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Senate Report 119-98 - THE VETPAC ACT OF 2025
[Senate Report 119-98]
[From the U.S. Government Publishing Office]
Calendar No. 279
119th Congress } { Report
SENATE
1st Session } { 119-98
======================================================================
THE VETPAC ACT OF 2025
_______
December 2, 2025.--Ordered to be printed
_______
Mr. Moran, from the Committee on Veterans' Affairs,
submitted the following
R E P O R T
[To accompany S. 787]
[Including cost estimate of the Congressional Budget Office]
The Committee on Veterans' Affairs, to which was referred
the bill (S. 787) to amend title 38, United States Code, to
establish a commission to review operations at the Veterans
Health Administration and submit to Congress reports with
respect to that review, and for other purposes, having
considered the same, reports favorably thereon with an
amendment in the nature of a substitute and recommends that the
bill, as amended, do pass.
Introduction
On February 27, 2025, Senator Bill Cassidy from Louisiana
introduced S. 787, the VetPAC Act of 2025. Senator Maizie
Hirono from Hawaii is an original cosponsor of the bill and
Senator Jerry Moran from Kansas was later added as a cosponsor
of the bill as well. The bill was referred to the Committee on
Veterans' Affairs (hereinafter, ``Committee'').
Committee Hearings
On March 11, 2025, the Committee held a hearing on
legislation pending before the Committee, including S. 787.
Testimony was received from: Mark R. Engelbaum, Assistant
Secretary, Office of Human Resources and Administration/
Operations, Security, and Preparedness, U.S. Department of
Veterans Affairs; Cole Lyle, Director, Veterans' Affairs and
Rehabilitation, The American Legion; Ashlynne Haycock-Lohmann,
Director, Government and Legislative Affairs, Tragedy
Assistance Program for Survivors; and Patrick Murray, Director,
National Legislative Service, Veterans of Foreign Wars of the
United States.
Committee Meeting
After reviewing the testimony from the foregoing hearing,
the Committee met in open session on July 30, 2025, to consider
the Committee Print to S. 787. The Committee, by voice vote,
voted to favorably report S. 787, as amended, en bloc with
other measures, to the Senate.
Summary of the Committee Bill as Reported
S. 787, as reported (hereinafter, ``the Committee bill''),
consists of two sections, summarized below.
Section 1 provides the short title of the bill, the VetPAC
Act of 2025.
Section 2 would establish the Veterans Health
Administration (VHA) Policy Advisory Commission to review
operations at VHA and submit to Congress reports with respect
to that review.
Background and Discussion
Sec. 2. Establishment of Veterans Health Administration Policy Advisory
Commission
Section 2 of the Committee bill would amend title 38,
United States Code (U.S.C.), by adding a new section to require
the Comptroller General of the United States (CG) to establish
the Veterans Health Administration Policy Advisory Commission,
hereby referred to as `the Commission', modeled after the
Medicaid and CHIP Payment and Access Commission (MACPAC) and
the Medicare Payment Advisory Commission (MedPAC). The
Commission would be responsible for regularly reviewing topics
such as quality and patient safety, staffing, information
technology, access to care, and more within VHA and reporting
to Congress with findings and recommendations based on those
findings. The Commission would consist of 17-members selected
by the CG based on their experience and expertise in health
care. Commissioner terms would be for a length of five years
with vacancies being filled on a rolling basis.
Background
VHA provides essential health care services to millions of
enrolled veterans annually, operating the largest integrated
health care system in the United States. Despite many
improvements over the years, persistent challenges remain in
VHA with respect to ensuring timely access to quality care,
optimizing workforce staffing, integrating technologies such as
electronic health records and artificial intelligence, and
maintaining high standards of patient safety and efficiency.
These issues have been highlighted in various oversight reports
from the Office of Inspector General (OIG), the Government
Accountability Office (GAO) and veteran advocates, underscoring
the need for ongoing, independent evaluation to adapt VHA to
evolving demands and improve outcomes for those who have served
our nation. The Committee sees the value of having an
independent commission as described in the legislation that can
review and assess VHA operations and make specific
recommendations to address issues that arise from such reviews.
