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Title 38 — Veterans’ Benefits

Part II · Chapter 17 — Hospital, Nursing Home, Domiciliary, and Medical Care

§ 1703C. Standards for quality

Statutory text

(a)

In General.—

(1)

The Secretary shall establish standards for quality regarding hospital care, medical services, and extended care services furnished by the Department pursuant to this title, including through non-Department health care providers pursuant to section 1703 of this title.

(2)
(A)

In establishing standards for quality under paragraph (1), the Secretary shall consider existing health quality measures that are applied to public and privately sponsored health care systems with the purpose of providing covered veterans relevant comparative information to make informed decisions regarding their health care.

(B)

The Secretary shall ensure that the standards for quality established under paragraph (1) are comparable to industry standards to ensure there is adequate data transference between care furnished by the Department and care furnished by a non-Department provider.

(3)

The Secretary shall collect and consider data for purposes of establishing the standards under paragraph (1). Such data collection shall include—

(A)

after consultation with veterans service organizations and other key stakeholders on survey development or modification of an existing survey, a survey of veterans who have used hospital care, medical services, or extended care services furnished by the Veterans Health Administration during the most recent 2-year period to assess the satisfaction of the veterans with service and quality of care; and

(B)

datasets that include, at a minimum, elements relating to the following:

(i)

Timely care.

(ii)

Effective care.

(iii)

Safety, including, at a minimum, complications, readmissions, and deaths.

(iv)

Efficiency.

(v)

Outcomes relating to patient quality of life.

(4)

The Secretary shall consult with all pertinent Federal entities (including the Department of Defense, the Department of Health and Human Services, the Centers for Medicare & Medicaid Services, and the Indian Health Service), entities in the private sector, and other non-governmental entities including Third Party Administrators in establishing standards for quality.

(5)

When collecting, considering, and applying data related to patient care for purposes of establishing standards for quality under paragraph (1), the Secretary shall ensure no metric is being over or under analyzed.

(6)

In establishing standards for quality under paragraph (1), the Secretary shall—

(A)

utilize the most up-to-date practices for extracting and analyzing relevant data;

(B)

utilize all relevant data available to the Secretary;

(C)

ensure the most efficient use of time and resources related to the use of data scientists employed by the Department; and

(D)

collaborate, as appropriate, with entities specified in paragraph (4).

(7)
(A)

Not less frequently than once every five years, the Secretary shall update the standards for quality established under paragraph (1) pursuant to the requirements for the establishment of such standards under this subsection.

(B)

Not later than 30 days after any date on which the Secretary updates, pursuant to subparagraph (A), the standards for quality under paragraph (1), the Secretary shall submit to the appropriate committees of Congress a report on such updated standards for quality.

(b)

Publication and Consideration of Public Comments.—

(1)

Not less frequently than once every three years, the Secretary shall publish the quality rating of medical facilities of the Department pursuant to standards for quality under subsection (a) in the publicly available Hospital Compare website through the Centers for Medicare & Medicaid Services for the purpose of providing veterans with information that allows them to compare performance measure information among Department and non-Department health care providers.

(2)

Not later than 2 years after the date on which the Secretary establishes or updates standards for quality under subsection (a), the Secretary shall consider and solicit public comment on potential changes to the measures used in such standards to ensure that they include the most up-to-date and applicable industry measures for veterans.

(c)

Definitions.—

In this section:

(1)

The term “appropriate committees of Congress” means—

(A)

the Committee on Veterans’ Affairs and the Committee on Appropriations of the Senate; and

(B)

the Committee on Veterans’ Affairs and the Committee on Appropriations of the House of Representatives.

(2)

The term “covered veterans” means veterans described in section 1703(b) of this title.

Legislative history

Reconstructed from this section’s Code source credit and amendment notes, resolved against the local Statutes at Large. Editorial notes are evidence, not the law that made the change.

