I 

111TH CONGRESS 

1ST SESSION H. R. 568 

To amend title 38, United States Code, to improve the quality of care 

provided to veterans in Department of Veterans Affairs medical facilities, 

to encourage highly qualified doctors to serve in hard-to-fill positions 

in such medical facilities, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 15, 2009 

Mr. COSTELLO (for himself, Mr. SHIMKUS, Mr. MITCHELL, and Mr. 

WHITFIELD) introduced the following bill; which was referred to the Committee on Veterans’ Affairs, and in addition to the Committee on Oversight and Government Reform, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions 

as fall within the jurisdiction of the committee concerned 

A BILL 

To amend title 38, United States Code, to improve the 

quality of care provided to veterans in Department of 

Veterans Affairs medical facilities, to encourage highly 

qualified doctors to serve in hard-to-fill positions in such 

medical facilities, 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 Health Care 

5 Quality Improvement Act’’. 


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1 SEC. 2. STANDARDS FOR APPOINTMENT AND PRACTICE OF 

2 PHYSICIANS IN DEPARTMENT OF VETERANS 

3 AFFAIRS MEDICAL FACILITIES. 

4 (a) STANDARDS.— 

5 (1) IN GENERAL.—Subchapter I of chapter 74 

6 of title 38, United States Code, is amended by in7 serting after section 7402 the following new section: 

8 ‘‘§ 7402A. Appointment and practice of physicians: 

9 standards 

10 ‘‘(a) IN GENERAL.—The Secretary shall, acting 

11 through the Under Secretary for Health, prescribe stand12 ards to be met by individuals in order to qualify for ap13 pointment in the Veterans Health Administration in the 

14 position of physician and to practice as a physician in 

15 medical facilities of the Veterans Health Administration. 

16 The standards shall incorporate the requirements of this 

17 section. 

18 ‘‘(b) DISCLOSURE OF CERTAIN INFORMATION BE19 FORE APPOINTMENT.—Each individual seeking appoint20 ment in the Veterans Health Administration in the posi21 tion of physician shall do the following: 

22 ‘‘(1) Provide the Secretary a full and complete 

23 explanation of the following: 

24 ‘‘(A) Each lawsuit, civil action, or other 

25 claim (whether open or closed) brought against 

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1 ligence (other than a lawsuit, action, or claim 

2 closed without any judgment against or pay3 ment by or on behalf of the individual). 

4 ‘‘(B) Each payment made by or on behalf 

5 of the individual to settle any lawsuit, action, or 

6 claim covered by subparagraph (A). 

7 ‘‘(C) Each investigation or disciplinary ac8 tion taken against the individual relating to the 

9 individual’s performance as a physician. 

10 ‘‘(2) Submit a written request and authoriza11 tion to the State licensing board of each State in 

12 which the individual holds or has held a license to 

13 practice medicine to disclose to the Secretary any in14 formation in the records of such State on the fol15 lowing: 

16 ‘‘(A) Each lawsuit, civil action, or other 

17 claim brought against the individual for medical 

18 malpractice or negligence covered by paragraph 

19 (1)(A) that occurred in such State. 

20 ‘‘(B) Each payment made by or on behalf 

21 of the individual to settle any lawsuit, action, or 

22 claim covered by subparagraph (A). 

23 ‘‘(C) Each medical malpractice judgment 

24 against the individual by the courts or adminis25 trative agencies or bodies of such State. 


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1 ‘‘(D) Each disciplinary action taken or 

2 under consideration against the individual by 

3 an administrative agency or body of such State. 

4 ‘‘(E) Any change in the status of the li5 cense to practice medicine issued the individual 

6 by such State, including any voluntary or non7 disciplinary surrendering of such license by the 

8 individual. 

9 ‘‘(F) Any open investigation of the indi10 vidual by an administrative agency or body of 

11 such State, or any outstanding allegation 

12 against the individual before such an adminis13 trative agency or body. 

14 ‘‘(G) Any written notification by the State 

15 to the individual of potential termination of a li16 cense for cause or otherwise. 

