Pilot program on reciprocal access to health care facilities, personnel, and services of Department of Defense and Department of Veterans Affairs

(a) In general The Secretary of Defense and the Secretary of Veterans Affairs shall jointly carry out a pilot program to assess the feasibility and advisability of expanding reciprocal access to health care facilities, personnel, and services between the Department of Defense and the Department of Veterans Affairs (in this section referred to as the pilot program). (b) Purposes The purposes of the pilot program are— (1) to improve access to timely, high-quality health care for covered beneficiaries; (2) to improve continuity of care for transitioning members of the Armed Forces and veterans; (3) to reduce duplication of health care capacity and infrastructure; (4) to enhance medical readiness and provider proficiency; (5) to maximize the efficient use of medical facilities and personnel of the Federal Government; and (6) to assess opportunities for future integration and coordination between the health care systems of the Department of Defense and the Department of Veterans Affairs. (c) Authorized activities (1) In general Under the pilot program, the Secretary of Defense and the Secretary of Veterans Affairs may authorize— (A) coordinated referral and specialty care arrangements; (B) integrated scheduling, credentialing, reimbursement, and care coordination processes; and (C) the sharing and interoperability of electronic health records and related health information systems consistent with applicable privacy and security requirements. (2) Priority Activities under the pilot program shall prioritize arrangements that cannot be readily achieved under sharing agreements in effect as of the date of the enactment of this Act due to administrative, eligibility, or systemic barriers. (d) Pilot sites (1) Initial sites Not later than 180 days after the date of the enactment of this Act, the Secretary of Defense and the Secretary of Veterans Affairs shall jointly designate not fewer than five and not more than 10 pilot sites. (2) Selection criteria In selecting pilot sites under paragraph (1), the Secretary of Defense and the Secretary of Veterans Affairs shall consider— (A) geographic areas with overlapping medical infrastructure of the Department of Defense and the Department of Veterans Affairs; (B) locations experiencing provider shortages or access challenges; (C) locations with significant populations of transitioning members of the Armed Forces, former members of the Armed Forces, or veterans; (D) locations where at least one of the local Federal facilities has the staff and operation capacity to take on the work of the pilot program; (E) opportunities to improve medical readiness of the Armed Forces; and (F) existing sharing agreements or integrated care models. (3) Modification of pilot sites The Secretary of Defense and the Secretary of Veterans Affairs may jointly add, remove, suspend, or modify pilot sites and services covered under the pilot program as the Secretary of Defense and the Secretary of Veterans Affairs jointly determine necessary based on performance, patient safety, operational requirements, beneficiary access, or other appropriate considerations if the Secretary of Defense and the Secretary of Veterans Affairs provide to the appropriate committees of Congress, not later than 30 days before adding, removing, suspending, or modifying any such site or service, a notification of such action. (e) Eligibility (1) In general The Secretary of Defense and the Secretary of Veterans Affairs shall jointly establish eligibility criteria and priority categories for participation in the pilot program. (2) Priority In establishing criteria under paragraph (1), the Secretary of Defense and the Secretary of Veterans Affairs shall prioritize— (A) transitioning members of the Armed Forces; (B) members of the Armed Forces and veterans residing in medically underserved areas; (C) beneficiaries requiring specialty care with extended wait times; (D) members of the Armed Forces and veterans receiving behavioral health care; and (E) military families if reciprocal access would improve continuity or access to care for such families. (f) Waiver of administrative requirements The Secretary of Defense and the Secretary of Veterans Affairs may waive or modify administrative requirements that would otherwise unnecessarily impede the operation of the pilot program, except requirements relating to patient safety, quality standards, or statutory eligibility for care. (g) Data collection and performance metrics (1) In general The Secretary of Defense and the Secretary of Veterans Affairs shall jointly establish metrics to evaluate the pilot program, including metrics relating to— (A) patient access and wait times; (B) quality of care and patient outcomes; (C) patient satisfaction and care coordination; (D) provider productivity and readiness impacts; (E) cost and resource utilization; (F) continuity of care for transitioning members of the Armed Forces; (G) continuity of care for veterans receiving care under the pilot program at facilities other than facilities of the Department of Veterans Affairs; (H) electronic health record interoperability