,,ii  #aag? ,,congress  #a/ ,session    
,s4 #cafc  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,novemb] #d1 #bjba,mr4 
,te/] 7= himself & ,mr4 ,moran7         
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,vet]ans' ,affairs  ,a ,,bill  ,to      
improve access to m$ical exam9ations    
requir$ by vet]ans to obta9 disability  
comp5sation or p5sion "u laws adm9i/]$  
by ! ,secret>y ( ,vet]ans ,affairs1 & = 
o!r purposes4  #a4 ,%ort title ,?is ,act
 may be cit$ z ! ,re=m & ,update ,rural 
,access to ,local ,exams ,act ( #bjba or
 ! ,,rural ,exams ,act ( #bjba4  #b4    
,def9itions ,9 ?is ,act3 7#a7 ,cov]$    
m$ical disability exam9ation ,! t]m     
cov]$ m$ical disability exam9ation means
 a m$ical exam9ation t ! ,secret>y (    
,vet]ans ,affairs det]m9es necess>y = ! 
purposes ( adjudicat+ a b5efit "u *apt] 
#aa or #ae ( title #ch1 ,unit$ ,/ates   
,code1 reg>dless ( :e!r conduct$ by an  
employee or a contractor ( ! ,dep>tm5t (
 ,vet]ans ,affairs4  7#b7 ,h\seb\nd ,!  

t]m h\seb\nd1 ) respect to a vet]an1    
means-- 7,a7 ! vet]an meets ! requirem5t
 ( p]man5tly h\seb\nd z describ$ 9      
section #aaad7s7 ( title #ch1 ,unit$    
,/ates ,code2  7,b7 ! vet]an meets !    
requirem5t ( p]man5tly h\seb\nd z       
describ$ 9 section #aejb7;c7 ( su*      
title2 or  7,c7 ! ,secret>y has det]m9$ 
t ! vet]an faces significant difficulty 
9 travel+ to obta9 a cov]$ m$ical       
disability exam9ation4  7#c7 ,rural area
 ,! t]m rural area means any non-urban  
area1 )9 ! mean+ ( ! ,rural-,urban      
,commut+ ,area ,codes sy/em ( !         
,dep>tm5t ( ,agriculture & ! ,dep>tm5t (
 ,heal? & ,human ,s]vices1 or successor 
sy/em4  7#d7 ,rural vet]an ,! t]m rural 
vet]an means a vet]an :o resides 9 a    
rural area4  #c4 ,improv+ data          
collection by ,dep>tm5t ( ,vet]ans      
,affairs on cov]$ m$ical disability     
exam9ations  7a7 ,data collection       
requir$ ,n lat] ?an #ahj days aft] !    
date ( ! enactm5t ( ?is ,act1 !         
,secret>y ( ,vet]ans ,affairs %all beg9 

collect+ data to improve access (       
vet]ans to cov]$ m$ical disability      
exam9ations4  7b7 ,elem5ts ,data        
collect$ "u subsection 7a7 %all include 
data reg>d+ ! foll[+3 7#a7 ,timel9ess1  
quality1 & vet]an satisfaction          
measurem5ts ( cov]$ m$ical disability   
exam9ations4  7#b7 ,proportion (        
complet$ cov]$ m$ical disability        
exam9ations det]m9$ to be inadequate = !
 adjudication ( a claim = comp5sation or
 p5sion "u *apt] #aa or #ae ( title #ch1
 ,unit$ ,/ates ,code4  7#c7 ,e p]=mance 
/&>d requir$ = eligibility = f9ancial   
inc5tives or dis9c5tives 9 a contract   
betwe5 ! ,dep>tm5t ( ,vet]ans ,affairs &
 any contractor = ! provision ( a cov]$ 
m$ical disability exam9ation4  7c7      
,disaggregation ( data ,! ,secret>y %all
 disaggregate data collect$ "u          
subsection 7a7 by-- 7#a7 ,/ate2  7#b7   
c\nty2 &  7#c7 z ! case may be-- 7,a7   
individual contractor ) a ,dep>tm5t (   
,vet]ans ,affairs contract = ! provision
 ( a cov]$ m$ical disability exam9ation2

