[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4624 Introduced in House (IH)]
<DOC>
117th CONGRESS
1st Session
H. R. 4624
To amend title 38, United States Code, to improve access to health care
for veterans, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 22, 2021
Mr. Bergman (for himself, Mr. Bost, and Mr. Panetta) introduced the
following bill; which was referred to the Committee on Veterans'
Affairs
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to improve access to health care
for veterans, 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 ``Guaranteeing
Healthcare Access to Personnel Who Served Act''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--MISSION ACT PROTECTION
Subtitle A--Access to Community Care
Sec. 101. Modifications to access standards for care furnished through
Community Care Program of Department of
Veterans Affairs.
Sec. 102. Strategic plan to ensure continuity of care in the case of
the realignment of a medical facility of
the Department.
Subtitle B--Community Care Self-Scheduling Pilot Program
Sec. 111. Definitions.
Sec. 112. Pilot program establishing a community care self-scheduling
appointment system.
Sec. 113. Capabilities of self-scheduling appointment system.
Sec. 114. Report.
Subtitle C--Non-Department of Veterans Affairs Providers
Sec. 121. Credentialing verification requirements for providers of non-
Department of Veterans Affairs health care
services.
Sec. 122. Inapplicability of certain providers to provide non-
Department of Veterans Affairs care.
TITLE II--IMPROVEMENT OF RURAL HEALTH AND TELEHEALTH
Sec. 201. Establishment of strategic plan requirement for Office of
Connected Care of Department of Veterans
Affairs.
Sec. 202. Comptroller General report on transportation services by
third parties for rural veterans.
Sec. 203. Comptroller General report on telehealth services of the
Department of Veterans Affairs.
TITLE III--FOREIGN MEDICAL PROGRAM
Sec. 301. Analysis of feasibility and advisability of expanding
assistance and support to caregivers to
include caregivers of veterans in the
Republic of the Philippines.
Sec. 302. Comptroller General report on Foreign Medical Program of
Department of Veterans Affairs.
TITLE IV--MENTAL HEALTH CARE
Sec. 401. Analysis of feasibility and advisability of Department of
Veterans Affairs providing evidence-based
treatments for the diagnosis of treatment-
resistant depression.
Sec. 402. Modification of resource allocation system to include peer
specialists.
Sec. 403. Gap analysis of psychotherapeutic interventions of the
Department of Veterans Affairs.
TITLE V--OTHER MATTERS
Sec. 501. Online health care education portal.
Sec. 502. Exclusion of application of Paperwork Reduction Act to
research activities of the Veterans Health
Administration.
TITLE I--MISSION ACT PROTECTION
Subtitle A--Access to Community Care
SEC. 101. MODIFICATIONS TO ACCESS STANDARDS FOR CARE FURNISHED THROUGH
COMMUNITY CARE PROGRAM OF DEPARTMENT OF VETERANS AFFAIRS.
(a) Access Standards.--
(1) In general.--Section 1703B of title 38, United States
Code, is amended--
(A) by striking subsections (a) through (g) and
inserting the following:
``(a) Threshold Eligibility Standards for Access to Community
Care.--(1) A covered veteran shall receive non-Department hospital
care, medical services, or extended care services through the Veterans
Community Care Program under section 1703 of this title pursuant to
subsection (d)(1)(D) of such section using the following eligibility
access standards:
``(A) With respect to primary care, mental health care, or
non-institutional extended care services, if the Department
cannot schedule an appointment for the covered veteran with a
health care provider of the Department--
``(i) within 30 minutes average driving time from
the residence of the veteran; and
``(ii) within 20 days of the date of request for
such an appointment unless a later date has been agreed
to by the veteran in consultation with the health care
provider.
``(B) With respect to specialty care or specialty services,
if the Department cannot schedule an appointment for the
covered veteran with a health care provider of the Department--
``(i) within 60 minutes average driving time from
the residence of the veteran; and
``(ii) within 28 days of the date of request for
such an appointment, unless a later date has been
agreed to by the veteran in consultation with the
health care provider.
``(2) For the purposes of determining the eligibility of a covered
veteran for care or services under paragraph (1), the Secretary shall
not take into consideration the availability of telehealth appointments
from the Department when determining whether the Department is able to
furnish such care or services in a manner that complies with the
eligibility access standards under such paragraph.
``(b) Access to Care Standards for Community Care.--(1) Subject to
subsection (c), the Secretary shall meet the following access to care
standards when furnishing non-Department hospital care, medical
services, or extended care services to a covered veteran through the
Veterans Community Care Program under section 1703 of this title:
``(A) With respect to an appointment for primary care,
mental health care, or non-institutional extended care
services--
``(i) within 30 minutes average driving time from
the residence of the veteran unless a longer driving
time has been agreed to by the veteran; and
``(ii) within 20 days of the date of request for
such an appointment unless a later date has been agreed
to by the veteran.
``(B) With respect to an appointment for specialty care or
specialty services--
``(i) within 60 minutes average driving time from
the residence of the veteran unless a longer driving
time has been agreed to by the veteran; and
``(ii) within 28 days of the date of request for
such an appointment unless a later date has been agreed
to by the veteran.
``(2) The Secretary shall ensure that health care providers
specified under section 1703(c) of this title are able to comply with
the applicable access to care standards under paragraph (1) for such
providers.
``(c) Waivers to Access to Care Standards for Community Care
Providers.--(1) A Third Party Administrator may request a waiver to the
access to care standards under subsection (b) if--
``(A)(i) the scarcity of available providers or facilities
in the region precludes the Third Party Administrator from
meeting those access to care standards; or
``(ii) the landscape of providers or facilities has
changed, and certain providers or facilities are not available
such that the Third Party Administrator is not able to meet
those access to care standards; and
``(B) to address the scarcity of available providers or the
change in the provider or facility landscape, as the case may
be, the Third Party Administrator has contracted with other
providers or facilities that may not meet those access to care
standards but are the currently available providers or
facilities most accessible to veterans within the region of
responsibility of the Third Party Administrator.
``(2) Any waiver requested by a Third Party Administrator under
paragraph (1) must be requested in writing and submitted to the Office
of Community Care of the Department for approval by that office.
