,,ii  #aac? ,,congress  #b;d ,session   
,s4 #bdbd  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,june #c1 #bjad ,mr4   
,mc,cain 7= himself1 ,mr4 ,coburn1 ,mr4 
,burr1 ,mr4 ,flake1 ,mr4 ,isakson1 ,mr4 
,inh(e1 ,mr4 ,grassley1 ,mr4 ,rob]ts1   
,mr4 ,hoev51 ,mr4 ,coats1 ,mr4 ,b>rasso1
 ,mr4 ,johanns1 ,mr4 ,rubio1 ,mr4       
,cornyn1 ,mr4 ,alex&]1 ,mr4 ,kirk1 ,mr4 
,wick]1 ,mrs4 ,fis*]1 ,mr4 ,portman1    
,mr4 ,toomey1 ,mr4 ,boozman1 ,mr4       
,moran1 ,mr4 ,?une1 ,mr4 ,scott1 ,mr4   
,enzi1 & ,mr4 ,graham7 introduc$ !      
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,vet]ans' ,affairs   
,a ,,bill  ,to provide vet]ans ) ! *oice
 ( m$ical provid]s & to increase        
transp>5cy & acc\ntability ( op]ations (
 ! ,vet]ans ,heal? ,adm9i/ration ( !    
,dep>tm5t ( ,vet]ans ,affairs1 & = o!r  
purposes4  #a4 ,%ort title  ,?is ,act   
may be cit$ z ! ,vet]ans ,*oice ,act (  
#bjad4  #b4 ,exp&$ availability (       
hospital c>e & m$ical s]vices = vet]ans 
?r\gh ! use ( contracts  7a7 ,expansion 

( available c>e & s]vices  7#a7 ,9 g5]al
 ,hospital c>e & m$ical s]vices "u *apt]
 #ag ( title #ch1 ,unit$ ,/ates ,code1  
%all be furni%$ to an eligible vet]an   
describ$ 9 subsection 7b71 at ! election
 ( su* vet]an1 ?r\gh contracts au?oriz$ 
"u subsection 7d71 or any o!r law       
adm9i/]$ by ! ,secret>y ( ,vet]ans      
,affairs1 ) heal? c>e provid]s t are    
p>ticipat+ 9 ! ,m$ic>e program "u title 
,,xviii ( ! ,social ,security ,act 7#db 
,u4,s4,c4 #acie et seq47 = ! furni%+ (  
su* c>e & s]vices to vet]ans4  7#b7     
,*oice ( provid] ,an eligible vet]an :o 
elects to receive c>e & s]vices "u ?is  
section may select ! provid] ( su* c>e &
 s]vices f among any s\rce ( provid] (  
su* c>e & s]vices specifi$ 9 p>agraph   
7#a7 t is accessible to ! vet]an4  7b7  
,eligible vet]ans ,a vet]an is an       
eligible vet]an = purposes ( ?is section
 if-- 7#a7 7,a7 ! vet]an is enroll$ 9 ! 
pati5t enrollm5t sy/em ( ! ,dep>tm5t (  
,vet]ans ,affairs e/abli%$ & op]at$ "u  
section #agje ( title #ch1 ,unit$ ,/ates

 ,code2 or  7,b7 ! vet]an is enroll$ 9  
su* sy/em1 has n receiv$ hospital c>e & 
m$ical s]vices f ! ,dep>tm5t1 & has     
contact$ ! ,dep>tm5t seek+ an initial   
appo9tm5t f ! ,dep>tm5t = ! receipt (   
su* c>e & s]vices2 &  7#b7 ! vet]an     
ei!r-- 7,a7 7i7 attempts1 or has        
attempt$ "u p>agraph 7#a77;,b71 to      
s*$ule an appo9tm5t = ! receipt ( su*   
c>e & s]vices b is unable to s*$ule an  
appo9tm5t )9 ! curr5t wait-"t goals ( ! 
,vet]ans ,heal? ,adm9i/ration = !       
deliv]y ( su* c>e & s]vices2 &  7ii7    
elects1 & is au?oriz$1 to be furni%$ su*
 c>e or s]vices pursuant to subsection  
7c77#b72 or  7,b7 resides m ?an #dj     
miles f ! ne>e/ m$ical facility ( !     
,dep>tm5t1 includ+ a community-bas$     
outpati5t cl9ic1 t is close/ to !       
resid5ce ( ! vet]an4  7c7 ,election &   
au?orization ,if ! ,secret>y confirms t 
an appo9tm5t = an eligible vet]an       
describ$ 9 subsection 7b77#b77;,a7 = !  
receipt ( hospital c>e or m$ical s]vices
 "u *apt] #ag ( title #ch1 ,unit$ ,/ates

