
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 23, 2000]
[Document affected by Public Law 107-135 Section 123]
[CITE: 38USC7311]

 
                      TITLE 38--VETERANS' BENEFITS
 
              PART V--BOARDS, ADMINISTRATIONS, AND SERVICES
 
 CHAPTER 73--VETERANS HEALTH ADMINISTRATION--ORGANIZATION AND FUNCTIONS
 
           SUBCHAPTER II--GENERAL AUTHORITY AND ADMINISTRATION
 
Sec. 7311. Quality assurance

    (a) The Secretary shall--
        (1) establish and conduct a comprehensive program to monitor and 
    evaluate the quality of health care furnished by the Veterans Health 
    Administration (hereinafter in this section referred to as the 
    ``quality-assurance program''); and
        (2) delineate the responsibilities of the Under Secretary for 
    Health with respect to the quality-assurance program, including the 
    duties prescribed in this section.

    (b)(1) As part of the quality-assurance program, the Under Secretary 
for Health shall periodically evaluate--
        (A) whether there are significant deviations in mortality and 
    morbidity rates for surgical procedures performed by the 
    Administration from prevailing national mortality and morbidity 
    standards for similar procedures; and
        (B) if there are such deviations, whether they indicate 
    deficiencies in the quality of health care provided by the 
    Administration.

    (2) The evaluation under paragraph (1)(A) shall be made using the 
information compiled under subsection (c)(1). The evaluation under 
paragraph (1)(B) shall be made taking into account the factors described 
in subsection (c)(2)(B).
    (3) If, based upon an evaluation under paragraph (1)(A), the Under 
Secretary for Health determines that there is a deviation referred to in 
that paragraph, the Under Secretary for Health shall explain the 
deviation in the report submitted under subsection (f).\1\
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    \1\ See References in Text note below.
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    (c)(1) The Under Secretary for Health shall--
        (A) determine the prevailing national mortality and morbidity 
    standards for each type of surgical procedure performed by the 
    Administration; and
        (B) collect data and other information on mortality and 
    morbidity rates in the Administration for each type of surgical 
    procedure performed by the Administration and (with respect to each 
    such procedure) compile the data and other information so 
    collected--
            (i) for each medical facility of the Department, in the case 
        of cardiac surgery, heart transplant, and renal transplant 
        programs; and
            (ii) in the aggregate, for each other type of surgical 
        procedure.

    (2) The Under Secretary for Health shall--
        (A) compare the mortality and morbidity rates compiled under 
    paragraph (1)(B) with the national mortality and morbidity standards 
    determined under paragraph (1)(A); and
        (B) analyze any deviation between such rates and such standards 
    in terms of the following:
            (i) The characteristics of the respective patient 
        populations.
            (ii) The level of risk for the procedure involved, based 
        on--
                (I) patient age;
                (II) the type and severity of the disease;
                (III) the effect of any complicating diseases; and
                (IV) the degree of difficulty of the procedure.

            (iii) Any other factor that the Under Secretary for Health 
        considers appropriate.

    (d) Based on the information compiled and the comparisons, analyses, 
evaluations, and explanations made under subsections (b) and (c), the 
Under Secretary for Health, in the report under subsection (f),\1\ shall 
make such recommendations with respect to quality assurance as the Under 
Secretary for Health considers appropriate.
    (e)(1) The Secretary shall allocate sufficient resources (including 
sufficient personnel with the necessary skills and qualifications) to 
enable the Administration to carry out its responsibilities under this 
section.
    (2) The Inspector General of the Department shall allocate 
sufficient resources (including sufficient personnel with the necessary 
skills and qualifications) to enable the Inspector General to monitor 
the quality-assurance program.

(Added Pub. L. 102-40, title IV, Sec. 401(a)(3), May 7, 1991, 105 Stat. 
214; amended Pub. L. 102-405, title III, Sec. 302(c)(1), Oct. 9, 1992, 
106 Stat. 1984; Pub. L. 103-446, title XII, Sec. 1201(g)(5), Nov. 2, 
1994, 108 Stat. 4687.)

