text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Veteran Care Agreements Rule 
  Enhancement Act'' or the ``Veteran CARE Act''.
  
  SEC. 2. PURPOSE.
  
      The purpose of this Act is--
              (1) to maintain the access of veterans to high-quality 
          hospital care, medical services, and extended care if that care 
          is not available directly from the Department of Veterans 
          Affairs;
              (2) to continue to allow the use by the Department of 
          agreements covered by the Federal Acquisition Regulation and 
          agreements that are not covered by such regulation, similar to 
          those agreements used under the original Medicare fee-for-
          service program (Medicare Parts A and B), if it is not 
          practicable to contract for the care needed by veterans through 
          an agreement covered by such regulation;
              (3) to address the fact that individual health care 
          providers, especially smaller providers in rural areas, may not 
          be willing to accept veterans as patients when doing so would 
          require the significant time and administrative requirements in 
          connection with entering into agreements with the Department 
          that are covered by such regulation;
              (4) to address the deficiencies in current law regarding 
          agreements entered into by the Department that have raised 
          legal issues; and
              (5) to ensure that agreements that are not covered by such 
          regulation include robust terms and conditions that address the 
          quality of health care for veterans, oversight of the provision 
          of such health care, and protections for taxpayers.
  
  SEC. 3. AUTHORIZATION OF AGREEMENTS BETWEEN THE DEPARTMENT OF VETERANS 
                AFFAIRS AND NON-DEPARTMENT HEALTH CARE PROVIDERS.
  
