TBI Treatment Act - Directs the Secretaries of Defense (DOD) and Veterans Affairs (Secretaries) to carry out a five-year pilot program under which each Secretary establishes a process for providing payments to facilities for treatments of traumatic brain injury (TBI) or post-traumatic stress disorder (PTSD) received by members of the Armed Forces and veterans in facilities other than military treatment facilities or Department of Veterans Affairs (VA) medical facilities. Subjects such payments to specified conditions, including approved treatment or study protocols. Requires the VA Secretary to notify each veteran with a service-connected injury or disability of the opportunity to receive such treatment or study protocol.
Requires the Secretaries to jointly: (1) develop and maintain a database containing data from each patient case involving the use of such treatments; and (2) report annually to Congress on the implementation of this Act.
[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4568 Introduced in House (IH)]
111th CONGRESS
2d Session
H. R. 4568
To direct the Secretary of Defense and the Secretary of Veterans
Affairs to carry out a pilot program under which the Secretaries make
payments for certain treatments of traumatic brain injury and post-
traumatic stress disorder.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 2, 2010
Mr. Sessions (for himself, Mr. Pascrell, and Mr. Platts) introduced the
following bill; which was referred to the Committee on Armed Services,
and in addition to the Committee on Veterans' Affairs, for a period to
be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
_______________________________________________________________________
A BILL
To direct the Secretary of Defense and the Secretary of Veterans
Affairs to carry out a pilot program under which the Secretaries make
payments for certain treatments of traumatic brain injury and post-
traumatic stress disorder.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``TBI Treatment Act''.
SEC. 2. PILOT PROGRAM ON PAYMENT FOR TREATMENT OF MEMBERS OF THE ARMED
FORCES AND VETERANS FOR TRAUMATIC BRAIN INJURY AND POST-
TRAUMATIC STRESS DISORDER.
(a) Payment Process.--The Secretary of Defense and the Secretary of
Veterans Affairs shall carry out a five-year pilot program under which
each such Secretary shall establish a process through which each
Secretary shall provide payment for treatments (including diagnostic
testing) of traumatic brain injury or post-traumatic stress disorder
received by members of the Armed Forces and veterans in health care
facilities other than military treatment facilities or Department of
Veterans Affairs medical facilities. Such process shall provide that
payment be made directly to the health care facility furnishing the
treatment.
(b) Conditions for Payment.--The approval by a Secretary for
payment for a treatment pursuant to subsection (a) shall be subject to
the following conditions:
(1) Any drug or device used in the treatment must be
approved or cleared by the Food and Drug Administration for any
purpose.
(2) The treatment or study protocol used in treating the
member or veteran must have been approved by an institutional
review board operating in accordance with regulations issued by
the Secretary of Health and Human Services.
(3) The approved treatment or study protocol (including any
patient disclosure requirements) must be used by the health
care provider delivering the treatment.
(4) The patient receiving the treatment or study protocol
must demonstrate an improvement as a result of the treatment on
one or more of the following:
(A) Standardized independent pre-treatment and
post-treatment neuropsychological testing.
(B) Accepted survey instruments.
(C) Neurological imaging.
(D) Clinical examination.
(5) The patient receiving the treatment or study protocol
must be receiving the treatment voluntarily.
(c) Additional Restrictions Prohibited.--Except as provided in this
subsection (b), no restriction or condition for reimbursement may be
placed on any health care provider that is operating lawfully under the
laws of the State in which the provider is located with respect to the
receipt of payment under this Act.
(d) Payment Deadline.--The Secretary of Defense and the Secretary
of Veterans Affairs shall make a payment for a treatment or study
protocol pursuant to subsection (a) not later than 30 days after a
member of the Armed Forces or veteran (or health care provider on
behalf of such member or veteran) submits to the Secretary
documentation regarding the treatment or study protocol. The Secretary
of Defense and the Secretary of Veterans Affairs shall ensure that the
documentation required under this subsection may not be an undue burden
on the member of the Armed Forces or veteran or on the health care
provider.
(e) Payment Source.--Subsection (c)(1) of section 1074 of title 10,
United States Code, shall apply with respect to the payment by the
Secretary of Defense for treatment or study protocols pursuant to
subsection (a) of traumatic brain injury and post-traumatic stress
disorder received by members of the Armed Forces.
(f) Payment Amount.--A payment under this Act shall be made at the
equivalent Centers for Medicare and Medicaid Services reimbursement
rate in effect for appropriate treatment codes for the State or
territory in which the treatment or study protocol is received. If no
such rate is in effect, payment shall be made at a fair market rate, as
determined by the Secretary of Defense, in consultation with the
Secretary of Health and Human Services, with respect to a patient who
is a member of the Armed Forces or the Secretary of Veterans Affairs
with respect to a patient who is a veteran.
