[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 2533 Enrolled Bill (ENR)]
S.2533
One Hundred Seventeenth Congress
of the
United States of America
AT THE SECOND SESSION
Begun and held at the City of Washington on Monday,
the third day of January, two thousand and twenty two
An Act
To improve mammography services furnished by the Department of Veterans
Affairs, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

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(a) Short Title.--This Act may be cited as the ``Making Advances in
Mammography and Medical Options for Veterans Act''.
(b) Table of Contents.--The table of contents for this Act is as
follows:

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TITLE I

-SCREENING AND EARLY DETECTION

Veterans Affairs to three-dimensional digital mammography.

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veterans and expansion of availability of such testing.

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furnished by Department of Veterans Affairs.

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TITLE II

-PARTNERSHIPS FOR RESEARCH AND ACCESS TO CARE

Defense on interagency collaboration on treating and
researching breast cancer.

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(a) In General.--Not later than one year after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall submit
to the Committee on Veterans' Affairs of the Senate and the Committee
on Veterans' Affairs of the House of Representatives a strategic plan
for improving breast imaging services for veterans.
(b) Elements.--The strategic plan required by subsection (a)
shall--
(1) cover the evolving needs of women veterans;
(2) address geographic disparities of breast imaging furnished
at a facility of the Department of Veterans Affairs and the use of
breast imaging through non-Department providers in the community;
(3) address the use of digital breast tomosynthesis (DBT-3D
breast imaging);
(4) address the needs of male veterans who require breast
cancer screening services; and
(5) provide recommendations on--
(A) potential expansion of breast imaging services
furnished at facilities of the Department, including
infrastructure and staffing needs;
(B) the use of digital breast tomosynthesis;
(C) the use of mobile mammography; and
(D) other access and equity improvements for breast
imaging.

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VETERANS AFFAIRS.
(a) In General.--Commencing not later than 18 months after the date
of the enactment of this Act, the Secretary of Veterans Affairs shall
carry out a pilot program to provide telescreening mammography services
for veterans who live in--
(1) States where the Department of Veterans Affairs does not
offer breast imaging services at a facility of the Department; or
(2) locations where access to breast imaging services at a
facility of the Department is difficult or not feasible, as
determined by the Secretary.
(b) Duration.--The Secretary shall carry out the pilot program
under subsection (a) for a three-year period beginning on the
commencement of the pilot program.
(c) Locations.--In carrying out the pilot program under subsection
(a), the Secretary may use community-based outpatient clinics, mobile
mammography, Federally qualified health centers (as defined in section
1861(aa)(4) of the Social Security Act (42 U.S.C. 1395x(aa)(4))), rural
health clinics, critical access hospitals, clinics of the Indian Health
Service, and such other sites as the Secretary determines feasible to
provide mammograms under the pilot program.
(d) Sharing of Images and Results.--Under the pilot program under
subsection (a)--
(1) mammography images generated shall be sent to a
telescreening mammography center of the Department for
interpretation by qualified radiologists; and
(2) results shall be shared with the veteran and their primary
care provider in accordance with policies established by the
Secretary.
(e) Report.--
(1) In general.--Not later than one year after the conclusion
of the pilot program under subsection (a), the Secretary shall
submit to the Committee on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of Representatives a
report evaluating the pilot program.
(2) Elements.--The report required by paragraph (1) shall
include the following:
(A) An assessment of the quality of the mammography
provided under the pilot program under subsection (a).
(B) Feedback from veterans and providers participating in
the pilot program.
(C) A recommendation of the Secretary on the continuation
or discontinuation of the pilot program.

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VETERANS AFFAIRS TO THREE-DIMENSIONAL DIGITAL MAMMOGRAPHY.
Not later than two years after the date of the enactment of this
Act, the Secretary of Veterans Affairs shall--
(1) upgrade all mammography services at facilities of the
Department of Veterans Affairs that provide such services to use
digital breast tomosynthesis technology, also known as three-
dimensional breast imaging; and
(2) submit to the Committee on Veterans' Affairs of the Senate
and the Committee on Veterans' Affairs of the House of
Representatives a report--
(A) indicating that the upgrade under paragraph (1) has
been completed; and
(B) listing the facilities or other locations of the
Department at which digital breast tomosynthesis technology is
used.

