Veteran-Centered Access to Coordinated Health Care Act of 2014 - Directs the Secretary of Veterans Affairs (VA) to provide certain enrolled veterans with health services (authorized hospital care or medical, rehabilitative, or preventive health services) that are provided by a non-VA provider with whom the Secretary enters into a contract if the Secretary determines that VA facilities are incapable of furnishing such services because of: (1) geographical inaccessibility; or (2) a lack of required personnel or ability to provide timely and reasonable access.
Specifies the order of priority of locations for such non-VA providers.
Sets forth requirements concerning VA care coordination with such providers and provider performance metrics.
Amends the Veterans' Mental Health and Other Care Improvements Act of 2008 to reauthorize, for three years, a VA pilot program of contract care authority within each Veterans Integrated Service Network for the health care needs of veterans in highly rural areas.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3858 Introduced in House (IH)]
113th CONGRESS
2d Session
H. R. 3858
To amend title 38, United States Code, to direct the Secretary of
Veterans Affairs to enter into contracts with health care providers to
improve health care access and care coordination for veterans, and for
other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 13, 2014
Mr. Kinzinger of Illinois introduced the following bill; which was
referred to the Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to direct the Secretary of
Veterans Affairs to enter into contracts with health care providers to
improve health care access and care coordination for veterans, and for
other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; SENSE OF CONGRESS.
(a) Short Title.--This Act may be cited as the ``Veteran-Centered
Access to Coordinated Health Care Act of 2014''.
(b) Sense of Congress.--It is the sense of Congress that--
(1) veterans who are authorized by the Secretary of
Veterans Affairs to receive health care in the community must
not lose the high quality, safety, care coordination, and other
veteran-centric elements that the health care system of the
Department of Veterans Affairs provides;
(2) many veterans receive health care from both the
Department and community providers but the lack of care
coordination among the Department and community providers when
veterans receive purchased care places veterans at risk for
poor health outcomes and results in inefficient use of finite
health care resources;
(3) veteran-centric care coordination is associated with
improved patient outcomes, as Department and non-Department
health care teams coordinate and collaborate to provide the
best care for veterans; and
(4) if the Secretary purchases care for veterans from the
private sector, such care must be secured in a cost-effective
manner, in a way that complements the larger health care system
of the Department by using industry standards for care and
costs.
SEC. 2. COMPREHENSIVE CONTRACT CARE COORDINATION PROGRAM FOR VETERANS.
(a) In General.--
(1) Type of care.--Subsection (a) of section 1703 of title
38, United States Code, is amended to read as follows:
``(a)(1) The Secretary shall provide an eligible veteran with
covered health services that are provided by a non-Department entity
whom the Secretary enters into a contract with under this section if
the Secretary determines that facilities of the Department are not
capable of--
``(A) economically furnishing covered health services to
such veteran because of geographical inaccessibility; or
``(B) furnishing covered health services to such veteran
because such facilities lack--
``(i) the required personnel who are appropriately
trained and experienced; or
``(ii) the ability to provide timely and reasonable
access.
``(2) Except as otherwise provided by this chapter or other law,
the Secretary shall ensure that health care provided to a veteran under
this title by a non-Department entity, including under the Patient-
Centered Community Care program or any other care-coordination program,
is provided in accordance with this section.
``(3) The Secretary shall provide covered health services pursuant
to this chapter at a location that is in accordance with the following
priority:
``(A) A facility of the Department.
``(B) A facility of a department or agency of the Federal
Government, or of a university, that the Secretary has entered
into a sharing agreement with respect to providing such health
services.
``(C) A non-Department facility in accordance with this
section.
``(D) A non-Department facility in accordance with a
provision of law other than this section.
``(4) The Secretary shall ensure that veterans who receive health
care under this title from a non-Department entity are able to
efficiently reenter the health care system of the Department, including
by coordinating care.
``(5) In this subsection:
``(A) The term `covered health services' means, with
respect to an eligible veteran, any hospital care, medical
service, rehabilitative service, or preventative health service
that is authorized to be provided by the Secretary to the
veteran under this chapter or any other provision of law.
``(B) The term `eligible veteran' means a veteran enrolled
in the health care system established under section 1705(a) of
this title who elects to receive care under this section.''.
