriz$ to consid] a jo9t resolution has report$ or has be5 dis*>g$ f consid]ation ( a jo9t resolution1 to move to proce$ to consid] ! jo9t resolution 9 ! ,h\se4 ,all po9ts ( ord] aga9/ ! motion are waiv$4 ,su* a motion %all n be 9 ord] aft] ! ,h\se has dispos$ ( a motion to proce$ on a jo9t resolution address+ a p>ticul> submission4 ,! previ\s "q %all be consid]$ z ord]$ on ! motion to its adoption )\t int]v5+ motion4 ,! motion %all n be debatable4 ,a motion to reconsid] ! vote by :i* ! motion is dispos$ ( %all n be 9 ord]4 7#c7 ,consid]ation ,! jo9t resolution %all be consid]$ z read4 ,all po9ts ( ord] aga9/ ! jo9t resolution & aga9/ its consid]ation are waiv$4 ,! previ\s "q %all be consid]$ z ord]$ on ! jo9t resolution to its passage )\t int]v5+ motion except #b h\rs ( debate equally divid$ & controll$ by ! propon5t & an oppon5t4 ,a motion to reconsid] ! vote on passage ( ! jo9t resolution %all n be 9 ord]4 7c7 ,consid]ation 9 ! ,s5ate 7#a7 ,ref]ral ,a jo9t resolution introduc$ 9 ! ,s5ate %all be ref]r$ to ! ,committee on ,vet]ans' ,affairs4 7#b7 ,report+ & dis*>ge ,any committee ( ! ,s5ate to :i* a jo9t resolution is ref]r$ %all report x to ! ,s5ate )\t am5dm5t n lat] ?an #ae session days aft] ! date ( introduction ( a jo9t resolution describ$ 9 subsection 7a74 ,if a committee fails to report ! jo9t resolution )9 t p]iod1 ! committee %all be dis*>g$ f fur!r consid]ation ( ! jo9t resolution & ! jo9t resolution %all be plac$ on ! cal5d>4 7#c7 ,floor consid]ation 7,a7 ,9 g5]al ,not)/&+ ,rule ,,xxii ( ! ,/&+ ,rules ( ! ,s5ate1 x is 9 ord] at any "t aft] ! ?ird session day on :i* ! ,committee on ,vet]ans' ,affairs has report$ or has be5 dis*>g$ f consid]ation ( a jo9t resolution describ$ 9 subsection 7a7 7ev5 ?\gh a previ\s motion to ! same effect has be5 disagre$ to7 to move to proce$ to ! consid]ation ( ! jo9t resolution1 & all po9ts ( ord] aga9/ ! jo9t resolution 7& aga9/ consid]ation ( ! jo9t resolution7 are waiv$4 ,! motion to proce$ is n debatable4 ,! motion is n subject to a motion to po/pone4 ,a motion to reconsid] ! vote by :i* ! motion is agre$ to or disagre$ to %all n be 9 ord]4 ,if a motion to proce$ to ! consid]ation ( ! resolution is agre$ to1 ! jo9t resolution %all rema9 ! unf9i%$ bus9ess until dispos$ (4 7,b7 ,consid]ation ,consid]ation ( ! jo9t resolution1 & on all debatable motions & appeals 9 connection !re)1 %all be limit$ to n m ?an #b h\rs1 :i* %all be divid$ equally betwe5 ! majority & m9ority lead]s or _! designees4 ,a motion fur!r to limit debate is 9 ord] & n debatable4 ,an am5dm5t to1 or a motion to po/pone1 or a motion to proce$ to ! consid]ation ( o!r bus9ess1 or a motion to recommit ! jo9t resolution is n 9 ord]4 7,c7 ,vote on passage ,if ! ,s5ate has vot$ to proce$ to a jo9t resolution1 ! vote on passage ( ! jo9t resolution %all occur imm$iately foll[+ ! conclusion ( consid]ation ( ! jo9t resolution1 & a s+le quorum call at ! conclusion ( ! debate if reque/$ 9 accordance ) ! rules ( ! ,s5ate4 7,d7 ,rul+s ( ! ,*air on proc$ure ,appeals f ! decisions ( ! ,*air relat+ to ! application ( ! rules ( ! ,s5ate1 z ! case may be1 to ! proc$ure relat+ to a jo9t resolution %all be decid$ )\t debate4 7d7 ,am5dm5t n 9 ord] ,a jo9t resolution ( disapproval consid]$ pursuant to ?is section %all n be subject to am5dm5t 9 ei!r ! ,h\se ( ,repres5tatives or ! ,s5ate4 7e7 ,coord9ation ) action by o!r ,h\se 7#a7 ,9 g5]al ,if1 be=e ! passage by "o ,h\se ( ! jo9t resolution ( t ,h\se1 t ,h\se receives ! jo9t resolution f ! o!r ,h\se1 !n ! foll[+ proc$ures %all apply3 7,a7 ,! jo9t resolution ( ! o!r ,h\se %all n be ref]r$ to a committee4 7,b7 ,) respect to ! jo9t resolution ( ! ,h\se receiv+ ! jo9t resolution-- 7i7 ! proc$ure 9 t ,h\se %all be ! same z if no jo9t resolution _h be5 receiv$ f ! o!r ,h\se2 b 7ii7 ! vote on passage %all be on ! jo9t resolution ( ! o!r ,h\se4 7#b7 ,treatm5t ( jo9t resolution ( o!r ,h\se ,if ! ,s5ate fails to introduce or consid] a jo9t resolution "u ?is section1 ! jo9t resolution ( ! ,h\se %all be entitl$ to exp$it$ floor proc$ures "u ?is section4 7#c7 ,treatm5t ( companion measures ,if1 foll[+ passage ( ! jo9t resolution 9 ! ,s5ate1 ! ,s5ate !n receives ! companion measure f ! ,h\se ( ,repres5tatives1 ! companion measure %all n be debatable4 7f7 ,rules ( ! ,h\se ( ,repres5tatives & ,s5ate ,?is section is enact$ by ,congress-- 7#a7 z an ex]cise ( ! rulemak+ p[] ( ! ,s5ate & ,h\se ( ,repres5tatives1 respectively1 & z su* x is deem$ a "p ( ! rules ( ea* ,h\se1 respectively1 b applicable only ) respect to ! proc$ure to be foll[$ 9 t ,h\se 9 ! case ( a jo9t resolution1 & x sup]s$es o!r rules only to ! ext5t t x is inconsi/5t ) su* rules2 & 7#b7 ) full recognition ( ! con/itutional "r ( ei!r ,h\se to *ange ! rules 7s f> z relat+ to ! proc$ure ( t ,h\se7 at any "t1 9 ! same mann]1 & to ! same ext5t z 9 ! case ( any o!r rule ( t ,h\se4 #bjh4 ,o!r matt]s 7a7 ,onl9e publication ( communications 7#a7 ,9 g5]al ,n lat] ?an #bd h\rs aft] ! transmission or receipt ( any communication "u ?is subtitle t is transmitt$ or receiv$ by a p>ty specifi$ 9 p>agraph 7#b71 ! ,secret>y ( ,vet]ans ,affairs %all publi% su* communication onl9e4 7#b7 ,p>ties specifi$ ,! p>ties specifi$ "u ?is p>agraph are ! foll[+3 7,a7 ,! ,secret>y ( ,vet]ans ,affairs4 7,b7 ,! ,commission4 7,c7 ,! ,presid5t4 7b7 ,cont9uation ( exi/+ con/ruction projects & plann+ ,dur+ activities t ! ,commission1 ,presid5t1 or ,congress c>ry out "u ?is subtitle1 ! ,secret>y ( ,vet]ans ,affairs may n /op1 solely because ( su* activities-- 7#a7 a con/ruction or leas+ project ( ! ,vet]ans ,heal? ,adm9i/ration2 7#b7 long t]m plann+ reg>d+ infra/ructure & assets ( ! ,vet]ans ,heal? ,adm9i/ration2 or 7#c7 budget>y processes = ! ,vet]ans ,heal? ,adm9i/ration4 7c7 ,recomm5dations = future asset reviews ,! ,secret>y ( ,vet]ans ,affairs may1 aft] consult+ ) vet]ans s]vice organizations1 include 9 budget submissions ! ,secret>y submits aft] ! t]m9ation ( ! ,commission recomm5dations = future su* commissions or o!r capital asset realignm5t & managem5t processes4 #bji4 ,def9itions ,9 ?is subtitle3 7#a7 ,! t]m ,acc\nt means ! ,dep>tm5t ( ,vet]ans ,affairs ,asset & ,infra/ructure ,review ,acc\nt e/abli%$ by section #bjf7;a74 7#b7 ,! t]m ,commission means ! ,commission e/abli%$ by section #bjb4 7#c7 ,! t]m date ( approval1 ) respect to a mod]nization or realignm5t ( a facility ( ! ,vet]ans ,heal? ,adm9i/ration1 means ! date on :i* ! au?ority ( ,congress to disapprove a recomm5dation ( mod]nization or realignm5t1 z ! case may be1 ( su* facility "u ?is subtitle expires4 7#d7 ,! t]m facility ( ! ,vet]ans ,heal? ,adm9i/ration-- 7,a7 means any l&1 build+1 /ructure1 or infra/ructure 7includ+ any m$ical c5t]1 nurs+ home1 domicili>y facility1 outpati5t cl9ic1 c5t] t provides readju/m5t c\nsel+1 or leas$ facility7 t is-- 7i7 "u ! jurisdiction ( ! ,dep>tm5t ( ,vet]ans ,affairs2 7ii7 "u ! control ( ! ,vet]ans ,heal? ,adm9i/ration2 & 7iii7 n "u ! control ( ! ,g5]al ,s]vices ,adm9i/ration2 or 7,b7 ) respect to a colocat$ facility ( ! ,dep>tm5t ( ,vet]ans ,affairs1 includes any l&1 build+1 or /ructure-- 7i7 "u ! jurisdiction ( ! ,dep>tm5t ( ,vet]ans ,affairs2 7ii7 "u ! control ( ano!r adm9i/ration ( ! ,dep>tm5t ( ,vet]ans ,affairs2 & 7iii7 n "u ! control ( ! ,g5]al ,s]vices ,adm9i/ration4 7#e7 ,! t]m infra/ructure means improvem5ts to l& o!r ?an build+s or /ructures4 7#f7 ,! t]m mod]nization includes-- 7,a7 any action1 includ+ closure1 requir$ to align ! =m & function ( a facility ( ! ,vet]ans ,heal? ,adm9i/ration to ! provision ( mod]n day heal? c>e1 includ+ utilities & environm5tal control sy/ems2 7,b7 ! con/ruction1 pur*ase1 lease1 or %>+ ( a facility ( ! ,vet]ans ,heal? ,adm9i/ration2 & 7,c7 realignm5ts1 disposals1 ex*anges1 collaborations betwe5 ! ,dep>tm5t ( ,vet]ans ,affairs & o!r ,f$]al entities1 & /rategic collaborations betwe5 ! ,dep>tm5t & non-,f$]al entities1 includ+ tribal organizations4 7#g7 ,! t]m realignm5t1 ) respect to a facility ( ! ,vet]ans ,heal? ,adm9i/ration1 includes-- 7,a7 any action t *anges ! numb]s ( or relocates s]vices1 functions1 & p]sonnel positions2 7,b7 disposals or ex*anges betwe5 ! ,dep>tm5t ( ,vet]ans ,affairs & o!r ,f$]al entities1 includ+ ! ,dep>tm5t ( ,def5se2 & 7,c7 /rategic collaborations betwe5 ! ,dep>tm5t ( ,vet]ans ,affairs & non-,f$]al entities1 includ+ tribal organizations4 7#h7 ,! t]m r$evelopm5t au?ority1 9 ! case ( a facility ( ! ,vet]ans ,heal? ,adm9i/ration clos$ or mod]niz$ "u ?is subtitle1 means any entity 7includ+ an entity e/abli%$ by a ,/ate or local gov]nm5t7 recogniz$ by ! ,secret>y ( ,vet]ans ,affairs z ! entity responsible = develop+ ! r$evelopm5t plan ) respect to ! facility or = direct+ ! implem5tation ( su* plan4 7#i7 ,! t]m r$evelopm5t plan 9 ! case ( a facility ( ! ,vet]ans ,heal? ,adm9i/ration to be clos$ or realign$ "u ?is subtitle1 means a plan t-- 7,a7 is agre$ to by ! local r$evelopm5t au?ority ) respect to ! facility2 & 7,b7 provides = ! reuse or r$evelopm5t ( ! real prop]ty & p]sonal prop]ty ( ! facility t is available = su* reuse & r$evelopm5t z a result ( ! closure or realignm5t ( ! facility4 7#aj7 ,! t]m ,secret>y means ! ,secret>y ( ,vet]ans ,affairs4 7#aa7 ,! t]m tribal organization has ! mean+ giv5 su* t]m 9 section #cgfe ( title #ch1 ,unit$ ,/ates ,code4 ,b ,o!r ,infra/ructure ,matt]s #baa4 ,improvem5t to tra9+ ( con/ruction p]sonnel ,subsection 7g7 ( section #hajc ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ to read z foll[s3 7g7 7#a7 7,a7 ,n lat] ?an ,septemb] #cj ( ! fiscal ye> foll[+ ! fiscal ye> dur+ :i* ! ,,va ,asset & ,infra/ructure ,review ,act ( #bjah is enact$1 ! ,secret>y %all implem5t ! cov]$ tra9+ curriculum & ! cov]$ c]tification program4 7,b7 ,9 design+ & implem5t+ ! cov]$ tra9+ curriculum & ! cov]$ c]tification program "u p>agraph 7#a71 ! ,secret>y %all use z models exi/+ tra9+ curricula & c]tification programs t h be5 e/abli%$ "u *apt] #hg ( title #aj1 ,unit$ ,/ates ,code1 z det]m9$ relevant by ! ,secret>y4 7#b7 ,! ,secret>y may develop ! tra9+ curriculum "u p>agraph 7#a77;,a7 9 a mann] t provides su* tra9+ 9 any comb9ation (-- 7,a7 tra9+ provid$ 9 p]son2 7,b7 tra9+ provid$ ov] an int]net website2 or 7,c7 tra9+ provid$ by ano!r dep>tm5t or ag5cy ( ! ,f$]al ,gov]nm5t4 7#c7 ,! ,secret>y may develop ! c]tification program "u p>agraph 7#a77;,a7 9 a mann] t uses-- 7,a7 "o level ( c]tification2 or 7,b7 m ?an "o level ( c]tification1 z det]m9$ appropriate by ! ,secret>y ) respect to ! level ( c]tification = diff]5t grades ( ! ,g5]al ,s*$ule4 7#d7 ,! ,secret>y may ent] into a contract ) an appropriate entity to provide ! cov]$ tra9+ curriculum & ! cov]$ c]tification program "u p>agraph 7#a77;,a74 7#e7 7,a7 ,n lat] ?an ,septemb] #cj ( ! second fiscal ye> foll[+ ! fiscal ye> dur+ :i* ! ,,va ,asset & ,infra/ructure ,review ,act ( #bjah is enact$1 ! ,secret>y %all ensure t ! majority ( employees subject to ! cov]$ c]tification program a*ieve ! c]tification or ! appropriate level ( c]tification pursuant to p>agraph 7#c71 z ! case may be4 7,b7 ,aft] c>ry+ out subp>agraph 7,a71 ! ,secret>y %all ensure t ea* employee subject to ! cov]$ c]tification program a*ieves ! c]tification or ! appropriate level ( c]tification pursuant to p>agraph 7#c71 z ! case may be1 z quickly z practicable4 7#f7 ,9 ?is subsection3 7,a7 ,! t]m cov]$ c]tification program means1 ) respect to employees ( ! ,dep>tm5t ( ,vet]ans ,affairs :o are memb]s ( occupational s]ies relat+ to con/ruction or facilities managem5t1 or employees ( ! ,dep>tm5t :o aw>d or adm9i/] contracts = major con/ruction1 m9or con/ruction1 or nonrecurr+ ma9t5ance1 includ+ z contract speciali/s or contract+ (fic]s' repres5tatives1 a program to c]tify k & skills relat+ to con/ruction or facilities managem5t & to ensure t su* employees ma9ta9 adequate exp]tise relat+ to indu/ry /&>ds & be/ practices = ! acquisition ( design & con/ruction s]vices4 7,b7 ,! t]m cov]$ tra9+ curriculum means1 ) respect to employees specifi$ 9 subp>agraph 7,a71 a tra9+ curriculum relat+ to con/ruction or facilities managem5t4 4 #bab4 ,review ( enhanc$ use leases ,section #hafb7;b77#f7 is am5d$ to read z foll[s3 7#f7 ,! ,(fice ( ,managem5t & ,budget %all review ea* enhanc$-use lease be=e ! lease goes into effect to det]m9e :e!r ! lease is 9 compliance ) p>agraph 7#e74 4 #bac4 ,assessm5t ( heal? c>e furni%$ by ! ,dep>tm5t to vet]ans :o live 9 ! ,pacific t]ritories 7a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ! ,h\se ( ,repres5tatives a report reg>d+ heal? c>e furni%$ by ! ,dep>tm5t ( ,vet]ans ,affairs to vet]ans :o live 9 ! ,pacific t]ritories4 7b7 ,elem5ts ,! report "u subsection 7a7 %all include assessm5ts ( ! foll[+3 7#a7 ,! ability ( ! ,dep>tm5t to furni% to vet]ans :o live 9 ! ,pacific t]ritories ! foll[+3 7,a7 ,hospital c>e4 7,b7 ,m$ical s]vices4 7,c7 ,m5tal heal? s]vices4 7,d7 ,g]iatric s]vices4 7#b7 ,! feasibility ( e/abli%+ a community-bas$ outpati5t cl9ic ( ! ,dep>tm5t 9 any ,pacific t]ritory t does n conta9 su* a facility4 7c7 ,def9ition ,9 ?is section1 ! t]m ,pacific t]ritories means ,am]ican ,samoa1 ,guam1 & ! ,nor!rn ,m>iana ,isl&s4 ,,iii ,improvem5ts to ,recruitm5t ( ,heal? ,c>e ,pr(essionals #cja4 ,designat$ s*ol>%ips = physicians & d5ti/s "u ,dep>tm5t ( ,vet]ans ,affairs ,heal? ,pr(essional ,s*ol>%ip ,program 7a7 ,s*ol>%ips = physicians & d5ti/s ,section #gfab7;b7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#f7 7,a7 ,( ! s*ol>%ips aw>d$ "u ?is sub*apt]1 ! ,secret>y %all ensure t n less ?an #ej s*ol>%ips are aw>d$ ea* ye> to individuals :o are accept$ = enrollm5t or enroll$ 7z describ$ 9 section #gfjb ( ?is title7 9 a program ( education or tra9+ lead+ to employm5t z a physician or d5ti/ until su* date z ! ,secret>y det]m9es t ! /aff+ %ortage ( physicians & d5ti/s 9 ! ,dep>tm5t is less ?an #ejj4 7,b7 ,aft] su* date1 ! ,secret>y %all ensure t ( ! s*ol>%ips aw>d$ "u ?is sub*apt]1 a numb] ( s*ol>%ips is aw>d$ ea* ye> to individuals ref]r$ to 9 subp>agraph 7,a7 9 an am\nt equal to n less ?an t5 p]c5t ( ! /aff+ %ortage ( physicians & d5ti/s 9 ! ,dep>tm5t1 z det]m9$ by ! ,secret>y4 7,c7 ,not)/&+ subsection 7c77#a71 ! agreem5t betwe5 ! ,secret>y & a p>ticipant 9 ! ,s*ol>%ip ,program :o receives a s*ol>%ip pursuant to ?is p>agraph %all provide ! foll[+3 7i7 ,! ,secret>y's agreem5t to provide ! p>ticipant ) a s*ol>%ip "u ?is sub*apt] = a specifi$ numb] 7f two to f\r7 ( s*ool ye>s dur+ :i* ! p>ticipant is