17 ‘‘(c) DISCLOSURE OF CERTAIN INFORMATION FOL18 LOWING APPOINTMENT.—(1) Each individual appointed 

19 in the Veterans Health Administration in the position of 

20 physician after the date of the enactment of the Veterans 

21 Health Care Quality Improvement Act shall, as a condi22 tion of service under the appointment, disclose to the Sec23 retary, not later than 30 days after the occurrence of such 

24 event, the following: 


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1 ‘‘(A) A judgment against the individual for 

2 medical malpractice or negligence. 

3 ‘‘(B) A payment made by or on behalf of the 

4 individual to settle any lawsuit, action, or claim dis5 closed under paragraph (1) or (2) of subsection (b). 

6 ‘‘(C) Any disposition of or material change in a 

7 matter disclosed under paragraph (1) or (2) of sub8 section (b). 

9 ‘‘(2) Each individual appointed in the Veterans 

10 Health Administration in the position of physician as of 

11 the date of the enactment of the Veterans Health Care 

12 Quality Improvement Act shall do the following: 

13 ‘‘(A) Not later than the end of the 60-day pe14 riod beginning on the date of the enactment of that 

15 Act and as a condition of service under the appoint16 ment after the end of that period, submit the re17 quest and authorization described in subsection 

18 (b)(2). 

19 ‘‘(B) Agree, as a condition of service under the 

20 appointment, to disclose to the Secretary, not later 

21 than 30 days after the occurrence of such event, the 

22 following: 

23 ‘‘(I) A judgment against the individual for 

24 medical malpractice or negligence. 


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1 ‘‘(ii) A payment made by or on behalf of 

2 the individual to settle any lawsuit, action, or 

3 claim disclosed pursuant to subparagraph (A) 

4 or under this subparagraph. 

5 ‘‘(iii) Any disposition of or material change 

6 in a matter disclosed pursuant to subparagraph 

7 (A) or under this subparagraph. 

8 ‘‘(3) Each individual appointed in the Veterans 

9 Health Administration in the position of physician shall, 

10 as part of the biennial review of the performance of the 

11 physician under the appointment, submit the request and 

12 authorization described in subsection (b)(2). The require13 ment of this paragraph is in addition to the requirements 

14 of paragraph (1) or (2), as applicable. 

15 ‘‘(d) INVESTIGATION OF DISCLOSED MATTERS.—(1) 

16 The Director of the Veterans Integrated Services Network 

17 (VISN) in which an individual is seeking appointment in 

18 the Veterans Health Administration in the position of phy19 sician shall perform a comprehensive investigation (in 

20 such manner as the standards required by this section 

21 shall specify) of each matter disclosed under subsection 

22 (b) with respect to the individual. 

23 ‘‘(2) The Director of the Veterans Integrated Serv24 ices Network in which an individual is appointed in the 

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1 cian shall perform a comprehensive investigation (in a 

2 manner so specified) of each matter disclosed under sub3 section (c) with respect to the individual. 

4 ‘‘(3) The results of each investigation performed 

5 under this subsection shall be fully documented. 

6 ‘‘(e) APPROVAL OF APPOINTMENTS BY DIRECTORS

7 OF VISNS.—(1) An individual may not be appointed in 

8 the Veterans Health Administration in the position of phy9 sician without the approval of the Director of the Veterans 

10 Integrated Services Network in which the individual will 

11 first serve under the appointment. 

12 ‘‘(2) In approving the appointment under this sub13 section of an individual for whom any matters have been 

14 disclosed under subsection (b), a Director shall— 

15 ‘‘(A) certify in writing the completion of the 

16 performance of the investigation under subsection 

17 (d)(1) of each such matter, including the results of 

18 such investigation; and 

19 ‘‘(B) provide a written justification why any 

20 matters raised in the course of such investigation do 

21 not disqualify the individual from appointment. 

22 ‘‘(f) ENROLLMENT OF PHYSICIANS WITH PRACTICE

23 PRIVILEGES IN PROACTIVE DISCLOSURE SERVICE.—Each 

24 medical facility of the Department at which physicians are 

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1 cian extended such privileges in the Proactive Disclosure 

2 Service of the National Practitioners Data Bank. 

3 ‘‘(g) ENCOURAGING HIRING OF PHYSICIANS WITH

4 BOARD CERTIFICATION.—(1) The Secretary shall, for 

5 each performance contract with a Director of a Veterans 

6 Integrated Services Network (VISN), include in such con7 tract a provision that encourages the director to hire phy8 sicians who are board eligible or board certified in the spe9 cialty in which the physicians will practice. 

