Mike Bost
Representative for Illinois · Republican · United States
“(B) Elements.--The Secretary, in coordination with participating critical access hospitals, shall ensure that any contract, agreement, or other arrangement entered into under subparagraph (A) establishes criteria, as the Secretary considers appropriate, to ensure-- (i) the provision of timely, safe, and high-quality health care services t…”
“(B) Elements.--The Secretary, in coordination with participating critical access hospitals, shall ensure that any contract, agreement, or other arrangement entered into under subparagraph (A) establishes criteria, as the Secretary considers appropriate, to ensure-- (i) the provision of timely, safe, and high-quality health care services t…”
“(a) In General.--Paragraph (2) of section 2306(h) of title 38, United States Code, is amended to read as follows: ``(2) If the Secretary furnishes an urn or commemorative plaque for an individual under paragraph (1), the Secretary may not provide for such individual a headstone or marker under this section, or any interment benefit under…”
“(a) In General.--Paragraph (2) of section 2306(h) of title 38, United States Code, is amended to read as follows: ``(2) If the Secretary furnishes an urn or commemorative plaque for an individual under paragraph (1), the Secretary may not provide for such individual a headstone or marker under this section, or any interment benefit under…”
“(d) Update of Information on Providers.--Not later than one year after the date of the enactment of this Act, the Secretary, through the Office of Integrated Veteran Care or successor office, shall develop a process to ensure that third party administrators regularly, not less frequently than quarterly-- (1) update their lists of communit…”
“(d) Update of Information on Providers.--Not later than one year after the date of the enactment of this Act, the Secretary, through the Office of Integrated Veteran Care or successor office, shall develop a process to ensure that third party administrators regularly, not less frequently than quarterly-- (1) update their lists of communit…”
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“As Congress continues its consideration of this legislation, we urge Members to preserve and strengthen key protections: no retroactive harm to veterans currently receiving compensation; prospective application only to future claims or future requests for increased ratings; full transparency from VA, the White House, and the Administration regarding any independent regulatory or policy action; and a final package that ensures expanded benefits are delivered responsibly and effectively. We are committed to working with Congress, VA, the Administration, coalition partners, and the broader veteran community to improve the pay-for, identify any credible alternative path forward, and secure the strongest possible outcome.”
“Given that reality, we believe the practical question before Congress is whether this process should continue so these resources can be reinvested in veterans, caregivers, families, and survivors, or whether the opportunity to enact this package is lost while unresolved funding questions remain. We support advancing the Take Care of America's Veterans Act because the bill represents a net expansion of benefits and support for the veteran community and contains protections intended to prevent reductions for current beneficiaries. The goodness and positive impact of this package should not be lost in the debate over its financing.”
“Unfortunately, the current environment is far from ideal, and veterans, families, survivors, and caregivers have already waited years across multiple Congresses and administrations for action on provisions that maintain strong bipartisan support. The Administration must also provide immediate clarity on whether these rating-schedule changes are intended to proceed independently of the Take Care of America's Veterans Act through VA regulation, White House direction, or other administrative action. That clarity is essential because the bill's financing rests on assumptions that remain unresolved. If similar VASRD changes are implemented outside this legislation, the resulting savings could revert to the Treasury rather than be reinvested in veterans, families, survivors, and caregivers.”
“Veterans do not need a bill that makes Members feel good for a day and then dies in the Senate. They need legislation that can pass. Mr. Speaker, veterans groups agree. I include in the Record a letter from 20 different veterans organizations in support of this legislation. Richard Star Act would be funded through the defense authorizing committees and fu11y end the unjust wounded veteran tax on combat-injured warriors. Pay-as-you-go rules would be waived for these earned benefits. There would be complete clarity from the Administration and VA about whether long-anticipated VASRD changes will proceed independently of this bill.”
“This is not about denying these conditions exist. Let's be clear. This is not cutting benefits. No one will lose their benefits who are receiving them. {time} 0920 It is about making sure the VA rating schedule follows modern science and using those savings to fund the expansion of benefits and other VA programs. Mr. Speaker, if we don't pass H.R. 9237 today, VA can make these rating changes as planned but the savings would go back to one place: Big Government. I want those savings to go instead into the pockets and the benefits for millions of veterans and their families. Mr. Speaker, as a United States Marine Corps veteran, you can bet your bottom dollar that I believe that this bill would not harm a single veteran, and I would not bring it forward to this floor if I thought it would.”
