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<bill bill-stage="Introduced-in-Senate" dms-id="A1" public-private="public" slc-id="S1-HEY23D06-8SG-MM-82P">
<metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
<dublinCore>
<dc:title>118 S2745 IS: Veterans Affairs Peer Review Neutrality Act of 2023</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2023-09-07</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
</dublinCore>
</metadata>
<form>
<distribution-code display="yes">II</distribution-code>
<congress>118th CONGRESS</congress><session>1st Session</session>
<legis-num>S. 2745</legis-num>
<current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber>
<action>
<action-date date="20230907">September 7, 2023</action-date>
<action-desc><sponsor name-id="S380">Mr. Peters</sponsor> (for himself and <cosponsor name-id="S343">Mr. Boozman</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSVA00">Committee on Veterans' Affairs</committee-name></action-desc>
</action>
<legis-type>A BILL</legis-type>
<official-title>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.</official-title>
</form>
<legis-body id="HAB3AA4710AA944D4A48B3253F0F45F61">
<section id="S1" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Veterans Affairs Peer Review Neutrality Act of 2023</short-title></quote>.</text></section> <section commented="no" display-inline="no-display-inline" id="idbc08cd67fdcb416e80d2dc7a3081e3cc"><enum>2.</enum><header>Elimination of conflicts of interest in peer review, administrative investigation boards, and factfindings of Veterans Health Administration</header> <subsection commented="no" display-inline="no-display-inline" id="id9703bf2f7ba64656aae9e71fe7f45de1"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text>Subchapter II of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/73">chapter 73</external-xref> of title 38, United States Code, is amended by inserting after <external-xref legal-doc="usc" parsable-cite="usc/38/7311A">section 7311A</external-xref> the following new section:</text>
<quoted-block style="USC" display-inline="no-display-inline" id="id04378D63E887471FBB193EA084313025">
<section commented="no" display-inline="no-display-inline" id="id995a43f15ee548ce9b24d43e11996ac8"><enum>7311B.</enum><header>Elimination of conflicts of interest in peer review, administrative investigation boards, and factfindings of Veterans Health Administration</header>
<subsection commented="no" display-inline="no-display-inline" id="id8e85b0d4a4974c7caf9758dbb87aa1bb"><enum>(a)</enum><header display-inline="yes-display-inline">Peer review</header>
<paragraph commented="no" display-inline="no-display-inline" id="id84c787638bb64a618351c228435222dd"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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—</text> <subparagraph commented="no" display-inline="no-display-inline" id="idf6fab26b927448f68a997164f4b871a4"><enum>(A)</enum><text display-inline="yes-display-inline">the individual has direct involvement with the care under review; or</text></subparagraph>
<subparagraph id="id520e05d5d39b4dba85de09c2bb3aadaf"><enum>(B)</enum><text>the individual is unable to conduct an objective, impartial, accurate, and informed review.</text></subparagraph></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="iddc2e57e2e9f34a3c8b9c9419aec730d0"><enum>(2)</enum><header>Neutral assessment of conduct of committee members</header><text>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. </text></paragraph></subsection>
<subsection id="id97aa50b3c3fe4f9aa3c08cc3da7a3b64"><enum>(b)</enum><header>Administrative investigation boards and factfindings</header>
<paragraph commented="no" display-inline="no-display-inline" id="idc31c61a6163e451aab34db2be22d4b6c"><enum>(1)</enum><header display-inline="yes-display-inline">Knowledge of confidential information</header><text>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—</text> <subparagraph commented="no" display-inline="no-display-inline" id="id5dc95a25480541d7b486ed8c9826e4bb"><enum>(A)</enum><text display-inline="yes-display-inline">serve on the administrative investigation board or as a factfinder; or</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="idb0c53d78128b40e891628edb87384405"><enum>(B)</enum><text display-inline="yes-display-inline">disclose such information to an administrative investigation board or a factfinder. </text></subparagraph></paragraph> <paragraph id="idfffab87394bc41b5b1fdba9ecefc9941"><enum>(2)</enum><header>Personal interest, involvement, or relationship</header> <subparagraph commented="no" display-inline="no-display-inline" id="idbb0eeabe3c8e491caaf2ca4154664019"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary shall ensure that each member of an administrative investigative board or factfinder does not have—</text>