(g) Data Collection and Availability.--
(1) In general.--The Secretary of Defense and the Secretary
of Veterans Affairs shall jointly develop and maintain a
database containing data from each patient case involving the
use of a treatment under this section. The Secretaries shall
ensure that the database preserves confidentiality and be made
available only--
(A) for third-party payer examination;
(B) to the appropriate congressional committees and
employees of the Department of Defense, the Department
of Veterans Affairs, the Department of Health and Human
Services, and appropriate State agencies; and
(C) to the primary investigator of the
institutional review board that approved the treatment
or study protocol, in the case of data relating to a
patient case involving the use of such treatment or
study protocol.
(2) Enrollment in institutional review board study.--In the
case of a patient enrolled in a registered institutional review
board study, results may be publically distributable in
accordance with the regulations prescribed pursuant to the
Health Insurance Portability and Accountability Act of 1996
(Public Law 104-191) and other regulations and practices in
effect as of the date of the enactment of this Act.
(3) Qualified institutional review boards.--The Secretary
of Defense and the Secretary of Veterans Affairs shall each
ensure that the Internet website of their respective
departments includes a list of all civilian institutional
review board studies that have received a payment under this
Act.
(h) Assistance for Members To Obtain Treatment.--
(1) Assignment to temporary duty.--The Secretary of a
military department may assign a member of the Armed Forces
under the jurisdiction of the Secretary to temporary duty or
allow the member a permissive temporary duty in order to permit
the member to receive treatment or study protocol for traumatic
brain injury or post-traumatic stress disorder, for which
payments shall be made under subsection (a), at a location
beyond reasonable commuting distance of the member's permanent
duty station.
(2) Payment of per diem.--A member who is away from the
member's permanent station may be paid a per diem in lieu of
subsistence in an amount not more than the amount to which the
member would be entitled if the member were performing travel
in connection with a temporary duty assignment.
(3) Gift rule waiver.--Notwithstanding any rule of any
department or agency with respect to ethics or the receipt of
gifts, any assistance provided to a member of the Armed Forces
with a service-connected injury or disability for travel,
meals, or entertainment incidental to receiving treatment or
study protocol under this Act, or for the provision of such
treatment or study protocol, shall not be subject to or covered
by any such rule.
(i) Retaliation Prohibited.--No retaliation may be made against any
member of the Armed Forces or veteran who receives treatment or study
protocol as part of registered institutional review board study carried
out by a civilian health care practitioner.
(j) Treatment of University and Nationally Accredited Institutional
Review Boards.--For purposes of this Act, a university-affiliated or
nationally accredited institutional review board shall be treated in
the same manner as a Government institutional review board.
(k) Memoranda of Understanding.--The Secretary of Defense and the
Secretary of Veterans Affairs shall seek to expeditiously enter into
memoranda of understandings with civilian institutional review boards
described in subsection (j) for the purpose of providing for members of
the Armed Forces and veterans to receive treatment carried out by
civilian health care practitioners under a treatment or study protocol
approved by and under the oversight of civilian institutional review
boards that would qualify for payment under this Act.
(l) Outreach Required.--
(1) Outreach to veterans.--The Secretary of Veterans
Affairs shall notify each veteran with a service-connected
injury or disability of the opportunity to receive treatment or
study protocol pursuant to this Act.
(2) Outreach to members of the armed forces.--The Secretary
of Defense shall notify each member of the Armed Forces with a
service-connected injury or disability of the opportunity to
receive treatment or study protocol pursuant to this Act.
(m) Report to Congress.--Not later than 30 days after the last day
of each fiscal year during which the Secretary of Defense and the
Secretary of Veterans Affairs are authorized to make payments under
this Act, the Secretaries shall jointly submit to Congress an annual
report on the implementation of this Act. Such report shall include
each of the following for that fiscal year:
(1) The number of individuals for whom the Secretary has
provided payments under this Act.
(2) The condition for which each such individual receives
treatment for which payment is provided under this Act and the
success rate of each such treatment.
(3) Treatment methods that are used by entities receiving
payment provided under this Act and the respective rate of
success of each such method.
(4) The recommendations of the Secretaries with respect to
the integration of treatment methods for which payment is
provided under this Act into facilities of the Department of
Defense and Department of Veterans Affairs.
(n) Termination.--The authority to make a payment under this Act
shall terminate on the date that is five years after the date of the
enactment of this Act.
(o) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this Act $10,000,000 for each fiscal year
during which the Secretary of Veterans Affairs and the Secretary of
Defense are authorized to make payments under this Act.
<all>
Introduced in House
Introduced in House
Referred to House Armed Services
Referred to the Committee on Armed Services, and in addition to the Committee on Veterans' Affairs, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to House Veterans' Affairs
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Military Personnel.
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