[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 2745 Introduced in Senate (IS)]

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118th CONGRESS
  1st Session
                                S. 2745

   To amend title 38, United States Code, to eliminate conflicts of 
     interest in conduct of quality management and administrative 
 investigations by the Veterans Health Administration and to limit the 
   detail of directors of medical centers of Department of Veterans 
        Affairs to different positions, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 7, 2023

Mr. Peters (for himself and Mr. Boozman) introduced the following bill; 
which was read twice and referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
   To amend title 38, United States Code, to eliminate conflicts of 
     interest in conduct of quality management and administrative 
 investigations by the Veterans Health Administration and to limit the 
   detail of directors of medical centers of Department of Veterans 
        Affairs to different positions, 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 ``Veterans Affairs Peer Review 
Neutrality Act of 2023''.

SEC. 2. ELIMINATION OF CONFLICTS OF INTEREST IN PEER REVIEW, 
              ADMINISTRATIVE INVESTIGATION BOARDS, AND FACTFINDINGS OF 
              VETERANS HEALTH ADMINISTRATION.

    (a) In General.--Subchapter II of chapter 73 of title 38, United 
States Code, is amended by inserting after section 7311A the following 
new section:
``Sec. 7311B. Elimination of conflicts of interest in peer review, 
              administrative investigation boards, and factfindings of 
              Veterans Health Administration
    ``(a) Peer Review.--
            ``(1) In general.--Each individual responsible for 
        conducting peer review for quality management of care provided 
        by a health care provider at a medical facility of the 
        Department and each member of a peer review committee with 
        respect to quality management of such care shall withdraw from 
        participation in a case review if--
                    ``(A) the individual has direct involvement with 
                the care under review; or
                    ``(B) the individual is unable to conduct an 
                objective, impartial, accurate, and informed review.
            ``(2) Neutral assessment of conduct of committee members.--
        Each medical facility of the Department shall develop 
        procedures and guidelines for that facility to require that any 
        initial peer review for quality management that is conducted 
        with respect to care provided by a health care provider who is 
        a member of the peer review committee for that facility be 
        evaluated, discussed, and assigned a final level review by a 
        neutral peer review committee at another facility of the 
        Department.
    ``(b) Administrative Investigation Boards and Factfindings.--
            ``(1) Knowledge of confidential information.--Individuals 
        with knowledge of confidential quality assurance information 
        specific to a matter under investigation by an administrative 
        investigation board or factfinder with respect to quality 
        management of care provided by a health care provider at a 
        medical facility of the Department may not--
                    ``(A) serve on the administrative investigation 
                board or as a factfinder; or
                    ``(B) disclose such information to an 
                administrative investigation board or a factfinder.
            ``(2) Personal interest, involvement, or relationship.--
                    ``(A) In general.--The Secretary shall ensure that 
                each member of an administrative investigative board or 
                factfinder does not have--
                            ``(i) any personal interest or other bias 
                        concerning the investigation being conducted;
                            ``(ii) direct involvement in matters being 
                        investigated; or
                            ``(iii) a supervisory or personal 
                        relationship with the subject of the 
                        investigation.
                    ``(B) Recusal.--If a potential member of an 
                administrative investigative board or factfinder has a 
                personal interest or other bias concerning the 
                investigation being conducted, direct involvement in 
                matters being investigated, or a supervisory or 
                personal relationship with the subject of the 
                investigation, the potential member shall inform the 
                authority responsible for the investigation and recuse 
                themselves from such matter.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such subchapter is amended by inserting after the item relating to 
section 7311A the following new item:

``7311B. Elimination of conflicts of interest in peer review, 
                            administrative investigation boards, and 
                            factfindings of Veterans Health 
                            Administration.''.

SEC. 3. LIMITATION ON DETAIL OF DIRECTORS OF MEDICAL CENTERS OF 
              DEPARTMENT OF VETERANS AFFAIRS TO DIFFERENT POSITIONS.

    (a) Notification.--
            (1) In general.--Not later than 90 days after detailing a 
        director of a medical center of the Department of Veterans 
        Affairs to a different position within the Department, the 
        Secretary of Veterans Affairs shall notify the Committee on 
        Veterans' Affairs of the Senate and the Committee on Veterans' 
        Affairs of the House of Representatives of such detail.
            (2) Matters to be included.--The notification required by 
        paragraph (1) shall include, with respect to a director of a 
        medical center who is detailed to a different position within 
        the Department, the following information:
                    (A) The location at which the director is detailed.
                    (B) The position title of the detail.
                    (C) The estimated time the director is expected to 
                be absent from their duties at the medical center.
                    (D) Such other information as the Secretary may 
                determine appropriate.
    (b) Appointment of Acting Director.--Not later than 120 days after 
detailing a director of a medical center of the Department to a 
different position within the Department, the Secretary shall appoint 
an individual as acting director of such medical center with all of the 
authority and responsibilities of the detailed director.
    (c) Update on Detail.--Not later than 120 days after detailing a 
director of a medical center of the Department to a different position 
within the Department, and not less frequently than every 30 days 
thereafter while the detail is in effect or while the director position 
at the medical center is vacant, the Secretary shall submit to the 
Committee on Veterans' Affairs of the Senate and the Committee on 
Veterans' Affairs of the House of Representatives an update regarding 
the status of the detail.
    (d) Return to Position or Reassignment.--
            (1) In general.--Except as provided in paragraph (2), not 
        later than 180 days after detailing a director of a medical 
        center of the Department to a different position within the 
        Department, for a reason other than an ongoing investigation or 
        administrative action with respect to the director, the 
        Secretary shall--
                    (A) return the individual to the position as 
                director of the medical center; or
                    (B) reassign the individual from the position as 
                director of the medical center and begin the process of 
                hiring a new director for such position.
            (2) Waiver.--
                    (A) In general.--The Secretary may waive the 
                requirement under paragraph (1) with respect to an 
                individual for successive 90-day increments for a total 
                period of not more than 540 days from the original date 
                the individual was detailed away from their position as 
                director of a medical center.
                    (B) Notification.--Not later than 30 days after 
                exercising a waiver under subparagraph (A), the 
                Secretary shall notify Congress of the waiver and 
                provide to Congress information as to why the waiver is 
                necessary.
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