 ,code1 is unavailable )9 ! curr5t      
wait-"t goals ( ! ,dep>tm5t = ! furni%+ 
( su* c>e or s]vices1 ! ,secret>y %all1 
at ! election ( ! eligible vet]an-- 7#a7
 place su* eligible vet]an on an        
electronic wait+ li/ = su* an appo9tm5t 
t is ma9ta9$ by ! ,dep>tm5t & accessible
 to ! vet]an via www4myheal?4va4gov or  
any successor website2 or  7#b7 7,a7    
au?orize t su* c>e & s]vices be furni%$ 
to ! eligible vet]an "u ?is section = a 
p]iod ( "t specifi$ by ! ,secret>y2 &   
7,b7 s5d a lett] to ! eligible vet]an   
describ+ ! c>e & s]vices ! eligible     
vet]an is eligible to receive "u ?is    
section4  7d7 ,c>e & s]vices ?r\gh      
contracts  7#a7 ,9 g5]al ,! ,secret>y   
%all ent] into contracts ) heal? c>e    
provid]s t are p>ticipat+ 9 ! ,m$ic>e   
program "u title ,,xviii ( ! ,social    
,security ,act 7#db ,u4,s4,c4 #acie et  
seq47 to furni% c>e & s]vices to        
eligible vet]ans "u ?is section4  7#b7  
,rates & reimbursem5t  7,a7 ,9 g5]al ,9 
ent]+ into a contract "u ?is subsection1

 ! ,secret>y %all-- 7i7 negotiate rates 
= ! furni%+ ( c>e & s]vices "u ?is      
section2 &  7ii7 reimburse ! heal? c>e  
provid] = su* c>e & s]vices at ! rates  
negotiat$ pursuant to clause 7i7 z      
provid$ 9 su* contract4  7,b7 ,limit on 
rates ,rates negotiat$ "u subp>agraph   
7,a77i7 %all n be m ?an ! rates paid by 
! ,unit$ ,/ates to a provid] ( s]vices  
7z def9$ 9 section #ahfa7u7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#aciex7u777 or a suppli] 7z def9$ 9     
section #ahfa7;d7 ( su* ,act 7#db       
,u4,s4,c4 #aciex7d777 "u ! ,m$ic>e      
program "u title ,,xviii ( ! ,social    
,security ,act 7#db ,u4,s4,c4 #acie et  
seq47 = ! same c>e & s]vices4  7,c7     
,limit on collection ,= ! furni%+ ( c>e 
& s]vices pursuant to a contract "u ?is 
section1 a heal? c>e provid] may n      
collect any am\nt t is great] ?an ! rate
 negotiat$ pursuant to subp>agraph      
7,a77i74  7#c7 ,in=mation on policies & 
proc$ures ,! ,secret>y %all provide to  
any heal? c>e provid] ) :i* ! ,secret>y 

has ent]$ into a contract "u p>agraph   
7#a7 ! foll[+3 7,a7 ,in=mation on       
applicable policies & proc$ures =       
submitt+ bills or claims = au?oriz$ c>e 
& s]vices furni%$ to eligible vet]ans "u
 ?is section4  7,b7 ,access to a        
telephone hotl9e ma9ta9$ by ! ,dep>tm5t 
t su* heal? c>e provid] may call =      
in=mation on ! foll[+3 7i7 ,proc$ures = 
furni%+ c>e & s]vices "u ?is section4   
7ii7 ,proc$ures = submitt+ bills or     
claims = au?oriz$ c>e & s]vices furni%$ 
to eligible vet]ans "u ?is section & be+
 reimburs$ = furni%+ su* c>e & s]vices4 
7iii7 ,:e!r p>ticul> c>e or s]vices "u  
?is section are au?oriz$1 & ! proc$ures 
= au?orization ( su* c>e or s]vices4    
7e7 ,*oice c>d  7#a7 ,9 g5]al ,=        
purposes ( receiv+ c>e & s]vices "u ?is 
section1 ! ,secret>y %all issue to ea*  
eligible vet]an a c>d t ! eligible      
vet]an %all pres5t to a heal? c>e       
provid] t is eligible to furni% c>e &   
s]vices "u ?is section be=e receiv+ su* 
c>e & s]vices4  7#b7 ,"n ( c>d ,ea* c>d 

