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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“(2) Elements.--The dashboard established pursuant to paragraph (1) shall cover the following: (A) Claims relating to military sexual trauma submitted to the Secretary for benefits under laws administered by the Secretary that have been submitted, completed, or appealed, including appeals pending at the agency of jurisdiction and at the Board of Veterans' Appeals. (B) For comparison purposes with subparagraph (A), claims not relating to military sexual trauma submitted to the Secretary for benefits under laws administered by the Secretary that have been submitted, completed, or appealed. (C) Overall, cumulative information relating to claims relating to military sexual trauma submitted to the Secretary for benefits under laws administered by the Secretary, including the following: (i) Average number of days a claim is pending review.”
“(5) Review and implementation.--Not later than one year after the date of the enactment of this Act, the Under Secretary for Benefits of the Department and the Secretary shall-- (A) review the recommendations submitted under paragraph (3)(C); and (B) implement the recommendations that, as determined by the Under Secretary and the Secretary, would improve the claims process for individuals who file claims described in paragraph (1). (f) Military Sexual Trauma Claims Performance Dashboard.-- (1) Establishment.--The Secretary of Veterans Affairs shall establish an interactive performance dashboard displaying information about claims relating to military sexual trauma submitted to the Secretary for benefits under laws administered by the Secretary.”
“(4) Report.--Not later than one year after the date of the enactment of this Act, the Secretary shall submit to Congress a report that includes the following: (A) The views of the working group on efforts by the Department to eliminate re-traumatization of individuals who file claims described in subsection (a). (B) Legislative proposals to improve the experience of such individuals in pursuing such claims. (C) The recommendations submitted under paragraph (3)(C). (D) The plan of the Under Secretary for Benefits of the Department and the Secretary to implement such recommendations.”
“(3) Duties.--Not later than 180 days after the date of the enactment of this Act, the working group shall-- (A) review the quality of medical examinations described in paragraph (1); (B) review the feasibility of minimizing re-examinations for conditions relating to military sexual trauma; and (C) submit to the Under Secretary for Benefits of the Department and the Secretary recommendations on how to-- (i) eliminate re-traumatization of individuals who file claims described in paragraph (1); and (ii) reduce the overdevelopment of such claims.”
“(2) Membership.--The working group shall be composed of the following: (A) Staff of the operations center for military sexual trauma of the Department of Veterans Affairs who have experience reviewing the quality of medical examinations in support of claims for disability compensation under chapter 11 of title 38, United States Code. (B) Staff of the Medical Disability Examination Office of the Department. (C) Veterans service officers who have experience with claims described in paragraph (1). (D) Medical examiners who have experience with such claims. (E) Staff of the Veterans Experience Office of the Department. (F) Such other individuals as the Secretary considers appropriate.”
“(4) Sunset.--On the date that is 5 years after the enactment of this Act, paragraph (1)(A) shall cease to be in effect. (e) Working Group on Medical Examinations for Claims for Disability Compensation for Disabilities Relating to Military Sexual Trauma.-- (1) In general.--Not later than 90 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall establish a working group on medical examinations for claims for disability compensation under chapter 11 of title 38, United States Code, for disabilities relating to military sexual trauma (in this section referred to as the ``working group'').”
“5048) is amended-- (A) in paragraph (1), by striking ``through 2027'' and inserting ``until the day described in section 109(d)(4) of the Take Care of America's Veterans Act''; and (B) in paragraph (2), by adding at the end the following new subparagraph: ``(I) The findings of the most recent special focus review conducted under subsection (d)(1)(A) of section 109 of the Take Care of America's Veterans Act, including-- ``(i) the elements under subsection (d)(1)(B) of such section; ``(ii) the number of claims returned for reprocessing under subsection (d)(2) of such section; and ``(iii) the number of claims described in clause (ii) for which the decision relating to service-connection or entitlement to compensation changed as a result of reprocessing the claim.''.”
“(2) Reprocessing of claims.--If the Under Secretary finds, pursuant to a special focus review conducted under paragraph (1)(A), that an error was made with respect to the entitlement of a veteran to a benefit under the laws administered by the Secretary, the Secretary shall return the relevant claim of the veteran to the appropriate office of the Department for reprocessing to ensure that the veteran receives an accurate decision with respect to the claim. (3) Report.--Section 5501(b) of the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act [[Page H4559]] of 2020 (Public Law 116-315; 134 Stat.”
