[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3643 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 3643
To amend title 38, United States Code, to improve the annual reports
submitted to Congress with respect to the Veterans Benefits
Administration and the Veterans Health Administration, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 29, 2025
Mr. McGuire (for himself and Mr. Bost) introduced the following bill;
which was referred to the Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to improve the annual reports
submitted to Congress with respect to the Veterans Benefits
Administration and the Veterans Health Administration, 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 ``VA Data Transparency and Trust
Act''.
SEC. 2. IMPROVEMENTS TO ANNUAL REPORTS ON THE VETERANS BENEFITS
ADMINISTRATION AND THE VETERANS HEALTH ADMINISTRATION.
(a) VHA Report.--Section 7330B of title 38, United States Code, is
amended to read as follows:
``Sec. 7330B. Annual report on Veterans Health Administration and
furnishing of hospital care, medical services, and
nursing home care
``(a) Report Required.--During the period beginning on the date of
the enactment of the VA Data Transparency and Trust Act and ending on
the date that is five years after such date, the Secretary shall submit
to the Committees on Veterans' Affairs of the House of Representatives
and the Senate a report on, for the calendar year preceding the
calendar year during which the report is submitted--
``(1) the furnishing of hospital care, medical services,
and nursing home care under the laws administered by the
Secretary; and
``(2) the administration of the furnishing of such care and
services by the Veterans Health Administration.
``(b) Elements.--Each report required by subsection (a) shall
include each of the following for the year covered by the report:
``(1) The total number of veterans who received hospital
care, medical services, and nursing home care under the laws
administered by the Secretary furnished by the Veterans Health
Administration.
``(2) Information with respect to the health status of
veterans described in paragraph (1), that includes the rate of
incidence among such veterans of major chronic conditions,
disaggregated by condition, including--
``(A) traumatic brain injury;
``(B) diabetes;
``(C) cardiovascular disease; and
``(D) cancer.
``(3) Demographic information with respect to such
veterans, disaggregated by--
``(A) age;
``(B) period of--
``(i) active military, naval, air, or space
service; or
``(ii) service in a Reserve component; and
``(C) sex.
``(4) Information with respect to furnishing of health care
during the period covered by the report to--
``(A) veterans who served on active duty during the
Post-9/11 Global Operations period (as defined in
section 3105 of this title), including--
``(i) a summary of conditions the Secretary
determines are commonly present in such
veterans;
``(ii) a summary of common conditions in
such veterans that the Secretary determines
have arisen since the date of the submission of
the preceding report;
``(iii) an estimate of the number of such
veterans that belong to a different priority
group specified in subsection (a) of section
1705 of this title than on the date of the
submission of the preceding report; and
``(iv) an estimate of the number of such
veterans who are enrolled in a health insurance
plan that is not a health insurance plan under
the laws administered by the Secretary;
``(B) veterans with mental health conditions
(including traumatic brain injury and suicidal
ideation);
``(C) veterans with polytrauma;
``(D) veterans with spinal cord injury or
dysfunction;
``(E) veterans with service-connected disabilities,
including the average cost to the Department of
furnishing such care to such veterans; and
``(F) homeless veterans, including--
``(i) the average age of such veterans;
``(ii) estimates of the geographic
locations of such veterans;
``(iii) estimates of the average duration
of homelessness for such veterans; and
``(iv) the periods during which such
veterans performed active military, naval, air,
or space service.
``(5) Information with respect to veterans who received
long term care under the laws administered by the Secretary
during the period covered by the report, including--
``(A) the demographic information of such veterans,
including common chronic illnesses present in such
veterans;
``(B) the average amount of copayments for such
long term care made by such veterans;
``(C) a description of the types of such long term
care; and
``(D) funding levels for State homes as of the date
of the submission of the report.
