II 

Calendar No. 537 

116TH CONGRESS 

2D SESSION S. 629 

To require the Secretary of Veterans Affairs to review the processes and 

requirements of the Department of Veterans Affairs for scheduling appointments for health care and conducting consultations under the laws 

administered by the Secretary, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 28, 2019 

Mr. TESTER (for himself, Mrs. MURRAY, Mr. BLUMENTHAL, Mr. BROWN, and 

Ms. DUCKWORTH) introduced the following bill; which was read twice and 

referred to the Committee on Veterans’ Affairs 

SEPTEMBER 15, 2020 

Reported by Mr. MORAN, with an amendment 

[Strike out all after the enacting clause and insert the part printed in italic] 

A BILL 

To require the Secretary of Veterans Affairs to review the 

processes and requirements of the Department of Veterans Affairs for scheduling appointments for health care 

and conducting consultations under the laws administered by the Secretary, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


kjohnson on DSK79L0C42PROD with BILLS
2 

•S 629 RS

1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Accountability in De3 partment of Veterans Affairs Scheduling and Consult 

4 Management Act’’. 

5 SEC. 2. PROCESSES AND REQUIREMENTS FOR SCHED6 ULING APPOINTMENTS FOR HEALTH CARE 

7 FROM DEPARTMENT OF VETERANS AFFAIRS. 

8 (a) PROCESSES AND REQUIREMENTS.— 

9 (1) IN GENERAL.—Not later than 60 days after 

10 the date of the enactment of this Act, the Secretary 

11 of Veterans Affairs shall submit to the Committee 

12 on Veterans’ Affairs of the Senate and the Com13 mittee on Veterans’ Affairs of the House of Rep14 resentatives a description of the processes and re15 quirements of the Department of Veterans Affairs 

16 for scheduling appointments for health care from the 

17 Department at the medical facility level. 

18 (2) PERIODIC REVISION.— 

19 (A) IN GENERAL.—The Secretary may re20 vise the processes and requirements required 

21 under paragraph (1) as the Secretary considers 

22 necessary. 

23 (B) SUBMITTAL TO CONGRESS.—Not later 

24 than 30 days before revising the processes and 

25 requirements under subparagraph (A), the Sec26 retary shall submit to the Committee on VetVerDate Sep 11 2014 00:32 Sep 16, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6401 E:\BILLS\S629.RS S629

kjohnson on DSK79L0C42PROD with BILLS
3 

•S 629 RS

1 erans’ Affairs of the Senate and the Committee 

2 on Veterans’ Affairs of the House of Represent3 ative a description of those revised processes 

4 and requirements, including a description of 

5 any modifications to the certification and train6 ing under subsection (b). 

7 (b) TRAINING ON PROCESSES AND REQUIRE8 MENTS.— 

9 (1) CERTIFICATION.—Not later than one year 

10 after the date of the enactment of this Act, the Sec11 retary shall require individuals involved in the sched12 uling of appointments for health care from the De13 partment to certify to the Secretary that the indi14 vidual understands the processes and requirements 

15 described in subsection (a), including the maximum 

16 number of days allowed to complete each step of the 

17 scheduling process. 

18 (2) NEW EMPLOYEES.—The Secretary shall re19 quire all employees hired by the Department after 

20 the date of the enactment of this Act who are to be 

21 involved in the scheduling of appointments for health 

22 care from the Department to undergo training on 

23 the processes and requirements described in sub24 section (a) as part of the onboarding process. 

25 (c) METHOD TO MONITOR COMPLIANCE.— 


kjohnson on DSK79L0C42PROD with BILLS
4 

•S 629 RS

1 (1) IN GENERAL.—Not later than 180 days 

2 after the date of the enactment of this Act, the Sec3 retary shall establish or maintain a method or tool 

4 to enable real-time monitoring of and ensure that 

5 each medical facility of the Department complies 

6 with the scheduling processes and requirements de7 scribed in subsection (a), including compliance with 

8 policies of the Department relating to the maximum 

9 number of days allowed to complete each step of the 

10 scheduling process. 

11 (2) USE THROUGHOUT DEPARTMENT.— 

12 (A) IN GENERAL.—The Secretary shall re13 quire each medical facility of the Department to 

14 use the method or tool described in paragraph 

15 (1). 

16 (B) CERTIFICATION.—Not later than one 

17 year after the date of the enactment of this Act, 

18 the Secretary shall require the director of each 

19 medical facility of the Department to certify to 

20 the Secretary that the director is using the 

21 method or tool described in paragraph (1). 

22 (d) COMPTROLLER GENERAL REPORT.—Not later 

23 than two years after the date of the enactment of this Act, 

24 the Comptroller General of the United States shall submit 

25 to the Committee on Veterans’ Affairs of the Senate and 


kjohnson on DSK79L0C42PROD with BILLS
5 

•S 629 RS

1 the Committee on Veterans’ Affairs of the House of Rep2 resentatives a report on the compliance of the Secretary 

3 with the requirements of this section. 

