IIB 

116TH CONGRESS 

1ST SESSION H. R. 3530 

IN THE SENATE OF THE UNITED STATES 

DECEMBER 18, 2019 

Received; read twice and referred to the Committee on Veterans’ Affairs 

AN ACT 

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, 


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1 SECTION 1. SHORT TITLE. 

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

3 in Veterans’ Care Act’’. 

4 SEC. 2. COMPLIANCE WITH REQUIREMENTS FOR EXAM5 INING QUALIFICATIONS AND CLINICAL ABILI6 TIES OF DEPARTMENT OF VETERANS AF7 FAIRS HEALTH CARE PROFESSIONALS. 

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

9 38, United States Code, is amended by adding at the end 

10 the following new section: 

11 ‘‘§ 7414. Compliance with requirements for examining 

12 qualifications and clinical abilities of 

13 health care professionals 

14 ‘‘(a) COMPLIANCE WITH CREDENTIALING REQUIRE15 MENTS.—The Secretary shall ensure that each medical 

16 center of the Department, in a consistent manner— 

17 ‘‘(1) compiles, verifies, and reviews documenta18 tion for each health care professional of the Depart19 ment at such medical center regarding, at a min20 imum— 

21 ‘‘(A) the professional licensure, certifi22 cation, or registration of the health care profes23 sional; 

24 ‘‘(B) whether the health care professional 

25 holds a Drug Enforcement Administration reg26 istration; and 


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

2 malpractice history, and clinical competence of 

3 the health care professional; and 

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

5 matters under paragraph (1), including with respect 

6 to suspensions, restrictions, limitations, probations, 

7 denials, revocations, and other changes, relating to 

8 the failure of a health care professional to meet gen9 erally accepted standards of clinical practice in a 

10 manner that presents reasonable concern for the 

11 safety of patients. 

12 ‘‘(b) REGISTRATION REGARDING CONTROLLED SUB13 STANCES.—(1) Except as provided by paragraph (2), the 

14 Secretary shall ensure that each covered health care pro15 fessional holds an active Drug Enforcement Administra16 tion registration. 

17 ‘‘(2) The Secretary shall— 

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

19 medical center of the Department must obtain a 

20 waiver under section 303 of the Controlled Sub21 stances Act (21 U.S.C. 823) with respect to covered 

22 health care professionals; and 

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

24 request such waivers. 


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

2 shall ensure that each medical center of the Department 

3 monitors the Drug Enforcement Administration registra4 tions of covered health care professionals at such medical 

5 center in a manner that ensures the medical center is 

6 made aware of any change in status in the registration 

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

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

9 hold an active Drug Enforcement Administration registra10 tion, the Secretary shall carry out any of the following ac11 tions, as the Secretary determines appropriate: 

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

13 (2). 

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

15 position that does not require prescribing, dis16 pensing, administering, or conducting research with 

17 controlled substances. 

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

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

20 Department, or terminate the services of a con21 tractor, with respect to a contractor of the Depart22 ment. 

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

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


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1 each medical center of the Department, in a consistent 

2 manner, carries out— 

3 ‘‘(A) ongoing, retrospective, and comprehensive moni4 toring of the performance and quality of the health care 

5 delivered by each health care professional of the Depart6 ment located at the medical center, including with respect 

7 to the safety of such care; and 

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

9 an individual notifies the Secretary of any potential con10 cerns relating to a failure of the health care professional 

11 to meet generally accepted standards of clinical practice 

12 in a manner that presents reasonable concern for the safe13 ty of patients. 

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

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

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

17 center of the Department must initiate the review of 

18 a concern described in subparagraph (B) of such 

19 paragraph following the date on which the concern 

20 is received; and 

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

22 center with such policy. 

23 ‘‘(d) COMPLIANCE WITH REQUIREMENTS FOR RE24 PORTING QUALITY OF CARE CONCERNS.—When the Sec25 retary substantiates a concern relating to the clinical comVerDate Sep 11 2014 03:15 Dec 19, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3530.RFS H3530

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1 petency of, or quality of care delivered by, a health care 

2 professional of the Department (including a former such 

3 health care professional), the Secretary shall ensure that 

4 the appropriate medical center of the Department timely 

5 notifies the following entities of such concern, as appro6 priate: 

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

8 certification body in each State in which the health 

9 care professional is licensed, registered, or certified. 

10 ‘‘(2) The Drug Enforcement Administration. 