issu$ "u p>agraph 7#a7 %all be kn[n z a 
,*oice ,c>d4  7#c7 ,details ( c>d ,ea*  
,*oice ,c>d issu$ to an eligible vet]an 
"u p>agraph 7#a7 %all include ! foll[+3 
7,a7 ,! "n ( ! eligible vet]an4  7,b7   
,an id5tification numb] = ! eligible    
vet]an t is n ! social security numb] ( 
! eligible vet]an4  7,c7 ,! contact     
in=mation ( an appropriate (fice ( !    
,dep>tm5t = heal? c>e provid]s to       
confirm t c>e & s]vices "u ?is section  
is au?oriz$ = ! eligible vet]an4  7,d7  
,contact in=mation & o!r relevant       
in=mation = ! submittal ( claims or     
bills = ! furni%+ ( c>e & s]vices "u ?is
 section4  7,e7 ,! foll[+ /atem5t3 ,?is 
c>d is = qualify+ m$ical c>e outside !  
,dep>tm5t ( ,vet]ans ,affairs4 ,please  
call ! ,dep>tm5t ( ,vet]ans ,affairs    
phone numb] specifi$ on ?is c>d to      
ensure t treatm5t has be5 au?oriz$44    
7#d7 ,in=mation on use ( c>d ,^u issu+ a
 ,*oice ,c>d to an eligible vet]an1 !   
,secret>y %all provide ! eligible vet]an
 ) in=mation cle>ly /at+ ! circum/ances 

"u :i* ! vet]an may be eligible = c>e & 
s]vices "u ?is section4  7f7 ,in=mation 
on availability ( c>e ,! ,secret>y %all 
provide in=mation to a vet]an ab\t !    
availability ( c>e & s]vices "u ?is     
section 9 ! foll[+ circum/ances3 7#a7   
,:5 ! vet]an enrolls 9 ! pati5t         
enrollm5t sy/em ( ! ,dep>tm5t "u section
 #agje ( title #ch1 ,unit$ ,/ates ,code4
  7#b7 ,:5 ! vet]an attempts to s*$ule  
an appo9tm5t = ! receipt ( hospital c>e 
or m$ical s]vices f ! ,dep>tm5t b is    
unable to s*$ule an appo9tm5t )9 !      
curr5t wait-"t goals ( ! ,vet]ans ,heal?
 ,adm9i/ration = deliv]y ( su* c>e or   
s]vices4  7g7 ,provid]s ,to be eligible 
to furni% c>e & s]vices "u ?is section1 
a heal? c>e provid] mu/ ma9ta9 at lea/ !
 same or simil> cr$5tials & lic5ses z ^?
 cr$5tials & lic5ses t are requir$ (    
heal? c>e provid]s ( ! ,dep>tm5t1 z     
det]m9$ by ! ,secret>y = purposes ( ?is 
section4  7h7 ,co/-,%>+ ,! ,secret>y    
%all require an eligible vet]an to pay a
 copaym5t to ! ,dep>tm5t = ! receipt (  

c>e & s]vices "u ?is section only if !  
eligible vet]an w\ld be requir$ to pay  
su* copaym5t = ! receipt ( su* c>e &    
s]vices at a m$ical facility ( !        
,dep>tm5t4  7i7 ,claims process+ sy/em  
7#a7 ,9 g5]al ,! ,secret>y %all provide 
= an effici5t nationwide sy/em =        
process+ & pay+ bills or claims =       
au?oriz$ c>e & s]vices furni%$ to       
eligible vet]ans "u ?is section4  7#b7  
,regulations ,n lat] ?an #ij days aft] !
 date ( ! enactm5t ( ?is ,act1 !        
,secret>y ( ,vet]ans ,affairs %all      
prescribe regulations = ! implem5tation 
( ! effici5t nationwide sy/em requir$ by
 p>agraph 7#a74  7j7 ,cont9uity ( m$ical
 records ,! ,secret>y %all ensure t     
m$ical records ( vet]ans ma9ta9$ by !   
,dep>tm5t are updat$ to accurately      
reflect any c>e & s]vices furni%$ "u ?is
 section4  7k7 ,track+ ( miss$          
appo9tm5ts ,! ,secret>y %all implem5t a 
me*anism to track any miss$ appo9tm5ts =
 c>e & s]vices "u ?is section by        
eligible vet]ans to ensure t ! ,dep>tm5t

