,,ii  #aagth ,,congress  #ast ,session  
,s4 #ahfc  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,may #bf1      
#bjba,mr4 ,moran 7for himself1 ,mr4     
,boozman1 ,mr4 ,cassidy1 ,mr4 ,tillis1  
,mr4 ,sullivan1 ,mrs4 ,blackburn1 ,mr4  
,cramer1 and ,mr4 ,tuberville7          
introduced the following bill2 which was
 read twice and referred to the         
,committee on ,veterans' ,affairs  ,a   
,,bill  ,to amend title #ch1 ,united    
,states ,code1 to improve access to     
health care for veterans1 and for other 
purposes4  #a4 ,short title2 table of   
contents  7a7 ,short title ,this ,act   
may be cited as the ,guaranteeing       
,healthcare ,access to ,personnel ,who  
,served ,act4  7b7 ,table of contents   
,the table of contents for this ,act is 
as follows3 ,sec4 #a4 ,short title2     
table of contents4,,title ,i--,,mission 
,act ,protection,subtitle ,a--,access to
 community care,sec4 #aja4              
,modifications to access standards for  
care furnished through ,community ,care 

,program of ,department of ,veterans    
,affairs4,sec4 #ajb4 ,strategic plan to 
ensure continuity of care in the case of
 the realignment of a medical facility  
of the ,department4,subtitle            
,b--,community care self-scheduling     
pilot program,sec4 #aaa4                
,definitions4,sec4 #aab4 ,pilot program 
establishing a community care           
self-scheduling appointment system4,sec4
 #aac4 ,capabilities of self-scheduling 
appointment system4,sec4 #aad4          
,report4,subtitle ,c--,non-,department  
of ,veterans ,affairs providers,sec4    
#aba4 ,credentialing verification       
requirements for providers of           
non-,department of ,veterans ,affairs   
health care services4,sec4 #abb4        
,inapplicability of certain providers to
 provide non-,department of ,veterans   
,affairs care4,,title ,,ii--,improvement
 of rural health and telehealth,sec4    
#bja4 ,establishment of strategic plan  
requirement for ,office of ,connected   
,care of ,department of ,veterans       

,affairs4,sec4 #bjb4 ,comptroller       
,general report on transportation       
services by third parties for rural     
veterans4,sec4 #bjc4 ,comptroller       
,general report on telehealth services  
of the ,department of ,veterans         
,affairs4,,title ,,iii--,foreign        
,medical ,program,sec4 #cja4 ,analysis  
of feasibility and advisability of      
expanding assistance and support to     
caregivers to include caregivers of     
veterans in the ,republic of the        
,philippines4,sec4 #cjb4 ,comptroller   
,general report on ,foreign ,medical    
,program of ,department of ,veterans    
,affairs4,,title ,,iv--,mental health   
care,sec4 #dja4 ,analysis of feasibility
 and advisability of ,department of     
,veterans ,affairs providing            
evidence-based treatments for the       
diagnosis of treatment-resistant        
depression4,sec4 #djb4 ,modification of 
resource allocation system to include   
peer specialists4,sec4 #djc4 ,gap       
analysis of psychotherapeutic           

interventions of the ,department of     
,veterans ,affairs4,,title ,v--,other   
matters,sec4 #eja4 ,online health care  
education portal4,sec4 #ejb4 ,exclusion 
of application of ,paperwork ,reduction 
,act to research activities of the      
,veterans ,health ,administration4  ,i  
,,mission ,act ,protection  ,a ,access  
to community care  #aja4 ,modifications 
to access standards for care furnished  
through ,community ,care ,program of    
,department of ,veterans ,affairs  7a7  
,access standards  7#a7 ,in general     
,section #agjc;,b of title #ch1 ,united 
,states ,code1 is amended-- 7,a7 by     
striking subsections 7a7 through 7g7 and
 inserting the following3  7a7          
,threshold eligibility standards for    
access to community care  7#a7 ,a       
covered veteran shall receive           
non-,department hospital care1 medical  
services1 or extended care services     
through the ,veterans ,community ,care  
,program under section #agjc of this    
title pursuant to subsection            

7d77#a77;,d7 of such section using the  
following eligibility access standards3 
7,a7 ,with respect to primary care1     
mental health care1 or non-institutional
 extended care services1 if the         
,department cannot schedule an          
appointment for the covered veteran with
 a health care provider of the          
,department-- 7i7 within #cj minutes    
average driving time from the residence 
of the veteran2 and  7ii7 within #bj    
days of the date of request for such an 
appointment unless a later date has been
 agreed to by the veteran in            
consultation with the health care       
provider4  7,b7 ,with respect to        
specialty care or specialty services1 if
 the ,department cannot schedule an     
appointment for the covered veteran with
 a health care provider of the          
,department-- 7i7 within #fj minutes    
average driving time from the residence 
of the veteran2 and  7ii7 within #bh    
days of the date of request for such an 
appointment1 unless a later date has    

been agreed to by the veteran in        
consultation with the health care       
provider4  7#b7 ,for the purposes of    
determining the eligibility of a covered
 veteran for care or services under     
paragraph 7#a71 the ,secretary shall not
 take into consideration the            
availability of telehealth appointments 
from the ,department when determining   
whether the ,department is able to      
furnish such care or services in a      
manner that complies with the           
eligibility access standards under such 
paragraph4  7b7 ,access to care         
standards for community care  7#a7      
,subject to subsection 7c71 the         
,secretary shall meet the following     
access to care standards when furnishing
 non-,department hospital care1 medical 
services1 or extended care services to a
 covered veteran through the ,veterans  
,community ,care ,program under section 
#agjc of this title3 7,a7 ,with respect 
to an appointment for primary care1     
mental health care1 or non-institutional

 extended care services-- 7i7 within #cj
 minutes average driving time from the  
residence of the veteran unless a longer
 driving time has been agreed to by the 
veteran2 and  7ii7 within #bj days of   
the date of request for such an         
appointment unless a later date has been
 agreed to by the veteran4  7,b7 ,with  
respect to an appointment for specialty 
care or specialty services-- 7i7 within 
#fj minutes average driving time from   
the residence of the veteran unless a   
longer driving time has been agreed to  
by the veteran2 and  7ii7 within #bh    
days of the date of request for such an 
appointment unless a later date has been
 agreed to by the veteran4  7#b7 ,the   
,secretary shall ensure that health care
 providers specified under section      
#agjc7;c7 of this title are able to     
comply with the applicable access to    
care standards under paragraph 7#a7 for 
such providers4  7c7 ,waivers to access 
to care standards for community care    
providers  7#a7 ,a ,third ,party        

,administrator may request a waiver to  
the access to care standards under      
subsection 7b7 if-- 7,a7 7i7 the        
scarcity of available providers or      
facilities in the region precludes the  
,third ,party ,administrator from       
meeting those access to care standards2 
or  7ii7 the landscape of providers or  
facilities has changed1 and certain     
providers or facilities are not         
available such that the ,third ,party   
,administrator is not able to meet those
 access to care standards2 and  7,b7 to 
address the scarcity of available       
providers or the change in the provider 
or facility landscape1 as the case may  
be1 the ,third ,party ,administrator has
 contracted with other providers or     
facilities that may not meet those      
access to care standards but are the    
currently available providers or        
facilities most accessible to veterans  
within the region of responsibility of  
the ,third ,party ,administrator4  7#b7 
,any waiver requested by a ,third ,party

