Veterans Choice Act of 2014 - Requires hospital care and medical services to be furnished to veterans through contracts with Medicare providers if the veterans: (1) have been unable to schedule an appointment at a Department of Veterans Affairs (VA) medical facility within the Veterans Health Administration's (VHA's) wait-time goals for hospital care or medical services, and (2) opt for care or services from such providers.
Directs the VA Secretary to provide veterans with information about the availability of care and services from Medicare providers when they: (1) enroll in the VA patient enrollment system, and (2) attempt to schedule an appointment for VA hospital care or medical services but are unable to do so within VHA's wait-time goals.
Terminates this Act's requirement that the Secretary furnish care and services through contracts with Medicare providers two years after the Secretary publishes interim final regulations implementing the program.
Expresses the sense of Congress that the Secretary must comply with the prompt payment rule or any similar regulation or ruling in paying for health care under contracts with non-VA providers.
Requires the Secretary to ensure that scheduling and wait-time metrics or goals are not used as factors in determining the performance of: (1) directors, associate directors, assistant directors, deputy directors, chiefs of staff, and clinical leads of VA medical centers; and (2) directors, assistant directors, and quality management officers of the Veterans Integrated Service Networks (VISNs).
Directs the Secretary to modify the performance plans of the directors of VA medical centers and VISNs to ensure that such plans are based on the quality of care received by veterans at the health care facilities under their jurisdiction.
Requires the Secretary to publish: (1) within 90 days after this Act's enactment, VA's wait-time goals for the scheduling of a veterans' appointment for health care; and (2) within one year after this Act's enactment, the current wait times for an appointment for primary care and specialty care at each VA medical center.
Directs the Secretary to develop, update, and make publicly available a comprehensive database containing all applicable patient safety, quality of care, and outcome measures for VA health care that are tracked by the Secretary.
Requires the Secretary to enter into an agreement with the Secretary of Health and Human Services (HHS) to provide the HHS Secretary with the information needed to make VA medical center patient quality and outcome information publicly available through HHS's Hospital Compare website.
Requires: (1) the VA website to include a link to the VA's health care providers database that provides veterans with the location of each VA physician's residency training, and (2) each veteran who is to undergo a surgical procedure by or through the VA to be provided information on the credentials of the surgeon who is to perform the procedure.
Directs the Comptroller General (GAO) to submit an assessment to Congress of: (1) the manner in which contractors under the VA's Patient-Centered Community Care initiative oversee the credentials of physicians within their networks, and (2) VA's oversight of the contracts under the Patient-Centered Community Care initiative.
Requires the annual budget that the President submits to Congress to include specified information regarding: (1) the cost of providing, and the number of veterans receiving, medical care through contracts with Medicare providers; and (2) the number of VA employees on paid administrative leave during the preceding fiscal year.
Directs the Secretary to establish policies penalizing VA employees who knowingly submit, or knowingly require another VA employee to submit, to another VA employee false data concerning health care wait times or quality measures.
Authorizes the Secretary to: (1) remove any individual from the VA's Senior Executive Service if the Secretary determines that the individual's performance warrants such removal, and (2) remove such individual from the civil service or appoint the individual to a General Schedule position at any grade the Secretary determines to be appropriate. Requires such removals to be performed in the same manner as removals of professional staff of Members of Congress.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 2424 Introduced in Senate (IS)]
113th CONGRESS
2d Session
S. 2424
To provide veterans with the choice of medical providers and to
increase transparency and accountability of operations of the Veterans
Health Administration of the Department of Veterans Affairs, and for
other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 3, 2014
Mr. McCain (for himself, Mr. Coburn, Mr. Burr, Mr. Flake, Mr. Isakson,
Mr. Inhofe, Mr. Grassley, Mr. Roberts, Mr. Hoeven, Mr. Coats, Mr.
Barrasso, Mr. Johanns, Mr. Rubio, Mr. Cornyn, Mr. Alexander, Mr. Kirk,
Mr. Wicker, Mrs. Fischer, Mr. Portman, Mr. Toomey, Mr. Boozman, Mr.
