Department of Veteran Affairs Provider Accountability Act

II 117TH CONGRESS 1ST SESSION S. 1307 To amend title 38, United States Code, to direct the Secretary of Veterans Affairs to enforce licensure and related requirements for health care professionals of the Department of Veterans Affairs, and for other pur- poses. IN THE SENATE OF THE UNITED STATES APRIL 22, 2021 Mr. MORAN introduced the following bill; which was read twice and referred to the Committee on Veterans’ Affairs A BILL To amend title 38, United States Code, to direct the Sec- retary of Veterans Affairs to enforce licensure and re- lated requirements for health care professionals of the Department of Veterans Affairs, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Department of Veteran 4 Affairs Provider Accountability Act’’. 5 VerDate Sep 11 2014 16:20 May 19, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1307.IS S1307 pamtmann on DSKBC07HB2PROD with BILLS 2 •S 1307 IS SEC. 2. COMPLIANCE WITH REQUIREMENTS FOR EXAM- 1 INING QUALIFICATIONS AND CLINICAL ABILI- 2 TIES OF HEALTH CARE PROFESSIONALS OF 3 DEPARTMENT OF VETERANS AFFAIRS. 4 (a) IN GENERAL.—Subchapter I of chapter 74 of title 5 38, United States Code, is amended by adding at the end 6 the following new section: 7 ‘‘§ 7414. Compliance with requirements for examining 8 qualifications and clinical abilities of 9 health care professionals 10 ‘‘(a) COMPLIANCE WITH CREDENTIALING REQUIRE- 11 MENTS.—The Secretary shall ensure that each medical 12 center of the Department, in a consistent manner— 13 ‘‘(1) compiles, verifies, and reviews documenta- 14 tion for each health care professional of the Depart- 15 ment at such medical center regarding, at a min- 16 imum— 17 ‘‘(A) the professional licensure, certifi- 18 cation, or registration of the health care profes- 19 sional; 20 ‘‘(B) whether the health care professional 21 holds a Drug Enforcement Administration reg- 22 istration; and 23 ‘‘(C) the education, training, experience, 24 malpractice history, and clinical competence of 25 the health care professional; and 26 VerDate Sep 11 2014 16:20 May 19, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1307.IS S1307 pamtmann on DSKBC07HB2PROD with BILLS 3 •S 1307 IS ‘‘(2) continuously monitors any changes to the 1 matters under paragraph (1), including with respect 2 to suspensions, restrictions, limitations, probations, 3 denials, revocations, and other changes, relating to 4 the failure of a health care professional to meet gen- 5 erally accepted standards of clinical practice in a 6 manner that presents reasonable concern for the 7 safety of patients. 8 ‘‘(b) REGISTRATION REGARDING CONTROLLED SUB- 9 STANCES.—(1) Except as provided in paragraph (2), the 10 Secretary shall ensure that each covered health care pro- 11 fessional holds an active Drug Enforcement Administra- 12 tion registration. 13 ‘‘(2) The Secretary shall— 14 ‘‘(A) determine the circumstances in which a 15 medical center of the Department must obtain a 16 waiver under section 303 of the Controlled Sub- 17 stances Act (21 U.S.C. 823) with respect to covered 18 health care professionals; and 19 ‘‘(B) establish a process for medical centers to 20 request such waivers. 21 ‘‘(3) In carrying out paragraph (1), the Secretary 22 shall ensure that each medical center of the Department 23 monitors the Drug Enforcement Administration registra- 24 tions of covered health care professionals at such medical 25 VerDate Sep 11 2014 16:20 May 19, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1307.IS S1307 pamtmann on DSKBC07HB2PROD with BILLS 4 •S 1307 IS center in a manner that ensures the medical center is 1 made aware of any change in status in the registration 2 by not later than seven days after such change in status. 3 ‘‘(4) If a covered health care professional does not 4 hold an active Drug Enforcement Administration registra- 5 tion, the Secretary shall carry out any of the following ac- 6 tions, as the Secretary determines appropriate: 7 ‘‘(A) Obtain a waiver pursuant to paragraph 8 (2). 9 ‘‘(B) Transfer the health care professional to a 10 position that does not require prescribing, dis- 11 pensing, administering, or conducting research with 12 controlled substances. 13 ‘‘(C) Take adverse actions under subchapter V 14 of this chapter, with respect to an employee of the 15 Department, or take appropriate contract adminis- 16 tration actions, with respect to a contractor of the 17 Department. 18 ‘‘(c) REVIEWS OF CONCERNS RELATING TO QUALITY 19 OF CLINICAL CARE.