 ,administrator under paragraph 7#a7    
must be requested in writing and        
submitted to the ,office of ,community  
,care of the ,department for approval by
 that office4  7#c7 ,as part of any     
waiver request under paragraph 7#a71 a  
,third ,party ,administrator must       
include conclusive evidence and         
documentation that the access to care   
standards under subsection 7b7 cannot be
 met because of scarcity of available   
providers or changes to the landscape of
 providers or facilities4  7#d7 ,in     
evaluating a waiver request under       
paragraph 7#a71 the ,secretary shall    
consider the following3 7,a7 ,the number
 and geographic distribution of eligible
 health care providers available within 
the geographic area and specialty       
referenced in the waiver request4  7,b7 
,the prevailing market conditions within
 the geographic area and specialty      
referenced in the waiver request1 which 
shall include the number and            
distribution of health care providers   

contracting with other health care plans
 7including commercial plans and the    
,medicare program under title ,,xviii of
 the ,social ,security ,act 7#db        
,u4,s4,c4 #acie et seq477 operating in  
the geographic area and specialty       
referenced in the waiver request4  7,c7 
,whether the service area is comprised  
of highly rural1 rural1 or urban areas  
or some combination of such areas4  7,d7
 ,how significantly the waiver request  
differs from the relevant access to care
 standards under subsection 7b74  7#e7  
,the ,secretary shall not consider      
inability to contract as a valid sole   
rationale for granting a waiver under   
paragraph 7#a74  7d7 ,calculation of    
driving time ,for purposes of           
calculating average driving time from   
the residence of the veteran under      
subsections 7a7 and 7b71 the ,secretary 
shall use geographic information system 
software4  7e7 ,periodic review of      
access standards ,not later than three  
years after the date of the enactment of

 the ,guaranteeing ,healthcare ,access  
to ,personnel ,who ,served ,act1 and not
 less frequently than once every three  
years thereafter1 the ,secretary shall--
 7#a7 conduct a review of the           
eligibility access standards under      
subsection 7a7 and the access to care   
standards under subsection 7b71 in      
consultation with-- 7,a7 such ,federal  
entities as the ,secretary considers    
appropriate1 including the ,department  
of ,defense1 the ,department of ,health 
and ,human ,services1 and the ,centers  
for ,medicare  ,medicaid ,services2     
7,b7 entities in the private sector2 and
  7,c7 other entities that are not part 
of the ,federal ,government2 and  7#b7  
submit to the appropriate committees of 
,congress a report on-- 7,a7 the        
findings of the ,secretary with respect 
to the review conducted under paragraph 
7#a72 and  7,b7 such recommendations as 
the ,secretary may have with respect to 
the eligibility access standards under  
subsection 7a7 and the access to care   

standards under subsection 7b74  7f7    
,publication of eligibility access      
standards and wait times  7#a7 ,the     
,secretary shall publish on a publicly  
available internet website of the       
,department the eligibility access      
standards under subsection 7a74  7#b7   
7,a7 ,the ,secretary shall publish on a 
publicly available internet website of  
the ,department the average wait time   
for a veteran to schedule an appointment
 at each medical center of the          
,department for the receipt of primary  
care and specialty care1 measured from  
the date of request for the appointment 
to the date on which the care was       
provided4  7,b7 ,the ,secretary shall   
update the wait times published under   
subparagraph 7,a7 not less frequently   
than monthly4  2  7,b7 by redesignating 
subsections 7h7 and 7i7 as subsections  
7g7 and 7h71 respectively2  7,c7 in     
subsection 7g71 as redesignated by      
subparagraph 7,b7-- 7i7 in paragraph    
7#a71 by striking designated access     

standards established under this section
 and inserting eligibility access       
standards under subsection 7a72 and     
7ii7 in paragraph 7#b77;,b71 by striking
 designated access standards established
 under this section and inserting       
eligibility access standards under      
subsection 7a72 and  7,d7 in subsection 
7h71 as so redesignated1 by adding at   
the end the following new paragraphs3   
7#c7 ,the term inability to contract1   
with respect to a ,third ,party         
,administrator1 means the inability of  
the ,third ,party ,administrator to     
successfully negotiate and establish a  
community care network contract with a  
provider or facility4  7#d7 ,the term   
,third ,party ,administrator means an   
entity that manages a provider network  
and performs administrative services    
related to such network within the      
,veterans ,community ,care ,program     
under section #agjc of this title4  4   
7#b7 ,conforming amendments ,section    
#agjc7;d7 of such title is amended--    

7,a7 in paragraph 7#a77;,d71 by striking
 designated access standards developed  
by the ,secretary under section #agjc;,b
 of this title and inserting eligibility
 access standards under section         
#agjc;,b7a7 of this title2 and  7,b7 in 
paragraph 7#c71 by striking designated  
access standards developed by the       
,secretary under section #agjc;,b of    
this title and inserting eligibility    
access standards under section          
#agjc;,b7a7 of this title4  7b7         
,prevention of suspension of ,veterans  
,community ,care ,program ,section      
#agjc7;a7 of such title is amended by   
adding at the end the following new     
paragraph3  7#d7 ,nothing in this       
section shall be construed to authorize 
the ,secretary to suspend the program   
established under paragraph 7#a74  2 and
  #ajb4 ,strategic plan to ensure       
continuity of care in the case of the   
realignment of a medical facility of the
 ,department  7a7 ,sense of ,congress   
,it is the sense of ,congress that the  

,veterans ,health ,administration should
 work closely with ,third ,party        
,administrators to ensure that veterans 
do not experience a lapse of care when  
transitioning to receiving care or      
services under the ,community ,care     
,program due to the realignment of a    
medical facility of the ,department of  
,veterans ,affairs4  7b7 ,development of
 strategic plan  7#a7 ,in general ,the  
,secretary of ,veterans ,affairs1 acting
 through the ,office of ,community ,care
 and the ,office of ,veterans ,access to
 ,care of the ,department1 shall develop
 and periodically update a strategic    
plan to ensure continuity of health care
 under the ,community ,care ,program for
 veterans impacted by the realignment of
 a medical facility of the ,department4 
7#b7 ,elements ,the strategic plan      
required under paragraph 7#a7 shall     
include1 at a minimum1 the following3   
7,a7 ,an assessment of the progress of  
the ,department in identifying impending
 realignments of medical facilities of  

the ,department and the impact of such  
realignments on the network of health   
care providers under the ,community     
,care ,program within the catchment area
 of such facilities4  7,b7 ,an outline  
of collaborative actions and processes  
the ,office of ,community ,care and the 
,office of ,veterans ,access to ,care of
 the ,department can take to address    
potential gaps in health care created by
 the realignment of a medical facility  
of the ,department4  7,c7 ,a description
 of how the ,department can identify to 
,third ,party ,administrators changes in
 the catchment areas of medical         
facilities to be realigned and develop a
 process with ,third ,party             
,administrators to strengthen provider  
coverage in advance of such             
realignments4  7#c7 ,submittal to       
,congress ,not later than #ahj days     
after the date of the enactment of this 
,act1 the ,under ,secretary for ,health 
of the ,department shall submit to the  
,committee on ,veterans' ,affairs of the