(2) Qualified entities; care coordination.--Such section is
amended by adding at the end the following new subsections:
``(e) The Secretary shall enter into a contract with a non-
Department entity under this section. The Secretary shall ensure that
the resources of the Department are not used to duplicate
administrative functions and information technology systems that are
provided by the non-Department entity under such a contract. A non-
Department entity shall be eligible for such a contract if the entity
demonstrates experience with respect to--
``(1) the ability to provide non-Department health care
services to veterans;
``(2) meeting or exceeding internal credentialing standards
of the Department and standards of the Utilization Review
Accreditation Commission;
``(3) having care coordinators who help veterans make,
confirm, and keep medical appointments;
``(4) having the ability to obtain clinical information
from non-Department entities and submit such information to the
Department;
``(5) having--
``(A) experience using an information technology
system that--
``(i) has the ability to track and monitor
veterans that is accessible by employees of the
Department using a portal on an Internet
website; and
``(ii) allows veterans to file complaints;
and
``(B) the ability to respond to potential quality
indicators and patient safety events; and
``(6) having the experience and ability to--
``(A) process claims in the provider network;
``(B) bill a third party (as defined in section
1725(f)(2) of this title) for care provided under this
section, as appropriate; and
``(C) transmit directly to the Secretary any
amounts received pursuant to subparagraph (B).
``(f) In carrying out this section, the Secretary shall ensure the
following:
``(1) With respect to each medical center of the
Department, the Secretary is consistent in determining the
eligibility of veterans under subsection (a).
``(2) The Secretary requires care coordinators of a non-
Department entity described in subsection (e)(3) who will
coordinate care of a veteran by the entity with a care
coordinator of the Department.
``(3) The Department and a non-Department entity under this
section exchange clinical information to improve both clinical
decisionmaking and the care a veteran receives.
``(4) Both non-Department facilities under this section and
Department facilities meet performance metrics regarding--
``(A) the quality of health care provided;
``(B) the satisfaction of veterans;
``(C) clinical information return within 30 days of
a health care visit of a patient;
``(D) a no-show rate at a rate less than the
industry standard;
``(E) claims being paid within 30 days;
``(F) timely access to health care, including
initial appointments occurring less than 30 days after
being requested;
``(G) cost effectiveness; and
``(H) sufficient volume and case mix to ensure
cost-effective vendor prices.
``(g)(1) Not later than October 31 of each year, 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 care provided under this section, including--
``(A) the cost to the Department;
``(B) the number of veterans receiving care under this
section as compared to the number of veterans receiving care
from non-Department facilities under other provisions of law;
``(C) the quality of such care and the satisfaction of such
veterans;
``(D) the performance metrics under subsection (f)(4); and
``(E) other matters the Secretary considers appropriate.
``(2) Not later than March 1 of each odd-numbered year, 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 allocation of resources with respect to
care provided by the Department and by non-Department facilities.''.
(3) Effective date.--The amendments made by this subsection
shall take effect 180 days after the date of the enactment of
this Act.
(b) Reauthorization of Project Arch.--Section 403 of the Veterans'
Mental Health and Other Care Improvements Act of 2008 (Public Law 110-
387; 38 U.S.C. 1703 note) is amended--
(1) in subsection (a)(3), by striking ``A veteran'' and
inserting ``Except as provided by subsection (i), a veteran'';
and
(2) by adding at the end the following new subsection:
``(i) Reauthorization.--
``(1) Recommencement.--Not later than 90 days after the
date of the enactment of the Veteran-Centered Collaborative
Health Care Act of 2014, the Secretary shall again commence the
conduct of the pilot program under subsection (a)(1).
``(2) Program locations.--Notwithstanding subsection
(a)(4), the Secretary shall carry out the pilot program
pursuant to paragraph (1) within each Veterans Integrated
Service Network.
``(3) Appointments.--In carrying out the pilot program
pursuant to paragraph (1), the Secretary shall ensure that
medical appointments for veterans occur during the 30-day
period beginning on the date that is 15 days after the date on
which the appointment is requested.
``(4) Outreach.--The Secretary shall ensure that a veteran
eligible for the pilot program carried out pursuant to
paragraph (1) is informed of such program.
``(5) Termination.--The authority of the Secretary to carry
out the pilot program pursuant to paragraph (1) shall terminate
on the date that is three years after the date on which the
Secretary commences such program under such paragraph.''.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Veterans' Affairs.
Referred to the Subcommittee on Health.
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