IIB 

115TH CONGRESS 

1ST SESSION H. R. 1848 

IN THE SENATE OF THE UNITED STATES 

JULY 25, 2017 

Received; read twice and referred to the Committee on Veterans’ Affairs 

AN ACT 

To direct the Secretary of Veterans Affairs to carry out 

a pilot program on the use of medical scribes in Department of Veterans Affairs medical centers, 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, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Veterans Affairs Med3 ical Scribe Pilot Act of 2017’’. 

4 SEC. 2. DEPARTMENT OF VETERANS AFFAIRS MEDICAL 

5 SCRIBE PILOT PROGRAM. 

6 (a) IN GENERAL.—The Secretary of Veterans Affairs 

7 shall carry out a 2-year pilot program under which the 

8 Secretary shall increase the use of medical scribes at De9 partment of Veterans Affairs medical centers. 

10 (b) LOCATIONS.—The Secretary shall carry out the 

11 pilot program at the 10 medical centers of the Department 

12 as follows: 

13 (1) At least four such medical centers located 

14 in rural areas. 

15 (2) At least four such medical centers located 

16 in urban areas. 

17 (3) Two such medical centers located in areas 

18 with need for increased access or increased effi19 ciency, as determine by the Secretary. 

20 (c) MEDICAL SCRIBES.— 

21 (1) HIRING.—Under the pilot program the Sec22 retary shall— 

23 (A) hire 20 new Department of Veterans 

24 Affairs term employees as medical scribes; and 


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1 (B) seek to enter into contracts with ap2 propriate entities for the employment of 20 ad3 ditional medical scribes. 

4 (2) DISTRIBUTION.—The Secretary shall assign 

5 four medical scribes to each of the 10 medical cen6 ters of the Department where the Secretary carries 

7 out the pilot program as follows: 

8 (A) Two scribes shall be assigned to each 

9 of two physicians. 

10 (B) Thirty percent of the scribes shall be 

11 employed in the provision of emergency care. 

12 (C) Seventy percent of the scribes shall be 

13 employed in the provision of speciality care in 

14 specialties with the longest patient wait times 

15 or lowest efficiency ratings, as determined by 

16 the Secretary. 

17 (d) REPORTS.— 

18 (1) REPORTS TO CONGRESS.—Not later than 

19 180 days after the commencement of the pilot pro20 gram required under this section, and every 180 

21 days thereafter for the duration of the pilot pro22 gram, the Secretary of Veterans Affairs shall submit 

23 to Congress a report on the pilot program. Each 

24 such report shall include each of the following: 


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1 (A) A separate analysis of each the fol2 lowing with respect to medical scribes employed 

3 by the Department of Veterans Affairs and 

4 medical scribes performing Department of Vet5 erans Affairs functions under a contract: 

6 (i) Provider efficiency. 

7 (ii) Patient satisfaction. 

8 (iii) Average wait time. 

9 (iv) The number of patients seen per 

10 day by each physician or practitioner. 

11 (v) The amount of time required to 

12 hire and train an employee to perform 

13 medical scribe functions under the pilot 

14 program. 

15 (B) Metrics and data for analyzing the ef16 fects of the pilot program, including an evalua17 tion of the each of the elements under clauses 

18 (i) through (iv) of subparagraph (A) at medical 

19 centers who employed scribes under the pilot 

20 program for an appropriate period preceding 

21 the hiring of such scribes. 

22 (2) COMPTROLLER GENERAL REPORT.—Not 

23 later than 90 days after the termination of the pilot 

24 program under this section, the Comptroller General 

25 of the United States shall submit to Congress a reVerDate Sep 11 2014 03:05 Jul 26, 2017 Jkt 069200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1848.RFS H1848

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1 port on the pilot program. Such report shall include 

2 a comparison of the pilot program with similar pro3 grams carried out in the private sector. 

4 (e) DEFINITIONS.—In this section: 

5 (1) The term ‘‘medical scribe’’ means an unli6 censed individual hired to enter information into the 

7 electronic health record or chart at the direction of 

8 a physician or licensed independent practitioner 

9 whose responsibilities include the following: 

10 (A) Assisting the physician or practitioner 

11 in navigating the electronic health record. 

12 (B) Responding to various messages as di13 rected by the physician or practitioner. 

14 (C) Entering information into the elec15 tronic health record, as directed by the physi16 cian or practitioner. 

17 (2) The terms ‘‘urban’’ and ‘‘rural’’ have the 

18 meanings given such terms under the rural-urban 

19 commuting codes developed by the Secretary of Agri20 culture and the Secretary of Health and Human 

21 Services. 

22 (f) FUNDING.—The pilot program under this section 

23 shall be carried out using amounts otherwise authorized 

24 to be appropriated for the Department of Veterans AfVerDate Sep 11 2014 03:05 Jul 26, 2017 Jkt 069200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1848.RFS H1848

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1 fairs. No additional amounts are authorized to be appro2 priated to carry out such program. 

3 SEC. 3. PROHIBITION ON SMOKING IN FACILITIES OF THE 

4 VETERANS HEALTH ADMINISTRATION. 

5 (a) PROHIBITION.—Section 1715 of title 38, United 

6 States Code, is amended to read as follows: 

7 ‘‘§ 1715. Prohibition on smoking in facilities of the 

8 Veterans Health Administration 

9 ‘‘(a) PROHIBITION.—(1)(A) Except as provided in 

10 subparagraph (B), no person may smoke indoors in any 

11 facility of the Veterans Health Administration. 

12 ‘‘(B) In the case of a facility of the Veterans Health 

13 Administration that is a community living center, no per14 son may smoke indoors in such facility on or after Decem15 ber 31, 2018. 

16 ‘‘(2) No person may smoke outdoors in any facility 

17 of the Veterans Health Administration on or after October 

18 1, 2021. 

19 ‘‘(b) DEFINITIONS.—In this section: 

20 ‘‘(1) The term ‘smoke’ includes the smoking of 

21 cigarettes (including e-cigarettes or electronic ciga22 rettes), cigars, pipes, and any other combustion of 

23 tobacco. 

24 ‘‘(2) The term ‘facility of the Veterans Health 

25 Administration’ means any land or building (includVerDate Sep 11 2014 03:05 Jul 26, 2017 Jkt 069200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H1848.RFS H1848

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1 ing any medical center, nursing home, domiciliary 

2 facility, outpatient clinic, or center that provides re3 adjustment counseling) that is— 

4 ‘‘(A) under the jurisdiction of the Depart5 ment of Veterans Affairs; 

6 ‘‘(B) under the control of the Veterans 

7 Health Administration; and 

8 ‘‘(C) not under the control of the General 

9 Services Administration. 

10 ‘‘(3) The term ‘community living center’ means 

11 a facility of the Department that provides nursing 

12 home care.’’. 

13 (b) CONFORMING AMENDMENTS.— 

14 (1) The table of sections at the beginning of 

15 chapter 17 of such title is amended by striking the 

16 item relating to section 1715 and inserting the fol17 lowing: 

‘‘1715. Prohibition on smoking in facilities of the Veterans Health Administration.’’. 

18 (2) Section 526 of the Veterans Health Care 

19 Act of 1992 (Public Law 102–585) is repealed. 


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1 (c) EFFECTIVE DATE.—This section shall take effect 

2 90 days after the date of the enactment of this Act. 

Passed the House of Representatives July 24, 2017. 

Attest: KAREN L. HAAS, 

Clerk. 


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