4 SEC. 3. AUDITS REGARDING SCHEDULING OF APPOINT5 MENTS AND MANAGEMENT OF CONSULTA6 TIONS FOR HEALTH CARE FROM DEPART7 MENT OF VETERANS AFFAIRS. 

8 (a) IN GENERAL.—Not later than one year after the 

9 date of the enactment of this Act, and not less frequently 

10 than annually thereafter, the Secretary of Veterans Af11 fairs shall provide for the conduct of facility-level audits 

12 of the scheduling of appointments and the management 

13 of consultations for health care under the laws adminis14 tered by the Secretary. 

15 (b) ELEMENTS.—Each audit conducted under sub16 section (a) shall include the following: 

17 (1) With respect to each medical center of the 

18 Department of Veterans Affairs, an assessment of 

19 any scheduling or consultation management issues 

20 at that medical center, including the following: 

21 (A) An assessment of non-compliance with 

22 policies of the Veterans Health Administration 

23 relating to scheduling appointments and man24 aging consultations. 


kjohnson on DSK79L0C42PROD with BILLS
6 

•S 629 RS

1 (B) An assessment of the extent to which 

2 appointments or consultations are not timely 

3 processed. 

4 (C) A description of any backlogs in ap5 pointments or consultations that are awaiting 

6 action. 

7 (D) An assessment of whether consulta8 tions are appropriately processed. 

9 (E) Data with respect to consultations as 

10 follows: 

11 (i) Consultations that were scheduled 

12 within the request window. 

13 (ii) Duplicate consultation requests. 

14 (iii) Consultations that were discon15 tinued. 

16 (iv) Delays in consultations. 

17 (v) Consultations that were not prop18 erly closed or discontinued, including a de19 scription of remediation attempts. 

20 (F) A review for accuracy with respect to 

21 consultation management as follows: 

22 (i) A review of the accuracy of the 

23 type of service, either administrative or 

24 clinical, that is inputted in the electronic 

25 health record. 


kjohnson on DSK79L0C42PROD with BILLS
7 

•S 629 RS

1 (ii) A review of the accuracy of the 

2 type of consultation setting, either impa3 tient or outpatient, that is inputted in the 

4 electronic health record. 

5 (iii) A review of the appropriateness 

6 of the level of urgency of the consultation 

7 that is inputted in the electronic health 

8 record. 

9 (iv) A review of any delayed or unre10 solved consultations. 

11 (2) An identification of such recommendations 

12 for corrective action as the Secretary considers nec13 essary, including additional training, increased per14 sonnel, and other resources. 

15 (3) A certification that the director of each 

16 medical center of the Department is in compliance 

17 with the processes and requirements described in 

18 section 2(a) and such other requirements relating to 

19 the scheduling of appointments and management of 

20 consultations as the Secretary considers appropriate. 

21 (4) With respect to referrals for health care be22 tween health care providers or facilities of the De23 partment, a measurement of, for each medical facil24 ity of the Department, the time it takes from the 

25 date that a clinician of the Department determines 


kjohnson on DSK79L0C42PROD with BILLS
8 

•S 629 RS

1 that a veteran requires care from another health 

2 care provider or facility to each of the following: 

3 (A) The date that the referral for care is 

4 sent to the other health care provider or facil5 ity. 

6 (B) The date that the other health care 

7 provider or facility accepts the referral. 

8 (C) The date that the appointment with 

9 the other health care provider or at the other 

10 facility is made. 

11 (D) The date of the appointment with the 

12 other health care provider or at the other facil13 ity. 

14 (E) Any other step that the Secretary de15 termines necessary to measure. 

16 (c) CONDUCT OF AUDIT BY THIRD PARTY.—Each 

17 audit conducted under subsection (a) with respect to a 

18 medical facility of the Department shall be conducted by 

19 an individual or entity that is not affiliated with the facil20 ity. 

21 (d) TRANSMITTAL TO VHA.—Each audit conducted 

22 under subsection (a) shall be transmitted to the Under 

23 Secretary for Health of the Department so that the Under 

24 Secretary can— 


kjohnson on DSK79L0C42PROD with BILLS
9 

•S 629 RS

1 (1) strengthen oversight of the scheduling of 

2 appointments and management of consultations 

3 throughout the Department; 

4 (2) monitor national policy on such scheduling 

5 and management; 

6 (3) determine if a mobile deployment team fur7 nished under the pilot program established under 

8 section 402 of the VA MISSION Act of 2018 (Pub9 lic Law 115–182) is warranted; and 

10 (4) develop a remediation plan to address issues 

11 uncovered by those audits. 