pursu+ a c\rse ( education or tra9+ lead+ to employm5t z a physician or d5ti/4 7ii7 ,! p>ticipant's agreem5t to s]ve z a full-"t employee 9 ! ,vet]ans ,heal? ,adm9i/ration = a p]iod ( "t 7h]e9aft] 9 ?is sub*apt] ref]r$ to z ! p]iod ( obligat$ s]vice7 ( #ah mon?s = ea* s*ool ye> or "p !re( = :i* ! p>ticipant 0 provid$ a s*ol>%ip "u ! ,s*ol>%ip ,program4 7,d7 ,9 provid+ s*ol>%ips pursuant to ?is p>agraph1 ! ,secret>y may provide a pref]5ce = applicants :o are vet]ans4 7,e7 ,on an annual basis1 ! ,secret>y %all provide to appropriate educational in/itutions in=mational mat]ial ab\t ! availability ( s*ol>%ips "u ?is p>agraph4 4 7b7 ,brea* ( agreem5t ,section #gfag ( su* title is am5d$-- 7#a7 by r$esignat+ p>agraphs 7#d7 & 7#e7 z p>agraphs 7#e7 & 7#f71 respectively2 & 7#b7 by ins]t+ aft] p>agraph 7#c7 ! foll[+ new p>agraph 7#d73 7#d7 ,9 ! case ( a p>ticipant :o is enroll$ 9 a program or education or tra9+ lead+ to employm5t z a physician1 ! p>ticipant fails to successfully complete po/-graduate tra9+ lead+ to eligibility = bo>d c]tification 9 a specialty4 4 7c7 ,ext5sion ( program ,section #gfai ( su* title is am5d$ by /rik+ ,decemb] #ca1 #bjai & ins]t+ ,decemb] #ca1 #bjcc4 #cjb4 ,increase 9 maximum am\nt ( debt t may be r$uc$ "u ,education ,debt ,r$uction ,program ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,increase 9 am\nt ,section #gfhc7;d77#a7 is am5d$-- 7#a7 by /rik+ #abj1jjj & ins]t+ #bjj1jjj2 & 7#b7 by /rik+ #bd1jjj & ins]t+ #dj1jjj4 7b7 ,/udy 7#a7 ,9 g5]al ,n lat] ?an #a ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all-- 7,a7 conduct a /udy on ! dem& = education debt r$uction "u sub*apt] ,,vii ( *apt] #gf ( title #ch1 ,unit$ ,/ates ,code2 & 7,b7 submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! f9d+s ( ! ,secret>y ) respect to ! /udy c>ri$ out "u subp>agraph 7,a74 7#b7 ,consid]ations ,9 c>ry+ out ! /udy requir$ by p>agraph 7#a77;,a71 ! ,secret>y %all consid] ! foll[+3 7,a7 ,! total numb] ( vacancies )9 ! ,vet]ans ,heal? ,adm9i/ration ^: applicants are eligible to p>ticipate 9 ! ,education ,debt ,r$uction ,program pursuant to section #gfhb7;a7 ( su* title4 7,b7 ,! types ( m$ical pr(essionals 9 greate/ dem& 9 ! ,unit$ ,/ates4 7,c7 ,projections by ! ,secret>y ( ! numb]s & types ( m$ical pr(essions t meet ! ne$s ( vet]ans4 #cjc4 ,e/abli%+ ! ,dep>tm5t ( ,vet]ans ,affairs ,specialty ,education ,loan ,repaym5t ,program 7a7 ,9 g5]al ,*apt] #gf ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by ins]t+ aft] sub*apt] ,,vii ! foll[+ new sub*apt]3 ,,viii ,specialty ,education ,loan ,repaym5t ,program #gfia4 ,e/abli%m5t ,z "p ( ! ,educational ,assi/ance ,program1 ! ,secret>y may c>ry out a /ud5t loan repaym5t program "u section #ecgi ( title #e4 ,! program %all be kn[n z ! ,dep>tm5t ( ,vet]ans ,affairs ,specialty ,education ,loan ,repaym5t ,program 79 ?is *apt] ref]r$ to z ! ,specialty ,education ,loan ,repaym5t ,program74 #gfib4 ,purpose ,! purpose ( ! ,specialty ,education ,loan ,repaym5t ,program is to assi/1 ?r\gh ! e/abli%m5t ( an inc5tive program = c]ta9 individuals employ$ 9 ! ,vet]ans ,heal? ,adm9i/ration1 9 meet+ ! /aff+ ne$s ( ! ,vet]ans ,heal? ,adm9i/ration = physicians 9 m$ical specialties = :i* ! ,secret>y det]m9es recruitm5t or ret5tion ( qualifi$ p]sonnel is difficult4 #gfic4 ,eligibility2 pref]5ces2 cov]$ co/s 7a7 ,eligibility ,an individual is eligible to p>ticipate 9 ! ,specialty ,education ,loan ,repaym5t ,program if ! individual-- 7#a7 is hir$ "u section #gdja ( ?is title to "w 9 an occupation describ$ 9 section #gfib ( ?is title2 7#b7 owes any am\nt ( pr9cipal or int]e/ "u a loan1 ! proce$s ( :i* 7 us$ by or on behalf ( t individual to pay co/s relat+ to a c\rse ( education or tra9+ :i* l$ to a degree t qualifi$ ! individual = ! position ref]r$ to 9 p>agraph 7#a72 & 7#c7 is-- 7,a7 rec5tly graduat$ f an accr$it$ m$ical or o/eopa?ic s*ool & mat*$ to an accr$it$ resid5cy program 9 a m$ical specialty describ$ 9 section #gfib ( ?is title2 or 7,b7 a physician 9 tra9+ 9 a m$ical specialty describ$ 9 section #gfib ( ?is title ) m ?an #b ye>s rema9+ 9 su* tra9+4 7b7 ,pref]5ces ,9 select+ individuals = p>ticipation 9 ! ,specialty ,education ,loan ,repaym5t ,program "u ?is sub*apt]1 ! ,secret>y may give pref]5ce to ! foll[+3 7#a7 ,individuals :o are1 or w be1 p>ticipat+ 9 resid5cy programs 9 heal? c>e facilities-- 7,a7 locat$ 9 rural areas2 7,b7 op]at$ by ,indian tribes1 tribal organizations1 or ! ,indian ,heal? ,s]vice2 or 7,c7 affiliat$ ) und]s]v$ heal? c>e facilities ( ! ,dep>tm5t4 7#b7 ,vet]ans4 7c7 ,cov]$ co/s ,= purposes ( subsection 7a77#b71 co/s relat+ to a c\rse ( education or tra9+ include-- 7#a7 tuition exp5ses2 7#b7 all o!r reasonable educational exp5ses1 includ+ exp5ses = fees1 books1 equipm5t1 & laboratory exp5ses2 & 7#c7 reasonable liv+ exp5ses4 #gfid4 ,specialty education loan repaym5t 7a7 ,9 g5]al ,paym5ts "u ! ,specialty ,education ,loan ,repaym5t ,program %all consi/ ( paym5ts = ! pr9cipal & int]e/ on loans describ$ 9 section #gfhb7;a77#b7 ( ?is title = individuals select$ to p>ticipate 9 ! ,program to ! hold]s ( su* loans4 7b7 ,frequ5cy ( paym5t ,! ,secret>y %all make paym5ts = any giv5 p>ticipant 9 ! ,specialty ,education ,loan ,repaym5t ,program on a s*$ule det]m9$ appropriate by ! ,secret>y4 7c7 ,maximum am\nt2 waiv] 7#a7 ,! am\nt ( paym5ts made = a p>ticipant "u ! ,specialty ,education ,loan ,repaym5t ,program may n exce$ #afj1jjj ov] a total ( #d ye>s ( p>ticipation 9 ! ,program1 ( :i* n m ?an #dj1jjj ( su* paym5ts may be made 9 ea* ye> ( p>ticipation 9 ! ,program4 7#b7 7,a7 ,! ,secret>y may waive ! limitations "u p>agraph 7#a7 9 ! case ( a p>ticipant describ$ 9 subp>agraph 7,b74 ,9 ! case ( su* a waiv]1 ! total am\nt ( paym5ts payable to or = t p>ticipant is ! total am\nt ( ! pr9cipal & ! int]e/ on ! p>ticipant's loans ref]r$ to 9 subsection 7a74 7,b7 ,a p>ticipant describ$ 9 ?is subp>agraph is a p>ticipant 9 ! ,program :o ! ,secret>y det]m9es s]ves 9 a position = :i* !re is a %ortage ( qualifi$ employees by reason ( ei!r ! location or ! requirem5ts ( ! position4 #gfie4 ,*oice ( location ,ea* p>ticipant 9 ! ,specialty ,education ,loan ,repaym5t ,program :o completes resid5cy may select1 f a li/ ( m$ical facilities ( ! ,vet]ans ,heal? ,adm9i/ration provid$ by ! ,secret>y1 at :i* su* facility ! p>ticipant w "w 9 a m$ical specialty describ$ 9 section #gfib ( ?is title4 #gfif4 ,t]m ( obligat$ s]vice 7a7 ,9 g5]al ,9 addition to any requirem5ts "u section #ecgi7;c7 ( title #e1 a p>ticipant 9 ! ,specialty ,education ,loan ,repaym5t ,program mu/ agree1 9 writ+ & be=e ! ,secret>y may make any paym5t to or = ! p>ticipant1 to-- 7#a7 obta9 a lic5se to practice m$ic9e 9 a ,/ate2 7#b7 successfully complete po/-graduate tra9+ lead+ to eligibility = bo>d c]tification 9 a specialty2 7#c7 s]ve z a full-"t cl9ical practice employee ( ! ,vet]ans ,heal? ,adm9i/ration = #ab mon?s = e #dj1jjj 9 su* b5efits t ! employee receives1 b 9 no case = few] ?an #bd mon?s2 & 7#d7 except z provid$ 9 subsection 7b71 to beg9 su* s]vice z a full-"t practice employee by n lat] ?an #fj days aft] complet+ a resid5cy4 7b7 ,fell[%ip ,9 ! case ( a p>ticipant :o receives an accr$it$ fell[%ip 9 a m$ical specialty o!r ?an a m$ical