 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    
,representatives the plan developed     
under paragraph 7#a74  7c7 ,definitions 
,in this section3 7#a7 ,community ,care 
,program ,the term ,community ,care     
,program means the ,veterans ,community 
,care ,program under section #agjc of   
title #ch1 ,united ,states ,code4  7#b7 
,realignment ,the term realignment1 with
 respect to a facility of the           
,department of ,veterans ,affairs1      
includes-- 7,a7 any action that changes 
the number of facilities or relocates   
services1 functions1 or personnel       
positions2 and  7,b7 strategic          
collaborations between the ,department  
and non-,federal ,government entities1  
including tribal organizations4  7#c7   
,third ,party ,administrator ,the term  
,third ,party ,administrator means an   
entity that manages a provider network  
and performs administrative services    
related to such network within the      
,veterans ,community ,care ,program     

under section #agjc of title #ch1       
,united ,states ,code4  7#d7 ,tribal    
organization ,the term tribal           
organization has the meaning given that 
term in section #d of the ,indian       
,self-,determination and ,education     
,assistance ,act 7#be ,u4,s4,c4 #ecjd74 
,b ,community care self-scheduling pilot
 program  #aaa4 ,definitions ,in this   
subtitle3 7#a7 ,appropriate             
congressional committees ,the term      
appropriate congressional committees    
means-- 7,a7 the ,committee on          
,veterans' ,affairs and the ,committee  
on ,appropriations of the ,senate2 and  
7,b7 the ,committee on ,veterans'       
,affairs and the ,committee on          
,appropriations of the ,house of        
,representatives4  7#b7 ,covered veteran
 ,the term covered veteran means a      
covered veteran under section #agjc7;b7 
of title #ch1 ,united ,states ,code4    
7#c7 ,pilot program ,the term pilot     
program means the pilot program required
 under section #aab7;a74  7#d7 ,veterans

 ,community ,care ,program ,the term    
,veterans ,community ,care ,program     
means the program to furnish hospital   
care1 medical services1 and extended    
care services to covered veterans under 
section #agjc of title #ch1 ,united     
,states ,code4  #aab4 ,pilot program    
establishing a community care           
self-scheduling appointment system  7a7 
,pilot program ,not later than #abj days
 after the date of the enactment of this
 ,act1 the ,secretary of ,veterans      
,affairs shall commence a pilot program 
under which covered veterans eligible   
for hospital care1 medical services1 or 
extended care services under subsection 
7d77#a7 of section #agjc of title #ch1  
,united ,states ,code1 may use an       
internet website or mobile application  
that has the capabilities specified in  
section #aac7;a7 to request1 schedule1  
and confirm medical appointments with   
health care providers participating in  
the ,veterans ,community ,care ,program4
  7b7 ,system expansion or development  

of new system ,in carrying out the pilot
 program1 the ,secretary may expand     
capabilities of an existing             
self-scheduling appointment system of   
the ,department of ,veterans ,affairs or
 develop a new self-scheduling system   
mobile application or internet website4 
7c7 ,contract authority for developing a
 new system  7#a7 ,in general ,if the   
,secretary elects to develop a new      
self-scheduling system under subsection 
7b71 the ,secretary shall seek to enter 
into a contract using competitive       
procedures with one or more contractors 
to provide the capabilities specified in
 section #aac7;a74  7#b7 ,notice of     
competition  7,a7 ,in general ,if the   
,secretary elects to develop a new      
system under subsection 7b71 not later  
than #fj days after the date of the     
enactment of this ,act1 the ,secretary  
shall issue a request for proposals to  
provide the capabilities specified in   
section #aac7;a74  7,b7 ,open to any    
contractor ,a request for proposals     

under subparagraph 7,a7 shall be full   
and open to any contractor that has an  
existing commercially available1        
off-the-shelf1 online patient           
self-scheduling system that includes the
 capabilities specified in section      
#aac7;a74  7#c7 ,selection ,if the      
,secretary elects to develop a new      
self-scheduling system under subsection 
7b71 not later than #abj days after the 
date of the enactment of this ,act1 the 
,secretary shall award a contract to one
 or more contractors pursuant to the    
request for proposals under paragraph   
7#b77;,a74  7d7 ,selection of locations 
,the ,secretary shall select not fewer  
than five ,veterans ,integrated         
,services ,networks of the ,department  
in which to carry out the pilot program4
  7e7 ,duration of pilot program  7#a7  
,in general ,except as provided in      
paragraph 7#b71 the ,secretary shall    
carry out the pilot program for an      
#ah-month period4  7#b7 ,extension ,the 
,secretary may extend the duration of   

the pilot program and may expand the    
selection of ,veterans ,integrated      
,services ,networks under subsection 7d7
 if the ,secretary determines that the  
pilot program is reducing the wait times
 of veterans seeking hospital care1     
medical services1 or extended care      
services under the ,veterans ,community 
,care ,program4  7f7 ,outreach ,the     
,secretary shall ensure that veterans   
participating in the ,veterans          
,community ,care ,program in ,veterans  
,integrated ,services ,networks in which
 the pilot program is being carried out 
are informed about the pilot program4   
7g7 ,mobile application defined ,in this
 section1 the term mobile application   
means a software program that runs on   
the operating system of a cellular      
telephone1 tablet computer1 or similar  
portable computing device that transmits
 data over a wireless connection4  #aac4
 ,capabilities of self-scheduling       
appointment system  7a7 ,minimum        
capabilities ,the ,secretary of         

,veterans ,affairs shall ensure that the
 self-scheduling appointment system used
 in the pilot program includes1 at a    
minimum1 the following capabilities3    
7#a7 ,capability to request1 schedule1  
modify1 and cancel appointments for     
primary care1 specialty care1 and mental
 health care under the ,veterans        
,community ,care ,program with regard to
 each category of eligibility under     
section #agjc7;d77#a7 of title #ch1     
,united ,states ,code4  7#b7 ,capability
 to support appointments for the        
provision of health care under the      
,veterans ,community ,care ,program     
regardless of whether such care is      
provided in person or through telehealth
 services4  7#c7 ,capability to view    
appointment availability in real time to
 the extent practicable4  7#d7          
,capability to load relevant patient    
information from the ,decision ,support 
,tool of the ,department or any other   
information technology system of the    
,department used to determine the       

eligibility of veterans for health care 
under section #agjc7;d77#a7 of title    
#ch1 ,united ,states ,code4  7#e7       
,capability to search for providers and 
facilities participating in the         
,veterans ,community ,care ,program     
based on distance from the residential  
address of a veteran4  7#f7 ,capability 
to provide telephonic and electronic    
contact information for all such        
providers that do not offer online      
scheduling at the time4  7#g7           
,capability to store and print          
authorization letters for veterans for  
health care under the ,veterans         
,community ,care ,program4  7#h7        
,capability to provide prompts or       
reminders to veterans to schedule       
initial appointments or follow-up       
appointments4  7#i7 ,capability to be   
used #bd hours per day1 seven days per  
week4  7#aj7 ,capability to integrate   
with the ,veterans ,health ,information 
,systems and ,technology ,architecture  
of the ,department1 or any successor    

information technology system of the    
,department4  7#aa7 ,capability to      
integrate with information technology   
systems of ,third ,party                
,administrators4  7b7 ,independent      
validation and verification  7#a7       
,independent entity  7,a7 ,in general   
,the ,secretary shall seek to enter into
 an agreement with an appropriate       
nongovernmental1 not-for-profit entity  
with expertise in health information    
technology to independently validate and
 verify that the self-scheduling        
appointment system used in the pilot    
program includes the capabilities       
specified in subsection 7a74  7,b7      
,timing ,the independent validation and 
verification conducted under            
subparagraph 7,a7 shall be completed    
before the fielding of the              
self-scheduling appointment system used 
in the pilot program to the first       
,veterans ,integrated ,services ,network
 of the ,department in which the pilot  
program is to be carried out4  7#b7     