10 ‘‘(2) The Secretary may determine the nature and 

11 manner of the provision described in paragraph (1).’’. 

12 (2) CLERICAL AMENDMENT.—The table of sec13 tions at the beginning of chapter 74 of such title is 

14 amended by inserting after the item relating to sec15 tion 7402 the following new item: 

‘‘7402A. Appointment and practice of physicians: standards.’’. 

16 (b) EFFECTIVE DATE AND APPLICABILITY.— 

17 (1) EFFECTIVE DATE.—Except as provided in 

18 paragraphs (2) and (3), the amendments made by 

19 subsection (a) shall take effect on the date of the en20 actment of this Act. 

21 (2) APPLICABILITY OF CERTAIN REQUIRE22 MENTS TO PHYSICIANS PRACTICING ON EFFECTIVE

23 DATE.—In the case of an individual appointed to the 

24 Veterans Health Administration in the position of 

25 physician as of the date of the enactment of this 


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1 Act, the requirements of subsection (f) of section 

2 7402A, United States Code, as added by subsection 

3 (a) of this section, shall take effect on the date that 

4 is one year after the date of the enactment of this 

5 Act. 

6 (3) APPLICABILITY OF REQUIREMENTS RE7 LATED TO HIRING OF PHYSICIANS WITH BOARD CER8 TIFICATION.—The requirements of subsection (g) of 

9 such section 7402A shall apply with respect to the 

10 first cycle of performance contracts for directors of 

11 Veterans Integrated Services Networks beginning 

12 after the date of the enactment of this Act and each 

13 subsequent cycle. 

14 SEC. 3. ENHANCEMENT OF QUALITY ASSURANCE BY THE 

15 VETERANS HEALTH ADMINISTRATION. 

16 (a) ENHANCEMENT OF QUALITY ASSURANCE

17 THROUGH QUALITY ASSURANCE OFFICERS.— 

18 (1) IN GENERAL.—Subchapter II of chapter 73 

19 of title 38, United States Code, is amended by in20 serting after section 7311 the following new section: 

21 ‘‘§ 7311A. Quality assurance officers 

22 ‘‘(a) NATIONAL QUALITY ASSURANCE OFFICER.—(1) 

23 The Under Secretary for Health shall designate an official 

24 of the Veterans Health Administration to act as the prin25 cipal quality assurance officer for the quality-assurance 


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1 program required by section 7311 of this title. The official 

2 so designated may be known as the ‘National Quality As3 surance Officer of the Veterans Health Administration’ (in 

4 this section referred to as the ‘National Quality Assurance 

5 Officer’). 

6 ‘‘(2) The National Quality Assurance Officer shall re7 port directly to the Under Secretary for Health in the dis8 charge of responsibilities and duties of the Officer under 

9 this section. 

10 ‘‘(3) The National Quality Assurance Officer shall be 

11 the official within the Veterans Health Administration 

12 who is principally responsible for the quality-assurance 

13 program referred to in paragraph (1). In carrying out that 

14 responsibility, the Officer shall be responsible for— 

15 ‘‘(A) establishing and enforcing the require16 ments of that program; and 

17 ‘‘(B) carrying out such other responsibilities 

18 and duties relating to quality assurance in the Vet19 erans Health Administration as the Under Secretary 

20 for Health shall specify. 

21 ‘‘(4) The requirements under paragraph (3) shall in22 clude requirements regarding the following: 

23 ‘‘(A) A confidential system for the submittal of 

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1 sonnel regarding quality assurance at Department 

2 facilities. 

3 ‘‘(B) Mechanisms for the peer review of the ac4 tions of individuals appointed in the Veterans Health 

5 Administration in the position of physician. 

6 ‘‘(C) Mechanisms for the accountability of the 

7 facility director and chief medical officer of each 

8 Veterans Health Administration medical facility for 

9 the actions of physicians in such facility. 

10 ‘‘(b) QUALITY ASSURANCE OFFICERS FOR VISNS.— 

11 (1) The Director of each Veterans Integrated Services 

12 Network (VISN) shall appoint an official of the Network 

13 to act as the quality assurance officer of the Network. 

