[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 740 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 740
To improve the provision of care and services under the Veterans
Community Care Program of the Department of Veterans Affairs, and for
other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 28, 2025
Mr. Bost (for himself, Mr. Bergman, Mr. Hamadeh of Arizona, Mrs.
Miller-Meeks, Mr. Barrett, Mrs. Kiggans of Virginia, and Mrs. King-
Hinds) introduced the following bill; which was referred to the
Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To improve the provision of care and services under the Veterans
Community Care Program 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; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Veterans' Assuring
Critical Care Expansions to Support Servicemembers Act of 2025'' or the
``Veterans' ACCESS Act of 2025''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--IMPROVEMENT OF VETERANS COMMUNITY CARE PROGRAM
Sec. 101. Codification of requirements for eligibility standards for
access to community care from Department of
Veterans Affairs.
Sec. 102. Requirement that Secretary notify veterans of eligibility for
care under Veterans Community Care Program.
Sec. 103. Consideration under Veterans Community Care Program of
veteran preference for care, continuity of
care, and need for caregiver or attendant.
Sec. 104. Notification of denial of request for care under Veterans
Community Care Program.
Sec. 105. Discussion of telehealth options under Veterans Community
Care Program.
Sec. 106. Extension of deadline for submittal of claims by health care
entities and providers under prompt payment
standard.
TITLE II--MENTAL HEALTH TREATMENT PROGRAMS
Sec. 201. Definitions.
Sec. 202. Standardized process to determine eligibility of covered
veterans for participation in certain
mental health treatment programs.
Sec. 203. Improvements to Department of Veterans Affairs Mental Health
Residential Rehabilitation Treatment
Program.
TITLE III--OTHER HEALTH CARE MATTERS
Sec. 301. Plan on establishment of interactive, online self-service
module for care.
Sec. 302. Modification of requirements for Center for Innovation for
Care and Payment of the Department of
Veterans Affairs and requirement for pilot
program.
Sec. 303. Reports.
TITLE I--IMPROVEMENT OF VETERANS COMMUNITY CARE PROGRAM
SEC. 101. CODIFICATION OF REQUIREMENTS FOR ELIGIBILITY STANDARDS FOR
ACCESS TO COMMUNITY CARE FROM DEPARTMENT OF VETERANS
AFFAIRS.
(a) Eligibility Access Standards.--Section 1703B of title 38,
United States Code, is amended--
(1) by striking subsections (a) through (e) and inserting
the following:
``(a) Eligibility Standards for Access to Community Care.--(1) A
covered veteran shall be eligible to elect to receive non-Department
hospital care, medical services, or extended care services, excluding
nursing home care, through the Veterans Community Care Program under
section 1703 of this title pursuant to subsection (d)(1)(D) of such
section using the following eligibility access standards:
``(A) With respect to primary care, mental health care, or
extended care services, excluding nursing home care, if the
Department cannot schedule an appointment for the covered
veteran with a health care provider of the Department who can
provide the needed service--
``(i) within 30 minutes average driving time (or
such shorter average driving time as the Secretary may
prescribe) from the residence of the veteran unless a
longer average driving time has been agreed to by the
veteran in consultation with a health care provider of
the veteran; and
``(ii) within 20 days (or such shorter period as
the Secretary may prescribe) of the date of request for
such an appointment unless a later date has been agreed
to by the veteran in consultation with a health care
provider of the veteran.
``(B) With respect to specialty care, if the Department
cannot schedule an appointment for the covered veteran with a
health care provider of the Department who can provide the
needed service--
``(i) within 60 minutes average driving time (or
such shorter average driving time as the Secretary may
prescribe) from the residence of the veteran unless a
longer average driving time has been agreed to by the
veteran in consultation with a health care provider of
the veteran; and
``(ii) within 28 days (or such shorter period as
the Secretary may prescribe) of the date of request for
such an appointment unless a later date has been agreed
to by the veteran in consultation with a health care
provider of the veteran.
``(2) For the purposes of determining the eligibility of a covered
veteran for care or services under paragraph (1), the Secretary shall
not take into consideration the availability of telehealth appointments
from the Department when determining whether the Department is able to
furnish such care or services in a manner that complies with the
eligibility access standards under such paragraph.
``(3) In the case of a covered veteran who has had an appointment
with a health care provider of the Department canceled by the
Department for a reason other than the request of the veteran, in
calculating a wait time for a subsequent appointment under paragraph
(1), the Secretary shall calculate such wait time from the date of the
request for the original, canceled appointment.