“These are not new ideas, and there is nothing unprecedented about this. This bill would not eliminate disability ratings for sleep apnea or tinnitus. It would not automatically reduce any veteran's current disability rating. Future veterans with sleep apnea will still get treatment through VA healthcare, but if a CPAP eliminates your symptoms, VA would compensate you less. Currently, the amount of compensation for sleep apnea is often more than the amount that a veteran receives if they lose a limb. This change is just common sense. It is why VA has worked hard to propose changes like these, which reflect modern medicine. For tinnitus, VA has found it is best understood as a symptom of another condition such as hearing loss or TBI. Under the proposed change, tinnitus would still be rated as part of another underlying condition.”
“The Take Care of America's Veterans Act would expand benefits and push VA to do better. Mr. Speaker, I also want to address how this bill is funded, as I have heard a lot of misinformation about this point. H.R. 9237 would codify VA's own pending regulation on how to evaluate sleep apnea and tinnitus' effect on a veteran's workplace earnings. This regulation was proposed by the Biden-era VA in 2022, created by VA's team of doctors and researchers. It was part of VA's efforts to modernize its disability rating schedule created in the 1940s. President Biden's Under Secretary for Benefits, Josh Jacobs, testified in favor of these changes at his confirmation hearing. Earlier this year, VA's executive director of compensation confirmed plans to finalize these changes this year.”
“These American families have not seen a meaningful increase in decades. Mr. Speaker, this bill also includes the Veterans' ACCESS Act. Veterans should be able to access healthcare in their own communities. Too many veterans still face delays, confusion, and barriers when trying to use VA community care. This bill would also improve mental health care and community-based suicide prevention. A veteran's healthcare should be driven by the veteran's needs, not by government control. H.R. 9237 would improve education benefits and vocational training to help veterans transition into civilian life. It would modernize the VA's claims and appeals process so veterans have a system that works for them. It would streamline the way VA handles construction, leasing, contracting, IT, and finances.”
“The Love Lives On Act is another important provision included in this bill. Currently, surviving spouses lose their benefits if they remarry before age 55, but those benefits were earned by their spouse's sacrifice for this country. The Love Lives On Act would allow surviving spouses to remarry at any age. Another important provision in this bill is the Sharri Briley and Eric Edmundson Veterans Benefits Expansion Act. This bill would provide long-awaited increases to catastrophically disabled veterans and surviving spouses. Eric was 25 years old when an IED left him with a fractured spine and a traumatic brain injury. H.R. 9237 would increase benefits for catastrophically disabled veterans like Eric by $10,000 a year. It would also increase benefits for surviving spouses.”
“For decades, medically retired, combat-injured veterans have had their military retirement offset dollar-for-dollar by their VA disability. While some disabled veterans who served 20 years receive both, there are tens of thousands of combat-injured veterans who currently do not. Many combat- injured veterans would have served longer if their injuries had not taken that opportunity from them. H.R. 9237 would help end that injustice. It would end that offset for combat-injured veterans, allowing them to receive both benefits up to what a 20-year retiree with the same disabilities would receive. Members on both sides of the aisle and veterans service organizations support this and have for years. A press release, a handshake, or a discharge petition does not end the wounded warrior tax. This bill will.”
“9237, the Take Care of America's Veterans Act. [[Page H4606]] As a veteran of the United States Marine Corps, for me, this bill is personal. When a young man or woman raises their right hand and agrees to serve this country, America makes a promise. That promise does not end when a servicemember is wounded. It is my goal--and the goal of my friend, Senator Jerry Moran--to deliver on that promise. This bill would be one of the most comprehensive veteran packages considered by Congress in a decade. This bill includes more than 60 bipartisan provisions that would improve healthcare, benefits, operations, and accountability across the VA. Mr. Speaker, I would like to tell you more about some of those important provisions. One is the Major Richard Star Act.”
“The bill, as amended, shall be debatable for 1 hour, equally divided and controlled by the chair and ranking minority member of the Committee on Veterans' Affairs, or their respective designees. The gentleman from Illinois (Mr. Bost) and the gentleman from California (Mr. Takano) each will control 30 minutes. The Chair recognizes the gentleman from Illinois. General Leave Mr. BOST. Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days in which to revise and extend their remarks and insert extraneous material into the Record on H.R. 9237. The SPEAKER pro tempore. Is there objection to the request of the gentleman from Illinois? There was no objection. Mr. BOST. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise today in strong support of my bill, H.R.”