``(6) The number of veterans who enrolled in the annual
system for patient enrollment under section 1705 of this title
during the period covered by the report, disaggregated by--
``(A) priority group specified in subsection (a) of
such section;
``(B) age;
``(C) sex;
``(D) annual income; and
``(E) enrollment in a health insurance plan that is
not a health insurance plan under the laws administered
by the Secretary.
``(7) With respect to veterans described in paragraph (6),
the average period of time between the date on which such a
veteran was separated from active military, naval, air, or
space service and the earlier of--
``(A) the date on which the veteran enrolled in
such annual system for patient enrollment; and
``(B) the date on which the veteran first received
hospital care, medical services, or nursing home care
under the laws administered by the Secretary furnished
by the Veterans Health Administration.
``(8) The total number of visits to facilities of the
Department for hospital care, medical services, and nursing
home care under laws administered by the Secretary.
``(9) A summary of each type of hospital care, medical
service, or nursing home care under laws administered by the
Secretary furnished by the Veterans Health Administration to
veterans, including--
``(A) inpatient care;
``(B) outpatient care;
``(C) prescription drugs;
``(D) mental health care; and
``(E) primary care.
``(10) A statement of the percentage of hospital care,
medical service, or nursing home care under laws administered
by the Secretary furnished by the Veterans Health
Administration to veterans during the period covered by the
report intended to treat--
``(A) service-connected disabilities; and
``(B) non-service-connected disabilities.
``(11) With respect to prescription drugs and medicines
furnished to veterans by the Veterans Health Administration
during the period covered by the report, a statement of--
``(A) the total number of such prescriptions for
such drugs and medicine dispensed to veterans--
``(i) during the course of inpatient care
at a facility of the Department;
``(ii) at a community-based outpatient
clinic of the Department;
``(iii) at a non-Department facility; and
``(iv) through a mail-order prescription;
and
``(B) the average term of a prescription for each
drug or medicine furnished to a veteran by the Veterans
Health Administration during such period.
``(12) With respect to inpatient care provided to veterans
at facilities of the Department--
``(A) the average length of stay at such a facility
for a veteran in receipt of such inpatient care; and
``(B) the average cost to a veteran of such
inpatient care.
``(13) A summary of diagnostic services provided to
veterans during by the report that includes--
``(A) a statement of the percentage of such
diagnostic services provided for--
``(i) a service-connected disability; and
``(ii) a non-service connected disability;
and
``(B) a description of conditions diagnosed
pursuant to such diagnostic services, disaggregated by
body system associated with such condition.
``(14) An assessment of the extent to which veterans who
received hospital care, medical services, and nursing home care
furnished by the Veterans Health Administration during the
period covered by the report rely on the Veterans Health
Administration for health care, disaggregated by veterans--
``(A) who are--
``(i) younger than 65 years of age;
``(ii) 65 years of age or older;
``(iii) fully reliant on the Veterans
Health Administration;
``(iv) partially reliant on the Veterans
Health Administration; and
``(v) not reliant on the Veterans Health
Administration;
``(B) who received--
``(i) inpatient care; and
``(ii) outpatient care.
``(15) An assessment of the quality of health care
furnished to veterans by the Veterans Health Administration
that includes a measurement of--
``(A) the incidence of hospital acquired infections
among veterans;
``(B) the extent to which veterans are satisfied
with such health care, disaggregated by such health
care provided at--
``(i) a facility of the Department; and
``(ii) a non-Department facility.
``(16) A summary of the hospital care, medical services,
and nursing home care furnished by the Veterans Health
Administration--
``(A) required under VA MISSION Act of 2018 (Public
Law 115-182; 38 U.S.C. 301 note);
``(B) required under the Honoring our PACT Act of
2022 (Public Law 117-168);
``(C) under section 1781 of this title, that
includes an estimate of the average cost to the
Department of furnishing such care, disaggregated by
the age of the individual to which such care was
furnished; and
``(D) under section 1703 of this title.