  1. Caring for Our Veterans Act of 2018

    Pub. L. 115–182 title I § 104(a) · 132 Stat. 1393

    Enacted · 38 U.S.C. § 1703C

    Added Pub. L. 115–182, title I, § 104(a), June 6, 2018, 132 Stat. 1410

    Source evidence

    Code source credit
    Added Pub. L. 115–182, title I, § 104(a), June 6, 2018, 132 Stat. 1410

    Enacted provision · exact public law section
    (a) In General.— Subchapter I of chapter 17, as amended by section 102, is further amended by inserting after section 1703A the following new sections: “§ 1703B. Access standards “(a) (1) The Secretary shall establish access standards for furnishing hospital care, medical services, or extended care services to covered veterans for the purposes of section 1703(d). “(2) The Secretary shall ensure that the access standards established under paragraph (1) define such categories of care to cover all care and services within the medical benefits package of the Department of Veterans Affairs. “(b) The Secretary shall ensure that the access standards provide covered veterans, employees of the Department, and health care providers in the network established under section 1703(h) with relevant comparative information that is clear, useful, and timely, so that covered veterans can make informed decisions regarding their health care. “(c) The Secretary shall consult with all pertinent Federal entities (including the Department of Defense, the Department of Health and Human Services, and the Centers for Medicare & Medicaid Services), entities in the private sector, and other nongovernmental entities in establishing access standards. “(d) (1) Not later than 270 days after the date of the enactment of the Caring for Our Veterans Act of 2018, the Secretary shall submit to the appropriate committees of Congress a report detailing the access standards. “(2) (A) Before submitting the report required under paragraph (1), the Secretary shall provide periodic updates to the appropriate committees of Congress to confirm the Department’s progress towards developing the access standards required by this section. “(B) The first update under subparagraph (A) shall occur no later than 120 days from the date of the enactment of the Caring for Our Veterans Act of 2018. “(3) Not later than 540 days after the date on which the Secretary implements the access standards established under subsection (a), the Secretary shall submit to the appropriate committees of Congress a report detailing the implementation of and compliance with such access standards by Department and non-Department entities or providers. “(e) Not later than 3 years after the date on which the Secretary establishes access standards under subsection (a) and not less frequently than once every 3 years thereafter, the Secretary shall— “(1) conduct a review of such standards; and “(2) submit to the appropriate committees of Congress a report on the findings and any modification to the access standards with respect to the review conducted under paragraph (1). “(f) The Secretary shall ensure health care providers specified under section 1703(c) are able to comply with the applicable access standards established by the Secretary. “(g) The Secretary shall publish in the Federal Register and on an internet website of the Department the designated access standards established under this section for purposes of section 1703(d)(1)(D). “(h) (1) Consistent with paragraphs (1)(D) and (3) of section 1703(d), covered veterans may contact the Department at any time to request a determination regarding whether they are eligible to receive care and services from a non-Department entity or provider based on the Department being unable to furnish such care and services in a manner that complies with the designated access standards established under this section. “(2) The Secretary shall establish a process to review such requests from covered veterans to determine whether— “(A) the requested care is clinically necessary; and “(B) the Department is able to provide such care in a manner that complies with designated access standards established under this section. “(3) The Secretary shall promptly respond to any such request by a covered veteran. “(i) (1) The term ‘appropriate committees of Congress’ means— “(A) the Committee on Veterans’ Affairs and the Committee on Appropriations of the Senate; and “(B) the Committee on Veterans’ Affairs and the Committee on Appropriations of the House of Representatives. “(2) The term ‘covered veterans’ refers to veterans described in section 1703(b) of this title. “§ 1703C. Standards for quality “(a) In General.— (1) The Secretary shall establish standards for quality regarding hospital care, medical services, and extended care services furnished by the Department pursuant to this title, including through non-Department health care providers pursuant to section 1703 of this title. “(2) In establishing standards for quality under paragraph (1), the Secretary shall consider existing health quality measures that are applied to public and privately sponsored health care systems with the purpose of providing covered veterans relevant comparative information to make informed decisions regarding their health care. “(3) The Secretary shall collect and consider data for purposes of establishing the standards under paragraph (1). Such data collection shall include— “(A) after consultation with veterans service organizations and other key stakeholders on survey development or modification of an existing survey, a survey of veterans who have used hospital care, medical services, or extended care services furnished by the Veterans Health Administration during the most recent 2-year period to assess the satisfaction of the veterans with service and quality of care; and “(B) datasets that include, at a minimum, elements relating to the following: “(i) Timely care. “(ii) Effective care. “(iii) Safety, including, at a minimum, complications, readmissions, and deaths. “(iv) Efficiency. “(4) The Secretary shall consult with all pertinent Federal entities (including the Department of Defense, the Department of Health and Human Services, and the Centers for Medicare & Medicaid Services), entities in the private sector, and other nongovernmental entities in establishing standards for quality. “(5) (A) Not later than 270 days after the date of the enactment of the Caring for Our Veterans Act of 2018, the Secretary shall submit to the appropriate committees of Congress a report detailing the standards for quality. “(B) (i) Before submitting the report required under subparagraph (A), the Secretary shall provide periodic updates to the appropriate committees of Congress to confirm the Department’s progress towards developing the standards for quality required by this section. “(ii) The first update under clause (i) shall occur no later than 120 days from the date of the enactment of the Caring for Our Veterans Act of 2018. “(b) Publication and Consideration of Public Comments.— (1) Not later than 1 year after the date on which the Secretary establishes standards for quality under subsection (a), the Secretary shall publish the quality rating of medical facilities of the Department in the publicly available Hospital Compare website through the Centers for Medicare & Medicaid Services for the purpose of providing veterans with information that allows them to compare performance measure information among Department and non-Department health care providers. “(2) Not later than 2 years after the date on which the Secretary establishes standards for quality under subsection (a), the Secretary shall consider and solicit public comment on potential changes to the measures used in such standards to ensure that they include the most up-to-date and applicable industry measures for veterans. “(c) (1) The term ‘appropriate committees of Congress’ means— “(A) the Committee on Veterans’ Affairs and the Committee on Appropriations of the Senate; and “(B) the Committee on Veterans’ Affairs and the Committee on Appropriations of the House of Representatives. “(2) The term ‘covered veterans’ refers to veterans described in section 1703(b) of this title.” .