In a February 27, 2025, press release marking the
introduction of the bill, Senator Bill Cassidy stated:
American veterans deserve the best health care our
nation can offer . . . The VHA must be held to the
highest standard, and regular reports will allow
Congress to hold them to this.
Additionally, Senator Mazie Hirono stated:
Veterans have made unimaginable sacrifices in service
to our country and it is crucial that we continue
working to ensure our veterans can access the high-
quality health care they deserve . . . I'm proud to
reintroduce the VetPAC Act to create a new, independent
commission to address challenges within the VHA and
improve health care access, delivery, and quality for
our veterans.
Advancement of this legislation underscores the Committee's
priority to promote innovation, accountability, and high-
quality outcomes in VHA. By establishing VetPAC, the Committee
bill will empower Congress, with expert guidance, to address
systemic issues, ultimately leading to better health outcomes,
reduced inefficiencies, and positive outcomes for America's
veterans.
Committee Bill
Section 2 of the Committee bill would amend Chapter 1 of
title 38, U.S.C. to create a new section ``120. Veterans Health
Administration Policy Advisory Commission.'' Sec. 120(a) would
establish the new Veterans Health Administration Policy
Advisory Commission, henceforth referred to as `Commission'.
Sec. 120(b)(1) describes that the Commission would be composed
of 17 members appointed by the Comptroller General, of which
not fewer than 2 shall be veterans. Sec. 120(b)(2) describes
the qualification requirements for members of the Commission,
which includes individuals with significant experience in
operating or advising large medical systems, including
expertise in quality of care, staffing issues, information
technology, artificial intelligence in health care, medical
supply chains, procurement of medical supplies, medical
facility construction or leasing, medical research, and managed
care plans and networks. This subsection also would require the
Comptroller General to select individuals from backgrounds that
reflect the broad diversity of health care received by
veterans, including non-profit health systems, public and
private health systems, care furnished by the Department, and
care furnished by the Department of Defense. Sec. 120(b)(3)
describes that Commission members shall be considered employees
of Congress whose compensation is disbursed by the Secretary of
the Senate for the purpose of ethical disclosures. Sec. 120(c)
describes terms for members of the Commission and how vacancies
would be handled. This subsection would set a term of five
years for members and require the Comptroller General to
stagger terms of the first appointed members. This would ensure
all 17 members do not turn over every five years. This
subsection would also require that future vacancies be filled
with the same requirements as initial appointments.
Sec. 120(d) would set the frequency for Commission meetings
at the call of the Chairman of the Commission, but not less
frequently than once per year. This subsection would also set
the requirement for quorum of a majority of the members but
allows for a lesser number of members to hold meetings.
Sec. 120(e) would require the Comptroller General to designate
one member of the Commission as Chairman and one member as Vice
Chairman. Sec. 120(f) outlines the duties of the Commission and
the scope of their review that would be reported on to
Congress, including recommendations to Congress based on such
reviews. Sec. 120(f)(2) outlines the topics that would be
reviewed by the Commission including IT infrastructure at
medical facilities, including electronic health record systems;
referrals to care at Department facilities and under the
Veterans Community Care Program; access and wait times at
Department medical facilities and in the Veterans Community
Care Program; quality of care furnished by the Department and
in the Veterans Community Care Program; workforce issues;
patient satisfaction; training of health care providers; the
long-term budgetary outlook of the Veteran Health
Administration; procurement of supplies; research at the
Department, including internal and external, hospital
construction, leasing, and capital requirements; and the
interaction of care between Medicaid, Medicare, and VA.
Sec. 120(f)(3) outlines how the Commission would utilize
existing data, to the extent practicable, that has been
compiled for the Department or purchased by the Department.
Sec. 120(f)(5) would require the Secretary or the Inspector
General of the Department to transmit reports to the Commission
that are required by Congress or a committee of Congress.