12 (e) ANNUAL REPORT.— 

13 (1) IN GENERAL.—Not later than December 31 

14 of each year, the Secretary shall submit to the Com15 mittee on Veterans’ Affairs of the Senate and the 

16 Committee on Veterans’ Affairs of the House of 

17 Representatives a report on the audits conducted 

18 under subsection (a) during the year ending on that 

19 date. 

20 (2) ELEMENTS.—The Secretary shall include in 

21 each report required by paragraph (1)— 

22 (A) a description of the audits conducted 

23 under subsection (a) with respect to each facil24 ity of the Department; 


kjohnson on DSK79L0C42PROD with BILLS
10 

•S 629 RS

1 (B) an assessment of how the Department 

2 strengthened oversight of the scheduling of ap3 pointments and management of consultations at 

4 that facility as a result of those audits; 

5 (C) an assessment of how those audits in6 formed the national policy of the Department 

7 with respect to the scheduling of appointments 

8 and management of consultations; and 

9 (D) a description of any remediation plans 

10 to address issues raised by those audits that 

11 were completed. 

12 SEC. 4. ADMINISTRATION OF NON-DEPARTMENT OF VET13 ERANS AFFAIRS HEALTH CARE. 

14 (a) CERTIFICATION OF PROPER ADMINISTRATION.— 

15 (1) REVIEW.— 

16 (A) IN GENERAL.—The Secretary of Vet17 erans Affairs shall conduct a review of the 

18 staffing, training, and other requirements nec19 essary to administer section 101 of the Vet20 erans Access, Choice, and Accountability Act of 

21 2014 (Public Law 113–146; 38 U.S.C. 1701 

22 note), section 1703 of title 38, United States 

23 Code (as in effect on the date specified in sec24 tion 101(b) of the Caring for Our Veterans Act 

25 of 2018 (title I of Public Law 115–182)), and 


kjohnson on DSK79L0C42PROD with BILLS
11 

•S 629 RS

1 any other community care program of the De2 partment of Veterans Affairs. 

3 (B) ELEMENTS.—The review conducted 

4 under paragraph (1) shall include, with respect 

5 to each medical facility of the Department— 

6 (i) an assessment of the type of posi7 tions required to be staffed at the medical 

8 facility; 

9 (ii) the number of such positions au10 thorized; 

11 (iii) the number of such positions 

12 filled; and 

13 (iv) the number of additional such po14 sitions required to be authorized. 

15 (2) CERTIFICATION.—Not later than 180 days 

16 after the date of the enactment of this Act, and 

17 every 180 days thereafter, the Secretary of Veterans 

18 Affairs shall submit to the Committee on Veterans’ 

19 Affairs of the Senate and the Committee on Vet20 erans’ Affairs of the House of Representatives the 

21 results of the review conducted under paragraph (1), 

22 including a certification that all staffing, training, 

23 and other requirements described in paragraph 

24 (1)(A) are fulfilled. 

25 (b) SCHEDULING OF APPOINTMENTS.— 


kjohnson on DSK79L0C42PROD with BILLS
12 

•S 629 RS

1 (1) IN GENERAL.—The Secretary shall be re2 sponsible for ensuring that appointments for health 

3 care from non-Department health care providers 

4 under the laws administered by the Secretary are 

5 scheduled. 

6 (2) TIMELINESS GOALS.—Not later than 30 

7 days after the date of the enactment of this Act, the 

8 Secretary shall establish timeliness goals for each 

9 step in scheduling an appointment for health care 

10 from a non-Department health care provider set 

11 forth under subparagraphs (A) through (F) of para12 graph (3). 

13 (3) MEASUREMENT OF TIMELINESS FOR EACH

14 FACILITY.—Not later than 120 days after the date 

15 of the enactment of this Act, the Secretary shall 

16 measure, for each medical facility of the Depart17 ment, the time it takes from the date that a clinician 

18 of the Department determines that a veteran re19 quires care from a non-Department health care pro20 vider to each of the following: 

21 (A) The date that the referral for care is 

22 sent to the non-Department health care pro23 vider. 

24 (B) The date that the non-Department 

25 health care provider accepts the referral. 


kjohnson on DSK79L0C42PROD with BILLS
13 

•S 629 RS

1 (C) The date that the appointment with 

2 the non-Department health care provider is 

3 made. 

4 (D) The date that the appointment with 

5 the non-Department health care provider oc6 curs. 

7 (E) The date that the referral to the non8 Department health care provider is completed. 

9 (F) Any other step that the Secretary de10 termines necessary to measure. 

11 (4) PUBLICATION OF DATA.— 

12 (A) IN GENERAL.—Not later than one year 

13 after the date of the enactment of this Act, the 

14 Secretary shall publish the data measured 

15 under paragraph (3), disaggregated by medical 

16 facility, on a publicly available Internet website 

17 of the Department. 