``(3) As part of any waiver request under paragraph (1), a Third
Party Administrator must include conclusive evidence and documentation
that the access to care standards under subsection (b) cannot be met
because of scarcity of available providers or changes to the landscape
of providers or facilities.
``(4) In evaluating a waiver request under paragraph (1), the
Secretary shall consider the following:
``(A) The number and geographic distribution of eligible
health care providers available within the geographic area and
specialty referenced in the waiver request.
``(B) The prevailing market conditions within the
geographic area and specialty referenced in the waiver request,
which shall include the number and distribution of health care
providers contracting with other health care plans (including
commercial plans and the Medicare program under title XVIII of
the Social Security Act (42 U.S.C. 1395 et seq.)) operating in
the geographic area and specialty referenced in the waiver
request.
``(C) Whether the service area is comprised of highly
rural, rural, or urban areas or some combination of such areas.
``(D) How significantly the waiver request differs from the
relevant access to care standards under subsection (b).
``(5) The Secretary shall not consider inability to contract as a
valid sole rationale for granting a waiver under paragraph (1).
``(d) Calculation of Driving Time.--For purposes of calculating
average driving time from the residence of the veteran under
subsections (a) and (b), the Secretary shall use geographic information
system software.
``(e) Periodic Review of Access Standards.--Not later than three
years after the date of the enactment of the Guaranteeing Healthcare
Access to Personnel Who Served Act, and not less frequently than once
every three years thereafter, the Secretary shall--
``(1) conduct a review of the eligibility access standards
under subsection (a) and the access to care standards under
subsection (b), in consultation with--
``(A) such Federal entities as the Secretary
considers appropriate, including the Department of
Defense, the Department of Health and Human Services,
and the Centers for Medicare & Medicaid Services;
``(B) entities in the private sector; and
``(C) other entities that are not part of the
Federal Government; and
``(2) submit to the appropriate committees of Congress a
report on--
``(A) the findings of the Secretary with respect to
the review conducted under paragraph (1); and
``(B) such recommendations as the Secretary may
have with respect to the eligibility access standards
under subsection (a) and the access to care standards
under subsection (b).
``(f) Publication of Eligibility Access Standards and Wait Times.--
(1) The Secretary shall publish on a publicly available internet
website of the Department the eligibility access standards under
subsection (a).
``(2)(A) The Secretary shall publish on a publicly available
internet website of the Department the average wait time for a veteran
to schedule an appointment at each medical center of the Department for
the receipt of primary care and specialty care, measured from the date
of request for the appointment to the date on which the care was
provided.
``(B) The Secretary shall update the wait times published under
subparagraph (A) not less frequently than monthly.'';
(B) by redesignating subsections (h) and (i) as
subsections (g) and (h), respectively;
(C) in subsection (g), as redesignated by
subparagraph (B)--
(i) in paragraph (1), by striking
``designated access standards established under
this section'' and inserting ``eligibility
access standards under subsection (a)''; and
(ii) in paragraph (2)(B), by striking
``designated access standards established under
this section'' and inserting ``eligibility
access standards under subsection (a)''; and
(D) in subsection (h), as so redesignated, by
adding at the end the following new paragraphs:
``(3) The term `inability to contract', with respect to a
Third Party Administrator, means the inability of the Third
Party Administrator to successfully negotiate and establish a
community care network contract with a provider or facility.
``(4) The term `Third Party Administrator' means an entity
that manages a provider network and performs administrative
services related to such network within the Veterans Community
Care Program under section 1703 of this title.''.
(2) Conforming amendments.--Section 1703(d) of such title
is amended--
(A) in paragraph (1)(D), by striking ``designated
access standards developed by the Secretary under
section 1703B of this title'' and inserting
``eligibility access standards under section 1703B(a)
of this title''; and
(B) in paragraph (3), by striking ``designated
access standards developed by the Secretary under
section 1703B of this title'' and inserting
``eligibility access standards under section 1703B(a)
of this title''.
(b) Prevention of Suspension of Veterans Community Care Program.--
Section 1703(a) of such title is amended by adding at the end the
following new paragraph:
``(4) Nothing in this section shall be construed to authorize the
Secretary to suspend the program established under paragraph (1).''.
SEC. 102. STRATEGIC PLAN TO ENSURE CONTINUITY OF CARE IN THE CASE OF
THE REALIGNMENT OF A MEDICAL FACILITY OF THE DEPARTMENT.
(a) Sense of Congress.--It is the sense of Congress that the
Veterans Health Administration should work closely with Third Party
Administrators to ensure that veterans do not experience a lapse of
care when transitioning to receiving care or services under the
Community Care Program due to the realignment of a medical facility of
the Department of Veterans Affairs.
(b) Development of Strategic Plan.--
(1) In general.--The Secretary of Veterans Affairs, acting
through the Office of Community Care and the Office of Veterans
Access to Care of the Department, shall develop and
periodically update a strategic plan to ensure continuity of
health care under the Community Care Program for veterans
impacted by the realignment of a medical facility of the
Department.
(2) Elements.--The strategic plan required under paragraph
(1) shall include, at a minimum, the following:
(A) An assessment of the progress of the Department
in identifying impending realignments of medical
facilities of the Department and the impact of such
realignments on the network of health care providers
under the Community Care Program within the catchment
area of such facilities.
(B) An outline of collaborative actions and
processes the Office of Community Care and the Office
of Veterans Access to Care of the Department can take
to address potential gaps in health care created by the
realignment of a medical facility of the Department.
(C) A description of how the Department can
identify to Third Party Administrators changes in the
catchment areas of medical facilities to be realigned
and develop a process with Third Party Administrators
to strengthen provider coverage in advance of such
realignments.
(3) Submittal to congress.--Not later than 180 days after
the date of the enactment of this Act, the Under Secretary for
Health of the Department shall submit to the Committee on
Veterans' Affairs of the Senate and the Committee on Veterans'
Affairs of the House of Representatives the plan developed
under paragraph (1).
(c) Definitions.--In this section:
(1) Community care program.--The term ``Community Care
Program'' means the Veterans Community Care Program under
section 1703 of title 38, United States Code.