Sec. 120(f)(6)(A) would require the Commission to periodically
consult with the chairman and ranking member of the House and
Senate Veterans Affairs Committees regarding the agenda of the
Commission and progress towards achieving that agenda. This
would allow the House and Senate Veterans' Affairs Committees
to be updated on the Commission's ongoing work and review
process.
Sec. 120(f)(6)(B) would give the Commission the ability to
conduct additional reviews outside of the scope of the topics
laid out by Sec. 120(f)(2) as requested by the Chairman or
members of the Commission. Sec. 120(f)(6)(C) would allow the
chairman and ranking member of the House and Senate Veterans
Affairs Committees to request special studies from the
Commission. The Commission would determine whether those
requested special studies are appropriate. Sec. 120(f)(7) would
require the Commission, to the extent practicable, to
coordinate with the Inspector General of the Department during
ongoing reviews to not interfere with investigations or
remediations underway by the Inspector General.
Sec. 120(f)(9) would require the Commission to submit a
report to Congress by March 15th of each year, containing
results of their reviews and include recommendations if a
simple majority of members of the Commission vote to include
the recommendations in the report. Sec. 120(g)(1)(A) would
allow the Commission to employ personnel as may be necessary to
carry out the duties of the Commission, without regard to the
provisions of title 5 USC governing appointments in the
competitive service. The remainder of Sec. 120(g)(1) would give
the Commission the authority to seek assistance and support
from other federal departments or agencies, to enter into
contracts or make necessary arrangements, make payments related
to the work of the Commission, provide transportation for
individuals serving the Commission, and prescribe rules and
regulations as the Commission determines necessary with respect
to internal organization and operation of the Commission.
Sec. 120(g)(2) would give the Commission the authority to
utilize existing information, both published and unpublished
that is collected and assed either by its own staff or under
other arrangements. This subsection would give the Commission
the authority to award grants or contracts for research and
experimentation if existing information is inadequate and would
allow the Commission to establish procedures to allow
interested parties to submit information for use by the
Commission. Sec. 120(g)(3) would give the Commission the
ability to secure relevant information from other departments
or agencies of the United States. This subsection would allow
federal departments and agencies who the Commission requested
information from up to 180 days to transmit such requested
information. Sec. 120(h) outlines the compensation of members
and staff of the Commission, including compensation for travel
related to the business of the Commission, benefits, rights,
and privileges.
Sec. 120(i) would authorize employees of the Federal
Government to be detailed to the Commission without
reimbursement and without interruption or loss of civil service
status or privileges. Sec. 120(j) would require the Commission
to provide to the Comptroller General, the Congressional
Research Service, and the Congressional Budget Office
unrestricted access to all deliberations, records, and
nonproprietary data of the Commission within 30 days of a
request. Sec. 120(k) would require that the Commission submit
requests for appropriations in the same manner as the
Comptroller General submits appropriations requests, but
amounts appropriated for the Commission would be separate from
amounts appropriated for the Comptroller General. This
subsection would authorize such sums as may be necessary to
carry out the section.
Section 2 (c) would require the Comptroller General to make
initial appointments to the Commission within 280 days from the
date that funds are first appropriated for the Commission.
Congressional Budget Office Cost Estimate
In accordance with paragraph 11(a) of rule XXVI of the
Standing Rules of the Senate and section 402 of the
Congressional Budget Act of 1974, the Committee provides the
following cost estimate, prepared by the Congressional Budget
Office:
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
S. 787 would establish the Veterans Health Administration
Policy Advisory Commission as a permanent body to review
operations and provide annual recommendations to the Congress
on the Veterans Health Administration (VHA). The 17-member
commission would be authorized to hire support staff, conduct
studies, and enter into contracts for original research.
Because the bill would allow 280 days to appoint members, CBO
anticipates that the commission would begin operating in 2027.
On the basis of costs to operate similar advisory bodies,
CBO estimates that salaries and benefits for commission staff,
per diem payments and travel reimbursement for members, and
other operating expenses would cost $1 million annually. In
addition, CBO expects that the commission would use its
authority to contract for original research to evaluate the
effectiveness of VHA programs and compare performance across
facilities. Using information on the cost of similar
activities, CBO estimates those contracts would cost $1 million
annually. In total, implementing S. 787 would cost $8 million
over the 2025-2030 period. Such spending would be subject to
the availability of appropriated funds.
