HR 4626 RFS
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘VA Assessment by 
Independent Measures Act’’ or the ‘‘VA AIM Act’’. 
SEC. 2. REQUIREMENT FOR ONGOING INDEPENDENT AS-
SESSMENTS OF HEALTH CARE DELIVERY SYS-
TEMS AND MANAGEMENT PROCESSES OF 
THE DEPARTMENT OF VETERANS AFFAIRS. 
(a) ONGOING ASSESSMENTS.—Chapter 17 of title 38, 
United States Code, is amended by inserting after section 
1704 the following new section: 
‘‘§ 1704A. Independent assessments of health care de-
livery systems and management proc-
esses 
‘‘(a) INDEPENDENT ASSESSMENTS.—Not less fre-
quently than once every 10 years, the Secretary of Vet-
erans Affairs shall enter into one or more contracts with 
a private sector entity or entities described in subsection 
(d) to conduct an independent assessment of the hospital 
care, medical services, and other health care furnished by 
the Department of Veterans Affairs. Such assessment 
shall address each of the following: 
‘‘(1) Current and projected demographics and 
unique health care needs of the patient population 
served by the Department. 
‘‘(2) The accuracy of models and forecasting 
methods used by the Department to project health 
VerDate Sep 11 2014 
01:33 Nov 18, 2021
Jkt 029200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H4626.RFS
H4626
kjohnson on DSK79L0C42PROD with BILLS
HR 4626 RFS
care demand, including with respect to veteran de-
mographics, rates of use of health care furnished by 
the Department, the inflation of health care costs, 
and such other factors as may be determined rel-
evant by the Secretary. 
‘‘(3) The reliability and accuracy of models and 
forecasting methods used by the Department to 
project the budgetary needs of the Veterans Health 
Administration and how such models and forecasting 
methods inform budgetary trends. 
‘‘(4) The authorities and mechanisms under 
which the Secretary may furnish hospital care, med-
ical services, and other health care at Department 
and non-Department facilities, including through 
Federal and private sector partners and at joint 
medical facilities, and the effect of such authorities 
and mechanisms on eligibility and access to care. 
‘‘(5) The organization, workflow processes, and 
tools used by the Department to support clinical 
staffing, access to care, effective length-of-stay man-
agement and care transitions, positive patient expe-
rience, accurate documentation, and subsequent cod-
ing of inpatient services. 
‘‘(6) The efforts of the Department to recruit 
and retain staff at levels necessary to carry out the 
VerDate Sep 11 2014 
01:33 Nov 18, 2021
Jkt 029200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H4626.RFS
H4626
kjohnson on DSK79L0C42PROD with BILLS
HR 4626 RFS
functions of the Veterans Health Administration and 
the process used by the Department to determine 
staffing levels necessary for such functions. 
‘‘(7) The staffing level at each medical facility 
of the Department and the productivity of each 
health care provider at the medical facility, com-
pared with health care industry performance 
metrics, which may include the following: 
‘‘(A) An assessment of the case load of, 
and number of patients treated by, each health 
care provider at such medical facility during an 
average week. 
‘‘(B) An assessment of the time spent by 
each such health care provider on matters other 
than the case load of the health care provider, 
including time spent by the health care provider 
as follows: 
‘‘(i) At a medical facility that is affili-
ated with the Department. 
‘‘(ii) Conducting research. 
‘‘(iii) Training or supervising other 
health care professionals of the Depart-
ment. 
‘‘(8) The information technology strategies of 
the Department with respect to furnishing and man-
VerDate Sep 11 2014 
01:33 Nov 18, 2021
Jkt 029200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H4626.RFS
H4626
kjohnson on DSK79L0C42PROD with BILLS
HR 4626 RFS
aging health care, including an identification of any 
weaknesses or opportunities with respect to the tech-
nology used by the Department, especially those 
strategies with respect to clinical documentation of 
hospital care, medical services, and other health 
care, including any clinical images and associated 
textual reports, furnished by the Department in De-
partment or non-Department facilities. 
‘‘(9) Business processes of the Veterans Health 
Administration, including processes relating to fur-
nishing non-Department health care, insurance iden-
tification, third-party revenue collection, and vendor 
reimbursement, including an identification of mecha-
nisms as follows: 
‘‘(A) To avoid the payment of penalties to 
vendors. 
‘‘(B) To increase the collection of amounts 
owed to the Department for hospital care, med-
ical services, or other health care provided by 
the Department, for which reimbursement from 
a third party is authorized and to ensure that 
such amounts collected are accurate. 
‘‘(C) To increase the collection of any 
other amounts owed to the Department with re-
spect to hospital care, medical services, or other 
VerDate Sep 11 2014 
01:33 Nov 18, 2021
Jkt 029200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H4626.RFS
H4626
kjohnson on DSK79L0C42PROD with BILLS
HR 4626 RFS
health care and to ensure that such amounts 
collected are accurate. 
‘‘(D) To increase the accuracy and timeli-
ness of Department payments to vendors and 
providers. 
‘‘(E) To reduce expenditures while improv-
ing the quality of care furnished. 
‘‘(10) The purchase, distribution, and use of 
pharmaceuticals, medical and surgical supplies, med-
ical devices, and health care-related services by the 
Department, including the following: 
‘‘(A) The prices paid for, standardization 
of, and use by, the Department with respect to 
the following: 
‘‘(i) Pharmaceuticals. 
‘‘(ii) Medical and surgical supplies. 
‘‘(iii) Medical devices. 
‘‘(B) The use by the Department of group 
purchasing arrangements to purchase pharma-
ceuticals, medical and surgical supplies, medical 
devices, and health care-related services. 
‘‘(C) The strategy and systems used by the 
Department to distribute pharmaceuticals, med-
ical and surgical supplies, medical devices, and 
health care-related services to Veterans Inte-
VerDate Sep 11 2014 
01:33 Nov 18, 2021
Jkt 029200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H4626.RFS
H4626
kjohnson on DSK79L0C42PROD with BILLS
HR 4626 RFS
grated Service Networks and medical facilities 
of the Department. 
‘‘(11) The process of the Department for car-
rying out construction and maintenance projects at 
medical facilities of the Department and the medical 
facility leasing program of the Department. 
‘‘(12) The competency of Department leader-
ship with respect to culture, accountability, reform 
readiness, leadership development, physician align-
ment, employee engagement, succession planning, 
and performance management. 
‘‘(13) The effectiveness of the authorities and 
programs of the Department to educate and train 
health personnel pursuant to section 7302 of this 
title. 
‘‘(14) The conduct of medical and prosthetic re-
search of the Department. 
‘‘(15) The provision of Department assistance 
to Federal agencies and personnel involved in re-
sponding to a disaster or emergency. 
‘‘(16) Such additional matters as may be deter-
mined relevant by the Secretary. 
‘‘(b) TIMING.—The private sector entity or entities 
carrying out an assessment pursuant to subsection (a) 
shall complete such assessment not later than one year 
VerDate Sep 11 2014 
01:33 Nov 18, 2021
Jkt 029200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H4626.RFS
H4626
kjohnson on DSK79L0C42PROD with BILLS