Page:United States Statutes at Large Volume 99 Part 1.djvu/973

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PUBLIC LAW 99-000—MMMM. DD, 1985

PUBLIC LAW 99-166—DEC. 3, 1985

99 STAT. 951

"(3) If, based upon an evaluation under paragraph (I)(A) of this subsection, the Chief Medical Director determines that there is a deviation referred to in that paragraph, the Chief Medical Director shall explain the deviation in the next report submitted under section 4152 of this title. Infra. "(c)(1) The Chief Medical Director shall— "(A) determine the prevailing national mortality and morbidity standards for each type of surgical procedure performed by the Department of Medicine and Surgery; and "(B) collect data and other information on mortality and morbidity rates in the Department of Medicine and Surgery for each type of surgical procedure performed by the Department and (with respect to each such procedure) compile the data and other information so collected— "(i) for each medical facility of the Veterans* Administration, 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 Chief Medical Director shall— "(A) compare the mortality and morbidity rates compiled under paragraph (1)(B) of this subsection with the national mortality and morbidity standards determined under paragraph (1)(A) of this subsection; and "(B) analyze any deviation between such rates and such standards in terms of— "(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; and "(iii) any other factor that the Chief Medical Director considers appropriate. "(d) Based on the information compiled and the comparisons, analyses, evaluations, and explanations made under subsections (b) and (c) of this section, the Chief Medical Director, in each report under section 4152 of this title, shall make such recommendations with respect to quality assurance as the Chief Medical Director considers appropriate. "(e)(1) The Administrator shall allocate sufficient resources (including sufficient personnel with the necessary skills and qualifications) to enable the Department of Medicine and Surgery to carry out its responsibilities under this section. "(2) The Inspector General of the Veterans' Administration shall allocate sufficient resources (including sufficient personnel with the necessary skills and qualifications) to enable the Inspector General to monitor the quality-assurance program. "§ 4152. Quality-assurance reports 38 USC 4152. "(a)(1) Not later than February 1 of 1987, 1989, and 1991, the Chief Medical Director shall submit to the Administrator a report on the experience through the end of the preceding fiscal year under the quality-assurance program carried out under section 4151 cf this title.

Ante, p. 950.