[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 3163 Introduced in Senate (IS)]
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117th CONGRESS
1st Session
S. 3163
To improve access to medical examinations required by veterans to
obtain disability compensation or pension under laws administered by
the Secretary of Veterans Affairs, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
November 4, 2021
Mr. Tester (for himself and Mr. Moran) introduced the following bill;
which was read twice and referred to the Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To improve access to medical examinations required by veterans to
obtain disability compensation or pension under laws administered by
the Secretary of Veterans Affairs, 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.
This Act may be cited as the ``Reform and Update Rural Access to
Local Exams Act of 2021'' or the ``RURAL Exams Act of 2021''.
SEC. 2. DEFINITIONS.
In this Act:
(1) Covered medical disability examination.--The term
``covered medical disability examination'' means a medical
examination that the Secretary of Veterans Affairs determines
necessary for the purposes of adjudicating a benefit under
chapter 11 or 15 of title 38, United States Code, regardless of
whether conducted by an employee or a contractor of the
Department of Veterans Affairs.
(2) Housebound.--The term ``housebound'', with respect to a
veteran, means--
(A) the veteran meets the requirement of
``permanently housebound'' as described in section
1114(s) of title 38, United States Code;
(B) the veteran meets the requirement of
``permanently housebound'' as described in section
1502(c) of such title; or
(C) the Secretary has determined that the veteran
faces significant difficulty in traveling to obtain a
covered medical disability examination.
(3) Rural area.--The term ``rural area'' means any non-
urban area, within the meaning of the Rural-Urban Commuting
Area Codes system of the Department of Agriculture and the
Department of Health and Human Services, or successor system.
(4) Rural veteran.--The term ``rural veteran'' means a
veteran who resides in a rural area.
SEC. 3. IMPROVING DATA COLLECTION BY DEPARTMENT OF VETERANS AFFAIRS ON
COVERED MEDICAL DISABILITY EXAMINATIONS.
(a) Data Collection Required.--Not later than 180 days after the
date of the enactment of this Act, the Secretary of Veterans Affairs
shall begin collecting data to improve access of veterans to covered
medical disability examinations.
(b) Elements.--Data collected under subsection (a) shall include
data regarding the following:
(1) Timeliness, quality, and veteran satisfaction
measurements of covered medical disability examinations.
(2) Proportion of completed covered medical disability
examinations determined to be inadequate for the adjudication
of a claim for compensation or pension under chapter 11 or 15
of title 38, United States Code.
(3) Every performance standard required for eligibility for
financial incentives or disincentives in a contract between the
Department of Veterans Affairs and any contractor for the
provision of a covered medical disability examination.
(c) Disaggregation of Data.--The Secretary shall disaggregate data
collected under subsection (a) by--
(1) State;
(2) county; and
(3) as the case may be--
(A) individual contractor with a Department of
Veterans Affairs contract for the provision of a
covered medical disability examination; or
(B) individual Veterans Health Administration
facility conducting a covered medical disability
examination.
(d) Publication.--Not later than one year after the date of the
enactment of this Act, the Secretary shall make publicly available on
an internet website, and updated not less frequently than quarterly,
all data collected under subsection (a).
SEC. 4. STUDY ON IMPROVEMENTS TO DEPARTMENT OF VETERANS AFFAIRS COVERED
MEDICAL DISABILITY EXAMINATIONS IN RURAL AREAS.
(a) Study Required.--Not later than one year after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall complete
a study on access by rural veterans to covered medical disability
examinations.
(b) Elements.--
(1) In general.--The study conducted under subsection (a)
shall include the following:
(A) A comparison of the average number of days to
complete covered medical disability examinations for
rural veterans compared to the national non-rural
average time to complete covered medical disability
examinations, by either contractors or employees of the
Department.
(B) A root cause analysis of differences identified
pursuant to subparagraph (A).
(C) The plan of the Secretary for the following
year to improve access described in subsection (a),
which shall include a plan for the pursuit of a
commercial or industry-standard solution or technology
that could enable rural or housebound veterans to
receive examinations without traveling long distances.
