S. 2533 — what changed

Elements— The strategic plan required by subsection (a) shall—

cover the evolving needs of women veterans;

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;

address the use of digital breast tomosynthesis (DBT–3D breast imaging);

address the needs of male veterans who require breast cancer screening services; and

provide recommendations on—

potential expansion of breast imaging services furnished at facilities of the Department, including infrastructure and staffing needs;

the use of digital breast tomosynthesis;

the use of mobile mammography; and

other access and equity improvements for breast imaging.

States where the Department of Veterans Affairs does not offer breast imaging services at a facility of the Department; or

locations where access to breast imaging services at a facility of the Department is difficult or not feasible, as determined by the Secretary.

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.

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.

Sharing of images and results— Under the pilot program under subsection (a)—

Elements— The report required by paragraph (1) shall include the following:

An assessment of the quality of the mammography provided under the pilot program under subsection (a).

Feedback from veterans and providers participating in the pilot program.

A recommendation of the Secretary on the continuation or discontinuation of the pilot program.

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

indicating that the upgrade under paragraph (1) has been completed; and

listing the facilities or other locations of the Department at which digital breast tomosynthesis technology is used.

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.

Elements— In conducting the study under paragraph (1), the Secretary shall examine—

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

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.

the results of the study under subsection (a);

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.

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.

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.

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.

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.

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

if such rates are not available, a description of the method developed to measure such rates as required under paragraph (3)(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—

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

provide additional information to the provider on best practices for screening and treating veterans with a spinal cord injury or disorder.

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.

Elements— The report required by subsection (a) shall include an assessment of—

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;

the quality of such screenings and reading of the images from such screenings, including whether such screenings use three-dimensional mammography;

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;

the performance of the Women’s Breast Oncology System of Excellence of the Department; and

the access of veterans diagnosed with breast cancer to a comprehensive breast cancer care team of the Department.

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.

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.

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

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.

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

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.