(2) Realignment.--The term ``realignment'', with respect to
a facility of the Department of Veterans Affairs, includes--
(A) any action that changes the number of
facilities or relocates services, functions, or
personnel positions; and
(B) strategic collaborations between the Department
and non-Federal Government entities, including tribal
organizations.
(3) Third party administrator.--The term ``Third Party
Administrator'' means an entity that manages a provider network
and performs administrative services related to such network
within the Veterans Community Care Program under section 1703
of title 38, United States Code.
(4) Tribal organization.--The term ``tribal organization''
has the meaning given that term in section 4 of the Indian
Self-Determination and Education Assistance Act (25 U.S.C.
5304).
Subtitle B--Community Care Self-Scheduling Pilot Program
SEC. 111. DEFINITIONS.
In this subtitle:
(1) Appropriate congressional committees.--The term
``appropriate congressional committees'' means--
(A) the Committee on Veterans' Affairs and the
Committee on Appropriations of the Senate; and
(B) the Committee on Veterans' Affairs and the
Committee on Appropriations of the House of
Representatives.
(2) Covered veteran.--The term ``covered veteran'' means a
covered veteran under section 1703(b) of title 38, United
States Code.
(3) Pilot program.--The term ``pilot program'' means the
pilot program required under section 112(a).
(4) Veterans community care program.--The term ``Veterans
Community Care Program'' means the program to furnish hospital
care, medical services, and extended care services to covered
veterans under section 1703 of title 38, United States Code.
SEC. 112. PILOT PROGRAM ESTABLISHING A COMMUNITY CARE SELF-SCHEDULING
APPOINTMENT SYSTEM.
(a) Pilot Program.--Not later than 120 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall commence
a pilot program under which covered veterans eligible for hospital
care, medical services, or extended care services under subsection
(d)(1) of section 1703 of title 38, United States Code, may use an
internet website or mobile application that has the capabilities
specified in section 113(a) to request, schedule, and confirm medical
appointments with health care providers participating in the Veterans
Community Care Program.
(b) System Expansion or Development of New System.--In carrying out
the pilot program, the Secretary may expand capabilities of an existing
self-scheduling appointment system of the Department of Veterans
Affairs or develop a new self-scheduling system mobile application or
internet website.
(c) Contract Authority for Developing a New System.--
(1) In general.--If the Secretary elects to develop a new
self-scheduling system under subsection (b), the Secretary
shall seek to enter into a contract using competitive
procedures with one or more contractors to provide the
capabilities specified in section 113(a).
(2) Notice of competition.--
(A) In general.--If the Secretary elects to develop
a new system under subsection (b), not later than 60
days after the date of the enactment of this Act, the
Secretary shall issue a request for proposals to
provide the capabilities specified in section 113(a).
(B) Open to any contractor.--A request for
proposals under subparagraph (A) shall be full and open
to any contractor that has an existing commercially
available, off-the-shelf, online patient self-
scheduling system that includes the capabilities
specified in section 113(a).
(3) Selection.--If the Secretary elects to develop a new
self-scheduling system under subsection (b), not later than 120
days after the date of the enactment of this Act, the Secretary
shall award a contract to one or more contractors pursuant to
the request for proposals under paragraph (2)(A).
(d) Selection of Locations.--The Secretary shall select not fewer
than five Veterans Integrated Services Networks of the Department in
which to carry out the pilot program.
(e) Duration of Pilot Program.--
(1) In general.--Except as provided in paragraph (2), the
Secretary shall carry out the pilot program for an 18-month
period.
(2) Extension.--The Secretary may extend the duration of
the pilot program and may expand the selection of Veterans
Integrated Services Networks under subsection (d) if the
Secretary determines that the pilot program is reducing the
wait times of veterans seeking hospital care, medical services,
or extended care services under the Veterans Community Care
Program.
(f) Outreach.--The Secretary shall ensure that veterans
participating in the Veterans Community Care Program in Veterans
Integrated Services Networks in which the pilot program is being
carried out are informed about the pilot program.
(g) Mobile Application Defined.--In this section, the term ``mobile
application'' means a software program that runs on the operating
system of a cellular telephone, tablet computer, or similar portable
computing device that transmits data over a wireless connection.
SEC. 113. CAPABILITIES OF SELF-SCHEDULING APPOINTMENT SYSTEM.
(a) Minimum Capabilities.--The Secretary of Veterans Affairs shall
ensure that the self-scheduling appointment system used in the pilot
program includes, at a minimum, the following capabilities:
(1) Capability to request, schedule, modify, and cancel
appointments for primary care, specialty care, and mental
health care under the Veterans Community Care Program with
regard to each category of eligibility under section 1703(d)(1)
of title 38, United States Code.
(2) Capability to support appointments for the provision of
health care under the Veterans Community Care Program
regardless of whether such care is provided in person or
through telehealth services.
(3) Capability to view appointment availability in real
time to the extent practicable.
(4) Capability to load relevant patient information from
the Decision Support Tool of the Department or any other
information technology system of the Department used to
determine the eligibility of veterans for health care under
section 1703(d)(1) of title 38, United States Code.
(5) Capability to search for providers and facilities
participating in the Veterans Community Care Program based on
distance from the residential address of a veteran.
(6) Capability to provide telephonic and electronic contact
information for all such providers that do not offer online
scheduling at the time.
(7) Capability to store and print authorization letters for
veterans for health care under the Veterans Community Care
Program.
(8) Capability to provide prompts or reminders to veterans
to schedule initial appointments or follow-up appointments.
(9) Capability to be used 24 hours per day, seven days per
week.
(10) Capability to integrate with the Veterans Health
Information Systems and Technology Architecture of the
Department, or any successor information technology system of
the Department.
(11) Capability to integrate with information technology
systems of Third Party Administrators.
(b) Independent Validation and Verification.--
(1) Independent entity.--
(A) In general.--The Secretary shall seek to enter
into an agreement with an appropriate nongovernmental,
not-for-profit entity with expertise in health
information technology to independently validate and
verify that the self-scheduling appointment system used
in the pilot program includes the capabilities
specified in subsection (a).