 does n pay = su* c>e & s]vices t 7 n   
furni%$4  7l7 ,implem5tation ,n lat] ?an
 #ij days aft] ! date ( ! enactm5t ( ?is
 ,act1 ! ,secret>y %all prescribe int]im
 f9al regulations on ! implem5tation (  
?is section & publi% su* regulations 9 !
 ,f$]al ,regi/]4  7m7 ,inspector ,g5]al 
audit ,n lat] ?an #edj days aft] !      
publication ( ! int]im f9al regulations 
"u subsection 7l71 ! ,inspector ,g5]al (
 ! ,dep>tm5t %all conduct an audit ( c>e
 & s]vices furni%$ "u ?is section to    
ensure ! accuracy ( paym5ts by !        
,dep>tm5t = ! co/ ( c>e & s]vices       
furni%$ "u ?is section4  7n7 ,t]m9ation 
,! requirem5t ( ! ,secret>y to furni%   
c>e & s]vices "u ?is section t]m9ates on
 ! date t is two ye>s aft] ! date on :i*
 ! ,secret>y publi%es ! int]im f9al     
regulations "u subsection 7l74  7o7     
,reports ,n less frequ5tly ?an once e   
#ij days1 ! ,secret>y %all submit to    
,congress a report on ! furni%+ ( c>e & 
s]vices "u ?is section t includes !     
foll[+3 7#a7 ,! numb] ( vet]ans :o h    

receiv$ c>e & s]vices "u ?is section    
dur+ ! #ij-;day p]iod prec$+ ! submittal
 ( ! report4  7#b7 ,a description ( !   
type ( c>e & s]vices furni%$ to vet]ans 
"u ?is section dur+ su* #ij-;day p]iod4 
#c4 ,s5se ( ,congress on prompt paym5t  
by ,dep>tm5t ( ,vet]ans ,affairs ,x is !
 s5se ( ,congress t ! ,secret>y (       
,vet]ans ,affairs %all comply ) section 
#acae ( title #e1 ,code ( ,f$]al        
,regulations 7commonly kn[n z ! prompt  
paym5t rule71 or any correspond+ simil> 
regulation or rul+1 9 pay+ = heal? c>e  
pursuant to contracts ent]$ into )      
non-,dep>tm5t ( ,vet]ans ,affairs       
provid]s to provide heal? c>e "u ! laws 
adm9i/]$ by ! ,secret>y4  #d4 ,improv$  
p]=mance metrics = heal? c>e provid$ by 
,dep>tm5t ( ,vet]ans ,affairs  7a7      
,prohibition on use ( s*$ul+ & wait-,"t 
metrics 9 det]m9ation ( p]=mance aw>ds  
,! ,secret>y %all ensure t s*$ul+ &     
wait-"t metrics or goals are n us$ z    
factors 9 det]m9+ ! p]=mance ( ! foll[+ 
employees = purposes ( det]m9+ :e!r to  

pay p]=mance aw>ds to su* employees3    
7#a7 ,directors1 associate directors1   
assi/ant directors1 deputy directors1   
*iefs ( /aff1 & cl9ical leads ( m$ical  
c5t]s ( ! ,dep>tm5t4  7#b7 ,directors1  
assi/ant directors1 & quality managem5t 
(fic]s ( ,vet]ans ,integrat$ ,s]vice    
,networks ( ! ,dep>tm5t4  7b7           
,modification ( p]=mance plans  7#a7 ,9 
g5]al ,n lat] ?an #cj days aft] ! date (
 ! enactm5t ( ?is ,act1 ! ,secret>y %all
 modify ! p]=mance plans ( ! directors (
 ! m$ical c5t]s ( ! ,dep>tm5t & !       
directors ( ! ,vet]ans ,integrat$       
,s]vice ,networks to ensure t su* plans 
are bas$ on ! quality ( c>e receiv$ by  
vet]ans at ! heal? c>e facilities "u !  
jurisdictions ( su* directors4  7#b7    
,factors ,9 modify+ p]=mance plans "u   
p>agraph 7#a71 ! ,secret>y %all ensure t
 assessm5t ( ! quality ( c>e provid$ at 
heal? c>e facilities "u ! jurisdiction (
 a director describ$ 9 p>agraph 7#a7    
includes consid]ation ( ! foll[+3 7,a7  
,rec5t reviews by ! ,jo9t ,commission   