``(17) A summary of collections of copayments for health
care under the laws administered by the Secretary that
includes--
``(A) a statement of the percentage of such
copayments made by--
``(i) veterans; and
``(ii) third parties; and
``(B) a comparison of such collections to health
care billings owed to the Department.
``(18) Data with respect to the Medical Care Collections
Fund established under section 1729A of this title that
includes, with respect to the period covered by the report--
``(A) an identification of the total number of
veterans from whom amounts were collected;
``(B) the average amount so collected--
``(i) per veteran; and
``(ii) per priority group specified in
subsection (a) of section 1705 of this title;
and
``(C) the total amount so collected.
``(19) Information with respect to physicians employed by
the Veterans Health Administration, that includes--
``(A) the number of such physicians who are full-
time employees, disaggregated by--
``(i) specialty; and
``(ii) the type of medical facility where
the physician is employed;
``(B) the average annual salary for such
physicians, including bonuses and other pay awards; and
``(C) for such physicians who are primary care
physicians--
``(i) the average number of patients,
adjusted for patient health status, treated
per--
``(I) week; and
``(II) calendar year; and
``(ii) the average amount of time such
physicians spend with patients during
appointments for primary care.
``(20) Information with respect to medical professionals
employed by the Veterans Health Administration that includes a
statement of--
``(A) the average number of patients such a medical
professional treats each week; and
``(B) the average amount of time such physicians
spend with patients during appointments for primary
care.
``(21) An assessment of the management of facilities of
Veterans Health Administration that includes--
``(A) for each medical facility under the
jurisdiction of the Veterans Health Administration a
statement of--
``(i) the date of--
``(I) the original construction;
and
``(II) the most recent renovation
project carried out, if applicable;
``(ii) the total square feet;
``(iii) the cost to the Department of
regular maintenance and repairs;
``(B) for each such medical facility that provides
inpatient care, the rate of occupancy; and
``(C) for each such medical facility that provides
outpatient care, the number of patient visits,
disaggregated by type of health care provided at the
visit.
``(22) A summary of major capital spending pursuant to the
administration by the Veterans Health Administration of
furnishing medical care and services under the laws
administered by the Secretary that includes a description of--
``(A) planned construction of new facilities;
``(B) planned renovation of facilities; and
``(C) any purchase of medical equipment that totals
more than $20,000.
``(23) For each priority group specified in subsection (a)
of section 1705 of this title--
``(A) demographic information of veterans that
comprise each such priority group;
``(B) an assessment of the extent to which veterans
that comprise each such priority group use the benefits
under the laws administered by the Secretary for which
such veterans are eligible; and
``(C) an estimate of the average cost to the
Department of furnishing health care under the laws
administered by the Secretary to veterans that comprise
each such priority group.
``(24) The percentage of hospital care, medical services,
and nursing home care provided to veterans in facilities of the
Department and in non-Department facilities and any changes in
such percentages compared to the year preceding the year
covered by the report.
``(c) Data Sharing System.--(1) The Secretary shall develop and
carry out a data sharing system to grant individuals described in
paragraph (2) access to aggregated, anonymized data with respect to
veterans and individuals receiving health care furnished under laws
administered by the Secretary.
``(2) An eligible individual described in this paragraph is a
researcher who meets the criteria for data security and data protection
established by the Secretary in regulations for the purposes of
administering the data sharing system under paragraph (1).
``(3) In developing the data sharing system under paragraph (1),
the Secretary shall consider the Centers for Medicare & Medicaid
Services Qualified Entity Program (commonly referred to as the
`Medicare Data Sharing for Performance Measurement Program')
established pursuant to section 1874(e) of the Social Security Act (42
U.S.C. 1395kk(e), 1395kk-2).