 or  7,b7 individual ,vet]ans ,heal?    
,adm9i/ration facility conduct+ a cov]$ 
m$ical disability exam9ation4  7d7      
,publication ,n lat] ?an "o ye> aft] !  
date ( ! enactm5t ( ?is ,act1 !         
,secret>y %all make publicly available  
on an int]net website1 & updat$ n less  
frequ5tly ?an qu>t]ly1 all data collect$
 "u subsection 7a74  #d4 ,/udy on       
improvem5ts to ,dep>tm5t ( ,vet]ans     
,affairs cov]$ m$ical disability        
exam9ations 9 rural areas  7a7 ,/udy    
requir$ ,n lat] ?an "o ye> aft] ! date (
 ! enactm5t ( ?is ,act1 ! ,secret>y (   
,vet]ans ,affairs %all complete a /udy  
on access by rural vet]ans to cov]$     
m$ical disability exam9ations4  7b7     
,elem5ts  7#a7 ,9 g5]al ,! /udy conduct$
 "u subsection 7a7 %all include !       
foll[+3 7,a7 ,a comp>ison ( ! av]age    
numb] ( days to complete cov]$ m$ical   
disability exam9ations = rural vet]ans  
comp>$ to ! national non-rural av]age "t
 to complete cov]$ m$ical disability    
exam9ations1 by ei!r contractors or     

employees ( ! ,dep>tm5t4  7,b7 ,a root  
cause analysis ( diff]5ces id5tifi$     
pursuant to subp>agraph 7,a74  7,c7 ,!  
plan ( ! ,secret>y = ! foll[+ ye> to    
improve access describ$ 9 subsection    
7a71 :i* %all include a plan = ! pursuit
 ( a comm]cial or indu/ry-/&>d solution 
or te*nology t c\ld enable rural or     
h\seb\nd vet]ans to receive exam9ations 
)\t travel+ long di/ances4  7#b7        
,national non-rural av]age def9$ ,=     
purposes ( p>agraph 7#a77;,a71 ! t]m    
national non-rural av]age means !       
national av]age ( all p]iods 9 ! previ\s
 cal5d> ye>-- 7,a7 beg9n+ on ! date on  
:i* a contractor receiv$ a reque/ f !   
,secret>y to conduct a cov]$ m$ical     
disability exam9ation = a vet]an :o is n
 a rural vet]an2 &  7,b7 end+ on ! date 
on :i* ! exam9ation 0 complet$4  7c7    
,report on /udy ,n lat] ?an "o 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 !   
f9d+s ( ! ,secret>y ) respect to ! /udy 
complet$ "u subsection 7a74  7d7 ,annual
 report on plans ,n lat] ?an two ye>s   
aft] ! date ( ! enactm5t ( ?is ,act & 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        
evaluat+ ! conduct ( ! plans ( !        
,secret>y to improve access describ$ 9  
subsection 7a7 & a new or revis$ plan = 
su* improvem5t 9 ! foll[+ ye>4  #e4     
,dep>tm5t ( ,vet]ans ,affairs timel9ess 
requirem5ts = provision ( cov]$ m$ical  
disability exam9ations by contractors to
 rural & h\seb\nd vet]ans ,9 ea*        
contract ent]$ into by ! ,secret>y (    
,vet]ans ,affairs aft] ! date ( !       
enactm5t ( ?is ,act = ! provision by a  
contractor ( a cov]$ m$ical disability  
exam9ation1 ! ,secret>y %all include !  
foll[+3 7#a7 ,su* f9ancial inc5tives z !
 ,secret>y consid]s appropriate to      