7=m]ly kn[n z ! ,jo9t ,commission on    
,accr$itation ( ,heal?c>e               
,organizations7 ( su* facilities4  7,b7 
,! numb] & nature ( recomm5dations      
conc]n+ su* facilities by ! ,inspector  
,g5]al ( ! ,dep>tm5t 9 reviews conduct$ 
?r\gh ,comb9$ ,assessm5t ,program       
7,,cap7 reviews1 9 ! reviews by !       
,inspector ,g5]al ( community-bas$      
outpati5t cl9ics & prim>y c>e cl9ics1 & 
9 reviews conduct$ ?r\gh ! ,(fice (     
,heal?c>e ,inspections dur+ ! two mo/   
rec5tly complet$ fiscal ye>s4  7,c7 ,!  
numb] ( recomm5dations describ$ 9       
subp>agraph 7,b7 t ! ,inspector ,g5]al (
 ! ,dep>tm5t det]m9es h n be5 c>ri$ out 
satisfactorily ) respect to su*         
facilities4  7,d7 ,reviews ( su*        
facilities by ! ,commission on          
,accr$itation ( ,rehabilitation         
,facilities4  7,e7 ,! numb] & outcomes (
 adm9i/rative inve/igation bo>ds1 root  
cause analysis1 & pe] reviews conduct$  
at su* facilities dur+ ! fiscal ye> =   
:i* ! assessm5t is be+ conduct$4  7,f7  

,! effectiv5ess ( any rem$ial actions or
 plans result+ f any ,inspector ,g5]al  
recomm5dations 9 ! reviews & analyses   
describ$ 9 subp>agraphs 7,a7 ?r\gh 7,e74
  7#c7 ,additional lead]%ip positions   
,to ! degree practicable1 ! ,secret>y   
%all assess ! p]=mance ( o!r employees (
 ! ,dep>tm5t 9 lead]%ip positions at    
,dep>tm5t m$ical c5t]s1 includ+         
associate directors1 assi/ant directors1
 deputy directors1 *iefs ( /aff1 &      
cl9ical leads1 & 9 ,vet]ans ,integrat$  
,s]vice ,networks1 includ+ assi/ant     
directors & quality managem5t (fic]s1   
us+ factors & crit]ia simil> to ^? us$ 9
 ! p]=mance plans modifi$ "u p>agraph   
7#a74  #e4 ,improv$ transp>5cy conc]n+  
heal? c>e provid$ by ,dep>tm5t (        
,vet]ans ,affairs  7a7 ,publication (   
wait times  7#a7 ,goals  7,a7 ,initial  
,n lat] ?an #ij days aft] ! date ( !    
enactm5t ( ?is ,act1 ! ,secret>y (      
,vet]ans ,affairs %all publi% 9 ! ,f$]al
 ,regi/]1 & on an ,int]net website      
accessible to ! public ( ea* m$ical c5t]

 ( ! ,dep>tm5t ( ,vet]ans ,affairs1 !   
wait-"t goals ( ! ,dep>tm5t = ! s*$ul+ (
 an appo9tm5t by a vet]an = ! receipt ( 
heal? c>e f ! ,dep>tm5t4  7,b7          
,subsequ5t *anges  7i7 ,9 g5]al ,if !   
,secret>y modifies ! wait-"t goals      
describ$ 9 subp>agraph 7,a71 ! ,secret>y
 %all publi% ! new wait-"t goals-- 7,i7 
on an ,int]net website accessible to !  
public ( ea* m$ical c5t] ( ! ,dep>tm5t n
 lat] ?an #cj days aft] su*             
modification2 &  7,,ii7 9 ! ,f$]al      
,regi/] n lat] ?an #ij days aft] su*    
modification4  7ii7 ,effective date ,any
 modification "u clause 7i7 %all take   
effect on ! date ( publication 9 !      
,f$]al ,regi/]4  7,c7 ,goals describ$   
,wait-"t goals publi%$ "u ?is p>agraph  
%all include goals = prim>y c>e         
appo9tm5ts1 specialty c>e appo9tm5ts1 & 
goals = su* appo9tm5ts bas$ on ! g5]al  
sev]ity ( ! condition ( ! vet]an4  7#b7 
,wait times at m$ical c5t]s ( !         
,dep>tm5t ,n lat] ?an "o ye> aft] ! date
 ( ! enactm5t ( ?is ,act1 ! ,secret>y ( 