(2) National non-rural average defined.--For purposes of
paragraph (1)(A), the term ``national non-rural average'' means
the national average of all periods in the previous calendar
year--
(A) beginning on the date on which a contractor
received a request from the Secretary to conduct a
covered medical disability examination for a veteran
who is not a rural veteran; and
(B) ending on the date on which the examination was
completed.
(c) Report on Study.--Not later than one year after the date of the
enactment of this Act, 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 on the findings of the
Secretary with respect to the study completed under subsection (a).
(d) Annual Report on Plans.--Not later than two years after the
date of the enactment of this Act and not less frequently than once
each year 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 evaluating the conduct of the
plans of the Secretary to improve access described in subsection (a)
and a new or revised plan for such improvement in the following year.
SEC. 5. DEPARTMENT OF VETERANS AFFAIRS TIMELINESS REQUIREMENTS FOR
PROVISION OF COVERED MEDICAL DISABILITY EXAMINATIONS BY
CONTRACTORS TO RURAL AND HOUSEBOUND VETERANS.
In each contract entered into by the Secretary of Veterans Affairs
after the date of the enactment of this Act for the provision by a
contractor of a covered medical disability examination, the Secretary
shall include the following:
(1) Such financial incentives as the Secretary considers
appropriate to encourage a contractor to provide a covered
medical disability examination to a rural veteran or a
housebound veteran in a timely manner.
(2) Such financial disincentives as the Secretary considers
appropriate to discourage a contractor from failing to provide
a covered medical disability examination to a rural veteran or
a housebound veteran in a timely manner.
(3) A requirement that the contractor cooperate with
inspections conducted under the program required by section
6(a).
SEC. 6. ANNUAL INSPECTIONS BY DEPARTMENT OF VETERANS AFFAIRS OF
FACILITIES USED BY CONTRACTORS FOR PROVISION OF COVERED
MEDICAL DISABILITY EXAMINATIONS.
(a) Program Required.--Not later than one year after the date of
the enactment of this Act, the Secretary of Veterans Affairs shall
establish a program of periodic inspections of sites, locations, and
facilities where covered medical disability examinations are provided
by contractors of the Department of Veterans Affairs.
(b) Number and Periodicity.--
(1) In general.--Under the program required by subsection
(a), the Secretary shall, each year, inspect not fewer than
three percent of all sites, locations, and facilities used by a
contractor of the Department to provide a covered medical
disability examination during the previous one-year period.
(2) Initial inspections.--Paragraph (1) shall apply with
respect to the first one-year period beginning after the date
of the establishment of the program pursuant to subsection (a)
and each year thereafter.
(c) Selection of Sites, Locations, and Facilities for Inspection.--
Under the program required by subsection (a), the Secretary shall--
(1) use both random and targeted methods of selecting
sites, locations, and facilities for inspection; and
(2) ensure that the number of inspections of sites,
locations, and facilities in rural areas bears the same ratio
to the total number of inspections as the number of covered
medical disability examinations provided by contractors of the
Department to rural veterans bears to the total number of
covered medical disability examinations provided by contractors
of the Department to all veterans.
(d) Notice and Timing.--Each inspection under the program required
by subsection (a) shall be conducted during such business hours as the
Secretary considers reasonable and the Secretary shall provide no more
notice than the Secretary considers necessary to ensure the inspected
facility is available for such inspection.
(e) Elements.--Each inspection conducted under the program required
by subsection (a) shall include inspection of a site, location, or
facility for the following:
(1) Compliance with the terms of any applicable contract.
(2) Compliance with the Americans with Disabilities Act of
1990 (42 U.S.C. 12101 et seq.).
(3) Cleanliness.
(4) General fitness for a covered medical disability
examination.
(5) Such other elements as the Secretary considers
necessary to ensure that covered medical disability
examinations provided on behalf of the Department are safe,
clean, accessible, and dignified.
(f) Annual Reports.--Not later than one year after the date of the
establishment of the program required by 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 a
report on the findings of the Secretary with respect to the inspections
conducted under the program during the one-year period ending on the
date of the submittal of the report.
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