14 ‘‘(2) Each official appointed as a quality assurance 

15 officer under this subsection shall be a board-certified phy16 sician. 

17 ‘‘(3) The quality assurance officer for a Veterans In18 tegrated Services Network shall report to the Director of 

19 the Veterans Integrated Services Network, and to the Na20 tional Quality Assurance Officer, regarding the discharge 

21 of the responsibilities and duties of the officer under this 

22 section. 

23 ‘‘(4) The quality assurance officer for a Veterans In24 tegrated Services Network shall— 


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1 ‘‘(A) direct the quality assurance office in the 

2 Network; and 

3 ‘‘(B) coordinate, monitor, and oversee the qual4 ity assurance programs and activities of the Vet5 erans Health Administration medical facilities in the 

6 Network in order to ensure the thorough and uni7 form discharge of quality assurance requirements 

8 under such programs and activities throughout such 

9 facilities. 

10 ‘‘(c) QUALITY ASSURANCE OFFICERS FOR MEDICAL

11 FACILITIES.—(1) The director of each Veterans Health 

12 Administration medical facility shall appoint a quality as13 surance officer for that facility. 

14 ‘‘(2) Each official appointed as a quality assurance 

15 officer under this subsection shall be a board-certified phy16 sician. 

17 ‘‘(3) The official appointed as a quality assurance of18 ficer for a facility under this subsection shall be a prac19 ticing physician at the facility. If the official appointed as 

20 quality assurance officer for a facility has other clinical 

21 or administrative duties, the director of the facility shall 

22 ensure that those duties are sufficiently limited in scope 

23 so as to ensure that those duties do not prevent the officer 

24 from effectively discharging the responsibilities and duties 

25 of quality assurance officer at the facility. 


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1 ‘‘(4) The quality assurance officer for a facility shall 

2 report directly to the director of the facility, and to the 

3 quality assurance officer of the Veterans Integrated Serv4 ices Network in which the facility is located, regarding the 

5 discharge of the responsibilities and duties of the quality 

6 assurance officer under this section. 

7 ‘‘(5) The quality assurance officer for a facility shall 

8 be responsible for designing, disseminating, and imple9 menting quality assurance programs and activities for the 

10 facility that meet the requirements established by the Na11 tional Quality Assurance Officer under subsection (a).’’. 

12 (2) CLERICAL AMENDMENT.—The table of sec13 tions at the beginning of chapter 73 of such title is 

14 amended by inserting after the item relating to sec15 tion 7311 the following new item: 

‘‘7311A. Quality assurance officers.’’. 

16 (b) BOARD-CERTIFIED PHYSICIAN REQUIREMENT

17 FOR INDIVIDUALS APPOINTED AS UNDER SECRETARY

18 FOR HEALTH.—Section 305(a)(2) of title 38, United 

19 States Code, is amended by inserting ‘‘shall be a board20 certified physician and’’ before ‘‘shall be’’. 

21 (c) REPORTS ON QUALITY CONCERNS UNDER QUAL22 ITY-ASSURANCE PROGRAM.—Section 7311(b) of such title 

23 is amended by adding at the end the following new para24 graph: 


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1 ‘‘(4) As part of the quality-assurance program, the 

2 Under Secretary for Health shall establish mechanisms 

3 through which employees of Veterans Health Administra4 tion facilities may submit reports, on a confidential basis, 

5 on matters relating to quality of care in Veterans Health 

6 Administration facilities to the quality assurance officers 

7 of such facilities under section 7311A(c) of this title and 

8 to the quality assurance officers of the Veterans Inte9 grated Services Networks (VISNs) in which such facilities 

10 are located under section 7311A(b) of this title. The mech11 anisms shall provide for the prompt and thorough review 

12 of any reports so submitted by the receiving officials.’’. 

13 (d) REVIEW OF CURRENT HEALTH CARE QUALITY

14 SAFEGUARDS.— 

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

16 Affairs shall conduct a comprehensive review of all 

17 current policies and protocols of the Department of 

18 Veterans Affairs for maintaining health care quality 

19 and patient safety at Department of Veterans Af20 fairs medical facilities. The review shall include a re21 view and assessment of the National Surgical Qual22 ity Improvement Program (NSQIP), including an 

23 assessment of— 

24 (A) the efficacy of the quality indicators 

25 under the program; 


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1 (B) the efficacy of the data collection 

2 methods under the program; 

3 (C) the efficacy of the frequency with 

4 which regular data analyses are performed 

5 under the program; and 

6 (D) the extent to which the resources allo7 cated to the program are adequate to fulfill the 

8 stated function of the program. 