18 (B) UPDATE.—Not less frequently than bi19 weekly, the Secretary shall update the data 

20 published under subparagraph (A). 

21 (c) COMPTROLLER GENERAL REPORT.— 

22 (1) REVIEW.—Beginning not later than one 

23 year after the date of the enactment of this Act, the 

24 Comptroller General of the United States shall re25 view compliance by the Secretary with the requireVerDate Sep 11 2014 00:32 Sep 16, 2020 Jkt 099200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6401 E:\BILLS\S629.RS S629

kjohnson on DSK79L0C42PROD with BILLS
14 

•S 629 RS

1 ments of this section, including a review of the valid2 ity and reliability of data published by the Secretary 

3 under subsection (b)(4). 

4 (2) COMPLETION.—Not later than three years 

5 after the date of the enactment of this Act, the 

6 Comptroller General shall submit to the Committee 

7 on Veterans’ Affairs of the Senate and the Com8 mittee on Veterans’ Affairs of the House of Rep9 resentatives the results of the review conducted 

10 under paragraph (1). 

11 SEC. 5. REQUESTS FOR MOBILE DEPLOYMENT TEAMS BY 

12 DIRECTORS OF MEDICAL CENTERS OF DE13 PARTMENT OF VETERANS AFFAIRS. 

14 (a) IN GENERAL.—A director of a medical center of 

15 the Department of Veterans Affairs shall request from the 

16 Secretary of Veterans Affairs a mobile deployment team 

17 under the pilot program established under section 402 of 

18 the VA MISSION Act of 2018 (Public Law 115–182) if 

19 requirements of the Department under sections 2 and 4 

20 have not been met with respect to a facility under the ju21 risdiction of the director. 

22 (b) REPORT.—Not less frequently than once every 

23 180 days, the Secretary shall submit to the appropriate 

24 committees of Congress a report setting forth each request 

25 under subsection (a) during the period covered by the reVerDate Sep 11 2014 00:32 Sep 16, 2020 Jkt 099200 PO 00000 Frm 00014 Fmt 6652 Sfmt 6401 E:\BILLS\S629.RS S629

kjohnson on DSK79L0C42PROD with BILLS
15 

•S 629 RS

1 port, including an explanation of why a mobile deployment 

2 team was or was not provided, as the case may be. 

3 (c) APPROPRIATE COMMITTEES OF CONGRESS DE4 FINED.—In this section, the term ‘‘appropriate commit5 tees of Congress’’ means— 

6 (1) the Committee on Veterans’ Affairs and the 

7 Committee on Appropriations of the Senate; and 

8 (2) the Committee on Veterans’ Affairs and the 

9 Committee on Appropriations of the House of Rep10 resentatives. 

11 SEC. 6. EXAMINATION OF HEALTH CARE CONSULTATION 

12 AND SCHEDULING POSITIONS OF DEPART13 MENT OF VETERANS AFFAIRS. 

14 (a) PROPER GRADING OF CONSULTATION AND

15 SCHEDULING POSITIONS.— 

16 (1) IN GENERAL.—The Secretary of Veterans 

17 Affairs shall conduct an examination of health care 

18 positions of the Department of Veterans Affairs to 

19 determine whether health care positions involved in 

20 the consultation and scheduling processes are appro21 priately graded. 

22 (2) CONSULTATION.—In conducting the exam23 ination under paragraph (1), the Secretary shall 

24 consult with health care staffing experts in the Fed25 eral Government and the private sector. 


kjohnson on DSK79L0C42PROD with BILLS
16 

•S 629 RS

1 (3) SUBMITTAL TO CONGRESS.—Not later than 

2 120 days after the date of the enactment of this Act, 

3 the Secretary shall submit to the appropriate com4 mittees of Congress the results of the examination 

5 conducted under paragraph (1). 

6 (b) REVIEW OF ONBOARDING PROCESS.—Not later 

7 than 180 days after the date of the enactment of this Act, 

8 the Secretary shall submit to the appropriate committees 

9 of Congress— 

10 (1) a review of the onboarding process of indi11 viduals in health care positions described in sub12 section (a), including how long it takes to hire those 

13 individuals; and 

14 (2) a description of any changes that the Sec15 retary has made or plans to make to improve that 

16 process. 

17 (c) APPROPRIATE COMMITTEES OF CONGRESS DE18 FINED.—In this section, the term ‘‘appropriate commit19 tees of Congress’’ means— 

20 (1) the Committee on Veterans’ Affairs and the 

21 Committee on Appropriations of the Senate; and 

22 (2) the Committee on Veterans’ Affairs and the 

23 Committee on Appropriations of the House of Rep24 resentatives. 


kjohnson on DSK79L0C42PROD with BILLS
17 

•S 629 RS

1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Accountability in De3 partment of Veterans Affairs Scheduling and Consult Man4 agement Act’’. 