—(1) The Secretary shall ensure that 20 each medical center of the Department, in a consistent 21 manner, carries out— 22 ‘‘(A) ongoing, retrospective, and comprehensive 23 monitoring of the performance and quality of the 24 health care delivered by each health care profes- 25 VerDate Sep 11 2014 16:20 May 19, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1307.IS S1307 pamtmann on DSKBC07HB2PROD with BILLS 5 •S 1307 IS sional of the Department located at the medical cen- 1 ter, including with respect to the safety of such care; 2 and 3 ‘‘(B) timely and documented reviews of such 4 care if an individual notifies the Secretary of any po- 5 tential concerns relating to a failure of a health care 6 professional of the Department to meet generally ac- 7 cepted standards of clinical practice in a manner 8 that presents reasonable concern for the safety of 9 patients. 10 ‘‘(2) The Secretary shall establish a policy to carry 11 out paragraph (1), including with respect to— 12 ‘‘(A) determining the period by which a medical 13 center of the Department must initiate the review of 14 a concern described in subparagraph (B) of such 15 paragraph following the date on which the concern 16 is received; and 17 ‘‘(B) ensuring the compliance of each medical 18 center with such policy. 19 ‘‘(d) COMPLIANCE WITH REQUIREMENTS FOR RE- 20 PORTING QUALITY OF CARE CONCERNS.—If the Secretary 21 substantiates a concern relating to the clinical competency 22 of, or quality of care delivered by, a health care profes- 23 sional of the Department (including a former health care 24 professional of the Department), the Secretary shall en- 25 VerDate Sep 11 2014 16:20 May 19, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1307.IS S1307 pamtmann on DSKBC07HB2PROD with BILLS 6 •S 1307 IS sure that the appropriate medical center of the Depart- 1 ment timely notifies the following entities of such concern, 2 as appropriate: 3 ‘‘(1) The appropriate licensing, registration, or 4 certification body in each State in which the health 5 care professional is licensed, registered, or certified. 6 ‘‘(2) The Drug Enforcement Administration. 7 ‘‘(3) The National Practitioner Data Bank es- 8 tablished pursuant to the Health Care Quality Im- 9 provement Act of 1986 (42 U.S.C. 11101 et seq.). 10 ‘‘(4) Any other relevant entity. 11 ‘‘(e) PROHIBITION ON CERTAIN SETTLEMENT 12 AGREEMENT TERMS.—(1) Except as provided in para- 13 graph (2), the Secretary may not enter into a settlement 14 agreement relating to an adverse action against a health 15 care professional of the Department if such agreement in- 16 cludes terms that require the Secretary to conceal from 17 the personnel file of the employee a serious medical error 18 or lapse in clinical practice that constitutes a substantial 19 failure to meet generally accepted standards of clinical 20 practice as to raise reasonable concern for the safety of 21 patients. 22 ‘‘(2) Paragraph (1) does not apply to adverse actions 23 that the Special Counsel under section 1211 of title 5 de- 24 termines constitutes a prohibited personnel practice. 25 VerDate Sep 11 2014 16:20 May 19, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1307.IS S1307 pamtmann on DSKBC07HB2PROD with BILLS 7 •S 1307 IS ‘‘(f) TRAINING.—Not less frequently than biannually, 1 the Secretary shall provide mandatory training on the fol- 2 lowing duties to employees of the Department who are re- 3 sponsible for performing such duties: 4 ‘‘(1) Compiling, validating, or reviewing the cre- 5 dentials of health care professionals of the Depart- 6 ment. 7 ‘‘(2) Reviewing the quality of clinical care deliv- 8 ered by health care professionals of the Department. 9 ‘‘(3) Taking adverse privileging actions or mak- 10 ing determinations relating to other disciplinary ac- 11 tions or employment actions against health care pro- 12 fessionals of the Department for reasons relating to 13 the failure of a health care professional to meet gen- 14 erally accepted standards of clinical practice in a 15 manner that presents reasonable concern for the 16 safety of patients. 17 ‘‘(4) Making notifications under subsection (d). 18 ‘‘(g) DEFINITIONS.—In this section: 19 ‘‘(1) The term ‘controlled substance’ has the 20 meaning given that term in section 102 of the Con- 21 trolled Substances Act (21 U.S.C. 802). 22 ‘‘(2) The term ‘covered health care professional’ 23 means a person employed in a position as a health 24 care professional of the Department, or a contractor 25 VerDate Sep 11 2014 16:20 May 19, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1307.IS S1307 pamtmann on DSKBC07HB2PROD with BILLS 8 •S 1307 IS of the Department, that requires the person to be 1 authorized to prescribe, dispense, administer, or con- 2 duct research with, controlled substances. 3 ‘‘(3) The term ‘Drug Enforcement Administra- 4 tion registration’ means registration with the Drug 5 Enforcement Administration under section 303 of 6 the Controlled Substances Act (21 U.S.C. 823) by 7 health care practitioners authorized to dispense, pre- 8 scribe, administer, or conduct research with, con- 9 trolled substances. 