II 

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. 

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Veterans Affairs Peer 

5 Review Neutrality Act of 2023’’. 


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1 SEC. 2. ELIMINATION OF CONFLICTS OF INTEREST IN PEER 

2 REVIEW, ADMINISTRATIVE INVESTIGATION 

3 BOARDS, AND FACTFINDINGS OF VETERANS 

4 HEALTH ADMINISTRATION. 

5 (a) IN GENERAL.—Subchapter II of chapter 73 of 

6 title 38, United States Code, is amended by inserting after 

7 section 7311A the following new section: 

8 ‘‘§ 7311B. Elimination of conflicts of interest in peer 

9 review, administrative investigation 

10 boards, and factfindings of Veterans 

11 Health Administration 

12 ‘‘(a) PEER REVIEW.— 

13 ‘‘(1) IN GENERAL.—Each individual responsible 

14 for conducting peer review for quality management 

15 of care provided by a health care provider at a med16 ical facility of the Department and each member of 

17 a peer review committee with respect to quality man18 agement of such care shall withdraw from participa19 tion in a case review if— 

20 ‘‘(A) the individual has direct involvement 

21 with the care under review; or 

22 ‘‘(B) the individual is unable to conduct an 

23 objective, impartial, accurate, and informed re24 view. 

25 ‘‘(2) NEUTRAL ASSESSMENT OF CONDUCT OF

26 COMMITTEE MEMBERS.—Each medical facility of the 


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1 Department shall develop procedures and guidelines 

2 for that facility to require that any initial peer re3 view for quality management that is conducted with 

4 respect to care provided by a health care provider 

5 who is a member of the peer review committee for 

6 that facility be evaluated, discussed, and assigned a 

7 final level review by a neutral peer review committee 

8 at another facility of the Department. 

9 ‘‘(b) ADMINISTRATIVE INVESTIGATION BOARDS AND

10 FACTFINDINGS.— 

11 ‘‘(1) KNOWLEDGE OF CONFIDENTIAL INFORMA12 TION.—Individuals with knowledge of confidential 

13 quality assurance information specific to a matter 

14 under investigation by an administrative investiga15 tion board or factfinder with respect to quality man16 agement of care provided by a health care provider 

17 at a medical facility of the Department may not— 

18 ‘‘(A) serve on the administrative investiga19 tion board or as a factfinder; or 

20 ‘‘(B) disclose such information to an ad21 ministrative investigation board or a factfinder. 

22 ‘‘(2) PERSONAL INTEREST, INVOLVEMENT, OR

23 RELATIONSHIP.— 

24 ‘‘(A) IN GENERAL.—The Secretary shall 

25 ensure that each member of an administrative 


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1 investigative board or factfinder does not 

2 have— 

3 ‘‘(i) any personal interest or other 

4 bias concerning the investigation being 

5 conducted; 

6 ‘‘(ii) direct involvement in matters 

7 being investigated; or 

8 ‘‘(iii) a supervisory or personal rela9 tionship with the subject of the investiga10 tion. 

11 ‘‘(B) RECUSAL.—If a potential member of 

12 an administrative investigative board or 

13 factfinder has a personal interest or other bias 

14 concerning the investigation being conducted, 

15 direct involvement in matters being inves16 tigated, or a supervisory or personal relation17 ship with the subject of the investigation, the 

18 potential member shall inform the authority re19 sponsible for the investigation and recuse them20 selves from such matter.’’. 

21 (b) CLERICAL AMENDMENT.—The table of sections 

22 at the beginning of such subchapter is amended by insert23 ing after the item relating to section 7311A the following 

24 new item: 

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


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1 SEC. 3. LIMITATION ON DETAIL OF DIRECTORS OF MED2 ICAL CENTERS OF DEPARTMENT OF VET3 ERANS AFFAIRS TO DIFFERENT POSITIONS. 

4 (a) NOTIFICATION.— 

5 (1) IN GENERAL.—Not later than 90 days after 

6 detailing a director of a medical center of the De7 partment of Veterans Affairs to a different position 

8 within the Department, the Secretary of Veterans 

9 Affairs shall notify the Committee on Veterans’ Af10 fairs of the Senate and the Committee on Veterans’ 

11 Affairs of the House of Representatives of such de12 tail. 

13 (2) MATTERS TO BE INCLUDED.—The notifica14 tion required by paragraph (1) shall include, with re15 spect to a director of a medical center who is de16 tailed to a different position within the Department, 

17 the following information: 

18 (A) The location at which the director is 

19 detailed. 

20 (B) The position title of the detail. 

21 (C) The estimated time the director is ex22 pected to be absent from their duties at the 

23 medical center. 

24 (D) Such other information as the Sec25 retary may determine appropriate. 


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1 (b) APPOINTMENT OF ACTING DIRECTOR.—Not later 

2 than 120 days after detailing a director of a medical cen3 ter of the Department to a different position within the 

4 Department, the Secretary shall appoint an individual as 

5 acting director of such medical center with all of the au6 thority and responsibilities of the detailed director. 

7 (c) UPDATE ON DETAIL.—Not later than 120 days 

8 after detailing a director of a medical center of the De9 partment to a different position within the Department, 

10 and not less frequently than every 30 days thereafter while 

11 the detail is in effect or while the director position at the 

12 medical center is vacant, the Secretary shall submit to the 

13 Committee on Veterans’ Affairs of the Senate and the 

14 Committee on Veterans’ Affairs of the House of Rep15 resentatives an update regarding the status of the detail. 

16 (d) RETURN TO POSITION OR REASSIGNMENT.— 

17 (1) IN GENERAL.—Except as provided in para18 graph (2), not later than 180 days after detailing a 

19 director of a medical center of the Department to a 

20 different position within the Department, for a rea21 son other than an ongoing investigation or adminis22 trative action with respect to the director, the Sec23 retary shall— 

24 (A) return the individual to the position as 

25 director of the medical center; or 


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1 (B) reassign the individual from the posi2 tion as director of the medical center and begin 

3 the process of hiring a new director for such po4 sition. 

5 (2) WAIVER.— 

6 (A) IN GENERAL.—The Secretary may 

7 waive the requirement under paragraph (1) 

8 with respect to an individual for successive 90- 

9 day increments for a total period of not more 

10 than 540 days from the original date the indi11 vidual was detailed away from their position as 

12 director of a medical center. 

13 (B) NOTIFICATION.—Not later than 30 

14 days after exercising a waiver under subpara15 graph (A), the Secretary shall notify Congress 

16 of the waiver and provide to Congress informa17 tion as to why the waiver is necessary. 

Æ 


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