HR 3994 — ACT for Veterans Act

(a) In General.— (1) There is established a program to furnish hospital care, medical services, and extended care services to covered veterans through health care providers specified in subsection (c). (2) The Secretary shall coordinate the furnishing of hospital care, medical services, and extended care services under this section to covered veterans, including coordination of, at a minimum, the following: (A) Ensuring the scheduling of medical appointments in a timely manner and the establishment of a mechanism to receive medical records from non-Department providers. (B) Ensuring continuity of care and services. (C) Ensuring coordination among regional networks if the covered veteran accesses care and services in a different network than the regional network in which the covered veteran resides. (D) Ensuring that covered veterans do not experience a lapse in care resulting from errors or delays by the Department or its contractors or an unusual or excessive burden in accessing hospital care, medical services, or extended care services. (3) A covered veteran may only receive care or services under this section upon the authorization of such care or services by the Secretary. (4) Nothing in this section shall be construed to authorize the Secretary to suspend the program established under paragraph (1). (b) Covered Veterans.— For purposes of this section, a covered veteran is any veteran who— (1) is enrolled in the system of annual patient enrollment established and operated under section 1705 of this title; or (2) is not enrolled in such system but is otherwise entitled to hospital care, medical services, or extended care services under subsection (c)(2) of such section. (c) Health Care Providers Specified.— Health care providers specified in this subsection are the following: (1) 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. (2) The Department of Defense. (3) The Indian Health Service. (4) 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))). (5) 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. (d) Conditions Under Which Care Is Required To Be Furnished Through Non-Department Providers.— (1) The Secretary shall, subject to the availability of appropriations, furnish hospital care, medical services, and extended care services to a covered veteran through health care providers specified in subsection (c) if— (A) the Department does not offer the care or services the veteran requires; (B) the Department does not operate a full-service medical facility in the State in which the covered veteran resides; (C) (i) the covered veteran was an eligible veteran under section 101(b)(2)(B) of the Veterans Access, Choice, and Accountability Act of 2014 (Public Law 113–146; 38 U.S.C. 1701 note) as of the day before the date of the enactment of the Caring for Our Veterans Act of 2018; (ii) continues to reside in a location that would qualify the veteran for eligibility under such section; and (iii) either— (I) resides in one of the five States with the lowest population density as determined by data from the 2010 decennial census; or (II) resides in a State not described in subclause (I) and— (aa) received care or services under this title in the year preceding the enactment of the Caring for Our Veterans Act of 2018; and (bb) is seeking care or services within 2 years of the date of the enactment of the Caring for Our Veterans Act of 2018; (D) the covered veteran has contacted the Department to request care or services and the Department is not able to furnish such care or services in a manner that complies with designated access standards developed by the Secretary under section 1703B o...