“(c) Elements.--The plan required under subsection (a) shall include an assessment of disability-related barriers to care at medical facilities of the Department of Veterans Affairs and through community care networks of non-Department providers for veterans with spinal cord injury or disorder and a description of the actions needed to overcome such barriers, including cost estimates, timelines for corrective action, and requests for legislative action, if any. (d) Veterans Service Organization Defined.--In this section, the term ``veterans service organization'' means any organization recognized by the Secretary under section 5902 of title 38, United States Code. The SPEAKER pro tempore.”
“(a) In General.--Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives a plan on improving disability-related access to care from facilities of the Department and from non- Department facilities and providers through which the Secretary furnishes care and services under section 1703 of title 38, United States Code, for veterans with spinal cord injury or disorder. (b) Consultation.--In developing the plan required under subsection (a), the Secretary shall consult with relevant stakeholders, including veterans service organizations who serve veterans with spinal cord injury or disorder.”
“(c) Veterans Service Organization Defined.--In this section, the term ``veterans service organization'' means any organization recognized by the Secretary under section 5902 of title 38, United States Code. SEC. 676. PLAN ON INCREASING ACCESSIBILITY OF CARE FOR VETERANS WITH SPINAL CORD INJURY OR DISORDER.”
“(a) In General.--Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs, in consultation with veterans service organizations, veterans, caregivers of veterans, employees of the Department of Veterans Affairs, and other stakeholders as determined by 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 containing recommendations for legislative or administrative action to improve the clinical appeals process of the Department with respect to timeliness, transparency, objectivity, consistency, and fairness. (b) Inapplicability of Requirements Relating to Federal Advisory Committees.--Chapter 10 of title 5, United States Code, shall not apply to the consultation required by subsection (a).”
“1396 et seq.), and the TRICARE program (as defined in section 1072 of title 10).''; and (2) in subsection (d), by inserting ``or federally funded research and development center'' after ``private entity''. SEC. 675. REPORT ON IMPROVEMENTS TO CLINICAL APPEALS PROCESS.”
“(B) A pilot program to test innovative payment models involving payment bundling for integrated care during an episode of care authorized under the Veterans Community Care Program under section 1703 of title 38, United States Code, to improve the coordination, quality, and efficiency of health care delivery under such program. (f) Modification of Independent Assessments of Health Care Delivery Systems and Management Processes.--Section 1704A of title 38, United States Code, is amended-- (1) in subsection (a)(2)(I), by adding at the end the following new clause: ``(vi) To identify proven management and payment best practices of the Federal Government used under the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.), the Medicaid program under title XIX of such Act (42 U.S.C.”
“(e) Pilot Programs.-- (1) In general.--Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall commence carrying out the pilot programs described in paragraph (2) through the Center for Innovation established by section 326 of title 38, United States Code, as added by subsection (a), and the Office of Management of the Department of Veterans Affairs. (2) Pilot programs described.--The Secretary shall carry out the following pilot programs: (A) A pilot program to test innovative payment models for the furnishing of preventive health services, as such term is defined in section 1701 of title 38, United States Code.”
“(B) Report.--Not later than 30 days after the conclusion of the review required 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 written report containing-- (i) a complete and unredacted list of all findings and recommendations from the review; and (ii) any legislative, administrative, regulatory, policy, or other changes sought by the Secretary as a result of such findings. (4) Veterans community care program defined.--In this subsection, the term ``Veterans Community Care Program'' means the Veterans Community Care Program under section 1703 of title 38, United States Code.”
“(G) assess such other factors as determined appropriate by the Secretary in consultation with Congress. (3) Briefing and report.-- (A) Briefing.--Periodically throughout the duration of the review required under paragraph (1), but not less frequently than quarterly, the Secretary shall brief the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives on the status and preliminary findings of such review.”
