text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Department of Veterans Affairs 
  Purchased Health Care Streamlining and Modernization Act''.
  
  SEC. 2. AGREEMENTS.
  
      (a) In General.--Subchapter I of chapter 17 of title 38, United 
  States Code, is amended by inserting after section 1703 the following 
  new section:
  ``Sec. 1703A. Veterans Care Agreements with certain health care 
                providers
      ``(a) Veterans Care Agreements.--(1) In addition to furnishing 
  hospital care, medical services, or extended care under this chapter at 
  facilities of the Department or under contracts or sharing agreements 
  entered into pursuant to provisions of law other than this section, the 
  Secretary may furnish such care and services to eligible veterans 
  through the use of agreements entered into under this section by the 
  Secretary with eligible providers.
      ``(2) The Secretary may enter into Veterans Care Agreements under 
  this section with eligible providers to furnish hospital care, medical 
  services, and extended care to veterans whom the Secretary determines 
  that furnishing such care and services at facilities of the Department 
  or under contracts or sharing agreements under provisions of law other 
  than this section is impracticable or inadvisable because of the 
  medical condition of the veteran, the travel involved, or the nature of 
  the care or services required, or a combination of such factors.
      ``(b) Veteran Eligibility.--Eligibility of a veteran for care and 
  services under this section 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 and services 
  in a facility of the Department shall apply to veterans receiving care 
  and services under this section.
      ``(c) Provider Eligibility.--Subject to the certification process 
  pursuant to subsection (d)(1), a provider of hospital care, medical 
  services, or extended care is eligible to enter into a Veterans Care 
  Agreement under this section if the Secretary determines that the 
  provider meets each of the following criteria:
              ``(1) The gross annual revenue of the provider in the year 
          preceding the year in which the provider enters into the 
          Veterans Care Agreement does not exceed $11,000,000 (as 
          adjusted in a manner similar to amounts adjusted pursuant to 
          section 5312 of this title).
              ``(2) The provider does not otherwise provide such care or 
          services to patients pursuant to a contract entered into with a 
          department or agency of the Federal Government.
              ``(3) The provider is--
                      ``(A) 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));
                      ``(B) 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));
                      ``(C) 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;
                      ``(D) 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
                      ``(E) a center for independent living (as defined 
                  in section 702 of the Rehabilitation Act of 1973 (29 
                  U.S.C. 796a)).
              ``(4) Any additional criteria determined appropriate by the 
          Secretary.
      ``(d) Provider Certification.--(1) The Secretary shall establish a 
  process for the certification of eligible providers to enter into 
  Veterans Care Agreements under this section that shall, at a minimum, 
  set forth the following:
              ``(A) Procedures for the submission of applications for 
          certification and deadlines for actions taken by the Secretary 
          with respect to such applications.
              ``(B) Standards and procedures for the approval and denial 
          of certifications and the revocation of certifications.
              ``(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. 1395(j)(2)(B)) and the standards 
          set forth under section 9.104 of title 48, Code of Federal 
          Regulations, or any successor regulation.
              ``(D) Requirement for denial or revocation of certification 
          if the Secretary determines that the otherwise 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.
              ``(E) Procedures by which a provider whose certification is 
          denied or revoked under the procedures established under this 
          subsection will be identified as an excluded source on the list 
          maintained in the System for Award Management, or successor 
          system, if the Secretary determines that such exclusion is 
          appropriate.
      ``(2) To the extent practicable, the Secretary shall establish the 
  procedures under paragraph (1) in a manner that takes into account any 
  certification process administered by another department or agency of 
  the Federal Government that an eligible provider has completed by 
  reason of being a provider described in any of subparagraphs (A) 
  through (E) of subsection (c)(3).
      ``(e) Terms of Agreements.--The Secretary shall ensure that each 
  Veterans Care Agreement 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--
                      ``(A) the rates paid by the United States for such 
                  care 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.);
                      ``(B) the rates paid by the United States pursuant 
                  to the Alaska Fee Schedule of the Department of 
                  Veterans Affairs;
                      ``(C) the rates paid by the United States pursuant 
                  to an All-Payer Model Agreement under the Social 
                  Security Act; or
                      ``(D) the rates paid by the United States in a 
                  highly rural area pursuant to section 
                  101(d)(2)(B)(ii)(I) of the Veterans Access, Choice, and 
                  Accountability Act of 2014 (38 U.S.C. 1701 note).
              ``(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.
              ``(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 and 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 and services under this section to the Department in a 
          timeframe and format specified by the Secretary for purposes of 
          this section, except the Secretary may not require that any 
          payment by the Secretary to the eligible provider be contingent 
          on such provision of medical records.
              ``(7) To meet other such terms and conditions, including 
          quality of care assurance standards, as the Secretary may 
          specify for purposes of this section.
      ``(f) Exclusion of Certain Federal Contracting Provisions.--(1) 
  Notwithstanding any other provision of law, the Secretary may enter 
  into a Veterans Care Agreement using procedures other than competitive 
  procedures.
      ``(2)(A) Except as provided in subparagraph (B) and unless 
  otherwise provided in this section, an eligible provider that enters 
  into a Veterans Care Agreement under this section is not subject to, in 
  the carrying out of the agreement, any provision of law that providers 
  of services and suppliers under the original Medicare fee-for-service 
  program under parts A and B of title XVIII of the Social Security Act 
  (42 U.S.C. 1395 et seq.) or the Medicaid program under title XIX of 
  such Act (42 U.S.C. 1396 et seq.) are not subject to.
      ``(B) In addition to the provisions of laws covered by subparagraph 
  (A), an eligible provider shall be subject to the following provisions 
  of law:
              ``(i) Any applicable law regarding integrity, ethics, or 
          fraud, or that subject a person to civil or criminal penalties.