The CBO staff contact for this estimate is Noah Callahan.
The estimate was reviewed by Christina Hawley Anthony, Deputy
Director of Budget Analysis.
Mark P. Hadley
(For Phillip L. Swagel, Director, Congressional Budget Office).
Regulatory Impact Statement
In compliance with paragraph 11(b) of rule XXVI of the
Standing Rules of the Senate, the Committee on Veterans'
Affairs has made an evaluation of the regulatory impact that
would be incurred in carrying out the Committee bill. The
Committee finds that the Committee bill would not entail any
regulation of individuals or businesses, result in any impact
on the personal privacy of any individuals, and that the
paperwork resulting from enactment would be minimal.
Tabulation of Votes Cast in Committee
In compliance with paragraph 7(b) of rule XXVI of the
Standing Rules of the Senate, the following is a tabulation of
votes cast in person or by proxy by members of the Committee on
Veterans' Affairs at its July 30, 2025, meeting.
During this meeting, Chairman Moran called up 24 bills,
including S. 787, as amended, to be considered en bloc. The
bills were reported favorably by voice vote en bloc.
Agency Report
On March 11, 2025, Mark R. Engelbaum, Assistant Secretary,
Office of Human Resources and Administration/Operations,
Security, and Preparedness, U.S. Department of Veterans
Affairs, appeared before the Committee and submitted testimony
on S. 787. An excerpt from that testimony relevant to S. 787 is
reprinted below:
Statement of Mr. Mark R. Engelbaum, Assistant Secretary, Office of
Human Resources and Administration/Operations, Security, and
Preparedness, Department of Veterans Affairs (VA) Before the Senate
Committee on Veterans' Affairs
vetpac act of 2025
Section 2(a) of this bill would create a new section 7310B
in title 38, United States Code, establishing a Veterans Health
Administration Policy Advisory Commission (the Commission). The
Commission would be composed of 17 members appointed by the
Comptroller General; at least 2 members would have to be
Veterans. Proposed section 7310B(b) would further define the
qualifications of members of the Commission and would include
information regarding ethical disclosure of certain
information. Proposed section 7310B(c) would set forth terms
regarding the period of appointment for members of the
Commission and how vacancies would be addressed. Proposed
section 7310B(d) would require the Commission to meet at least
annually and would require a majority of the members of the
Commission to constitute a quorum (although a lesser number of
members could hold hearings). Proposed section 7310B(e) would
provide for the appointment of a Chairman and Vice Chairman of
the Commission.
Proposed section 7310B(f) would set forth the duties of the
Commission; these would include reviewing VHA operations and
preparing reports for Congress based on these reviews. The
Commission would have to conduct periodic reviews of a range of
topics, including but not limited to information technology
(IT) infrastructure at VA medical facilities, referrals to care
in VA and non-VA facilities through the Veterans Community Care
Program (VCCP), access and wait times at VA and non-VA
facilities through the VCCP, quality of care in VA and non-VA
facilities through the VCCP, workforce issues, patient
satisfaction and customer service at VA and non-VA facilities
through the VCCP, the training of health care providers and
standards of care at VA and non-VA facilities through the VCCP;
the long-term budgetary outlook of VHA; procurement of supplies
at VA medical facilities; VA's research program; hospital
construction, leasing, and capital requirements; and the
interaction of care under the Medicare Program, the Medicaid
Program, the TRICARE Program, commercial health plans, and VA
health care. In carrying out these requirements, the Commission
would have to review the effect of policies under title 38 on
the delivery of health care to Veterans and assess the
implications of changes in health care delivery for Veterans in
the United States (US). If VA or the VA Office of Inspector
General (OIG) submitted a report to Congress that is required
by law and relates to policies for health care furnished under
the laws administered by VA, VA would have to transmit a copy
of that report to the Commission as well. In carrying out its
requirements, the Commission would have to consult periodically
with the chairmen and ranking members of the Committees on
Veterans' Affairs of the House of Representatives and the
Senate (HVAC and SVAC) regarding the agenda of the Commission
and its progress toward achieving that agenda. The Commission
could conduct additional review and submit additional report to
Congress from time to time on such topics as may be requested
by the Chairman and members as the Commission determines
appropriate. The Commission also could conduct special studies
requested by the chairmen and ranking members of HVAC and SVAC
as the Commission determines appropriate. Before making any
recommendation to Congress, the Commission would have examined
the budget consequences of such recommendations, directly or
through consultation with appropriate expert entities. The
Commission will have to submit to Congress a report by March 15
of each year containing the results and recommendations of its
review of VHA's operations. Recommendations included in these
reports may be included if a simple majority of the members of
the Commission vote to include the recommendation in the
report.