“1396 et seq.), and the TRICARE program (as defined in section 1072 of title 10, United States Code); (B) determine what best practices, if any, identified under subparagraph (A) should be adopted and implemented by the Secretary, including those practices that would require legislative action before adoption and implementation; (C) determine how the Secretary can improve access to care through the Veterans Community Care Program for veterans eligible for such care; (D) identify solutions to ease administrative, legislative, and regulatory burdens and improve efficiency in the Veterans Community Care Program; (E) identify improvements to the Veterans Community Care Program that can enhance the experience of veterans and participating entities and providers furnishing hospital care, medical services, and extended care services under the Veterans Community Care Program; (F) review how the Secretary-- (i) identifies eligibility for and reviews, processes, and approves referrals for care under the Veterans Community Care Program; (ii) authorizes the furnishing of services under the Veterans Community Care Program; and (iii) receives, reviews, processes, and approves requests for payment from participating entities and providers furnishing services under the Veterans Community Care Program.”
“(d) Review of Veterans Community Care Program.-- (1) In general.--Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs, acting through the Office of Management of the Department of Veterans Affairs, shall conduct a review of all aspects of the Veterans Community Care Program. (2) Elements.--The review required by paragraph (1) shall-- (A) identify proven management and payment best practices of the Federal Government used under the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.), the Medicaid program under title XIX of such Act (42 U.S.C.”
“(B) Chapter 3.--The table of sections at the beginning of chapter 3 of such title is amended by adding at the end the following new item: ``326. Center for Innovation.''. (c) Comptroller General Report.--Not later than 18 months after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress a report-- (1) on the efforts of the Center for Innovation of the Department of Veterans Affairs in fulfilling the objectives and requirements under section 326 of title 38, United States Code, as added by subsection (a); and (2) containing such recommendations as the Comptroller General considers appropriate.”
“1701 note) is amended-- (i) in subsection (a)(2)(A)(viii), by striking ``the Center for Innovation for Care and Payment of the Department under section 1703E of title 38, United States Code'' and inserting ``the Center for Innovation under section 326 of title 38, United States Code''; and (ii) in subsection (c)(1), by striking ``the Center for Innovation for Care and Payment established under section 1703E of title 38, United States Code'' and inserting ``the Center for Innovation under section 326 of title 38, United States Code''. (3) Clerical amendments.-- (A) Chapter 17.--The table of sections at the beginning of chapter 17 of title 38, United States Code, is amended by striking the item relating to section 1703E.”
“(B) Pilot program on consolidating approval process of department of veterans affairs for covered dental care.-- Section 106(a) of the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act (Public Law 118-210; 38 U.S.C. 1703 note) is amended, in the matter preceding paragraph (1), by striking ``the Center for Innovation for Care and Payment established under section 1703E of title 38, United States Code'' and inserting ``the Center for Innovation established under section 326 of title 38, United States Code''. [[Page H4605]] (C) Strategic plan on value-based health care system for veterans health administration; pilot program.--Section 107 of the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act (Public Law 118-210; 38 U.S.C.”
“(b) Conforming and Clerical Amendments.-- (1) Conforming repeal.--Section 1703E of title 38, United States Code, is repealed. (2) Conforming amendments.-- (A) Pilot program to improve administration of care under veterans community care program.--Section 105(a) of the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act (Public Law 118-210; 38 U.S.C. 1703 note) is amended, in the matter preceding paragraph (1), by striking ``Pursuant to section 1703E of title 38, United States Code, the Secretary of Veterans Affairs, acting through the Center for Innovation for Care and Payment'' and inserting ``Pursuant to section 326 of title 38, United States Code, the Secretary of Veterans Affairs, acting through the Center for Innovation''.”
“``(h) Cost Neutrality and Funding.-- ``(1) In general.--Implementation or expansion of any model under this section shall be conducted in a manner that is cost-neutral to the Department over the duration of the use of the model, including administrative costs. ``(2) Use of available amounts.--The Secretary shall ensure that expenditures under this section are made from amounts otherwise available to the Department for medical services, community care, or medical support and compliance. ``(i) Rule of Construction.--Nothing in this section shall be construed to authorize the Secretary to reduce the scope or amount of benefits under this title, or to impose additional eligibility requirements, except as may be necessary to carry out an approved model under this section.''.”
“``(g) Expansion of Successful Models.-- ``(1) In general.--Except as provided in paragraph (2), the Secretary may, through rulemaking, expand the duration and scope of a model tested under this section to the extent that-- ``(A) the Secretary determines such expansion is expected to-- ``(i) reduce program expenditures without reducing quality of care; or ``(ii) improve quality of care without increasing program expenditures; and ``(B) the Chief Financial Officer of the Department certifies that such expansion will maintain budget neutrality. ``(2) Limitation.--The Secretary shall not expand a model unless the results of the evaluation of the model under subsection (e) demonstrate that the requirements of paragraph (1) are satisfied.”