“(B) Elements.--Each review conducted under subparagraph (A) shall include a review of the following: (i) A statistically significant, nationally representative sample of all claims for benefits under the laws administered by the Secretary of Veterans Affairs relating to military sexual trauma filed during the fiscal year preceding the fiscal year in which the report is submitted. (ii) The accuracy of each decision made with respect to each claim described in clause (i). (iii) The types of benefit entitlement errors found, disaggregated by category. (iv) Trends from year to year. (v) Training completion rates for personnel of the Department who process claims described in subparagraph (A).”
“(3) Report required.--Not later than one year 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 a report detailing the findings of the Secretary with respect to the study conducted under paragraph (1). (d) Annual Special Focus Review of Claims for Disability Compensation for Disabilities Relating to Military Sexual Trauma.-- (1) Annual special focus review.-- (A) In general.--Each year, the Under Secretary for Benefits of the Department of Veterans Affairs shall conduct a special focus review on the accuracy of the processing of claims for disability compensation under chapter 11 of title 38, United States Code, for disabilities relating to military sexual trauma.”
“(ii) Whether the training has resulted in improvements to the processing of claims described in such subsection and issue-based accuracy. (iii) Such recommendations as the Secretary may have for improving the training. (B) With respect to the quality of procedures described in paragraph (2) of such subsection: (i) Whether the procedures of the Department for reviewing the accuracy of the processing of claims described in such subsection comport with generally accepted statistical methodologies to ensure reasonable accuracy of such reviews. (ii) Whether such procedures adequately include mechanisms to correct errors found in such reviews. (iii) A summary of quality assurance reviews and reports conducted as part of such procedures. (iv) Such recommendations as the Secretary may have for improving such procedures.”
“(c) Study on Training and Processing Relating to Claims for Disability Compensation Relating to Military Sexual Trauma.-- (1) Study required.--The Secretary of Veterans Affairs shall conduct a study on-- (A) the quality of training provided to personnel of the Department of Veterans Affairs who review claims for disability compensation under chapter 11 of title 38, United States Code, for disabilities relating to military sexual trauma; and (B) the quality of the procedures of the Department for reviewing the accuracy of the processing of such claims. (2) Elements.--The study required by subsection (a) shall include the following: (A) With respect to the quality of training described in paragraph (1) of such subsection: (i) Whether the Department ensures personnel complete such training on time.”
“``(3) In this subsection: ``(A) The term `individual who has experienced military sexual trauma' means-- ``(i) an individual who has filed a claim for compensation under chapter 11 of this title relating to military sexual trauma; ``(ii) a veteran who has been awarded compensation under such chapter relating to military sexual trauma; or ``(iii) a member of the Armed Forces (including a member of the National Guard or Reserves), a former member of the Armed Forces, or a veteran who is receiving care from the Department relating to military sexual trauma. ``(B) The term `military sexual trauma' has the meaning given that term in section 1166(d)(2) of this title. ``(C) The term `Veterans Crisis Line' means the toll-free hotline for veterans established under section 1720F(h) of this title.''.”
“``(B) Information on the eligibility of the individual for services provided through the Readjustment Counseling Service location described in subparagraph (A)(iv). ``(2) The Secretary shall ensure that any written communication under this section from the Department to an individual who has experienced military sexual trauma that includes notification of an award of compensation under chapter 11 of this title relating to military sexual trauma includes-- ``(A) the contact information described in paragraph (1); and ``(B) the contact information for the military sexual trauma coordinator of the Veterans Benefits Administration.”
“(D) Board of veterans' appeals.--Section 7104 of title 38, United States Code, is amended by adding at the end the following new subsection: ``(g)(1) The Secretary shall ensure that any written communication under this section from the Department to an individual who has experienced military sexual trauma includes each of the following: ``(A) Contact information for each of the following: ``(i) The military sexual trauma coordinator of the Veterans Health Administration. ``(ii) The Veterans Crisis Line. ``(iii) The facility of the Veterans Health Administration closest to where the individual resides. ``(iv) The Readjustment Counseling Service location closest to where the individual resides.”