Proposed Sec. 7310B(g) would allow the Commission to employ
and fix the compensation of an Executive Director and other
personnel; it could also seek assistance and support as may be
required in the performance of its duties from appropriate
departments and agencies of the Federal or State governments.
Additionally, it could enter into contracts or make other
arrangements as necessary for the conduct of the work of the
Commission without regard to section 3709 of the Revised
Statutes (41 U.S.C. Sec. 5) and could make advance, progress,
and other payments that relate to its work. Finally, the
Commission could provide transportation and subsistence for
individuals serving the Commission without compensation and
prescribe such rules and regulations as necessary with respect
to its internal organization and operation. The Commission
would have to utilize existing information collected and
assessed either by its own staff or under other arrangements;
carry out or award grants or contracts for, original research
and experimentation, if existing information is inadequate; and
adopt procedures allowing any interested party to submit
information for use by the Commission in making reports and
recommendations. The Commission could secure directly from any
relevant department or agency of the US health care information
the Chairman determines would be helpful to enable the
Commission to carry out this section, and the head of a US
department or agency would have to furnish information
requested on an agreed upon schedule or not later than 180 days
after the date of the request.
Proposed Sec. 7310B(h) would set forth terms and conditions
for compensation and travel expenses for members of the
Commission, as well as establish rules regarding the treatment
of personnel for purposes of pay and employment benefits,
rights, and privileges. Proposed Sec. 7310B(i) would permit
Federal employees to be detailed to the Commission without
reimbursement and without interruption or loss of civil service
status or privileges. Proposed Sec. 7310B(j) would state the
Commission would provide to the Comptroller General, the
Congressional Research Service, and the Congressional Budget
Office unrestricted access to all deliberations, records, and
non-proprietary data of the Commission within 30 days after
such access is requested. Proposed Sec. 7310B(k) would require
the Commission to submit requests for appropriations in the
same manner as the Comptroller General normally does, but such
amounts appropriate for the Commission would be separate from
amounts appropriated for the Comptroller General. There would
be authorized to be appropriated such sums as may be necessary
to carry out this section.
Finally, section 2(c) would require the initial
appointments of members of the Commission to be made not later
than 280 days after the date on which amounts are first
appropriated to the Commission.
va supports this bill, subject to amendments and the availability of
appropriations
We note the Commission's scope of review and
responsibilities would seemingly be very similar to those
conducted under the quadrennial VHA review required by 38
U.S.C. Sec. 7330C and the decennial independent assessments of
health care delivery systems and management processes under 38
U.S.C. Sec. 1704A. These current efforts, in addition to those
reviews conducted by OIG, the Government Accountability Office,
the Office of the Medical Inspector, and the Office of Special
Counsel, may already provide the oversight and information the
Commission would gather at no additional cost.
We have some concerns that, if not well coordinated, the
Commission could impede VA's ability to respond quickly to
address Veterans' needs if it is requesting information or
conducting investigations while VA is attempting to respond to
a new problem.
We also have technical comments on the bill. First,
placement of this authority in subchapter I of chapter 73 of
title 38 does not seem appropriate; the other sections in that
subchapter refer to the organizational structure and functions
of VHA itself, while the Commission would not be a part of VHA.