,vet]ans ,affairs %all publi% on an     
,int]net website accessible to ! public 
( ea* m$ical c5t] ( ! ,dep>tm5t ! curr5t
 wait "t = an appo9tm5t = prim>y c>e &  
specialty c>e at ! m$ical c5t]4  7b7    
,publicly available database ( pati5t   
safety1 quality ( c>e1 & outcome        
measures  7#a7 ,9 g5]al ,n lat] ?an #ahj
 days aft] ! date ( ! enactm5t ( ?is    
,act1 ! ,secret>y %all develop & make   
available to ! public a compreh5sive    
database conta9+ all applicable pati5t  
safety1 quality ( c>e1 & outcome        
measures = heal? c>e provid$ by !       
,dep>tm5t t are track$ by ! ,secret>y4  
7#b7 ,update frequ5cy ,! ,secret>y %all 
update ! database requir$ by p>agraph   
7#a7 n less frequ5tly ?an once ea* ye>4 
7#c7 ,unavailable measures ,= all       
measures t ! ,secret>y w\ld o!rwise     
publi% 9 ! database requir$ by p>agraph 
7#a7 b has n done s because su* measures
 are n available1 ! ,secret>y %all      
publi% notice 9 ! database ( ! reason = 
su* unavailability & a timel9e = mak+   

su* measures available 9 ! database4    
7#d7 ,accessibility ,! ,secret>y %all   
ensure t ! database requir$ by p>agraph 
7#a7 is accessible to ! public ?r\gh !  
prim>y ,int]net website ( ! ,dep>tm5t & 
?r\gh ea* prim>y ,int]net website ( a   
,dep>tm5t m$ical c5t]4  7c7 ,hospital   
,comp>e website ( ,dep>tm5t ( ,heal? &  
,human ,s]vices  7#a7 ,agreem5t requir$ 
,n lat] ?an #ahj days aft] ! date ( !   
enactm5t ( ?is ,act1 ! ,secret>y (      
,vet]ans ,affairs %all ent] into an     
agreem5t ) ! ,secret>y ( ,heal? & ,human
 ,s]vices = ! provision by ! ,secret>y (
 ,vet]ans ,affairs ( su* in=mation z !  
,secret>y ( ,heal? & ,human ,s]vices may
 require to report & make publicly      
available pati5t quality & outcome      
in=mation conc]n+ ,dep>tm5t ( ,vet]ans  
,affairs m$ical c5t]s ?r\gh ! ,hospital 
,comp>e ,int]net website ( ! ,dep>tm5t (
 ,heal? & ,human ,s]vices or any        
successor ,int]net website4  7#b7       
,in=mation provid$ ,! in=mation provid$ 
by ! ,secret>y ( ,vet]ans ,affairs to ! 

,secret>y ( ,heal? & ,human ,s]vices "u 
p>agraph 7#a7 %all include ! foll[+3    
7,a7 ,measures ( timely & effective     
heal? c>e4  7,b7 ,measures (            
readmissions1 complications ( dea?1     
includ+ ) respect to #cj-;day mortality 
rates & #cj-;day readmission rates1     
surgical complication measures1 & heal? 
c>e relat$ infection measures4  7,c7    
,survey data ( pati5t exp]i5ces1 includ+
 ! ,hospital ,consum] ,assessm5t (      
,heal?c>e ,provid]s & ,sy/ems or any    
simil> successor survey develop$ by !   
,dep>tm5t ( ,heal? & ,human ,s]vices4   
7,d7 ,any o!r measures requir$ ( or     
report$ ) respect to hospitals          
p>ticipat+ 9 ! ,m$ic>e program "u title 
,,xviii ( ! ,social ,security ,act 7#db 
,u4,s4,c4 #acie et seq474  7#c7         
,unavailable in=mation ,= any applicable
 metric collect$ by ! ,dep>tm5t (       
,vet]ans ,affairs or requir$ to be      
provid$ "u p>agraph 7#b7 & )held f or   
unavailable 9 ! ,hospital ,comp>e       
,int]net website1 ! ,secret>y ( ,vet]ans

