H.R. 3643

[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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