5 SEC. 2. PROCESS AND REQUIREMENTS FOR SCHEDULING 

6 APPOINTMENTS FOR HEALTH CARE FROM DE7 PARTMENT OF VETERANS AFFAIRS. 

8 (a) PROCESS AND REQUIREMENTS.— 

9 (1) IN GENERAL.—Not later than 60 days after 

10 the date of the enactment of this Act, the Secretary of 

11 Veterans Affairs shall— 

12 (A) establish a process and requirements for 

13 scheduling appointments for health care from the 

14 Department of Veterans Affairs; and 

15 (B) submit to the Committee on Veterans’ 

16 Affairs of the Senate and the Committee on Vet17 erans’ Affairs of the House of Representatives a 

18 description of such process and requirements. 

19 (2) ELEMENTS OF DESCRIPTION.—The descrip20 tion of the process and requirements for scheduling 

21 appointments for health care from the Department re22 quired to be submitted under paragraph (1)(B) shall 

23 include— 

24 (A) information on how such process and 

25 requirements take into account the access standVerDate Sep 11 2014 00:32 Sep 16, 2020 Jkt 099200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6203 E:\BILLS\S629.RS S629

kjohnson on DSK79L0C42PROD with BILLS
18 

•S 629 RS

1 ards established under section 1703B of title 38, 

2 United States Code; and 

3 (B) the maximum number of days allowed 

4 to complete each step of such process. 

5 (3) PERIODIC REVISION.— 

6 (A) IN GENERAL.—The Secretary may re7 vise the process and requirements required under 

8 paragraph (1) as the Secretary considers nec9 essary. 

10 (B) SUBMITTAL TO CONGRESS.—Not later 

11 than 30 days before revising the process and re12 quirements under subparagraph (A), the Sec13 retary shall submit to the Committee on Vet14 erans’ Affairs of the Senate and the Committee 

15 on Veterans’ Affairs of the House of Representa16 tives a description of such revised process and re17 quirements, including a description of any modi18 fications to the certification and training under 

19 subsection (b). 

20 (b) CERTIFICATION AND TRAINING ON PROCESS AND

21 REQUIREMENTS.— 

22 (1) CERTIFICATION.—Not later than one year 

23 after the date of the enactment of this Act, the Sec24 retary shall require individuals involved in the sched25 uling of appointments for health care from the DeVerDate Sep 11 2014 00:32 Sep 16, 2020 Jkt 099200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6203 E:\BILLS\S629.RS S629

kjohnson on DSK79L0C42PROD with BILLS
19 

•S 629 RS

1 partment, including schedulers, clinical coordinators, 

2 and supervisors, to certify to the Secretary that the 

3 individual understands the process and requirements 

4 established under subsection (a), including the max5 imum number of days allowed to complete each step 

6 of such process. 

7 (2) NEW EMPLOYEES.—The Secretary shall re8 quire all employees hired by the Department on or 

9 after the date of the enactment of this Act who are to 

10 be involved in the scheduling of appointments for 

11 health care from the Department— 

12 (A) to undergo training on the process and 

13 requirements established under subsection (a) as 

14 part of training for the position for which they 

15 have been hired; and 

16 (B) to make the certification to the Sec17 retary required under paragraph (1). 

18 (c) METHOD TO MONITOR COMPLIANCE.— 

19 (1) IN GENERAL.—Not later than 180 days after 

20 the date of the enactment of this Act, the Secretary 

21 shall establish or maintain a method or tool— 

22 (A) to enable monitoring of the compliance 

23 of the Department with the process and require24 ments established under subsection (a), including 

25 compliance with policies of the Department reVerDate Sep 11 2014 00:32 Sep 16, 2020 Jkt 099200 PO 00000 Frm 00019 Fmt 6652 Sfmt 6203 E:\BILLS\S629.RS S629

kjohnson on DSK79L0C42PROD with BILLS
20 

•S 629 RS

1 lating to the maximum number of days allowed 

2 to complete each step of such process; and 

3 (B) to ensure that each medical facility of 

4 the Department complies with such process and 

5 requirements. 

6 (2) USE THROUGHOUT DEPARTMENT.— 

7 (A) IN GENERAL.—The Secretary shall re8 quire each medical facility of the Department to 

9 use the method or tool described in paragraph 

10 (1). 

11 (B) REPORT.—Not later than one year after 

12 the date of the enactment of this Act, the Sec13 retary shall submit to the Committee on Vet14 erans’ Affairs of the Senate and the Committee 

15 on Veterans’ Affairs of the House of Representa16 tives a report indicating whether each medical 

17 facility of the Department is using the method or 

18 tool described in paragraph (1). 

