H. R. 2617—952 
(3) PROGRAM
IMPLEMENTATION
EVALUATION.—The Sec-
retary shall establish a program evaluation tool to learn best 
practices and to inform the Department and Congress regarding 
further use of the disease specific model of care delivery. 
(4) PROSTATE
CANCER
RESEARCH.—The Secretary shall 
submit to Congress a plan that provides for continual funding 
through the Office of Research and Development of the Depart-
ment of Veterans for supporting prostate cancer research 
designed to position the Department as a national resource 
for prostate cancer detection and treatment. Such plan shall— 
(A) include details regarding the funding of and 
coordination between the National Precision Oncology Pro-
gram of the Department and the PCF–VA Precision 
Oncology Centers of Excellence as related to the require-
ments of this Act; and 
(B) affirm that no funding included in such funding 
plan is duplicative in nature. 
(d) REPORT ON NATIONAL REGISTRY.—The Secretary of Veterans 
Affairs shall submit to Congress a report on the barriers and 
challenges associated with creating a national prostate cancer reg-
istry. Such report shall include recommendations for centralizing 
data about veterans with prostate cancer for the purpose of 
improving outcomes and serving as a resource for providers. 
(e) DEFINITIONS.—In this section: 
(1) CLINICAL PATHWAY.—The term ‘‘clinical pathway’’ means 
a health care management tool designed around research and 
evidence-backed practices that provides direction for the clinical 
care and treatment of a specific episode of a condition or ail-
ment. 
(2) EVIDENCE-BASED RISK FACTORS.—The term ‘‘evidence- 
based risk factors’’ includes race, ethnicity, socioeconomic 
status, geographic location, exposure risks, genetic risks, 
including family history, and such other factors as the Secretary 
determines appropriate. 
Subtitle B—Health Care Employees 
SEC. 111. THIRD PARTY REVIEW OF APPOINTEES IN VETERANS 
HEALTH ADMINISTRATION WHO HAD A LICENSE TERMI-
NATED 
FOR 
CAUSE 
AND 
NOTICE 
TO 
INDIVIDUALS 
TREATED BY THOSE APPOINTEES IF DETERMINED THAT 
AN EPISODE OF CARE OR SERVICES THAT THEY RECEIVED 
WAS BELOW THE STANDARD OF CARE. 
(a) THIRD PARTY REVIEW.— 
(1) IN GENERAL.—Not later than 180 days after the date 
of the enactment of this Act, the Secretary of Veterans Affairs 
shall enter into a contract or other agreement with an organiza-
tion that is not part of the Federal Government to conduct 
a clinical review for quality management of hospital care or 
medical services furnished by covered providers. 
(2) QUALIFICATIONS.—The Secretary shall ensure that each 
review of a covered provider under this subsection is performed 
by an individual who is licensed in the same specialty as 
the covered provider. 
(b) NOTICE TO PATIENTS TREATED BY COVERED PROVIDERS.— 
With respect to hospital care or medical services furnished by
H. R. 2617—953 
a covered provider under the laws administered by the Secretary, 
if a clinical review for quality management under subsection (a) 
determines that the standard of care was not met during an episode 
of care, the Secretary shall notify the individual who received 
such care or services from the covered provider as described in 
applicable policy of the Veterans Heath Administration. 
(c) DEFINITIONS.—In this section: 
(1) COVERED
PROVIDER.—The term ‘‘covered provider’’ 
means an individual who— 
(A) was appointed to the Veterans Health Administra-
tion under section 7401 of title 38, United States Code; 
and 
(B) before such appointment, had a license terminated 
for cause by a State licensing board for hospital care or 
medical services provided in a facility that is not a facility 
of the Veterans Health Administration. 
(2) HOSPITAL CARE OR MEDICAL SERVICES.—The terms ‘‘hos-
pital care’’ and ‘‘medical services’’ have the meanings given 
those terms in section 1701 of title 38, United States Code. 
SEC. 112. COMPLIANCE WITH REQUIREMENTS FOR EXAMINING QUALI-
FICATIONS AND CLINICAL ABILITIES OF HEALTH CARE 
PROFESSIONALS OF DEPARTMENT OF VETERANS AFFAIRS. 