  2. Department of Veterans Affairs Expiring Authorities Act of 2018

    Pub. L. 115–251 title II § 211(a)(4) · 132 Stat. 3166

    1. Inserted · 38 U.S.C. § 1703C(c)

      Pub. L. 115–251 inserted heading and introductory provisions

    2. Substituted · 38 U.S.C. § 1703C(c)

      Pub. L. 115–251 substituted “means” for “refers to” in par. (2), and realigned margins

    Source evidence

    Code amendment note
    Subsec. (c). Pub. L. 115–251 inserted heading and introductory provisions, substituted “means” for “refers to” in par. (2), and realigned margins.

    Enacted provision · exact public law section
    (4) Standards for quality.— Section 1703C(c) is amended— (A) by striking “(c)(1) The term” and inserting “(c) Definitions .— In this section: “(1) The term” ; (B) in paragraph (1), by moving subparagraphs (A) and (B) two ems to the right; (C) by moving paragraph (2) two ems to the right; and (D) in paragraph (2), by striking “refers to” and inserting “means”.

  3. Pub. L. 118–210 § 104(a)(1)(A) · 138 Stat. 2711

    1. Amended · 38 U.S.C. § 1703C(a)(2)

      Pub. L. 118–210, § 104(a)(1)(A), designated existing provisions as subpar. (A)

    2. Added · 38 U.S.C. § 1703C(a)(2)

      Pub. L. 118–210, § 104(a)(1)(A), added subpar. (B)

    Unresolved: Pub. L. 118–210 was not found in the local Statutes at Large index.

    Source evidence

    Code amendment note
    Subsec. (a)(2). Pub. L. 118–210, § 104(a)(1)(A), designated existing provisions as subpar. (A) and added subpar. (B).

  4. Pub. L. 118–210 § 104(a)(1)(B) · 138 Stat. 2711

    Added · 38 U.S.C. § 1703C(a)(3)(B)(v)

    Pub. L. 118–210, § 104(a)(1)(B), added cl. (v)

    Unresolved: Pub. L. 118–210 was not found in the local Statutes at Large index.

