IB 
Union Calendar No. 807 
115TH CONGRESS 
2D SESSION 
H. R. 6066 
[Report No. 115–1034] 
To amend title 38, United States Code, to improve the productivity of the 
management of Department of Veterans Affairs health care, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 8, 2018 
Mr. WENSTRUP introduced the following bill; which was referred to the 
Committee on Veterans’ Affairs 
NOVEMBER 16, 2018 
Reported with an amendment, committed to the Committee of the Whole 
House on the State of the Union, and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in italic] 
[For text of introduced bill, see copy of bill as introduced on June 8, 2018] 
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A BILL 
To amend title 38, United States Code, to improve the 
productivity of the management of Department of Vet-
erans Affairs health care, and for other purposes. 
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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. DEPARTMENT OF VETERANS AFFAIRS HEALTH 
CARE PRODUCTIVITY IMPROVEMENT. 
(a) IN GENERAL.—Subchapter I of chapter 17 of title 
38, United States Code, is amended by inserting after sec-
tion 1705A the following new section: 
‘‘§ 1705B. Management of health care: productivity 
‘‘(a) RELATIVE VALUE UNIT TRACKING.—The Sec-
retary shall track relative value units for all Department 
providers. 
‘‘(b) CLINICAL PROCEDURE CODING TRAINING.—If the 
coding accuracy of a Department provider within a clinical 
area of responsibility of the provider falls below the min-
imum threshold set by the Secretary, the Secretary shall re-
quire the Department provider to attend training on clin-
ical procedure coding. 
‘‘(c) PERFORMANCE STANDARDS.—(1) The Secretary 
shall establish for each Department facility— 
‘‘(A) in accordance with paragraph (2), stand-
ardized performance standards based on nationally 
recognized relative value unit production standards 
applicable to each specific profession in order to 
evaluate clinical productivity at the provider and fa-
cility level; 
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‘‘(B) remediation plans to address low clinical 
productivity and clinical inefficiency; and 
‘‘(C) an ongoing process to systematically review 
the content, implementation, and outcome of the plans 
developed under subparagraph (B). 
‘‘(2) In establishing the performance standards under 
paragraph (1)(A), the Secretary— 
‘‘(A) may incorporate values-based productivity 
models and may incorporate other productivity meas-
ures and models determined appropriate by the Sec-
retary; and 
‘‘(B) shall take into account non-clinical duties, 
including with respect to training and research; 
‘‘(C) shall take into account factors that impede 
productivity and efficiency and, in developing reme-
diation plans under paragraph (1)(B), shall incor-
porate action plans to address such factors. 
‘‘(d) DEFINITIONS.—In this section: 
‘‘(1) The term ‘Department provider’ means an 
employee of the Department who has been appointed 
to the Veterans Health Administration as a physi-
cian, a dentist, an optometrist, a podiatrist, a chiro-
practor, an advanced practice registered nurse, or a 
physician’s assistant acting as an independent pro-
vider. 
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‘‘(2) The term ‘relative value unit’ means a unit 
for measuring workload by determining the time, 
mental effort and judgment, technical skill, physical 
effort, and stress involved in delivering a service.’’. 
(b) CLERICAL AMENDMENT.—The table of sections at 
the beginning of such chapter is amended by inserting after 
the item relating to section 1705A the following new item: 
‘‘1705B. Management of health care: productivity.’’. 
(c) REPORT.—Not later than one year after the date 
of the enactment of this Act, the Secretary of Veterans Af-
fairs shall submit to Congress a report on the implementa-
tion of section 1705B of title 38, United States Code, as 
added by subsection (a). Such report shall include, for each 
professional category of Department of Veterans Affairs 
providers, the relative value unit of such category of pro-
viders at the national, Veterans Integrated Service Network, 
and facility levels. 
(d) COMPREHENSIVE STAFFING MODELS.—Not later 
than one year after the date of the enactment of this Act, 
the Secretary of Veterans Affairs shall develop comprehen-
sive staffing models for all Department of Veterans Affairs 
medical centers. 
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