(a) IN GENERAL.—Subchapter I of chapter 74 of title 38, United 
States Code, is amended by adding at the end the following new 
section: 
‘‘§ 7414. Compliance with requirements for examining quali-
fications and clinical abilities of health care profes-
sionals 
‘‘(a) COMPLIANCE WITH CREDENTIALING REQUIREMENTS.—The 
Secretary shall ensure that each medical center of the Department, 
in a consistent manner— 
‘‘(1) compiles, verifies, and reviews documentation for each 
health care professional of the Department at such medical 
center regarding, at a minimum— 
‘‘(A) the professional licensure, certification, or registra-
tion of the health care professional; 
‘‘(B) whether the health care professional holds a Drug 
Enforcement Administration registration; and 
‘‘(C) the education, training, experience, malpractice 
history, and clinical competence of the health care profes-
sional; and 
‘‘(2) continuously monitors any changes to the matters 
under paragraph (1), including with respect to suspensions, 
restrictions, limitations, probations, denials, revocations, and 
other changes, relating to the failure of a health care profes-
sional to meet generally accepted standards of clinical practice 
in a manner that presents reasonable concern for the safety 
of patients. 
‘‘(b) REGISTRATION REGARDING CONTROLLED SUBSTANCES.—(1) 
Except as provided in paragraph (2), the Secretary shall ensure 
that each covered health care professional holds an active Drug 
Enforcement Administration registration. 
‘‘(2) The Secretary shall— 
‘‘(A) determine the circumstances in which a medical center 
of the Department must obtain a waiver under section 302(d)
H. R. 2617—954 
of the Controlled Substances Act (21 U.S.C. 822(d)) with respect 
to covered health care professionals; and 
‘‘(B) establish a process for medical centers to request such 
waivers. 
‘‘(3) In carrying out paragraph (1), the Secretary shall ensure 
that each medical center of the Department monitors the Drug 
Enforcement Administration registrations of covered health care 
professionals at such medical center in a manner that ensures 
the medical center is made aware of any change in status in 
the registration by not later than seven days after such change 
in status. 
‘‘(4) If a covered health care professional does not hold an 
active Drug Enforcement Administration registration, the Secretary 
shall carry out any of the following actions, as the Secretary deter-
mines appropriate: 
‘‘(A) Obtain a waiver pursuant to paragraph (2). 
‘‘(B) Transfer the health care professional to a position 
that does not require prescribing, dispensing, administering, 
or conducting research with controlled substances. 
‘‘(C) Take appropriate actions under subchapter V of this 
chapter, with respect to an employee of the Department, or 
take appropriate contract administration actions, with respect 
to a contractor of the Department. 
‘‘(c) REVIEWS OF CONCERNS RELATING TO QUALITY OF CLINICAL 
CARE.—(1) The Secretary shall ensure that each medical center 
of the Department, in a consistent manner, carries out— 
‘‘(A) ongoing, retrospective, and comprehensive monitoring 
of the performance and quality of the health care delivered 
by each health care professional of the Department located 
at the medical center, including with respect to the safety 
of such care; and 
‘‘(B) timely and documented reviews of such care if an 
individual notifies the Secretary of any potential concerns 
relating to a failure of a health care professional of the Depart-
ment to meet generally accepted standards of clinical practice 
in a manner that presents reasonable concern for the safety 
of patients. 
‘‘(2) The Secretary shall establish a policy to carry out para-
graph (1), including with respect to— 
‘‘(A) determining the period by which a medical center 
of the Department must initiate the review of a concern 
described in subparagraph (B) of such paragraph following 
the date on which the concern is received; and 
‘‘(B) ensuring the compliance of each medical center with 
such policy. 
‘‘(d) COMPLIANCE WITH REQUIREMENTS FOR REPORTING QUALITY 
OF CARE CONCERNS.—If the Secretary substantiates a concern 
relating to the clinical competency of, or quality of care delivered 
by, a health care professional of the Department (including a former 
health care professional of the Department), the Secretary shall 
ensure that the appropriate medical center of the Department 
timely notifies the following entities of such concern, as appropriate: 
‘‘(1) The appropriate licensing, registration, or certification 
body in each State in which the health care professional is 
licensed, registered, or certified. 
