,,ii  #aahth ,,congress  #b;d ,session  
,s4 #ddcg  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,june #c1      
#bjbd,mr4 ,moran 7for himself and ,mr4  
,king7 introduced the following bill2   
which was read twice and referred to the
 ,committee on ,veterans' ,affairs  ,a  
,,bill  ,to require the ,secretary of   
,veterans ,affairs to carry out a pilot 
program to coordinate1 navigate1 and    
manage care and benefits for veterans   
enrolled in both the ,medicare program  
and the system of annual patient        
enrollment of the ,department of        
,veterans ,affairs4  #a4 ,short title   
,this ,act may be cited as the          
,coordinating ,care for ,senior         
,veterans and ,wounded ,warriors ,act4  
#b4 ,pilot program on coordination of   
care between ,department of ,veterans   
,affairs and ,medicare program  7a7 ,in 
general ,the ,secretary1 in consultation
 with the ,secretary of ,health and     
,human ,services1 shall carry out a     
pilot program 7in this section referred 

to as the pilot program7 to coordinate1 
navigate1 and manage care and benefits  
for covered veterans4  7b7 ,purposes of 
pilot program ,the purposes of the pilot
 program are as follows3 7#a7 ,to       
improve access to health care services  
for covered veterans at medical         
facilities of the ,department of        
,veterans ,affairs1 from health care    
providers under the ,veterans ,community
 ,care ,program under section #agjc of  
title #ch1 ,united ,states ,code1 from  
health care providers with which the    
,department has established a ,veterans 
,care ,agreement under section #agjc;,a 
of such title1 and from health care     
providers participating in the ,medicare
 program under title ,,xviii of the     
,social ,security ,act 7#db ,u4,s4,c4   
#acie et seq474  7#b7 ,to improve       
outcomes of care received by covered    
veterans4  7#c7 ,to improve quality of  
care received by covered veterans4  7#d7
 ,to lower costs of care received by    
covered veterans4  7#e7 ,to eliminate   

gaps in care and duplication of services
 and expenses for covered veterans4     
7#f7 ,to improve care coordination for  
covered veterans1 including coordination
 of patient information and medical     
records between providers4  7c7         
,administration  7#a7 ,in general ,the  
,secretary shall carry out the pilot    
program through the ,center for         
,innovation for ,care and ,payment of   
the ,department of ,veterans ,affairs4  
7#b7 ,locations ,the ,secretary shall   
carry out the pilot program in not less 
than three but not more than five       
,veterans ,integrated ,service ,networks
 with a large number of covered veterans
 and varying degrees of urbanization1   
including-- 7,a7 locations that are in  
rural or highly rural areas1 as         
determined through the use of the       
,rural-,urban ,commuting ,areas coding  
system of the ,department of            
,agriculture2 and  7,b7 locations that  
are medically underserved4  7d7 ,case   
manager  7#a7 ,assignment of case       

manager ,in carrying out the pilot      
program1 the ,secretary shall assign    
each covered veteran participating in   
the pilot program a case manager        
responsible for developing an           
individualized needs assessment for such
 veteran and1 based on such assessment1 
a care coordination plan with defined   
treatment goals4  7#b7 ,accessing       
services ,a case manager assigned to a  
covered veteran under paragraph 7#a7 is 
responsible for assisting such veteran  
in accessing services needed by such    
veteran and navigating the systems of   
care under the laws administered by the 
,secretary and under the ,medicare      
program under title ,,xviii of the      
,social ,security ,act 7#db ,u4,s4,c4   
#acie et seq474  7e7 ,use of existing   
models ,in designing the pilot program1 
the ,secretary shall1 to the extent     
practicable1 use existing models1       
including value-based care models1 used 
by commercial health care programs to   
improve access1 health outcomes1        