“``(3) In this subsection: ``(A) The term `individual who has experienced military sexual trauma' means-- ``(i) an individual who has filed a claim for compensation under chapter 11 of this title relating to military sexual trauma; ``(ii) a veteran who has been awarded compensation under such chapter relating to military sexual trauma; or ``(iii) a member of the Armed Forces (including a member of the National Guard or Reserves), a former member of the Armed Forces, or a veteran who is receiving care from the Department relating to military sexual trauma. ``(B) The term `military sexual trauma' has the meaning given that term in section 1166(d)(2) of this title. ``(C) The term `Veterans Crisis Line' means the toll-free hotline for veterans established under section 1720F(h) of this title.''.”
“``(B) Information on the eligibility of the individual for services provided through the Readjustment Counseling Service location described in subparagraph (A)(iv). ``(2) The Secretary shall ensure that any written communication under this section from the Department to an individual who has experienced military sexual trauma that includes notification of an award of compensation under chapter 11 of this title relating to military sexual trauma includes-- ``(A) the contact information described in paragraph (1); and ``(B) the contact information for the military sexual trauma coordinator of the Veterans Benefits Administration.”
“(C) Higher-level review by the agency of original jurisdiction.--Section 5104B of title 38, United States Code, is amended by adding at the end the following new subsection: ``(f) Written Communications to Individuals Who Have Experienced Military Sexual Trauma.-- ``(1) The Secretary shall ensure that any written communication under this section from the Department to an individual who has experienced military sexual trauma includes each of the following: ``(A) Contact information for each of the following: ``(i) The military sexual trauma coordinator of the Veterans Health Administration. ``(ii) The Veterans Crisis Line. ``(iii) The facility of the Veterans Health Administration closest to where the individual resides. ``(iv) The Readjustment Counseling Service location closest to where the individual resides.”
“``(3) In this subsection: ``(A) The term `individual who has experienced military sexual trauma' means-- ``(i) an individual who has filed a claim for compensation under chapter 11 of this title relating to military sexual trauma; ``(ii) a veteran who has been awarded compensation under such chapter relating to military sexual trauma; or ``(iii) a member of the Armed Forces (including a member of the National Guard or Reserves), a former member of the Armed Forces, or a veteran who is receiving care from the Department relating to military sexual trauma. ``(B) The term `military sexual trauma' has the meaning given that term in section 1166(d)(2) of this title. ``(C) The term `Veterans Crisis Line' means the toll-free hotline for veterans established under section 1720F(h) of this title.''.”
“``(B) Information on the eligibility of the individual for services provided through the Readjustment Counseling Service location described in subparagraph (A)(iv). ``(2) The Secretary shall ensure that any written communication under this section from the Department to an individual who has experienced military sexual trauma that includes notification of an award of compensation under chapter 11 of this title relating to military sexual trauma includes-- ``(A) the contact information described in paragraph (1); and ``(B) the contact information for the military sexual trauma coordinator of the Veterans Benefits Administration.”
“(B) Decisions and notices of decisions.--Section 5104 of title 38, United States Code, is amended by adding at the end the following new subsection: ``(e)(1) The Secretary shall ensure that any written communication under this section from the Department to an individual who has experienced military sexual trauma includes each of the following: ``(A) Contact information for each of the following: ``(i) The military sexual trauma coordinator of the Veterans Health Administration. ``(ii) The Veterans Crisis Line. [[Page H4558]] ``(iii) The facility of the Veterans Health Administration closest to where the individual resides. ``(iv) The Readjustment Counseling Service location closest to where the individual resides.”
“``(2) In this subsection: ``(A) The term `individual who has experienced military sexual trauma' means-- ``(i) an individual who has filed a claim for compensation under chapter 11 of this title relating to military sexual trauma; ``(ii) a veteran who has been awarded compensation under such chapter relating to military sexual trauma; or ``(iii) a member of the Armed Forces (including a member of the National Guard or Reserves), a former member of the Armed Forces, or a veteran who is receiving care from the Department relating to military sexual trauma. ``(B) The term `military sexual trauma' has the meaning given that term in section 1166(d)(2) of this title. ``(C) The term `Veterans Crisis Line' means the toll-free hotline for veterans established under section 1720F(h) of this title.''.”
“``(iv) The facility of the Veterans Health Administration closest to where the individual resides. ``(v) The Readjustment Counseling Service location closest to where the individual resides. ``(B) Information on the eligibility of the individual for services provided through the Readjustment Counseling Service location described in subparagraph (A)(v).”
