#aaeth ,,congress  #ast ,session  ,h4   
,r4 #ahdh  ,,an ,,act  ,to direct the   
,secretary of ,veterans ,affairs to     
carry out a pilot program on the use of 
medical scribes in ,department of       
,veterans ,affairs medical centers1 and 
for other purposes4  #a4 ,short title   
,this ,act may be cited as the ,veterans
 ,affairs ,medical ,scribe ,pilot ,act  
of #bjag4  #b4 ,department of ,veterans 
,affairs medical scribe pilot program   
7a7 ,in general ,the ,secretary of      
,veterans ,affairs shall carry out a    
#b-year pilot program under which the   
,secretary shall increase the use of    
medical scribes at ,department of       
,veterans ,affairs medical centers4  7b7
 ,locations ,the ,secretary shall carry 
out the pilot program at the #aj medical
 centers of the ,department as follows3 
7#a7 ,at least four such medical centers
 located in rural areas4  7#b7 ,at least
 four such medical centers located in   
urban areas4  7#c7 ,two such medical    
centers located in areas with need for  

increased access or increased           
efficiency1 as determine by the         
,secretary4  7c7 ,medical scribes  7#a7 
,hiring ,under the pilot program the    
,secretary shall-- 7,a7 hire #bj new    
,department of ,veterans ,affairs term  
employees as medical scribes2 and  7,b7 
seek to enter into contracts with       
appropriate entities for the employment 
of #bj additional medical scribes4  7#b7
 ,distribution ,the ,secretary shall    
assign four medical scribes to each of  
the #aj medical centers of the          
,department where the ,secretary carries
 out the pilot program as follows3  7,a7
 ,two scribes shall be assigned to each 
of two physicians4  7,b7 ,thirty percent
 of the scribes shall be employed in the
 provision of emergency care4  7,c7     
,seventy percent of the scribes shall be
 employed in the provision of speciality
 care in specialties with the longest   
patient wait times or lowest efficiency 
ratings1 as determined by the           
,secretary4  7d7 ,reports  7#a7 ,reports

 to ,congress ,not later than #ahj days 
after the commencement of the pilot     
program required under this section1 and
 every #ahj days thereafter for the     
duration of the pilot program1 the      
,secretary of ,veterans ,affairs shall  
submit to ,congress a report on the     
pilot program4 ,each such report shall  
include each of the following3  7,a7 ,a 
separate analysis of each the following 
with respect to medical scribes employed
 by the ,department of ,veterans        
,affairs and medical scribes performing 
,department of ,veterans ,affairs       
functions under a contract3 7i7         
,provider efficiency4  7ii7 ,patient    
satisfaction4  7iii7 ,average wait time4
  7iv7 ,the number of patients seen per 
day by each physician or practitioner4  
7v7 ,the amount of time required to hire
 and train an employee to perform       
medical scribe functions under the pilot
 program4  7,b7 ,metrics and data for   
analyzing the effects of the pilot      
program1 including an evaluation of the 

each of the elements under clauses 7i7  
through 7iv7 of subparagraph 7,a7 at    
medical centers who employed scribes    
under the pilot program for an          
appropriate period preceding the hiring 
of such scribes4  7#b7 ,comptroller     
,general report ,not later than #ij days
 after the termination of the pilot     
program under this section1 the         
,comptroller ,general of the ,united    
,states shall submit to ,congress a     
report on the pilot program4 ,such      
report shall include a comparison of the
 pilot program with similar programs    
carried out in the private sector4  7e7 
,definitions ,in this section3 7#a7 ,the
 term medical scribe means an unlicensed
 individual hired to enter information  
into the electronic health record or    
chart at the direction of a physician or
 licensed independent practitioner whose
 responsibilities include the following3
  7,a7 ,assisting the physician or      
practitioner in navigating the          
electronic health record4  7,b7         

,responding to various messages as      
directed by the physician or            
practitioner4  7,c7 ,entering           
information into the electronic health  
record1 as directed by the physician or 
practitioner4  7#b7 ,the terms urban and
 rural have the meanings given such     
terms under the rural-urban commuting   
codes developed by the ,secretary of    
,agriculture and the ,secretary of      
,health and ,human ,services4  7f7      
,funding ,the pilot program under this  
section shall be carried out using      
amounts otherwise authorized to be      
appropriated for the ,department of     
,veterans ,affairs4 ,no additional      
amounts are authorized to be            
appropriated to carry out such program4 
#c4 ,prohibition on smoking in          
facilities of the ,veterans ,health     
,administration  7a7 ,prohibition       
,section #agae of title #ch1 ,united    
,states ,code1 is amended to read as    
follows3  #agae4 ,prohibition on smoking
 in facilities of the ,veterans ,health 

,administration  7a7 ,prohibition  7#a7 
7,a7 ,except as provided in subparagraph
 7,b71 no person may smoke indoors in   
any facility of the ,veterans ,health   
,administration4  7,b7 ,in the case of a
 facility of the ,veterans ,health      
,administration that is a community     
living center1 no person may smoke      
indoors in such facility on or after    
,december #ca1 #bjah4  7#b7 ,no person  
may smoke outdoors in any facility of   
the ,veterans ,health ,administration on
 or after ,october #a1 #bjba4  7b7      
,definitions ,in this section3  7#a7    
,the term smoke includes the smoking of 
cigarettes 7including e-cigarettes or   
electronic cigarettes71 cigars1 pipes1  
and any other combustion of tobacco4    
7#b7 ,the term facility of the ,veterans
 ,health ,administration means any land 
or building 7including any medical      
center1 nursing home1 domiciliary       
facility1 outpatient clinic1 or center  
that provides readjustment counseling7  
that is--  7,a7 under the jurisdiction  

of the ,department of ,veterans         
,affairs2  7,b7 under the control of the
 ,veterans ,health ,administration2 and 
7,c7 not under the control of the       
,general ,services ,administration4     
7#c7 ,the term community living center  
means a facility of the ,department that
 provides nursing home care4  4  7b7    
,conforming amendments  7#a7 ,the table 
of sections at the beginning of chapter 
#ag of such title is amended by striking
 the item relating to section #agae and 
inserting the following3  #agae4        
,prohibition on smoking in facilities of
 the ,veterans ,health ,administration4 
4  7#b7 ,section #ebf of the ,veterans  
,health ,care ,act of #aiib 7,public    
,law #ajb-ehe7 is repealed4  7c7        
,effective date ,this section shall take
 effect #ij days after the date of the  
enactment of this ,act4  ,passed the    
,house of ,representatives ,july #bd1   
#bjag4;,clerk4