                       References in Text

    Subsection (f), referred to in subsecs. (b)(3) and (d), was repealed 
by Pub. L. 103-446, title XII, Sec. 1201(g)(5), Nov. 2, 1994, 108 Stat. 
4687.


                               Amendments

    1994--Subsecs. (f), (g). Pub. L. 103-446 struck out subsecs. (f) and 
(g) which read as follows:
    ``(f)(1) Not later than February 1, 1991, the Under Secretary for 
Health shall submit to the Secretary a report on the experience through 
the end of the preceding fiscal year under the quality-assurance program 
carried out under this section.
    ``(2) Such report shall include--
        ``(A) the data and other information compiled and the 
    comparisons, analyses, and evaluations made under subsections (b) 
    and (c) with respect to the period covered by the report; and
        ``(B) recommendations under subsection (d).
    ``(g)(1) Not later than 60 days after receiving such report, the 
Secretary shall submit to the Committees on Veterans' Affairs of the 
Senate and House of Representatives a copy of the report, together with 
any comment concerning the report that the Secretary considers 
appropriate.
    ``(2) A report submitted under paragraph (1) shall not be considered 
to be a record or document as described in section 5705(a) of this 
title.''
    1992--Subsecs. (a) to (d), (f). Pub. L. 102-405 substituted ``Under 
Secretary for Health'' for ``Chief Medical Director'' wherever 
appearing.


                      Quality Assurance Activities

    Section 104 of Pub. L. 102-405 provided that: ``Effective on October 
1, 1992, programs and activities which (1) the Secretary carries out 
pursuant to section 7311(a) of title 38, United States Code, or (2) are 
described in sections 201(a)(1) and 201(a)(3) of Public Law 100-322 
[formerly set out as a note under former section 4151 of this title] 
(102 Stat. 508) shall be deemed to be part of the operation of 
hospitals, nursing homes, and domiciliary facilities of the Department 
of Veterans Affairs, without regard to the location of the duty stations 
of employees carrying out those programs and activities.''


        Regulations for Standards of Performance in Laboratories

    Pub. L. 102-139, title I, Sec. 101, Oct. 28, 1991, 105 Stat. 742, 
provided that:
    ``(a) Regulations for Standards of Performance in Department of 
Veterans Affairs Laboratories.--(1) Within the 120-day period beginning 
on the date on which the Secretary of Health and Human Services 
promulgates final regulations to implement the standards required by 
section 353 of the Public Health Service Act (42 U.S.C. 263a), the 
Secretary of Veterans Affairs, in accordance with the Secretary's 
authority under title 38, United States Code, shall prescribe 
regulations to assure consistent performance by medical facility 
laboratories under the jurisdiction of the Secretary of valid and 
reliable laboratory examinations and other procedures. Such regulations 
shall be prescribed in consultation with the Secretary of Health and 
Human Services and shall establish standards equal to that applicable to 
other medical facility laboratories in accordance with the requirements 
of section 353(f) of the Public Health Service Act.
    ``(2) Such regulations--
        ``(A) may include appropriate provisions respecting waivers 
    described in section 353(d) of such Act and accreditations described 
    in section 353(e) of such Act; and
        ``(B) shall include appropriate provisions respecting compliance 
    with such requirements.
    ``(b) Report.--Within the 180-day period beginning on the date on 
which the Secretary of Veterans Affairs prescribes regulations required 
by subsection (a), the Secretary shall submit to the appropriate 
committees of the Congress a report on those regulations.
    ``(c) Definition.--As used in this section, the term `medical 
facility laboratories' means facilities for the biological, micro-
biological, serological, chemical, immunohematological, hematological, 
biophysical, cytological, pathological, or other physical examination of 
materials derived from the human body for the purpose of providing 
information for the diagnosis, prevention, or treatment of any disease 
or impairment of, or the assessment of the health of, human beings.''

                  Section Referred to in Other Sections

    This section is referred to in section 5705 of this title.
