II
118THCONGRESS
1
STSESSION 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 posi-
tions, and for other purposes.
IN THE SENATE OF THE UNITED STATES
SEPTEMBER7, 2023
Mr. P
ETERS(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 admin-
istrative investigations by the Veterans Health Adminis-
tration 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 Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE. 3
This Act may be cited as the ‘‘Veterans Affairs Peer 4
Review Neutrality Act of 2023’’. 5
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SEC. 2. ELIMINATION OF CONFLICTS OF INTEREST IN PEER 1
REVIEW, ADMINISTRATIVE INVESTIGATION 2
BOARDS, AND FACTFINDINGS OF VETERANS 3
HEALTH ADMINISTRATION. 4
(a) I
NGENERAL.—Subchapter II of chapter 73 of 5
title 38, United States Code, is amended by inserting after 6
section 7311A the following new section: 7
‘‘§ 7311B. Elimination of conflicts of interest in peer 8
review, administrative investigation 9
boards, and factfindings of Veterans 10
Health Administration 11
‘‘(a) P
EERREVIEW.— 12
‘‘(1) I
N GENERAL.—Each individual responsible 13
for conducting peer review for quality management 14
of care provided by a health care provider at a med-15
ical facility of the Department and each member of 16
a peer review committee with respect to quality man-17
agement of such care shall withdraw from participa-18
tion in a case review if— 19
‘‘(A) the individual has direct involvement 20
with the care under review; or 21
‘‘(B) the individual is unable to conduct an 22
objective, impartial, accurate, and informed re-23
view. 24
‘‘(2) N
EUTRAL ASSESSMENT OF CONDUCT OF 25
COMMITTEE MEMBERS .—Each medical facility of the 26
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Department shall develop procedures and guidelines 1
for that facility to require that any initial peer re-2
view for quality management that is conducted with 3
respect to care provided by a health care provider 4
who is a member of the peer review committee for 5
that facility be evaluated, discussed, and assigned a 6
final level review by a neutral peer review committee 7
at another facility of the Department. 8
‘‘(b) A
DMINISTRATIVEINVESTIGATIONBOARDS AND 9
F
ACTFINDINGS.— 10
‘‘(1) K
NOWLEDGE OF CONFIDENTIAL INFORMA -11
TION.—Individuals with knowledge of confidential 12
quality assurance information specific to a matter 13
under investigation by an administrative investiga-14
tion board or factfinder with respect to quality man-15
agement of care provided by a health care provider 16
at a medical facility of the Department may not— 17
‘‘(A) serve on the administrative investiga-18
tion board or as a factfinder; or 19
‘‘(B) disclose such information to an ad-20
ministrative investigation board or a factfinder. 21
‘‘(2) P
ERSONAL INTEREST , INVOLVEMENT, OR 22
RELATIONSHIP.— 23
‘‘(A) I
N GENERAL.—The Secretary shall 24
ensure that each member of an administrative 25
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investigative board or factfinder does not 1
have— 2
‘‘(i) any personal interest or other 3
bias concerning the investigation being 4
conducted; 5
‘‘(ii) direct involvement in matters 6
being investigated; or 7
‘‘(iii) a supervisory or personal rela-8
tionship with the subject of the investiga-9
tion. 10
‘‘(B) R
ECUSAL.—If a potential member of 11
an administrative investigative board or 12
factfinder has a personal interest or other bias 13
concerning the investigation being conducted, 14
direct involvement in matters being inves-15
tigated, or a supervisory or personal relation-16
ship with the subject of the investigation, the 17
potential member shall inform the authority re-18
sponsible for the investigation and recuse them-19
selves from such matter.’’. 20
(b) C
LERICALAMENDMENT.—The table of sections 21
at the beginning of such subchapter is amended by insert-22
ing after the item relating to section 7311A the following 23
new item: 24
‘‘7311B. Elimination of conflicts of interest in peer review, administrative inves-
tigation boards, and factfindings of Veterans Health Adminis-
tration.’’.
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SEC. 3. LIMITATION ON DETAIL OF DIRECTORS OF MED-1
ICAL CENTERS OF DEPARTMENT OF VET-2
ERANS AFFAIRS TO DIFFERENT POSITIONS. 3
(a) N
OTIFICATION.— 4
(1) I
N GENERAL.—Not later than 90 days after 5
detailing a director of a medical center of the De-6
partment of Veterans Affairs to a different position 7
within the Department, the Secretary of Veterans 8
Affairs shall notify the Committee on Veterans’ Af-9
fairs of the Senate and the Committee on Veterans’ 10
Affairs of the House of Representatives of such de-11
tail. 12
(2) M
ATTERS TO BE INCLUDED .—The notifica-13
tion required by paragraph (1) shall include, with re-14
spect to a director of a medical center who is de-15
tailed to a different position within the Department, 16
the following information: 17
(A) The location at which the director is 18
detailed. 19
(B) The position title of the detail. 20
(C) The estimated time the director is ex-21
pected to be absent from their duties at the 22
medical center. 23
(D) Such other information as the Sec-24
retary may determine appropriate. 25
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(b) APPOINTMENT OFACTINGDIRECTOR.—Not later 1
than 120 days after detailing a director of a medical cen-2
ter of the Department to a different position within the 3
Department, the Secretary shall appoint an individual as 4
acting director of such medical center with all of the au-5
thority and responsibilities of the detailed director. 6
(c) U
PDATE ONDETAIL.—Not later than 120 days 7
after detailing a director of a medical center of the De-8
partment to a different position within the Department, 9
and not less frequently than every 30 days thereafter while 10
the detail is in effect or while the director position at the 11
medical center is vacant, the Secretary shall submit to the 12
Committee on Veterans’ Affairs of the Senate and the 13
Committee on Veterans’ Affairs of the House of Rep-14
resentatives an update regarding the status of the detail. 15
(d) R
ETURN TOPOSITION ORREASSIGNMENT.— 16
(1) I
N GENERAL.—Except as provided in para-17
graph (2), not later than 180 days after detailing a 18
director of a medical center of the Department to a 19
different position within the Department, for a rea-20
son other than an ongoing investigation or adminis-21
trative action with respect to the director, the Sec-22
retary shall— 23
(A) return the individual to the position as 24
director of the medical center; or 25
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(B) reassign the individual from the posi-1
tion as director of the medical center and begin 2
the process of hiring a new director for such po-3
sition. 4
(2) W
AIVER.— 5
(A) I
N GENERAL.—The Secretary may 6
waive the requirement under paragraph (1) 7
with respect to an individual for successive 90- 8
day increments for a total period of not more 9
than 540 days from the original date the indi-10
vidual was detailed away from their position as 11
director of a medical center. 12
(B) N
OTIFICATION.—Not later than 30 13
days after exercising a waiver under subpara-14
graph (A), the Secretary shall notify Congress 15
of the waiver and provide to Congress informa-16
tion as to why the waiver is necessary. 17
Æ
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