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AMONG VETERANS AND EXPANSION OF AVAILABILITY OF SUCH TESTING.
(a) Study.--
(1) In general.--The Secretary of Veterans Affairs shall
conduct a study on the availability of access to testing for the
breast cancer gene for veterans diagnosed with breast cancer, as
recommended by the guidelines set forth by the National
Comprehensive Cancer Network.
(2) Elements.--In conducting the study under paragraph (1), the
Secretary shall examine--
(A) the feasibility of expanding the Joint Medicine Service
of the Department of Veterans Affairs to provide genetic
testing and counseling for veterans with breast cancer across
the country; and
(B) access to such testing and counseling for veterans
living in rural or highly rural areas, and any gaps that may
exist with respect to such access.
(b) Expansion of Availability of Testing.--
(1) In general.--The Secretary shall update guidelines or
institute new guidelines to increase the use of molecular testing
and genetic counseling for veterans diagnosed with breast cancer,
including veterans living in rural or highly rural areas.
(2) Decision support tools.--In updating or instituting
guidelines under paragraph (1), the Secretary may develop clinical
decision support tools, such as clinical pathways, to facilitate
delivery of breast cancer care that is in line with national cancer
guidelines.
(c) Report.--Not later than two years after the date of the
enactment of this Act, the Secretary shall submit to the Committee on
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs
of the House of Representatives a report on--
(1) the results of the study under subsection (a);
(2) any updates to guidelines or new guidelines instituted
under subsection (b);
(3) breast cancer clinical pathways implemented by the
Department of Veterans Affairs and the utilization of those
pathways across the Department; and
(4) any progress of the Department in improving access to and
usage of molecular and genetic testing among veterans diagnosed
with breast cancer, including for veterans living in rural or
highly rural areas.
(d) Definitions.--In this section, the terms ``rural'' and ``highly
rural'' have the meanings given those terms in the Rural-Urban
Commuting Areas coding system of the Department of Agriculture.

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VETERANS.
(a) Study.--
(1) In general.--The Secretary of Veterans Affairs shall
conduct a study on the accessibility of breast imaging services at
facilities of the Department of Veterans Affairs for veterans with
paralysis, spinal cord injury or disorder (SCI/D), or another
disability.
(2) Accessibility.--The study required by paragraph (1) shall
include an assessment of the accessibility of the physical
infrastructure at breast imaging facilities of the Department,
including the imaging equipment, transfer assistance, and the room
in which services will be provided as well as adherence to best
practices for screening and treating veterans with a spinal cord
injury or disorder.
(3) Screening rates.--
(A) Measurement.--The study required by paragraph (1) shall
include a measurement of breast cancer screening rates for
veterans with a spinal cord injury or disorder during the two-
year period preceding the commencement of the study, including
a breakout of the screening rates for such veterans living in
rural or highly rural areas.
(B) Development of method.--If the Secretary is unable to
provide the measurement required under subparagraph (A), the
Secretary shall develop a method to track breast cancer
screening rates for veterans with a spinal cord injury or
disorder.
(4) Report.--Not later than two years after the date of the
enactment of this Act, the Secretary shall submit to the Committee
on Veterans' Affairs of the Senate and the Committee on Veterans'
Affairs of the House of Representatives a report on the findings of
the study required by paragraph (1), including--
(A) the rates of screening among veterans with a spinal
cord injury or disorder, including veterans living in rural or
highly rural areas, as required under paragraph (3)(A); or
(B) if such rates are not available, a description of the
method developed to measure such rates as required under
paragraph (3)(B).
(b) Care From Non-Department Providers.--The Secretary shall update
the policies and directives of the Department to ensure that, in
referring a veteran with a spinal cord injury or disorder for care from
a non-Department provider, the Secretary shall--
(1) confirm with the provider the accessibility of the breast
imaging site, including the imaging equipment, transfer assistance,
and the room in which services will be provided; and
(2) provide additional information to the provider on best
practices for screening and treating veterans with a spinal cord
injury or disorder.
(c) Definitions.--In this section, the terms ``rural'' and ``highly
rural'' have the meanings given those terms in the Rural-Urban
Commuting Areas coding system of the Department of Agriculture.