‘‘(2) The Drug Enforcement Administration.
H. R. 2617—955 
‘‘(3) The National Practitioner Data Bank established 
pursuant to the Health Care Quality Improvement Act of 1986 
(42 U.S.C. 11101 et seq.). 
‘‘(4) Any other relevant entity. 
‘‘(e) 
PROHIBITION
ON
CERTAIN
SETTLEMENT
AGREEMENT 
TERMS.—(1) The Secretary may not enter into a settlement agree-
ment relating to an adverse action against a health care professional 
of the Department if such agreement includes terms that require 
the Secretary to conceal from the personnel file of the employee 
a serious medical error or lapse in clinical practice that constitutes 
a substantial failure to meet generally accepted standards of clinical 
practice as to raise reasonable concern for the safety of patients. 
‘‘(2) Nothing in paragraph (1) limits— 
‘‘(A) the right of an employee to appeal a quality of care 
determination; or 
‘‘(B) the rights of an employee under sections 1214 and 
1221 of title 5. 
‘‘(f) TRAINING.—Not less frequently than annually, the Secretary 
shall provide mandatory training on the following duties to 
employees of the Department who are responsible for performing 
such duties: 
‘‘(1) Compiling, validating, or reviewing the credentials of 
health care professionals of the Department. 
‘‘(2) Reviewing the quality of clinical care delivered by 
health care professionals of the Department. 
‘‘(3) Taking adverse privileging actions or making deter-
minations relating to other disciplinary actions or employment 
actions against health care professionals of the Department 
for reasons relating to the failure of a health care professional 
to meet generally accepted standards of clinical practice in 
a manner that presents reasonable concern for the safety of 
patients. 
‘‘(4) Making notifications under subsection (d). 
‘‘(g) DEFINITIONS.—In this section: 
‘‘(1) The term ‘controlled substance’ has the meaning given 
that term in section 102 of the Controlled Substances Act 
(21 U.S.C. 802). 
‘‘(2) The term ‘covered health care professional’ means an 
individual employed in a position as a health care professional 
of the Department, or a contractor of the Department, that 
requires the individual to be authorized to prescribe, dispense, 
administer, or conduct research with, controlled substances. 
‘‘(3) The term ‘Drug Enforcement Administration registra-
tion’ means registration with the Drug Enforcement Adminis-
tration under section 303 of the Controlled Substances Act 
(21 U.S.C. 823) 302 of the Controlled Substances Act (21 U.S.C. 
822) by health care practitioners authorized to dispense, pre-
scribe, administer, or conduct research with, controlled sub-
stances. 
‘‘(4) The term ‘health care professional of the Department’ 
means an individual working for the Department in a position 
described in section 7401 of this title, including a contractor 
of the Department serving in such a position.’’.
H. R. 2617—956 
(b) CLERICAL AMENDMENT.—The table of sections at the begin-
ning of such chapter is amended by inserting after the item relating 
to section 7413 the following new item: 
‘‘7414. Compliance with requirements for examining qualifications and clinical abili-
ties of health care professionals.’’. 
(c) DEADLINE FOR IMPLEMENTATION.—The Secretary of Veterans 
Affairs shall commence the implementation of section 7414 of title 
38, United States Code, as added by subsection (a), by the following 
dates: 
(1) With respect to subsections (a), (c)(2), (d), and (f) of 
such section, not later than 180 days after the date of the 
enactment of this Act. 
(2) With respect to subsection (c)(1) of such section, not 
later than one year after the date of the enactment of this 
Act. 
(3) With respect to subsection (b)(2) of such section, not 
later than 18 months after the date of the enactment of this 
Act. 
(d) AUDITS AND REPORTS.— 
(1) AUDITS.— 
(A) IN GENERAL.—The Secretary of Veterans Affairs 
shall carry out annual audits of the compliance of medical 
centers of the Department of Veterans Affairs with the 
matters required by section 7414 of title 38, United States 
Code, as added by subsection (a). 