 ,affairs %all publi% a notice 9 !      
,f$]al ,regi/] /at+ ! reason :y su*     
metric 0 )held f public disclosure & a  
timel9e = mak+ su* metric available1 if 
applicable4  7d7 ,comptroll] ,g5]al     
review ( publicly available safety &    
quality metrics ,n lat] ?an ?ree ye>s   
aft] ! date ( ! enactm5t ( ?is ,act1 !  
,comptroll] ,g5]al ( ! ,unit$ ,/ates    
%all conduct a review ( ! safety &      
quality metrics made publicly available 
by ! ,secret>y ( ,vet]ans ,affairs "u   
?is section to assess ! degree to :i* ! 
,secret>y is comply+ ) ! provisions (   
?is section4  #f4 ,in=mation = vet]ans  
on ! cr$5tials ( ,dep>tm5t ( ,vet]ans   
,affairs physicians  7a7 ,improvem5t (  
,our ,provid]s ,int]net website l9ks    
7#a7 ,availability ?r\gh ,dep>tm5t (    
,vet]ans ,affairs homepage ,a l9k to !  
,our ,provid]s heal? c>e provid]s       
database ( ! ,dep>tm5t ( ,vet]ans       
,affairs1 or any successor database1    
%all be available on & ?r\gh ! homepage 
( ! ,int]net website ( ! ,dep>tm5t t is 

accessible to ! public4  7#b7 ,in=mation
 on location ( resid5cy tra9+ ,!        
,int]net website ( ! ,dep>tm5t t is     
accessible to ! public %all include "u !
 l9k to ! ,our ,provid]s heal? c>e      
provid]s database ( ! ,dep>tm5t1 or any 
successor database1 ! location (        
resid5cy tra9+ ( ea* lic5s$ physician ( 
! ,dep>tm5t4  7#c7 ,in=mation on        
physicians at p>ticul> facilities ,!    
,our ,provid]s heal? c>e provid]s       
database ( ! ,dep>tm5t1 or any successor
 database1 %all id5tify :e!r ea* lic5s$ 
physician ( ! ,dep>tm5t is a physician 9
 resid5cy4  7b7 ,in=mation on cr$5tials 
( physicians = vet]ans und]go+ surgical 
proc$ures ,ea* vet]an :o is und]go+ a   
surgical proc$ure by or ?r\gh !         
,dep>tm5t %all be provid$1 at su* "t 9  
advance ( ! proc$ure z is appropriate to
 p]mit su* vet]an to evaluate su*       
in=mation1 in=mation on ! cr$5tials ( ! 
surgeon to be p]=m+ su* proc$ure4  7c7  
,,gao report ,n lat] ?an two ye>s aft] !
 date ( ! enactm5t ( ?is ,act1 !        

,comptroll] ,g5]al ( ! ,unit$ ,/ates    
%all submit to ! ,committees on         
,vet]ans' ,affairs ( ! ,s5ate & ! ,h\se 
( ,repres5tatives a report sett+ =? an  
assessm5t by ! ,comptroll] ,g5]al ( !   
foll[+3 7#a7 ,! mann] 9 :i* contractors 
"u ! ,pati5t-,c5t]$ ,community ,c>e     
initiative ( ! ,dep>tm5t p]=m ov]sight (
 ! cr$5tials ( physicians )9 ! networks 
( su* contractors "u ! initiative4  7#b7
 ,! ov]sight by ! ,dep>tm5t ( !         
contracts "u ! ,pati5t-,c5t]$ ,community
 ,c>e initiative4  #g4 ,in=mation 9     
annual budget ( ! ,presid5t on hospital 
c>e & m$ical s]vices provid$ "u section 
#b ,! mat]ials on ! ,dep>tm5t ( ,vet]ans
 ,affairs 9 ! budget ( ! ,presid5t = a  
fiscal ye>1 z submitt$ to ,congress     
pursuant to section #aaje7;a7 ( title   
#ca1 ,unit$ ,/ates ,code1 %all set =? ! 
foll[+3 7#a7 ,! numb] ( vet]ans :o      
receiv$ hospital c>e & m$ical s]vices "u
 section #b ( ?is ,act dur+ ! fiscal ye>
 prec$+ ! fiscal ye> 9 :i* su* budget is
 submitt$4  7#b7 ,! am\nt exp5d$ by !   

