text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``21st Century Veterans Equitable 
  Treatment Act''.
  
  SEC. 2. FINDINGS.
  
      Congress makes the following findings:
              (1) Veterans were promised by the Federal Government that 
          for their service to the country they would be provided a 
          lifetime of health care services, as well as their own health 
          care service network.
              (2) The current allocation system for appropriations made 
          to the Department of Veterans Affairs for medical care, known 
          as the Veterans Equitable Resource Allocation (VERA) formula 
          and established by the Secretary of Veterans Affairs pursuant 
          to section 429 of the Departments of Veterans Affairs and 
          Housing and Urban Development, and Independent Agencies 
          Appropriations Act, 1997 (Public Law 104-204; 110 Stat. 2929), 
          has proved to be an ineffective means of allocating such funds 
          fairly across the 22 national service regions, known as 
          Veterans Integrated Service Networks (VISNs), of the Department 
          of Veterans Affairs.
              (3) The VERA formula has resulted in a system in which 
          veterans in some regions of the country are forced to compete 
          with veterans in other regions for critical medical care funds, 
          whereas the system should be providing the funding necessary to 
          meet the health care needs of all veterans, regardless of where 
          they live, to ensure that all veterans have access to the level 
          and quality of care that they have all earned and deserve.
              (4) The Secretary of Veterans Affairs established a set of 
          performance goals in fiscal year 2000, which are referred to as 
          ``30-30-20'', representing the Secretary's goal to schedule 
          nonurgent primary care visits within 30 days, specialty care 
          visits within 30 days, and the maximum amount of time veterans 
          must wait once they arrive to be seen by a doctor as 20 
          minutes.
              (5) According to the Department's Performance Report for 
          Fiscal Year 2001, nationally 87 percent of primary care 
          appointments were scheduled within 30 days of the desired date 
          and 84 percent of specialty care appointments were scheduled 
          within 30 days of the desired date, while in VISN 1, only 82 
          percent of primary care appointments were scheduled within 30 
          days of the desired date and only 80 percent of specialty care 
          appointments were scheduled within 30 days of the desired date.
              (6) Until the VERA formula is changed to ensure a more 
          equitable and adequate distribution of medical care funding 
          within the Department of Veterans Affairs system, providing 
          appropriate access to medical care for the Nation's veterans 
          must remain a national priority with a method found to provide 
          a safety net that will ensure that veterans have access to the 
          health care they need without undermining the existing health 
          care network of the Department of Veterans Affairs.
  
  SEC. 3. STANDARD FOR TIME FOR REFERRAL FOR SPECIALIST CARE.
  
      (a) Time for Specialist Appointments.--(1) The Secretary of 
  Veterans Affairs shall establish by regulation a maximum specialist 
  referral period, subject to such exceptions as the Secretary considers 
  necessary.
      (2) For purposes of paragraph (1), the term ``specialist referral 
  period'' means the period of time between (A) the date on which a 
  veteran is referred to a specialty clinic of the Department by the 
  veteran's primary care physician within the Department of Veterans 
  Affairs health care system, and (B) the date for which the veteran is 
  scheduled for an appointment with a Department specialist pursuant to 
  such referral.
      (3) In establishing a maximum specialist referral period under 
  paragraph (1), the Secretary shall act in a manner consistent with the 
  current treatment policies of the Department based on clinical need and 
  with the established 30-30-20 performance goal of the Department for 
  such a referral period.
      (b) Standard for Transportation.--The Secretary shall take such 
  steps as necessary to ensure that the Department of Veterans Affairs is 
  able to provide appropriate transportation services for qualified 
  veterans within a reasonable time period of a scheduled appointment.
  
  SEC. 4. CONTRACT CARE TO BE PROVIDED WHEN DEPARTMENT OF VETERANS 
                AFFAIRS CARE NOT AVAILABLE IN ACCORDANCE WITH STANDARDS.
  
      (a) Contract Care.--In any case in which the Secretary of Veterans 
  Affairs is not able to provide hospital care or medical services in 
  accordance with the standard prescribed under section 3(a) or to 
  provide transportation services in accordance with section 3(b), the 
  Secretary shall promptly provide for such care or transportation from a 
  private source. Hospital care or medical services so provided shall be 
  those for which the veteran is otherwise eligible within the Department 
  of Veterans Affairs medical care system.
      (b) Reimbursement Rate.--Whenever care or services are provided 
  under subsection (a), the Secretary shall reimburse the provider of 
  such care or services for the reasonable value of such care or 
  services, as determined by the Secretary. Such reimbursement shall be 
  provided in the same manner as applies to reimbursement for emergency 
  treatment under section 1725 of title 38, United States Code, subject 
  to such of the terms and conditions otherwise applicable to such 
  reimbursements under such section as the Secretary determines to be 
  appropriate for purposes of this section.
      (c) Expedited Reimbursement Procedures.--The Secretary shall take 
  appropriate steps to expedite the reimbursement required by subsection 
  (b). Such steps may include steps to take advantage of modern 
  technology, including so-called ``smart card'' technology that would 
  allow claims for such reimbursement to be processed electronically. The 
  Secretary shall, to the extent possible, also apply such steps for 
  expediting reimbursement to claims for emergency services provided to 
  veterans for which the Secretary provides reimbursement under 
  provisions of law in effect before the date of the enactment of this 
  Act.
  
  SEC. 5. TERMINATION OF 24-MONTH RULE FOR REIMBURSEMENT FOR EMERGENCY 
                SERVICES.
  
      The provisions of subparagraph (B) of section 1725(b)(2) of title 
  38, United States Code, shall not apply with respect to emergency 
  treatment furnished on or after the date of the enactment of this Act.
  
  SEC. 6. MEDICAL ADMINISTRATOR PERFORMANCE RATINGS.
  
      The Secretary of Veterans Affairs shall include in the standards of 
  performance used for measuring performance of administrators in the 
  Department of Veterans Affairs medical care system a standard of 
  assessing improvements in appointment waiting times.
  
  SEC. 7. REPORTS.
  
      The Secretary of Veterans Affairs shall submit to the Committees on 
  Veterans' Affairs of the Senate and House of Representatives a report 
  at the end of each fiscal-year quarter on the waiting times for 
  appointments in the Department of Veterans Affairs medical care system. 
  The report shall describe any reductions in such waiting times and any 
  experience with appointment delays.
target: 21st Century Veterans Equitable Treatment Act - Directs the Secretary of Veterans Affairs to: (1) establish a maximum specialist referral period (the period between a veteran's referral to a specialty clinic of the Department of Veterans Affairs by a Department primary care physician and the actual appointment with a specialist); and (2) provide appropriate transportation to such appointments for qualified veterans.Requires the Secretary, in any case in which such period is exceeded or in which transportation was not so provided, to promptly provide for such care or transportation from a private source and to reimburse such source at an appropriate rate. Requires expedited reimbursement procedures.Directs the Secretary to include within standards of performance used for measuring Department medical care administration a standard of assessing improvements in appointment waiting times.
feat_title: To amend title 38, United States Code, to provide for a more equitable geographic allocation of funds appropriated to the Department of Veterans Affairs for medical care.