[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 3466 Introduced in Senate (IS)]
<DOC>
119th CONGRESS
1st Session
S. 3466
To improve health care provided by the Department of Veterans Affairs,
and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
December 11, 2025
Mr. Blumenthal (for himself, Ms. Alsobrooks, Mr. King, Ms. Duckworth,
Ms. Hirono, Mr. Sanders, Mrs. Murray, and Ms. Cortez Masto) introduced
the following bill; which was read twice and referred to the Committee
on Veterans' Affairs
_______________________________________________________________________
A BILL
To improve health care provided by 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 ``Honor Our Promise
to Veterans Act of 2025''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Implementation.
TITLE I--IMPROVEMENTS TO CARE
Subtitle A--Scheduling
Sec. 101. Timing for scheduling of appointments.
Sec. 102. Consideration of telehealth in determining whether an
appointment can be scheduled within the
access standards of the Department of
Veterans Affairs and limitation on
availability of telehealth through
community care.
Sec. 103. Information for veterans regarding access to care.
Subtitle B--Provider Requirements
Sec. 111. Extension of period for submittal of claims by health care
entities and providers.
Sec. 112. Rating program relating to military sexual trauma for
providers under Veterans Community Care
Program of Department of Veterans Affairs.
Sec. 113. Requirements relating to quality of community care providers.
Sec. 114. Community care provider training requirements.
Sec. 115. Waivers for network adequacy.
Sec. 116. Contracting requirements.
Sec. 117. Inspector General oversight authority over community care.
Sec. 118. Requirement that health care providers under Veterans
Community Care Program provide certain
data.
Sec. 119. Full practice authority for certain positions within
Department of Veterans Affairs.
Sec. 119A. Treatment of psychologists.
Subtitle C--Reports and Related Matters
Sec. 121. Information on lessons learned to improve contracting for
community care.
Sec. 122. Analysis of impact of spending under Veterans Community Care
Program on budgets of medical centers and
Veterans Integrated Service Networks of the
Department of Veterans Affairs.
Sec. 123. Study on recovery of revenue from private health insurers.
Sec. 124. Matters relating to emergency care.
Sec. 125. Review of dialysis care furnished by Department of Veterans
Affairs.
Sec. 126. Benefits for persons disabled by treatment under Veterans
Community Care Program of Department of
Veterans Affairs.
TITLE II--STAFFING MATTERS
Subtitle A--Salaries
Sec. 201. Modification of limitation on waiver for pay of critical
health care personnel.
Sec. 202. Increase of maximum amount of incentive pay for Department
pharmacist executives.
Sec. 203. Modification of special pay authority for nurse executives.
Subtitle B--Recruitment and Retention
Sec. 211. Inclusion of police officers of Department of Veterans
Affairs as law enforcement officers.
Sec. 212. Mentorship program for executive leadership teams at medical
centers of the Department of Veterans
Affairs.
Sec. 213. Requirement for equivalent role postings for vacant positions
at Department of Veterans Affairs.
Sec. 214. Hiring processes.
Sec. 215. Staffing models.
Sec. 216. Telework policy.
Subtitle C--Education
Sec. 221. Establishment of Start and Stay at VA Program.
Sec. 222. Building and maintenance professionals educational assistance
program.
Sec. 223. Expansion of reimbursement of continuing professional
education expenses.
Sec. 224. Payment of licensure exam costs for recipients of
scholarships from Department of Veterans
Affairs.
Subtitle D--Reports
Sec. 231. Department of Veterans Affairs personnel transparency.
Sec. 232. Report on Grow Our Own Program.
Sec. 233. Provision of data on educational assistance programs of
Veterans Health Administration.
TITLE III--INFRASTRUCTURE MATTERS
Sec. 301. Definitions.
Subtitle A--Investing in Department of Veterans Infrastructure to
Increase Capacity to Serve Veterans
Sec. 311. Authorization of funding for certain land acquisitions for
medical facilities of Department of
Veterans Affairs.
Sec. 312. Detachment of congressional committee approval requests of
major medical facility leases from annual
budget submission of Department of Veterans
Affairs.
Sec. 313. Improvement of capital asset staffing of Department of
Veterans Affairs.
Sec. 314. Development of performance metrics of capital asset
management by Department of Veterans
Affairs and monitoring for improvement.
Sec. 315. Expansion of membership of the Capital Asset Planning
Committee.