(B) Timing.--The independent validation and
verification conducted under subparagraph (A) shall be
completed before the fielding of the self-scheduling
appointment system used in the pilot program to the
first Veterans Integrated Services Network of the
Department in which the pilot program is to be carried
out.
(2) GAO evaluation.--
(A) In general.--The Comptroller General of the
United States shall evaluate the validation and
verification conducted under paragraph (1).
(B) Report.--Not later than 30 days after the date
on which the Comptroller General completes the
evaluation under paragraph (1), the Comptroller General
shall submit to the appropriate congressional
committees a report on such evaluation.
(c) Certification.--
(1) Capabilities included.--Not later than May 31, 2022,
the Secretary shall certify to the Committee on Veterans'
Affairs of the Senate and the Committee on Veterans' Affairs of
the House of Representatives that the self-scheduling
appointment system used in the pilot program and any other
patient self-scheduling appointment system developed or used by
the Department of Veterans Affairs as of the date of the
certification to schedule appointments under the Veterans
Community Care Program includes the capabilities specified in
subsection (a).
(2) New systems.--If the Secretary develops a new self-
scheduling appointment system to schedule appointments under
the Veterans Community Care Program that is not covered by a
certification made under paragraph (1), the Secretary shall
certify to the Committee on Veterans' Affairs of the Senate and
the Committee on Veterans' Affairs of the House of
Representatives that such new system includes the capabilities
specified in subsection (a) by not later than the date that is
30 days after the date on which the Secretary determines to
replace the previous self-scheduling appointment system.
(3) Replacement of systems not certified.--If the Secretary
does not make a timely certification under paragraph (1) or
paragraph (2), as the case may be, the Secretary shall replace
any self-scheduling appointment system used by the Secretary to
schedule appointments under the Veterans Community Care Program
that is in use with a commercially available, off-the-shelf,
online self-scheduling appointment system that includes the
capabilities specified in subsection (a).
(d) Third Party Administrator Defined.--In this section, the term
``Third Party Administrator'' means an entity that manages a provider
network and performs administrative services related to such network
within the Veterans Community Care Program under section 1703 of title
38, United States Code.
SEC. 114. REPORT.
Not later than 180 days after the date of the enactment of this
Act, and every 180 days thereafter, the Secretary of Veterans Affairs
shall submit to the appropriate congressional committees a report that
includes--
(1) an assessment by the Secretary of the pilot program
during the 180-day period preceding the date of the report,
including--
(A) the cost of the pilot program;
(B) the volume of usage of the self-scheduling
appointment system under the pilot program;
(C) the quality of the pilot program;
(D) patient satisfaction with the pilot program;
(E) benefits to veterans of using the pilot
program;
(F) the feasibility of allowing self-scheduling for
different specialties under the pilot program;
(G) participating in the pilot program by health
care providers under the Veterans Community Care
Program; and
(H) such other findings and conclusions with
respect to the pilot program as the Secretary considers
appropriate; and
(2) such recommendations as the Secretary considers
appropriate regarding--
(A) extension of the pilot program to other or all
Veterans Integrated Service Networks of the Department
of Veterans Affairs; and
(B) making the pilot program permanent.
Subtitle C--Non-Department of Veterans Affairs Providers
SEC. 121. CREDENTIALING VERIFICATION REQUIREMENTS FOR PROVIDERS OF NON-
DEPARTMENT OF VETERANS AFFAIRS HEALTH CARE SERVICES.
(a) Credentialing Verification Requirements.--
(1) In general.--Subchapter I of chapter 17 of title 38,
United States Code, is amended by inserting after section 1703E
the following new section:
``Sec. 1703F. Credentialing verification requirements for providers of
non-Department health care services
``(a) In General.--The Secretary shall ensure that Third Party
Administrators and credentials verification organizations comply with
the requirements specified in subsection (b) to help ensure certain
health care providers are excluded from providing non-Department health
care services.
``(b) Requirements Specified.--The Secretary shall require Third
Party Administrators and credentials verification organizations to
carry out the following:
``(1) Hold and maintain an active credential verification
accreditation from a national health care accreditation body.
``(2) Conduct initial verification of provider history and
license sanctions for all States and United States territories
for a period of time--
``(A) that includes the period before the provider
began providing non-Department health care services;
and
``(B) dating back not less than 10 years.
``(3) Not less frequently than every three years, perform
recredentialing, including verifying provider history and
license sanctions for all States and United States territories.
``(4) Implement continuous monitoring of each provider
through the National Practitioner Data Bank established
pursuant to the Health Care Quality Improvement Act of 1986 (42
U.S.C. 11101 et seq.).
``(c) Definitions.--In this section:
``(1) The term `credentials verification organization'
means an entity that manages the provider credentialing process
and performs credentialing verification for non-Department
providers that participate in the Veterans Community Care
Program under section 1703 of this title through a Veterans
Care Agreement.
``(2) The term `Third Party Administrator' means an entity
that manages a provider network and performs administrative
services related to such network within the Veterans Community
Care Program under section 1703 of this title.
``(3) The term `Veterans Care Agreement' means an agreement
for non-Department health care services entered into under
section 1703A of this title.
``(4) The term `non-Department health care services' means
services--
``(A) provided under this subchapter at non-
Department facilities (as defined in section 1701 of
this title);
``(B) provided under section 101 of the Veterans
Access, Choice, and Accountability Act of 2014 (Public
Law 113-146; 38 U.S.C. 1701 note);
``(C) purchased through the Medical Community Care
account of the Department; or
``(D) purchased with amounts deposited in the
Veterans Choice Fund under section 802 of the Veterans
Access, Choice, and Accountability Act of 2014 (Public
Law 113-146; 38 U.S.C. 1701 note).''.
(2) Clerical amendment.--The table of sections at the
beginning of such subchapter is amended by inserting after the
item relating to section 1703E the following new item:
``1703F. Credentialing verification requirements for providers of non-
Department health care services.''.
(b) Deadline for Implementation.--Not later than 180 days after the
date of the enactment of this Act, the Secretary of Veterans Affairs
shall commence the implementation of section 1703F of title 38, United
States Code, as added by subsection (a)(1).