10 ‘‘(4) The term ‘health care professional of the 11 Department’ means the professionals described in 12 section 1730C(b) of this title, and includes a con- 13 tractor of the Department serving as such a profes- 14 sional.’’. 15 (b) CLERICAL AMENDMENT.—The table of sections 16 at the beginning of such chapter is amended by inserting 17 after the item relating to section 7413 the following new 18 item: 19 ‘‘7414. Compliance with requirements for examining qualifications and clinical abilities of health care professionals.’’. (c) DEADLINE FOR IMPLEMENTATION.—The Sec- 20 retary of Veterans Affairs shall commence the implemen- 21 tation of section 7414 of title 38, United States Code, as 22 added by subsection (a), by the following dates: 23 VerDate Sep 11 2014 16:20 May 19, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1307.IS S1307 pamtmann on DSKBC07HB2PROD with BILLS 9 •S 1307 IS (1) With respect to subsections (a), (c)(2), (d), 1 and (f) of such section, not later than 180 days after 2 the date of the enactment of this Act. 3 (2) With respect to subsection (c)(1) of such 4 section, not later than one year after the date of the 5 enactment of this Act. 6 (3) With respect to subsection (b)(2) of such 7 section, not later than 18 months after the date of 8 the enactment of this Act. 9 (d) AUDITS AND REPORTS.— 10 (1) AUDITS.— 11 (A) IN GENERAL.—The Secretary of Vet- 12 erans Affairs shall carry out annual audits of 13 the compliance of medical centers of the De- 14 partment of Veterans Affairs with the matters 15 required by section 7414 of title 38, United 16 States Code, as added by subsection (a). 17 (B) CONDUCT OF AUDITS.—In carrying 18 out audits under subparagraph (A), the Sec- 19 retary— 20 (i) may not authorize the medical cen- 21 ter being audited to conduct the audit; and 22 (ii) may enter into an agreement with 23 another department or agency of the Fed- 24 VerDate Sep 11 2014 16:20 May 19, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1307.IS S1307 pamtmann on DSKBC07HB2PROD with BILLS 10 •S 1307 IS eral Government or a nongovernmental en- 1 tity to conduct such audits. 2 (2) REPORTS.— 3 (A) IN GENERAL.—Not later than one year 4 after the date of the enactment of this Act, and 5 annually thereafter for five years, the Secretary 6 of Veterans Affairs shall submit to the Com- 7 mittee on Veterans’ Affairs of the Senate and 8 the Committee on Veterans’ Affairs of the 9 House of Representatives a report on the audits 10 conducted under paragraph (1). 11 (B) ELEMENTS.—Each report submitted 12 under subparagraph (A) shall include a sum- 13 mary of the compliance by each medical center 14 with the matters required by section 7414 of 15 title 38, United States Code, as added by sub- 16 section (a). 17 (C) INITIAL REPORT.—The Secretary of 18 Veterans Affairs shall include in the first report 19 submitted under subparagraph (A) the fol- 20 lowing: 21 (i) A description of the progress made 22 by the Secretary in implementing such sec- 23 tion 7414, including any matters under 24 VerDate Sep 11 2014 16:20 May 19, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1307.IS S1307 pamtmann on DSKBC07HB2PROD with BILLS 11 •S 1307 IS such section that the Secretary has not 1 fully implemented. 2 (ii) An analysis of the feasibility, ad- 3 visability, and cost of requiring 4 credentialing employees of the Depart- 5 ment— 6 (I) to be trained by an outside 7 entity; and 8 (II) to maintain a credentialing 9 certification. 10 (e) REPORT ON UPDATES TO POLICY FOR REPORT- 11 ING PATIENT SAFETY CONCERNS TO APPROPRIATE 12 STATE AND OTHER ENTITIES.— 13 (1) IN GENERAL.—Not later than 90 days after 14 the date of the enactment of this Act, the Secretary 15 of Veterans Affairs shall submit to the Committee 16 on Veterans’ Affairs of the Senate and the Com- 17 mittee on Veterans’ Affairs of the House of Rep- 18 resentatives a report on the efforts of the Depart- 19 ment of Veterans Affairs to update policies and 20 practices for employees of medical centers, Veterans 21 Integrated Service Networks, and the Veterans 22 Health Administration to report to State licensing 23 boards, the National Practitioner Data Bank of the 24 Department of Health and Human Services, and 25 VerDate Sep 11 2014 16:20 May 19, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1307.IS S1307 pamtmann on DSKBC07HB2PROD with BILLS 12 •S 1307 IS any other relevant entity health care professionals 1 who are employed by or separated from employment 2 with the Department and whose behavior and clin- 3 ical practice so substantially failed to meet generally 4 accepted standards of clinical practice as to raise 5 reasonable concern for the safety of patients. 6 (2) ELEMENTS.—The report required under 7 paragraph (1) shall include a description of the ef- 8 forts of the Department to consult with— 9 (A) State licensing boards; [Text truncated for display. 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