“(2) Contents of certain written communications to individuals who have experienced military sexual trauma.-- (A) Notice to claimants of required information and evidence.--Section 5103 of title 38, United States Code, is amended by adding at the end the following new subsection: ``(c) Written Communications to Individuals Who Have Experienced Military Sexual Trauma.-- ``(1) The Secretary shall ensure that any written communication under this section from the Department to an individual who has experienced military sexual trauma includes each of the following: ``(A) Contact information for each of the following: ``(i) The military sexual trauma coordinator of the Veterans Benefits Administration. ``(ii) The military sexual trauma coordinator of the Veterans Health Administration. ``(iii) The Veterans Crisis Line.”
“(D) Individual who has experienced military sexual trauma defined.--In this subsection, the term ``individual who has experienced military sexual trauma'' means-- (i) an individual who has filed a claim for compensation under chapter 11 of title 38, United States Code, relating to military sexual trauma; (ii) a veteran who has been awarded compensation under such chapter relating to military sexual trauma; or (iii) a member of the Armed Forces (including a member of the National Guard or Reserves), a former member of the Armed Forces, or a veteran who is receiving care from the Department relating to military sexual trauma.”
“(C) Duties.--The working group established under subparagraph (A) shall-- (i) review standard correspondence, which may include templates for notices under sections 5103, 5104, 5104B, and 7104 of title 38, United States Code, from the Department to individuals who have experienced military sexual trauma for sensitivity; and (ii) ensure that the correspondence-- (I) treats such individuals with dignity and respect; and (II) does not re-traumatize such individuals.”
“(B) Membership.--The working group established under subparagraph (A) shall be composed of members who shall be appointed by the Secretary from among employees of the Department of Veterans Affairs who are experts in military sexual trauma and mental health, of whom-- (i) one or more shall be appointed from among mental health providers of the Veterans Health Administration; (ii) one or more shall be appointed from among experts on sexual assault and sexual harassment of the Veterans Benefits Administration; and (iii) one or more shall be appointed from among experts on sexual assault and sexual harassment of the Board of Veterans' Appeals.”
“Evaluation of claims involving military sexual trauma.''. (b) Communications From the Department of Veterans Affairs to Individuals Who Have Experienced Military Sexual Trauma.-- (1) Review working group.-- (A) In general.--The Secretary of Veterans Affairs shall establish a working group to review correspondence relating to military sexual trauma.”
“(2) Outreach.-- (A) In general.--Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall implement, with input from the veteran community, an informative outreach program for veterans regarding the standard of proof for evaluation of claims relating to military sexual trauma, including requirements for a medical examination and opinion. (B) Targeted outreach.--In implementing the program under subparagraph (A), the Secretary shall, to the extent practicable, target outreach to veterans who submitted a claim relating to military sexual trauma that was denied. (3) Clerical amendment.--The table of sections at the beginning of chapter 11 of such title is amended by inserting after the item relating to section 1166 the following new item: ``1166A.”
“``(1) The Secretary shall ensure that not less than annually, the policies and procedures employed by the specialized team established under section 1166 of this title are reviewed by medical or mental health professionals as the Secretary considers appropriate to determine whether the current standard of evidentiary review for acceptable documentation adequately evaluates the likelihood a military sexual trauma occurred. ``(2) The Secretary shall also conduct periodic quality reviews of claims processed by the specialized teams established under section 1166 to identify inconsistencies, training deficiencies, or procedural shortcomings and implement corrective actions as appropriate.''.”
“``(b) Point of Contact.--The Secretary shall ensure that each document provided to a veteran relating to a claim for compensation under this chapter for a military sexual trauma includes contact information for an appropriate point of contact with the Department. ``(c) Specialized Teams.--The Secretary shall ensure that all claims for compensation under this chapter for a military sexual trauma are reviewed and processed by a specialized team established under section 1166 of this title.”
“(a) Evaluation of Claims Involving Military Sexual Trauma.-- (1) In general.--Subchapter VI of chapter 11 of such title is amended by inserting after section 1166 the following new section: ``Sec. 1166A. Evaluation of claims involving military sexual trauma ``(a) Notice and Opportunity to Supply Evidence.--The Secretary may not deny a claim of a veteran for compensation under this chapter for military sexual trauma without first-- ``(1) advising the veteran of the evidence that would constitute credible corroborating evidence of the military sexual trauma; and ``(2) allowing the veteran an opportunity to furnish such corroborating evidence.”
