SECTION 1. SHORT TITLE; SENSE OF CONGRESS.

    (a) Short Title.--This Act may be cited as the ``Enhanced Veteran 
Healthcare Experience Act of 2011''.
    (b) Sense of Congress.--It is the sense of Congress that--
            (1) the current health care system of the Department of 
        Veterans Affairs is neither fiscally efficient nor effective in 
        providing easily accessible treatment for all veterans;
            (2) health care can be provided more efficiently to provide 
        veterans with care that is available closer to where they live 
        and to allow veterans more flexibility in choosing their own 
        doctors; and
            (3) better health care can be provided to veterans at 
        little-to-no increased cost to the taxpayer by replacing the 
        fee-based care system of the Department with the veterans 
        enhanced care program, as described under section 2, and 
        reprogramming funds to this program.

SEC. 2. ENHANCED CONTRACT CARE AUTHORITY FOR HEALTH CARE NEEDS OF 
              VETERANS.

    (a) In General.--
            (1) Type of care.--Subsection (a) of section 1703 of title 
        38, United States Code, is amended to read as follows:
    ``(a)(1) The Secretary shall provide an eligible veteran with 
covered health services that are provided by a non-Department provider 
whom the Secretary enters into a contract with under this section if 
the Secretary determines that facilities of the Department are not 
capable of--
            ``(A) economically furnishing covered health services to 
        such veteran because of geographical inaccessibility; or
            ``(B) furnishing covered health services to such veteran 
        because such facilities lack the required personnel, resources, 
        or ability.
    ``(2) In this subsection:
            ``(A) The term `covered health services' means, with 
        respect to an eligible veteran, any hospital care, medical 
        service, rehabilitative service, or preventative health service 
        that is authorized to be provided by the Secretary to the 
        veteran under this chapter or any other provision of law.
            ``(B) The term `eligible veteran' means a veteran enrolled 
        in the health care system established under section 1705(a) of 
        this title who elects to receive care under this section.''.
            (2) Qualified providers; quality of care.--Such section is 
        amended by adding at the end the following new subsections:
    ``(e) The Secretary may enter into a contract with a non-Department 
provider under this section if such provider--
            ``(1) demonstrates the ability to provide non-Department 
        health care services to veterans;
            ``(2) meets or exceeds internal credentialing standards of 
        the Department and standards of the Utilization Review 
        Accreditation Commission;
            ``(3) has care coordinators who help veterans make, 
        confirm, and keep medical appointments;
            ``(4) has--
                    ``(A) a system that allows veterans to file 
                complaints; and
                    ``(B) a demonstrated ability to respond to 
                potential quality indicators and patient safety events; 
                and
            ``(5) has the ability to--
                    ``(A) process claims from others in the network of 
                the provider;
                    ``(B) bill a third party (as defined in section 
                1725(f)(2) of this title) for care provided under this 
                section, as appropriate; and
                    ``(C) transmit directly to the Secretary any 
                amounts received pursuant to subparagraph (B).
    ``(f) In carrying out this section, the Secretary shall ensure the 
following:
            ``(1) With respect to each medical center of the 
        Department, the Secretary is consistent in determining the 
        eligibility of veterans under subsection (a).
            ``(2) The Secretary includes care coordinators of a non-
        Department provider described in subsection (e)(3) in 
        initiatives of the Department to provide patient-centered care 
        and uses such coordinators when the Secretary is unable to 
        assign a veteran a case manager from the Department.
            ``(3) The Department and a non-Department provider under 
        this section exchange clinical information to improve both 
        clinical decision-making and the care a veteran receives.
            ``(4) Both non-Department facilities under this section and 
        Department facilities meet performance metrics regarding--
                    ``(A) the quality of health care provided; and
                    ``(B) the satisfaction of veterans.
            ``(5) A non-Department facility under this section or 
        employee of the Department who exceeds performance metrics 
        under paragraph (4) are eligible for incentive or bonus 
        payments.
    ``(g)(1) Not later than October 31 of each year, the Secretary 
shall submit to the Committee of Veterans' Affairs of the Senate and 
the Committee on Veterans' Affairs of the House of Representatives a 
report on care provided under this section, including--
            ``(A) the cost to the Department;
            ``(B) the number of veterans receiving care under this 
        section;
            ``(C) the quality of such care and the satisfaction of such 
        veterans; and
            ``(D) other matters the Secretary considers appropriate.
    ``(2) Not later than March 1 of each odd-numbered year, the 
Secretary shall submit to the Committee of Veterans' Affairs of the 
Senate and the Committee on Veterans' Affairs of the House of 
Representatives a report on the allocation of resources with respect to 
care provided by the Department and by non-Department facilities.''.
            (3) Effective date.--The amendments made by paragraphs (1) 
        and (2) shall take effect on October 1, 2012.
    (b) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary to carry out section 1703 of title 38, 
United States Code, as amended by this section, for fiscal year 2013 
$5,000,000,000.
Enhanced Veteran Healthcare Experience Act of 2011 - Expresses the sense of Congress that better health care can be provided to veterans at little-to-no increased cost by revising the Department of Veterans Affairs (VA) fee-based system for hospital care and medical services in non-VA facilities.

Directs the Secretary of Veterans Affairs to provide certain enrolled veterans with health services (authorized hospital care or medical, rehabilitative, or preventative health services) that are provided by a non-VA provider with whom the Secretary enters into a contract pursuant to this Act if the Secretary determines that VA facilities are incapable of furnishing such services because of: (1) geographical inaccessibility; or (2) a lack of required personnel, resources, or ability at VA facilities.

Authorizes the Secretary to enter a contract with a non-VA provider that: (1) demonstrates the ability to provide non-VA health care services to veterans; (2) meets or exceeds credentialing standards of the VA and the Utilization Review Accreditation Commission; (3) has coordinators who help veterans make, confirm, and keep medical appointments, a system that allows veterans to file complaints, and a demonstrated ability to respond to potential quality indicators and patient safety events; and (4) has the ability to process claims from other providers in its network, bill third parties, and transmit received amounts to the Secretary.

Sets forth requirements concerning the VA's coordination with non-VA providers, performance metrics, and bonus payments for exceeding such metrics.
{"src": "billsum_test", "title": "To amend title 38, United States Code, to direct the Secretary of Veterans Affairs to enter into contracts with health care providers to improve access to health care for veterans who have difficulty receiving treatment at a health care facility of the Department of Veterans Affairs, and for other purposes."}