Placement in chapter 73 leads to a statutory conflict with
provisions related to authorities of the VA Secretary and is
inconsistent with apparent Congressional intent. See, e.g. 38
U.S.C. Sec. Sec. 7306(a)(12), 7306(f), and 7421(b)(9).
Second, section 2(f)(3) would require the Commission to
review the effect of policies under title 38 on the delivery of
health care to Veterans and assess the implications of changes
in health care delivery for Veterans in the US; however, VA is
not limited to only providing health care in the US. Through
the Foreign Medical Program, and pursuant to amendments made by
the Compact of Free Association Amendments Act of 2024 (Title
II, Division G, of Public Law 118-42), VA can furnish care
outside the US in certain circumstances. If the intent is to
exclude this care, no changes to the bill are needed; if this
was not the intent, the bill should be amended accordingly.
Finally, the Commission does not appear to be subject to
the Federal Advisory Committee Act (5 U.S.C. Sec. 1001 et
seq.). In this regard, the Commission's work would not
generally be publicly available, and so this could raise
concerns from a viewpoint focused on public transparency.
Changes in Existing Law
In compliance with paragraph 12 of rule XXVI of the
Standing Rules of the Senate, changes in existing law made by
the Committee bill are shown as follows: (existing law proposed
to be omitted is enclosed in black brackets, new matter is
printed in italics, existing law in which no change is proposed
is shown in roman):
TITLE 38. VETERANS' BENEFITS
* * * * * * *
PART I. GENERAL PROVISIONS
* * * * * * *
CHAPTER 1. GENERAL
* * * * * * *
Sec. 120. Veterans Health Administration Policy Advisory Commission
(a) Establishment.--There is established the Veterans
Health Administration Policy Advisory Commission (in this
section referred to as the `Commission').
(b) Membership.--
(1) Composition.--The Commission shall be composed of
17 members appointed by the Comptroller General of the
United States, of which not fewer than 2 shall be
veterans.
(2) Qualifications.--
(A) In general.--An individual is eligible
for appointment to the Commission under
paragraph (1) if the individual has significant
expertise in operating or advising large
medical systems, including expertise in quality
of care, staffing issues, information
technology, artificial intelligence in health
care, medical supply chains, procurement of
medical supplies, medical facility construction
or leasing, medical facility architecture or
engineering, medical research, and managed care
plans and networks.
(B) Experience of members.--In appointing
members under paragraph (1), the Comptroller
General shall select individuals from
backgrounds that reflect the broad diversity of
health care received by veterans, including
nonprofit health systems, public and private
health systems, care furnished by the Veterans
Health Administration, and care furnished by
the Department of Defense.
(3) Ethical disclosure.--A member of the Commission
shall be considered an employee of Congress whose
compensation is disbursed by the Secretary of the
Senate for purposes of applying subchapter I of chapter
131 of title 5, United States Code, except that a
member of the Commission is required to file public
financial disclosure reports without regard to their
number of days of service or rate of pay.
(c) Period of Appointment; Vacancies.--
(1) Terms.--A member of the Commission shall be
appointed under subsection (b)(1) for a term of 5
years, except that the Comptroller General shall
designate staggered terms for the members first
appointed.
(2) Vacancies.--
(A) In general.--A vacancy on the Commission
shall be filled in the manner in which the
original appointment was made and shall be
subject to any conditions that applied with
respect to the original appointment.
(B) Filling unexpired term.--An individual
chosen to fill a vacancy shall be appointed for
the unexpired term of the member replaced.
(3) Expiration of terms.--The term of any member
shall not expire before the date on which the member's
successor takes office.
(d) Meetings.--
(1) Frequency.--The Commission shall meet at the call
of the Chairman, but not less frequently than once per
year.
(2) Quorum.--A majority of the members of the
Commission shall constitute a quorum, but a lesser
number of members may hold meetings.