“(C) Claimants or appellants for whom a medical disability examination is requested of the Department have agency in determining when and where the examination is conducted. (D) Claimants or appellants for whom a medical disability examination is requested of the Department have a seamless experience when scheduling their examinations without regard to who conducts the examinations. (E) The Department conducts customer satisfaction and experience surveys of claimants or appellants who attend medical disability examinations provided under laws administered by the Secretary. SEC. 111. IMPROVEMENTS TO PROCESSING AND OUTREACH REGARDING CLAIMS INVOLVING MILITARY SEXUAL TRAUMA.”
“(2) Plan required.--Not later than one year 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 a plan to ensure the following: (A) Systems and processes used by the Department enable seamless and clear communication of requirements between the claims processors who request medical disability examinations and the persons who conduct such examinations, including through a contract. (B) Medical disability examiners, including through a contract, have access to the medical records and claims information they need to conduct exams that are adequate for purposes of rating claims for benefits under laws administered by the Secretary.”
“(d) Review and Plan Regarding Department of Veterans Affairs Scheduling of Medical Examinations.-- (1) Review required.--Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall complete a review of scheduling request tools, contracts, and systems used by employees and contractors of the Department of Veterans Affairs to order and conduct medical disability examinations.”
“(5) Comptroller general of the united states study.--The Comptroller General of the United States shall conduct a review of [[Page H4557]] the methodology and effectiveness of the review required in paragraph (1). (6) Covered medical disability examination defined.--In this subsection, the term ``covered medical disability examination'' means a medical examination or opinion for the purposes of adjudicating a claim for a benefit under chapter 11 or 15 of title 38, United States Code, regardless of whether conducted by an employee or a contractor of the Department.”
“(4) Priority processing.-- (A) In general.--Except as provided for in subparagraph (B), if during a review under paragraph (1) the Secretary finds any covered medical disability examination to be not adequate for adjudicating a claim, the Secretary shall ensure the claimant examined by that examination-- (i) receives another examination, if necessary, on a priority basis; and (ii) receives priority processing for the entirety of the impacted claim. (B) Exception.--The Secretary is not required to furnish an additional examination under subparagraph (A) if the Secretary determines such an examination to be unnecessary for purposes of adjudicating the claim.”
“(3) Analysis.--Under each review required by paragraph (1), the Secretary shall-- (A) analyze the samples specified in paragraph (2); and (B) pursuant to such analysis, identify-- (i) the percentage of examinations that were adequate for purposes of adjudicating the particular claim for a benefit under chapter 11 or 15 of title 38, United States Code, for which the examination was ordered by the Department; and (ii) the percentage of examinations considered overdeveloped for purposes of adjudicating claims for a benefit under chapter 11 or 15 of title 38, United States Code, for which the examination was ordered by the Department.”
“(2) Further sample requirements.--Under each review required by paragraph (1), the Secretary shall ensure the review includes-- (A) a statistically significant sample of covered medical disability examinations completed by employees of the Department of Veterans Affairs; and (B) a statistically significant sample of covered medical disability examinations completed by each contractor that provides such examinations for the Department.”
“(7) Definition of covered medical disability examination.-- In this subsection, the term ``covered medical disability examination'' means a medical examination or medical opinion that the Secretary determines necessary for the purposes of adjudicating a claim for a benefit under chapter 11 or 15 of title 38, United States Code, regardless of whether conducted by an employee or a contractor of the Department. (c) Review and Priority Processing of Claims With Inadequate or Unnecessary Examinations.-- (1) Review.--Not later than 1 year after the date of the enactment of this Act and not less frequently than once every three months thereafter, the Secretary of Veterans Affairs shall review a random and representative sample of all covered medical disability examinations completed during the previous three-month period.”
“(6) Modification of reports by the board of veterans' appeals and united states court of appeals for veterans claims.-- (A) Board of veterans' appeals.--Section 7101(d)(2) of title 38, United States Code, is amended-- (i) in subparagraph (F), by striking ``; and'' and inserting a semicolon; (ii) in subparagraph (G), by striking the period at the end and inserting ``; and''; and (iii) by adding at the end the following new subparagraph: ``(H) a summary of recurring issues that result in the Board remanding appeals back to the agency of original jurisdiction.''. (B) United states court of appeals for veterans claims.-- Section 7288(b) of title 38, United States Code, is amended by adding at the end the following new paragraph: ``(16) A summary of recurring issues that result in remands.''.”