9 (2) REPORT.—Not later than 60 days after the 

10 date of the enactment of this Act, the Secretary 

11 shall submit to Congress a report on the review con12 ducted under paragraph (1), including the findings 

13 of the Secretary as a result of the review and such 

14 recommendations as the Secretary considers appro15 priate in light of the review. 

16 SEC. 4. INCENTIVES TO ENCOURAGE HIGH-QUALITY PHYSI17 CIANS TO SERVE IN THE VETERANS HEALTH 

18 ADMINISTRATION. 

19 (a) INCENTIVES REQUIRED.— 

20 (1) IN GENERAL.—Subchapter III of chapter 

21 74 of title 38, United States Code, is amended by 

22 inserting after section 7431 the following new sec23 tion: 


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1 ‘‘§ 7431A. Physicians: additional incentives for service 

2 in hard-to-fill positions 

3 ‘‘(a) LOAN REPAYMENT FOR PHYSICIANS WHO

4 SERVE IN HARD-TO-FILL POSITIONS.—(1) In order to re5 cruit and retain physicians in the Veterans Health Admin6 istration in hard-to-fill positions (as designated by the Sec7 retary for purposes of this subsection), the Secretary shall 

8 repay, for each individual who agrees to serve as a physi9 cian for a period of not less than three years in an Admin10 istration facility in such a position, any loan of such indi11 vidual as follows: 

12 ‘‘(A) Any loan of the individual described in 

13 paragraphs (1) through (4) of section 16302(a) of 

14 title 10. 

15 ‘‘(B) Any other loan of the individual des16 ignated by the Secretary for purposes of this sub17 section the proceeds of which were used by the indi18 vidual to finance education leading to the medical 

19 degree of the individual. 

20 ‘‘(2) Each individual seeking repayment of loans 

21 under paragraph (1) shall enter into an agreement with 

22 the Secretary regarding the repayment of loans. Under the 

23 agreement, the individual shall agree— 

24 ‘‘(A) to perform satisfactory service in a physi25 cian position specified in the agreement in an Ad26 ministration facility specified in the agreement for 


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1 such period of years as the agreement shall specify; 

2 and 

3 ‘‘(B) to possess and retain for the period of the 

4 agreement such professional qualifications as are 

5 necessary for the service specified under subpara6 graph (A). 

7 ‘‘(3) Repayment of loans under this subsection shall 

8 be made on the basis of complete years of service under 

9 the agreement under this subsection. The amount to be 

10 repaid under an agreement under this subsection for a 

11 complete year of service specified in the agreement shall 

12 be such amount, not to exceed $30,000, for each complete 

13 year of service as the agreement shall specify. 

14 ‘‘(b) TUITION REIMBURSEMENT FOR PHYSICIAN

15 STUDENTS WHO AGREE TO SERVE IN HARD-TO-FILL

16 POSITIONS.—(1) In order to recruit and retain physicians 

17 in the Veterans Health Administration in hard-to-fill posi18 tions (as designated by the Secretary for purposes of this 

19 subsection), the Secretary shall reimburse individuals who 

20 are enrolled in a course of education leading toward board 

21 certification as a physician for the tuition charged for pur22 suit of such course of education if such individuals agree 

23 to serve as a physician in an Administration facility in 

24 such a position. 


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1 ‘‘(2) Each individual seeking tuition reimbursement 

2 under paragraph (1) shall enter into an agreement with 

3 the Secretary regarding such tuition reimbursement. 

4 Under the agreement, the individuals shall agree— 

5 ‘‘(A) to satisfactorily complete the course of 

6 education of the individual described in paragraph 

7 (1); and 

8 ‘‘(B) upon completion of the course of edu9 cation, to become board-certified as a physician; and 

10 ‘‘(C) upon completion of the matters referred to 

11 in subparagraphs (A) and (B)— 

12 ‘‘(I) to perform satisfactory service in a 

13 physician position specified in the agreement in 

14 an Administration facility specified in the 

15 agreement for such period of years as the 

16 agreement shall specify; and 

17 ‘‘(ii) to possess and retain for the period of 

18 the agreement such professional qualifications 

19 as are necessary for the service specified under 

20 clause (I). 