19 (d) COMPTROLLER GENERAL REPORT.—Not later than 

20 two years after the date of the enactment of this Act, the 

21 Comptroller General of the United States shall submit to 

22 the Committee on Veterans’ Affairs of the Senate and the 

23 Committee on Veterans’ Affairs of the House of Representa24 tives a report on the compliance of the Secretary with the 

25 requirements of this section. 


kjohnson on DSK79L0C42PROD with BILLS
21 

•S 629 RS

1 SEC. 3. AUDITS REGARDING SCHEDULING OF APPOINT2 MENTS AND MANAGEMENT OF CONSULTA3 TIONS FOR HEALTH CARE FROM DEPART4 MENT OF VETERANS AFFAIRS. 

5 (a) IN GENERAL.—Not later than each of one year and 

6 two years after the date of the enactment of this Act, the 

7 Secretary of Veterans Affairs shall provide for the conduct 

8 of a facility-level audit of the scheduling of appointments 

9 and the management of consultations for health care under 

10 the laws administered by the Secretary. 

11 (b) APPLICATION.— 

12 (1) FIRST AUDIT.—The first audit required 

13 under subsection (a) shall apply to each medical facil14 ity of the Department of Veterans Affairs. 

15 (2) SECOND AUDIT.—The second audit required 

16 under subsection (a) shall apply to only those medical 

17 facilities of the Department that did not fare well in 

18 the first audit and are in need of corrective action, 

19 as determined by the Secretary. 

20 (c) ELEMENTS.—Each audit conducted under sub21 section (a) shall include the following: 

22 (1) With respect to each medical center of the 

23 Department covered by the audit, an assessment of 

24 any scheduling or consultation management issues at 

25 that medical center, including the following: 


kjohnson on DSK79L0C42PROD with BILLS
22 

•S 629 RS

1 (A) An assessment of noncompliance with 

2 policies of the Veterans Health Administration 

3 relating to scheduling appointments and man4 aging consultations. 

5 (B) An assessment of the extent to which 

6 appointments or consultations are not timely 

7 processed. 

8 (C) A description of any backlogs in ap9 pointments or consultations that are awaiting 

10 action. 

11 (D) An assessment of whether consultations 

12 are appropriately processed. 

13 (E) Data with respect to consultations as 

14 follows: 

15 (i) Consultations that were scheduled 

16 within the request window. 

17 (ii) Duplicate consultation requests. 

18 (iii) Consultations that were discon19 tinued. 

20 (iv) Delays in consultations. 

21 (v) Consultations that were not prop22 erly closed or discontinued, including a de23 scription of remediation attempts. 

24 (F) A review for accuracy with respect to 

25 consultation management as follows: 


kjohnson on DSK79L0C42PROD with BILLS
23 

•S 629 RS

1 (i) A review of the accuracy of the type 

2 of service, either administrative or clinical, 

3 that is inputted in the electronic health 

4 record. 

5 (ii) A review of the accuracy of the 

6 type of consultation setting, either impa7 tient or outpatient, that is inputted in the 

8 electronic health record. 

9 (iii) A review of the appropriateness of 

10 the level of urgency of the consultation that 

11 is inputted in the electronic health record. 

12 (iv) A review of any delayed or unre13 solved consultations. 

14 (2) An identification of such recommendations 

15 for corrective action as the Secretary considers nec16 essary, including additional training, increased per17 sonnel, and other resources. 

18 (3) A certification that the director of each med19 ical center of the Department covered by the audit is 

20 in compliance with the process and requirements es21 tablished under section 2(a) and such other require22 ments relating to the scheduling of appointments and 

23 management of consultations as the Secretary con24 siders appropriate. 


kjohnson on DSK79L0C42PROD with BILLS
24 

•S 629 RS

1 (4) With respect to referrals for health care be2 tween health care providers or facilities of the Depart3 ment, a measurement of, for each medical facility of 

4 the Department covered by the audit, the time it takes 

5 from the date that a clinician of the Department de6 termines that a veteran requires care from another 

7 health care provider or facility to each of the fol8 lowing: 

9 (A) The date that the referral for care is 

10 sent to the other health care provider or facility. 

11 (B) The date that the other health care pro12 vider or facility accepts the referral. 

13 (C) The date that the appointment with the 

14 other health care provider or at the other facility 

15 is made. 

16 (D) The date of the appointment with the 

17 other health care provider or at the other facility. 

18 (E) Any other step that the Secretary deter19 mines necessary to measure. 

20 (d) CONDUCT OF AUDIT BY THIRD PARTY.—Each 

21 audit conducted under subsection (a) with respect to a med22 ical facility of the Department shall be conducted by an 

23 individual or entity that is not affiliated with the facility. 