SEC. 122. INAPPLICABILITY OF CERTAIN PROVIDERS TO PROVIDE NON-
DEPARTMENT OF VETERANS AFFAIRS CARE.
Section 108 of the VA MISSION Act of 2018 (Public Law 115-182; 38
U.S.C. 1701 note) is amended--
(1) by redesignating subsections (d) and (e) as subsections
(e) and (f), respectively; and
(2) by inserting after subsection (c) the following new
subsection (d):
``(d) Application.--The requirement to deny or revoke the
eligibility of a health care provider to provide non-Department health
care services to veterans under subsection (a) shall apply to any
removal under paragraph (1) of such subsection or violation under
paragraph (2) of such subsection that occurred on or after the date
that is five years before the date of the enactment of this Act.''.
TITLE II--IMPROVEMENT OF RURAL HEALTH AND TELEHEALTH
SEC. 201. ESTABLISHMENT OF STRATEGIC PLAN REQUIREMENT FOR OFFICE OF
CONNECTED CARE OF DEPARTMENT OF VETERANS AFFAIRS.
(a) Findings.--Congress makes the following findings:
(1) The COVID-19 pandemic caused the Department of Veterans
Affairs to exponentially increase telehealth and virtual care
modalities, including VA Video Connect, to deliver health care
services to veteran patients.
(2) Between January 2020 and January 2021, the number of
telehealth appointments offered by the Department increased by
1,831 percent.
(3) The Department maintains strategic partnerships, such
as the Digital Divide Consult, with a goal of ensuring veterans
who reside in rural, highly rural, or medically underserved
areas have access to high-quality telehealth services offered
by the Department.
(4) As of 2019, veterans who reside in rural and highly
rural areas make up approximately \1/3\ of veteran enrollees in
the patient enrollment system, and are on average, older than
their veteran peers in urban areas, experience higher degrees
of financial instability, and live with a greater number of
complex health needs and comorbidities.
(5) The Federal Communications Commission estimated in 2020
that 15 percent of veteran households do not have an internet
connection.
(6) Under the Coronavirus Aid, Relief, and Economic
Security Act (Public Law 116-136), Congress granted the
Department additional authority to enter into short-term
agreements or contracts with private sector telecommunications
companies to provide certain broadband services for the
purposes of providing expanded mental health services to
isolated veterans through telehealth or VA Video Connect during
a public health emergency.
(7) The authority described in paragraph (6) was not
utilized to the fullest extent by the Department.
(8) Though the Department has made significant progress in
expanding telehealth services offered to veterans who are
enrolled in the patient enrollment system, significant gaps
still exist to ensure all veterans receive equal and high-
quality access to virtual care.
(9) Questions regarding the efficacy of using telehealth
for certain health care services and specialities remain, and
should be further studied.
(10) The Department continues to expand telehealth and
virtual care offerings for primary care, mental health care,
specialty care, urgent care, and even remote intensive care
units.
(b) Sense of Congress.--It is the sense of Congress that the
telehealth services offered by the Department of Veterans Affairs
should be routinely measured and evaluated to ensure the telehealth
technologies and modalities delivered to veteran patients to treat a
wide variety of health conditions are as effective as in-person
treatment for primary care, mental health care, and other forms of
specialty care.
(c) Development of Strategic Plan.--
(1) In general.--Not later than one year after the date of
the enactment of this Act, the Secretary of Veterans Affairs,
acting through the Office of Connected Care of the Department
of Veterans Affairs, shall develop a strategic plan to ensure
the effectiveness of the telehealth technologies and modalities
delivered by the Department to veterans who are enrolled in the
patient enrollment system.
(2) Update.--
(A) In general.--The Secretary shall update the
strategic plan required under paragraph (1) not less
frequently than once every three years following
development of the plan.
(B) Consultation.--The Secretary shall prepare any
update required under subparagraph (A) in consultation
with the following:
(i) The Chief Officer of the Office of
Connected Care of the Department.
(ii) The Executive Director of Telehealth
Services of the Office of Connected Care.
(iii) The Executive Director of Connected
Health of the Office of Connected Care.
(iv) The Executive Director of the Office
of Rural Health of the Department.
(v) The Executive Director of Solution
Delivery, IT Operations and Services of the
Office of Information and Technology of the
Department.
(3) Elements.--The strategic plan required under paragraph
(1), and any update to that plan under paragraph (2), shall
include, at a minimum, the following:
(A) A comprehensive list of all health care
specialities the Department is currently delivering by
telehealth or virtual care.
(B) An assessment of the effectiveness and patient
outcomes for each type of health care speciality
delivered by telehealth or virtual care by the
Department.
(C) An assessment of satisfaction of veterans in
receiving care through telehealth or virtual care
disaggregated by age group and by Veterans Integrated
Service Network.
(D) An assessment of the percentage of virtual
visits delivered by the Department through each
modality including standard telephone telehealth, VA
Video Connect, and the Accessing Telehealth through
Local Area Stations program of the Department.
(E) An outline of all current partnerships
maintained by the Department to bolster telehealth or
virtual care services for veterans.
(F) An assessment of the barriers faced by the
Department in delivering telehealth or virtual care
services to veterans residing in rural and highly rural
areas, and the strategies the Department is deploying
beyond purchasing hardware for veterans who are
enrolled in the patient enrollment system.
(G) A detailed plan illustrating how the Department
is working with other Federal agencies, including the
Department of Health and Human Services, the Department
of Agriculture, the Federal Communications Commission,
and the National Telecommunications and Information
Administration, to enhance connectivity in rural,
highly rural, and medically underserved areas to better
reach all veterans.
(H) The feasibility and advisability of partnering
with Federally qualified health centers, rural health
clinics, and critical access hospitals to fill the gap
for health care services that exists for veterans who
reside in rural and highly rural areas.
(I) An evaluation of the number of veterans who are
enrolled in the patient enrollment system who have
previously received care under the Veterans Community
Care Program under section 1703 of title 38, United
States Code.
(d) Submittal to Congress.--Not later than 180 days after the
development of the strategic plan under paragraph (1) of subsection
(c), and not later than 180 days after each update under paragraph (2)
of such subsection thereafter, 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 that
includes the following:
(1) The completed strategic plan or update, as the case may
be.