specialty describ$ 9 section #gfib ( ?is title1 ! ,secret>y1 on writt5 reque/ ( ! p>ticipant1 may delay ! t]m ( obligat$ s]vice "u subsection 7a7 = ! p>ticipant until aft] ! p>ticipant completes ! fell[%ip1 b 9 no case lat] ?an #fj days aft] completion ( su* fell[%ip4 7c7 ,p5alty 7#a7 ,an employee :o does n complete a p]iod ( obligat$ s]vice "u ?is section %all owe ! ,f$]al ,gov]nm5t an am\nt det]m9$ 9 accordance ) ! foll[+ =mula3 ,a ,b 77,t ,s7 ,t774 7#b7 ,9 ! =mula 9 p>agraph 7#a73 7,a7 ,a is ! am\nt ! employee owes ! ,f$]al ,gov]nm5t4 7,b7 ,b is ! sum ( all paym5ts to or = ! p>ticipant "u ! ,specialty ,education ,loan ,repaym5t ,program4 7,c7 ,t is ! numb] ( mon?s 9 ! p]iod ( obligat$ s]vice ( ! employee4 7,d7 ,s is ! numb] ( :ole mon?s ( su* p]iod ( obligat$ s]vice s]v$ by ! employee4 #gfig4 ,relation%ip to ,educational ,assi/ance ,program ,assi/ance "u ! ,specialty ,education ,loan ,repaym5t ,program may be 9 addition to o!r assi/ance available to individuals "u ! ,educational ,assi/ance ,program4 4 7b7 ,con=m+ & te*nical am5dm5ts 7#a7 ,con=m+ am5dm5ts 7,a7 ,section #gfja7;a7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7i7 9 p>agraph 7#d71 by /rik+ &2 7ii7 9 p>agraph 7#e71 by /rik+ ! p]iod & ins]t+ 2 &2 & 7iii7 by add+ at ! end ! foll[+ new p>agraph3 7#f7 ! specialty education loan repaym5t program provid$ = 9 sub*apt] ,,viii ( ?is *apt]4 4 7,b7 ,section #gfjc7;a77#a7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by /rik+ or ,,vi & ins]t+ ,,vi1 or ,,viii4 7,c7 ,section #gfjd ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by /rik+ or ,,vi ea* place x appe>s & ins]t+ ,,vi1 or ,,viii4 7,d7 ,section #gfca ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7i7 9 subsection 7a77#a7-- 7,i7 by /rik+ & aft] s*ol>%ip am\nt12 & 7,,ii7 by ins]t+ 1 & ! maximum specialty education loan repaym5t am\nt aft] r$uction paym5ts am\nt2 & 7ii7 9 subsection 7b7 by add+ at ! end ! foll[+ new p>agraph3 7#g7 ,! t]m specialty education loan repaym5t am\nt means ! maximum am\nt ( specialty education loan repaym5t paym5ts payable to or = a p>ticipant 9 ! ,dep>tm5t ( ,vet]ans ,affairs ,specialty ,education ,loan ,repaym5t ,program "u sub*apt] ,,viii ( ?is *apt]1 z specifi$ 9 section #gfid7;c77#a7 ( ?is title & z previ\sly adju/$ 7if at all7 9 accordance ) ?is section4 4 7,e7 ,section #gfcb ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7i7 9 p>agraph 7#a71 by /rik+ & ! ,education ,debt ,r$uction ,program & ins]t+ ! ,education ,debt ,r$uction ,program1 & ! ,specialty ,education ,loan ,repaym5t ,program2 & 7ii7 9 p>agraph 7#d71 by /rik+ & p] p>ticipant 9 ! ,education ,debt ,r$uction ,program & ins]t+ p] p>ticipant 9 ! ,education ,debt ,r$uction ,program1 & p] p>ticipant 9 ! ,specialty ,education ,loan ,repaym5t ,program4 7#b7 ,table ( sections ,! table ( sections at ! beg9n+ ( *apt] #gf ( su* title is am5d$ by ins]t+ aft] ! items relat+ to sub*apt] ,,vii ! foll[+3 ,sub*apt] ,,viii--,specialty ,education ,loan ,repaym5t ,program #gfia4 ,e/abli%m5t4 #gfib4 ,purpose4 #gfic4 ,eligibility2 pref]5ces2 cov]$ co/s4 #gfid4 ,specialty education loan repaym5t4 #gfie4 ,*oice ( location4 #gfif4 ,t]m ( obligat$ s]vice4 #gfig4 ,relation%ip to ,educational ,assi/ance ,program4 4 7c7 ,ne$s ( ! ,,vha ,9 mak+ det]m9ations ea* ye> "u section #gfib ( title #ch1 ,unit$ ,/ates ,code1 z enact$ by subsection 7a71 ! ,secret>y ( ,vet]ans ,affairs %all consid] ! anticipat$ ne$s ( ! ,vet]ans ,heal? ,adm9i/ration dur+ ! p]iod #b to #f ye>s 9 ! future4 7d7 ,pref]5ce ,9 grant+ pref]5ce "u section #gfic ( title #ch1 ,unit$ ,/ates ,code1 z enact$ by subsection 7a71 ! ,secret>y ( ,vet]ans ,affairs %all det]m9e :e!r a facility ( ! ,dep>tm5t is und]s]v$ bas$ on ! crit]ia develop$ "u section #dja ( ?is ,act4 7e7 ,(f] deadl9e ,9 ! case ( an applicant :o applies be=e receiv+ a resid5cy mat* & :om ! ,secret>y ( ,vet]ans ,affairs selects = p>ticipation 9 ! ,specialty ,education ,loan ,repaym5t ,program e/abli%$ by subsection 7a71 ! ,secret>y %all (f] p>ticipation to ! applicant n lat] ?an #bh days aft]-- 7#a7 ! applicant mat*es ) a resid5cy 9 a m$ical specialty describ$ 9 section #gfib ( title #ch1 ,unit$ ,/ates ,code1 z enact$ by subsection 7a72 & 7#b7 su* mat* is publi%$4 7f7 ,publicity ,! ,secret>y ( ,vet]ans ,affairs %all take su* /eps z ! ,secret>y det]m9es are appropriate to publicize ! ,specialty ,education ,loan ,repaym5t ,program e/abli%$ "u sub*apt] ,,viii ( *apt] #gf ( title #ch1 ,unit$ ,/ates ,code1 z enact$ by subsection 7a74 #cjd4 ,vet]ans heal+ vet]ans m$ical access & s*ol>%ip program 7a7 ,e/abli%m5t ,! ,secret>y ( ,vet]ans ,affairs1 act+ ?r\gh ! ,(fice ( ,academic ,affiliations ( ! ,dep>tm5t ( ,vet]ans ,affairs1 %all c>ry out a pilot program "u :i* ! ,secret>y %all provide fund+ = ! m$ical education ( a total ( #ah eligible vet]ans4 ,su* fund+ %all be provid$ = two vet]ans enroll$ 9 ea* cov]$ m$ical s*ools 9 accordance ) ?is section4 7b7 ,eligible vet]ans ,to be eligible to receive fund+ = m$ical education "u ?is section1 a vet]an %all-- 7#a7 h be5 dis*>g$ f ! ,arm$ ,=ces n m ?an #aj ye>s be=e ! date ( application = admission to a cov]$ m$ical s*ool2 7#b7 n be entitl$ to educational assi/ance "u *apt] #cj1 #ca1 #cb1 #cc1 #cd1 or #ce ( title #ch1 ,unit$ ,/ates ,code1 or *apt] #afjf or #afjg ( title #aj1 ,unit$ ,/ates ,code2 7#c7 apply = admission to a cov]$ m$ical s*ool = ! ent]+ class ( #bjai2 7#d7 indicate on su* application = admission t ! vet]an w\ld l to be consid]$ = an aw>d ( fund+ "u ?is section2 7#e7 meet ! m9imum admissions crit]ia = ! cov]$ m$ical s*ool to :i* ! vet]an applies2 & 7#f7 ent] into an agreem5t describ$ 9 subsection 7e74 7c7 ,aw>d ( fund+ 7#a7 ,9 g5]al ,ea* cov]$ m$ical s*ool t opts to p>ticipate 9 ! program "u ?is section %all res]ve two seats 9 ! ent]+ class ( #bjai = eligible vet]ans :o receive fund+ "u su* program4 ,su* fund+ %all be aw>d$ to ! two eligible vet]ans ) ! highe/ admissions rank+s = su* class at su* s*ool4 7#b7 ,am\nt ( fund+ ,ea* eligible vet]an :o receives fund+ "u ?is section %all receive an am\nt equal to ! actual co/ (-- 7,a7 tuition at ! cov]$ m$ical s*ool at :i* ! vet]an enrolls = #d ye>s2 7,b7 books1 fees1 & te*nical equipm5t2 7,c7 fees associat$ ) ! ,national ,resid5cy ,mat* ,program2 7,d7 two away rotations p]=m$ dur+ ! f\r? ye> at a ,dep>tm5t ( ,vet]ans ,affairs m$ical facility2 & 7,e7 a mon?ly /ip5d = ! #d-ye> p]iod dur+ :i* ! vet]an is enroll$ 9 m$ical s*ool 9 an am\nt to be det]m9$ by ! ,secret>y4 7#c7 ,di/ribution ( fund+ ,9 ! ev5t t two or m eligible vet]ans d n apply = admission at "o ( ! cov]$ m$ical s*ools = ! ent]+ class ( #bjai1 ! ,secret>y %all di/ribute ! available fund+ to eligible vet]ans :o appli$ = admission at o!r cov]$ m$ical s*ools4 7d7 ,agreem5t 7#a7 ,t]ms ( agreem5t ,ea* eligible vet]an :o accepts fund+ = m$ical education "u ?is section %all ent] into an agreem5t ) ! ,secret>y t provides t ! vet]an agrees-- 7,a7 to ma9ta9 enrollm5t & att5dance 9 ! m$ical s*ool2 7,b7 :ile enroll$ 9 su* m$ical s*ool1 to ma9ta9 an acceptable level ( academic /&+ 7z det]m9$ by ! m$ical s*ool "u regulations prescrib$ by ! ,secret>y72 7,c7 to complete po/-graduate tra9+ lead+ to eligibility = bo>d c]tification 9 a speciality applicable to ! ,dep>tm5t ( ,vet]ans ,affairs1 z det]m9$ by ! ,secret>y2 7,d7 aft] completion ( m$ical s*ool1 to obta9 a lic5se to practice m$ic9e 9 a ,/ate2 & 7,e7 aft] completion ( m$ical s*ool & po/-graduate tra9+1 to s]ve z a full-"t cl9ical practice employee 9 ! ,vet]ans ,heal? ,adm9i/ration = a p]iod ( #d ye>s4 7#b7 ,brea* ( agreem5t ,if an eligible vet]an :o accepts fund+ "u ?is section brea*es ! t]ms ( ! agreem5t describ$ 9 p>agraph 7#a71 ! ,unit$ ,/ates %all be entitl$ to recov] damages 9 an am\nt equal to ! total am\nt ( su* fund+ receiv$ by ! vet]an4 7e7 ,rule ( con/ruction ,no?