To designate certain amounts authorized to be appropriated for the provision by the Secretary of Veterans Affairs of hospital care and medical services in non-Department of Veterans Affairs facilities pursuant to contracts as changes in concepts and definitions for certain budgetary purposes, and for other purposes.

In general— Amounts authorized to be appropriated to carry out section 1703 of title 38, United States Code, shall be considered changes in concepts and definitions pursuant to section 251(b)(1) of the Balanced Budget and Emergency Deficit Control Act of 1985 (2 U.S.C. 901(b)(1)). These changes shall be reflected only in the budget year in each sequestration preview report required by section 254(c) of such Act. For each budget year, the baseline level of new budget authority using up-to-date concepts and definitions shall be equal to the discretionary appropriations that are specified for those authorizations of appropriations in the budget that the President submits under section 1105 of title 31, United States Code, including those already provided for that fiscal year as advance discretionary new budget authority.

Adjustment of fiscal year 2019 discretionary spending limits— Within 15 days of the publication of a final rule in the Federal Register promulgating the regulations pursuant to section 101(c) of this Act, the Office of Management and Budget shall further adjust the fiscal year 2019 discretionary spending limits to reflect the impact of those regulations, as estimated by the Department of Veterans Affairs, on the discretionary appropriations that are specified for those authorizations of appropriations in the Budget that the President submitted for that fiscal year under section 1105 of title 31 United States Code, and shall provide written notification to the Congress of such further adjustments.

Report to Congress— Not later than 10 days after the date each year on which the President submits the budget request under section 1105 of title 31 United States Code, and also 10 days after the publication of the final rule previously referenced in this section, the Secretary of Veterans Affairs shall submit to the Committees on Appropriations of both Houses of Congress a report detailing the estimates of the resources required by the Department for those authorizations of appropriations, as forecast using the Enrollee Health Care Projections Model, or other methodologies used by the Department.

Adjustment of future discretionary spending limits— For each fiscal year, the Office of Management and Budget shall further adjust the discretionary spending limits in section 251(c) of the Balanced Budget and Emergency Deficit Control Act of 1985 (2 U.S.C. 901(c)) to reflect the transmittal of any formal and informal supplementals and amendments, as those terms are defined in section 110 of Office of Management and Budget Circular A–11, for those authorizations of appropriations and shall provide written notification to the Congress of such further adjustments within 15 days of such transmittal.