(2) An identification of areas of improvement by the
Department in the delivery of telehealth and virtual care
services to veterans who are enrolled in the patient enrollment
system, with a timeline for improvements to be implemented.
(e) Definitions.--
(1) Patient enrollment system.--The term ``patient
enrollment system'' means the system of annual patient
enrollment of the Department of Veterans Affairs established
and operated under section 1705(a) of title 38, United States
Code.
(2) Rural; highly rural.--The terms ``rural'' and ``highly
rural'' have the meanings given those terms in the Rural-Urban
Commuting Areas coding system of the Department of Agriculture.
(3) VA video connect.--The term ``VA Video Connect'' means
the program of the Department of Veterans Affairs to connect
veterans with their health care team from anywhere, using
encryption to ensure a secure and private connection.
(4) Veteran.--The term ``veteran'' has the meaning given
that term in section 101(2) of title 38, United States Code.
SEC. 202. COMPTROLLER GENERAL REPORT ON TRANSPORTATION SERVICES BY
THIRD PARTIES FOR RURAL VETERANS.
(a) Report Required.--Not later than one year after the date of the
enactment of this Act, the Comptroller General of the United States
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 program established under section 111A(b) of title 38,
United States Code.
(b) Contents.--The report submitted under subsection (a) shall
include the following:
(1) A description of the program described in such
subsection, including descriptions of the following:
(A) The purpose of the program.
(B) The activities carried out under the program.
(2) An assessment of the sufficiency of the program with
respect to the purpose of the program.
(3) An assessment of the cost effectiveness of the program
in comparison to alternatives.
(4) An assessment of the health benefits for veterans who
have participated in the program.
(5) An assessment of the sufficiency of staffing of
employees of the Department of Veterans Affairs who are
responsible for facilitating the maintenance of the program.
(6) An assessment, with respect to the purpose of the
program, of the number of vehicles owned by and operating in
conjunction with the program.
(7) An assessment of the awareness and usage of the program
by veterans and their families.
(8) An assessment of other options for transportation under
the program, such as local taxi companies and ridesharing
programs such as Uber and Lyft.
SEC. 203. COMPTROLLER GENERAL REPORT ON TELEHEALTH SERVICES OF THE
DEPARTMENT OF VETERANS AFFAIRS.
(a) In General.--Not later than 18 months after the date of the
enactment of this Act, the Comptroller General of the United States
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 telehealth services provided by the Department of Veterans
Affairs.
(b) Elements.--The report required by subsection (a) shall include
an assessment of the following:
(1) The telehealth and virtual health care programs of the
Department of Veterans Affairs, including VA Video Connect.
(2) The challenges faced by the Department in delivering
telehealth and virtual health care to veterans who reside in
rural and highly rural areas due to lack of connectivity in
many rural areas.
(3) Any mitigation strategies used by the Department to
overcome connectivity barriers for veterans who reside in rural
and highly rural areas.
(4) The partnerships entered into by the Office of
Connected Care of the Department in an effort to bolster
telehealth services.
(5) The extent to which the Department has examined the
effectiveness of health care services provided to veterans
through telehealth in comparison to in-person treatment.
(6) Satisfaction of veterans with respect to the telehealth
services provided by the Department.
(7) The use by the Department of telehealth appointments in
comparison to referrals to care under the Veterans Community
Care Program under section 1703 of title 38, United States
Code.
(8) Such other areas as the Comptroller General considers
appropriate.
TITLE III--FOREIGN MEDICAL PROGRAM
SEC. 301. ANALYSIS OF FEASIBILITY AND ADVISABILITY OF EXPANDING
ASSISTANCE AND SUPPORT TO CAREGIVERS TO INCLUDE
CAREGIVERS OF VETERANS IN THE REPUBLIC OF THE
PHILIPPINES.
(a) Findings.--Congress makes the following findings:
(1) Although section 161 of the VA MISSION Act of 2018
(Public Law 115-182; 132 Stat. 1438) expanded the program of
comprehensive assistance for family caregivers of the
Department of Veterans Affairs under section 1720G(a) of title
38, United States Code, to veterans of all eras, it did not
expand the program to family caregivers for veterans overseas.
(2) Although caregivers for veterans overseas can access
online resources as part of the program of support services for
caregivers of veterans under subsection (b) section 1720G of
such title, those caregivers miss out on all of the
comprehensive services and benefits provided under subsection
(a) of such section.
(3) The Department has an outpatient clinic and a regional
benefits office in Manila, Republic of the Philippines, and the
Foreign Medical Program of the Department under section 1724 of
such title is used heavily in the Republic of the Philippines
by veterans who live in that country.
(4) Due to the presence of facilities of the Department in
the Republic of the Philippines and the number of veterans who
reside there, that country is a suitable test case to analyze
the feasibility and advisability of expanding caregiver support
to caregivers of veterans overseas.
(b) Analysis.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall complete
an analysis of the feasibility and advisability of making assistance
and support under section 1720G(a) of title 38, United States Code,
available to caregivers of veterans in the Republic of the Philippines.
(c) Report.--Not later than 180 days after the conclusion of the
analysis conducted under subsection (b), 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 that
includes the following:
(1) The results of such analysis.
(2) An assessment of the number of veterans who are
enrolled in the patient enrollment system and reside in the
Republic of the Philippines.
(3) An assessment of the number of veterans who are
enrolled in the patient enrollment system and reside in the
Republic of the Philippines that have a caregiver to provide
them personal care services described in section 1720G(a)(C) of
title 38, United States Code.
(4) An assessment of the staffing needs and associated cost
of making assistance and support to available to caregivers of
veterans in the Republic of the Philippines.
(d) Definitions.--In this section:
(1) Caregiver.--The term ``caregiver'' has the meaning
given that term in section 1720G(d) of title 38, United States
Code.
(2) Patient enrollment system.--The term ``patient
enrollment system'' means the system of annual patient
enrollment of the Department of Veterans Affairs established
and operated under section 1705(a) of such title.
(3) Veteran.--The term ``veteran'' has the meaning given
that term in section 101(2) of such title.