,dep>tm5t on furni%+ c>e & s]vices "u   
su* section dur+ ! fiscal ye> prec$+ !  
fiscal ye> 9 :i* su* budget is submitt$4
  7#c7 ,! am\nt reque/$ 9 su* budget = !
 co/s ( furni%+ c>e & s]vices "u su*    
section dur+ ! fiscal ye> cov]$ by su*  
budget1 set =? 9 aggregate & by am\nts =
 ea* acc\nt = :i* am\nts are s reque/$4 
7#d7 ,! numb] ( vet]ans t ! ,dep>tm5t   
e/imates w receive hospital c>e & m$ical
 s]vices "u su* section dur+ ! fiscal   
ye>s cov]$ by ! budget submission4  7#e7
 ,! numb] ( employees ( ! ,dep>tm5t on  
paid adm9i/rative leave at any po9t dur+
 ! fiscal ye> prec$+ ! fiscal ye> 9 :i* 
su* budget is submitt$4  #h4            
,prohibition on falsification ( data    
conc]n+ wait times & quality measures at
 ,dep>tm5t ( ,vet]ans ,affairs ,n lat]  
?an #fj days aft] ! date ( ! enactm5t ( 
?is ,act1 & 9 accordance ) title #e1    
,unit$ ,/ates ,code1 ! ,secret>y (      
,vet]ans ,affairs %all e/abli% policies 
:]eby any employee ( ! ,dep>tm5t (      
,vet]ans ,affairs :o kn[+ly submits     

false data conc]n+ wait times = heal?   
c>e or quality measures ) respect to    
heal? c>e to ano!r employee ( !         
,dep>tm5t or kn[+ly requires ano!r      
employee ( ! ,dep>tm5t to submit false  
data conc]n+ su* wait times or quality  
measures to ano!r employee ( ! ,dep>tm5t
 is subject to a p5alty ! ,secret>y     
consid]s appropriate aft] notice & an   
opportunity = a he>+1 includ+ civil     
p5alties1 unpaid susp5sions1 or         
t]m9ation4  #i4  ,removal ( ,s5ior      
,executive ,s]vice employees ( !        
,dep>tm5t ( ,vet]ans ,affairs = p]=mance
  7a7  ,9 g5]al  ,*apt] #g ( title #ch1 
,unit$ ,/ates ,code1 is am5d$ by add+ at
 ! end ! foll[+ new section3  #gac4     
,s5ior ,executive ,s]vice3 removal bas$ 
on p]=mance  7a7  ,9 g5]al  7#a7        
,not)/&+ sub*apt] ,v ( *apt] #ce ( title
 #e1 sub*apt] ,v ( *apt] #ge ( title #e1
 or any o!r provision ( law1 ! ,secret>y
 may remove any individual :o is an     
employee ( ! ,dep>tm5t f a ,s5ior       
,executive ,s]vice position 7z def9$ 9  

section #cacb7;a7 ( title #e7 if !      
,secret>y det]m9es ! p]=mance ( !       
individual w>rants su* removal4  7#b7   
,if ! ,secret>y s removes su* an        
individual1 ! ,secret>y may--  7,a7     
remove ! individual f ! civil s]vice 7z 
def9$ 9 section #baja ( title #e72 or   
7,b7 appo9t ! individual to a ,g5]al    
,s*$ule position at any grade ( ! ,g5]al
 ,s*$ule ! ,secret>y det]m9es           
appropriate4  7b7  ,notice to ,congress 
,n lat] ?an #cj days aft] remov+ an     
individual f ! ,s5ior ,executive ,s]vice
 "u subsection 7a71 ! ,secret>y %all    
submit to ! ,committee on ,vet]ans'     
,affairs ( ! ,s5ate & ! ,committee on   
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives notice 9 writ+ ( su*    
removal & ! reason = su* removal4  7c7  
,mann] ( removal  ,a removal "u ?is     
section %all be done 9 ! same mann] z ! 
removal ( a pr(essional /aff memb]      
employ$ by a ,memb] ( ,congress4  4  7b7
  ,cl]ical am5dm5t  ,! table ( sections 
at ! beg9n+ ( su* *apt] is am5d$ by add+

 at ! end ! foll[+ new item3  #gac4     
,s5ior ,executive ,s]vice3 removal bas$ 
on p]=mance4  4