Moran, Mr. Thune, Mr. Scott, Mr. Enzi, and Mr. Graham) introduced the
following bill; which was read twice and referred to the Committee on
Veterans' Affairs
_______________________________________________________________________
A BILL
To provide veterans with the choice of medical providers and to
increase transparency and accountability of operations of the Veterans
Health Administration of the Department of Veterans Affairs, 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.
This Act may be cited as the ``Veterans Choice Act of 2014''.
SEC. 2. EXPANDED AVAILABILITY OF HOSPITAL CARE AND MEDICAL SERVICES FOR
VETERANS THROUGH THE USE OF CONTRACTS.
(a) Expansion of Available Care and Services.--
(1) In general.--Hospital care and medical services under
chapter 17 of title 38, United States Code, shall be furnished
to an eligible veteran described in subsection (b), at the
election of such veteran, through contracts authorized under
subsection (d), or any other law administered by the Secretary
of Veterans Affairs, with health care providers that are
participating in the Medicare program under title XVIII of the
Social Security Act (42 U.S.C. 1395 et seq.) for the furnishing
of such care and services to veterans.
(2) Choice of provider.--An eligible veteran who elects to
receive care and services under this section may select the
provider of such care and services from among any source of
provider of such care and services specified in paragraph (1)
that is accessible to the veteran.
(b) Eligible Veterans.--A veteran is an eligible veteran for
purposes of this section if--
(1)(A) the veteran is enrolled in the patient enrollment
system of the Department of Veterans Affairs established and
operated under section 1705 of title 38, United States Code; or
(B) the veteran is enrolled in such system, has not
received hospital care and medical services from the
Department, and has contacted the Department seeking an initial
appointment from the Department for the receipt of such care
and services; and
(2) the veteran either--
(A)(i) attempts, or has attempted under paragraph
(1)(B), to schedule an appointment for the receipt of
such care and services but is unable to schedule an
appointment within the current wait-time goals of the
Veterans Health Administration for the delivery of such
care and services; and
(ii) elects, and is authorized, to be furnished
such care or services pursuant to subsection (c)(2); or
(B) resides more than 40 miles from the nearest
medical facility of the Department, including a
community-based outpatient clinic, that is closest to
the residence of the veteran.
(c) Election and Authorization.--If the Secretary confirms that an
appointment for an eligible veteran described in subsection (b)(2)(A)
for the receipt of hospital care or medical services under chapter 17
of title 38, United States Code, is unavailable within the current
wait-time goals of the Department for the furnishing of such care or
services, the Secretary shall, at the election of the eligible
veteran--
(1) place such eligible veteran on an electronic waiting
list for such an appointment that is maintained by the
Department and accessible to the veteran via
www.myhealth.va.gov or any successor website; or
(2)(A) authorize that such care and services be furnished
to the eligible veteran under this section for a period of time
specified by the Secretary; and
(B) send a letter to the eligible veteran describing the
care and services the eligible veteran is eligible to receive
under this section.
(d) Care and Services Through Contracts.--
(1) In general.--The Secretary shall enter into contracts
with health care providers that are participating in the
Medicare program under title XVIII of the Social Security Act
(42 U.S.C. 1395 et seq.) to furnish care and services to
eligible veterans under this section.
(2) Rates and reimbursement.--
(A) In general.--In entering into a contract under
this subsection, the Secretary shall--
(i) negotiate rates for the furnishing of
care and services under this section; and
(ii) reimburse the health care provider for
such care and services at the rates negotiated
pursuant to clause (i) as provided in such
contract.
(B) Limit on rates.--Rates negotiated under
subparagraph (A)(i) shall not be more than the rates
paid by the United States to a provider of services (as
defined in section 1861(u) of the Social Security Act
(42 U.S.C. 1395x(u))) or a supplier (as defined in
section 1861(d) of such Act (42 U.S.C. 1395x(d))) under
the Medicare program under title XVIII of the Social
Security Act (42 U.S.C. 1395 et seq.) for the same care
and services.
(C) Limit on collection.--For the furnishing of
care and services pursuant to a contract under this
section, a health care provider may not collect any
amount that is greater than the rate negotiated
pursuant to subparagraph (A)(i).
(3) Information on policies and procedures.--The Secretary
shall provide to any health care provider with which the
Secretary has entered into a contract under paragraph (1) the
following:
(A) Information on applicable policies and
procedures for submitting bills or claims for
authorized care and services furnished to eligible
veterans under this section.