24 (e) TRANSMITTAL TO VHA.—Each audit conducted 

25 under subsection (a) shall be transmitted to the Under SecVerDate Sep 11 2014 00:32 Sep 16, 2020 Jkt 099200 PO 00000 Frm 00024 Fmt 6652 Sfmt 6203 E:\BILLS\S629.RS S629

kjohnson on DSK79L0C42PROD with BILLS
25 

•S 629 RS

1 retary for Health of the Department so that the Under Sec2 retary can— 

3 (1) strengthen oversight of the scheduling of ap4 pointments and management of consultations 

5 throughout the Department; 

6 (2) monitor national policy on such scheduling 

7 and management; and 

8 (3) develop a remediation plan to address issues 

9 uncovered by those audits. 

10 (f) ANNUAL REPORT.— 

11 (1) IN GENERAL.—Not later than December 31 of 

12 each year in which an audit is conducted under sub13 section (a), the Secretary shall submit to the Com14 mittee on Veterans’ Affairs of the Senate and the 

15 Committee on Veterans’ Affairs of the House of Rep16 resentatives a report on the audit conducted during 

17 that year. 

18 (2) ELEMENTS.—The Secretary shall include in 

19 each report required by paragraph (1)— 

20 (A) a description of the audits conducted 

21 under subsection (a) with respect to each facility 

22 of the Department covered by such audits; 

23 (B) an assessment of how the Department 

24 strengthened oversight of the scheduling of apVerDate Sep 11 2014 00:32 Sep 16, 2020 Jkt 099200 PO 00000 Frm 00025 Fmt 6652 Sfmt 6203 E:\BILLS\S629.RS S629

kjohnson on DSK79L0C42PROD with BILLS
26 

•S 629 RS

1 pointments and management of consultations at 

2 that facility as a result of those audits; 

3 (C) an assessment of how those audits in4 formed the national policy of the Department 

5 with respect to the scheduling of appointments 

6 and management of consultations; and 

7 (D) a description of any remediation plans 

8 to address issues raised by those audits that were 

9 completed. 

10 SEC. 4. ADMINISTRATION OF NON-DEPARTMENT OF VET11 ERANS AFFAIRS HEALTH CARE. 

12 (a) CERTIFICATION OF PROPER ADMINISTRATION OF

13 NON-DEPARTMENT CARE.— 

14 (1) REVIEW.— 

15 (A) IN GENERAL.—The Secretary of Vet16 erans Affairs shall conduct a review of the staff17 ing, training, and other requirements necessary 

18 to administer section 1703 of title 38, United 

19 States Code. 

20 (B) ELEMENTS.—The review conducted 

21 under subparagraph (A) shall include, with re22 spect to each medical facility of the Depart23 ment— 


kjohnson on DSK79L0C42PROD with BILLS
27 

•S 629 RS

1 (i) an assessment of the type of posi2 tions required to be staffed at the medical 

3 facility; 

4 (ii) the number of such positions au5 thorized; 

6 (iii) the number of such positions 

7 filled; and 

8 (iv) the number of additional such po9 sitions required to be authorized. 

10 (2) SUBMITTAL TO CONGRESS.—Not later than 

11 180 days after the date of the enactment of this Act, 

12 and every 180 days thereafter, the Secretary shall 

13 submit to the Committee on Veterans’ Affairs of the 

14 Senate and the Committee on Veterans’ Affairs of the 

15 House of Representatives— 

16 (A) the results of the review conducted 

17 under paragraph (1); and 

18 (B) a certification that the Secretary has es19 tablished all staffing, training, and other re20 quirements required to be reviewed under such 

21 paragraph. 

22 (b) SCHEDULING OF APPOINTMENTS.— 

23 (1) IN GENERAL.—The Secretary shall be respon24 sible for ensuring that appointments for health care 

25 from non-Department of Veterans Affairs health care 


kjohnson on DSK79L0C42PROD with BILLS
28 

•S 629 RS

1 providers under section 1703 of title 38, United 

2 States Code, are scheduled. 

3 (2) TIMELINESS GOALS.—Not later than 30 days 

4 after the date of the enactment of this Act, the Sec5 retary shall establish timeliness goals for each step in 

6 scheduling an appointment for health care from a 

7 non-Department health care provider set forth under 

8 subparagraphs (A) through (F) of paragraph (3). 

9 (3) MEASUREMENT OF TIMELINESS FOR EACH

10 FACILITY.—Not later than 120 days after the date of 

11 the enactment of this Act, the Secretary shall meas12 ure, for each medical facility of the Department, the 

13 time it takes from the date that a clinician of the De14 partment determines that a veteran requires care, or 

15 a veteran presents to the Department requesting care, 

16 from a non-Department health care provider to each 

17 of the following: 

18 (A) The date that the referral for care is 

19 sent to a non-Department health care provider. 