21 ‘‘(3) The amount of reimbursement payable to an in22 dividual under paragraph (1) for a year may not exceed 

23 $30,000. 

24 ‘‘(4) Any individual receiving tuition reimbursement 

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1 ments of the agreement under paragraph (2) shall be sub2 ject to such repayment requirements as the Secretary shall 

3 specify in the agreement. 

4 ‘‘(5) An individual receiving tuition reimbursement 

5 under paragraph (1) for pursuit of a course of education 

6 shall also be paid a stipend in the amount of $5,000 for 

7 each academic year of pursuit of such course of education 

8 after entry into an agreement under paragraph (2). 

9 ‘‘(c) PARTICIPATION IN FEHBP OF PHYSICIANS

10 WHO SERVE PART-TIME IN HARD-TO-FILL POSITIONS.— 

11 (1) In order to recruit and retain physicians in the Vet12 erans Health Administration in hard-to-fill positions (as 

13 designated by the Secretary for purposes of this sub14 section), an individual not otherwise eligible for health in15 surance under chapter 89 of title 5 who agrees to serve 

16 as a physician in an Administration facility in such a posi17 tion for not less than five days per month (of which two 

18 days must occur in each 14-day period) shall be eligible 

19 for enrollment in the health benefit plans under chapter 

20 89 of title 5 on a self only or self and family basis (as 

21 applicable). 

22 ‘‘(2) The Secretary shall administer this subsection 

23 in consultation with the Director of the Office of Per24 sonnel Management. 


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1 ‘‘(d) ADDITIONAL PROGRAMS.—It is the sense of 

2 Congress that the Secretary should undertake active and 

3 on-going efforts to establish additional incentive programs 

4 to encourage individuals to serve in the position of physi5 cian in the Veterans Health Administration, or otherwise 

6 practice in the Administration, in hard-to-fill positions, in7 cluding, in particular, incentive programs to encourage 

8 more experienced physicians to serve or practice in such 

9 positions. 

10 ‘‘(e) CONSTRUCTION.—The incentives required under 

11 this section are in addition to any other special pays or 

12 benefits to which the individuals covered by this section 

13 are eligible or entitled under law.’’. 

14 (2) CLERICAL AMENDMENT.—The table of sec15 tions at the beginning of chapter 74 of such title is 

16 amended by inserting after the item relating to sec17 tion 731 the following new item: 

‘‘7431A. Physicians: additional incentives for service in hard-to-fill positions.’’. 

18 (b) AFFILIATION OF DEPARTMENT OF VETERANS

19 AFFAIRS MEDICAL FACILITIES WITH MEDICAL

20 SCHOOLS.—The Secretary of Veterans Affairs shall, to the 

21 extent practicable, require each medical facility of the De22 partment of Veterans Affairs to seek to establish an affili23 ation with a medical school within reasonable proximity 

24 of such medical facility. 


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1 SEC. 5. REPORTS TO CONGRESS. 

2 (a) REPORT.—Not later than December 15, 2009, 

3 and each year thereafter through 2012, the Secretary of 

4 Veterans Affairs shall submit to the congressional vet5 erans affairs committees a report on the implementation 

6 of this Act and the amendments made by this Act during 

7 the preceding fiscal year. Each report shall include, for 

8 the fiscal year covered by such report, the following: 

9 (1) A comprehensive description of the imple10 mentation of this Act and the amendments made by 

11 this Act. 

12 (2) Such recommendations as the Secretary 

13 considers appropriate for legislative or administra14 tive action to improve the authorities and require15 ments in this Act and the amendments made by this 

16 Act or to otherwise improve the quality of health 

17 care and the quality of the physicians in the Vet18 erans Health Administration. 

19 (b) CONGRESSIONAL VETERANS AFFAIRS COMMIT20 TEES DEFINED.—In this section, the term ‘‘congressional 

21 veterans affairs committees’’ means— 

22 (1) the Committees on Veterans’ Affairs and 

23 Appropriations of the Senate; and 

24 (2) the Committees on Veterans’ Affairs and 

25 Appropriations of the House of Representatives. 

Æ 


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