enc\rage a contractor to provide a cov]$
 m$ical disability exam9ation to a rural
 vet]an or a h\seb\nd vet]an 9 a timely 
mann]4  7#b7 ,su* f9ancial dis9c5tives z
 ! ,secret>y consid]s appropriate to    
disc\rage a contractor f fail+ to       
provide a cov]$ m$ical disability       
exam9ation to a rural vet]an or a       
h\seb\nd vet]an 9 a timely mann]4  7#c7 
,a requirem5t t ! contractor coop]ate ) 
inspections conduct$ "u ! program       
requir$ by section #f7;a74  #f4 ,annual 
inspections by ,dep>tm5t ( ,vet]ans     
,affairs ( facilities us$ by contractors
 = provision ( cov]$ m$ical disability  
exam9ations  7a7 ,program requir$ ,n    
lat] ?an "o ye> aft] ! date ( ! enactm5t
 ( ?is ,act1 ! ,secret>y ( ,vet]ans     
,affairs %all e/abli% a program (       
p]iodic inspections ( sites1 locations1 
& facilities :]e cov]$ m$ical disability
 exam9ations are provid$ by contractors 
( ! ,dep>tm5t ( ,vet]ans ,affairs4  7b7 
,numb] & p]iodicity  7#a7 ,9 g5]al ,"u !
 program requir$ by subsection 7a71 !   

,secret>y %all1 ea* ye>1 inspect n few] 
?an ?ree p]c5t ( all sites1 locations1 &
 facilities us$ by a contractor ( !     
,dep>tm5t to provide a cov]$ m$ical     
disability exam9ation dur+ ! previ\s    
"o-ye> p]iod4  7#b7 ,initial inspections
 ,p>agraph 7#a7 %all apply ) respect to 
! fir/ "o-ye> p]iod beg9n+ aft] ! date (
 ! e/abli%m5t ( ! program pursuant to   
subsection 7a7 & ea* ye> !reaft]4  7c7  
,selection ( sites1 locations1 &        
facilities = inspection ,"u ! program   
requir$ by subsection 7a71 ! ,secret>y  
%all-- 7#a7 use bo? r&om & t>get$ me?ods
 ( select+ sites1 locations1 &          
facilities = inspection2 &  7#b7 ensure 
t ! numb] ( inspections ( sites1        
locations1 & facilities 9 rural areas   
be>s ! same ratio to ! total numb] (    
inspections z ! numb] ( cov]$ m$ical    
disability exam9ations provid$ by       
contractors ( ! ,dep>tm5t to rural      
vet]ans be>s to ! total numb] ( cov]$   
m$ical disability exam9ations provid$ by
 contractors ( ! ,dep>tm5t to all       

vet]ans4  7d7 ,notice & tim+ ,ea*       
inspection "u ! program requir$ by      
subsection 7a7 %all be conduct$ dur+ su*
 bus9ess h\rs z ! ,secret>y consid]s    
reasonable & ! ,secret>y %all provide no
 m notice ?an ! ,secret>y consid]s      
necess>y to ensure ! inspect$ facility  
is available = su* inspection4  7e7     
,elem5ts ,ea* inspection conduct$ "u !  
program requir$ by subsection 7a7 %all  
include inspection ( a site1 location1  
or facility = ! foll[+3 7#a7 ,compliance
 ) ! t]ms ( any applicable contract4    
7#b7 ,compliance ) ! ,am]icans )        
,disabilities ,act ( #aiij 7#db         
,u4,s4,c4 #abaja et seq474  7#c7        
,cleanl9ess4  7#d7 ,g5]al fitness = a   
cov]$ m$ical disability exam9ation4     
7#e7 ,su* o!r elem5ts z ! ,secret>y     
consid]s necess>y to ensure t cov]$     
m$ical disability exam9ations provid$ on
 behalf ( ! ,dep>tm5t are safe1 clean1  
accessible1 & dignifi$4  7f7 ,annual    
reports ,n lat] ?an "o ye> aft] ! date (
 ! e/abli%m5t ( ! program requir$ by    

subsection 7a71 ! ,secret>y %all 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 ! inspections conduct$ "u !  
program dur+ ! "o-ye> p]iod end+ on !   
date ( ! submittal ( ! report4