Sec. 316. Authorization of appropriations.
Subtitle B--Reviews and Reports
Sec. 321. Review of resilience of facilities, land, and other relevant
capital assets of Department of Veterans
Affairs.
Sec. 322. Reports on key capital asset investments, activities, and
performance of Department of Veterans
Affairs.
Sec. 323. Report on long-term care physical infrastructure needs of
Department of Veterans Affairs.
Sec. 324. Report on women veterans retrofit initiative.
Sec. 325. Report on capital asset and information technology needs of
the research and development program of
Department of Veterans Affairs.
Sec. 326. Review and report on provisions of law relating to Department
of Veterans Affairs capital asset
management and oversight.
Sec. 327. Improving prevention, detection, and reporting of waste,
fraud, and abuse in Department of Veterans
Affairs capital asset projects and
activities.
Sec. 328. Comptroller General report on continued need for non-
Department of Veterans Affairs project
management for super construction projects.
SEC. 2. IMPLEMENTATION.
Unless otherwise specified, the Secretary of Veterans Affairs shall
implement this Act and the amendments made by this Act by not later
than the date that is one year after the date of the enactment of this
Act.
TITLE I--IMPROVEMENTS TO CARE
Subtitle A--Scheduling
SEC. 101. TIMING FOR SCHEDULING OF APPOINTMENTS.
(a) In General.--Subchapter I of chapter 17 of title 38, United
States Code, is amended by inserting after section 1706A the following
new section:
``Sec. 1706B. Requirements for timing of scheduling of appointments
``(a) In General.--The Secretary shall ensure that an appointment
for a veteran for care or services under this chapter, including under
section 1703 of this title--
``(1) in the case of a non-urgent appointment, is scheduled
(but may occur at a later date) not later than seven days after
the earlier of the date on which--
``(A) a clinician of the Department determines that
the veteran requires care; or
``(B) the veteran presents to the Department
requesting care; and
``(2) in the case of an appointment for urgent care, is
completed not later than 48 hours after the earlier of the date
on which--
``(A) a clinician of the Department determines that
the veteran requires care; or
``(B) the veteran presents to the Department
requesting care.
``(b) Report on Community Care Scheduling.--
``(1) In general.--Not less frequently than quarterly, 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 average time it takes each
medical facility of the Department to schedule appointments for
care or services under section 1703 of this title,
disaggregated by primary care, mental health care, and each
type of specialty care.
``(2) Data included.--Each report required under paragraph
(1) shall indicate what data for wait times for various types
of care, services, or locations, if any, were not included in
the calculation of the average times and why that data was not
included.
``(3) Inclusion in existing reports.--The Secretary may
include each report required under paragraph (1) in any
existing report required to be submitted to Congress that
relates to the same or a similar topic.
``(4) Analysis of reasons for noncompliance.--
``(A) In general.--Each medical facility of the
Department for which any average time reported under
paragraph (1) for the facility is more than seven days
shall submit to the Under Secretary for Health, not
later than 30 days after the date of the report--
``(i) an analysis of why such average time
is more than seven days, including the extent
to which staffing shortages of a type or
position of employee, insufficient provider
networks, surges of appointments, or any other
factor is increasing such average times;
``(ii) a remediation plan to bring such
average time to not more than seven days; and
``(iii) an explanation for how each issue
specified in clause (i) is being mitigated.
``(B) Treatment of insufficient provider network.--
With respect to any analysis under subparagraph (A)(i)
that determines an insufficient provider network, the
Under Secretary for Health shall--
``(i) consult with any third party
administrator responsible for administering
such network regarding--
``(I) if such network insufficiency
has been previously identified, whether
mitigation is planned for areas where
average times exceed seven days; and
``(II) if such network
insufficiency has not been previously
identified or if previous mitigation
plans have not worked, how network
insufficiency can be overcome; and
``(ii) examine whether the third party
administrator is meeting contractual
obligations regarding network sufficiency.''.
(b) Clerical Amendment.--The table of sections at the beginning of
such chapter is amended by inserting after the item relating to section
1706A the following new item:
``1706B. Requirements for timing of scheduling of appointments.''.
(c) Effective Date.--The Secretary of Veterans Affairs shall comply
with the requirements under section 1706B of title 38, United States
Code, as added by subsection (a), by not later than 180 days after the
date of the enactment of this Act.