(e) Chairman and Vice Chairman.--The Comptroller General
shall designate one member of the Commission as Chairman and
one member of the Commission as Vice Chairman, at the time of
appointment of such member and for the term of appointment of
such member, except that in the case of vacancy of the
Chairmanship or Vice Chairmanship, the Comptroller General may
designate another member for the remainder of that member's
term.
(f) Duties of the Commission.--
(1) Review.--The Commission shall--
(A) review operations at the Veterans Health
Administration; and
(B) prepare reports for Congress based on
such review, including recommendations to
Congress.
(2) Topics to be reviewed.--In conducting a review
under paragraph (1)(A), the Commission shall include
periodic reviews of the following, taking into
consideration other independent assessments in
selecting topics to limit duplicative efforts:
(A) Information technology infrastructure at
medical facilities of the Department, including
with respect to electronic health record
systems.
(B) Referrals to care at facilities of the
Department and under the Veterans Community
Care Program under section 1703 of this title,
and factors impacting those referrals.
(C) Access and wait times at medical
facilities of the Department and under the
Veterans Community Care Program, including both
primary and specialty care, and factors
impacting those wait times.
(D) The quality of health care furnished by
the Department and through the Veterans
Community Care Program.
(E) Workforce issues, including workforce
performance, recruitment, and retention
factors.
(F) Patient satisfaction and customer service
at medical facilities of the Department and
through the Veterans Community Care Program.
(G) The training of health care providers and
the standards of care at facilities of the
Department and in the Veterans Community Care
Program.
(H) The long-term budgetary outlook of the
Veterans Health Administration, as well as key
components driving budgetary changes over time.
(I) Procurement of supplies at medical
facilities of the Department.
(J) The research program of the Department,
including both internal and external research.
(K) Hospital construction, leasing, and
capital requirements.
(L) The interaction of care under the
Medicare program under title XVIII of the
Social Security Act (42 U.S.C. 1395 et seq.),
the Medicaid program under title XIX of such
Act (42 U.S.C. 1396 et seq.), the TRICARE
program under chapter 55 of title 10, and
commercial health care plans with care
furnished by the Veterans Health
Administration.
(3) Use of existing data.--In carrying out the
requirements of this subsection, the Commission, to the
extent practicable, shall use existing data that has
been compiled by the Department, compiled for the
Department, or purchased by the Department, including--
(A) data described in subsection
(c)(1) of section 1704A of this title;
and
(B) the results of the independent
assessments conducted under such
section.
(4) Issues regarding veteran health care delivery
generally.--In carrying out the requirements of this
subsection, the Commission shall review the effect of
policies under this title on the delivery of health
care services to veterans and assess the implications
of changes in health care delivery for veterans under
the laws administered by the Secretary.
(5) Transmittal of certain reports.--If the Secretary
or the Inspector General of the Department of Veterans
Affairs submits to Congress (or a committee of
Congress) a report that is required by law and that
relates to policies for health care furnished under the
laws administered by the Secretary, the Secretary shall
transmit a copy of that report to the Commission.
(6) Consultation and additonal reviews and studies.--
(A) Consultation.--In carrying out the
requirements of this subsection, the Commission
shall consult periodically with the chairmen
and ranking members of the Committee on
Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of
Representatives regarding the agenda of the
Commission and progress towards achieving that
agenda.
(B) Additional reviews and reports.--The
Commission may conduct additional reviews, and
may submit additional reports to the Committee
on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of
Representatives, from time to time on such
topics relating to the activities of the
Commission as may be requested by the Chairman
and members and as the Commission determines
appropriate.
(C) Special studies.--The Commission may
conduct special studies requested by the
chairman or ranking member of the Committee on
Veterans' Affairs of the Senate or the
Committee on Veterans' Affairs of the House of
Representatives and as the Commission
determines appropriate.
(7) Coordination.--In carrying out reviews, preparing
reports, and conducting studies under this section, the
Commission shall, to the extent practicable, coordinate
with the Inspector General of the Department to ensure
the work of the Commission does not interfere with
investigations or remediations underway by the
Inspector General.