quality1 and customer experience and    
lower per capita costs4  7f7            
,contracting with private sector        
entities  7#a7 ,in general ,the         
,secretary shall1 to the greatest extent
 practicable1 contract with private     
sector entities carrying out commercial 
health care programs for assistance in  
designing1 implementing1 and managing   
care and benefits under the pilot       
program1 to include providing care      
coordination4  7#b7 ,notification ,if   
the ,secretary determines that          
contracting with private sector entities
 under paragraph 7#a7 is not            
practicable1 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    
notification of that determination2     
7,b7 a description of the steps the     
,secretary has taken to contract with a 
private sector entity2  7,c7 a          
justification for why the ,secretary has

 determined that contracting with a     
private sector entity is not            
practicable2 and  7,d7 a plan for how   
the ,secretary will carry out the pilot 
program without contracting with a      
private sector entity1 including through
 the use of employees of the ,department
 of ,veterans ,affairs or other         
government agencies1 nonprofit          
organizations1 or other entities4  7g7  
,metrics  7#a7 ,in general ,the         
,secretary shall track metrics under the
 pilot program1 including the following3
 7,a7 ,the number of veterans           
participating in the pilot program1     
disaggregated by ,veterans ,integrated  
,service ,network4  7,b7 ,reliance on   
health care services administered by the
 ,secretary4  7,c7 ,reliance on health  
care services administered under the    
,medicare program under title ,,xviii of
 the ,social ,security ,act 7#db        
,u4,s4,c4 #acie et seq474  7,d7 ,quality
 of care1 including patient outcomes4   
7,e7 ,cost of care4  7,f7 ,access to    

care1 including under the designated    
access standards developed by the       
,secretary under section #agjc;,b of    
title #ch1 ,united ,states ,code4  7,g7 
,patient satisfaction4  7,h7 ,provider  
satisfaction4  7,i7 ,care coordination1 
including timely information sharing and
 medical documentation return4  7#b7    
,elements ,in tracking metrics under    
paragraph 7#a71 the ,secretary shall    
track information relating to-- 7,a7    
whether care received by a covered      
veteran is related to a                 
service-connected disability 7as defined
 in section #aja of title #ch1 ,united  
,states ,code72  7,b7 the priority group
 under section #agje7;a7 of title #ch1  
,united ,states ,code1 through which    
each covered veteran was enrolled in the
 system of annual patient enrollment of 
the ,department of ,veterans ,affairs   
under such section2  7,c7 the type of   
care and services provided to covered   
veterans2 and  7,d7 the demographics of 
covered veterans participating in the   

pilot program1 including age4  7h7      
,duration ,the ,secretary shall carry   
out the pilot program for a #c-year     
period beginning on the commencement of 
the pilot program4  7i7 ,reports  7#a7  
,development1 implementation1 results1  
and design of pilot program  7,a7 ,in   
general ,not less frequently than       
quarterly during the two-year period    
beginning on the date of the enactment  
of this ,act1 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 on 
the development1 implementation1        
results1 and design of the pilot        
program1 including information on the   
metrics tracked under subsection 7g74   
7,b7 ,final design ,one of the reports  
required under subparagraph 7,a7 shall  
contain a description of the final      
design of the pilot program4  7#b7      
,results of pilot program ,not later    
than one year after the submission of   

the final report under paragraph 7#a71  
and not less frequently than annually   
thereafter during the duration of the   
pilot program1 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 on 
the results of the pilot program4  7#c7 
,final report ,not later than #ahj days 
before the termination of the pilot     
program1 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 final report on the  
pilot program1 which shall include the  
recommendation of the ,secretary for    
whether the pilot program should be     
extended or made permanent4  7j7        
,definitions ,in this section3 7#a7     
,covered veteran ,the term covered      
veteran means a veteran who is enrolled 
in both the ,medicare program under     
title ,,xviii of the ,social ,security  

,act 7#db ,u4,s4,c4 #acie et seq47 and  
the system of annual patient enrollment 
of the ,department of ,veterans ,affairs
 under section #agje7;a7 of title #ch1  
,united ,states ,code4  7#b7 ,secretary 
,the term ,secretary means the          
,secretary of ,veterans ,affairs4