Title: Improving Confidence in Veterans’ Care Act
Policy area: Armed Forces and National Security

Summary:
Improving Confidence in Veterans' Care 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 biannually, to employees of each medical center who are responsible for specified tasks (e.g., those who are responsible for compiling, validating, or reviewing the credentials of VA health care professionals).

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 217 Introduced in House (IH)]

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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' 
                                Affairs

_______________________________________________________________________

                                 A BILL


 
   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 ``Improving Confidence in Veterans' 
Care Act''.

SEC. 2. COMPLIANCE WITH REQUIREMENTS FOR EXAMINING QUALIFICATIONS AND 
              CLINICAL ABILITIES OF DEPARTMENT OF VETERANS AFFAIRS 
              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:
``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 by 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 7 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 adverse actions under subchapter V of this 
        chapter, with respect to an employee of the Department, or 
        terminate the services of a contractor, 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 the health care professional 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.--When 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 such health care 
professional), 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 by 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 biannually, the Secretary 
shall provide mandatory training to employees of each medical center of 
the Department who are responsible for any of the following activities:
            ``(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 a 
        person employed in a position as a health care professional of 
        the Department, or a contractor of the Department, that 
        requires the person 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 the professionals described in section 1730C(b) of this 
        title, and includes a contractor of the Department serving as 
        such a professional.''.
    (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), 
        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 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). 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 another 
                department or agency of the Federal Government or a 
                nongovernmental entity to conduct 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 Affairs shall submit to the Committees on 
        Veterans' Affairs of the House of Representatives and the 
        Senate a report on the audits conducted under paragraph (1). 
        Each such report shall include a summary of the compliance by 
        each medical center with the matters required by such section 
        7414.
            (3) Initial report.--The Secretary shall include 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, advisability, 
                and cost of requiring credentialing employees of the 
                Department to be trained by an outside entity and to 
                maintain a credentialing certification.
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