SEC. 302. COMPTROLLER GENERAL REPORT ON FOREIGN MEDICAL PROGRAM OF
DEPARTMENT OF VETERANS AFFAIRS.
(a) In General.--Not later than two years after the date of the
enactment of this Act, the Comptroller General of the United States
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 Foreign Medical Program.
(b) Elements.--The report required by subsection (a) shall include,
for the most recent five fiscal years for which data are available, an
assessment of the following:
(1) The number of veterans who live overseas and are
eligible for the Foreign Medical Program.
(2) The number of veterans who live overseas, are
registered for the Foreign Medical Program, and use such
program.
(3) The number of veterans who live overseas, are
registered for the Foreign Medical Program, and do not use such
program.
(4) The number of veterans who are eligible for care
furnished by the Department of Veterans Affairs, live in the
United States, including territories of the United States, and
make use of such care, including through the Veterans Community
Care Program under section 1703 of title 38, United States
Code.
(5) Any challenges faced by the Department in administering
the Foreign Medical Program, including--
(A) outreach to veterans on eligibility for such
program and ensuring veterans who live overseas are
aware of such program;
(B) executing timely reimbursements of claims by
veterans under such program; and
(C) need for and use of translation services.
(6) Any trends relating to--
(A) the timeliness of processing by the Department
of claims under the Foreign Medical Program and
reimbursement of veterans under such program;
(B) types of care or treatment sought by veterans
who live overseas that is reimbursed under such
program; and
(C) types of care or treatment eligible for
reimbursement under such program that veterans have
difficulty accessing overseas.
(7) Any barriers or obstacles cited by veterans who live
overseas who are registered for the Foreign Medical Program,
including any differences between veterans who use the program
and veterans who do not.
(8) Satisfaction of veterans who live overseas with the
Foreign Medical Program.
(9) Such other areas as the Comptroller General considers
appropriate.
(c) Foreign Medical Program Defined.--In this section, the term
``Foreign Medical Program'' means the program under with the Secretary
of Veterans Affairs provides hospital care and medical services under
section 1724 of title 38, United States Code.
TITLE IV--MENTAL HEALTH CARE
SEC. 401. ANALYSIS OF FEASIBILITY AND ADVISABILITY OF DEPARTMENT OF
VETERANS AFFAIRS PROVIDING EVIDENCE-BASED TREATMENTS FOR
THE DIAGNOSIS OF TREATMENT-RESISTANT DEPRESSION.
(a) Findings.--Congress makes the following findings:
(1) A systematic review in 2019 of the economics and
quality of life relating to treatment-resistant depression
summarized that major depressive disorder (in this subsection
referred to as ``MDD'') is a global public health concern and
that treatment-resistant depression in particular represents a
key unmet need. The findings of that review highlighted the
need for improved therapies for treatment-resistant depression
to reduce disease burden, lower medical costs, and improve the
quality of life of patients.
(2) The Clinical Practice Guideline for the Management of
MDD (in this subsection referred to as the ``CPG'') developed
jointly by the Department of Veterans Affairs and the
Department of Defense defines treatment-resistant depression as
at least two adequate treatment trials and lack of full
response to each.
(3) The CPG recommends electro-convulsive therapy (in this
subsection referred to as ``ECT'') as a treatment strategy for
patients who have failed multiple other treatment strategies.
(4) The CPG recommends offering repetitive transcranial
magnetic stimulation (in this subsection referred to as
``rTMS''), an intervention that is indicated by the Food and
Drug Administration, for treatment during a major depressive
episode in patients with treatment-resistant MDD.
(5) The final report of the Creating Options for Veterans'
Expedited Recovery Commission (commonly referred to as the
``COVER Commission'') established under section 931 of the
Jason Simcakoski Memorial and Promise Act (title IX of Public
Law 114-198; 38 U.S.C. 1701 note) found that treatment-
resistant depression is a major issue throughout the mental
health treatment system, and that an estimated 50 percent of
depressed patients are inadequately treated by available
interventions.
(6) The COVER Commission also reported data collected from
the Department of Veterans Affairs that found that only
approximately 1,166 patients throughout the Department were
referred for ECT in 2018 and only approximately 772 patients
were referred for rTMS during that year.
(b) Analysis.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall complete
an analysis of the feasibility and advisability of making repetitive
transcranial magnetic stimulation available at all medical facilities
of the Department of Veterans Affairs and electro-convulsive therapy
available at one medical center located within each Veterans Integrated
Service Network for the treatment of veterans who are enrolled in the
patient enrollment system and have a diagnosis of treatment-resistant
depression.
(c) Inclusion of Assessment of Report.--The analysis conducted
under subsection (b) shall include an assessment of the final report of
the COVER Commission submitted under section 931(e)(2) of the Jason
Simcakoski Memorial and Promise Act (title IX of Public Law 114-198; 38
U.S.C. 1701 note).
(d) Report.--Not later than 180 days after the conclusion of the
analysis conducted under subsection (b), 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 that
includes the following:
(1) The results of such analysis.
(2) An assessment of the number of veterans who are
enrolled in the patient enrollment system and who have a
diagnosis of treatment-resistant depression per Veterans
Integrated Service Network during the two-year period preceding
the date of the report.
(3) An assessment of the number of the veterans who are
enrolled in the patient enrollment system who have a diagnosis
of treatment-resistant depression and who have received or are
currently receiving repetitive transcranial magnetic
stimulation or electro-convulsive therapy as a treatment
modality during the two-year period preceding the date of the
report.
(4) An assessment of the number and locations of medical
centers of the Department that currently provide repetitive
transcranial magnetic stimulation to veterans who are enrolled
in the patient enrollment system and who have a diagnosis of
treatment-resistant depression.
(5) An assessment of the number and locations of medical
centers of the Department that currently provide electro-
convulsive therapy to veterans who are enrolled in the patient
enrollment system and who have a diagnosis of treatment-
resistant depression.
(e) Definitions.--In this section:
(1) Patient enrollment system.--The term ``patient
enrollment system'' means the system of annual patient
enrollment of the Department of Veterans Affairs established
and operated under section 1705(a) of title 38, United States
Code.
(2) Veteran.--The term ``veteran'' has the meaning given
that term in section 101(2) of title 38, United States Code.
