[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4626 Referred in Senate (RFS)]
<DOC>
117th CONGRESS
1st Session
H. R. 4626
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
November 17, 2021
Received; read twice and referred to the Committee on Veterans' Affairs
_______________________________________________________________________
AN ACT
To amend title 38, United States Code, to require an independent
assessment of health care delivery systems and management processes of
the Department of Veterans Affairs be conducted once every 10 years,
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 ``VA Assessment by Independent
Measures Act'' or the ``VA AIM Act''.
SEC. 2. REQUIREMENT FOR ONGOING INDEPENDENT ASSESSMENTS OF HEALTH CARE
DELIVERY SYSTEMS AND MANAGEMENT PROCESSES OF THE
DEPARTMENT OF VETERANS AFFAIRS.
(a) Ongoing Assessments.--Chapter 17 of title 38, United States
Code, is amended by inserting after section 1704 the following new
section:
``Sec. 1704A. Independent assessments of health care delivery systems
and management processes
``(a) Independent Assessments.--Not less frequently than once every
10 years, the Secretary of Veterans Affairs shall enter into one or
more contracts with a private sector entity or entities described in
subsection (d) to conduct an independent assessment of the hospital
care, medical services, and other health care furnished by the
Department of Veterans Affairs. Such assessment shall address each of
the following:
``(1) Current and projected demographics and unique health
care needs of the patient population served by the Department.
``(2) The accuracy of models and forecasting methods used
by the Department to project health care demand, including with
respect to veteran demographics, rates of use of health care
furnished by the Department, the inflation of health care
costs, and such other factors as may be determined relevant by
the Secretary.
``(3) The reliability and accuracy of models and
forecasting methods used by the Department to project the
budgetary needs of the Veterans Health Administration and how
such models and forecasting methods inform budgetary trends.
``(4) The authorities and mechanisms under which the
Secretary may furnish hospital care, medical services, and
other health care at Department and non-Department facilities,
including through Federal and private sector partners and at
joint medical facilities, and the effect of such authorities
and mechanisms on eligibility and access to care.
``(5) The organization, workflow processes, and tools used
by the Department to support clinical staffing, access to care,
effective length-of-stay management and care transitions,
positive patient experience, accurate documentation, and
subsequent coding of inpatient services.
``(6) The efforts of the Department to recruit and retain
staff at levels necessary to carry out the functions of the
Veterans Health Administration and the process used by the
Department to determine staffing levels necessary for such
functions.
``(7) The staffing level at each medical facility of the
Department and the productivity of each health care provider at
the medical facility, compared with health care industry
performance metrics, which may include the following:
``(A) An assessment of the case load of, and number
of patients treated by, each health care provider at
such medical facility during an average week.
``(B) An assessment of the time spent by each such
health care provider on matters other than the case
load of the health care provider, including time spent
by the health care provider as follows:
``(i) At a medical facility that is
affiliated with the Department.
``(ii) Conducting research.
``(iii) Training or supervising other
health care professionals of the Department.
``(8) The information technology strategies of the
Department with respect to furnishing and managing health care,
including an identification of any weaknesses or opportunities
with respect to the technology used by the Department,
especially those strategies with respect to clinical
documentation of hospital care, medical services, and other
health care, including any clinical images and associated
textual reports, furnished by the Department in Department or
non-Department facilities.
``(9) Business processes of the Veterans Health
Administration, including processes relating to furnishing non-
Department health care, insurance identification, third-party
revenue collection, and vendor reimbursement, including an
identification of mechanisms as follows:
``(A) To avoid the payment of penalties to vendors.
``(B) To increase the collection of amounts owed to
the Department for hospital care, medical services, or
other health care provided by the Department, for which
reimbursement from a third party is authorized and to
ensure that such amounts collected are accurate.
``(C) To increase the collection of any other
amounts owed to the Department with respect to hospital
care, medical services, or other health care and to
ensure that such amounts collected are accurate.
``(D) To increase the accuracy and timeliness of
Department payments to vendors and providers.
``(E) To reduce expenditures while improving the
quality of care furnished.
``(10) The purchase, distribution, and use of
pharmaceuticals, medical and surgical supplies, medical
devices, and health care-related services by the Department,
including the following:
``(A) The prices paid for, standardization of, and
use by, the Department with respect to the following:
``(i) Pharmaceuticals.
``(ii) Medical and surgical supplies.
``(iii) Medical devices.