(B) CONDUCT OF AUDITS.—In carrying out audits under 
subparagraph (A), the Secretary— 
(i) may not authorize the medical center being 
audited to conduct the audit; and 
(ii) may enter into an agreement with another 
department or agency of the Federal Government or 
a nongovernmental entity to conduct such audits. 
(2) REPORTS.— 
(A) IN GENERAL.—Not later than one year after the 
date of the enactment of this Act, and annually thereafter 
for five years, the Secretary of Veterans Affairs shall 
submit to the Committee on Veterans’ Affairs of the Senate 
and the Committee on Veterans’ Affairs of the House of 
Representatives a report on the audits conducted under 
paragraph (1). 
(B) ELEMENTS.—Each report submitted under subpara-
graph (A) shall include a summary of the compliance by 
each medical center of the Department of Veterans Affairs 
with the matters required by section 7414 of title 38, United 
States Code, as added by subsection (a). 
(C) INITIAL REPORT.—The Secretary shall include in 
the first report submitted under subparagraph (A) the fol-
lowing: 
(i) A description of the progress made by the Sec-
retary in implementing section 7414 of title 38, United 
States Code, as added by subsection (a), including any 
matters under such section that the Secretary has 
not fully implemented. 
(ii) An analysis of the feasibility, advisability, and 
cost of requiring credentialing employees of the Depart-
ment to be trained by an outside entity and to maintain 
a credentialing certification.
H. R. 2617—957 
(e) REPORT ON UPDATES TO POLICY OF THE DEPARTMENT OF 
VETERANS AFFAIRS FOR REPORTING PATIENT SAFETY CONCERNS TO 
APPROPRIATE STATE AND OTHER ENTITIES.— 
(1) IN GENERAL.—Not later than 90 days after the date 
of the enactment of this Act, the Secretary of Veterans Affairs 
shall submit to the Committee on Veterans’ Affairs of the 
Senate and the Committee on Veterans’ Affairs of the House 
of Representatives a report on the efforts of the Department 
of Veterans Affairs to update policies and practices for 
employees of medical centers of the Department, Veterans 
Integrated Service Networks, and the Veterans Health 
Administration to report to State licensing boards, the National 
Practitioner Data Bank established pursuant to the Health 
Care Quality Improvement Act of 1986 (42 U.S.C. 11101 et 
seq.), and any other relevant entity health care professionals 
who are employed by or separated from employment with the 
Department and whose behavior and clinical practice so 
substantially failed to meet generally accepted standards of 
clinical practice as to raise reasonable concern for the safety 
of patients. 
(2) CONSULTATION.—The report required by paragraph (1) 
shall include a description of the efforts of the Department 
to consult with— 
(A) State licensing boards; 
(B) the Centers for Medicare & Medicaid Services; 
(C) the National Practitioner Data Bank; and 
(D) the exclusive representative of employees of the 
Department appointed under section 7401(1) of title 38, 
United States Code. 
Subtitle C—Care From Non-Department of 
Veterans Affairs Providers 
CHAPTER 1—WAIT TIMES FOR CARE 
SEC. 121. CALCULATION OF WAIT TIME FOR PURPOSES OF ELIGIBILITY 
UNDER VETERANS COMMUNITY CARE PROGRAM. 
Section 1703(d) of title 38, United States Code, is amended 
by adding at the end the following new paragraph: 
‘‘(4) In determining under paragraph (1)(D) whether the Depart-
ment is able to furnish care or services in a manner that complies 
with designated access standards developed by the Secretary under 
section 1703B of this title, for purposes of calculating a wait time 
for a veteran to schedule an appointment at a medical facility 
of the Department, the Secretary shall measure from the date 
of request for the appointment, unless a later date has been agreed 
to by the veteran in consultation with a health care provider of 
the Department, to the first next available appointment date rel-
evant to the requested medical service.’’. 
SEC. 122. PLAN REGARDING INFORMING VETERANS OF EXPECTED 
WAIT TIMES FOR APPOINTMENTS FOR CARE. 