    Source evidence

    Code amendment note
    Subsec. (a)(3)(B)(v). Pub. L. 118–210, § 104(a)(1)(B), added cl. (v).

  5. Pub. L. 118–210 § 104(a)(1)(C) · 138 Stat. 2711

    1. Substituted · 38 U.S.C. § 1703C(a)(4)

      Pub. L. 118–210, § 104(a)(1)(C), substituted “the Centers for Medicare & Medicaid Services, and the Indian Health Service” for “and the Centers for Medicare & Medicaid Services”

    2. Substituted · 38 U.S.C. § 1703C(a)(4)

      Pub. L. 118–210, § 104(a)(1)(C), substituted “and other non-governmental entities including Third Party Administrators” for “and other nongovernmental entities”

    Unresolved: Pub. L. 118–210 was not found in the local Statutes at Large index.

    Source evidence

    Code amendment note
    Subsec. (a)(4). Pub. L. 118–210, § 104(a)(1)(C), substituted “the Centers for Medicare & Medicaid Services, and the Indian Health Service” for “and the Centers for Medicare & Medicaid Services” and “and other non-governmental entities including Third Party Administrators” for “and other nongovernmental entities”.

  6. Pub. L. 118–210 § 104(a)(1)(D) · 138 Stat. 2711

    1. Added · 38 U.S.C. § 1703C(a)(5)(7)

      Pub. L. 118–210, § 104(a)(1)(D), added pars. (5) to (7)

    2. Struck · 38 U.S.C. § 1703C(a)(5)(7)

      Pub. L. 118–210, § 104(a)(1)(D), struck out former par. (5) which read as follows:

    Unresolved: Pub. L. 118–210 was not found in the local Statutes at Large index.

    Source evidence

    Code amendment note
    Subsec. (a)(5) to (7). Pub. L. 118–210, § 104(a)(1)(D), added pars. (5) to (7) and struck out former par. (5) which read as follows:

    “(A) Not later than 270 days after the date of the enactment of the Caring for Our Veterans Act of 2018, the Secretary shall submit to the appropriate committees of Congress a report detailing the standards for quality. “(B)(i) Before submitting the report required under subparagraph (A), the Secretary shall provide periodic updates to the appropriate committees of Congress to confirm the Department’s progress towards developing the standards for quality required by this section. “(ii) The first update under clause (i) shall occur no later than 120 days from the date of the enactment of the Caring for Our Veterans Act of 2018.”

  7. Pub. L. 118–210 § 104(a)(2)(A) · 138 Stat. 2711

    1. Substituted · 38 U.S.C. § 1703C(b)(1)

      Pub. L. 118–210, § 104(a)(2)(A), substituted “Not less frequently than once every three years” for “Not later than 1 year after the date on which the Secretary establishes standards for quality under subsection (a)”

    2. Inserted · 38 U.S.C. § 1703C(b)(1)

      Pub. L. 118–210, § 104(a)(2)(A), inserted “pursuant to standards for quality under subsection (a)” after “medical facilities of the Department”

    Unresolved: Pub. L. 118–210 was not found in the local Statutes at Large index.

    Source evidence

    Code amendment note
    Subsec. (b)(1). Pub. L. 118–210, § 104(a)(2)(A), substituted “Not less frequently than once every three years” for “Not later than 1 year after the date on which the Secretary establishes standards for quality under subsection (a)” and inserted “pursuant to standards for quality under subsection (a)” after “medical facilities of the Department”.

  8. Pub. L. 118–210 § 104(a)(2)(B) · 138 Stat. 2711

    Inserted · 38 U.S.C. § 1703C(b)(2)

    Pub. L. 118–210, § 104(a)(2)(B), inserted “or updates” after “establishes”

    Unresolved: Pub. L. 118–210 was not found in the local Statutes at Large index.

    Source evidence

    Code amendment note
    Subsec. (b)(2). Pub. L. 118–210, § 104(a)(2)(B), inserted “or updates” after “establishes”.

