I 
117TH CONGRESS 
2D SESSION 
H. R. 7277 
To improve the methods by which the Secretary of Veterans Affairs identifies 
health care providers that are not eligible to participate in the Veterans 
Community Care Program. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 29, 2022 
Mr. PAPPAS (for himself and Mr. MANN) introduced the following bill; which 
was referred to the Committee on Veterans’ Affairs 
A BILL 
To improve the methods by which the Secretary of Veterans 
Affairs identifies health care providers that are not eligi-
ble to participate in the Veterans Community Care Pro-
gram. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Improving Oversight 
of the Veterans Community Care Providers Act of 2022’’. 
VerDate Sep 11 2014 
01:48 Mar 31, 2022
Jkt 029200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H7277.IH
H7277
kjohnson on DSK79L0C42PROD with BILLS
SEC. 2. IDENTIFICATION OF HEALTH CARE PROVIDERS 
THAT ARE NOT ELIGIBLE TO PARTICIPATE IN 
VETERANS COMMUNITY CARE PROGRAM. 
(a) PLAN.— 
(1) REQUIREMENT.—Beginning not later than 
90 days after the date of the enactment of this Act, 
the Secretary of Veterans Affairs, acting through 
the Under Secretary for Health, shall carry out a 
plan to improve the methods by which the Secretary 
identifies health care providers that are not eligible 
to participate in the Veterans Community Care Pro-
gram. 
(2) MATTERS
INCLUDED.—The plan under 
paragraph (1) shall include the following: 
(A) Modifying the standard operating pro-
cedures of the Office of Community Care of the 
Veterans Health Administration regarding the 
exclusion of health care providers from partici-
pating in the Veterans Community Care Pro-
gram to require the automated continuous 
matching of health care providers in the Pro-
vider Profile Management System of the Vet-
erans Health Administration, or such successor 
system, with covered data systems using mul-
tiple unique identifiers, including taxpayer iden-
VerDate Sep 11 2014 
01:48 Mar 31, 2022
Jkt 029200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H7277.IH
H7277
kjohnson on DSK79L0C42PROD with BILLS
tification number, national provider identifier, 
Social Security number, and date of birth. 
(B) A fraud risk analysis conducted by the 
Office of Community Care regarding the exclu-
sion of health care providers from participating 
in the Veterans Community Care Program that 
includes— 
(i) an assessment of the likelihood and 
impact of inherent fraud risks relating to 
the self-certification of State licenses and 
addresses provided by health care pro-
viders; 
(ii) a determination of the fraud risk 
tolerance; and 
(iii) an examination of the suitability 
of existing fraud controls. 
(C) Any other matters the Under Sec-
retary determines will improve the oversight of 
health care providers participating in the Vet-
erans Community Care Program. 
(b) CERTIFICATION.—Not later than December 31, 
2022, the Secretary shall certify to the Committees on 
Veterans’ Affairs of the House of Representatives and the 
Senate that the Secretary has implemented the plan under 
subsection (a). 
VerDate Sep 11 2014 
01:48 Mar 31, 2022
Jkt 029200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H7277.IH
H7277
kjohnson on DSK79L0C42PROD with BILLS
(c) REPORT.—Not later than January 31, 2023, the 
Secretary shall submit to the Committees on Veterans’ Af-
fairs of the House of Representatives and the Senate a 
report that— 
(1) describes the progress the Under Secretary 
has made in carrying out the plan under subsection 
(a); and 
(2) includes recommendations for legislative ac-
tion to further improve the methods by which the 
Secretary identifies health care providers that are 
not eligible to participate in the Veterans Commu-
nity Care Program. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘covered data systems’’ means 
the following: 
(A) The List of Excluded Individuals/Enti-
ties of the Office of Inspector General of the 
Department of Health and Human Services. 
(B) The System for Award Management 
Exclusions list described in part 9 of title 48, 
Code of Federal Regulations, and part 180 of 
title 2 of such Code, or successor regulations. 
(C) The monthly deactivation file of the 
National Plan and Provider Enumeration Sys-
VerDate Sep 11 2014 
01:48 Mar 31, 2022
Jkt 029200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H7277.IH
H7277
kjohnson on DSK79L0C42PROD with BILLS
tem of the Centers for Medicare & Medicaid 
Services. 
(D) The National Practitioner Data Bank 
established pursuant to the Health Care Quality 
Improvement Act of 1986 (42 U.S.C. 11101 et 
seq.). 
(2) The term ‘‘Veterans Community Care Pro-
gram’’ means the program established under section 
1703 of title 38, United States Code. 
Æ 
VerDate Sep 11 2014 
01:48 Mar 31, 2022
Jkt 029200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6301
E:\BILLS\H7277.IH
H7277
kjohnson on DSK79L0C42PROD with BILLS