(a) IN GENERAL.—Not later than October 1, 2023, the Secretary 
of Veterans Affairs shall develop a plan to ensure that veterans 
eligible for care or services pursuant to section 1703(d)(1) of title 
38, United States Code, including veterans making their own
H. R. 2617—958 
appointments using advanced technology, are informed of the 
expected number of days between the date on which the veteran 
requested care until— 
(1) the date on which the veteran will be able to receive 
care through a non-Department of Veterans Affairs provider 
under such section; 
(2) the date on which the veteran will be able to receive 
care through a provider of the Department; 
(3) the date on which— 
(A) the Department will schedule an appointment for 
care through a non-Department provider under such sec-
tion; or 
(B) for veterans making their own appointments using 
advanced technology, the veteran would be able to schedule 
an appointment for care through a provider of the Depart-
ment or through a non-Department provider under such 
section; 
(4) the date on which the Department will schedule an 
appointment for care through a provider of the Department. 
(b) IMPLEMENTATION.—The Secretary shall implement the plan 
required under subsection (a) not later than three years after the 
date of the enactment of this Act. 
(c) MATTERS TO BE INCLUDED.—The Secretary shall include 
in the plan required under subsection (a) a list of the information 
technology systems, contracting mechanisms, staff, legislative 
authorities, pilot programs, and other components that the Sec-
retary determines necessary to implement the plan within the three- 
year implementation deadline under subsection (b), as well as their 
associated milestones and resource requirements. 
(d) UPDATES.—Not less frequently than quarterly, the Secretary 
shall brief the Committee on Veterans’ Affairs of the Senate and 
the Committee on Veterans’ Affairs of the House of Representatives 
and submit to those committees a report in writing regarding the 
status of the implementation of the plan required under subsection 
(a), to include an assessment of the progress of the Secretary 
in meeting the three-year implementation deadline under subsection 
(b). 
CHAPTER 2—IMPROVEMENT OF PROVISION OF CARE 
SEC. 125. MODIFICATIONS TO ACCESS STANDARDS FOR CARE FUR-
NISHED 
THROUGH 
COMMUNITY 
CARE 
PROGRAM 
OF 
DEPARTMENT OF VETERANS AFFAIRS. 
(a) ACCESS STANDARDS.—Section 1703B of title 38, United 
States Code, is amended— 
(1) by striking subsections (f) and (g) and inserting the 
following: 
‘‘(f)(1) Subject to paragraph (3), the Secretary shall meet the 
access standards established under subsection (a) when furnishing 
hospital care, medical services, or extended care services to a cov-
ered veteran under section 1703 of this title and shall ensure 
that meeting such access standards is reflected in the contractual 
requirements of Third Party Administrators. 
‘‘(2) The Secretary shall ensure that health care providers speci-
fied under section 1703(c) of this title are able to comply with 
the access standards established under subsection (a) for such pro-
viders.
H. R. 2617—959 
‘‘(3)(A) A Third Party Administrator may request a waiver 
to the requirement under this subsection to meet the access stand-
ards established under subsection (a) if— 
‘‘(i)(I) the scarcity of available providers or facilities in 
the region precludes the Third Party Administrator from 
meeting those access standards; or 
‘‘(II) the landscape of providers or facilities has changed, 
and certain providers or facilities are not available such that 
the Third Party Administrator is not able to meet those access 
standards; and 
‘‘(ii) to address the scarcity of available providers or the 
change in the provider or facility landscape, as the case may 
be, the Third Party Administrator has contracted with other 
providers or facilities that may not meet those access standards 
but are the currently available providers or facilities most 
accessible to veterans within the region of responsibility of 
the Third Party Administrator. 
‘‘(B) Any waiver requested by a Third Party Administrator 
under subparagraph (A) must be requested in writing and submitted 
to the Office of Integrated Veteran Care of the Department for 
approval by that office. 
‘‘(C) As part of any waiver request under subparagraph (A), 
a Third Party Administrator must include conclusive evidence and 
documentation that the access standards established under sub-
section (a) cannot be met because of scarcity of available providers 
or changes to the landscape of providers or facilities. 