+ 9 ?is section %all be con/ru$ to prev5t any cov]$ m$ical s*ool f accept+ m ?an two eligible vet]ans = ! ent]+ class ( #bjai4 7f7 ,report to ,congress ,n lat] ?an ,decemb] #ca1 #bjbj1 & annually !reaft] = ! subsequ5t #c ye>s1 ! ,secret>y %all submit to ,congress a report on ! pilot program "u ?is section4 ,su* report %all include ! evaluation ( ! ,secret>y ( ! success ( ! pilot program1 includ+ ! numb] ( vet]ans :o receiv$ fund+ "u ! program :o matriculat$ & an evaluation ( ! academic progress ( su* vet]ans4 7g7 ,cov]$ m$ical s*ools ,9 ?is section1 ! t]m cov]$ m$ical s*ool means any ( ! foll[+3 7#a7 ,! ,teague-,cran/on m$ical s*ools1 consi/+ (-- 7,a7 ,texas ,a,m ,college ( ,m$ic9e2 7,b7 ,quill5 ,college ( ,m$ic9e at ,ea/ ,t5nessee ,/ate ,univ]sity2 7,c7 ,boon%(t ,s*ool ( ,m$ic9e at ,wright ,/ate ,univ]sity2 7,d7 ,joan ,c4 ,edw>ds ,s*ool ( ,m$ic9e at ,m>%all ,univ]sity2 & 7,e7 ,univ]sity ( ,s\? ,c>ol9a ,s*ool ( ,m$ic9e4 7#b7 ,*>les ,r ,drew ,univ]sity ( ,m$ic9e & ,sci5ce4 7#c7 ,h[>d ,univ]sity ,college ( ,m$ic9e4 7#d7 ,meh>ry ,m$ical ,college4 7#e7 ,moreh\se ,s*ool ( ,m$ic9e4 #cje4 ,bonuses = recruitm5t1 relocation1 & ret5tion ,section #gje7;a7 ( ! ,vet]ans ,access1 ,*oice1 & ,acc\ntability ,act ( #bjad 7,public ,law #aac-adf2 #ch ,u4,s4,c4 #gjc note7 is am5d$-- 7#a7 9 p>agraph 7#a71 by /rik+ #bcj1jjj1jjj & ins]t+ #bej1jjj1jjj1 ( :i* n less ?an #bj1jjj1jjj %all be = recruitm5t1 relocation1 & ret5tion bonuses2 & 7#b7 9 p>agraph 7#b71 by /rik+ #bbe1jjj1jjj & ins]t+ #bij1jjj1jjj1 ( :i* n less ?an #bj1jjj1jjj %all be = recruitm5t1 relocation1 & ret5tion bonuses4 #cjf4 ,inclusion ( ,vet ,c5t] employees 9 ,education ,debt ,r$uction ,program ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all ensure t cl9ical /aff work+ at ,vet ,c5t]s are eligible to p>ticipate 9 ! ,education ,debt ,r$uction ,program ( ! ,dep>tm5t ( ,vet]ans ,affairs "u sub*apt] ,,vii ( *apt] #gf ( title #ch1 ,unit$ ,/ates ,code4 7b7 ,report ,n lat] ?an #a ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! numb] ( p>ticipants 9 ! ,education ,debt ,r$uction ,program ( ! ,dep>tm5t "u su* sub*apt] :o "w at ,vet ,c5t]s4 7c7 ,vet ,c5t] def9$ ,9 ?is section1 ! t]m ,vet ,c5t] has ! mean+ giv5 t t]m 9 section #agab;,a7h7 ( title #ch1 ,unit$ ,/ates ,code4 ,,iv ,heal? ,c>e 9 ,und]s]v$ ,areas #dja4 ,developm5t ( crit]ia = designation ( c]ta9 m$ical facilities ( ! ,dep>tm5t ( ,vet]ans ,affairs z und]s]v$ facilities & plan to address problem ( und]s]v$ facilities 7a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all develop crit]ia to designate m$ical c5t]s1 ambulatory c>e facilities1 & community bas$ outpati5t cl9ics ( ! ,dep>tm5t ( ,vet]ans ,affairs z und]s]v$ facilities4 7b7 ,consid]ation ,crit]ia develop$ "u subsection 7a7 %all include consid]ation ( ! foll[+ ) respect to a facility3 7#a7 ,! ratio ( vet]ans to heal? c>e provid]s ( ! ,dep>tm5t ( ,vet]ans ,affairs = a /&>diz$ geographic area surr\nd+ ! facility1 includ+ a sep>ate ratio = g5]al practition]s & speciali/s4 7#b7 ,! range ( cl9ical specialties cov]$ by su* provid]s 9 su* area4 7#c7 ,:e!r ! local community is m$ically und]s]v$4 7#d7 ,! type1 numb]1 & age ( op5 consults4 7#e7 ,:e!r ! facility is meet+ ! wait-"t goals ( ! ,dep>tm5t4 7#f7 ,su* o!r crit]ia z ! ,secret>y consid]s important 9 det]m9+ :i* facilities are n adequately s]v+ area vet]ans4 7c7 ,analysis ( facilities ,n less frequ5tly ?an annually1 directors ( ,vet]ans ,integrat$ ,s]vice ,networks ( ! ,dep>tm5t %all p]=m an analysis to det]m9e :i* facilities )9 t ,vet]ans ,integrat$ ,s]vice ,network qualify z und]s]v$ facilities pursuant to crit]ia develop$ "u subsection 7a74 7d7 ,annual plan ,to address und]s]v$ facilities 7#a7 ,plan requir$ ,n lat] ?an #a ye> aft] ! date ( ! enactm5t ( ?is ,act & n less frequ5tly ?an once ea* ye>1 ! ,secret>y %all submit to ,congress a plan to address ! problem ( und]s]v$ facilities ( ! ,dep>tm5t1 z designat$ pursuant to crit]ia develop$ "u subsection 7a74 7#b7 ,cont5ts ,ea* plan submitt$ "u p>agraph 7#a7 %all address ! foll[+3 7,a7 ,increas+ p]sonnel or tempor>y p]sonnel assi/ance1 includ+ mobile deploym5t teams furni%$ "u section #djg ( ?is ,act4 7,b7 ,provid+ special hir+ inc5tives1 includ+ "u ! ,education ,debt ,r$uction ,program "u sub*apt] ,,vii ( *apt] #gf ( title #ch1 ,unit$ ,/ates ,code1 & recruitm5t1 relocation1 & ret5tion inc5tives4 7,c7 ,us+ direct hir+ au?ority4 7,d7 ,improv+ tra9+ opportunities = /aff4 7,e7 ,su* o!r actions z ! ,secret>y consid]s appropriate4 #djb4 ,pilot program to furni% mobile deploym5t teams to und]s]v$ facilities 7a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all c>ry out a pilot program to furni% mobile deploym5t teams ( m$ical p]sonnel to und]s]v$ facilities4 7b7 ,elem5ts ,9 furni%+ mobile deploym5t teams "u subsection 7a71 ! ,secret>y %all consid] ! foll[+ elem5ts3 7#a7 ,! m$ical positions ( greate/ ne$ at und]s]v$ facilities4 7#b7 ,! size & composition ( teams to be deploy$4 7#c7 ,su* o!r elem5ts z ! ,secret>y consid]s necess>y = effective ov]sight ( ! program e/abli%$ "u subsection 7a74 7c7 ,use ( annual analysis ,! ,secret>y %all use ! results ( ! annual analysis conduct$ "u section #dja7;c7 ( ?is ,act to =m mobile deploym5t teams "u subsection 7a7 t are compos$ ( ! mo/ ne$$ m$ical p]sonnel = und]s]v$ facilities4 7d7 ,report+ 7#a7 ,progress report ,n lat] ?an #a ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all submit a report to ,congress on ! implem5tation ( ! pilot program "u ?is section4 7#b7 ,f9al report ,n lat] ?an ! t]m9ation ( ! pilot program "u ?is section1 ! ,secret>y %all submit a f9al report to ,congress t conta9s ! recomm5dations ( ! ,secret>y reg>d+ ! feasibility & advisability (-- 7,a7 ext5d+ or exp&+ ! pilot program2 & 7,b7 mak+ ! pilot program 7or any aspect !re(7 p]man5t4 7e7 ,duration ,! pilot program "u ?is section %all t]m9ate #c ye>s aft] ! date ( ! enactm5t ( ?is ,act4 7f7 ,und]s]v$ facility def9$ ,9 ?is section1 ! t]m und]s]v$ facility means a m$ical c5t]1 ambulatory c>e facility1 or community bas$ outpati5t cl9ic ( ! ,dep>tm5t ( ,vet]ans ,affairs designat$ by ! ,secret>y ( ,vet]ans ,affairs z und]s]v$ pursuant to crit]ia develop$ "u section #dja ( ?is ,act4 #djc4 ,pilot program on graduate m$ical education & resid5cy 7a7 ,e/abli%m5t 7#a7 ,9 g5]al ,subject to p>agraph 7#e71 ! ,secret>y ( ,vet]ans ,affairs %all e/abli% a pilot program to e/abli% m$ical resid5cy positions au?oriz$ "u section #cja7;b77#b7 ( ! ,vet]ans ,access1 ,*oice1 & ,acc\ntability ,act ( #bjad 7,public ,law #aac-adf2 #ch ,u4,s4,c4 #gcjb note7 at cov]$ facilities4 7#b7 ,cov]$ facilities ,= purposes ( ?is section1 a cov]$ facility is any ( ! foll[+3 7,a7 ,a heal? c>e facility ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7,b7 ,a heal? c>e facility op]at$ by an ,indian tribe or a tribal organization1 z ^? t]ms are def9$ 9 section #d ( ! ,indian ,self-,det]m9ation & ,education ,assi/ance ,act 7#be ,u4,s4,c4 #ecjd74 7,c7 ,a heal? c>e facility op]at$ by ! ,indian ,heal? ,s]vice4 7,d7 ,a ,f$]ally-qualifi$ heal? c5t]1 z def9$ 9 section #aije7l77#b77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7l77#b77;,b774 7,e7 ,a heal? c>e facility op]at$ by ! ,dep>tm5t ( ,def5se4 7,f7 ,su* o!r heal? c>e facility z ! ,secret>y consid]s appropriate = purposes ( ?is section4 7#c7 ,agreem5ts ,to c>ry out ! pilot program "u ?is section1 ! ,secret>y may ent] into agreem5ts ) entities t op]ate cov]$ facilities 9 :i* ! ,secret>y places resid5ts "u p>agraph 7#a74 7#d7 ,p>amet]s = location1 affiliate sponsor1 & duration ,:5 det]m9+ 9 :i* cov]$ facilities to place resid5ts "u p>agraph 7#a71 ! ,secret>y %all consid] ! ext5t to :i* !re is a cl9ical ne$ = provid]s 9 an area1 z det]m9$ by ! foll[+3 7,a7 ,! ratio ( vet]ans to heal? c>e provid]s ( ! ,dep>tm5t = a /&>diz$ geographic area surr\nd+ a facility1 includ+ a sep>ate ratio = g5]al practition]s & speciali/s4 7,b7 ,! range ( cl9ical specialties ( provid]s 9 /&>diz$ geographic areas surr\nd+ a facility4 7,c7 ,:e!r ! specialty ( a provid] is includ$ 9 ! mo/ rec5t /aff+ %ortage det]m9ation ( ! ,dep>tm5t "u section #gdab ( title #ch1 ,unit$ ,/ates ,code4 7,d7 ,:e!r ! local community is designat$ by ! ,secret>y ( ,vet]ans ,affairs z und]s]v$ pursuant to crit]ia develop$ "u section #dja ( ?is ,act4 7,e7 ,:e!r ! facility is locat$ 9 a community t is designat$ by ! ,secret>y ( ,heal? & ,human ,s]vices z a heal? pr(essional %ortage area "u section #ccb ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;e74 7,f7 ,:e!r ! facility is locat$ 9 a rural or remote area4 7,g7 ,su* o!r crit]ia z ! ,secret>y consid]s important 9 det]m9+ :i* facilities are n adequately s]v+ area vet]ans4 7#e7 ,priority 9 placem5ts ,dur+ ! pilot program "u ?is section1 ! ,secret>y %all place no few] ?an #ajj resid5ts 9 cov]$ facilities-- 7,a7 op]at$ by ! ,indian ,heal? ,s]vice2 7,b7 op]at$ by an ,indian tribe2 7,c7 op]at$ by a tribal organization2 or 7,d7 locat$ 9 communities designat$ by ! ,secret>y z und]s]v$ pursuant to crit]ia develop$ "u section #dja ( ?is ,act4 7#f7 ,/ip5ds & b5efits ,! ,secret>y may pay /ip5ds & provide b5efits = resid5ts 9 positions "u p>agraph 7#a71 reg>dless ( :e!r !y h be5 assign$ 9 a ,dep>tm5t facility4 7b7 ,reimbursem5t ,if a cov]$ facility e/abli%es a new resid5cy program 9 :i* ! ,secret>y places a resid5t "u ! pilot program1 ! ,secret>y %all reimburse t cov]$ facility = co/s ( ! foll[+3 7#a7 ,curriculum developm5t4 7#b7 ,recruitm5t & ret5tion ( faculty4 7#c7 ,accr$itation ( ! program by ! ,accr$itation ,c\ncil = ,graduate ,m$ical ,education4 7#d7 ,! portion ( faculty sal>ies attributable to duties "u an agreem5t subsection 7a77#c74 7#e7 ,exp5ses relat+ to educat+ a resid5t "u ! pilot program4 7c7 ,report+ 7#a7 ,9 g5]al ,n lat] ?an #a ye> aft] ! date ( ! enactm5t ( ?is ,act & n less frequ5tly ?an once ea* ye> !reaft] until ! t]m9ation ( ! pilot program1 ! ,secret>y %all submit to ,congress a report on ! implem5tation ( ! pilot program4 7#b7 ,elem5ts ,ea* report submitt$ "u p>agraph 7#a7 %all include ! foll[+ ) reg>d to ! imm$iately prec$+ ye>1 & 9 comp>ison to ! ye> imm$iately prec$+ t ye>3 7,a7 ,! numb] ( vet]ans :o receiv$ c>e f resid5ts "u ! pilot program4 7,b7 ,! numb] ( vet]ans :o receiv$ c>e f ea* resid5t p] position describ$ 9 subsection 7a77#a7 "u ! pilot program4 7,c7 ,! numb] ( vet]ans :o receiv$ c>e f resid5ts "u ! pilot program express$ z a p]c5tage ( all individuals :o receiv$ c>e f su* resid5ts4 7,d7 ,! numb] ( cl9ical appo9tm5ts = vet]ans conduct$ by ea* resid5t "u ! pilot program4 7,e7 ,! numb] ( cl9ical appo9tm5ts = vet]ans conduct$ by resid5ts p] position describ$ 9 subsection 7a77#a7 "u ! pilot program4 7,f7 ,! numb] ( cl9ical appo9tm5ts = vet]ans express$ z a p]c5tage ( all cl9ical appo9tm5ts conduct$ by resid5ts "u ! pilot program4 7,g7 ,! numb] ( positions describ$ 9 subsection 7a77#a7 at ea* cov]$ facility "u ! pilot program4 7,h7 ,= ea* position describ$ 9 subsection 7a77#a7 9 a resid5cy program affiliat$ ) a heal? c>e facility ( ! ,dep>tm5t1 ! "t a resid5t "u ! pilot program sp5t tra9+ at t facility ( ! ,dep>tm5t1 express$ z a p]c5tage ( ! total tra9+ "t = t resid5t position4 7,i7 ,= ea* resid5cy program affiliat$ ) a heal? c>e facility ( ! ,dep>tm5t1 ! "t all resid5ts "u ! pilot program sp5t tra9+ at t facility ( ! ,dep>tm5t1 express$ z a p]c5tage ( ! total tra9+ "t = ^? resid5ts4 7,j7 ,! "t t all resid5ts "u ! pilot program :o are assign$ to programs affiliat$ ) heal? c>e facilities ( ! ,dep>tm5t sp5t tra9+ at facilities ( ! ,dep>tm5t1 express$ z a p]c5tage ( ! total tra9+ "t = ^? resid5ts4 7,k7 ,! co/ to ! ,dep>tm5t ( ,vet]ans ,affairs "u ! pilot program 9 ! ye> imm$iately prec$+ ! report & s9ce ! beg9n+ ( ! pilot program4 7,l7 ,! co/ to ! ,dep>tm5t ( ,vet]ans ,affairs p] resid5t plac$ "u ! pilot program at ea* cov]$ facility4 7,m7 ,! numb] ( resid5ts "u ! pilot program hir$ by ! ,secret>y to "w 9 ! ,vet]ans ,heal? ,adm9i/ration aft] completion ( resid5cy 9 ! ye> imm$iately prec$+ ! report & s9ce ! beg9n+ ( ! pilot program4 7,n7 ,! m$ical specialties pursu$ by resid5ts "u ! pilot program4 7d7 ,duration ,! pilot program "u ?is section %all t]m9ate on ,augu/ #g1 #bjbd4 ,v ,o!r ,matt]s #eja4 ,annual report on p]=mance aw>ds & bonuses aw>d$ to c]ta9 high-level employees ( ! dep>tm5t 7a7 ,9 g5]al ,*apt] #g ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new section3 #gbf4 ,annual report on p]=mance aw>ds & bonuses aw>d$ to c]ta9 high-level employees 7a7 ,9 g5]al ,n lat] ?an #ajj days aft] ! end ( ea* fiscal ye>1 ! ,secret>y %all submit to ! appropriate committees ( ,congress a report t conta9s1 = ! mo/ rec5t fiscal ye> end+ be=e ! submittal ( ! report1 a description ( all p]=mance aw>ds or bonuses aw>d$ to ea* ( ! foll[+3 7#a7 ,regional ,(fice ,director ( ! ,dep>tm5t4 7#b7 ,director ( a ,m$ical ,c5t] ( ! ,dep>tm5t4 7#c7 ,director ( a ,vet]ans ,integrat$ ,s]vice ,network4 7#d7 ,s5ior executive ( ! ,dep>tm5t4 7b7 ,elem5ts ,ea* report submitt$ "u subsection 7a7 %all include ! foll[+ ) respect to ea* p]=mance aw>d or bonus aw>d$ to an individual describ$ 9 su* subsection3 7#a7 ,! am\nt ( ea* aw>d or bonus4 7#b7 ,! job title ( ! individual aw>d$ ! aw>d or bonus4 7#c7 ,! location :]e ! individual aw>d$ ! aw>d or bonus works4 7c7 ,def9itions ,9 ?is section3 7#a7 ,! t]m appropriate committees ( ,congress means ! ,committees on ,vet]ans' ,affairs & ,appropriations ( ! ,s5ate & ,h\se ( ,repres5tatives4 7#b7 ,! t]m s5ior executive means-- 7,a7 a c>e] appo9tee2 or 7,b7 an individual-- 7i7 9 an adm9i/rative or executive position2 & 7ii7 appo9t$ "u section #gcjf7;a7 or section #gdja7a7 ( ?is title4 7#c7 ,! t]m c>e] appo9tee has ! mean+ giv5 t t]m 9 section #cacb7;a7 ( title #e1 ,unit$ ,/ates ,code4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat+ to section #gbe ! foll[+ new item3 #gbf4 ,annual report on p]=mance aw>ds & bonuses aw>d$ to c]ta9 high-level employees4 4 #ejb4 ,role ( podiatri/s 9 ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,inclusion z physician 7#a7 ,9 g5]al ,sub*apt] ,i ( *apt] #gd is am5d$ by add+ at ! end ! foll[+ new section3 #gdac4 ,treatm5t ( podiatri/s2 cl9ical ov]sight /&>ds 7a7 ,podiatri/s ,except z provid$ by subsection 7b71 a doctor ( podiatric m$ic9e :o is appo9t$ z a podiatri/ "u section #gdja7a7 ( ?is title is eligible = any sup]visory position 9 ! ,vet]ans ,heal? ,adm9i/ration to ! same degree t a physician appo9t$ "u su* section is eligible = ! position4 7b7 ,e/abli%m5t ( cl9ical ov]sight /&>ds ,! ,secret>y1 9 consultation ) appropriate /akehold]s1 %all e/abli% /&>ds to ensure t speciali/s appo9t$ 9 ! ,vet]ans ,heal? ,adm9i/ration to sup]visory positions d n provide direct cl9ical ov]sight = purposes ( pe] review or practice evaluation = provid]s ( o!r cl9ical specialties4 4 7#b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( *apt] #gd is am5d$ by ins]t+ aft] ! item relat+ to section #gdab ! foll[+ new item3 #gdac4 ,treatm5t ( podiatri/s2 cl9ical ov]sight /&>ds4 4 7b7 ,modification & cl>ification ( pay grade 7#a7 ,grade ,! li/ 9 section #gdjd7;b7 ( su* title is am5d$-- 7,a7 by /rik+ ,,physician ,,& ,,d5ti/ ,,s*$ule & ins]t+ ,,physician ,,& ,,surgeon 7,,md_/,,d71 ,,podiatric ,,surgeon 7,,dpm71 ,,& ,,d5ti/ ,,& ,,oral ,,surgeon 7,,dds1 ,,dmd7 ,,s*$ule2 7,b7 by /rik+ ,physician grade & ins]t+ ,physician & surgeon grade2 & 7,c7 by /rik+ ,,podiatri/1 ,,*iropractor1 ,,& & ins]t+ ,,*iropractor ,,&4 7#b7 ,application ,! am5dm5ts made by p>agraph 7#a7 %all apply ) respect to a pay p]iod ( ! ,dep>tm5t ( ,vet]ans ,affairs beg9n+ on or aft] ! date t is #cj days aft] ! date ( ! enactm5t ( ?is ,act4 #ejc4 ,def9ition ( major m$ical facility project 7a7 ,modification ( def9ition ( m$ical facility ,section #haja7c7 is am5d$ by /rik+ ,secret>y & all t foll[s ?r\gh nurs+ home1 & ins]t+ ,secret>y1 or z o!rwise au?oriz$ by law1 = ! provision ( heal?-c>e s]vices 7includ+ hospital1 outpati5t cl9ic1 nurs+ home14 7b7 ,modification ( def9ition ( major m$ical facility project ,p>agraph 7#c7 ( section #hajd7;a7 is am5d$ to read z foll[s3 7#c7 ,= purposes ( ?is subsection1 ! t]m major m$ical facility project means a project = ! con/ruction1 alt]ation1 or acquisition ( a m$ical facility involv+ a total exp5diture ( m ?an #bj1jjj1jjj1 b su* t]m does n include an acquisition by ex*ange1 nonrecurr+ ma9t5ance projects ( ! ,dep>tm5t1 or ! con/ruction1 alt]ation1 or acquisition ( a %>$ ,f$]al m$ical facility = :i* ! ,dep>tm5t's e/imat$ %>e ( ! project co/s does n exce$ #bj1jjj1jjj4 4 #ejd4 ,au?orization ( c]ta9 major m$ical facility projects ( ! ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,au?orization ,! ,secret>y ( ,vet]ans ,affairs may c>ry out ! foll[+ major m$ical facility project1 to be c>ri$ out 9 an am\nt n to exce$ ! am\nt specifi$ = t project3 ,con/ruction ( ! new ,ea/ ,bay ,community ,bas$ ,outpati5t ,cl9ic & all associat$ site "w1 utilities1 p>k+1 & l&scap+1 con/ruction ( ! ,c5tral ,valley ,eng9e]+ & ,logi/ics support facility1 & enhanc$ flood pla9 mitigation at ! ,c5tral ,valley & ,ea/ ,bay ,community ,bas$ ,outpati5t ,cl9ics z "p ( ! realignm5t ( m$ical facilities 9 ,liv]more1 ,cali=nia1 9 an am\nt n to exce$ #aag1cjj1jjj4 7b7 ,au?orization ( appropriations = con/ruction ,!re is au?oriz$ to be appropriat$ to ! ,secret>y ( ,vet]ans ,affairs = fiscal ye> #bjah or ! ye> 9 :i* funds are appropriat$ = ! ,con/ruction1 ,major ,projects acc\nt1 #aag1cjj1jjj = ! project au?oriz$ 9 subsection 7a74 7c7 ,submittal ( in=mation ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 = ! project au?oriz$ 9 subsection 7a71 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives ! foll[+ in=mation3 7#a7 ,a l9e item acc\nt+ ( exp5ditures relat+ to con/ruction managem5t c>ri$ out by ! ,dep>tm5t ( ,vet]ans ,affairs = su* project4 7#b7 ,! future am\nts t are budget$ to be obligat$ = con/ruction managem5t c>ri$ out by ! ,dep>tm5t = su* project4 7#c7 ,a ju/ification = ! exp5ditures describ$ 9 p>agraph 7#a7 & ! future am\nts describ$ 9 p>agraph 7#b74 7#d7 ,any agreem5t ent]$ into by ! ,secret>y reg>d+ a non-,dep>tm5t ( ,vet]ans ,affairs ,f$]al entity provid+ managem5t s]vices relat+ to su* project1 includ+ reimbursem5t agreem5ts & ! co/s to ! ,dep>tm5t = su* s]vices4 #eje4 ,dep>tm5t ( ,vet]ans ,affairs p]sonnel transp>5cy 7a7 ,publication ( /aff+ & vacancies 7#a7 ,website requir$ ,subject to p>agraph 7#b7 & n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all make publicly available on an ,int]net website ( ! ,dep>tm5t ( ,vet]ans ,affairs ! foll[+ in=mation1 :i* %all1 subject to subp>agraph 7,d71 be display$ by dep>tm5tal compon5t or1 9 ! case ( in=mation relat+ to ,vet]ans ,heal? ,adm9i/ration positions1 by m$ical facility3 7,a7 ,! numb] ( p]sonnel encumb]+ positions4 7,b7 ,! numb] ( accessions & sep>ation actions process$ dur+ ! qu>t] prec$+ ! date ( ! publication ( ! in=mation4 7,c7 ,! numb] ( vacancies1 by occupation4 7,d7 ,! p]c5tage ( new hires = ! ,dep>tm5t :o 7 hir$ )9 ! "t-to-hire t>get ( ! ,(fice ( ,p]sonnel ,managem5t1 disaggregat$ by adm9i/ration4 7#b7 ,exceptions ,! ,secret>y may )hold f publication "u p>agraph 7#a7 in=mation relat+ to law en=cem5t1 in=mation security1 or su* positions 9 ! ,dep>tm5t t ! ,secret>y det]m9es to be s5sitive4 7#c7 ,update ( in=mation ,! ,secret>y %all update ! in=mation on ! website requir$ "u p>agraph 7#a7 on a qu>t]ly basis4 7#d7 ,treatm5t ( contractor positions ,any ,dep>tm5t ( ,vet]ans ,affairs position t is fill$ ) a contractor may n be treat$ z a ,dep>tm5t position = purposes ( ! in=mation requir$ to be publi%$ "u p>agraph 7#a74 7#e7 ,inspector ,g5]al review ,on a semi-annual basis1 ! ,inspector ,g5]al ( ! ,dep>tm5t %all review ! adm9i/ration ( ! website requir$ "u p>agraph 7#a7 & make recomm5dations relat+ to ! improvem5t ( su* adm9i/ration4 7b7 ,report to ,congress ,! ,secret>y ( ,vet]ans ,affairs %all submit to ,congress an annual report on ! /eps ! ,dep>tm5t is tak+ to a*ieve full /aff+ capacity4 ,ea* su* report %all include ! am\nt ( additional funds necess>y to enable ! ,dep>tm5t to rea* full /aff+ capacity4 #ejf4 ,program on e/abli%m5t ( pe] speciali/s 9 pati5t align$ c>e team sett+s )9 m$ical c5t]s ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,program requir$ ,! ,secret>y ( ,vet]ans ,affairs %all c>ry out a program to e/abli% n few] ?an two pe] speciali/s 9 pati5t align$ c>e teams at m$ical c5t]s ( ! ,dep>tm5t ( ,vet]ans ,affairs to promote ! use & integration ( s]vices = m5tal heal?1 sub/ance use disord]1 & behavioral heal? 9 a prim>y c>e sett+4 7b7 ,timeframe = e/abli%m5t ( program ,! ,secret>y %all c>ry out ! program at m$ical c5t]s ( ! ,dep>tm5t z foll[s3 7#a7 ,n lat] ?an ,may #ca1 #bjai1 at n few] ?an #ae m$ical c5t]s ( ! ,dep>tm5t4 7#b7 ,n lat] ?an ,may #ca1 #bjbj1 at n few] ?an #cj m$ical c5t]s ( ! ,dep>tm5t4 7c7 ,selection ( locations 7#a7 ,9 g5]al ,! ,secret>y %all select m$ical c5t]s = ! program z foll[s3 7,a7 ,n few] ?an five %all be m$ical c5t]s ( ! ,dep>tm5t t are designat$ by ! ,secret>y z polytrauma c5t]s4 7,b7 ,n few] ?an #aj %all be m$ical c5t]s ( ! ,dep>tm5t t are n designat$ by ! ,secret>y z polytrauma c5t]s4 7#b7 ,consid]ations ,9 select+ m$ical c5t]s = ! program "u p>agraph 7#a71 ! ,secret>y %all consid] ! feasibility & advisability ( select+ m$ical c5t]s 9 ! foll[+ areas3 7,a7 ,rural areas & o!r areas t are und]s]v$ by ! ,dep>tm5t4 7,b7 ,areas t are n 9 close proximity to an active duty milit>y in/allation4 7,c7 ,areas repres5t+ diff]5t geographic locations1 su* z c5sus tracts e/abli%$ by ! ,bureau ( ! ,c5sus4 7d7 ,g5d]-,specific s]vices ,9 c>ry+ out ! program at ea* location select$ "u subsection 7c71 ! ,secret>y %all ensure t-- 7#a7 ! ne$s ( female vet]ans are specifically consid]$ & address$2 & 7#b7 female pe] speciali/s are made available to female vet]ans :o are treat$ at ea* location4 7e7 ,engagem5t ) community provid]s ,at ea* location select$ "u subsection 7c71 ! ,secret>y %all consid] ways 9 :i* pe] speciali/s c conduct outrea* to heal? c>e provid]s 9 ! community :o are kn[n to be s]v+ vet]ans to engage ) ^? provid]s & vet]ans s]v$ by ^? provid]s4 7f7 ,reports 7#a7 ,p]iodic reports 7,a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 & n less frequ5tly ?an once e #ahj days !reaft] until ! ,secret>y det]m9es t ! program is be+ c>ri$ out at ! la/ location to be select$ "u subsection 7c71 ! ,secret>y %all submit to ,congress a report on ! program4 7,b7 ,elem5ts ,ea* report requir$ by subp>agraph 7,a7 %all1 ) respect to ! #ahj-;day p]iod prec$+ ! submittal ( ! report1 include ! foll[+3 7i7 ,! f9d+s & conclusions ( ! ,secret>y ) respect to ! program4 7ii7 ,an assessm5t ( ! b5efits ( ! program to vet]ans & family memb]s ( vet]ans4 7iii7 ,an assessm5t ( ! effectiv5ess ( pe] speciali/s 9 engag+ "u subsection 7e7 ) heal? c>e provid]s 9 ! community & vet]ans s]v$ by ^? provid]s4 7#b7 ,f9al report ,n lat] ?an #ahj days aft] ! ,secret>y det]m9es t ! program is be+ c>ri$ out at ! la/ location to be select$ "u subsection 7c71 ! ,secret>y %all submit to ,congress a report detail+ ! recomm5dations ( ! ,secret>y z to ! feasibility & advisability ( exp&+ ! program to additional locations4 #ejg4 ,dep>tm5t ( ,vet]ans ,affairs m$ical scribe pilot program 7a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all c>ry out a #b-ye> pilot program "u :i* ! ,secret>y %all increase ! use ( m$ical scribes at ,dep>tm5t ( ,vet]ans ,affairs m$ical c5t]s4 7b7 ,locations ,! ,secret>y %all c>ry out ! pilot program at ! #aj m$ical c5t]s ( ! ,dep>tm5t z foll[s3 7#a7 ,at lea/ f\r su* m$ical c5t]s locat$ 9 rural areas4 7#b7 ,at lea/ f\r su* m$ical c5t]s locat$ 9 urban areas4 7#c7 ,two su* m$ical c5t]s locat$ 9 areas ) ne$ = increas$ access or increas$ effici5cy1 z det]m9e by ! ,secret>y4 7c7 ,m$ical scribes 7#a7 ,hir+ ,"u ! pilot program ! ,secret>y %all-- 7,a7 hire #bj new ,dep>tm5t ( ,vet]ans ,affairs t]m employees z m$ical scribes2 & 7,b7 seek to ent] into contracts ) appropriate entities = ! employm5t ( #bj additional m$ical scribes4 7#b7 ,di/ribution ,! ,secret>y %all assign f\r m$ical scribes to ea* ( ! #aj m$ical c5t]s ( ! ,dep>tm5t :]e ! ,secret>y c>ries out ! pilot program z foll[s3 7,a7 ,two scribes %all be assign$ to ea* ( two physicians4 7,b7 ,?irty p]c5t ( ! scribes %all be employ$ 9 ! provision ( em]g5cy c>e4 7,c7 ,sev5ty p]c5t ( ! scribes %all be employ$ 9 ! provision ( speciality c>e 9 specialties ) ! longe/ pati5t wait times or l[e/ effici5cy rat+s1 z det]m9$ by ! ,secret>y4 7d7 ,reports 7#a7 ,reports to ,congress ,n lat] ?an #ahj days aft] ! comm5cem5t ( ! pilot program requir$ "u ?is section1 & e #ahj days !reaft] = ! duration ( ! pilot program1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ,congress a report on ! pilot program4 ,ea* su* report %all include ea* ( ! foll[+3 7,a7 ,a sep>ate analysis ( ea* ! foll[+ ) respect to m$ical scribes employ$ by ! ,dep>tm5t ( ,vet]ans ,affairs & m$ical scribes p]=m+ ,dep>tm5t ( ,vet]ans ,affairs functions "u a contract3 7i7 ,provid] effici5cy4 7ii7 ,pati5t satisfaction4 7iii7 ,av]age wait "t4 7iv7 ,! numb] ( pati5ts se5 p] day by ea* physician or practition]4 7v7 ,! am\nt ( "t requir$ to hire & tra9 an employee to p]=m m$ical scribe functions "u ! pilot program4 7,b7 ,metrics & data = analyz+ ! effects ( ! pilot program1 includ+ an evaluation ( ! ea* ( ! elem5ts "u clauses 7i7 ?r\gh 7iv7 ( subp>agraph 7,a7 at m$ical c5t]s :o employ$ scribes "u ! pilot program = an appropriate p]iod prec$+ ! hir+ ( su* scribes4 7#b7 ,comptroll] ,g5]al report ,n lat] ?an #ij days aft] ! t]m9ation ( ! pilot program "u ?is section1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ,congress a report on ! pilot program4 ,su* report %all include a comp>ison ( ! pilot program ) simil> programs c>ri$ out 9 ! private sector4 7e7 ,def9itions ,9 ?is section3 7#a7 ,! t]m m$ical scribe means an unlic5s$ individual hir$ to ent] in=mation into ! electronic heal? record or *>t at ! direction ( a physician or lic5s$ indep5d5t practition] ^: responsibilities include ! foll[+3 7,a7 ,assi/+ ! physician or practition] 9 navigat+ ! electronic heal? record4 7,b7 ,respond+ to v>i\s messages z direct$ by ! physician or practition]4 7,c7 ,ent]+ in=mation into ! electronic heal? record1 z direct$ by ! physician or practition]4 7#b7 ,! t]ms urban & rural h ! mean+s giv5 su* t]ms "u ! rural-urban commut+ codes develop$ by ! ,secret>y ( ,agriculture & ! ,secret>y ( ,heal? & ,human ,s]vices4 7f7 ,fund+ ,! pilot program "u ?is section %all be c>ri$ out us+ am\nts o!rwise au?oriz$ to be appropriat$ = ! ,dep>tm5t ( ,vet]ans ,affairs4 ,no additional am\nts are au?oriz$ to be appropriat$ to c>ry out su* program4 #ejh4 ,ext5sion ( requirem5t to collect fees = h\s+ loans gu>ante$ by ,secret>y ( ,vet]ans ,affairs ,section #cgbi7;b77#b7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by /rik+ #bjbg ea* place x appe>s & ins]t+ #bjbh4 #eji4 ,ext5sion ( r$uction 9 am\nt ( p5sion furni%$ by ,dep>tm5t ( ,vet]ans ,affairs = c]ta9 vet]ans cov]$ by ,m$icaid plans = s]vices furni%$ by nurs+ facilities ,section #eejc7;d77#g7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by /rik+ ,septemb] #cj1 #bjbg & ins]t+ ,septemb] #cj1 #bjbh4 #eaj4 ,appropriation ( am\nts 7a7 ,vet]ans ,*oice ,program ,!re is au?oriz$ to be appropriat$1 & is appropriat$1 to ! ,secret>y ( ,vet]ans ,affairs1 out ( any funds 9 ! ,treasury n o!rwise appropriat$1 #e1bjj1jjj1jjj to be deposit$ 9 ! ,vet]ans ,*oice ,fund "u section #hjb ( ! ,vet]ans ,access1 ,*oice1 & ,acc\ntability ,act ( #bjad 7,public ,law #aac-adf2 #ch ,u4,s4,c4 #agja note74 7b7 ,availability ( am\nts ,! am\nts appropriat$ "u subsection 7a7 %all be available = obligation or exp5diture )\t fiscal ye> limitation4 #eaa4 ,te*nical correction ,section #agab;,i ( title #ch1 ,unit$ ,/ates ,code1 is r$esignat$ z section #agbj;,i ( su* title4 #eab4 ,budget>y effects 7a7 ,/atutory ,pay-,z-,y-,g scorec>ds ,! budget>y effects ( ?is ,act %all n be ent]$ on ei!r ,,paygo scorec>d ma9ta9$ pursuant to section #d7;d7 ( ! ,/atutory ,pay-,z-,y-,g ,act ( #bjaj4 7b7 ,s5ate ,,paygo scorec>ds ,! budget>y effects ( ?is ,act %all n be ent]$ on any ,,paygo scorec>d ma9ta9$ = purposes ( section #dajf ( ,h4 ,con4 ,res4 #ga 7#aae? ,congress74 ,cl]k4