3 of 13 references resolved to an enrolled provision · 10 unresolved

Editorial Notes

Amendments2018–2025 · 2 rounds

2025

Subsec. (a)(2). Pub. L. 118–210, § 104(a)(1)(A), designated existing provisions as subpar. (A) and added subpar. (B).

Subsec. (a)(3)(B)(v). Pub. L. 118–210, § 104(a)(1)(B), added cl. (v).

Subsec. (a)(4). Pub. L. 118–210, § 104(a)(1)(C), substituted “the Centers for Medicare & Medicaid Services, and the Indian Health Service” for “and the Centers for Medicare & Medicaid Services” and “and other non-governmental entities including Third Party Administrators” for “and other nongovernmental entities”.

Subsec. (a)(5) to (7). Pub. L. 118–210, § 104(a)(1)(D), added pars. (5) to (7) and struck out former par. (5) which read as follows:

“(A) Not later than 270 days after the date of the enactment of the Caring for Our Veterans Act of 2018, the Secretary shall submit to the appropriate committees of Congress a report detailing the standards for quality.

“(B)(i) Before submitting the report required under subparagraph (A), the Secretary shall provide periodic updates to the appropriate committees of Congress to confirm the Department’s progress towards developing the standards for quality required by this section.

“(ii) The first update under clause (i) shall occur no later than 120 days from the date of the enactment of the Caring for Our Veterans Act of 2018.”

Subsec. (b)(1). Pub. L. 118–210, § 104(a)(2)(A), substituted “Not less frequently than once every three years” for “Not later than 1 year after the date on which the Secretary establishes standards for quality under subsection (a)” and inserted “pursuant to standards for quality under subsection (a)” after “medical facilities of the Department”.

Subsec. (b)(2). Pub. L. 118–210, § 104(a)(2)(B), inserted “or updates” after “establishes”.

2018

Subsec. (c). Pub. L. 115–251 inserted heading and introductory provisions, substituted “means” for “refers to” in par. (2), and realigned margins.

Statutory Notes and Related Subsidiaries

Deadline for Update

Pub. L. 118–210, title I, § 104(b), , 138 Stat. 2712, provided that: “The Secretary, pursuant to paragraph (7) of section 1703C(a) of title 38, United States Code (as added by subsection (a)), shall make the first update to the standards for quality established under paragraph (1) of such section not later than the date that is five years after the date on which the Secretary submits the report under paragraph (2) of subsection (d) [of section 104 of Pub. L. 118–210, set out as a note below].”

Updates to Quality Care Metrics

Pub. L. 118–210, title I, § 104(d), , 138 Stat. 2712, provided that:

“(1)

Initial report.—

Not later than one year after the date of the enactment of this Act [], the Secretary of Veterans Affairs shall submit to the appropriate committees of Congress [Committees on Veterans’ Affairs and Appropriations of the Senate and the House of Representatives] a report on how the Secretary plans to implement the amendments made by subsections [sic] (a) [amending this section].

“(2)

Deadline; summary report.—

Not later than two years after the date of the enactment of this Act, the Secretary shall—

“(A)

implement the amendments made by subsection (a), including by updating the standards for quality established under section 1703C of title 38, United States Code; and

“(B)

submit to the appropriate committees of Congress a report detailing the standards for quality updated pursuant to such amendments.”

[Pub. L. 118–210, title I, § 104(f), , 138 Stat. 2713, provided that: “In this section [amending this section and enacting provisions set out as notes above], the term ‘appropriate committees of Congress’ has the meaning given such term in section 1703C of title 38, United States Code.” ]

Credits

2018–2025 · 3 acts
  1. 2018Added Pub. L. 115–182, title I, § 104(a), , 132 Stat. 1410
  2. 2018amended Pub. L. 115–251, title II, § 211(a)(4), , 132 Stat. 3174
  3. 2025Pub. L. 118–210, title I, § 104(a), , 138 Stat. 2711.
Show as published

(Added Pub. L. 115–182, title I, § 104(a), , 132 Stat. 1410; amended Pub. L. 115–251, title II, § 211(a)(4), , 132 Stat. 3174; Pub. L. 118–210, title I, § 104(a), , 138 Stat. 2711.)

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