‘‘(D) In evaluating a waiver request under subparagraph (A), 
the Secretary shall consider the following: 
‘‘(i) The number and geographic distribution of eligible 
health care providers available within the geographic area and 
specialty referenced in the waiver request. 
‘‘(ii) The prevailing market conditions within the geographic 
area and specialty referenced in the waiver request, which 
shall include the number and distribution of health care pro-
viders contracting with other health care plans (including 
commercial plans and the Medicare program under title XVIII 
of the Social Security Act (42 U.S.C. 1395 et seq.)) operating 
in the geographic area and specialty referenced in the waiver 
request. 
‘‘(iii) Whether the service area is comprised of highly rural, 
rural, or urban areas or some combination of such areas. 
‘‘(iv) How significantly the waiver request differs from the 
access standards established under subsection (a). 
‘‘(v) The rates offered to providers in the geographic area 
covered by the waiver. 
‘‘(E) The Secretary shall not consider inability to contract as 
a valid sole rationale for granting a waiver under subparagraph 
(A). 
‘‘(g)(1) The Secretary shall publish in the Federal Register 
and on a publicly available internet website of the Department 
the designated access standards established under this section for 
purposes of section 1703(d)(1)(D) of this title. 
‘‘(2) The Secretary shall publish on a publicly available internet 
website of the Department the access standards established under 
subsection (a).’’; and 
(2) in subsection (i), by adding at the end the following 
new paragraphs:
H. R. 2617—960 
‘‘(3) The term ‘inability to contract’, with respect to a Third 
Party Administrator, means the inability of the Third Party 
Administrator to successfully negotiate and establish a commu-
nity care network contract with a provider or facility. 
‘‘(4) The term ‘Third Party Administrator’ means an entity 
that manages a provider network and performs administrative 
services related to such network within the Veterans Commu-
nity Care Program under section 1703 of this title.’’. 
(b) PREVENTION OF SUSPENSION OF VETERANS COMMUNITY CARE 
PROGRAM.—Section 1703(a) of such title is amended by adding 
at the end the following new paragraph: 
‘‘(4) Nothing in this section shall be construed to authorize 
the Secretary to suspend the program established under paragraph 
(1).’’. 
SEC. 126. STRATEGIC PLAN TO ENSURE CONTINUITY OF CARE IN THE 
CASE OF THE REALIGNMENT OF A MEDICAL FACILITY OF 
THE DEPARTMENT. 
(a) SENSE
OF CONGRESS.—It is the sense of Congress that 
the Veterans Health Administration should ensure that veterans 
do not experience a lapse of care when transitioning in receiving 
care due to the realignment of a medical facility of the Department 
of Veterans Affairs. 
(b) DEVELOPMENT OF STRATEGIC PLAN.— 
(1) IN GENERAL.—The Secretary of Veterans Affairs, acting 
through the Office of Integrated Veteran Care, the Chief 
Strategy Office, the Office of Asset Enterprise Management, 
or any successor office that has similar and related functions, 
shall develop and periodically update a strategic plan to ensure 
continuity of health care through care furnished at a facility 
of the Department or through the Community Care Program 
for veterans impacted by the realignment of a medical facility 
of the Department. 
(2) ELEMENTS.—The strategic plan required under para-
graph (1) shall include, at a minimum, the following: 
(A) An assessment of the progress of the Department 
in identifying impending realignments of medical facilities 
of the Department and the impact of such realignments 
on access of veterans to care, including any impact on 
the network of health care providers under the Community 
Care Program. 
(B) The progress of the Department in establishing 
operated sites of care and related activities to address 
the impact of such a realignment. 
(C) An outline of collaborative actions and processes 
the Department can take to address potential gaps in 
health care created by such a realignment, including 
actions and processes to be taken by the Office of Integrated 
Veteran Care, the Chief Strategy Office, and the Office 
of Asset Enterprise Management of the Department. 
(D) A description of how the Department can identify 
to Third Party Administrators changes in the catchment 
areas of medical facilities to be realigned and develop a 
process with Third Party Administrators to strengthen pro-
vider coverage in advance of such realignments. 
(3) SUBMITTAL
TO
CONGRESS.—Not later than 180 days 
after the date of the enactment of this Act, the Under Secretary