(8) Budgetary considerations.--Before making any
recommendations to Congress, the Commission shall
examine the budget consequences of such
recommendations, directly or through consultation with
appropriate expert entities.
(9) Report.--
(A) In general.--By not later than March 15
of each year, the Commission shall submit to
Congress a report containing the results and
recommendations from the review conducted under
paragraph (1).
(B) Inclusion of recommendations.--A
recommendation may be included in a report
under subparagraph (A) if a simple majority of
the members of the Commission vote to include
the recommendation in the report.
(g) Powers of Commission.--
(1) In general.--The Commission may--
(A) employ and fix the compensation of an
Executive Director (at a rate of pay not
greater than that provided for level III of the
Executive Schedule under section 5314 of title
5) and such other personnel as may be necessary
to carry out the duties of the Commission,
without regard to the provisions of title 5
governing appointments in the competitive
service;
(B) seek such assistance and support as may
be required in the performance of its duties
from appropriate departments and agencies of
the United States or departments or agencies of
a State;
(C) enter into contracts or make other
arrangements, as may be necessary for the
conduct of the work of the Commission (without
regard to section 3709 of the Revised Statutes
(41 U.S.C. 6101));
(D) make advance, progress, and other
payments that relate to the work of the
Commission;
(E) provide transportation and subsistence
for individuals serving the Commission without
compensation; and
(F) prescribe such rules and regulations as
the Commission determines necessary with
respect to the internal organization and
operation of the Commission.
(2) Data collection.--In order to carry out its
functions, the Commission shall--
(A) utilize existing information, both
published and unpublished, if possible,
collected and assessed either by its own staff
or under other arrangements made in accordance
with this section;
(B) carry out, or award grants or contracts
for, original research and experimentation, if
existing information is inadequate; and
(C) adopt procedures allowing any interested
party to submit information for use by the
Commission in making reports and
recommendations.
(3) Information from federal agencies.--
(A) In general.--The Commission may secure
directly from any relevant department or agency
of the United States health care information
the Chairman determines would be helpful to
enable the Commission to carry out this
section.
(B) Timing.--Upon request of the Chairman,
the head of a department or agency of the
United States shall furnish information
requested under subparagraph (A) to the
Commission on an agreed upon schedule or not
later than 180 days after the date of the
request.
(h) Compensation.--
(1) Members.--
(A) In general.--While conducting the
business of the Commission (including travel
time), a member of the Commission shall be
entitled to compensation at the per diem
equivalent of the rate provided for level IV of
the Executive Schedule under section 5315 of
title 5.
(B) Travel expenses.--While conducting the
business of the Commission away from home and
the regular place of business of the member, a
member may be allowed travel expenses, as
authorized by the Chairman.
(2) Physician comparability allowance for
personnel.--The Commission may provide a physician
comparability allowance to physicians serving as
personnel of the Commission in the same manner as
physicians of the Federal Government may be provided
such an allowance by an agency under section 5948 of
title 5, and for such purpose, subsection (i) of such
section shall apply to the Commission in the same
manner as it applies to the Tennessee Valley Authority.
(3) Treatment of personnel.--For purposes of pay
(other than pay of members of the Commission) and
employment benefits, rights, and privileges, all
personnel of the Commission shall be treated as if they
were employees of the United States Senate.
(i) Detail of Federal Employees.--An employee of the
Federal Government may be detailed to the Commission without
reimbursement and without interruption or loss of civil service
status or privileges.
(j) Access of Congressional Support Agencies to
Information.--The Commission shall provide to the Comptroller
General, the Congressional Research Service, and the
Congressional Budget Office unrestricted access to all
deliberations, records, and nonproprietary data of the
Commission not later than 30 days after such access is
requested.
(k) Authorization of Appropriations.--
(1) Request for appropriations.--The Commission shall
submit requests for appropriations in the same manner
as the Comptroller General submits requests for
appropriations, but amounts appropriated for the
Commission shall be separate from amounts appropriated
for the Comptroller General.
(2) Authorization.--There are authorized to be
appropriated such sums as may be necessary to carry out
this section.
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