Department of Veterans Affairs Provider Accountability Act
Bill: S.2041 | Sponsor: Sen. Manchin, Joe, III (D-WV)
Policy area: Armed Forces and National Security

Summary:
Department of Veterans Affairs Provider Accountability Act
This bill prescribes oversight requirements for the Department of Veterans Affairs (VA) regarding health care professionals at VA medical centers.
Specifically, the bill requires the VA to ensure each VA medical center consistently compiles, verifies, and reviews specified documentation for each VA health care professional (including contractors).
The VA shall ensure that specified health care professionals hold an active Drug Enforcement Administration registration.
Each VA medical center must implement (1) monitoring of the performance and quality of the health care delivered by each health care professional at the center, and (2) reviews of such care if an individual notifies the VA of any potential concerns relating to a failure to meet generally accepted standards of clinical practice.
The bill imposes notification requirements in situations where the VA substantiates a concern relating to the clinical competency of, or quality of care delivered by, a current or former VA health care professional.
The VA is prohibited from entering into a settlement agreement relating to an adverse action against a VA health care professional if such agreement includes terms that require the VA to conceal certain information from the employee's personnel file. Such prohibition does not apply to adverse actions determined to be prohibited personnel practices.
The VA must provide mandatory training, at least annually, to employees who are responsible for specified tasks (e.g., those who are responsible for compiling, validating, or reviewing the credentials of VA health care professionals).

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.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Department of Veterans Affairs 
Provider Accountability Act''.

SEC. 2. COMPLIANCE WITH REQUIREMENTS FOR EXAMINING QUALIFICATIONS 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:
``Sec. 7414. Compliance with requirements for examining qualifications 
              and clinical abilities of health care professionals
    ``(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 
                registration 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 professional; 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 
        professional 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 303 of the 
        Controlled Substances 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 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 determines 
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 
        Department 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 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 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.
            ``(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) 
Except as provided in paragraph (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 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) Paragraph (1) does not apply to adverse actions that the 
Special Counsel under section 1211 of title 5 determines constitutes a 
prohibited personnel practice.
    ``(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 
        determinations 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 
        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, prescribe, administer, or conduct research with, 
        controlled substances.
            ``(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.''.
    (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 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 
                subparagraph (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 
                following:
                            (i) A description of the progress made by 
                        the Secretary 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 Department to be 
                        trained by an outside entity and to maintain a 
                        credentialing certification.
    (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.
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