``(4) The Secretary shall ensure that data available through such
data sharing system includes--
``(A) each type data available under the Medicare Data
Sharing for Performance Measurement Program, where applicable;
``(B) data on veterans enrolled in the annual system for
patient enrollment established under section 1705 of this
title, including--
``(i) demographic data;
``(ii) the number of veterans that comprise each
priority group specified in subsection (a) of such
section; and
``(iii) the number of veterans with service-
connected disabilities, disaggregated by level of
disability rating determined by the Secretary;
``(C) data on visits for health care under laws
administered by the Secretary furnished at facilities of the
Department, including--
``(i) types of health care providers furnishing
such health care during such visits;
``(ii) diagnostic codes associated with illnesses
in veterans diagnosed during the course of such visits;
``(iii) with respect to such visits for outpatient
care, an identification of the date of such visit; and
``(iv) with respect to such visits for inpatient
care, an identification of the applicable admission
date and discharge date; and
``(D) data on insurance claims submitted to the Secretary
for health care furnished at non-Department facilities,
including--
``(i) provider numbers of applicable insurance
companies;
``(ii) payments made by the Secretary to veterans
pursuant to such claims; and
``(iii) payments made by veterans with respect to
such insurance claims.
``(d) Definitions.--In this section, the terms `hospital care',
`medical services', `nursing home care', `facilities of the
Department', and `non-Department facilities' have the meanings given
those terms in section 1701 of this title.''.
(b) Additional Data for Inclusion in Annual VBA Report.--Subchapter
II of chapter 77 of title 38, United States Code, is amended by adding
at the end the following new section (and conforming the table of
sections at the beginning of such chapter accordingly):
``Sec. 7735. Additional data for inclusion in annual report to
Congress; data sharing system
``(a) In General.--(1) During the period beginning on the date of
the enactment of the VA Data Transparency and Trust Act and ending on
the date that is five years after such date, the Secretary shall
include in the Annual Benefits Report of the Veterans Benefits
Administration the following:
``(A) The number of veterans in receipt of benefits under
the laws administered by the Secretary, disaggregated by--
``(i) age;
``(ii) income level;
``(iii) period and length of--
``(I) active military, naval, air, or space
service; or
``(II) service in a Reserve component.
``(B) A summary of the types of benefits under the laws
administered by the Secretary furnished to veterans.
``(C) Demographic data with respect to veterans with
service-connected disabilities, disaggregated by each schedule
of disability rating specified in section 1155 of this title,
including--
``(i) age;
``(ii) sex;
``(iii) race;
``(iv) highest level of educational attainment;
``(v) period and length of--
``(I) active military, naval, air, or space
service; or
``(II) service in a Reserve component.
``(D) A statement of the number of veterans with service-
connected disabilities to whom the Secretary assigned a
disability rating different from the disability rating
initially assigned to the veteran.
``(E) The average amount of compensation under chapter 11
of this title paid to veterans--
``(i) with dependents;
``(ii) in receipt of special monthly compensation
under subsection (r) of section 1114 of this title; and
``(iii) with a disability rated as total by reason
of unemployability under section 1164 of this title.
``(F) Data with respect to veterans with disability ratings
reevaluated by the Secretary, including--
``(i) the number of such veterans;
``(ii) the conditions associated with such
disability ratings;
``(iii) the number of such veterans assigned,
pursuant to such reevaluation--
``(I) an increased disability rating; or
``(II) a decreased disability rating.
``(G) For each of fiscal years 1997 through 2024, a
statement of the number of reevaluations of disability ratings
initiated by the Secretary.
``(H) For each condition for which a presumption of
service-connection is established under chapter 11 of this
title--
``(i) the number of veterans with such condition in
receipt of compensation under such chapter,
disaggregated by each schedule of disability rating
specified in section 1155; and
``(ii) the average amount of such compensation paid
to such veterans.
``(I) For each non-service-connected disability that is
compensable under the laws administered by the Secretary, a
statement of the average amount of compensation under chapater
11 of this title paid to veterans with each such non-service-
connected disability.