,,gao evaluation  7,a7 ,in general ,the 
,comptroller ,general of the ,united    
,states shall evaluate the validation   
and verification conducted under        
paragraph 7#a74  7,b7 ,report ,not later
 than #cj days after the date on which  
the ,comptroller ,general completes the 
evaluation under paragraph 7#a71 the    
,comptroller ,general shall submit to   
the appropriate congressional committees
 a report on such evaluation4  7c7      
,certification  7#a7 ,capabilities      
included ,not later than ,may #ca1      
#bjbb1 the ,secretary shall certify to  
the ,committee on ,veterans' ,affairs of
 the ,senate and the ,committee on      
,veterans' ,affairs of the ,house of    
,representatives that the               
self-scheduling appointment system used 
in the pilot program and any other      
patient self-scheduling appointment     
system developed or used by the         
,department of ,veterans ,affairs as of 
the date of the certification to        
schedule appointments under the         

,veterans ,community ,care ,program     
includes the capabilities specified in  
subsection 7a74  7#b7 ,new systems ,if  
the ,secretary develops a new           
self-scheduling appointment system to   
schedule appointments under the         
,veterans ,community ,care ,program that
 is not covered by a certification made 
under paragraph 7#a71 the ,secretary    
shall certify to the ,committee on      
,veterans' ,affairs of the ,senate and  
the ,committee on ,veterans' ,affairs of
 the ,house of ,representatives that    
such new system includes the            
capabilities specified in subsection 7a7
 by not later than the date that is #cj 
days after the date on which the        
,secretary determines to replace the    
previous self-scheduling appointment    
system4  7#c7 ,replacement of systems   
not certified ,if the ,secretary does   
not make a timely certification under   
paragraph 7#a7 or paragraph 7#b71 as the
 case may be1 the ,secretary shall      
replace any self-scheduling appointment 

system used by the ,secretary to        
schedule appointments under the         
,veterans ,community ,care ,program that
 is in use with a commercially          
available1 off-the-shelf1 online        
self-scheduling appointment system that 
includes the capabilities specified in  
subsection 7a74  7d7 ,third ,party      
,administrator defined ,in this section1
 the term ,third ,party ,administrator  
means an entity that manages a provider 
network and performs administrative     
services related to such network within 
the ,veterans ,community ,care ,program 
under section #agjc of title #ch1       
,united ,states ,code4  #aad4 ,report   
,not later than #ahj days after the date
 of the enactment of this ,act1 and     
every #ahj days thereafter1 the         
,secretary of ,veterans ,affairs shall  
submit to the appropriate congressional 
committees a report that includes-- 7#a7
 an assessment by the ,secretary of the 
pilot program during the #ahj-;day      
period preceding the date of the report1

 including-- 7,a7 the cost of the pilot 
program2  7,b7 the volume of usage of   
the self-scheduling appointment system  
under the pilot program2  7,c7 the      
quality of the pilot program2  7,d7     
patient satisfaction with the pilot     
program2  7,e7 benefits to veterans of  
using the pilot program2  7,f7 the      
feasibility of allowing self-scheduling 
for different specialties under the     
pilot program2  7,g7 participating in   
the pilot program by health care        
providers under the ,veterans ,community
 ,care ,program2 and  7,h7 such other   
findings and conclusions with respect to
 the pilot program as the ,secretary    
considers appropriate2 and  7#b7 such   
recommendations as the ,secretary       
considers appropriate regarding-- 7,a7  
extension of the pilot program to other 
or all ,veterans ,integrated ,service   
,networks of the ,department of         
,veterans ,affairs2 and  7,b7 making the
 pilot program permanent4  ,c           
,non-,department of ,veterans ,affairs  

providers  #aba4 ,credentialing         
verification requirements for providers 
of non-,department of ,veterans ,affairs
 health care services  7a7              
,credentialing verification requirements
  7#a7 ,in general ,subchapter ,i of    
chapter #ag of title #ch1 ,united       
,states ,code1 is amended by inserting  
after section #agjc;,e the following new
 section3  #agjc;,f4 ,credentialing     
verification requirements for providers 
of non-,department health care services 
7a7 ,in general ,the ,secretary shall   
ensure that ,third ,party               
,administrators and credentials         
verification organizations comply with  
the requirements specified in subsection
 7b7 to help ensure certain health care 
providers are excluded from providing   
non-,department health care services4   
7b7 ,requirements specified ,the        
,secretary shall require ,third ,party  
,administrators and credentials         
verification organizations to carry out 
the following3 7#a7 ,hold and maintain  

an active credential verification       
accreditation from a national health    
care accreditation body4  7#b7 ,conduct 
initial verification of provider history
 and license sanctions for all ,states  
and ,united ,states territories for a   
period of time-- 7,a7 that includes the 
period before the provider began        
providing non-,department health care   
services2 and  7,b7 dating back not less
 than #aj years4  7#c7 ,not less        
frequently than every three years1      
perform recredentialing1 including      
verifying provider history and license  
sanctions for all ,states and ,united   
,states territories4  7#d7 ,implement   
continuous monitoring of each provider  
through the ,national ,practitioner     
,data ,bank established pursuant to the 
,health ,care ,quality ,improvement ,act
 of #aihf 7#db ,u4,s4,c4 #aaaja et      
seq474  7c7 ,definitions ,in this       
section3 7#a7 ,the term credentials     
verification organization means an      
entity that manages the provider        

credentialing process and performs      
credentialing verification for          
non-,department providers that          
participate in the ,veterans ,community 
,care ,program under section #agjc of   
this title through a ,veterans ,care    
,agreement4  7#b7 ,the term ,third      
,party ,administrator means an entity   
that manages a provider network and     
performs administrative services related
 to such network within the ,veterans   
,community ,care ,program under section 
#agjc of this title4  7#c7 ,the term    
,veterans ,care ,agreement means an     
agreement for non-,department health    
care services entered into under section
 #agjc;,a of this title4  7#d7 ,the term
 non-,department health care services   
means services-- 7,a7 provided under    
this subchapter at non-,department      
facilities 7as defined in section #agja 
of this title72  7,b7 provided under    
section #aja of the ,veterans ,access1  
,choice1 and ,accountability ,act of    
#bjad 7,public ,law #aac-adf2 #ch       

,u4,s4,c4 #agja note72  7,c7 purchased  
through the ,medical ,community ,care   
account of the ,department2 or  7,d7    
purchased with amounts deposited in the 
,veterans ,choice ,fund under section   
#hjb of the ,veterans ,access1 ,choice1 
and ,accountability ,act of #bjad       
7,public ,law #aac-adf2 #ch ,u4,s4,c4   
#agja note74  4  7#b7 ,clerical         
amendment ,the table of sections at the 
beginning of such subchapter is amended 
by inserting after the item relating to 
section #agjc;,e the following new item3
  #agjc;,f4 ,credentialing verification 
requirements for providers of           
non-,department health care services4  4
  7b7 ,deadline for implementation ,not 
later than #ahj days after the date of  
the enactment of this ,act1 the         
,secretary of ,veterans ,affairs shall  
commence the implementation of section  
#agjc;,f of title #ch1 ,united ,states  
,code1 as added by subsection 7a77#a74  
#abb4 ,inapplicability of certain       
providers to provide non-,department of 

