,,ib  ,union ,calendar ,no4 #hjg  #aaeth
 ,,congress  #b;d ,session  ,h4 ,r4     
#fjff  ,report ,no4 #aae-ajcd  ,,in     
,,the ,,house ,,of ,,representatives    
,june #h1 #bjah ,mr4 ,wenstrup          
introduced the following bill2 which was
 referred to the ,committee on          
,veterans' ,affairs  ,november #af1     
#bjah ,reported with an amendment1      
committed to the ,committee of the      
,whole ,house on the ,state of the      
,union1 and ordered to be printed       
,strike out all after the enacting      
clause and insert the part printed in   
italic ,for text of introduced bill1 see
 copy of bill as introduced on ,june #h1
 #bjah  ,a ,,bill  ,to amend title #ch1 
,united ,states ,code1 to improve the   
productivity of the management of       
,department of ,veterans ,affairs health
 care1 and for other purposes4  #a4     
,department of ,veterans ,affairs health
 care productivity improvement  7a7 ,in 
general ,subchapter ,i of chapter #ag of
 title #ch1 ,united ,states ,code1 is   

amended by inserting after section      
#agje;,a the following new section3     
#agje;,b4 ,management of health care3   
productivity  7a7 ,relative value unit  
tracking ,the ,secretary shall track    
relative value units for all ,department
 providers4  7b7 ,clinical procedure    
coding training ,if the coding accuracy 
of a ,department provider within a      
clinical area of responsibility of the  
provider falls below the minimum        
threshold set by the ,secretary1 the    
,secretary shall require the ,department
 provider to attend training on clinical
 procedure coding4  7c7 ,performance    
standards  7#a7 ,the ,secretary shall   
establish for each ,department          
facility-- 7,a7 in accordance with      
paragraph 7#b71 standardized 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 facility level2  7,b7 remediation   

plans to address low clinical           
productivity and clinical inefficiency2 
and  7,c7 an ongoing process to         
systematically review the content1      
implementation1 and outcome of the plans
 developed under subparagraph 7,b74     
7#b7 ,in establishing the performance   
standards under paragraph 7#a77;,a71 the
 ,secretary-- 7,a7 may incorporate      
values-based productivity models and may
 incorporate other productivity measures
 and models determined appropriate by   
the ,secretary2 and  7,b7 shall take    
into account non-clinical duties1       
including with respect to training and  
research2  7,c7 shall take into account 
factors that impede productivity and    
efficiency and1 in developing           
remediation plans under paragraph       
7#a77;,b71 shall incorporate action     
plans to address such factors4  7d7     
,definitions ,in this section3 7#a7 ,the
 term ,department provider means an     
employee of the ,department who has been
 appointed to the ,veterans ,health     

,administration as a physician1 a       
dentist1 an optometrist1 a podiatrist1 a
 chiropractor1 an advanced practice     
registered nurse1 or a physician's      
assistant acting as an independent      
provider4  7#b7 ,the term relative value
 unit means a unit for measuring        
workload by determining the time1 mental
 effort and judgment1 technical skill1  
physical effort1 and stress involved in 
delivering a service4  4  7b7 ,clerical 
amendment ,the table of sections at the 
beginning of such chapter is amended by 
inserting after the item relating to    
section #agje;,a the following new item3
  #agje;,b4 ,management of health care3 
productivity4  4  7c7 ,report ,not later
 than one year after the date of the    
enactment of this ,act1 the ,secretary  
of ,veterans ,affairs shall submit to   
,congress a report on the implementation
 of section #agje;,b of title #ch1      
,united ,states ,code1 as added by      
subsection 7a74 ,such report shall      
include1 for each professional category 

of ,department of ,veterans ,affairs    
providers1 the relative value unit of   
such category of providers at the       
national1 ,veterans ,integrated ,service
 ,network1 and facility levels4  7d7    
,comprehensive staffing models ,not     
later than one year after the date of   
the enactment of this ,act1 the         
,secretary of ,veterans ,affairs shall  
develop comprehensive staffing models   
for all ,department of ,veterans        
,affairs medical centers4  ,november    
#af1 #bjah ,reported with an amendment1 
committed to the ,committee of the      
,whole ,house on the ,state of the      
,union1 and ordered to be printed