(B) Access to a telephone hotline maintained by the
Department that such health care provider may call for
information on the following:
(i) Procedures for furnishing care and
services under this section.
(ii) Procedures for submitting bills or
claims for authorized care and services
furnished to eligible veterans under this
section and being reimbursed for furnishing
such care and services.
(iii) Whether particular care or services
under this section are authorized, and the
procedures for authorization of such care or
services.
(e) Choice Card.--
(1) In general.--For purposes of receiving care and
services under this section, the Secretary shall issue to each
eligible veteran a card that the eligible veteran shall present
to a health care provider that is eligible to furnish care and
services under this section before receiving such care and
services.
(2) Name of card.--Each card issued under paragraph (1)
shall be known as a ``Choice Card''.
(3) Details of card.--Each Choice Card issued to an
eligible veteran under paragraph (1) shall include the
following:
(A) The name of the eligible veteran.
(B) An identification number for the eligible
veteran that is not the social security number of the
eligible veteran.
(C) The contact information of an appropriate
office of the Department for health care providers to
confirm that care and services under this section is
authorized for the eligible veteran.
(D) Contact information and other relevant
information for the submittal of claims or bills for
the furnishing of care and services under this section.
(E) The following statement: ``This card is for
qualifying medical care outside the Department of
Veterans Affairs. Please call the Department of
Veterans Affairs phone number specified on this card to
ensure that treatment has been authorized.''.
(4) Information on use of card.--Upon issuing a Choice Card
to an eligible veteran, the Secretary shall provide the
eligible veteran with information clearly stating the
circumstances under which the veteran may be eligible for care
and services under this section.
(f) Information on Availability of Care.--The Secretary shall
provide information to a veteran about the availability of care and
services under this section in the following circumstances:
(1) When the veteran enrolls in the patient enrollment
system of the Department under section 1705 of title 38, United
States Code.
(2) When the veteran attempts to schedule an appointment
for the receipt of hospital care or medical services from the
Department but is unable to schedule an appointment within the
current wait-time goals of the Veterans Health Administration
for delivery of such care or services.
(g) Providers.--To be eligible to furnish care and services under
this section, a health care provider must maintain at least the same or
similar credentials and licenses as those credentials and licenses that
are required of health care providers of the Department, as determined
by the Secretary for purposes of this section.
(h) Cost-Sharing.--The Secretary shall require an eligible veteran
to pay a copayment to the Department for the receipt of care and
services under this section only if the eligible veteran would be
required to pay such copayment for the receipt of such care and
services at a medical facility of the Department.
(i) Claims Processing System.--
(1) In general.--The Secretary shall provide for an
efficient nationwide system for processing and paying bills or
claims for authorized care and services furnished to eligible
veterans under this section.
(2) Regulations.--Not later than 90 days after the date of
the enactment of this Act, the Secretary of Veterans Affairs
shall prescribe regulations for the implementation of the
efficient nationwide system required by paragraph (1).
(j) Continuity of Medical Records.--The Secretary shall ensure that
medical records of veterans maintained by the Department are updated to
accurately reflect any care and services furnished under this section.
(k) Tracking of Missed Appointments.--The Secretary shall implement
a mechanism to track any missed appointments for care and services
under this section by eligible veterans to ensure that the Department
does not pay for such care and services that were not furnished.
(l) Implementation.--Not later than 90 days after the date of the
enactment of this Act, the Secretary shall prescribe interim final
regulations on the implementation of this section and publish such
regulations in the Federal Register.
(m) Inspector General Audit.--Not later than 540 days after the
publication of the interim final regulations under subsection (l), the
Inspector General of the Department shall conduct an audit of care and
services furnished under this section to ensure the accuracy of
payments by the Department for the cost of care and services furnished
under this section.
(n) Termination.--The requirement of the Secretary to furnish care
and services under this section terminates on the date that is two
years after the date on which the Secretary publishes the interim final
regulations under subsection (l).
(o) Reports.--Not less frequently than once every 90 days, the
Secretary shall submit to Congress a report on the furnishing of care
and services under this section that includes the following:
(1) The number of veterans who have received care and
services under this section during the 90-day period preceding
the submittal of the report.
(2) A description of the type of care and services
furnished to veterans under this section during such 90-day
period.