,veterans ,affairs care ,section #ajh of
 the ,,va ,,mission ,act of #bjah       
7,public ,law #aae-ahb2 #ch ,u4,s4,c4   
#agja note7 is amended-- 7#a7 by        
redesignating subsections 7d7 and 7e7 as
 subsections 7e7 and 7f71 respectively2 
and  7#b7 by inserting after subsection 
7c7 the following new subsection 7d73   
7d7 ,application ,the requirement to    
deny or revoke the eligibility of a     
health care provider to provide         
non-,department health care services to 
veterans under subsection 7a7 shall     
apply to any removal under paragraph    
7#a7 of such subsection or violation    
under paragraph 7#b7 of such subsection 
that occurred on or after the date that 
is five years before the date of the    
enactment of this ,act4  4  ,,ii        
,improvement of rural health and        
telehealth  #bja4 ,establishment of     
strategic plan requirement for ,office  
of ,connected ,care of ,department of   
,veterans ,affairs  7a7 ,findings       
,congress makes the following findings3 

7#a7 ,the ,,covid-#ai pandemic caused   
the ,department of ,veterans ,affairs to
 exponentially increase telehealth and  
virtual care modalities1 including ,,va 
,video ,connect1 to deliver health care 
services to veteran patients4  7#b7     
,between ,january #bjbj and ,january    
#bjba1 the number of telehealth         
appointments offered by the ,department 
increased by #a1hca percent4  7#c7 ,the 
,department maintains strategic         
partnerships1 such as the ,digital      
,divide ,consult1 with a goal of        
ensuring veterans who reside in rural1  
highly rural1 or medically underserved  
areas have access to high-quality       
telehealth services offered by the      
,department4  7#d7 ,as of #bjai1        
veterans who reside in rural and highly 
rural areas make up approximately       
#a_/cof veteran enrollees in the patient
 enrollment system1 and are on average1 
older than their veteran peers in ubran 
areas1 experience higher degrees of     
financial instability1 and live with a  

greater number of complex health needs  
and comorbidities4  7#e7 ,the ,federal  
,communications ,commission estimated in
 #bjbj that #ae percent of veteran      
households do not have an internet      
connection4  7#f7 ,under the            
,coronavirus ,aid1 ,relief1 and         
,economic ,security ,act 7,public ,law  
#aaf-acf71 ,congress granted the        
,department additional authority to     
enter into short-term agreements or     
contracts with private sector           
telecommunications companies to provide 
certain broadband services for the      
purposes of providing expanded mental   
health services to isolated veterans    
through telehealth or ,,va ,video       
,connect during a public health         
emergency4  7#g7 ,the authority         
described in paragraph 7#f7 was not     
utilized to the fullest extent by the   
,department4  7#h7 ,though the          
,department has made significant        
progress in expanding telehealth        
services offered to veterans who are    

enrolled in the patient enrollment      
system1 significant gaps still exist to 
ensure all veterans receive equal and   
high-quality access to virtual care4    
7#i7 ,questions regarding the efficacy  
of using telehealth for certain health  
care services and specialities remain1  
and should be further studied4  7#aj7   
,the ,department continues to expand    
telehealth and virtual care offerings   
for primary care1 mental health care1   
specialty care1 urgent care1 and even   
remote intensive care units4  7b7 ,sense
 of ,congress ,it is the sense of       
,congress that the telehealth services  
offered by the ,department of ,veterans 
,affairs should be routinely measured   
and evaluated to ensure the telehealth  
technologies and modalities delivered to
 veteran patients to treat a wide       
variety of health conditions are as     
effective as in-person treatment for    
primary care1 mental health care1 and   
other forms of specialty care4  7c7     
,development of strategic plan  7#a7 ,in

 general ,not later than one year after 
the date of the enactment of this ,act1 
the ,secretary of ,veterans ,affairs1   
acting through the ,office of ,connected
 ,care of the ,department of ,veterans  
,affairs1 shall develop a strategic plan
 to ensure the effectiveness of the     
telehealth technologies and modalities  
delivered by the ,department to veterans
 who are enrolled in the patient        
enrollment system4  7#b7 ,update  7,a7  
,in general ,the ,secretary shall update
 the strategic plan required under      
paragraph 7#a7 not less frequently than 
once every three years following        
development of the plan4  7,b7          
,consultation ,the ,secretary shall     
prepare any update required under       
subparagraph 7,a7 in consultation with  
the following3 7i7 ,the ,chief ,officer 
of the ,office of ,connected ,care of   
the ,department4  7ii7 ,the ,executive  
,director of ,telehealth ,services of   
the ,office of ,connected ,care4  7iii7 
,the ,executive ,director of ,connected 

,health of the ,office of ,connected    
,care4  7iv7 ,the ,executive ,director  
of the ,office of ,rural ,health of the 
,department4  7v7 ,the ,executive       
,director of ,solution ,delivery1 ,,it  
,operations and ,services of the ,office
 of ,information and ,technology of the 
,department4  7#c7 ,elements ,the       
strategic plan required under paragraph 
7#a71 and any update to that plan under 
paragraph 7#b71 shall include1 at a     
minimum1 the following3 7,a7 ,a         
comprehensive list of all health care   
specialities the ,department is         
currently delivering by telehealth or   
virtual care4  7,b7 ,an assessment of   
the effectiveness and patient outcomes  
for each type of health care speciality 
delivered by telehealth or virtual care 
by the ,department4  7,c7 ,an assessment
 of satisfaction of veterans in         
receiving care through telehealth or    
virtual care disaggregated by age group 
and by ,veterans ,integrated ,service   
,network4  7,d7 ,an assessment of the   

percentage of virtual visits delivered  
by the ,department through each modality
 including standard telephone           
telehealth1 ,,va ,video ,connect1 and   
the ,accessing ,telehealth through      
,local ,area ,stations program of the   
,department4  7,e7 ,an outline of all   
current partnerships maintained by the  
,department to bolster telehealth or    
virtual care services for veterans4     
7,f7 ,an assessment of the barriers     
faced by the ,department in delivering  
telehealth or virtual care services to  
veterans residing in rural and highly   
rural areas1 and the strategies the     
,department is deploying beyond         
purchasing hardware for veterans who are
 enrolled in the patient enrollment     
system4  7,g7 ,a detailed plan          
illustrating how the ,department is     
working with other ,federal agencies1   
including the ,department of ,health and
 ,human ,services1 the ,department of   
,agriculture1 the ,federal              
,communications ,commission1 and the    

,national ,telecommunications and       
,information ,administration1 to enhance
 connectivity in rural1 highly rural1   
and medically underserved areas to      
better reach all veterans4  7,h7 ,the   
feasibility and advisability of         
partnering with ,federally qualified    
health centers1 rural health clinics1   
and critical access hospitals to fill   
the gap for health care services that   
exists for veterans who reside in rural 
and highly rural areas4  7,i7 ,an       
evaluation of the number of veterans who
 are enrolled in the patient enrollment 
system who have previously received care
 under the ,veterans ,community ,care   
,program under section #agjc of title   
#ch1 ,united ,states ,code4  7d7        
,submittal to ,congress ,not later than 
#ahj days after the development of the  
strategic plan under paragraph 7#a7 of  
subsection 7c71 and not later than #ahj 
days after each update under paragraph  
7#b7 of such subsection thereafter1 the 
,secretary shall submit to the          

,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    
,representatives a report that includes 
the following3 7#a7 ,the completed      
strategic plan or update1 as the case   
may be4  7#b7 ,an identification of     
areas of improvement by the ,department 
in the delivery of telehealth and       
virtual care services to veterans who   
are enrolled in the patient enrollment  
system1 with a timeline for improvements
 to be implemented4  7e7 ,definitions   
7#a7 ,patient enrollment system ,the    
term patient enrollment system means the
 system of annual patient enrollment of 
the ,department of ,veterans ,affairs   
established and operated under section  
#agje7;a7 of title #ch1 ,united ,states 
,code4  7#b7 ,rural2 highly rural ,the  
terms rural and highly rural have the   
meanings given those terms in the       
,rural-,urban ,commuting ,areas coding  
system of the ,department of            
,agriculture4  7#c7 ,,va ,video ,connect