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FURNISHED BY DEPARTMENT OF VETERANS AFFAIRS.
(a) In General.--Not later than two years after the date of the
enactment of this Act, the Inspector General of the Department of
Veterans Affairs shall submit to the Secretary of Veterans Affairs, the
Committee on Veterans' Affairs of the Senate, and the Committee on
Veterans' Affairs of the House of Representatives a report on
mammography services furnished by the Department of Veterans Affairs.
(b) Elements.--The report required by subsection (a) shall include
an assessment of--
(1) the access of veterans to mammography screenings, whether
at a facility of the Department or through a non-Department
provider, including any staffing concerns of the Department in
providing such screenings;
(2) the quality of such screenings and reading of the images
from such screenings, including whether such screenings use three-
dimensional mammography;
(3) the communication of the results of such screenings,
including whether results are shared in a timely manner, whether
results are shared via the Joint Health Information Exchange or
another electronic mechanism, and whether results are incorporated
into the electronic health record of the veteran;
(4) the performance of the Women's Breast Oncology System of
Excellence of the Department; and
(5) the access of veterans diagnosed with breast cancer to a
comprehensive breast cancer care team of the Department.
(c) Follow-Up.--Not later than 180 days after the submittal of the
report under subsection (a), the Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and the Committee on
Veterans' Affairs of the House of Representatives a plan to address the
deficiencies identified in the report under subsection (a), if any.

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ACCESS OF VETERANS TO CANCER CARE.
(a) Access to Care in Each VISN.--
(1) In general.--The Secretary of Veterans Affairs shall enter
into a partnership with not fewer than one cancer center of the
National Cancer Institute of the National Institutes of Health in
each Veterans Integrated Service Network of the Department of
Veterans Affairs to expand access to high-quality cancer care for
women veterans.
(2) Treatment of rural veterans.--The Secretary, in carrying
out partnerships entered into under paragraph (1), shall ensure
that veterans with breast cancer who reside in rural areas or
States without a cancer center that has entered into such a
partnership with the Secretary are able to receive care through
such a partnership via telehealth.
(b) Report on Partnership To Increase Access to Clinical Trials.--
Not later than 180 days after the date of the enactment of this Act,
the Secretary shall submit to the Committee on Veterans' Affairs of the
Senate and the Committee on Veterans' Affairs of the House of
Representatives a report on--
(1) how the Secretary will ensure that the advancements made
through the existing partnership between the Department of Veterans
Affairs and the National Cancer Institute to provide veterans with
access to clinical cancer research trials (commonly referred to as
``NAVIGATE'') are permanently implemented; and
(2) the determination of the Secretary of whether expansion of
such partnership to more than the original 12 facilities of the
Department that were selected under such partnership is feasible.
(c) Periodic Reports.--Not later than three years after the date of
the enactment of this Act, and every three years thereafter, the
Secretary shall submit to the Committee on Veterans' Affairs of the
Senate and the Committee on Veterans' Affairs of the House of
Representatives a report--
(1) assessing how the partnerships entered into under
subsection (a)(1) have impacted access by veterans to cancer
centers of the National Cancer Institute, including an assessment
of the telehealth options made available and used pursuant to such
partnerships; and
(2) describing the advancements made with respect to access by
veterans to clinical cancer research trials through the partnership
described in subsection (b)(1), including how many of those
veterans were women veterans, minority veterans (including racial
and ethnic minorities), and rural veterans, and identifying
opportunities for further innovation.

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OF DEFENSE ON INTERAGENCY COLLABORATION ON TREATING AND
RESEARCHING BREAST CANCER.
(a) In General.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs, in
collaboration with the Secretary of Defense, shall submit to Congress a
report on all current research and health care collaborations between
the Department of Veterans Affairs and the Department of Defense on
treating veterans and members of the Armed Forces with breast cancer.
(b) Elements.--The report required by subsection (a)--
(1) shall include a description of potential opportunities for
future interagency collaboration between the Department of Veterans
Affairs and the Department of Defense with respect to treating and
researching breast cancer; and
(2) may include a focus on--
(A) with respect to women members of the Armed Forces with
a diagnosis of or who are undergoing screening for breast
cancer, transition of such members from receiving care from the
Department of Defense to receiving care from the Department of
Veterans Affairs;
(B) collaborative breast cancer research opportunities
between the Department of Veterans Affairs and the Department
of Defense;
(C) access to clinical trials; and
(D) such other matters as the Secretary of Veterans Affairs
and the Secretary of Defense consider appropriate.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.

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Making Advances in Mammography and Medical Options for Veterans Act — S. 2533

Other Sections

TITLE I

TITLE II

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