“(4) Report to congress.--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 a report detailing the findings of the Secretary with respect to the review conducted under paragraph (1), the data used by the Secretary to support such findings, and such recommendations as the Secretary may have for improvements to training or policies. (5) Comptroller general of the united states review of findings.--Not later than 180 days after the date on which the Secretary submits the report under paragraph (4), the Comptroller General of the United States shall conduct a review of the findings and recommendations contained in the report.”
“(3) Second-level review for new employees.--The Secretary shall evaluate the effectiveness of current policies requiring a second level of review of claims decisions made by new Veterans Service Representatives and Rating Veterans Service Representatives before such employees are authorized to order covered medical disability examinations, including any applicable accuracy thresholds.”
“(2) Scope of review.--The review shall include, at minimum, an evaluation of training and policies relating to-- (A) assessing the adequacy of covered medical disability examinations for claims adjudication; (B) determining the necessity of medical disability examinations where claims can be adjudicated based on existing evidence without ordering additional examinations; (C) relevant statutes, judicial decisions, regulations, and Department policies, including-- (i) the duty to assist claimants; (ii) evidentiary standards regarding causation; (iii) required elements and standards for covered medical disability examinations, including the need for reasoned medical opinions; and (iv) the absence of statutory or regulatory presumptions of service connection in covered medical disability examinations; and (D) input from impacted Department employees, including duly appointed labor representatives.”
“(b) Review of Training for Veterans Service Representatives and Rating Veterans Service Representatives.-- (1) Review required.--The Secretary of Veterans Affairs shall conduct a comprehensive review of the training provided to Veterans Service Representatives (VSRs) and Rating Veterans Service Representatives (RVSRs) regarding covered medical disability examinations for the purpose of claims adjudication.”
“(3) Report on study.--Not later than one year 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 a report on the findings of the Secretary with respect to the study completed under paragraph (1). (4) Definitions.--In this subsection: (A) The term ``covered medical disability examination'' means a medical nexus examination or medical opinion for the purposes of adjudicating a claim for a benefit under chapter 11 or 15 of title 38, United States Code, regardless of whether conducted by an employee or a contractor of the Department. (B) The terms ``rural'' and ``highly rural'' have the meanings given those terms under the rural-urban commuting areas coding system of the Department of Agriculture.”
“(iii) The plan of the Secretary for the following year to improve access described in paragraph (1), which shall include a plan for the pursuit of a commercial or industry- standard solution or technology that could enable housebound veterans or veterans who live in rural areas to receive examinations without traveling long distances. (B) Number of days to complete defined.--For purposes of subparagraph (A)(i), the term ``number of days to complete'' means the number of days in the period-- (i) beginning on the date on which a contractor or employee of the Department received a request from the Secretary to conduct a covered medical disability examination; and (ii) ending on the date on which the examination was completed.”
“(2) Elements.-- (A) In general.--The study conducted under paragraph (1) shall include the following: (i) A comparison of the average number of days to complete covered medical disability examinations, disaggregated by type of examination, for veterans who reside in rural and highly rural areas compared to an average time for veterans who reside in other areas to complete a covered medical disability examination, by either contractors or employees of the Department. (ii) A root cause analysis of differences identified pursuant to clause (i).”
“SEC. 110. DISABILITY EXAMINATIONS: STUDY ON ACCESS IN RURAL AREAS; REVIEW OF TRAINING; REVIEW OF INADEQUATE OR UNNECESSARY EXAMINATIONS. (a) Study on Improvements to Department of Veterans Affairs Covered Medical Disability Examinations in Rural Areas.-- (1) Study required.--Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall complete a study on access by veterans who reside in rural and highly rural areas to covered medical disability examinations.”
“Such report shall include, with respect to the one-year period after the date of the enactment of this Act, the following elements: (1) The number of examinations conducted pursuant to a contract under such authority. (2) The cost, timeliness, and legal adequacy of such examinations, disaggregated by-- (A) health care professional; and (B) contract. (3) The number of such examinations conducted in each State, the District of Columbia, or a Commonwealth, territory, or possession of the United States. (4) The numbers of each kind of health care professionals who conducted such examinations. (5) The number of examinations that were erroneously conducted by a health care professional-- (A) without such a contract; or (B) unauthorized to enter into such a contract. (6) The plan of the Secretary to correct errors in the use of such authority.”