 ,the term ,,va ,video ,connect means   
the program of the ,department of       
,veterans ,affairs to connect veterans  
with their health care team from        
anywhere1 using encryption to ensure a  
secure and private connection4  7#d7    
,veteran ,the term veteran has the      
meaning given that term in section      
#aja7b7 of title #ch1 ,united ,states   
,code4  #bjb4 ,comptroller ,general     
report on transportation services by    
third parties for rural veterans  7a7   
,report required ,not later than one    
year after the date of the enactment of 
this ,act1 the ,comptroller ,general of 
the ,united ,states shall submit to the 
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    
,representatives a report on the program
 established under section #aaa;,a7b7 of
 title #ch1 ,united ,states ,code4  7b7 
,contents ,the report submitted under   
subsection 7a7 shall include the        
following3 7#a7 ,a description of the   

program described in such subsection1   
including descriptions of the following3
 7,a7 ,the purpose of the program4  7,b7
 ,the activities carried out under the  
program4  7#b7 ,an assessment of the    
sufficiency of the program with respect 
to the purpose of the program4  7#c7 ,an
 assessment of the cost effectiveness of
 the program in comparison to           
alternatives4  7#d7 ,an assessment of   
the health benefits for veterans who    
have participated in the program4  7#e7 
,an assessment of the sufficiency of    
staffing of employees of the ,department
 of ,veterans ,affairs who are          
responsible for facilitating the        
maintenance of the program4  7#f7 ,an   
assessment1 with respect to the purpose 
of the program1 of the number of        
vehicles owned by and operating in      
conjunction with the program4  7#g7 ,an 
assessment of the awareness and usage of
 the program by veterans and their      
families4  7#h7 ,an assessment of other 
options for transportation under the    

program1 such as local taxi companies   
and ridesharing programs such as ,uber  
and ,lyft4  #bjc4 ,comptroller ,general 
report on telehealth services of the    
,department of ,veterans ,affairs  7a7  
,in general ,not later than #ah months  
after the date of the enactment of this 
,act1 the ,comptroller ,general of the  
,united ,states shall submit to the     
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    
,representatives a report on telehealth 
services provided by the ,department of 
,veterans ,affairs4  7b7 ,elements ,the 
report required by subsection 7a7 shall 
include an assessment of the following3 
7#a7 ,the telehealth and virtual health 
care programs of the ,department of     
,veterans ,affairs1 including ,,va      
,video ,connect4  7#b7 ,the challenges  
faced by the ,department in delivering  
telehealth and virtual health care to   
veterans who reside in rural and highly 
rural areas due to lack of connectivity 

in many rural areas4  7#c7 ,any         
mitigation strategies used by the       
,department to overcome connectivity    
barriers for veterans who reside in     
rural and highly rural areas4  7#d7 ,the
 partnerships entered into by the       
,office of ,connected ,care of the      
,department in an effort to bolster     
telehealth services4  7#e7 ,the extent  
to which the ,department has examined   
the effectiveness of health care        
services provided to veterans through   
telehealth in comparison to in-person   
treatment4  7#f7 ,satisfaction of       
veterans with respect to the telehealth 
services provided by the ,department4   
7#g7 ,the use by the ,department of     
telehealth appointments in comparison to
 referrals to care under the ,veterans  
,community ,care ,program under section 
#agjc of title #ch1 ,united ,states     
,code4  7#h7 ,such other areas as the   
,comptroller ,general considers         
appropriate4  ,,iii ,foreign ,medical   
,program  #cja4 ,analysis of feasibility

 and advisability of expanding          
assistance and support to caregivers to 
include caregivers of veterans in the   
,republic of the ,philippines  7a7      
,findings ,congress makes the following 
findings3 7#a7 ,although section #afa of
 the ,,va ,,mission ,act of #bjah       
7,public ,law #aae-ahb2 #acb ,stat4     
#adch7 expanded the program of          
comprehensive assistance for family     
caregivers of the ,department of        
,veterans ,affairs under section        
#agbj;,g7a7 of title #ch1 ,united       
,states ,code1 to veterans of all eras1 
it did not expand the program to family 
caregivers for veterans overseas4  7#b7 
,although caregivers for veterans       
overseas can access online resources as 
part of the program of support services 
for caregivers of veterans under        
subsection 7b7 section #agbj;,g of such 
title1 those caregivers miss out on all 
of the comprehensive services and       
benefits provided under subsection 7a7  
of such section4  7#c7 ,the ,department 

has an outpatient clinic and a regional 
benefits office in ,manila1 ,republic of
 the ,philippines1 and the ,foreign     
,medical ,program of the ,department    
under section #agbd of such title is    
used heavily in the ,republic of the    
,philippines by veterans who live in    
that country4  7#d7 ,due to the presence
 of facilities of the ,department in the
 ,republic of the ,philippines and the  
number of veterans who reside there1    
that country is a suitable test case to 
analyze the feasibility and advisability
 of expanding caregiver support to      
caregivers of veterans overseas4  7b7   
,analysis ,not later than #ahj days     
after the date of the enactment of this 
,act1 the ,secretary of ,veterans       
,affairs shall complete an analysis of  
the feasibility and advisability of     
making assistance and support under     
section #agbj;,g7a7 of title #ch1       
,united ,states ,code1 available to     
caregivers of veterans in the ,republic 
of the ,philippines4  7c7 ,report ,not  

later than #ahj days after the          
conclusion of the analysis conducted    
under subsection 7b71 the ,secretary    
shall submit to the ,committee on       
,veterans' ,affairs of the ,senate and  
the ,committee on ,veterans' ,affairs of
 the ,house of ,representatives a report
 that includes the following3 7#a7 ,the 
results of such analysis4  7#b7 ,an     
assessment of the number of veterans who
 are enrolled in the patient enrollment 
system and reside in the ,republic of   
the ,philippines4  7#c7 ,an assessment  
of the number of veterans who are       
enrolled in the patient enrollment      
system and reside in the ,republic of   
the ,philippines that have a caregiver  
to provide them personal care services  
described in section #agbj;,g7a77,c7 of 
title #ch1 ,united ,states ,code4  7#d7 
,an assessment of the staffing needs and
 associated cost of making assistance   
and support to available to caregivers  
of veterans in the ,republic of the     
,philippines4  7d7 ,definitions ,in this

 section3 7#a7 ,caregiver ,the term     
caregiver has the meaning given that    
term in section #agbj;,g7d7 of title    
#ch1 ,united ,states ,code4  7#b7       
,patient enrollment system ,the term    
patient enrollment system means the     
system of annual patient enrollment of  
the ,department of ,veterans ,affairs   
established and operated under section  
#agje7;a7 of such title4  7#c7 ,veteran 
,the term veteran has the meaning given 
that term in section #aja7b7 of such    
title4  #cjb4 ,comptroller ,general     
report on ,foreign ,medical ,program of 
,department of ,veterans ,affairs  7a7  
,in general ,not later than two years   
after the date of the enactment of this 
,act1 the ,comptroller ,general of the  
,united ,states shall submit to the     
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    
,representatives a report on the        
,foreign ,medical ,program4  7b7        
,elements ,the report required by       