      (a) In General.--Subchapter I of chapter 17 of title 38, United 
  States Code, is amended by adding after section 1703 the following new 
  section:
  ``Sec. 1703A. Veterans Care Agreements with certain health care 
                providers
      ``(a) Agreements To Furnish Care.--(1) If the Secretary is not 
  feasibly able to furnish hospital care, medical services, or extended 
  care under this chapter at facilities of the Department or under 
  contracts or sharing agreements entered into under authorities other 
  than this section, the Secretary may furnish such care and services by 
  entering into agreements under this section with eligible providers 
  that are certified under subsection (c). An agreement entered into 
  under this section may be referred to as a `Veterans Care Agreement'.
      ``(2) The Secretary is not feasibly able to furnish care or 
  services as described in paragraph (1) if the Secretary determines that 
  the medical condition of the veteran, the travel involved, the nature 
  of the care or services required, or a combination of those factors 
  make the use of facilities of the Department, contracts, or sharing 
  agreements impracticable or inadvisable.
      ``(3) Eligibility of a veteran under this section for the care or 
  services described in paragraph (1) shall be determined as if such care 
  or services were furnished in a facility of the Department and 
  provisions of this title applicable to veterans receiving such care or 
  services in a facility of the Department shall apply to veterans 
  receiving such care or services under this section.
      ``(b) Eligible Providers.--For purposes of this section, an 
  eligible provider is one of the following:
              ``(1) A provider of services that has enrolled and entered 
          into a provider agreement under section 1866(a) of the Social 
          Security Act (42 U.S.C. 1395cc(a)).
              ``(2) A physician or supplier that has enrolled and entered 
          into a participation agreement under section 1842(h) of such 
          Act (42 U.S.C. 1395u(h)).
              ``(3) A provider of items and services receiving payment 
          under a State plan under title XIX of such Act (42 U.S.C. 1396 
          et seq.) or a waiver of such a plan.
              ``(4) A provider that is--
                      ``(A) an Aging and Disability Resource Center, an 
                  area agency on aging, or a State agency (as defined in 
                  section 102 of the Older Americans Act of 1965 (42 
                  U.S.C. 3002)); or
                      ``(B) a center for independent living (as defined 
                  in section 702 of the Rehabilitation Act of 1973 (29 
                  U.S.C. 796a)).
              ``(5) Such other health care providers as the Secretary 
          considers appropriate for purposes of this section.
      ``(c) Certification of Eligible Providers.--(1) The Secretary shall 
  establish a process for the certification of eligible providers under 
  this section that shall, at a minimum, set forth the following:
              ``(A) Procedures for the submittal of applications for 
          certification and deadlines for actions taken by the Secretary 
          with respect to such applications.
              ``(B) Standards and procedures for approval and denial of 
          certification, duration of certification, revocation of 
          certification, and recertification.
              ``(C) Procedures for assessing eligible providers based on 
          the risk of fraud, waste, and abuse of such providers similar 
          to the level of screening under section 1866(j)(2)(B) of the 
          Social Security Act (42 U.S.C. 1395cc(j)(2)(B)) and the 
          standards set forth under section 9.104 of title 48, Code of 
          Federal Regulations, or any successor regulation.
      ``(2) The Secretary shall deny or revoke certification to an 
  eligible provider under this subsection if the Secretary determines 
  that the eligible provider is currently--
              ``(A) excluded from participation in a Federal health care 
          program (as defined in section 1128B(f) of the Social Security 
          Act (42 U.S.C. 1320a-7b(f))) under section 1128 or 1128A of the 
          Social Security Act (42 U.S.C. 1320a-7 and 1320a-7a); or
              ``(B) identified as an excluded source on the list 
          maintained in the System for Award Management, or any successor 
          system.
      ``(d) Terms of Agreements.--Each agreement entered into with an 
  eligible provider under this section shall include provisions requiring 
  the eligible provider to do the following:
              ``(1) To accept payment for care and services furnished 
          under this section at rates established by the Secretary for 
          purposes of this section, which shall be, to the extent 
          practicable, the rates paid by the United States for such care 
          and services to providers of services and suppliers under the 
          Medicare program under title XVIII of the Social Security Act 
          (42 U.S.C. 1395 et seq.).
              ``(2) To accept payment under paragraph (1) as payment in 
          full for care and services furnished under this section and to 
          not seek any payment for such care and services from the 
          recipient of such care and services.
              ``(3) To furnish under this section only the care and 
          services authorized by the Department under this section unless 
          the eligible provider receives prior written consent from the 
          Department to furnish care or services outside the scope of 
          such authorization.
              ``(4) To bill the Department for care and services 
          furnished under this section in accordance with a methodology 
          established by the Secretary for purposes of this section.
              ``(5) Not to seek to recover or collect from a health-plan 
          contract or third party, as those terms are defined in section 
          1729 of this title, for any care or services for which payment 
          is made by the Department under this section.
              ``(6) To provide medical records for veterans furnished 
          care or services under this section to the Department in a 
          timeframe and format specified by the Secretary for purposes of 
          this section.
              ``(7) To meet such other terms and conditions, including 
          quality of care assurance standards, as the Secretary may 
          specify for purposes of this section.
      ``(e) Termination of Agreements.--(1) An eligible provider may 
  terminate an agreement with the Secretary under this section at such 
  time and upon such notice to the Secretary as the Secretary may specify 
  for purposes of this section.
      ``(2) The Secretary may terminate an agreement with an eligible 
  provider under this section at such time and upon such notice to the 
  eligible provider as the Secretary may specify for purposes of this 
  section, if the Secretary--
              ``(A) determines that the eligible provider failed to 
          comply substantially with the provisions of the agreement or 
          with the provisions of this section and the regulations 
          prescribed thereunder;
              ``(B) determines that the eligible provider is--
                      ``(i) excluded from participation in a Federal 
                  health care program (as defined in section 1128B(f) of 
                  the Social Security Act (42 U.S.C. 1320a-7b(f))) under 
                  section 1128 or 1128A of the Social Security Act (42 
                  U.S.C. 1320a-7 and 1320a-7a); or
                      ``(ii) identified as an excluded source on the list 
                  maintained in the System for Award Management, or any 
                  successor system;
              ``(C) ascertains that the eligible provider has been 
          convicted of a felony or other serious offense under Federal or 
          State law and determines that the continued participation of 
          the eligible provider would be detrimental to the best 
          interests of veterans or the Department; or
              ``(D) determines that it is reasonable to terminate the 
          agreement based on the health care needs of a veteran or 
          veterans.
      ``(f) Periodic Review of Certain Agreements.--(1) Not less 
  frequently than once every two years, the Secretary shall review each 
  Veterans Care Agreement of material size entered into during the two-
  year period preceding the review to determine whether it is feasible 
  and advisable to furnish the hospital care, medical services, or 
  extended care furnished under such agreement at facilities of the 
  Department or through contracts or sharing agreements entered into 
  under authorities other than this section.
      ``(2)(A) Subject to subparagraph (B), a Veterans Care Agreement is 
  of material size as determined by the Secretary for purposes of this 
  section.
      ``(B) A Veterans Care Agreement entered into after September 30, 
  2016, for the purchase of extended care services is of material size if 
  the purchase of such services under the agreement exceeds $1,000,000 
  annually. The Secretary may adjust such amount to account for changes 
  in the cost of health care based upon recognized health care market 
  surveys and other available data and shall publish any such adjustments 
  in the Federal Register.
      ``(g) Exclusion of Certain Federal Contracting Provisions.--(1) An 
  agreement under this section may be entered into without regard to any 
  law that would require the Secretary to use competitive procedures in 
  selecting the party with which to enter into the agreement.
      ``(2)(A) Except as provided in subparagraph (B) and unless 
  otherwise provided in this section or regulations prescribed pursuant 
  to this section, an eligible provider that enters into an agreement 
  under this section is not subject to, in the carrying out of the 
  agreement, any law that providers of services and suppliers under the 
  Medicare program under title XVIII of the Social Security Act (42 
  U.S.C. 1395 et seq.) are not subject to.
      ``(B) An eligible provider that enters into an agreement under this 
  section is subject to--
              ``(i) all laws regarding integrity, ethics, fraud, or that 
          subject a person to civil or criminal penalties; and
              ``(ii) all laws that protect against employment 
          discrimination or that otherwise ensure equal employment 
          opportunities.
      ``(h) Monitoring of Quality of Care.--The Secretary shall establish 
  a system or systems, consistent with survey and certification 
  procedures used by the Centers for Medicare & Medicaid Services and 
  State survey agencies to the extent practicable--
              ``(1) to monitor the quality of care and services furnished 
          to veterans under this section; and
              ``(2) to assess the quality of care and services furnished 
          by an eligible provider for purposes of determining whether to 
          renew an agreement under this section with the eligible 
          provider.
      ``(i) Dispute Resolution.--(1) The Secretary shall establish 
  administrative procedures for eligible providers with which the 
  Secretary has entered an agreement under this section to present any 
  dispute arising under or related to the agreement.
      ``(2) Before using any dispute resolution mechanism under chapter 
  71 of title 41 with respect to a dispute arising under an agreement 
  under this section, an eligible provider must first exhaust the 
  administrative procedures established by the Secretary under paragraph 
  (1).''.
      (b) Regulations.--The Secretary of Veterans Affairs shall prescribe 
  an interim final rule to carry out section 1703A of such title, as 
  added by subsection (a), not later than one year after the date of the 
  enactment of this Act.
      (c) Clerical Amendment.--The table of sections at the beginning of 
  chapter 17 of such title is amended by inserting after the item related 
  to section 1703 the following new item:
  
