II 

117TH CONGRESS 

1ST SESSION S. 2041 

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 SENATE OF THE UNITED STATES 

JUNE 14, 2021 

Mr. MANCHIN (for himself, Mr. MORAN, Mr. BOOZMAN, Ms. COLLINS, and 

Mr. CASSIDY) introduced the following bill; which was read twice and 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 ‘‘Department of Vet5 erans Affairs Provider Accountability Act’’. 


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

4 DEPARTMENT OF VETERANS AFFAIRS. 

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 in 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 seven 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 appropriate actions under sub15 chapter V of this chapter, with respect to an em16 ployee of the Department, or take appropriate con17 tract administration actions, with respect to a con18 tractor of the Department. 

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 

24 monitoring of the performance and quality of the 

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1 sional of the Department located at the medical cen2 ter, including with respect to the safety of such care; 

3 and 

4 ‘‘(B) timely and documented reviews of such 

5 care if an individual notifies the Secretary of any po6 tential concerns relating to a failure of a health care 

7 professional of the Department to meet generally ac8 cepted standards of clinical practice in a manner 

9 that presents reasonable concern for the safety of 

10 patients. 

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

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

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

14 center of the Department must initiate the review of 

15 a concern described in subparagraph (B) of such 

16 paragraph following the date on which the concern 

17 is received; and 

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

19 center with such policy. 

20 ‘‘(d) COMPLIANCE WITH REQUIREMENTS FOR RE21 PORTING QUALITY OF CARE CONCERNS.—If the Secretary 

22 substantiates a concern relating to the clinical competency 

23 of, or quality of care delivered by, a health care profes24 sional of the Department (including a former health care 

25 professional of the Department), the Secretary shall enVerDate Sep 11 2014 07:07 Jun 23, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2041.IS S2041

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1 sure that the appropriate medical center of the Depart2 ment timely notifies the following entities of such concern, 

3 as appropriate: 

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

5 certification body in each State in which the health 

6 care professional is licensed, registered, or certified. 

7 ‘‘(2) The Drug Enforcement Administration. 

8 ‘‘(3) The National Practitioner Data Bank es9 tablished pursuant to the Health Care Quality Im10 provement Act of 1986 (42 U.S.C. 11101 et seq.). 

11 ‘‘(4) Any other relevant entity. 

12 ‘‘(e) PROHIBITION ON CERTAIN SETTLEMENT

13 AGREEMENT TERMS.—(1) Except as provided in para14 graph (2), the Secretary may not enter into a settlement 

15 agreement relating to an adverse action against a health 

16 care professional of the Department if such agreement in17 cludes terms that require the Secretary to conceal from 

18 the personnel file of the employee a serious medical error 

19 or lapse in clinical practice that constitutes a substantial 

20 failure to meet generally accepted standards of clinical 

21 practice as to raise reasonable concern for the safety of 

22 patients. 

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

24 that the Special Counsel under section 1211 of title 5 de25 termines constitutes a prohibited personnel practice. 


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

2 the Secretary shall provide mandatory training on the fol3 lowing duties to employees of the Department who are re4 sponsible for performing such duties: 

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 an individual employed in a position as a 

25 health care professional of the Department, or a 


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1 contractor of the Department, that requires the indi2 vidual to be authorized to prescribe, dispense, ad3 minister, or conduct research with, controlled sub4 stances. 

5 ‘‘(3) The term ‘Drug Enforcement Administra6 tion registration’ means registration with the Drug 

7 Enforcement Administration under section 303 of 

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

9 health care practitioners authorized to dispense, pre10 scribe, administer, or conduct research with, con11 trolled substances. 

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

13 Department’ means an individual working for the 

14 Department in a position described in section 7401 

15 of this title, including a contractor of the Depart16 ment serving in such a position.’’. 

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

18 at the beginning of such chapter is amended by inserting 

19 after the item relating to section 7413 the following new 

20 item: 

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

abilities of health care professionals.’’. 