subsection 7a7 shall include1 for the   
most recent five fiscal years for which 
data are available1 an assessment of the
 following3 7#a7 ,the number of veterans
 who live overseas and are eligible for 
the ,foreign ,medical ,program4  7#b7   
,the number of veterans who live        
overseas1 are registered for the        
,foreign ,medical ,program1 and use such
 program4  7#c7 ,the number of veterans 
who live overseas1 are registered for   
the ,foreign ,medical ,program1 and do  
not use such program4  7#d7 ,the number 
of veterans who are eligible for care   
furnished by the ,department of         
,veterans ,affairs1 live in the ,united 
,states1 including territories of the   
,united ,states1 and make use of such   
care1 including through the ,veterans   
,community ,care ,program under section 
#agjc of title #ch1 ,united ,states     
,code4  7#e7 ,any challenges faced by   
the ,department in administering the    
,foreign ,medical ,program1 including-- 
7,a7 outreach to veterans on eligibility

 for such program and ensuring veterans 
who live overseas are aware of such     
program2  7,b7 executing timely         
reimbursements of claims by veterans    
under such program2 and  7,c7 need for  
and use of translation services4  7#f7  
,any trends relating to-- 7,a7 the      
timeliness of processing by the         
,department of claims under the ,foreign
 ,medical ,program and reimbursement of 
veterans under such program2  7,b7 types
 of care or treatment sought by veterans
 who live overseas that is reimbursed   
under such program2 and  7,c7 types of  
care or treatment eligible for          
reimbursement under such program that   
veterans have difficulty accessing      
overseas4  7#g7 ,any barriers or        
obstacles cited by veterans who live    
overseas who are registered for the     
,foreign ,medical ,program1 including   
any differences between veterans who use
 the program and veterans who do not4   
7#h7 ,satisfaction of veterans who live 
overseas with the ,foreign ,medical     

,program4  7#i7 ,such other areas as the
 ,comptroller ,general considers        
appropriate4  7c7 ,foreign ,medical     
,program defined ,in this section1 the  
term ,foreign ,medical ,program means   
the program under with the ,secretary of
 ,veterans ,affairs provides hospital   
care and medical services under section 
#agbd of title #ch1 ,united ,states     
,code4  ,,iv ,mental health care  #dja4 
,analysis of feasibility and            
advisability of ,department of ,veterans
 ,affairs providing evidence-based      
treatments for the diagnosis of         
treatment-resistant depression  7a7     
,findings ,congress makes the following 
findings3 7#a7 ,a systematic review in  
#bjai of the economics and quality of   
life relating to treatment-resistant    
depression summarized that major        
depressive disorder 7in this subsection 
referred to as ,,mdd7 is a global public
 health concern and that                
treatment-resistant depression in       
particular represents a key unmet need4 

,the findings of that review highlighted
 the need for improved therapies for    
treatment-resistant depression to reduce
 disease burden1 lower medical costs1   
and improve the quality of life of      
patients4  7#b7 ,the ,clinical ,practice
 ,guideline for the ,management of ,,mdd
 7in this subsection referred to as the 
,,cpg7 developed jointly by the         
,department of ,veterans ,affairs and   
the ,department of ,defense defines     
treatment-resistant depression as at    
least two adequate treatment trials and 
lack of full response to each4  7#c7    
,the ,,cpg recommends electro-convulsive
 therapy 7in this subsection referred to
 as ,,ect7 as a treatment strategy for  
patients who have failed multiple other 
treatment strategies4  7#d7 ,the ,,cpg  
recommends offering repetitive          
transcranial magnetic stimulation 7in   
this subsection referred to as r,t,m,s71
 an intervention that is indicated by   
the ,food and ,drug ,administration1 for
 treatment during a major depressive    

episode in patients with                
treatment-resistant ,,mdd4  7#e7 ,the   
final report of the ,creating ,options  
for ,veterans' ,expedited ,recovery     
,commission 7commonly referred to as the
 ,,cover ,commission7 established under 
section #ica of the ,jason ,simcakoski  
,memorial and ,promise ,act 7title ,,ix 
of ,public ,law #aad-aih2 #ch ,u4,s4,c4 
#agja note7 found that                  
treatment-resistant depression is a     
major issue throughout the mental health
 treatment system1 and that an estimated
 #ej percent of depressed patients are  
inadequately treated by available       
interventions4  7#f7 ,the ,,cover       
,commission also reported data collected
 from the ,department of ,veterans      
,affairs that found that only           
approximately #a1aff patients throughout
 the ,department were referred for ,,ect
 in #bjah and only approximately #ggb   
patients were referred for r,t,m,s      
during that year4  7b7 ,analysis ,not   
later than #ahj days after the date of  

the enactment of this ,act1 the         
,secretary of ,veterans ,affairs shall  
complete an analysis of the feasibility 
and advisability of making repetitive   
transcranial magnetic stimulation       
available at all medical facilities of  
the ,department of ,veterans ,affairs   
and electro-convulsive therapy available
 at one medical center located within   
each ,veterans ,integrated ,service     
,network for the treatment of veterans  
who are enrolled in the patient         
enrollment system and have a diagnosis  
of treatment-resistant depression4  7c7 
,inclusion of assessment of report ,the 
analysis conducted under subsection 7b7 
shall include an assessment of the final
 report of the ,,cover ,commission      
submitted under section #ica7;e77#b7 of 
the ,jason ,simcakoski ,memorial and    
,promise ,act 7title ,,ix of ,public    
,law #aad-aih2 #ch ,u4,s4,c4 #agja      
note74  7d7 ,report ,not later than #ahj
 days after the conclusion of the       
analysis conducted under subsection 7b71

 the ,secretary shall submit to the     
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    
,representatives a report that includes 
the following3 7#a7 ,the results of such
 analysis4  7#b7 ,an assessment of the  
number of veterans who are enrolled in  
the patient enrollment system and who   
have a diagnosis of treatment-resistant 
depression per ,veterans ,integrated    
,service ,network during the two-year   
period preceding the date of the report4
  7#c7 ,an assessment of the number of  
the veterans who are enrolled in the    
patient enrollment system who have a    
diagnosis of treatment-resistant        
depression and who have received or are 
currently receiving repetitive          
transcranial magnetic stimulation or    
electro-convulsive therapy as a         
treatment modality during the two-year  
period preceding the date of the report4
  7#d7 ,an assessment of the number and 
locations of medical centers of the     

,department that currently provide      
repetitive transcranial magnetic        
stimulation to veterans who are enrolled
 in the patient enrollment system and   
who have a diagnosis of                 
treatment-resistant depression4  7#e7   
,an assessment of the number and        
locations of medical centers of the     
,department that currently provide      
electro-convulsive therapy to veterans  
who are enrolled in the patient         
enrollment system and who have a        
diagnosis of treatment-resistant        
depression4  7e7 ,definitions ,in this  
section3 7#a7 ,patient enrollment system
 ,the term patient enrollment system    
means the system of annual patient      
enrollment of the ,department of        
,veterans ,affairs established and      
operated under section #agje7;a7 of     
title #ch1 ,united ,states ,code4  7#b7 
,veteran ,the term veteran has the      
meaning given that term in section      
#aja7b7 of title #ch1 ,united ,states   
,code4  #djb4 ,modification of resource 

allocation system to include peer       
specialists  7a7 ,in general ,not later 
than one year after the date of the     
enactment of this ,act1 the ,secretary  
of ,veterans ,affairs shall modify the  
,veterans ,equitable ,resource          
,allocation system1 or successor system1
 to ensure that resource allocations    
under such system1 or successor system1 
include peer specialists appointed under
 section #gdjb7;b77#ac7 of title #ch1   
,united ,states ,code4  7b7 ,veterans   
,equitable ,resource ,allocation system 
defined ,in this section1 the term      
,veterans ,equitable ,resource          
,allocation system means the resource   
allocation system established pursuant  
to section #dbi of the ,departments of  
,veterans ,affairs and ,house and ,urban
 ,development1 and ,independent         
,agencies ,appropriations ,act1 #aiig   
7,public ,law #ajd-bjd2 #aaj ,stat4     
#bibi74  #djc4 ,gap analysis of         
psychotherapeutic interventions of the  
,department of ,veterans ,affairs  7a7  

