in which the individual will practice under the appoint-
ment. 
‘‘(2) A Regional Director may waive the limitation 
in paragraph (1) with respect to any individual who has 
completed a residency program within the two-year period 
ending on the date of such waiver if the individual provides 
satisfactory evidence (as determined in accordance with 
the standards required by this section) of an intent to be-
come board certified. The period of any waiver under this 
paragraph may not exceed one year. 
‘‘(g) STATE LICENSE REQUIRED FOR PRACTICE IN 
IN-STATE VA MEDICAL FACILITIES.—Each physician 
practicing at a medical facility of the Department in a 
State, whether under an appointment in the Administra-
tion or through the extension of privileges of practice, 
shall, as a condition of such practice, hold a license to 
practice medicine in the State within one year of appoint-
ment. 
‘‘(h) ENROLLMENT OF PHYSICIANS WITH PRACTICE 
PRIVILEGES IN PROACTIVE DISCLOSURE SERVICE.—Each 
medical facility of the Department at which physicians are 
extended the privileges of practice shall enroll each physi-
cian extended such privileges in the Proactive Disclosure 
Service of the National Practitioners Data Base.’’. 
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(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of chapter 74 of such title is 
amended by inserting after the item relating to sec-
tion 7402 the following new item: 
‘‘7402A. Appointment and practice of physicians: standards.’’. 
(b) EFFECTIVE DATE AND APPLICABILITY.— 
(1) EFFECTIVE DATE.—Except as provided in 
paragraph (2), the amendments made by subsection 
(a) shall take effect on the date of the enactment of 
this Act. 
(2) APPLICABILITY
OF
CERTAIN
REQUIRE-
MENTS TO PHYSICIANS PRACTICING ON EFFECTIVE 
DATE.—In the case of an individual appointed to the 
Veterans Health Administration in the position of 
physician as of the date of the enactment of this 
Act— 
(A) the requirements of subsections (f) and 
(g) of section 7402A, United States Code, as 
added by subsection (a) of this section, shall 
take effect on the date that is one year after 
the date of the enactment of this Act; and 
(B) the requirements of subsection (h) of 
such section 7402A, as so added, shall take ef-
fect on the date that is 60 days after the date 
of the enactment of this Act. 
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SEC. 3. ENHANCEMENT OF QUALITY ASSURANCE BY THE 
VETERANS HEALTH ADMINISTRATION. 
(a) 
ENHANCEMENT
OF
QUALITY
ASSURANCE 
THROUGH QUALITY ASSURANCE OFFICERS.— 
(1) IN GENERAL.—Subchapter II of chapter 73 
of title 38, United States Code, is amended by in-
serting after section 7311 the following new section: 
‘‘§ 7311A. Quality assurance officers 
‘‘(a) NATIONAL QUALITY ASSURANCE OFFICER.—(1) 
The Under Secretary of Health shall designate an official 
of the Administration to act as the principal quality assur-
ance officer for the quality-assurance program required by 
section 7311 of this title. The official so designated may 
be known as the ‘National Quality Assurance Officer of 
the Veterans Health Administration’ (in this section re-
ferred to as the ‘National Quality Assurance Officer’). 
‘‘(2) The National Quality Assurance Officer shall re-
port directly to the Under Secretary for Health in the dis-
charge of responsibilities and duties of the Officer under 
this section. 
‘‘(3) The National Quality Assurance Officer shall be 
the official within the Administration who is principally 
responsible for the quality-assurance program referred to 
in paragraph (1). In carrying out that responsibility, the 
Officer shall be responsible for— 
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‘‘(A) establishing and enforcing the require-
ments of that program; and 
‘‘(B) carrying out such other responsibilities 
and duties relating to quality assurance in the Ad-
ministration as the Under Secretary for Health shall 
specify. 
‘‘(4) The requirements under paragraph (3) shall in-
clude requirements regarding the following: 
‘‘(A) A confidential system for the submittal of 
reports by Administration personnel regarding qual-
ity assurance at Administration facilities. 
‘‘(B) Mechanisms for the peer review of the ac-
tions of individuals appointed in the Administration 
in the position of physician. 
‘‘(C) Mechanisms for the accountability of the 
facility director and chief medical officer of each Ad-
ministration medical facility for the actions of physi-
cians in such facility. 
‘‘(b) QUALITY ASSURANCE OFFICERS FOR VISNS.— 
(1) The Regional Director of each Veterans Integrated 
Services Network (VISN) shall appoint an official of the 
Network to act as the quality assurance officer of the Net-
work. 
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‘‘(2) Each official appointed as a quality assurance 
officer under this subsection shall be a board-certified phy-
sician. 
‘‘(3) The quality assurance officer for a Veterans In-
tegrated Services Network shall report to the Regional Di-
rector of the Veterans Integrated Services Network, and 
to the National Quality Assurance Officer, regarding the 
discharge of the responsibilities and duties of the officer 
under this section. 
‘‘(4) The quality assurance officer for a Veterans In-
tegrated Services Network shall— 
‘‘(A) direct the quality assurance office in the 
Network; and 
‘‘(B) coordinate, monitor, and oversee the qual-
ity assurance programs and activities of the Admin-
istration medical facilities in the Network in order to 
ensure the thorough and uniform discharge of qual-
ity assurance requirements under such programs 
and activities throughout such facilities. 
‘‘(c) QUALITY ASSURANCE OFFICERS FOR MEDICAL 
FACILITIES.—(1) The director of each Administration 
medical facility shall appoint a quality assurance officer 
for that facility. 
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‘‘(2) Each official appointed as a quality assurance 
officer under this subsection shall be a board-certified phy-
sician. 
‘‘(3) The official appointed as a quality assurance of-
ficer for a facility under this subsection shall be a prac-
ticing physician at the facility. If the official appointed as 
quality assurance officer for a facility has other clinical 
or administrative duties, the director of the facility shall 
ensure that those duties are sufficiently limited in scope 
so as to ensure that those duties do not prevent the officer 
from effectively discharging the responsibilities and duties 
of quality assurance officer at the facility. 
‘‘(4) The quality assurance officer for a facility shall 
report directly to the director of the facility, and to the 
quality assurance officer of the Veterans Integrated Serv-
ices Network in which the facility is located, regarding the 
discharge of the responsibilities and duties of the quality 
assurance officer under this section. 
‘‘(5) The quality assurance officer for a facility shall 
be responsible for designing, disseminating, and imple-
menting quality assurance programs and activities for the 
facility that meet the requirements established by the Na-
tional Quality Assurance Officer under subsection (a).’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of chapter 73 of such title is 
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