<clause commented="no" display-inline="no-display-inline" id="id85270d8edae54033b97b6cef1ab71514"><enum>(i)</enum><text display-inline="yes-display-inline">any personal interest or other bias concerning the investigation being conducted;</text></clause> <clause commented="no" display-inline="no-display-inline" id="id0c4172976bef40a395c6bc8875b85453"><enum>(ii)</enum><text display-inline="yes-display-inline">direct involvement in matters being investigated; or</text></clause>
<clause id="id9238965f341843f4bb2c41a288b9e969"><enum>(iii)</enum><text>a supervisory or personal relationship with the subject of the investigation. </text></clause></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="id9e6c873440c248cc95425edf447624a6"><enum>(B)</enum><header>Recusal</header><text>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.</text></subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection commented="no" display-inline="no-display-inline" id="id6ea41aaf9ffe4d1996ca23468f0780a1"><enum>(b)</enum><header>Clerical amendment</header><text>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:</text> <quoted-block style="USC" id="id83d21eca-a21e-4976-81a6-fa39a8373186"> <toc> <toc-entry level="section" idref="id995a43f15ee548ce9b24d43e11996ac8">7311B. Elimination of conflicts of interest in peer review, administrative investigation boards, and factfindings of Veterans Health Administration.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section> <section id="id0b927affff504ede940ef654e6ee0218"><enum>3.</enum><header>Limitation on detail of directors of medical centers of Department of Veterans Affairs to different positions</header> <subsection id="id27A9B9DFD3394FB58D4BC27E21C331F2"><enum>(a)</enum><header>Notification</header> <paragraph id="id4A8D8FCE7A8244AF909B1CA01A795D47"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></paragraph>
<paragraph id="id259ee7348cb34d18b1e6b47f48f78e8c"><enum>(2)</enum><header>Matters To be included</header><text>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:</text> <subparagraph id="id062393EB6289491F85A2B1ED8DB4CB87"><enum>(A)</enum><text>The location at which the director is detailed.</text></subparagraph>
<subparagraph id="id4A6E562CCAC34975B3D6275620E2F4F3"><enum>(B)</enum><text>The position title of the detail.</text></subparagraph> <subparagraph id="idbf65a38ec73947e1909a6ceff76db066"><enum>(C)</enum><text>The estimated time the director is expected to be absent from their duties at the medical center. </text></subparagraph>
<subparagraph id="id7618C24EBC5A45EC83645635B11DFA6C"><enum>(D)</enum><text>Such other information as the Secretary may determine appropriate. </text></subparagraph></paragraph></subsection> <subsection id="id9476daeaf9194d3dbe261ba5b48d29b2"><enum>(b)</enum><header>Appointment of acting director</header><text>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. </text></subsection>
<subsection id="id6be305affc0b478a82ca4bbc28e0eea3"><enum>(c)</enum><header>Update on detail</header><text>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.</text></subsection> <subsection id="idbbded2acdaac4ad2ab08c178926249b3"><enum>(d)</enum><header>Return to position or reassignment</header> <paragraph id="id694E8D8370A0435FA2F8908074383CC6"><enum>(1)</enum><header>In general</header><text>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—</text>
<subparagraph id="idb99b7b01fe2f4e1ebab600151e39871a"><enum>(A)</enum><text>return the individual to the position as director of the medical center; or</text></subparagraph> <subparagraph id="idbc0575fa986b4e338ed0dd3faf11680c"><enum>(B)</enum><text>reassign the individual from the position as director of the medical center and begin the process of hiring a new director for such position. </text></subparagraph></paragraph>
<paragraph id="id9d7ec4866232457ebed8f1a427ac5e00"><enum>(2)</enum><header>Waiver</header>
<subparagraph id="idFFB93512A33B4F0ABBA8B70E210F28EC"><enum>(A)</enum><header>In general</header><text>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.</text></subparagraph> <subparagraph id="idA7344B5AE54F4B238126B55AA00A3875" commented="no" display-inline="no-display-inline"><enum>(B)</enum><header>Notification</header><text>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. </text></subparagraph></paragraph></subsection></section>
</legis-body>
</bill> 