“``(2) Final report on models.--Not later than 180 days after completing each model under this section, 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 final report on such model, including-- ``(A) findings from the evaluation of such model; ``(B) updated findings under paragraph (1) with respect to such model; ``(C) an assessment of the fiscal impact of such model; and ``(D) recommendations for expansion or termination of the use of such model.”
“``(f) Reporting.-- ``(1) Annual report.--Not less frequently than annually, 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 models being tested under this section and their preliminary results, including-- ``(A) a brief narrative description of the model explaining its intent and the proposed manner in which it is supposed to reduce expenditures and increase quality of or access to care for veterans; ``(B) the number of veterans and providers participating in the model, broken down by demographics such as age, race or ethnicity, geographic location, and other characteristics as chosen by the Secretary; ``(C) gross and net savings or increases to the medical services account of the Department, including in comparison to baseline budgetary assumptions in the absence of the model; ``(D) an assessment of the utilization of the model, including the proportion of providers choosing to participate in the model and the proportion of veterans choosing to participate in the model, as the case may be; ``(E) an assessment of quality of care and patient outcomes as measured by discrete objective metrics, including changes to morbidity and mortality, changes to admission rates, changes to readmission rates, changes to population health metrics such as average blood pressure, A1C levels, body mass index, or other relevant health metrics, or other relevant clinical outcome metrics; ``(F) a description of provider, stakeholder, and veteran experiences; and ``(G) such other matters as the Secretary may consider relevant.”
“``(e) Testing and Evaluation.-- ``(1) In general.--The Secretary shall design and test each model under this section in a manner that allows for the evaluation of-- ``(A) changes in program expenditures; ``(B) changes in quality and outcomes of care for veterans; and ``(C) other factors the Secretary determines relevant to care coordination, access, and equity. ``(2) Evaluation.--The Secretary shall evaluate each model under this section using scientifically valid methodologies, including control or comparison groups if practicable.”
“``(C) Chronic care coordination models. ``(d) Selection of Models.-- ``(1) In general.--The Secretary, acting through the Center, shall select models to be tested under subsection (c) from among those that-- ``(A) address a defined population for which there are demonstrated deficits in care leading to poor clinical outcomes or potentially avoidable expenditures; and ``(B) are expected to reduce program costs while preserving or enhancing the quality of care furnished to veterans. ``(2) Criteria.--In selecting models under paragraph (1), the Secretary shall apply criteria consistent with the model selection framework used in evidence-based criteria that the Secretary determines appropriate.”
“``(c) Identification and Testing of Models.-- ``(1) In general.--The Center shall-- ``(A) identify and test health care payment and service delivery models under this title, including care from non- Department providers under subchapter I of chapter 17 of this title, that have the potential to-- ``(i) reduce program expenditures; and ``(ii) preserve or enhance the quality of care furnished to veterans; ``(B) give preference to models that improve the coordination, quality, and efficiency of health care services furnished under this title; and ``(C) evaluate the effect of applying such models on program expenditures and quality outcomes under this title. ``(2) Included models.--The models identified and tested under paragraph (1) may include the following: ``(A) Bundled payment arrangements. ``(B) Preventive care initiatives.”
“(a) In General.--Chapter 3 of title 38, United States Code, is amended by adding at the end the following new section: ``Sec. 326. Center for Innovation ``(a) Establishment.--There is established in the Department, within the Office of the Secretary, a Center for Innovation (in this section referred to as the `Center'). ``(b) Purpose.--The purpose of the Center is to test innovative payment and service delivery models to reduce program expenditures of the Department under chapter 17 of this title while preserving or enhancing the quality of care furnished to veterans and other eligible individuals.”
“(b) Submittal of Plan.-- (1) Initial plan.--Not later than 180 days after the date of the enactment of this Act, the Secretary shall submit to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives the plan developed under subsection (a). (2) Biannual update.--Not less frequently than once every 180 days during the two-year period beginning on the submittal of the plan under paragraph (1), the Secretary shall brief the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives on any updates on the implementation of such plan. SEC. 674. MODIFICATION OF REQUIREMENTS FOR CENTER FOR INNOVATION FOR CARE AND PAYMENT OF THE DEPARTMENT OF VETERANS AFFAIRS AND TRANSFER OF AUTHORITY.”