SEC. 3. SENSE OF CONGRESS ON PROMPT PAYMENT BY DEPARTMENT OF VETERANS
AFFAIRS.
It is the sense of Congress that the Secretary of Veterans Affairs
shall comply with section 1315 of title 5, Code of Federal Regulations
(commonly known as the ``prompt payment rule''), or any corresponding
similar regulation or ruling, in paying for health care pursuant to
contracts entered into with non-Department of Veterans Affairs
providers to provide health care under the laws administered by the
Secretary.
SEC. 4. IMPROVED PERFORMANCE METRICS FOR HEALTH CARE PROVIDED BY
DEPARTMENT OF VETERANS AFFAIRS.
(a) Prohibition on Use of Scheduling and Wait-Time Metrics in
Determination of Performance Awards.--The Secretary shall ensure that
scheduling and wait-time metrics or goals are not used as factors in
determining the performance of the following employees for purposes of
determining whether to pay performance awards to such employees:
(1) Directors, associate directors, assistant directors,
deputy directors, chiefs of staff, and clinical leads of
medical centers of the Department.
(2) Directors, assistant directors, and quality management
officers of Veterans Integrated Service Networks of the
Department.
(b) Modification of Performance Plans.--
(1) In general.--Not later than 30 days after the date of
the enactment of this Act, the Secretary shall modify the
performance plans of the directors of the medical centers of
the Department and the directors of the Veterans Integrated
Service Networks to ensure that such plans are based on the
quality of care received by veterans at the health care
facilities under the jurisdictions of such directors.
(2) Factors.--In modifying performance plans under
paragraph (1), the Secretary shall ensure that assessment of
the quality of care provided at health care facilities under
the jurisdiction of a director described in paragraph (1)
includes consideration of the following:
(A) Recent reviews by the Joint Commission
(formerly known as the ``Joint Commission on
Accreditation of Healthcare Organizations'') of such
facilities.
(B) The number and nature of recommendations
concerning such facilities by the Inspector General of
the Department in reviews conducted through Combined
Assessment Program (CAP) reviews, in the reviews by the
Inspector General of community-based outpatient clinics
and primary care clinics, and in reviews conducted
through the Office of Healthcare Inspections during the
two most recently completed fiscal years.
(C) The number of recommendations described in
subparagraph (B) that the Inspector General of the
Department determines have not been carried out
satisfactorily with respect to such facilities.
(D) Reviews of such facilities by the Commission on
Accreditation of Rehabilitation Facilities.
(E) The number and outcomes of administrative
investigation boards, root cause analysis, and peer
reviews conducted at such facilities during the fiscal
year for which the assessment is being conducted.
(F) The effectiveness of any remedial actions or
plans resulting from any Inspector General
recommendations in the reviews and analyses described
in subparagraphs (A) through (E).
(3) Additional leadership positions.--To the degree
practicable, the Secretary shall assess the performance of
other employees of the Department in leadership positions at
Department medical centers, including associate directors,
assistant directors, deputy directors, chiefs of staff, and
clinical leads, and in Veterans Integrated Service Networks,
including assistant directors and quality management officers,
using factors and criteria similar to those used in the
performance plans modified under paragraph (1).
SEC. 5. IMPROVED TRANSPARENCY CONCERNING HEALTH CARE PROVIDED BY
DEPARTMENT OF VETERANS AFFAIRS.
(a) Publication of Wait Times.--
(1) Goals.--
(A) Initial.--Not later than 90 days after the date
of the enactment of this Act, the Secretary of Veterans
Affairs shall publish in the Federal Register, and on
an Internet website accessible to the public of each
medical center of the Department of Veterans Affairs,
the wait-time goals of the Department for the
scheduling of an appointment by a veteran for the
receipt of health care from the Department.
(B) Subsequent changes.--
(i) In general.--If the Secretary modifies
the wait-time goals described in subparagraph
(A), the Secretary shall publish the new wait-
time goals--
(I) on an Internet website
accessible to the public of each
medical center of the Department not
later than 30 days after such
modification; and
(II) in the Federal Register not
later than 90 days after such
modification.
(ii) Effective date.--Any modification
under clause (i) shall take effect on the date
of publication in the Federal Register.
