MANAGEMENT OF HEALTH CARE.

SEC. 104. MANAGEMENT OF HEALTH CARE. (a) In General.—(1) Chapter 17 is amended by inserting after section 1704 the following new sections: “§ 1705. Management of health care: patient enrollment system “(a) In managing the provision of hospital care and medical services under section 1710(a) of this title, the Secretary, in accordance with regulations the Secretary shall prescribe, shall establish and operate a system of annual patient enrollment. The Secretary shall manage the enrollment of veterans in accordance with the following priorities, in the order listed: 110 STAT. 3183 “(1) Veterans with service-connected disabilities rated 50 percent or greater. “(2) Veterans with service-connected disabilities rated 30 percent or 40 percent. “(3) Veterans who are former prisoners of war, veterans with service-connected disabilities rated 10 percent or 20 percent, and veterans described in subparagraphs (B) and (C) of section 1710(a)(2) of this title. “(4) Veterans who are in receipt of increased pension based on a need of regular aid and attendance or by reason of being permanently housebound and other veterans who are catastrophically disabled. “(5) Veterans not covered by paragraphs (1) through (4) who are unable to defray the expenses of necessary care as determined under section 1722(a) of this title. “(6) All other veterans eligible for hospital care, medical services, and nursing home care under section 1710(a)(2) of this title. “(7) Veterans described in section 1710(a)(3) of this title. “(b) In the design of an enrollment system under subsection (a), the Secretary— “(1) shall ensure that the system will be managed in a manner to ensure that the provision of care to enrollees is timely and acceptable in quality; “(2) may establish additional priorities within each priority group specified in subsection (a), as the Secretary determines necessary; and “(3) may provide for exceptions to the specified priorities where dictated by compelling medical reasons. “(c)(1) Effective on October 1, 1998, the Secretary may not provide hospital care or medical services to a veteran under paragraph (2) or (3) of section 1710(a) of this title unless the veteran enrolls in the system of patient enrollment established by the Secretary under subsection (a). “(2) The Secretary shall provide hospital care and medical services under section 1710(a)(1) of this title, and under subparagraph (B) of section 1710(a)(2) of this title, for the 12-month period following such veteran’s discharge or release from service, to any veteran referred to in such sections for a disability specified in the applicable subparagraph of such section, notwithstanding the failure of the veteran to enroll in the system of patient enrollment referred to in subsection (a) of this section. “§ 1706. Management of health care: other requirements “(a) In managing the provision of hospital care and medical services under section 1710(a) of this title, the Secretary shall, to the extent feasible, design, establish and manage health care programs in such a manner as to promote cost-effective delivery of health care services in the most clinically appropriate setting. “(b)(1) In managing the provision of hospital care and medical services under such section, the Secretary shall ensure that the Department maintains its capacity to provide for the specialized treatment and rehabilitative needs of disabled veterans (including veterans with spinal cord dysfunction, blindness, amputations, and mental illness) within distinct programs or facilities of the Department that are dedicated to the specialized needs of those veterans in a manner that (A) affords those veterans reasonable access 110 STAT. 3184to care and services for those specialized needs, and (B) ensures that overall capacity of the Department to provide such services is not reduced below the capacity of the Department, nationwide, to provide those services, as of the date of the enactment of this section. The Secretary shall carry out this paragraph in consultation with the Advisory Committee on Prosthetics and Special Disabilities Programs and the Committee on Care of Severely Chronically Mentally Ill Veterans. “(2) Not later than April 1, 1997, April 1, 1998, and April 1, 1999, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the Secretary’s compliance, by facility and by service-network, with the requirements of this subsection.”. (2) The table of sections at the beginning of chapter 17 is amended by inserting after the item relating to section 1704 the following new items: “1705. Management of health care: patient enrollment system. “1706. Management of health care: other requirements.”. (b) Conforming Amendments to Section 1703.—Section 1703(a) is amended— (1) in the matter preceding paragraph (1), by striking out “or 1712”; (2) in paragraph (2)— (A) by striking out “1712(a)(1)(B)” in subparagraph (A) and inserting in lieu thereof “1710(a)(1)(B)”; (B) by striking out subparagraph (B) and inserting in lieu thereof the following: “(B) a veteran who (i) has been furnished hospital care, nursing home care, domiciliary care, or medical services, and (ii) requires medical services to complete treatment incident to such care or services; or”; and (C) by striking “section 1712(a)(3) (other than a veteran who is a former prisoner of war) of this title” in subparagraph (C) and inserting in lieu thereof “section 1710(a)(2)(E) of this title, or a veteran who is in receipt of increased pension, or additional compensation or allowances based on the need of regular aid and attendance or by reason of being permanently housebound (or who, but for the receipt of retired pay, would be in receipt of such pension, compensation, or allowance),”; and (3) in paragraph (7), by striking out “1712(b)(1)(F)” and inserting in lieu thereof “1712(a)(1)(F)”.