and information sharing; and (I) comparison of use of the pilot program to use of sharing agreements for similar services under other authorities. (2) Standardization The Secretary of Defense and the Secretary of Veterans Affairs shall ensure that data collection under this subsection is standardized across pilot sites to the maximum extent practicable. (h) Application of authority The pilot program shall— (1) build upon and not duplicate authorities under section 8111 of title 38, United States Code; and (2) apply only to the extent necessary to test enhanced reciprocal access to health care facilities, personnel, and services beyond sharing agreements in effect as of the date of the enactment of this Act. (i) Briefings and reports (1) Initial briefing Not later than 120 days after the date of the enactment of this Act, the Secretary of Defense and the Secretary of Veterans Affairs shall jointly provide to the appropriate committees of Congress a briefing regarding implementation plans for the pilot program. (2) Annual briefings Not later than April 1 of each year during the duration of the pilot program, the Secretary of Defense and the Secretary of Veterans Affairs shall jointly provide to the appropriate committees of Congress a briefing regarding— (A) pilot site performance; (B) beneficiary participation; (C) budgetary impacts; (D) patient safety and quality metrics; (E) any modifications to pilot sites or covered services; and (F) legislative recommendations, if any. (3) Interim report Not later than two years after commencement of operations under the pilot program at the first pilot site, the Secretary of Defense and the Secretary of Veterans Affairs shall jointly submit to the appropriate committees of Congress an interim report on the results of the pilot program. (4) Final report Not later than one year before the termination of the pilot program under subsection (k), the Secretary of Defense and the Secretary of Veterans Affairs shall jointly submit to the appropriate committees of Congress a final report containing— (A) an assessment of the effectiveness of the pilot program; (B) recommendations regarding expansion, modification, or termination of the pilot program; (C) an assessment of impacts on medical readiness of the Armed Forces and health care delivery for veterans; and (D) any recommendations for legislative or administrative action. (j) Voluntary participation and preservation of existing authorities (1) Voluntary participation Participation in the pilot program by veterans shall be voluntary. (2) Patient election A veteran eligible to participate in the pilot program may elect to receive care through— (A) a facility of the Department of Veterans Affairs; (B) a military medical treatment facility participating in the pilot program; or (C) a community provider pursuant to applicable community care authorities of the Department of Veterans Affairs. (3) No requirement to use Department of Defense facilities The Secretary of Veterans Affairs may not require a veteran to receive care through a facility of the Department of Defense as a condition of eligibility for, or receipt of, care or services under laws administered by the Secretary. (4) Patient notice The Secretary of Veterans Affairs shall ensure that veterans eligible to participate in the pilot program receive clear notice regarding available health care options, including the availability of community care if otherwise authorized by law. (5) No limitation on community care eligibility Nothing in this section may be construed to limit, alter, delay, or otherwise affect the eligibility of a veteran for care, services, or referrals furnished under the Veterans Community Care Program under section 1703 of title 38, United States Code, or any other authority available under laws administered by the Secretary of Veterans Affairs to receive care from non-Department of Veterans Affairs providers. (k) Duration The pilot program shall commence not later than one year after the date of the enactment of this Act and shall terminate five years after the commencement of operations of the pilot program at the first pilot site. (l) Definitions In this section: (1) Appropriate committees of Congress The term appropriate committees of Congress means— (A) the Committee on Armed Services and the Committee on Veterans’ Affairs of the Senate; and (B) the Committee on Armed Services and the Committee on Veterans’ Affairs of the House of Representatives. (2) Covered beneficiary The term covered beneficiary has the meaning given that term in section 1072 of title 10, United States Code. (3) Military medical treatment facility The term military medical treatment facility means a facility of the Defense Health Agency, a military department, or another component of the Department of Defense providing health care services. (4) Pilot site The term pilot site means any medical center, hospital, clinic, or other health care facility of the Department of Defense or the Department of Veterans Affairs that is participating in the pilot program. (5) Reciprocal access The term reciprocal access means systematic, non-excess-capacity access with integrated operations, as opposed to access that is limited to excess capacity only.