(C) Goals described.--Wait-time goals published
under this paragraph shall include goals for primary
care appointments, specialty care appointments, and
goals for such appointments based on the general
severity of the condition of the veteran.
(2) Wait times at medical centers of the department.--Not
later than one year after the date of the enactment of this
Act, the Secretary of Veterans Affairs shall publish on an
Internet website accessible to the public of each medical
center of the Department the current wait time for an
appointment for primary care and specialty care at the medical
center.
(b) Publicly Available Database of Patient Safety, Quality of Care,
and Outcome Measures.--
(1) In general.--Not later than 180 days after the date of
the enactment of this Act, the Secretary shall develop and make
available to the public a comprehensive database containing all
applicable patient safety, quality of care, and outcome
measures for health care provided by the Department that are
tracked by the Secretary.
(2) Update frequency.--The Secretary shall update the
database required by paragraph (1) not less frequently than
once each year.
(3) Unavailable measures.--For all measures that the
Secretary would otherwise publish in the database required by
paragraph (1) but has not done so because such measures are not
available, the Secretary shall publish notice in the database
of the reason for such unavailability and a timeline for making
such measures available in the database.
(4) Accessibility.--The Secretary shall ensure that the
database required by paragraph (1) is accessible to the public
through the primary Internet website of the Department and
through each primary Internet website of a Department medical
center.
(c) Hospital Compare Website of Department of Health and Human
Services.--
(1) Agreement required.--Not later than 180 days after the
date of the enactment of this Act, the Secretary of Veterans
Affairs shall enter into an agreement with the Secretary of
Health and Human Services for the provision by the Secretary of
Veterans Affairs of such information as the Secretary of Health
and Human Services may require to report and make publicly
available patient quality and outcome information concerning
Department of Veterans Affairs medical centers through the
Hospital Compare Internet website of the Department of Health
and Human Services or any successor Internet website.
(2) Information provided.--The information provided by the
Secretary of Veterans Affairs to the Secretary of Health and
Human Services under paragraph (1) shall include the following:
(A) Measures of timely and effective health care.
(B) Measures of readmissions, complications of
death, including with respect to 30-day mortality rates
and 30-day readmission rates, surgical complication
measures, and health care related infection measures.
(C) Survey data of patient experiences, including
the Hospital Consumer Assessment of Healthcare
Providers and Systems or any similar successor survey
developed by the Department of Health and Human
Services.
(D) Any other measures required of or reported with
respect to hospitals participating in the Medicare
program under title XVIII of the Social Security Act
(42 U.S.C. 1395 et seq.).
(3) Unavailable information.--For any applicable metric
collected by the Department of Veterans Affairs or required to
be provided under paragraph (2) and withheld from or
unavailable in the Hospital Compare Internet website, the
Secretary of Veterans Affairs shall publish a notice in the
Federal Register stating the reason why such metric was
withheld from public disclosure and a timeline for making such
metric available, if applicable.
(d) Comptroller General Review of Publicly Available Safety and
Quality Metrics.--Not later than three years after the date of the
enactment of this Act, the Comptroller General of the United States
shall conduct a review of the safety and quality metrics made publicly
available by the Secretary of Veterans Affairs under this section to
assess the degree to which the Secretary is complying with the
provisions of this section.
SEC. 6. INFORMATION FOR VETERANS ON THE CREDENTIALS OF DEPARTMENT OF
VETERANS AFFAIRS PHYSICIANS.
(a) Improvement of ``Our Providers'' Internet Website Links.--
(1) Availability through department of veterans affairs
homepage.--A link to the ``Our Providers'' health care
providers database of the Department of Veterans Affairs, or
any successor database, shall be available on and through the
homepage of the Internet website of the Department that is
accessible to the public.
(2) Information on location of residency training.--The
Internet website of the Department that is accessible to the
public shall include under the link to the ``Our Providers''
health care providers database of the Department, or any
successor database, the location of residency training of each
licensed physician of the Department.
(3) Information on physicians at particular facilities.--
The ``Our Providers'' health care providers database of the
Department, or any successor database, shall identify whether
each licensed physician of the Department is a physician in
residency.
