,,iib #aafth ,,congress #ast ,session ,h4 ,r4 #cecj ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,december #ah1 #bjai,received2 read twice and referred to the ,committee on ,veterans' ,affairs ,,an ,,act ,to amend title #ch1 ,united ,states ,code1 to direct the ,secretary of ,veterans ,affairs to enforce the licensure requirement for medical providers of the ,department of ,veterans ,affairs4 #a4 ,short title ,this ,act may be cited as the ,improving ,confidence in ,veterans' ,care ,act4 #b4 ,compliance with requirements for examining qualifications and clinical abilities of ,department of ,veterans ,affairs health care professionals 7a7 ,in general ,subchapter ,i of chapter #gd of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new section3 #gdad4 ,compliance with requirements for examining qualifications and clinical abilities of health care professionals 7a7 ,compliance with credentialing requirements ,the ,secretary shall ensure that each medical center of the ,department1 in a consistent manner-- 7#a7 compiles1 verifies1 and reviews documentation for each health care professional of the ,department at such medical center regarding1 at a minimum-- 7,a7 the professional licensure1 certification1 or registration of the health care professional2 7,b7 whether the health care professional holds a ,drug ,enforcement ,administration registration2 and 7,c7 the education1 training1 experience1 malpractice history1 and clinical competence of the health care professional2 and 7#b7 continuously monitors any changes to the matters under paragraph 7#a71 including with respect to suspensions1 restrictions1 limitations1 probations1 denials1 revocations1 and other changes1 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 patients4 7b7 ,registration regarding controlled substances 7#a7 ,except as provided by paragraph 7#b71 the ,secretary shall ensure that each covered health care professional holds an active ,drug ,enforcement ,administration registration4 7#b7 ,the ,secretary shall-- 7,a7 determine the circumstances in which a medical center of the ,department must obtain a waiver under section #cjc of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7 with respect to covered health care professionals2 and 7,b7 establish a process for medical centers to request such waivers4 7#c7 ,in carrying out paragraph 7#a71 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 #g days after such change in status4 7#d7 ,if a covered health care professional does not hold an active ,drug ,enforcement ,administration registration1 the ,secretary shall carry out any of the following actions1 as the ,secretary determines appropriate3 7,a7 ,obtain a waiver pursuant to paragraph 7#b74 7,b7 ,transfer the health care professional to a position that does not require prescribing1 dispensing1 administering1 or conducting research with controlled substances4 7,c7 ,take adverse actions under subchapter ,v of this chapter1 with respect to an employee of the ,department1 or terminate the services of a contractor1 with respect to a contractor of the ,department4 7c7 ,reviews of concerns relating to quality of clinical care 7#a7 ,the ,secretary shall ensure that each medical center of the ,department1 in a consistent manner1 carries out-- 7,a7 ongoing1 retrospective1 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 center1 including with respect to the safety of such care2 and 7,b7 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 patients4 7#b7 ,the ,secretary shall establish a policy to carry out paragraph 7#a71 including with respect to-- 7,a7 determining the period by which a medical center of the ,department must initiate the review of a concern described in subparagraph 7,b7 of such paragraph following the date on which the concern is received2 and 7,b7 ensuring the compliance of each medical center with such policy4 7d7 ,compliance with requirements for reporting quality of care concerns ,when the ,secretary substantiates a concern relating to the clinical competency of1 or quality of care delivered by1 a health care professional of the ,department 7including a former such health care professional71 the ,secretary shall ensure that the appropriate medical center of the ,department timely notifies the following entities of such concern1 as appropriate3 7#a7 ,the appropriate licensing1 registration1 or certification body in each ,state in which the health care professional is licensed1 registered1 or certified4 7#b7 ,the ,drug ,enforcement ,administration4 7#c7 ,the ,national ,practitioner ,data ,bank established pursuant to the ,health ,care ,quality ,improvement ,act of #aihf 7#db ,u4,s4,c4 #aaaja et seq474 7#d7 ,any other relevant entity4 7e7 ,prohibition on certain settlement agreement terms 7#a7 ,except as provided by paragraph 7#b71 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 patients4 7#b7 ,paragraph 7#a7 does not apply to adverse actions that the ,special ,counsel under section #abaa of title #e determines constitutes a prohibited personnel practice4 7f7 ,training ,not less frequently than biannually1 the ,secretary shall provide mandatory training to employees of each medical center of the ,department who are responsible for any of the following activities3 7#a7 ,compiling1 validating1 or reviewing the credentials of health care professionals of the ,department4 7#b7 ,reviewing the quality of clinical care delivered by health care professionals of the ,department4 7#c7 ,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 patients4 7#d7 ,making notifications under subsection 7d74 7g7 ,definitions ,in this section3 7#a7 ,the term controlled substance has the meaning given that term in section #ajb of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hjb74 7#b7 ,the term covered health care professional means a person employed in a position as a health care professional of the ,department1 or a contractor of the ,department1 that requires the person to be authorized to prescribe1 dispense1 administer1 or conduct research with1 controlled substances4 7#c7 ,the term ,drug ,enforcement ,administration registration means registration with the ,drug ,enforcement ,administration under section #cjc of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7 by health care practitioners authorized to dispense1 prescribe1 administer1 or conduct research with1 controlled substances4 7#d7 ,the term health care professional of the ,department means the professionals described in section #agcj;,c7b7 of this title1 and includes a contractor of the ,department serving as such a professional4 4 7b7 ,clerical amendment ,the table of sections at the beginning of such chapter is amended by inserting after the item relating to section #gdac the following new item3 #gdad4 ,compliance with requirements for examining qualifications and clinical abilities of health care professionals4 4 7c7 ,deadline for implementation ,the ,secretary of ,veterans ,affairs shall commence the implementation of section #gdad of title #ch1 ,united ,states ,code1 as added by subsection 7a71 by the following dates3 7#a7 ,with respect to subsections 7a71 7c77#b71 7d71 and 7f71 not later than #ahj days after the date of the enactment of this ,act4 7#b7 ,with respect to subsection 7c77#a71 not later than #a year after the date of the enactment of this ,act4 7#c7 ,with respect to subsection 7b77#b71 not later than #ah months after the date of the enactment of this ,act4 7d7 ,audits and reports 7#a7 ,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 #gdad of title #ch1 ,united ,states ,code1 as added by subsection 7a74 ,in carrying out such audits1 the ,secretary-- 7,a7 may not authorize the medical center being audited to conduct the audit2 and 7,b7 may enter into an agreement with another department or agency of the ,federal ,government or a nongovernmental entity to conduct such audits4 7#b7 ,reports ,not later than #a year after the date of the enactment of this ,act1 and annually thereafter for #e years1 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 7#a74 ,each such report shall include a summary of the compliance by each medical center with the matters required by such section #gdad4 7#c7 ,initial report ,the ,secretary shall include in the first report submitted under paragraph 7#b7 the following3 7,a7 ,a description of the progress made by the ,secretary in implementing such section #gdad1 including any matters under such section that the ,secretary has not fully implemented4 7,b7 ,an analysis of the feasibility1 advisability1 and cost of requiring credentialing employees of the ,department to be trained by anoutside entity and to maintain a credentialing certification4 ,passed the ,house of ,representatives ,december #ag1 #bjai4;,cheryl ,l4 ,johnson1,clerk