[Federal Register Volume 62, Number 195 (Wednesday, October 8, 1997)]
[Proposed Rules]
[Pages 52519-52520]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-26612]


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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 47

RIN 2900-AI78


Reporting Health Care Professionals to State Licensing Boards

AGENCY: Department of Veterans Affairs.

ACTION: Proposed rule.

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SUMMARY: It continues to be the policy of the Department of Veterans 
Affairs (VA) to report to State Licensing Boards any separated 
physician, dentist, or other licensed health care professional (one who 
no longer is on VA rolls) whose clinical practice so significantly 
failed to meet generally accepted standards of clinical practice as to 
raise reasonable concern for the safety of patients. This document 
proposes that, in addition, VA would report to State Licensing Boards 
any currently employed physician, dentist, or other licensed health 
care professional (one who is on VA rolls) whose clinical practice so 
significantly failed to meet generally accepted standards of clinical 
practice during VA employment as to raise reasonable concern for the 
safety of patients. Some health care professionals who are VA employees 
also provide health care outside VA's jurisdiction. Accordingly, the 
reporting of currently employed licensed health care professionals who 
meet the standard for reporting appears to be necessary so that State 
Licensing Boards can take action as appropriate to protect the public. 
Examples of actions that meet the criteria for reporting are set forth 
in the text portion of this rulemaking. Also, this document proposes to 
clarify that to be ``on VA rolls'' means on VA rolls regardless of the 
status of the health care professional, including full-time, part-time, 
contract service, fee-basis, or without compensation. This would 
identify more clearly those health care professionals who would be 
subject to the reporting policy. Further, nonsubstantive changes are 
made for purposes of clarity.

DATES: Comments must be received on or before December 8, 1997.

ADDRESSES: Mail or hand deliver written comments to: Director, Office 
of Regulations Management (02D), Department of Veterans Affairs, 810 
Vermont Avenue, NW, Room 1154, Washington, DC 20420. Comments should 
indicate that they are submitted in response to ``RIN 2900-AI16.'' All 
written comments received will be available for public inspection at 
the above address in the Office of Regulations Management, Room 1158, 
between the hours of 8:00 a.m. and 4:30 p.m., Monday through Friday 
(except holidays).

FOR FURTHER INFORMATION CONTACT: Ruth-Ann Phelps, Ph.D., Veterans 
Health Administration, Patient Care Services (11B), 810 Vermont Ave., 
NW., Washington, DC 20420, at (202) 273-8473 (this is not a toll-free 
number).

SUPPLEMENTARY INFORMATION:

Executive Order 12866

    This proposed rule has been reviewed by OMB under Executive Order 
12866.

Regulatory Flexibility Act

    The Secretary hereby certifies that this final rule will not have a 
significant economic impact on a substantial number of small entities 
as they are defined in the Regulatory Flexibility Act, 5 U.S.C. 601-
612. The rule will affect only individuals and will not directly affect 
any small entities. Therefore, pursuant to 5 U.S.C. 605(b), this rule 
is exempt from the initial and final regulatory flexibility analyses 
requirements of sections 603 and 604.
    There are no applicable Catalog of Federal Domestic Assistance 
program numbers.

List of Subjects in 38 CFR Part 47

    Health professions.

    Approved: September 5, 1997.
Hershel W. Gober,
Acting Secretary of Veterans Affairs.

    For the reasons set forth in the preamble, 38 CFR part 47 is 
proposed to be amended as follows:

PART 47--POLICY REGARDING REPORTING HEALTH CARE PROFESSIONALS TO 
STATE LICENSING BOARDS

    1. The authority citation for part 47 continues to read as follows:

    Authority: Pub. L. 99-166, 99 Stat. 941; 38 U.S.C. 501.

    2. The part heading for part 47 is revised to read as shown above.
    3. In part 47, subpart A and subpart B headings are removed.
    4. In Sec. 47.1, paragraph (a) is removed; paragraphs (b) through 
(h) are redesignated as paragraphs (a) through (g), respectively; new 
paragraphs (h) and (i) are added, and the authority citation is 
revised, to read as follows:


Sec. 47.1  Definitions.

* * * * *
    (h) Currently employed licensed health care professional means a 
licensed health care professional who is on VA rolls.
    (i) On VA rolls means on VA rolls, regardless of the status of the 
professional, such as full-time, part-time, contract service, fee-
basis, or without compensation.

(Authority: 38 U.S.C. 501, 7401-7405; Section 204(b) of Pub. L. 99-
166, 99 Stat. 952-953; Pub. L. 99-660, 100 Stat. 3743)


Sec. 47.2  [Removed]

    5. Section 47.2 is removed.


Sec. 47.3  [Redesignated as Sec. 47.2]

    6. Section 47.3 is redesignated as Sec. 47.2.
    7. The newly redesignated Sec. 47.2 is revised to read as follows:


Sec. 47.2  Reporting to State licensing boards.

    It is the policy of VA to report to State Licensing Boards any 
currently employed licensed health care professional or separated 
licensed health care professional whose clinical practice during VA 
employment so significantly failed to meet generally accepted standards 
of clinical practice as to raise reasonable concern for the safety of 
patients. The following are examples of actions that meet the criteria 
for reporting:
    (a) Significant deficiencies in clinical practice such as lack of 
diagnostic or treatment capability; errors in transcribing, 
administering or documenting medication; inability to perform clinical 
procedures considered basic to the performance of one's occupation; 
performing procedures not included in one's clinical privileges in 
other than emergency situations;
    (b) Patient neglect or abandonment;
    (c) Mental health impairment sufficient to cause the individual to 
behave inappropriately in the patient care environment;
    (d) Physical health impairment sufficient to cause the individual 
to provide unsafe patient care;
    (e) Substance abuse when it affects the individual's ability to 
perform appropriately as a health care provider or in the patient care 
environment;
    (f) Falsification of credentials;
    (g) Falsification of medical records or prescriptions;

[[Page 52520]]

    (h) Theft of drugs;
    (i) Inappropriate dispensing of drugs;
    (j) Unethical behavior or moral turpitude;
    (k) Mental, physical, sexual, or verbal abuse of a patient 
(examples of patient abuse include intentional omission of care, 
willful violation of a patient's privacy, willful physical injury, 
intimidation, harassment, or ridicule); and
    (l) Violation of research ethics.

(Authority: 38 U.S.C. 501, 7401-7405; Section 204(b) of Pub. L. 99-
166, 99 Stat. 952-953; Pub. L. 99-660, 100 Stat. 3743)

[FR Doc. 97-26612 Filed 10-7-97; 8:45 am]
BILLING CODE 8320-01-P