I 

117TH CONGRESS 

1ST SESSION H. R. 217 

To amend title 38, United States Code, to direct the Secretary of Veterans 

Affairs to enforce the licensure requirement for medical providers of 

the Department of Veterans Affairs. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 6, 2021 

Mr. CLOUD (for himself, Mr. ALLEN, Mr. STEUBE, Mr. DAVIDSON, Mr. 

BERGMAN, Mr. PALMER, Mr. RUTHERFORD, and Mr. BAIRD) introduced 

the following bill; which was referred to the Committee on Veterans’ Affairs 

A BILL 

To amend title 38, United States Code, to direct the Secretary of Veterans Affairs to enforce the licensure requirement for medical providers of the Department of 

Veterans Affairs. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Improving Confidence 

5 in Veterans’ Care Act’’. 


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1 SEC. 2. COMPLIANCE WITH REQUIREMENTS FOR EXAM2 INING QUALIFICATIONS AND CLINICAL ABILI3 TIES OF DEPARTMENT OF VETERANS AF4 FAIRS HEALTH CARE PROFESSIONALS. 

5 (a) IN GENERAL.—Subchapter I of chapter 74 of title 

6 38, United States Code, is amended by adding at the end 

7 the following new section: 

8 ‘‘§ 7414. Compliance with requirements for examining 

9 qualifications and clinical abilities of 

10 health care professionals 

11 ‘‘(a) COMPLIANCE WITH CREDENTIALING REQUIRE12 MENTS.—The Secretary shall ensure that each medical 

13 center of the Department, in a consistent manner— 

14 ‘‘(1) compiles, verifies, and reviews documenta15 tion for each health care professional of the Depart16 ment at such medical center regarding, at a min17 imum— 

18 ‘‘(A) the professional licensure, certifi19 cation, or registration of the health care profes20 sional; 

21 ‘‘(B) whether the health care professional 

22 holds a Drug Enforcement Administration reg23 istration; and 

24 ‘‘(C) the education, training, experience, 

25 malpractice history, and clinical competence of 

26 the health care professional; and 


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1 ‘‘(2) continuously monitors any changes to the 

2 matters under paragraph (1), including with respect 

3 to suspensions, restrictions, limitations, probations, 

4 denials, revocations, and other changes, relating to 

5 the failure of a health care professional to meet gen6 erally accepted standards of clinical practice in a 

7 manner that presents reasonable concern for the 

8 safety of patients. 

9 ‘‘(b) REGISTRATION REGARDING CONTROLLED SUB10 STANCES.—(1) Except as provided by paragraph (2), the 

11 Secretary shall ensure that each covered health care pro12 fessional holds an active Drug Enforcement Administra13 tion registration. 

14 ‘‘(2) The Secretary shall— 

15 ‘‘(A) determine the circumstances in which a 

16 medical center of the Department must obtain a 

17 waiver under section 303 of the Controlled Sub18 stances Act (21 U.S.C. 823) with respect to covered 

19 health care professionals; and 

20 ‘‘(B) establish a process for medical centers to 

21 request such waivers. 

22 ‘‘(3) In carrying out paragraph (1), the Secretary 

23 shall ensure that each medical center of the Department 

24 monitors the Drug Enforcement Administration registra25 tions of covered health care professionals at such medical 


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1 center in a manner that ensures the medical center is 

2 made aware of any change in status in the registration 

3 by not later than 7 days after such change in status. 

4 ‘‘(4) If a covered health care professional does not 

5 hold an active Drug Enforcement Administration registra6 tion, the Secretary shall carry out any of the following ac7 tions, as the Secretary determines appropriate: 

8 ‘‘(A) Obtain a waiver pursuant to paragraph 

9 (2). 

10 ‘‘(B) Transfer the health care professional to a 

11 position that does not require prescribing, dis12 pensing, administering, or conducting research with 

13 controlled substances. 

14 ‘‘(C) Take adverse actions under subchapter V 

15 of this chapter, with respect to an employee of the 

16 Department, or terminate the services of a con17 tractor, with respect to a contractor of the Depart18 ment. 

19 ‘‘(c) REVIEWS OF CONCERNS RELATING TO QUALITY

20 OF CLINICAL CARE.—(1) The Secretary shall ensure that 

21 each medical center of the Department, in a consistent 

22 manner, carries out— 

23 ‘‘(A) ongoing, retrospective, and comprehensive moni24 toring of the performance and quality of the health care 

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1 ment located at the medical center, including with respect 

2 to the safety of such care; and 

3 ‘‘(B) timely and documented reviews of such care if 

4 an individual notifies the Secretary of any potential con5 cerns relating to a failure of the health care professional 

6 to meet generally accepted standards of clinical practice 

7 in a manner that presents reasonable concern for the safe8 ty of patients. 

9 ‘‘(2) The Secretary shall establish a policy to carry 

10 out paragraph (1), including with respect to— 

11 ‘‘(A) determining the period by which a medical 

12 center of the Department must initiate the review of 

13 a concern described in subparagraph (B) of such 

14 paragraph following the date on which the concern 

15 is received; and 

16 ‘‘(B) ensuring the compliance of each medical 

17 center with such policy. 

18 ‘‘(d) COMPLIANCE WITH REQUIREMENTS FOR RE19 PORTING QUALITY OF CARE CONCERNS.—When the Sec20 retary substantiates a concern relating to the clinical com21 petency of, or quality of care delivered by, a health care 

22 professional of the Department (including a former such 

23 health care professional), the Secretary shall ensure that 

24 the appropriate medical center of the Department timely 


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1 notifies the following entities of such concern, as appro2 priate: 

3 ‘‘(1) The appropriate licensing, registration, or 

4 certification body in each State in which the health 

5 care professional is licensed, registered, or certified. 