SEC. 102. CONSIDERATION OF TELEHEALTH IN DETERMINING WHETHER AN
APPOINTMENT CAN BE SCHEDULED WITHIN THE ACCESS STANDARDS
OF THE DEPARTMENT OF VETERANS AFFAIRS AND LIMITATION ON
AVAILABILITY OF TELEHEALTH THROUGH COMMUNITY CARE.
(a) In General.--Section 1703 of title 38, United States Code, is
amended--
(1) in subsection (d), by adding at the end the following
new paragraph:
``(5) In determining under paragraph (1)(D) whether the Department
is able to furnish care or services in a manner that complies with
designated access standards under section 1703B of this title, for
purposes of determining the availability of an appointment, a
telehealth appointment shall be considered as an available appointment,
subject to subsection (r), if the veteran accepts the use of telehealth
or the only option for the appointment is via telehealth.'';
(2) by redesignating subsection (q) as subsection (r); and
(3) by inserting after subsection (p) the following new
subsection (q):
``(q) Availability of Telehealth.--(1) If a covered veteran is
authorized to receive care or services under this section, the covered
veteran may only seek such care or services via telehealth if--
``(A) such care or services via telehealth are not
available through the Department;
``(B) the wait time for such care or services via
telehealth is longer through the Department than through a
provider under this section; or
``(C) the veteran has already established related in-person
care or services through a provider under this section.
``(2) 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
through a non-Department provider, if telehealth--
``(A) is available to the veteran; and
``(B) is appropriate for the type of care or services the
veteran is seeking, as determined by the Secretary.''.
(b) Limitation on Telehealth Through Community Care Providers.--
When a veteran is authorized to seek care from a non-Department of
Veterans Affairs provider under the laws administered by the Secretary
of Veterans Affairs other than under section 1703 of title 38, United
States Code, the veteran may only seek care via telehealth under such
laws if--
(1) such care via telehealth is not available through the
Department;
(2) the wait time for such care via telehealth is longer
through the Department than through a community provider; or
(3) the veteran has already established related in-person
care through the community provider.
SEC. 103. INFORMATION FOR VETERANS REGARDING ACCESS TO CARE.
(a) In General.--Subchapter I of chapter 17 of title 38, United
States Code, is amended by inserting after section 1704A the following
new section:
``Sec. 1704B. Information regarding access to care
``(a) Provision of Information.--
``(1) In general.--To the greatest extent practicable, the
Secretary shall ensure that veterans are provided, for each
episode of care sought under the laws administered by the
Secretary, information on current wait time and average driving
time options for such episode of care, disaggregated by care
provided--
``(A) in person at a facility of the Department of
Veterans Affairs;
``(B) via telehealth through a provider of the
Department;
``(C) in person through the nearest suitable non-
Department facility with which the Department has a
provider agreement or other arrangement for non-
Department care pursuant to section 1703 of this title;
and
``(D) via telehealth through a non-Department
provider with which the Department has a provider
agreement or other arrangement for non-Department care
pursuant to such section with the shortest wait time.
``(2) Form of information.--Information provided under
paragraph (1)--
``(A) may be provided electronically; and
``(B) shall be documented in the health record of
the veteran.
``(3) Opt out.--The Secretary shall permit a veteran to opt
out of receiving information under paragraph (1).
``(b) Publication and Update of Information.--Not less frequently
than weekly, the Secretary shall update the Access to Care website of
the Department (or successor website) to include updated information
with respect to the following:
``(1) The information required under subsection (a).
``(2) The national average wait times for each appointment
at the Department and a non-Department facility for the receipt
of primary care, specialty care (which shall include a
disaggregated average wait time for outpatient in-person
individual mental health care), and hospital care.
``(3) Total completed appointments for care under the laws
administered by the Secretary disaggregated by appointments
completed during the following period following a request for
appointment:
``(A) Within 30 days.
``(B) More than 30 days.
``(C) More than 90 days.
``(D) More than 180 days.
``(4) Historical data, at a minimum dating back 10 years if
available, for each data point required to be calculated
under--
``(A) subsection (a);
``(B) section 206 of the Veterans Access, Choice,
and Accountability Act of 2014 (Public Law 113-146; 38
U.S.C. 1701 note);
``(C) section 195 of the Joseph Maxwell Cleland and
Robert Joseph D