Sec. 101. Establishment of Veterans Community Care Program
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Section 1703 is amended to read as follows: Subject to the availability of appropriations for such purpose and subject to paragraph (4), hospital care, medical services, and extended care services under this chapter shall be furnished to a covered veteran described in subsection
(b)by health care providers specified in subsection
(c)in accordance with this section. The furnishing of care and services under this section may be referred to as the Veterans Community Care Program . In carrying out this section, the Secretary may develop categories of certain health care providers specified in subsection
(c)for the purpose of providing a covered veteran hospital care, medical services, and extended care services when the covered veteran does not state a preference for a health care provider. In developing categories of health care providers under subparagraph (A), the Secretary shall not— prioritize or rank such categories in a manner that limits the options a covered veteran may have in selecting a health care provider specified in subsection (c); or direct a covered veteran to receive care or services from certain health care providers instead of other health care providers. In carrying out this section, the Secretary shall not limit any hospital care, medical service, extended care service, or class of hospital care, medical service, or extended care service that are set forth in the Medical Benefits Package of the Department, as modified as determined by the Secretary. For purposes of this section, a covered veteran is any veteran who— is enrolled in the patient enrollment system of the Department established and operated under section 1705 of this title; or is not enrolled in such system but is otherwise entitled to hospital care, a medical service, or an extended care service under subsection (c)(2) of such section; and has been furnished hospital care or medical services under this chapter on at least one occasion during the preceding two-year period; or requested a first-time appointment for hospital care or medical services at a Department facility. Health care providers specified in this subsection are the following: Any health care provider that is participating in the Medicare program under title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq.), including any physician furnishing services under such a program. The Department of Defense. The Indian Health Service. Any Federally-qualified health center (as defined in section 1905(l)(2)(B) of the Social Security Act ( 42 U.S.C. 1396d(l)(2)(B) )). Any health care provider not otherwise covered under any of paragraphs
(1)through
(4)that meets criteria established by the Secretary for purposes of this section. The Secretary shall enter into consolidated, competitively bid contracts, which may be regional contracts, to establish networks of non-Department health care providers specified in paragraphs
(1)and
(5)of subsection
(c)for contract purposes of— providing sufficient access to hospital care, medical services, and extended care services under this section; managing the operations of such health care providers; and managing the delivery of hospital care, medical services, and extended care services under this section. The Secretary may terminate a contract with an entity entered into under paragraph
(1)at such time and upon such notice to the entity as the Secretary may specify for purposes of this section. Whenever the Secretary provides notice to an entity under paragraph
(2)that the entity is failing to meet contractual obligations entered into under paragraph (1), 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 such failure and the decision of the Secretary to terminate the contract under paragraph (2). Each report submitted under subparagraph
(A)shall include the following: An explanation of the reasons for terminating the contract. A description of the effect of the failure of the entity to meet contractual obligations and the termination of the contract, including with respect to cost, schedule, and requirements. A description of the actions taken by the Secretary to mitigate such failure and termination. The Secretary shall ensure that for each covered veteran seeking care or services under this section, a care coordination team is provided by a medical facility of the Department. The Secretary shall ensure that each care coordination team provided under this section, with respect to a covered veteran, is responsible for the following: Coordination and management of hospital care, medical services (including telemedicine), and extended care services furnished under this title, including the following: Collaboration with the patient aligned care teams
(PACT)within the medical facility of the Department; and Coordination within and across Veterans Integrated Service Networks with non-Department health care providers acting under a contract or agreement to furnish hospital care, a medical service, or an extended care service on behalf of the Department and who meets such terms and conditions as the Secretary may require. Ensure continuity of care for the covered veteran to avoid any delay or lapse in care or services from an action or error of the Department or any individual of the care coordination team of the covered veteran. Submitting information to the Secretary in furtherance of analysis conducted under section 1730B(a) of this title. The Secretary shall develop an organizational construct for care coordination teams at medical facilities of the Department that may include the following individuals: An employee of the Department who furnishes hospital care, a medical service, or an extended care service at the facility. A non-Department health care provider acting under a contract or agreement to furnish hospital care, a medical service, or an extended care service on behalf of the Department and who meets such terms and conditions as the Secretary may require. An employee of the Department or a health care provider described in subparagraph
(B)who serves to seamlessly coordinate the delivery of hospital care, medical services, and extended care services to covered veterans. Subject to the availability of appropriations, the Secretary shall furnish hospital care, medical services, and extended care services to a covered veteran, at the election of a covered veteran, through health care providers specified in subsection
(c)as follows: When a medical facility of the Department does not offer the hospital care, medical services, or extended care services the covered veteran requires. When a medical facility of the Department cannot furnish or schedule an appointment for hospital care, medical services, or extended care services in accordance with access standards established under section 1703B of this title. When the covered veteran and a referring clinician of the covered veteran agree that furnishing hospital care, medical services, or extended care services through a non-Department entity or provider would be in the best medical interest of the covered veteran, after consideration of the standards established under sections 1703B and 1703C of this title or due to a non-clinical reason, compelling circumstance, or other considerations that are in the best medical interest of the covered veteran. Not later than 120 days after the date of the enactment of the Veterans Community Care and Access Act of 2017 , the Secretary shall submit to the appropriate committees of Congress a report describing the guidelines and standards the Secretary intends to use to carry out paragraph
(1)in accordance with sections 1703B and 1703C of this title. The Secretary shall ensure that services are established in order to schedule appointments for hospital care, medical services, and extended care services under this chapter. In carrying out paragraph (1), the Secretary shall determine whether services established under such paragraph should reside within the respective medical facility of the Department or reside with an entity with whom the Secretary enters into a contract for such services. In carrying out subparagraph (A), the Secretary shall assess the following: Whether a medical facility of the Department is currently managing scheduling services and the Secretary determines such medical facility has the capability to continue to manage scheduling. Whether a medical facility of the Department has the capacity to manage scheduling services based on the following: An initial review of the medical facility to acquire scheduling service responsibilities and the preference of the medical facility to acquire such responsibilities. The market area assessment currently underway pursuant to section 1730B(c) of this title. The capacity of the medical facility to perform scheduling services that meet standards established under sections 1703B and 1703C of this title. Whether one or more contracts were in effect on the day before the date of the enactment of the Veterans Community Care and Access Act of 2017 that include scheduling services, as determined by the Secretary, and may be modified by the Secretary for services under this subsection. In this section: The term appropriate committees of Congress means— the Committee on Veterans’ Affairs and the Committee on Appropriations of the Senate; and the Committee on Veterans’ Affairs and the Committee on Appropriations of the House of Representatives. The term clinician has the meaning given that term by the Centers for Medicare & Medicaid Services and includes Doctors of Medicine (MD), Doctors of Osteopathy (DO), Doctors of Dental Surgery or Dental Medicine (DMD/DDS), Doctors of Podiatry, Doctors of Optometry, Chiropractors, Physician Assistants (PA), Nurse Practitioners (NP), Clinical Nurse Specialists, Certified Registered Nurse Anesthetists, and such other health professionals as the Secretary may specify for purposes of this section. The term medical facility of the Department includes a medical center, a community-based outpatient clinic, an outpatient clinic, or any other facility of the Department at which hospital care, medical services, or extended care services are furnished. . The table of sections at the beginning of chapter 17 of such title is amended by striking the item relating to section 1703 and inserting the following new item: 1703. Veterans Community Care Program. . Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall promulgate regulations to carry out section 1703 of title 38, United States Code, as amended by subsection (a). The amendments made by subsection
(a)shall take effect on the date that the Secretary promulgates regulations under subsection (b).
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