11 ‘‘(3) The National Practitioner Data Bank es12 tablished pursuant to the Health Care Quality Im13 provement Act of 1986 (42 U.S.C. 11101 et seq.). 

14 ‘‘(4) Any other relevant entity. 

15 ‘‘(e) PROHIBITION ON CERTAIN SETTLEMENT

16 AGREEMENT TERMS.—(1) Except as provided by para17 graph (2), the Secretary may not enter into a settlement 

18 agreement relating to an adverse action against a health 

19 care professional of the Department if such agreement in20 cludes terms that require the Secretary to conceal from 

21 the personnel file of the employee a serious medical error 

22 or lapse in clinical practice that constitutes a substantial 

23 failure to meet generally accepted standards of clinical 

24 practice as to raise reasonable concern for the safety of 

25 patients. 


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

2 that the Special Counsel under section 1211 of title 5 de3 termines constitutes a prohibited personnel practice. 

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

5 the Secretary shall provide mandatory training to employ6 ees of each medical center of the Department who are re7 sponsible for any of the following activities: 

8 ‘‘(1) Compiling, validating, or reviewing the cre9 dentials of health care professionals of the Depart10 ment. 

11 ‘‘(2) Reviewing the quality of clinical care deliv12 ered by health care professionals of the Department. 

13 ‘‘(3) Taking adverse privileging actions or mak14 ing determinations relating to other disciplinary ac15 tions or employment actions against health care pro16 fessionals of the Department for reasons relating to 

17 the failure of a health care professional to meet gen18 erally accepted standards of clinical practice in a 

19 manner that presents reasonable concern for the 

20 safety of patients. 

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

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

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

24 meaning given that term in section 102 of the Con25 trolled Substances Act (21 U.S.C. 802). 


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

2 means a person employed in a position as a health 

3 care professional of the Department, or a contractor 

4 of the Department, that requires the person to be 

5 authorized to prescribe, dispense, administer, or con6 duct research with, controlled substances. 

7 ‘‘(3) The term ‘Drug Enforcement Administra8 tion registration’ means registration with the Drug 

9 Enforcement Administration under section 303 of 

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

11 health care practitioners authorized to dispense, pre12 scribe, administer, or conduct research with, con13 trolled substances. 

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

15 Department’ means the professionals described in 

16 section 1730C(b) of this title, and includes a con17 tractor of the Department serving as such a profes18 sional.’’. 

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

20 at the beginning of such chapter is amended by inserting 

21 after the item relating to section 7413 the following new 

22 item: 

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

abilities of health care professionals.’’. 

23 (c) DEADLINE FOR IMPLEMENTATION.—The Sec24 retary of Veterans Affairs shall commence the implemenVerDate Sep 11 2014 03:15 Dec 19, 2019 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H3530.RFS H3530

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1 tation of section 7414 of title 38, United States Code, as 

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

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

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

5 enactment of this Act. 

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

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

8 Act. 

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

10 than 18 months after the date of the enactment of 

11 this Act. 

12 (d) AUDITS AND REPORTS.— 

13 (1) AUDITS.—The Secretary of Veterans Af14 fairs shall carry out annual audits of the compliance 

15 of medical centers of the Department of Veterans 

16 Affairs with the matters required by section 7414 of 

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

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

19 (A) may not authorize the medical center 

20 being audited to conduct the audit; and 

21 (B) may enter into an agreement with an22 other department or agency of the Federal Gov23 ernment or a nongovernmental entity to con24 duct such audits. 


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

2 date of the enactment of this Act, and annually 

3 thereafter for 5 years, the Secretary of Veterans Af4 fairs shall submit to the Committees on Veterans’ 

5 Affairs of the House of Representatives and the Sen6 ate a report on the audits conducted under para7 graph (1). Each such report shall include a sum8 mary of the compliance by each medical center with 

9 the matters required by such section 7414. 

10 (3) INITIAL REPORT.—The Secretary shall in11 clude in the first report submitted under paragraph 

12 (2) the following: 

13 (A) A description of the progress made by 

14 the Secretary in implementing such section 

15 7414, including any matters under such section 

16 that the Secretary has not fully implemented. 

17 (B) An analysis of the feasibility, advis18 ability, and cost of requiring credentialing em19 ployees of the Department to be trained by an 


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1 outside entity and to maintain a credentialing 

2 certification. 

Passed the House of Representatives December 17, 

2019. 

Attest: CHERYL L. JOHNSON, 

Clerk. 


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