II 118th CONGRESS 1st Session S. 2745 IN THE SENATE OF THE UNITED STATES September 7, 2023 Mr. Peters (for himself and Mr. Boozman ) introduced the following bill; which was read twice and referred to the Committee on Veterans' Affairs A BILL To amend title 38, United States Code, to eliminate conflicts of interest in conduct of quality management and administrative investigations by the Veterans Health Administration and to limit the detail of directors of medical centers of Department of Veterans Affairs to different positions, and for other purposes.

1. Short title This Act may be cited as the Veterans Affairs Peer Review Neutrality Act of 2023 . 2. Elimination of conflicts of interest in peer review, administrative investigation boards, and factfindings of Veterans Health Administration (a) In general Subchapter II of chapter 73 of title 38, United States Code, is amended by inserting after section 7311A the following new section: 7311B. Elimination of conflicts of interest in peer review, administrative investigation boards, and factfindings of Veterans Health Administration (a) Peer review (1) In general Each individual responsible for conducting peer review for quality management of care provided by a health care provider at a medical facility of the Department and each member of a peer review committee with respect to quality management of such care shall withdraw from participation in a case review if— (A) the individual has direct involvement with the care under review; or (B) the individual is unable to conduct an objective, impartial, accurate, and informed review. (2) Neutral assessment of conduct of committee members Each medical facility of the Department shall develop procedures and guidelines for that facility to require that any initial peer review for quality management that is conducted with respect to care provided by a health care provider who is a member of the peer review committee for that facility be evaluated, discussed, and assigned a final level review by a neutral peer review committee at another facility of the Department. (b) Administrative investigation boards and factfindings (1) Knowledge of confidential information Individuals with knowledge of confidential quality assurance information specific to a matter under investigation by an administrative investigation board or factfinder with respect to quality management of care provided by a health care provider at a medical facility of the Department may not— (A) serve on the administrative investigation board or as a factfinder; or (B) disclose such information to an administrative investigation board or a factfinder. (2) Personal interest, involvement, or relationship (A) In general The Secretary shall ensure that each member of an administrative investigative board or factfinder does not have— (i) any personal interest or other bias concerning the investigation being conducted; (ii) direct involvement in matters being investigated; or (iii) a supervisory or personal relationship with the subject of the investigation. (B) Recusal If a potential member of an administrative investigative board or factfinder has a personal interest or other bias concerning the investigation being conducted, direct involvement in matters being investigated, or a supervisory or personal relationship with the subject of the investigation, the potential member shall inform the authority responsible for the investigation and recuse themselves from such matter. . (b) Clerical amendment The table of sections at the beginning of such subchapter is amended by inserting after the item relating to section 7311A the following new item: 7311B. Elimination of conflicts of interest in peer review, administrative investigation boards, and factfindings of Veterans Health Administration. . 3. Limitation on detail of directors of medical centers of Department of Veterans Affairs to different positions (a) Notification (1) In general Not later than 90 days after detailing a director of a medical center of the Department of Veterans Affairs to a different position within the Department, the Secretary of Veterans Affairs shall notify the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives of such detail. (2) Matters To be included The notification required by paragraph (1) shall include, with respect to a director of a medical center who is detailed to a different position within the Department, the following information: (A) The location at which the director is detailed. (B) The position title of the detail. (C) The estimated time the director is expected to be absent from their duties at the medical center. (D) Such other information as the Secretary may determine appropriate. (b) Appointment of acting director Not later than 120 days after detailing a director of a medical center of the Department to a different position within the Department, the Secretary shall appoint an individual as acting director of such medical center with all of the authority and responsibilities of the detailed director. (c) Update on detail Not later than 120 days after detailing a director of a medical center of the Department to a different position within the Department, and not less frequently than every 30 days thereafter while the detail is in effect or while the director position at the medical center is vacant, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives an update regarding the status of the detail. (d) Return to position or reassignment (1) In general Except as provided in paragraph (2), not later than 180 days after detailing a director of a medical center of the Department to a different position within the Department, for a reason other than an ongoing investigation or administrative action with respect to the director, the Secretary shall— (A) return the individual to the position as director of the medical center; or (B) reassign the individual from the position as director of the medical center and begin the process of hiring a new director for such position. (2) Waiver (A) In general The Secretary may waive the requirement under paragraph (1) with respect to an individual for successive 90-day increments for a total period of not more than 540 days from the original date the individual was detailed away from their position as director of a medical center. (B) Notification Not later than 30 days after exercising a waiver under subparagraph (A), the Secretary shall notify Congress of the waiver and provide to Congress information as to why the waiver is necessary.