“(a) In General.--The Secretary of Veterans Affairs shall develop and implement a plan to establish, to the greatest extent practicable, an interactive, online self-service module-- [[Page H4604]] (1) to allow veterans enrolled in the system of annual patient enrollment of the Department of Veterans Affairs established and operated under section 1705(a) of title 38, United States Code-- (A) to request appointments, track referrals for health care under the laws administered by the Secretary, whether at a facility of the Department of Veterans Affairs or through a non-Department provider, and receive appointment reminders; (B) to appeal and track decisions relating to-- (i) denials of requests for authorization for care or services under section 1703 of title 38, United States Code; or (ii) denials of requests for care or services at facilities of the Department, including under section 1710 of such title; (C) to compare the average wait times for appointments for the type of care sought by the veteran at facilities of the Department and with non-Department facilities and providers through which the Secretary furnishes care and services under section 1703 of such title; (D) to compare average driving times between their residence and the nearest facility of the Department that provides the care they are seeking and between their residence and the closest non-Department provider that provides the care they are seeking and through which the Secretary furnishes care and services under section 1703 of such title; and (E) to view a provider directory, information regarding pending medical claims, and explanations of benefits; and (2) to implement such other matters as determined appropriate by the Secretary.”
“Paragraph (4) of section 1722A(a) of title 38, United States Code, is amended to read as follows: ``(4) Paragraph (1) does not apply-- ``(A) to opioid antagonists furnished under this chapter to a veteran who is at high risk for overdose of a specific medication or substance in order to reverse the effect of such an overdose; and ``(B) to any limited supply prescription for medication, up to a 30-day supply of such medication, under section 1730D(b) of this title if the covered health care professional would have prescribed, delivered, distributed, or dispensed a supply for more than seven days if not for the restrictions under such section.''. SEC. 673. PLAN ON ESTABLISHMENT OF INTERACTIVE, ONLINE SELF- SERVICE MODULE FOR CARE.”
“(b) Clerical Amendment.--The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 1730C the following new item: ``1730D. Prescription, delivery, distribution, and dispensation of controlled substance medications via telemedicine.''. SEC. 672. COPAYMENTS FOR LIMITED SUPPLIES OF MEDICATIONS.”
“``(2) The term `covered health care professional' means-- ``(A) a health care professional who-- ``(i) is-- ``(I) an employee of the Department appointed under section 7306, 7401, 7405, 7406, or 7408 of this title or under title 5; or ``(II) operating from a facility of the Department, including a clinic of the Department; ``(ii) is authorized by the Secretary to provide health care under this chapter; ``(iii) is required to adhere to all standards for quality relating to the provision of health care in accordance with applicable policies of the Department; ``(iv) has an active, current, full, and unrestricted license, registration, or certification or meets qualification standards set forth by the Secretary within a specified time frame; and ``(v) with respect to a health care profession listed under section 7402(b) of this title, has the qualifications for such profession as set forth by the Secretary; and ``(B) a health professions trainee who-- ``(i) is appointed under section 7405 of this title; and ``(ii) is under the clinical supervision of a health care professional described in subparagraph (A).''.”
“``(g) Duration.--The authority under this section shall terminate on September 30, 2031. ``(h) Definitions.-- In this section: ``(1) The terms `controlled substance', `deliver', `dispense', and `distribute' have the meanings given those terms in section 102 of the Controlled Substances Act (21 U.S.C. 802).”
“``(2) Elements.--Each report under paragraph (1) shall indicate, at a minimum-- ``(A) how many patients received prescriptions for controlled substance medications through telemedicine under this section; ``(B) which controlled substances are being prescribed under this section and how many prescriptions were written for each such substance; ``(C) the number of individuals who received a controlled substance medication that was prescribed, delivered, distributed, or dispensed under this section without evidence of an in-person medical evaluation within the previous two years by a health care professional described in subsection (a)(1)(C); and ``(D) the barriers that exist to reviewing prescription drug monitoring programs of States and how often those barriers occur.”