``(B) The use by the Department of group purchasing
arrangements to purchase pharmaceuticals, medical and
surgical supplies, medical devices, and health care-
related services.
``(C) The strategy and systems used by the
Department to distribute pharmaceuticals, medical and
surgical supplies, medical devices, and health care-
related services to Veterans Integrated Service
Networks and medical facilities of the Department.
``(11) The process of the Department for carrying out
construction and maintenance projects at medical facilities of
the Department and the medical facility leasing program of the
Department.
``(12) The competency of Department leadership with respect
to culture, accountability, reform readiness, leadership
development, physician alignment, employee engagement,
succession planning, and performance management.
``(13) The effectiveness of the authorities and programs of
the Department to educate and train health personnel pursuant
to section 7302 of this title.
``(14) The conduct of medical and prosthetic research of
the Department.
``(15) The provision of Department assistance to Federal
agencies and personnel involved in responding to a disaster or
emergency.
``(16) Such additional matters as may be determined
relevant by the Secretary.
``(b) Timing.--The private sector entity or entities carrying out
an assessment pursuant to subsection (a) shall complete such assessment
not later than one year after entering into the contract described in
such paragraph.
``(c) Data.--To the extent practicable, the private sector entity
or entities carrying out an assessment pursuant to subsection (a) shall
make use of existing data that has been compiled by the Department,
including data that has been collected for--
``(1) the performance of quadrennial market assessments
under section 7330C of this title;
``(2) the quarterly publication of information on staffing
and vacancies with respect to the Veterans Health
Administration pursuant to section 505 of the VA MISSION Act of
2018 (Public Law 115-182; 38 U.S.C. 301 note); and
``(3) the conduct of annual audits pursuant to section 3102
of the Johnny Isakson and David P. Roe, M.D. Veterans Health
Care and Benefits Improvement Act of 2020 (Public Law 116-315;
38 U.S.C. 1701 note).
``(d) Private Sector Entities Described.--A private sector entity
described in this subsection is a private entity that--
``(1) has experience and proven outcomes in optimizing the
performance of the health care delivery systems of the Veterans
Health Administration and the private sector and in health care
management; and
``(2) specializes in implementing large-scale
organizational and cultural transformations, especially with
respect to health care delivery systems.
``(e) Program Integrator.--(1) If the Secretary enters into
contracts with more than one private sector entity under subsection (a)
with respect to a single assessment under such subsection, the
Secretary shall designate one such entity that is predominately a
health care organization as the program integrator.
``(2) The program integrator designated pursuant to paragraph (1)
shall be responsible for coordinating the outcomes of the assessments
conducted by the private sector entities pursuant to such contracts.
``(f) Reports.--(1) Not later than 60 days after completing an
assessment pursuant to subsection (a), the private sector entity or
entities carrying out such assessment shall submit to the Secretary of
Veterans Affairs and the Committees on Veterans' Affairs of the House
of Representatives and the Senate a report on the findings and
recommendations of the private sector entity or entities with respect
to such assessment. Such report shall include an identification of the
following:
``(A) Any changes with respect to the matters included in
such assessment since the date that is the later of the
following:
``(i) The date on which the independent assessment
under section 201 of the Veterans Access, Choice, and
Accountability Act of 2014 (Public Law 113-146; 38
U.S.C. 1701 note) was completed.
``(ii) The date on which the last assessment under
subsection (a) was completed.
``(B) Any recommendations regarding matters to be covered
by subsequent assessments under subsection (a), including any
additional matters to include for assessment or previously
assessed matters to exclude.
``(2) Not later than 30 days after receiving a report under
paragraph (1), the Secretary shall publish such report in the Federal
Register and on a publicly accessible internet website of the
Department.
``(3) Not later than 90 days after receiving a report under
paragraph (1), the Secretary shall submit to the Committees on
Veterans' Affairs of the House of Representatives and the Senate a
report outlining the feasibility, and advisability, of implementing the
recommendations made by the private sector entity or entities in such
report received, including an identification of the timeline, cost, and
any legislative authorities necessary for such implementation.''.
(b) Clerical Amendments.--The table of sections at the beginning of
such chapter is amended by inserting after the item relating to section
1704 the following new item:
``1704A. Independent assessments of health care delivery systems and
management processes.''.
(c) Deadline for Initial Assessment.--The initial assessment under
section 1704A of title 38, United States Code, as added by subsection
(a), shall be completed by not later than December 31, 2025.
Passed the House of Representatives November 16, 2021.
Attest:
CHERYL L. JOHNSON,
Clerk.