  ``1703A. Veterans Care Agreements with certain health care 
                              providers.''.
  
  SEC. 4. MODIFICATION OF AUTHORITY TO ENTER INTO AGREEMENTS WITH STATE 
                HOMES TO PROVIDE NURSING HOME CARE.
  
      (a) Use of Agreements.--
              (1) In general.--Paragraph (1) of section 1745(a) of title 
          38, United States Code, is amended, in the matter preceding 
          subparagraph (A), by striking ``a contract (or agreement under 
          section 1720(c)(1) of this title)'' and inserting ``an 
          agreement''.
              (2) Payment.--Paragraph (2) of such section is amended by 
          striking ``contract (or agreement)'' each place it appears and 
          inserting ``agreement''.
      (b) Exclusion of Certain Federal Contracting Provisions.--Such 
  section is amended by adding at the end the following new paragraph:
      ``(4)(A) An agreement under this section may be entered into 
  without regard to any law that would require the Secretary to use 
  competitive procedures in selecting the party with which to enter into 
  the agreement.
      ``(B)(i) Except as provided in clause (ii) and unless otherwise 
  provided in this section or regulations prescribed pursuant to this 
  section, a State home that enters into an agreement under this section 
  is not subject to, in the carrying out of the agreement, any law that 
  providers of services and suppliers under the Medicare program under 
  title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) are not 
  subject to.
      ``(ii) An eligible provider that enters into an agreement under 
  this section is subject to--
              ``(I) all laws regarding integrity, ethics, fraud, or that 
          subject a person to civil or criminal penalties; and
              ``(II) all laws that protect against employment 
          discrimination or that otherwise ensure equal employment 
          opportunities.''.
      (c) Effective Date.--
              (1) In general.--The amendments made by this section shall 
          apply to agreements entered into under section 1745 of such 
          title on and after the date on which the regulations prescribed 
          by the Secretary of Veterans Affairs to implement such 
          amendments take effect.
              (2) Publication.--The Secretary shall publish the date 
          described in paragraph (1) in the Federal Register not later 
          than 30 days before such date.
target: Veteran Care Agreements Rule Enhancement Act or Veteran CARE Act This bill authorizes the Department of Veterans Affairs (VA), if unable to furnish hospital care, medical services, or extended care at VA facilities or under other authorized contracts or sharing agreements, to enter into a Veterans Care Agreement with an eligible provider to furnish such care and services. The VA shall review agreements exceeding $1 million annually at least once every two years. The VA shall establish a process for the certification of eligible providers. An eligible provider is:   a physician or provider of services that has entered into a provider agreement under the Social Security Act;  a provider of items and services receiving payments under a state Medicaid plan;  an aging and disability resource center, an area agency on aging, or a center for independent living; or any other health care provider the VA considers appropriate.  The VA shall establish a system or systems to monitor the quality of care and services furnished to veterans, which shall be used in assessing whether to renew an agreement.  An agreement may be made with a health care provider to provide veterans with nursing home care.
feat_title: Veteran CARE Act