“``(f) Reporting.-- ``(1) In general.--Not later than one year after the date of the enactment of the Take Care of America's Veterans Act, and not less frequently than annually thereafter until the termination date under subsection (g), 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 that addresses the use of the authority under this section during the fiscal year preceding the date of submission of the report in each Veterans Integrated Service Network.”
“812) unless the covered health care professional is providing treatment-- ``(i) for opioid use disorder; ``(ii) for a patient receiving palliative care or enrolled in hospice care; or ``(iii) for a patient who is physically located in a medical facility where the patient is receiving in-person care. ``(B) Exception.--The prohibition under subparagraph (A) shall not apply to renewal or maintenance of a previously prescribed medication described in such subparagraph.”
“``(2) Elements.--The Secretary shall ensure the guidelines and process described in paragraph (1)-- ``(A) do not restrict access of a patient to in-person care; and ``(B) provide for the collection and analysis of data to determine if an individual has evidence of a prior in-person medical evaluation by a health care professional described in subsection (a)(1)(C) who would reasonably be expected to have prescribing authority based on their credential or organizational role. ``(3) Initiating treatment.-- ``(A) In general.--The guidelines established by paragraph (1) shall prohibit a covered health care professional from initiating treatment with an opioid medication listed in schedule II or III under section 202 of the Controlled Substances Act (21 U.S.C.”
“``(c) Maximum Supply.--The authority under this section may be used to supply a controlled substance for not more than a six-month period. ``(d) Use of Authority.--The Secretary shall ensure that the authority under this section is used to prevent interruptions to patient care and not as a replacement for routine in-person patient care. ``(e) Regulations.-- ``(1) In general.--The Secretary shall establish in regulations guidelines and a process for the prescription, delivery, distribution, and dispensation of a controlled substance pursuant to subsection (a).”
“``(b) Authority for Limited Supply.-- ``(1) In general.--If the databases and program described in subsection (a)(1)(D) are unavailable or inaccessible at the time of a telemedicine encounter conducted by a covered health care professional, the covered health care professional may not prescribe, deliver, distribute, or dispense more than a seven-day supply of a controlled substance until the covered health care professional is able to review such databases and program. ``(2) Databases unavailable or inaccessible.--If a database or program required to be reviewed under subsection (a)(1)(D) is unavailable or inaccessible for an extended period, as determined by the Secretary, a covered health care professional may provide additional seven-day supplies of a controlled substance until such database or program is accessible.”
“823(f)); ``(C) has access to medical documentation from an in-person medical evaluation of such patient in the past two years by-- ``(i) a covered health care professional; ``(ii) a health care professional who furnished care and services under the Veterans Community Care Program under section 1703 of this title; or ``(iii) a health care professional of the Department of Defense; and ``(D) at the time of the telemedicine visit of the patient-- ``(i) has reviewed the prescription data of the individual from the electronic health record database of the Department and data from the prescription drug monitoring program for the State in which the patient is located at the time of the telemedicine encounter (if such a program exists) for at least the one-year period preceding the date of the visit or, if less than one year of data is available, for the entire period available; and ``(ii) provides documentation of-- ``(I) such review; ``(II) all successful attempts to access such databases and program; and ``(III) all unsuccessful attempts to access such databases and program that resulted in the prescription of a limited supply under subsection (b); and ``(2) such substance is delivered, distributed, or dispensed for a legitimate medical purpose.”
“301 et seq.), regardless of whether such covered health care professional has conducted an in-person medical examination of such patient, if-- ``(1) such covered health care professional-- ``(A) is acting in the usual course of professional practice; ``(B) is registered pursuant to section 303(g) of the Controlled Substances Act (21 U.S.C. 823(g)) in any State or is utilizing the registration of a facility of the Department registered pursuant to section 303(f) of such Act (21 U.S.C.”
“Prescription, delivery, distribution, and dispensation of controlled substance medications via telemedicine ``(a) In General.--Notwithstanding sections 102(54) and 309(e) of the Controlled Substances Act (21 U.S.C. 802(54) and 829(e)), a covered health care professional may prescribe, deliver, distribute, and dispense a controlled substance if the covered health care professional is using telemedicine through the use of an interactive telecommunications system, including an audio-only telecommunications system when necessary, to prescribe, deliver, distribute, or dispense to a patient eligible to receive hospital care or medical services under this chapter a controlled substance that is a prescription drug as determined under the Federal Food, Drug, and Cosmetic Act (21 U.S.C.”