``(4) If a veteran agrees to a longer average drive time or a later
date under subparagraph (A) or (B) of paragraph (1), the Secretary
shall document the agreement to such longer average drive time or later
date in the electronic health record of the veteran and provide the
veteran a copy of such documentation. Such copy may be provided
electronically.
``(b) Application.--The Secretary shall ensure that the eligibility
access standards established under subsection (a) apply--
``(1) to all care and services within the medical benefits
package of the Department to which a covered veteran is
eligible under section 1703 of this title, excluding nursing
home care; and
``(2) to all covered veterans, regardless of whether a
veteran is a new or established patient.
``(c) Periodic Review of Access Standards.--Not later than three
years after the date of the enactment of the Veterans' Assuring
Critical Care Expansions to Support Servicemembers Act of 2025, and not
less frequently than once every three years thereafter, the Secretary
shall--
``(1) conduct a review of the eligibility access standards
under subsection (a) in consultation with--
``(A) such Federal entities as the Secretary
considers appropriate, including the Department of
Defense, the Department of Health and Human Services,
and the Centers for Medicare & Medicaid Services;
``(B) entities and individuals in the private
sector, including--
``(i) veteran patients;
``(ii) veterans service organizations; and
``(iii) health care providers participating
in the Veterans Community Care Program under
section 1703 of this title; and
``(C) other entities that are not part of the
Federal Government; and
``(2) submit to the appropriate committees of Congress a
report on--
``(A) the findings of the Secretary with respect to
the review conducted under paragraph (1); and
``(B) such recommendations as the Secretary may
have with respect to the eligibility access standards
under subsection (a).'';
(2) by striking subsection (g);
(3) by redesignating subsections (f), (h), and (i) as
subsections (d), (e), and (f), respectively;
(4) in subsection (d), as redesignated by paragraph (3)--
(A) by striking ``established'' each place it
appears; and
(B) in paragraph (1), by striking ``(1) Subject
to'' and inserting ``Compliance by Community Care
Providers With Access Standards.--(1) Subject to'';
(5) in subsection (e), as redesignated by paragraph (3)--
(A) in paragraph (1)--
(i) by striking ``(1) Consistent with'' and
inserting ``Determination Regarding
Eligibility.--(1) Consistent with''; and
(ii) by striking ``designated access
standards established under this section'' and
inserting ``eligibility access standards under
subsection (a)''; and
(B) in paragraph (2)(B), by striking ``designated
access standards established under this section'' and
inserting ``eligibility access standards under
subsection (a)''; and
(6) in subsection (f), as redesignated by paragraph (3)--
(A) in the matter preceding paragraph (1), by
striking ``In this section'' and inserting
``Definitions.--In this section''; and
(B) in paragraph (2)--
(i) by striking ``covered veterans'' and
inserting ``covered veteran''; and
(ii) by striking ``veterans described'' and
inserting ``a veteran described''.
(b) Conforming Amendments.--Section 1703(d) of such title is
amended--
(1) in paragraph (1)(D), by striking ``designated access
standards developed by the Secretary under section 1703B of
this title'' and inserting ``eligibility access standards under
section 1703B(a) of this title''; and
(2) in paragraph (3), by striking ``designated access
standards developed by the Secretary under section 1703B of
this title'' and inserting ``eligibility access standards under
section 1703B(a) of this title''.
SEC. 102. REQUIREMENT THAT SECRETARY NOTIFY VETERANS OF ELIGIBILITY FOR
CARE UNDER VETERANS COMMUNITY CARE PROGRAM.
Section 1703(a) of title 38, United States Code, is amended by
adding at the end the following new paragraph:
``(5)(A) The Secretary shall notify each covered veteran in writing
of the eligibility of such veteran for care or services under this
section as soon as possible, but not later than two business days,
after the date on which the Secretary is aware that the veteran is
seeking care or services and is eligible for such care or services
under this section.
``(B) With respect to each covered veteran eligible for care or
services under subsection (d), the Secretary shall provide such veteran
periodic reminders, as the Secretary determines appropriate, of their
ongoing eligibility under such subsection.
``(C) Any notification or reminder under this paragraph may be
provided electronically.''.
SEC. 103. CONSIDERATION UNDER VETERANS COMMUNITY CARE PROGRAM OF
VETERAN PREFERENCE FOR CARE, CONTINUITY OF CARE, AND NEED
FOR CAREGIVER OR ATTENDANT.
Section 1703(d)(2) of title 38, United States Code, is amended by
adding at the end the following new subparagraphs:
``(F) The preference of the covered veteran for where,
when, and how to seek hospital care, medical services, or
extended care services.
``(G) Continuity of care.
``(H) Whether the covered veteran requests or requires the
assistance of a caregiver or attendant when seeking hospital
care, medical services, or extended care services.''.