6 ‘‘(2) The Drug Enforcement Administration. 

7 ‘‘(3) The National Practitioner Data Bank es8 tablished pursuant to the Health Care Quality Im9 provement Act of 1986 (42 U.S.C. 11101 et seq.). 

10 ‘‘(4) Any other relevant entity. 

11 ‘‘(e) PROHIBITION ON CERTAIN SETTLEMENT

12 AGREEMENT TERMS.—(1) Except as provided by para13 graph (2), the Secretary may not enter into a settlement 

14 agreement relating to an adverse action against a health 

15 care professional of the Department if such agreement in16 cludes terms that require the Secretary to conceal from 

17 the personnel file of the employee a serious medical error 

18 or lapse in clinical practice that constitutes a substantial 

19 failure to meet generally accepted standards of clinical 

20 practice as to raise reasonable concern for the safety of 

21 patients. 

22 ‘‘(2) Paragraph (1) does not apply to adverse actions 

23 that the Special Counsel under section 1211 of title 5 de24 termines constitutes a prohibited personnel practice. 


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1 ‘‘(f) TRAINING.—Not less frequently than biannually, 

2 the Secretary shall provide mandatory training to employ3 ees of each medical center of the Department who are re4 sponsible for any of the following activities: 

5 ‘‘(1) Compiling, validating, or reviewing the cre6 dentials of health care professionals of the Depart7 ment. 

8 ‘‘(2) Reviewing the quality of clinical care deliv9 ered by health care professionals of the Department. 

10 ‘‘(3) Taking adverse privileging actions or mak11 ing determinations relating to other disciplinary ac12 tions or employment actions against health care pro13 fessionals of the Department for reasons relating to 

14 the failure of a health care professional to meet gen15 erally accepted standards of clinical practice in a 

16 manner that presents reasonable concern for the 

17 safety of patients. 

18 ‘‘(4) Making notifications under subsection (d). 

19 ‘‘(g) DEFINITIONS.—In this section: 

20 ‘‘(1) The term ‘controlled substance’ has the 

21 meaning given that term in section 102 of the Con22 trolled Substances Act (21 U.S.C. 802). 

23 ‘‘(2) The term ‘covered health care professional’ 

24 means a person employed in a position as a health 

25 care professional of the Department, or a contractor 


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1 of the Department, that requires the person to be 

2 authorized to prescribe, dispense, administer, or con3 duct research with, controlled substances. 

4 ‘‘(3) The term ‘Drug Enforcement Administra5 tion registration’ means registration with the Drug 

6 Enforcement Administration under section 303 of 

7 the Controlled Substances Act (21 U.S.C. 823) by 

8 health care practitioners authorized to dispense, pre9 scribe, administer, or conduct research with, con10 trolled substances. 

11 ‘‘(4) The term ‘health care professional of the 

12 Department’ means the professionals described in 

13 section 1730C(b) of this title, and includes a con14 tractor of the Department serving as such a profes15 sional.’’. 

16 (b) CLERICAL AMENDMENT.—The table of sections 

17 at the beginning of such chapter is amended by inserting 

18 after the item relating to section 7413 the following new 

19 item: 

‘‘7414. Compliance with requirements for examining qualifications and clinical 

abilities of health care professionals.’’. 

20 (c) DEADLINE FOR IMPLEMENTATION.—The Sec21 retary of Veterans Affairs shall commence the implemen22 tation of section 7414 of title 38, United States Code, as 

23 added by subsection (a), by the following dates: 


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1 (1) With respect to subsections (a), (c)(2), (d), 

2 and (f), not later than 180 days after the date of the 

3 enactment of this Act. 

4 (2) With respect to subsection (c)(1), not later 

5 than 1 year after the date of the enactment of this 

6 Act. 

7 (3) With respect to subsection (b)(2), not later 

8 than 18 months after the date of the enactment of 

9 this Act. 

10 (d) AUDITS AND REPORTS.— 

11 (1) AUDITS.—The Secretary of Veterans Af12 fairs shall carry out annual audits of the compliance 

13 of medical centers of the Department of Veterans 

14 Affairs with the matters required by section 7414 of 

15 title 38, United States Code, as added by subsection 

16 (a). In carrying out such audits, the Secretary— 

17 (A) may not authorize the medical center 

18 being audited to conduct the audit; and 

19 (B) may enter into an agreement with an20 other department or agency of the Federal Gov21 ernment or a nongovernmental entity to con22 duct such audits. 

23 (2) REPORTS.—Not later than 1 year after the 

24 date of the enactment of this Act, and annually 

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1 fairs shall submit to the Committees on Veterans’ 

2 Affairs of the House of Representatives and the Sen3 ate a report on the audits conducted under para4 graph (1). Each such report shall include a sum5 mary of the compliance by each medical center with 

6 the matters required by such section 7414. 

7 (3) INITIAL REPORT.—The Secretary shall in8 clude in the first report submitted under paragraph 

9 (2) the following: 

10 (A) A description of the progress made by 

11 the Secretary in implementing such section 

12 7414, including any matters under such section 

13 that the Secretary has not fully implemented. 

14 (B) An analysis of the feasibility, advis15 ability, and cost of requiring credentialing em16 ployees of the Department to be trained by an 

17 outside entity and to maintain a credentialing 

18 certification. 

Æ 


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