20 (B) The date that a non-Department health 

21 care provider accepts the referral. 

22 (C) The date that the referral to a non-De23 partment health care provider is completed. 

24 (D) The date that an appointment with a 

25 non-Department health care provider is made. 


kjohnson on DSK79L0C42PROD with BILLS
29 

•S 629 RS

1 (E) The date that an appointment with a 

2 non-Department health care provider occurs. 

3 (F) Any other step that the Secretary deter4 mines necessary to measure. 

5 (4) PUBLICATION OF DATA.— 

6 (A) IN GENERAL.—Not later than one year 

7 after the date of the enactment of this Act, the 

8 Secretary shall publish the data measured under 

9 paragraph (3), disaggregated by medical facility, 

10 on a publicly available website of the Depart11 ment. 

12 (B) UPDATE.—Not less frequently than bi13 weekly, the Secretary shall update the data pub14 lished under subparagraph (A). 

15 (5) METHOD TO MONITOR COMPLIANCE.—Not 

16 later than 180 days after the date of the enactment 

17 of this Act, the Secretary shall establish or maintain 

18 a method or tool— 

19 (A) to enable monitoring of compliance by 

20 each medical facility of the Department with the 

21 timeliness goals established under paragraph (2); 

22 and 

23 (B) to ensure that each medical facility of 

24 the Department complies such timeliness goals. 

25 (c) COMPTROLLER GENERAL REPORT.— 


kjohnson on DSK79L0C42PROD with BILLS
30 

•S 629 RS

1 (1) REVIEW.—Beginning not later than one year 

2 after the date of the enactment of this Act, the Comp3 troller General of the United States shall review com4 pliance by the Secretary with the requirements of this 

5 section, including a review of the validity and reli6 ability of data published by the Secretary under sub7 section (b)(4). 

8 (2) REPORT.—Not later than three years after 

9 the date of the enactment of this Act, the Comptroller 

10 General shall submit to the Committee on Veterans’ 

11 Affairs of the Senate and the Committee on Veterans’ 

12 Affairs of the House of Representatives the results of 

13 the review conducted under paragraph (1). 

14 SEC. 5. EXAMINATION OF HEALTH CARE CONSULTATION 

15 AND SCHEDULING POSITIONS OF DEPART16 MENT OF VETERANS AFFAIRS. 

17 (a) PROPER GRADING OF CONSULTATION AND SCHED18 ULING POSITIONS.— 

19 (1) IN GENERAL.—The Secretary of Veterans Af20 fairs shall conduct an examination of health care po21 sitions of the Department of Veterans Affairs to deter22 mine whether health care positions involved in the 

23 consultation and scheduling processes are appro24 priately graded. 


kjohnson on DSK79L0C42PROD with BILLS
31 

•S 629 RS

1 (2) CONSULTATION.—In conducting the exam2 ination under paragraph (1), the Secretary shall con3 sult with health care staffing experts in the Federal 

4 Government and the private sector. 

5 (3) SUBMITTAL TO CONGRESS.—Not later than 

6 120 days after the date of the enactment of this Act, 

7 the Secretary shall submit to the appropriate commit8 tees of Congress the results of the examination con9 ducted under paragraph (1). 

10 (b) REVIEW OF ONBOARDING PROCESS.—Not later 

11 than 180 days after the date of the enactment of this Act, 

12 the Secretary shall submit to the appropriate committees 

13 of Congress— 

14 (1) a review of the onboarding process of indi15 viduals in health care positions described in sub16 section (a), including how long it takes to hire those 

17 individuals; and 

18 (2) a description of any changes that the Sec19 retary has made or plans to make to improve that 

20 process. 

21 (c) APPROPRIATE COMMITTEES OF CONGRESS DE22 FINED.—In this section, the term ‘‘appropriate committees 

23 of Congress’’ means— 

24 (1) the Committee on Veterans’ Affairs and the 

25 Committee on Appropriations of the Senate; and 


kjohnson on DSK79L0C42PROD with BILLS
32 

•S 629 RS

1 (2) the Committee on Veterans’ Affairs and the 

2 Committee on Appropriations of the House of Rep3 resentatives. 


kjohnson on DSK79L0C42PROD with BILLS

kjohnson on DSK79L0C42PROD with BILLS
Calendar No. 537 

116TH CONGRESS 

2D SESSION S. 629 

A BILL 

To require the Secretary of Veterans Affairs to reSecretary, and for other purposes. sultations under the laws administered by the pointments for health care and conducting con- partment of Veterans Affairs for scheduling ap- view the processes and requirements of the DeSEPTEMBER 15, 2020 

Reported with an amendment 


kjohnson on DSK79L0C42PROD with BILLS