SEC. 104. NOTIFICATION OF DENIAL OF REQUEST FOR CARE UNDER VETERANS
COMMUNITY CARE PROGRAM.
Section 1703 of title 38, United States Code, is amended--
(1) by redesignating subsection (o) as subsection (p); and
(2) by inserting after subsection (n) the following new
subsection (o):
``(o) Notification of Denial of Request for Care and How To
Appeal.--(1) If a request by a veteran for care or services under this
section is denied, the Secretary shall notify the veteran in writing as
soon as possible, but not later than two business days, after the
denial is made--
``(A) of the reason for the denial; and
``(B) with instructions on how to appeal such denial using
the clinical appeals process of the Veterans Health
Administration.
``(2) If a denial under paragraph (1) is due to not meeting the
eligibility access standards under section 1703B(a) of this title,
notice under such paragraph shall include an explanation for why the
Secretary does not consider the veteran to have met such standards.
``(3) Any notification under this subsection may be provided
electronically.''.
SEC. 105. DISCUSSION OF TELEHEALTH OPTIONS UNDER VETERANS COMMUNITY
CARE PROGRAM.
Section 1703 of title 38, United States Code, as amended by section
104, is further amended--
(1) by redesignating subsection (p) as subsection (q); and
(2) by inserting after subsection (o) the following new
subsection (p):
``(p) Discussion of Options for Telehealth.--When discussing
options for care or services for a covered veteran under this section,
the Secretary shall ensure that the veteran is informed of the ability
of the veteran to seek care or services via telehealth, either through
a medical facility of the Department or under this section, if
telehealth--
``(1) is available to the veteran;
``(2) is appropriate for the type of care or services the
veteran is seeking, as determined by the Secretary; and
``(3) is acceptable to the veteran.''.
SEC. 106. EXTENSION OF DEADLINE FOR SUBMITTAL OF CLAIMS BY HEALTH CARE
ENTITIES AND PROVIDERS UNDER PROMPT PAYMENT STANDARD.
Section 1703D(b) of title 38, United States Code, is amended by
striking ``180 days'' and inserting ``one year''.
TITLE II--MENTAL HEALTH TREATMENT PROGRAMS
SEC. 201. DEFINITIONS.
In this title:
(1) Covered treatment program.--The term ``covered
treatment program''--
(A) means--
(i) a mental health residential
rehabilitation treatment program of the
Department of Veterans Affairs; or
(ii) a program of the Department for
residential care for mental health and
substance abuse disorders;
(B) includes--
(i) the programs designated as of the date
of the enactment of this Act as domiciliary
residential rehabilitation treatment programs;
and
(ii) any programs designated as domiciliary
residential rehabilitation treatment programs
on or after such date of enactment; and
(C) does not include Compensated Work Therapy
Transition Residence programs of the Department.
(2) Covered veteran.--The term ``covered veteran'' means a
veteran described in section 1703(b) of title 38, United States
Code.
(3) Social support systems.--The term ``social support
systems'', with respect to a covered veteran--
(A) means--
(i) a member of the family of the covered
veteran, including a parent, spouse, child,
step-family member, or extended family member;
or
(ii) an individual who lives with the
veteran but is not a member of the family of
the veteran; and
(B) does not include a facility-organized peer
support program.
(4) Treatment track.--The term ``treatment track'' means a
specialized treatment program that is provided to a subset of
covered veterans in a covered treatment program who receive the
same or similar intensive treatment and rehabilitative
services.
SEC. 202. STANDARDIZED PROCESS TO DETERMINE ELIGIBILITY OF COVERED
VETERANS FOR PARTICIPATION IN CERTAIN MENTAL HEALTH
TREATMENT PROGRAMS.
(a) Standardized Screening Process.--Not later than one year after
the date of the enactment of this Act, the Secretary of Veterans
Affairs shall establish a standardized screening process to determine,
based on clinical need, whether a covered veteran satisfies criteria
for priority or routine admission to a covered treatment program.
(b) Eligibility Criteria for Priority Admission.--
(1) In general.--Under the standardized screening process
required by subsection (a), a covered veteran shall be eligible
for priority admission to a covered treatment program if the
covered veteran meets criteria established by the Secretary
that include any of the following:
(A) Symptoms that--
(i) significantly affect activities of
daily life; and
(ii) increase the risk of such veteran for
adverse outcomes.
(B) An unsafe living situation.
(C) A high-risk flag for suicide.
(D) A determination of being a high risk for
suicide.
(E) Risk factors for overdose.
(F) Non-responsive, relapsed, or unable to find