,in general ,not later than #bgj days   
after the date of the enactment of this 
,act1 the ,secretary of ,veterans       
,affairs shall complete a gap analysis  
throughout the entire health care system
 of the ,veterans ,health               
,administration on the use and          
availability of psychotherapeutic       
interventions recommended in widely used
 clinical practice guidelines as        
recommended in the final report of the  
,,cover ,commission submitted under     
section #ica7;e77#b7 of the ,jason      
,simcakoski ,memorial and ,promise ,act 
7title ,,ix of ,public ,law #aad-aih2   
#ch ,u4,s4,c4 #agja note74  7b7         
,elements ,the gap analysis required    
under subsection 7a7 shall include the  
following3 7#a7 ,an assessment of the   
psychotherapeutic interventions         
available and routinely delivered to    
veterans at medical centers of the      
,department of ,veterans ,affairs within
 each ,veterans ,integrated ,service    
,network of the ,department4  7#b7 ,an  

assessment of the barriers faced by     
medical centers of the ,department in   
offering certain psychotherapeutic      
interventions and why those             
interventions are not widely implemented
 or are excluded from implementation    
throughout the entire health care system
 of the ,veterans ,health               
,administration4  7c7 ,report and plan  
,not later than #ahj days after         
completing the gap analysis under       
subsection 7a71 the ,secretary shall    
submit to the ,committee on ,veterans'  
,affairs of the ,senate and the         
,committee on ,veterans' ,affairs of the
 ,house of ,representatives-- 7#a7 a    
report on the results of the analysis2  
and  7#b7 a plan with measurable1       
time-limited steps for the ,department  
to implement-- 7,a7 to address the gaps 
that limit access of veterans to care2  
and  7,b7 to treat various mental health
 conditions across the entire health    
care system of the ,veterans ,health    
,administration4  ,v ,other matters     

#eja4 ,online health care education     
portal  7a7 ,in general ,not later than 
#ahj days after the date of the         
enactment of this ,act1 the ,secretary  
of ,veterans ,affairs shall establish an
 online health care education portal to 
ensure veterans enrolled in the patient 
enrollment system of the ,department of 
,veterans ,affairs under section        
#agje7;a7 of title #ch1 ,united ,states 
,code1 are aware of the health care     
services provided by the ,department and
 understand their basic health care     
entitlements under the laws administered
 by the ,secretary4  7b7 ,interactive   
modules  7#a7 ,in general ,the health   
care education portal established under 
subsection 7a7 shall include1 at a      
minimum1 interactive online educational 
modules on the following3 7,a7 ,health  
care from the ,veterans ,health         
,administration in the community1       
including under the ,veterans ,community
 ,care ,program under section #agjc of  
title #ch1 ,united ,states ,code4  7,b7 

,telehealth services4  7,c7 ,the appeals
 process for the ,veterans ,health      
,administration4  7,d7 ,patient aligned 
care teams4  7,e7 ,mental health care   
services4  7,f7 ,suicide prevention     
services4  7,g7 ,specialty care         
services4  7,h7 ,dental health services4
  7,i7 ,women's health services4  7,j7  
,navigating the publicly accessible     
internet websites and mobile            
applications of the ,veterans ,health   
,administration4  7,k7 ,vaccinations    
offered through the ,veterans ,health   
,administration4  7,l7 ,toxic exposure4 
7,m7 ,military sexual trauma4  7,n7     
,topics set forth under section #aba7;b7
 of the ,,va ,,mission ,act of #bjah    
7,public ,law #aae-ahb2 #ch ,u4,s4,c4   
#agja note74  7#b7 ,module updates ,the 
,secretary shall update the curriculum  
content of the modules described in     
paragraph 7#a7 not less frequently than 
annually to ensure such modules contain 
the most current information on the     
module topic4  7c7 ,health care         

education portal requirements ,the      
,secretary shall ensure that the health 
care education portal established under 
subsection 7a7 meets the following      
requirements3 7#a7 ,the portal is       
directly accessible from-- 7,a7 ,the    
main home page of the publicly          
accessible internet website of the      
,department2 and  7,b7 ,the main home   
page of the publicly accessible internet
 website of each medical center of the  
,department4  7#b7 ,the portal is easily
 understandable and usable by the       
general public4  7d7 ,print material ,in
 developing the health care education   
portal established under subsection 7a71
 the ,secretary shall ensure that       
materials included in such portal are   
accessible in print format at each      
medical center of the ,department to    
veterans who may not have access to the 
internet4  7e7 ,consultation and        
contract authority ,in carrying out the 
health care education portal established
 under subsection 7a71 the ,secretary-- 

7#a7 shall consult with organizations   
recognized by the ,secretary for the    
representation of veterans under section
 #eijb of title #ch1 ,united ,states    
,code2 and  7#b7 may enter into a       
contract with a company1 non-profit     
entity1 or other entity specializing in 
development of educational programs to  
design the portal and the curriculum for
 modules under subsection 7b74  7f7     
,report ,not later than one year after  
the establishment of the health care    
education portal under subsection 7a71  
and annually thereafter1 the ,secretary 
shall submit to the ,committee on       
,veterans' ,affairs of the ,senate and  
the ,committee on ,veterans' ,affairs of
 the ,house of ,representatives a       
report-- 7#a7 assessing the use by      
veterans of the portal1 including-- 7,a7
 overall usage of the portal2 and  7,b7 
use of each module under subsection 7b72
  7#b7 assessing the effectiveness of   
the education program contained in such 
portal2  7#c7 evaluating the curriculum 

contained in such portal2  7#d7         
providing such recommendations on       
modifications to the curriculum         
contained in such portal as the         
,secretary considers appropriate2 and   
7#e7 including such other elements the  
,secretary considers appropriate4  #ejb4
 ,exclusion of application of ,paperwork
 ,reduction ,act to research activities 
of the ,veterans ,health ,administration
  7a7 ,in general ,subchapter ,,ii of   
chapter #gc of title #ch1 ,united       
,states ,code1 is amended by adding at  
the end the following new section3      
#gccj;,d4 ,inapplicability of ,paperwork
 ,reduction ,act to research activities 
,subchapter ,i of chapter #ce of title  
#dd 7commonly referred to as the        
,paperwork ,reduction ,act7 shall not   
apply to the voluntary collection of    
information during the conduct of       
research by the ,veterans ,health       
,administration1 including the ,office  
of ,research and ,development1 or       
individuals or entities affiliated with 

the ,veterans ,health ,administration4  
4  7b7 ,clerical amendment ,the table of
 sections at the beginning of such      
subchapter is amended by inserting after
 the item relating to section #gccj;,c  
the following new item3  #gccj;,d4      
,inapplicability of ,paperwork          
,reduction ,act to research activities4 
4