SEC. 402. MODIFICATION OF RESOURCE ALLOCATION SYSTEM TO INCLUDE PEER
SPECIALISTS.
(a) In General.--Not later than one year after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall modify
the Veterans Equitable Resource Allocation system, or successor system,
to ensure that resource allocations under such system, or successor
system, include peer specialists appointed under section 7402(b)(13) of
title 38, United States Code.
(b) Veterans Equitable Resource Allocation System Defined.--In this
section, the term ``Veterans Equitable Resource Allocation system''
means the resource allocation system established pursuant to section
429 of the Departments of Veterans Affairs and House and Urban
Development, and Independent Agencies Appropriations Act, 1997 (Public
Law 104-204; 110 Stat. 2929).
SEC. 403. GAP ANALYSIS OF PSYCHOTHERAPEUTIC INTERVENTIONS OF THE
DEPARTMENT OF VETERANS AFFAIRS.
(a) In General.--Not later than 270 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall complete
a gap analysis throughout the entire health care system of the Veterans
Health Administration on the use and availability of psychotherapeutic
interventions recommended in widely used clinical practice guidelines
as recommended in the final report of the COVER Commission submitted
under section 931(e)(2) of the Jason Simcakoski Memorial and Promise
Act (title IX of Public Law 114-198; 38 U.S.C. 1701 note).
(b) Elements.--The gap analysis required under subsection (a) shall
include the following:
(1) An assessment of the psychotherapeutic interventions
available and routinely delivered to veterans at medical
centers of the Department of Veterans Affairs within each
Veterans Integrated Service Network of the Department.
(2) An assessment of the barriers faced by medical centers
of the Department in offering certain psychotherapeutic
interventions and why those interventions are not widely
implemented or are excluded from implementation throughout the
entire health care system of the Veterans Health
Administration.
(c) Report and Plan.--Not later than 180 days after completing the
gap analysis under subsection (a), the Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and the Committee on
Veterans' Affairs of the House of Representatives--
(1) a report on the results of the analysis; and
(2) a plan with measurable, time-limited steps for the
Department to implement--
(A) to address the gaps that limit access of
veterans to care; and
(B) to treat various mental health conditions
across the entire health care system of the Veterans
Health Administration.
TITLE V--OTHER MATTERS
SEC. 501. ONLINE HEALTH CARE EDUCATION PORTAL.
(a) In General.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall
establish an online health care education portal to ensure veterans
enrolled in the patient enrollment system of the Department of Veterans
Affairs under section 1705(a) of title 38, United States Code, are
aware of the health care services provided by the Department and
understand their basic health care entitlements under the laws
administered by the Secretary.
(b) Interactive Modules.--
(1) In general.--The health care education portal
established under subsection (a) shall include, at a minimum,
interactive online educational modules on the following:
(A) Health care from the Veterans Health
Administration in the community, including under the
Veterans Community Care Program under section 1703 of
title 38, United States Code.
(B) Telehealth services.
(C) The appeals process for the Veterans Health
Administration.
(D) Patient aligned care teams.
(E) Mental health care services.
(F) Suicide prevention services.
(G) Specialty care services.
(H) Dental health services.
(I) Women's health services.
(J) Navigating the publicly accessible internet
websites and mobile applications of the Veterans Health
Administration.
(K) Vaccinations offered through the Veterans
Health Administration.
(L) Toxic exposure.
(M) Military sexual trauma.
(N) Topics set forth under section 121(b) of the VA
MISSION Act of 2018 (Public Law 115-182; 38 U.S.C. 1701
note).
(2) Module updates.--The Secretary shall update the
curriculum content of the modules described in paragraph (1)
not less frequently than annually to ensure such modules
contain the most current information on the module topic.
(c) Health Care Education Portal Requirements.--The Secretary shall
ensure that the health care education portal established under
subsection (a) meets the following requirements:
(1) The portal is directly accessible from--
(A) the main home page of the publicly accessible
internet website of the Department; and
(B) the main home page of the publicly accessible
internet website of each medical center of the
Department.
(2) The portal is easily understandable and usable by the
general public.
(d) Print Material.--In developing the health care education portal
established under subsection (a), the Secretary shall ensure that
materials included in such portal are accessible in print format at
each medical center of the Department to veterans who may not have
access to the internet.
(e) Consultation and Contract Authority.--In carrying out the
health care education portal established under subsection (a), the
Secretary--
(1) shall consult with organizations recognized by the
Secretary for the representation of veterans under section 5902
of title 38, United States Code; and
(2) may enter into a contract with a company, non-profit
entity, or other entity specializing in development of
educational programs to design the portal and the curriculum
for modules under subsection (b).
(f) Report.--Not later than one year after the establishment of the
health care education portal under subsection (a), and annually
thereafter, 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--
(1) assessing the use by veterans of the portal,
including--
(A) overall usage of the portal; and
(B) use of each module under subsection (b);
(2) assessing the effectiveness of the education program
contained in such portal;
(3) evaluating the curriculum contained in such portal;
(4) providing such recommendations on modifications to the
curriculum contained in such portal as the Secretary considers
appropriate; and
(5) including such other elements the Secretary considers
appropriate.
SEC. 502. EXCLUSION OF APPLICATION OF PAPERWORK REDUCTION ACT TO
RESEARCH ACTIVITIES OF THE VETERANS HEALTH
ADMINISTRATION.
(a) In General.--Subchapter II of chapter 73 of title 38, United
States Code, is amended by adding at the end the following new section:
``SEC. 7330D. INAPPLICABILITY OF PAPERWORK REDUCTION ACT TO RESEARCH
ACTIVITIES.
``Subchapter I of chapter 35 of title 44 (commonly referred to as
the `Paperwork Reduction Act') shall not apply to the voluntary
collection of information during the conduct of research by the
Veterans Health Administration, including the Office of Research and
Development, or individuals or entities affiliated with the Veterans
Health Administration.''.
(b) Clerical Amendment.--The table of sections at the beginning of
such subchapter is amended by inserting after the item relating to
section 7330C the following new item:
``7330D. Inapplicability of Paperwork Reduction Act to research
activities.''.
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