,,ii  #aai? ,,congress  #b;d ,session   
,s4 #daca  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,m>* #ah1 #bjbf,mr4    
,cassidy introduc$ ! foll[+ bill2 :i* 0 
read twice & ref]r$ to ! ,committee on  
,vet]ans' ,affairs  ,a ,,bill  ,to      
require ! ,secret>y ( ,vet]ans ,affairs 
to c>ry out a pilot program to provide  
m>ket-bas$ rate adju/m5ts to c]ta9      
provid]s = furni%+ qualify+ specializ$  
surgical s]vices to vet]ans "u !        
,vet]ans ,community ,c>e ,program1 & =  
o!r purposes4  #a4 ,%ort title ,?is ,act
 may be cit$ z ! ,vet]an ,access to     
,neurosurg]y ,act ( #bjbf4  #b4 ,pilot  
program = m>ket-bas$ rate adju/m5ts =   
qualify+ specializ$ surgical s]vices "u 
! ,vet]ans ,community ,c>e ,program  7a7
 ,9 g5]al ,comm5c+ n lat] ?an "o ye>    
aft] ! date ( ! enactm5t ( ?is ,act1 !  
,secret>y ( ,vet]ans ,affairs %all c>ry 
out a pilot program to p]mit qualifi$   
provid]s to negotiate m>ket-bas$ rate   
adju/m5ts = furni%+ qualify+ specializ$ 
surgical s]vices to vet]ans "u !        

,vet]ans ,community ,c>e ,program 79 ?is
 section ref]r$ to z ! pilot program74  
7b7 ,duration ,! ,secret>y may c>ry out 
! pilot program = ! five-ye> p]iod      
beg9n+ on ! comm5cem5t ( ! pilot        
program4  7c7 ,locations ,! ,secret>y   
%all c>ry out ! pilot program 9 n less  
?an two ,vet]ans ,integrat$ ,s]vice     
,networks ( ! ,dep>tm5t ( ,vet]ans      
,affairs ) a l>ge numb] ( vet]ans resid+
 9 locations t are 9 rural or highly    
rural areas4  7d7 ,det]m9ation (        
m>ket-,bas$ rate adju/m5ts ,9 c>ry+ out 
! pilot program1 ! ,secret>y %all       
provide a m>ket-bas$ rate adju/m5t to a 
qualifi$ provid] 9 furni%+ qualifi$     
specializ$ surgical s]vices to a vet]an 
if-- 7#a7 ! provid] demon/rates t ! rate
 adju/m5t is necess>y to furni% su*     
s]vices2  7#b7 ! rate o!rwise applicable
 to su* s]vices "u ! ,vet]ans ,community
 ,c>e ,program is insuffici5t to cov] ! 
co/ ( furni%+ su* s]vices2 &  7#c7 !    
vet]an lives 9 a geographical area :]e  
!re are no o!r qualify+ specializ$      

surgical s]vices furni%$ by ! ,dep>tm5t 
( ,vet]ans ,affairs1 ei!r direct c>e or 
?r\gh ! ,vet]ans ,community ,c>e        
,program1 available )9 ei!r a #fj-;day  
wait-"t or di/ance ( #ajj miles4  7e7   
,regulations ,n lat] ?an #ahj days aft] 
! date ( ! enactm5t ( ?is ,act1 !       
,secret>y %all prescribe1 ?r\gh notice &
 comm5t rulemak+1 regulations necess>y  
to implem5t ?is section4  7f7 ,inspector
 ,g5]al review ,n lat] ?an "o ye> aft] !
 date ( ! enactm5t ( ?is ,act1 & n less 
frequ5tly ?an annually !reaft] = !      
duration ( ! pilot program1 ! ,inspector
 ,g5]al ( ! ,dep>tm5t ( ,vet]ans        
,affairs %all-- 7#a7 conduct a review ( 
! pilot program to ensure compliance by 
! ,secret>y ) requirem5ts "u ! pilot    
program & to ensure ! effici5cy &       
effectiv5ess ( ! pilot program2 &  7#b7 
submit to ! ,secret>y & ! appropriate   
committees ( ,congress a report conta9+ 
! f9d+s f su* review4  7g7 ,annual      
report ,n lat] ?an "o ye> aft] ! date ( 
! enactm5t ( ?is ,act1 & n less         

frequ5tly ?an annually !reaft] = !      
duration ( ! pilot program1 ! ,secret>y 
%all submit to ! appropriate committees 
( ,congress a report on ! pilot program 
t includes1 = ! ye> cov]$ by ! report1 !
 foll[+3 7#a7 ,! numb] ( pati5ts s]v$ "u
 ! pilot program4  7#b7 ,! diff]5t types
 ( qualify+ specializ$ surgical s]vices 
furni%$ "u ! pilot program & ! numb] (  
vet]ans furni%$ ea* su* s]vice4  7#c7 ,!
 total co/s incurr$ 9 furni%+ s]vices "u
 ! pilot program4  7#d7 ,a description (
 any measurable outcomes 9 t]ms ( heal? 
results = pati5ts "u ! pilot program4   
7#e7 ,any policy recomm5dations =       
improvem5t ( ! pilot program or         
recomm5dations z to :e!r ! pilot program
 %\ld be ext5d$ or made p]man5t4  7#f7  
,su* o!r in=mation z ! ,secret>y        
det]m9es relevant to include4  7h7      
,def9itions ,9 ?is section3 7#a7        
,appropriate committees ( ,congress ,!  
t]m appropriate committees ( ,congress  
means-- 7,a7 ! ,committee on ,vet]ans'  
,affairs ( ! ,s5ate2 &  7,b7 !          

,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives4  7#b7 ,qualifi$
 provid] ,! t]m qualifi$ provid] means a
 bo>d-c]tifi$ surgeon4  7#c7 ,qualify+  
specializ$ surgical s]vices ,! t]m      
qualify+ specializ$ surgical s]vices    
means s]vices relat+ to neurosurg]y4    
7#d7 ,vet]ans ,community ,c>e ,program  
,! t]m ,vet]ans ,community ,c>e ,program
 means ! program "u section #agjc (     
title #ch1 ,unit$ ,/ates ,code4