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’ Af-
fairs 
A BILL 
To amend title 38, United States Code, to direct the Sec-
retary of Veterans Affairs to enforce the licensure re-
quirement for medical providers of the Department of 
Veterans Affairs. 
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 Confidence 
in Veterans’ Care Act’’. 
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SEC. 2. COMPLIANCE WITH REQUIREMENTS FOR EXAM-
INING QUALIFICATIONS AND CLINICAL ABILI-
TIES OF DEPARTMENT OF VETERANS AF-
FAIRS HEALTH CARE PROFESSIONALS. 
(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 
qualifications and clinical abilities of 
health care professionals 
‘‘(a) COMPLIANCE WITH CREDENTIALING REQUIRE-
MENTS.—The Secretary shall ensure that each medical 
center of the Department, in a consistent manner— 
‘‘(1) compiles, verifies, and reviews documenta-
tion for each health care professional of the Depart-
ment at such medical center regarding, at a min-
imum— 
‘‘(A) the professional licensure, certifi-
cation, or registration of the health care profes-
sional; 
‘‘(B) whether the health care professional 
holds a Drug Enforcement Administration reg-
istration; and 
‘‘(C) the education, training, experience, 
malpractice history, and clinical competence of 
the health care professional; and 
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‘‘(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 professional to meet gen-
erally accepted standards of clinical practice in a 
manner that presents reasonable concern for the 
safety of patients. 
‘‘(b) REGISTRATION REGARDING CONTROLLED SUB-
STANCES.—(1) Except as provided by paragraph (2), the 
Secretary shall ensure that each covered health care pro-
fessional holds an active Drug Enforcement Administra-
tion registration. 
‘‘(2) The Secretary shall— 
‘‘(A) determine the circumstances in which a 
medical center of the Department must obtain a 
waiver under section 303 of the Controlled Sub-
stances Act (21 U.S.C. 823) 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 registra-
tions of covered health care professionals at such medical 
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center in a manner that ensures the medical center is 
made aware of any change in status in the registration 
by not later than 7 days after such change in status. 
‘‘(4) If a covered health care professional does not 
hold an active Drug Enforcement Administration registra-
tion, the Secretary shall carry out any of the following ac-
tions, as the Secretary determines appropriate: 
‘‘(A) Obtain a waiver pursuant to paragraph 
(2). 
‘‘(B) Transfer the health care professional to a 
position that does not require prescribing, dis-
pensing, administering, or conducting research with 
controlled substances. 
‘‘(C) Take adverse actions under subchapter V 
of this chapter, with respect to an employee of the 
Department, or terminate the services of a con-
tractor, with respect to a contractor of the Depart-
ment. 
‘‘(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 moni-
toring of the performance and quality of the health care 
delivered by each health care professional of the Depart-
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ment 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 con-
cerns relating to a failure of the health care professional 
to meet generally accepted standards of clinical practice 
in a manner that presents reasonable concern for the safe-
ty of patients. 
‘‘(2) The Secretary shall establish a policy to carry 
out paragraph (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 RE-
PORTING QUALITY OF CARE CONCERNS.—When the Sec-
retary substantiates a concern relating to the clinical com-
petency of, or quality of care delivered by, a health care 
professional of the Department (including a former such 
health care professional), the Secretary shall ensure that 
the appropriate medical center of the Department timely 
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notifies the following entities of such concern, as appro-
priate: 
‘‘(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. 
‘‘(3) The National Practitioner Data Bank es-
tablished pursuant to the Health Care Quality Im-
provement Act of 1986 (42 U.S.C. 11101 et seq.). 
‘‘(4) Any other relevant entity. 
‘‘(e) 
PROHIBITION
ON
CERTAIN
SETTLEMENT 
AGREEMENT TERMS.—(1) Except as provided by para-
graph (2), the Secretary may not enter into a settlement 
agreement relating to an adverse action against a health 
care professional of the Department if such agreement in-
cludes 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) Paragraph (1) does not apply to adverse actions 
that the Special Counsel under section 1211 of title 5 de-
termines constitutes a prohibited personnel practice. 
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‘‘(f) TRAINING.—Not less frequently than biannually, 
the Secretary shall provide mandatory training to employ-
ees of each medical center of the Department who are re-
sponsible for any of the following activities: 
‘‘(1) Compiling, validating, or reviewing the cre-
dentials of health care professionals of the Depart-
ment. 
‘‘(2) Reviewing the quality of clinical care deliv-
ered by health care professionals of the Department. 
‘‘(3) Taking adverse privileging actions or mak-
ing determinations relating to other disciplinary ac-
tions or employment actions against health care pro-
fessionals of the Department for reasons relating to 
the failure of a health care professional to meet gen-
erally 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 Con-
trolled Substances Act (21 U.S.C. 802). 
‘‘(2) The term ‘covered health care professional’ 
means a person employed in a position as a health 
care professional of the Department, or a contractor 
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of the Department, that requires the person to be 
authorized to prescribe, dispense, administer, or con-
duct research with, controlled substances. 
‘‘(3) The term ‘Drug Enforcement Administra-
tion registration’ means registration with the Drug 
Enforcement Administration under section 303 of 
the Controlled Substances Act (21 U.S.C. 823) by 
health care practitioners authorized to dispense, pre-
scribe, administer, or conduct research with, con-
trolled substances. 
‘‘(4) The term ‘health care professional of the 
Department’ means the professionals described in 
section 1730C(b) of this title, and includes a con-
tractor of the Department serving as such a profes-
sional.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning 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 
abilities of health care professionals.’’. 
(c) DEADLINE
FOR IMPLEMENTATION.—The Sec-
retary of Veterans Affairs shall commence the implemen-
tation of section 7414 of title 38, United States Code, as 
added by subsection (a), by the following dates: 
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(1) With respect to subsections (a), (c)(2), (d), 
and (f), not later than 180 days after the date of the 
enactment of this Act. 
(2) With respect to subsection (c)(1), not later 
than 1 year after the date of the enactment of this 
Act. 
(3) With respect to subsection (b)(2), not later 
than 18 months after the date of the enactment of 
this Act. 
(d) AUDITS AND REPORTS.— 
(1) AUDITS.—The Secretary of Veterans Af-
fairs 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). In carrying out such audits, the Secretary— 
(A) may not authorize the medical center 
being audited to conduct the audit; and 
(B) may enter into an agreement with an-
other department or agency of the Federal Gov-
ernment or a nongovernmental entity to con-
duct such audits. 
(2) REPORTS.—Not later than 1 year after the 
date of the enactment of this Act, and annually 
thereafter for 5 years, the Secretary of Veterans Af-
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fairs shall submit to the Committees on Veterans’ 
Affairs of the House of Representatives and the Sen-
ate a report on the audits conducted under para-
graph (1). Each such report shall include a sum-
mary of the compliance by each medical center with 
the matters required by such section 7414. 
(3) INITIAL REPORT.—The Secretary shall in-
clude in the first report submitted under paragraph 
(2) the following: 
(A) A description of the progress made by 
the Secretary in implementing such section 
7414, including any matters under such section 
that the Secretary has not fully implemented. 
(B) An analysis of the feasibility, advis-
ability, and cost of requiring credentialing em-
ployees of the Department to be trained by an 
outside entity and to maintain a credentialing 
certification. 
Æ 
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