              ``(ii) Section 431 of title 18.
              ``(iii) Section 1352 of title 31, except for the filing 
          requirements under subsection (b) of such section.
              ``(iv) Section 4705 or 4712 of title 41, and any other 
          applicable law regarding the protection of whistleblowers.
              ``(v) Section 4706(d) of title 41.
              ``(vi) Title VII of the Civil Rights Act of 1964 (42 U.S.C. 
          2000e et seq.) to the same extent as such title applies with 
          respect to the eligible provider in providing care or services 
          through an agreement or arrangement other than under a Veterans 
          Care Agreement.
      ``(C) An eligible provider that receives a payment from the Federal 
  Government pursuant to a Veterans Care Agreement shall not be treated 
  as a Federal contractor or subcontractor by the Office of Federal 
  Contract Compliance Programs of the Department of Labor based on the 
  work performed or actions taken by such eligible provider that resulted 
  in the receipt of such payments.
      ``(g) Termination of Veterans Care Agreement.--(1) An eligible 
  provider may terminate a Veterans Care 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 a Veterans Care 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 the purposes 
  of this section, if the Secretary--
              ``(A) determines that the eligible provider failed to 
          comply with the provisions of the agreement or this section or 
          other applicable provision of law;
              ``(B) makes a revocation pursuant to subsection (d)(1)(4);
              ``(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 of the Department; or
              ``(D) determines that it is reasonable to terminate the 
          agreement based on the health care needs of veterans.
      ``(h) Duration; Mandatory Reviews.--(1) Each Veterans Care 
  Agreement entered into under this section shall be for a two-year 
  period unless the Secretary extends the agreement pursuant to paragraph 
  (2)(B).
      ``(2)(A) During the 180-day period beginning 540 days after the 
  date on which a Veterans Care Agreement is entered into or renewed, the 
  Secretary shall review the agreement to determine whether it is 
  feasible and advisable to instead furnish the hospital care, medical 
  services, or extended care furnished under the agreement at facilities 
  of the Department or through contracts or sharing agreements entered 
  into under authorities other than this section.
      ``(B) If the Secretary determines under subparagraph (A) that it is 
  not feasible and advisable to instead furnish hospital care, medical 
  services, or extended care furnished under a Veterans Care Agreement at 
  facilities of the Department or through contracts or sharing agreements 
  entered into under authorities other than this section, the Secretary--
              ``(i) shall prepare a written memorandum of such 
          determination; and
              ``(ii) may renew such agreement.
      ``(i) Disputes.--(1) The Secretary shall establish administrative 
  procedures for eligible providers with which the Secretary has entered 
  into a Veterans Care Agreement 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 a Veterans Care 
  Agreement under this section, an eligible provider must first exhaust 
  the administrative procedures established by the Secretary under 
  paragraph (1).
      ``(j) Annual Reports.--Not later than October 1 of the year 
  following the fiscal year in which the Secretary first enters into a 
  Veterans Care Agreement, and each year thereafter, the Secretary shall 
  submit to the appropriate congressional committees an annual report 
  that includes--
              ``(1) a list of all Veterans Care Agreements entered into 
          as of the date of the report; and
              ``(2) summaries of each determination made by the Secretary 
          under subsection (h)(2) during the fiscal year covered by the 
          report.
      ``(k) Quality of Care.--In carrying out this section, the Secretary 
  shall use the quality of care standards set forth or used by the 
  Centers for Medicare & Medicaid Services.
      ``(l) Delegation.--The Secretary may delegate the authority to 
  enter into or terminate a Veterans Care Agreement, or to make a 
  determination described in subsection (h)(2), at a level not below the 
  Assistant Deputy Under Secretary for Health for Community Care.
      ``(m) Sunset.--The Secretary may not enter into or renew a Veterans 
  Care Agreement under this section after the date that is five years 
  after the enactment of this Act.
      ``(n) Definitions.--In this section:
              ``(1) The term `appropriate congressional committees' 
          means--
                      ``(A) the Committees on Veterans' Affairs of the 
                  House of Representatives and the Senate; and
                      ``(B) the Committees on Appropriations of the House 
                  of Representatives and the Senate.
              ``(2) The term `eligible provider' means a provider of 
          hospital care, medical services, or extended care that the 
          Secretary determines is eligible to enter into Veterans Care 
          Agreements under subsection (c).
              ``(3) The term `Veterans Care Agreement' means an agreement 
          entered into by the Secretary with an eligible provider under 
          subsection (a)(1).''.
      (b) 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.''.
      (c) Regulations.--Not later than one year after the date of the 
  enactment of this Act, the Secretary of Veterans Affairs shall 
  prescribe interim final regulations to implement section 1703A of title 
  38, United States Code, as added by subsection (a), and publish such 
  regulations in the Federal Register.
target: Department of Veterans Affairs Purchased Health Care Streamlining and Modernization Act This bill authorizes the Department of Veterans Affairs (VA), in addition to furnishing hospital care, medical services, or extended care at VA facilities or under contracts or sharing agreements, to furnish such care and services to eligible veterans through the use of Veterans Care Agreements with eligible providers.  An eligible provider is:  a provider whose income in the year preceding the year of entering into an agreement did not exceed $11 million; a provider who does not otherwise provide such care or services pursuant to a federal contract; and  a physician or provider of Medicaid or Medicare services, an Aging and Disability Resource Center, an area agency on aging, or a center for independent living.  The VA shall: (1) establish a certifying process for providers, (2) review agreements at least once every two years, and (3) use the quality of care standards set forth or used by the Centers for Medicare &amp; Medicaid Services. The VA may enter into an agreement using non-competitive procedures.
feat_title: Department of Veterans Affairs Purchased Health Care Streamlining and Modernization Act