I 
110TH CONGRESS 
1ST SESSION H. R. 1448 
To amend title 38, United States Code, to establish a Hospital Quality 
Report Card Initiative to report on health care quality in Department 
of Veterans Affairs hospitals. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 9, 2007 
Mrs. LOWEY (for herself and Mr. EDWARDS) introduced the following bill; 
which was referred to the Committee on Veterans’ Affairs 
A BILL 
To amend title 38, United States Code, to establish a Hos-
pital Quality Report Card Initiative to report on health 
care quality in Department of Veterans Affairs hospitals. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘VA Hospital Quality 
Report Card Act of 2007’’. 
SEC. 2. PURPOSE. 
The purpose of this Act is to establish the Hospital 
Quality Report Card Initiative under title 38, United 
States Code, to ensure that quality measures data for hos-
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pitals administered by the Secretary of Veterans Affairs 
are readily available and accessible in order to— 
(1) inform patients and consumers about health 
care quality in such hospitals; 
(2) assist Department of Veterans Affairs 
health care providers in identifying opportunities for 
quality improvement and cost containment; and 
(3) enhance the understanding of policy makers 
and public officials of health care issues, raise public 
awareness of hospital quality issues, and help con-
stituents of such policy makers and officials identify 
quality health care options. 
SEC. 3. DEPARTMENT OF VETERANS AFFAIRS HOSPITAL 
QUALITY REPORT CARD INITIATIVE. 
(a) IN GENERAL.—Subchapter III of chapter 17 of 
title 38, United States Code, is amended by adding at the 
end the following new section: 
‘‘§ 1730A. Hospital Quality Report Card Initiative 
‘‘(a) The Secretary shall establish and implement a 
Hospital Quality Report Card Initiative (in this section re-
ferred to as the ‘Initiative’) to report on health care qual-
ity in Department hospitals. 
‘‘(b)(1)(A) Not less than 2 times each year, the Sec-
retary shall publish and distribute, in accordance with sub-
paragraph (F), reports on Department hospital quality. 
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The reports shall include quality measures data that allow 
for an assessment of health care— 
‘‘(i) effectiveness; 
‘‘(ii) safety; 
‘‘(iii) timeliness; 
‘‘(iv) efficiency; 
‘‘(v) patient-centeredness; and 
‘‘(vi) equity. 
‘‘(B) In collecting and reporting data as provided for 
under subparagraph (A), the Secretary shall include De-
partment hospital information, as possible, relating to— 
‘‘(i) staffing levels of nurses and other health 
professionals, as appropriate; 
‘‘(ii) rates of nosocomial infections; 
‘‘(iii) the volume of various procedures per-
formed; 
‘‘(iv) hospital sanctions and other violations; 
‘‘(v) the quality of care for various patient pop-
ulations, including female, geriatric, disabled, rural, 
homeless, mentally ill, and racial and ethnic minority 
populations; 
‘‘(vi) the availability of emergency rooms, inten-
sive care units, maternity care, and specialty serv-
ices; 
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‘‘(vii) the quality of care in various hospital set-
tings, including inpatient, outpatient, emergency, 
maternity, and intensive care unit settings; 
‘‘(viii) ongoing patient safety initiatives; and 
‘‘(ix) other measures determined appropriate by 
the Secretary. 
‘‘(C)(i) In reporting data as provided for under sub-
paragraph (A), the Secretary may risk adjust quality 
measures to account for differences relating to— 
‘‘(I) the characteristics of the reporting Depart-
ment hospital, such as licensed bed size, geography, 
and teaching hospital status; and 
‘‘(II) patient characteristics, such as health sta-
tus, severity of illness, and socioeconomic status. 
‘‘(ii) If the Secretary reports data under subpara-
graph (A) using risk-adjusted quality measures, the Sec-
retary shall establish procedures for making the 
unadjusted data available to the public in a manner deter-
mined appropriate by the Secretary. 
‘‘(D) Under the Initiative, the Secretary may verify 
data reported under this paragraph to ensure accuracy 
and validity. 
‘‘(E) The Secretary shall disclose the entire method-
ology for the reporting of data under this paragraph to 
all relevant organizations and Department hospitals that 
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are the subject of any such information that is to be made 
available to the public prior to the public disclosure of such 
information. 
‘‘(F)(i) The Secretary shall submit each report to the 
appropriate committees of Congress. 
‘‘(ii) The Secretary shall ensure that reports are 
made available under this section in an electronic format, 
in an understandable manner with respect to various pop-
ulations (including those with low functional health lit-
eracy), and in a manner that allows health care quality 
comparisons to be made with local hospitals or regional 
hospitals, as appropriate. 
‘‘(iii) The Secretary shall establish procedures for 
making report findings available to the public, upon re-
quest, in a non-electronic format, such as through a toll- 
free telephone number. 
‘‘(G) The analytic methodologies and limitations on 
data sources utilized by the Secretary to develop and dis-
seminate the comparative data under this section shall be 
identified and acknowledged as part of the dissemination 
of such data, and such dissemination shall include the ap-
propriate and inappropriate uses of the data. 
‘‘(H) On at least an annual basis, the Secretary shall 
compare quality measures data submitted by each Depart-
ment hospital with data submitted in the prior year or 
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years by the same hospital in order to identify and report 
actions that would lead to false or artificial improvements 
in the hospital’s quality measurements. 
‘‘(2)(A) The Secretary shall develop and implement 
effective safeguards to protect against the unauthorized 
use or disclosure of Department hospital data that is re-
ported under this section. 
‘‘(B) The Secretary shall develop and implement ef-
fective safeguards to protect against the dissemination of 
inconsistent, incomplete, invalid, inaccurate, or subjective 
Department hospital data. 
‘‘(C) The Secretary shall ensure that identifiable pa-
tient data shall not be released to the public. 
‘‘(c)(1) The Secretary shall evaluate and periodically 
submit a report to Congress on the effectiveness of the 
Initiative, including the effectiveness of the Initiative in 
meeting the purpose described in section 2 of the VA Hos-
pital Quality Report Card Act of 2007. The Secretary 
shall make such reports available to the public. 
‘‘(2) The Secretary shall use the outcomes from the 
evaluation conducted pursuant to paragraph (1) to in-
crease the usefulness of the Initiative. 
‘‘(d) There are authorized to be appropriated to carry 
out this section such sums as may be necessary for each 
of fiscal years 2008 through 2017.’’. 
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(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 17, United States Code, is 
amended by inserting after the item relating to section 
1730 the following new item: 
‘‘1730A. Hospital Quality Report Card Initiative.’’. 
(c) EFFECTIVE DATE.—Section 1730A of title 38, 
United States Code, as added by subsection (a), shall take 
effect not later than 18 months after the date of the enact-
ment of this Act. 
Æ 
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