``(J) Data with respect to veterans in receipt of a pension
under chapter 15 of this title, including--
``(i) the number of such veterans, disaggregated
by--
``(I) age;
``(II) sex;
``(III) income level;
``(IV) period and length of--
``(aa) active military, naval, air,
or space service; or
``(bb) service in a Reserve
component;
``(ii) the average period of time between the date
on which such a veteran was separated from active
military, naval, air, or space service and the date on
which the veteran received the first payment of pension
under such chapter; and
``(iii) for each of fiscal years 2000 through 2024,
the average amount of pension paid to such veterans.
``(K) Data with respect to individuals in receipt of
dependency and indemnity compensation under chapter 13 of this
title, including--
``(i) demographic data; and
``(ii) a summary of the reasons such individuals
are eligible for such dependency and indemnity
compensation.
``(L) The number of new claims for disability compensation
under the laws administered by the Secretary, and the average
period of time between the date on which such claim was
submitted and the date on which the Secretary issued a decision
with respect to such claim.
``(M) The number of supplemental claims for disability
compensation under such laws, and the average period of time
between the date on which such claim was submitted and the date
on which the Secretary issued a decision with respect to such
claim.
``(N) Data on the staffing levels of the Veterans Benefits
Administration, including the number of full-time employees of
the Veterans Benefits Administration responsible for processing
such claims for disability compensation.
``(O) A statement, for each of fiscal years 2000 through
2024, of the average amount of disability compensation under
chapter 11 of this title paid to veterans with service-
connected disabilities, disaggreated by each schedule of rating
specified in section 1155 of this title.
``(2)(A) The first report submitted pursuant to subsection (a)
shall include each element specified in paragraphs (1) through (15) of
such subsection for--
``(i) the calendar year during which the first report is
submitted; and
``(ii) each calendar year during the five-year period that
precedes the date of the submission of the first report.
``(B) Each report submitted after the date on which the first
report is submitted shall include each such element for the calendar
year during which the report is submitted.
``(b) Data Sharing System.--(1) During the period the requirement
under subsection (a) is in effect, the Secretary shall develop and
carry out a data sharing system to grant eligible individuals described
in paragraph (2) access to individual-level, anonymized data with
respect to individuals in receipt of benefits furnished by the Under
Secretary for Benefits.
``(2) An eligible individual described in this paragraph is
researcher who meets the criteria for data security and data protection
established by the Secretary in regulations for the purposes of
administering the data sharing system under paragraph (1).
``(3) Data available through such data sharing system shall
include, for each individual in receipt of benefits furnished by the
Under Secretary for Benefits--
``(A) demographic information, including--
``(i) age;
``(ii) sex;
``(iii) race;
``(iv) period and length of--
``(I) active military, naval, air, or space
service; or
``(II) service in a Reserve component;
``(v) branch of service in the Armed Forces;
``(vi) number of dependents; and
``(vii) State of residence;
``(B) information with respect to each service-connected
disability for which the individual has filed a claim for
disability compensation under laws administered by the
Secretary, including--
``(i) whether such claim was--
``(I) approved by the Secretary; or
``(II) denied by the Secretary;
``(ii) the diagnostic code for the service-
connected disability; and
``(iii) the date on which--
``(I) the individual filed such claim; and
``(II) the Secretary issued a decision
under section 511 of this title with respect to
such claim; and
``(C) a description of any compensation under the laws
administered by the Secretary receives on annual basis,
including--
``(i) disability compensation;
``(ii) dependency and indemnity compensation;
``(iii) educational benefits;
``(iv) benefits under chapter 37 of this title;
``(v) special monthly compensation under subsection
(r) of section 1114 of this title; and
``(vi) compensation for a disability rated as total
by reason of unemployability under section 1164 of this
title.
``(4) In carrying out such data sharing system, the Secretary shall
ensure that--
``(A) no personally identifiable information about an
individual in receipt of benefits furnished by the Under
Secretary for Benefits is accessible through such data sharing
system; and
``(B) each individual about whom data is available under
the data sharing system is assigned a unique identifier for use
in such data sharing system.''.
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