,,ii  #aaith ,,congress  #b;d ,session  
,s4 #daca  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,march #ah1    
#bjbf,mr4 ,cassidy 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
 provide market-based rate adjustments  
to certain providers for furnishing     
qualifying specialized surgical services
 to veterans under the ,veterans        
,community ,care ,program1 and for other
 purposes4  #a4 ,short title ,this ,act 
may be cited as the ,veteran ,access to 
,neurosurgery ,act of #bjbf4  #b4 ,pilot
 program for market-based rate          
adjustments for qualifying specialized  
surgical services under the ,veterans   
,community ,care ,program  7a7 ,in      
general ,commencing not later than one  
year after the date of the enactment of 
this ,act1 the ,secretary of ,veterans  
,affairs shall carry out a pilot program

 to permit qualified providers to       
negotiate market-based rate adjustments 
for furnishing qualifying specialized   
surgical services to veterans under the 
,veterans ,community ,care ,program 7in 
this section referred to as the pilot   
program74  7b7 ,duration ,the ,secretary
 may carry out the pilot program for the
 five-year period beginning on the      
commencement of the pilot program4  7c7 
,locations ,the ,secretary shall carry  
out the pilot program in not less than  
two ,veterans ,integrated ,service      
,networks of the ,department of         
,veterans ,affairs with a large number  
of veterans residing in locations that  
are in rural or highly rural areas4  7d7
 ,determination of market-,based rate   
adjustments ,in carrying out the pilot  
program1 the ,secretary shall provide a 
market-based rate adjustment to a       
qualified provider in furnishing        
qualified specialized surgical services 
to a veteran if-- 7#a7 the provider     
demonstrates that the rate adjustment is

 necessary to furnish such services2    
7#b7 the rate otherwise applicable to   
such services under the ,veterans       
,community ,care ,program is            
insufficient to cover the cost of       
furnishing such services2 and  7#c7 the 
veteran lives in a geographical area    
where there are no other qualifying     
specialized surgical services furnished 
by the ,department of ,veterans         
,affairs1 either direct care or through 
the ,veterans ,community ,care ,program1
 available within either a #fj-;day     
wait-time or distance of #ajj miles4    
7e7 ,regulations ,not later than #ahj   
days after the date of the enactment of 
this ,act1 the ,secretary shall         
prescribe1 through notice and comment   
rulemaking1 regulations necessary to    
implement this section4  7f7 ,inspector 
,general review ,not later than one year
 after the date of the enactment of this
 ,act1 and not less frequently than     
annually thereafter for the duration of 
the pilot program1 the ,inspector       

,general of the ,department of ,veterans
 ,affairs shall-- 7#a7 conduct a review 
of the pilot program to ensure          
compliance by the ,secretary with       
requirements under the pilot program and
 to ensure the efficiency and           
effectiveness of the pilot program2 and 
7#b7 submit to the ,secretary and the   
appropriate committees of ,congress a   
report containing the findings from such
 review4  7g7 ,annual report ,not later 
than one year after the date of the     
enactment of this ,act1 and not less    
frequently than annually thereafter for 
the duration of the pilot program1 the  
,secretary shall submit to the          
appropriate committees of ,congress a   
report on the pilot program that        
includes1 for the year covered by the   
report1 the following3 7#a7 ,the number 
of patients served under the pilot      
program4  7#b7 ,the different types of  
qualifying specialized surgical services
 furnished under the pilot program and  
the number of veterans furnished each   

such service4  7#c7 ,the total costs    
incurred in furnishing services under   
the pilot program4  7#d7 ,a description 
of any measurable outcomes in terms of  
health results for patients under the   
pilot program4  7#e7 ,any policy        
recommendations for improvement of the  
pilot program or recommendations as to  
whether the pilot program should be     
extended or made permanent4  7#f7 ,such 
other information as the ,secretary     
determines relevant to include4  7h7    
,definitions ,in this section3 7#a7     
,appropriate committees of ,congress    
,the term appropriate committees of     
,congress means-- 7,a7 the ,committee on
 ,veterans' ,affairs of the ,senate2 and
  7,b7 the ,committee on ,veterans'     
,affairs of the ,house of               
,representatives4  7#b7 ,qualified      
provider ,the term qualified provider   
means a board-certified surgeon4  7#c7  
,qualifying specialized surgical        
services ,the term qualifying           
specialized surgical services means     

services relating to neurosurgery4  7#d7
 ,veterans ,community ,care ,program    
,the term ,veterans ,community ,care    
,program means the program under section
 #agjc of title #ch1 ,united ,states    
,code4