Veteran Access to Direct Primary Care Act

I 116TH CONGRESS 2D SESSION H. R. 6259 To direct the Secretary of Veterans Affairs to establish a pilot program to provide veteran health savings accounts to allow veterans to receive primary care furnished under non-Department direct primary care service arrangements, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MARCH 12, 2020 Mr. ROY introduced the following bill; which was referred to the Committee on Veterans’ Affairs A BILL To direct the Secretary of Veterans Affairs to establish a pilot program to provide veteran health savings accounts to allow veterans to receive primary care furnished under non-Department direct primary care service arrange- ments, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Veteran Access to Di- 4 rect Primary Care Act’’. 5 VerDate Sep 11 2014 17:50 Mar 27, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H6259.IH H6259 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 6259 IH SEC. 2. PILOT PROGRAM ON ESTABLISHMENT OF VETERAN 1 HEALTH SAVINGS ACCOUNTS TO ALLOW VET- 2 ERANS TO ACCESS DIRECT PRIMARY CARE 3 SERVICE ARRANGEMENTS. 4 (a) ESTABLISHMENT.—Beginning one year after the 5 date of the enactment of this Act, the Secretary of Vet- 6 erans Affairs shall carry out a five-year pilot program 7 under which the Secretary shall provide eligible veterans 8 with the option to choose to receive primary care services 9 furnished by a non-Department of Veterans Affairs health 10 care provider under a direct primary care service arrange- 11 ment through the use of a veteran health savings account 12 described in subsection (c). The pilot program shall be 13 conducted under the Center for Innovation for Care and 14 Payment under section 1703E of title 38, United States 15 Code. 16 (b) ELIGIBLE VETERAN.—For purposes of the pilot 17 program under this section, an eligible veteran is a veteran 18 who is enrolled in the patient enrollment system of the 19 Department of Veterans Affairs under section 1705 of 20 title 38, United States Code. 21 (c) VETERAN HEALTH SAVINGS ACCOUNTS.—The 22 Secretary shall provide to an eligible veteran who partici- 23 pates in the pilot program a veterans health savings ac- 24 count that may be used— 25 VerDate Sep 11 2014 17:50 Mar 27, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H6259.IH H6259 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 6259 IH (1) to purchase primary care services furnished 1 through a non-Department direct primary care serv- 2 ice arrangement; and 3 (2) for associated costs, including— 4 (A) periodic fees paid to a physician for a 5 defined set of medical services or for the right 6 to receive medical services on an as-needed 7 basis; 8 (B) amounts paid or prepaid for medical 9 services designed to screen for, diagnose, cure, 10 mitigate, treat, or prevent disease and promote 11 wellness; and 12 (C) prescription or non-prescription medi- 13 cines or drugs. 14 (d) ELIGIBILITY FOR DEPARTMENT MEDICAL 15 CARE.—A veteran who chooses to receive a veteran health 16 savings account described under subsection (c) may not 17 receive medical care furnished by the Department of Vet- 18 erans Affairs that is included in the direct primary care 19 service arrangement described in such subsection during 20 the period the veteran participates in the pilot program. 21 (e) PREVENTION OF FRAUDULENT ACTIVITY.—The 22 Secretary shall establish a mechanism to prevent fraudu- 23 lent activity in connection with payments made under this 24 VerDate Sep 11 2014 17:50 Mar 27, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H6259.IH H6259 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 6259 IH section and to ensure participating veterans use health 1 savings accounts only as authorized under this section. 2 (f) AMOUNTS DEPOSITED IN ACCOUNTS.—The Sec- 3 retary of Veterans Affairs shall— 4 (1) determine the annual amount to be depos- 5 ited in a veteran health savings account described in 6 subsection (c) using calculations conducted by the 7 Secretary and in consultation with an actuarial serv- 8 ice; and 9 (2) ensure that each participating eligible vet- 10 eran receives such amount on an annual basis dur- 11 ing the period the veteran participates in the pilot 12 program. 13 (g) DIRECT PRIMARY CARE SERVICE ARRANGE- 14 MENT.—In this section, the term ‘‘direct primary care 15 service arrangement’’ means an agreement under which 16 a defined set of medical services are provided to a patient 17 by a physician for fixed periodic fees. 18 (h) REPORTS.— 19 (1) IMPLEMENTATION REPORTS.—For each cal- 20 endar quarter during the two-year period beginning 21 on the date of the enactment of this Act, the Sec- 22 retary shall submit to the Committees on Veterans’ 23 Affairs of the Senate and House of Representatives 24 a report on the implementation of this section. One 25 VerDate Sep 11 2014 17:50 Mar 27, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H6259.IH H6259 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 6259 IH such report shall include a description of the final 1 design of the pilot program. 2 (2) ANNUAL REPORTS.—Not later than one 3 year after the date on which the final implementa- 4 tion report required by paragraph (1) is submitted, 5 and annually thereafter, the Secretary shall submit 6 to the Committees on Veterans’ Affairs of the Sen- 7 ate and House of Representatives a report on the re- 8 sults of the pilot program under this section. 9 (i) NO ADDITIONAL APPROPRIATIONS.—Amounts re- 10 quired to carry out this section shall be made available 11 from amounts otherwise authorized to be appropriated for 12 the Veterans Health Administration. 13 (j) TERMINATION.—The authority of the Secretary to 14 deposit funds in a veteran health savings account under 15 this section shall terminate on the date that is five years 16 after the date of the enactment of this Act. 17 Æ VerDate Sep 11 2014 17:50 Mar 27, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\H6259.IH H6259 pamtmann on DSKBC07HB2PROD with BILLS