(b) Information on Credentials of Physicians for Veterans
Undergoing Surgical Procedures.--Each veteran who is undergoing a
surgical procedure by or through the Department shall be provided, at
such time in advance of the procedure as is appropriate to permit such
veteran to evaluate such information, information on the credentials of
the surgeon to be performing such procedure.
(c) GAO Report.--Not later than two years after the date of the
enactment of this Act, the Comptroller General of the United States
shall submit to the Committees on Veterans' Affairs of the Senate and
the House of Representatives a report setting forth an assessment by
the Comptroller General of the following:
(1) The manner in which contractors under the Patient-
Centered Community Care initiative of the Department perform
oversight of the credentials of physicians within the networks
of such contractors under the initiative.
(2) The oversight by the Department of the contracts under
the Patient-Centered Community Care initiative.
SEC. 7. INFORMATION IN ANNUAL BUDGET OF THE PRESIDENT ON HOSPITAL CARE
AND MEDICAL SERVICES PROVIDED UNDER SECTION 2.
The materials on the Department of Veterans Affairs in the budget
of the President for a fiscal year, as submitted to Congress pursuant
to section 1105(a) of title 31, United States Code, shall set forth the
following:
(1) The number of veterans who received hospital care and
medical services under section 2 of this Act during the fiscal
year preceding the fiscal year in which such budget is
submitted.
(2) The amount expended by the Department on furnishing
care and services under such section during the fiscal year
preceding the fiscal year in which such budget is submitted.
(3) The amount requested in such budget for the costs of
furnishing care and services under such section during the
fiscal year covered by such budget, set forth in aggregate and
by amounts for each account for which amounts are so requested.
(4) The number of veterans that the Department estimates
will receive hospital care and medical services under such
section during the fiscal years covered by the budget
submission.
(5) The number of employees of the Department on paid
administrative leave at any point during the fiscal year
preceding the fiscal year in which such budget is submitted.
SEC. 8. PROHIBITION ON FALSIFICATION OF DATA CONCERNING WAIT TIMES AND
QUALITY MEASURES AT DEPARTMENT OF VETERANS AFFAIRS.
Not later than 60 days after the date of the enactment of this Act,
and in accordance with title 5, United States Code, the Secretary of
Veterans Affairs shall establish policies whereby any employee of the
Department of Veterans Affairs who knowingly submits false data
concerning wait times for health care or quality measures with respect
to health care to another employee of the Department or knowingly
requires another employee of the Department to submit false data
concerning such wait times or quality measures to another employee of
the Department is subject to a penalty the Secretary considers
appropriate after notice and an opportunity for a hearing, including
civil penalties, unpaid suspensions, or termination.
SEC. 9. REMOVAL OF SENIOR EXECUTIVE SERVICE EMPLOYEES OF THE DEPARTMENT
OF VETERANS AFFAIRS FOR PERFORMANCE.
(a) In General.--Chapter 7 of title 38, United States Code, is
amended by adding at the end the following new section:
``Sec. 713. Senior Executive Service: removal based on performance
``(a) In General.--(1) Notwithstanding subchapter V of chapter 35
of title 5, subchapter V of chapter 75 of title 5, or any other
provision of law, the Secretary may remove any individual who is an
employee of the Department from a Senior Executive Service position (as
defined in section 3132(a) of title 5) if the Secretary determines the
performance of the individual warrants such removal.
``(2) If the Secretary so removes such an individual, the Secretary
may--
``(A) remove the individual from the civil service (as
defined in section 2101 of title 5); or
``(B) appoint the individual to a General Schedule position
at any grade of the General Schedule the Secretary determines
appropriate.
``(b) Notice to Congress.--Not later than 30 days after removing an
individual from the Senior Executive Service under subsection (a), the
Secretary shall submit to the Committee on Veterans' Affairs of the
Senate and the Committee on Veterans' Affairs of the House of
Representatives notice in writing of such removal and the reason for
such removal.
``(c) Manner of Removal.--A removal under this section shall be
done in the same manner as the removal of a professional staff member
employed by a Member of Congress.''.
(b) Clerical Amendment.--The table of sections at the beginning of
such chapter is amended by adding at the end the following new item:
``713. Senior Executive Service: removal based on performance.''.
<all>
Introduced in Senate
Sponsor introductory remarks on measure. (CR S3381)
Read twice and referred to the Committee on Veterans' Affairs.
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