21 (c) DEADLINE FOR IMPLEMENTATION.—The Sec22 retary of Veterans Affairs shall commence the implemen23 tation of section 7414 of title 38, United States Code, as 

24 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) of such section, not later than 180 days after 

3 the date of the enactment of this Act. 

4 (2) With respect to subsection (c)(1) of such 

5 section, not later than one year after the date of the 

6 enactment of this Act. 

7 (3) With respect to subsection (b)(2) of such 

8 section, not later than 18 months after the date of 

9 the enactment of this Act. 

10 (d) AUDITS AND REPORTS.— 

11 (1) AUDITS.— 

12 (A) IN GENERAL.—The Secretary of Vet13 erans Affairs shall carry out annual audits of 

14 the compliance of medical centers of the De15 partment of Veterans Affairs with the matters 

16 required by section 7414 of title 38, United 

17 States Code, as added by subsection (a). 

18 (B) CONDUCT OF AUDITS.—In carrying 

19 out audits under subparagraph (A), the Sec20 retary— 

21 (i) may not authorize the medical cen22 ter being audited to conduct the audit; and 

23 (ii) may enter into an agreement with 

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1 eral Government or a nongovernmental en2 tity to conduct such audits. 

3 (2) REPORTS.— 

4 (A) IN GENERAL.—Not later than one year 

5 after the date of the enactment of this Act, and 

6 annually thereafter for five years, the Secretary 

7 of Veterans Affairs shall submit to the Com8 mittee on Veterans’ Affairs of the Senate and 

9 the Committee on Veterans’ Affairs of the 

10 House of Representatives a report on the audits 

11 conducted under paragraph (1). 

12 (B) ELEMENTS.—Each report submitted 

13 under subparagraph (A) shall include a sum14 mary of the compliance by each medical center 

15 of the Department of Veterans Affairs with the 

16 matters required by section 7414 of title 38, 

17 United States Code, as added by subsection (a). 

18 (C) INITIAL REPORT.—The Secretary shall 

19 include in the first report submitted under sub20 paragraph (A) the following: 

21 (i) A description of the progress made 

22 by the Secretary in implementing section 

23 7414 of title 38, United States Code, as 

24 added by subsection (a), including any 


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1 matters under such section that the Sec2 retary has not fully implemented. 

3 (ii) An analysis of the feasibility, ad4 visability, and cost of requiring credential5 ing employees of the Department to be 

6 trained by an outside entity and to main7 tain a credentialing certification. 

8 (e) REPORT ON UPDATES TO POLICY OF THE DE9 PARTMENT OF VETERANS AFFAIRS FOR REPORTING PA10 TIENT SAFETY CONCERNS TO APPROPRIATE STATE AND

11 OTHER ENTITIES.— 

12 (1) IN GENERAL.—Not later than 90 days after 

13 the date of the enactment of this Act, the Secretary 

14 of Veterans Affairs shall submit to the Committee 

15 on Veterans’ Affairs of the Senate and the Com16 mittee on Veterans’ Affairs of the House of Rep17 resentatives a report on the efforts of the Depart18 ment of Veterans Affairs to update policies and 

19 practices for employees of medical centers of the De20 partment, Veterans Integrated Service Networks, 

21 and the Veterans Health Administration to report to 

22 State licensing boards, the National Practitioner 

23 Data Bank established pursuant to the Health Care 

24 Quality Improvement Act of 1986 (42 U.S.C. 11101 

25 et seq.), and any other relevant entity health care 


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1 professionals who are employed by or separated from 

2 employment with the Department and whose behav3 ior and clinical practice so substantially failed to 

4 meet generally accepted standards of clinical practice 

5 as to raise reasonable concern for the safety of pa6 tients. 

7 (2) CONSULTATION.—The report required by 

8 paragraph (1) shall include a description of the ef9 forts of the Department to consult with— 

10 (A) State licensing boards; 

11 (B) the Centers for Medicare & Medicaid 

12 Services; 

13 (C) the National Practitioner Data Bank; 

14 and 

15 (D) the exclusive representative of employ16 ees of the Department appointed under section 

17 7401(1) of title 38, United States Code. 

Æ 


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