[Congressional Record Volume 142, Number 66 (Monday, May 13, 1996)]
[Senate]
[Page S4978]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. SIMPSON (by request):
  S. 1752. A bill to amend title 38, United States Code, to exempt 
full-time registered nurses, physician assistants, and expanded-
function dental auxiliaries from restrictions on remunerated outside 
professional activities; to the Committee on Veterans' Affairs.


                         veterans' legislation

 Mr. SIMPSON. Mr. President, as chairman of the Veterans' 
Affairs Committee, I have today introduced, at the request of the 
Secretary of Veterans Affairs, S. 1752, a bill to amend certain 
provisions of title 38, United States Code, to exempt full-time 
registered nurses, physician assistants, and expanded-function dental 
auxiliaries from restrictions on remunerated outside professional 
activities. The Secretary of Veterans Affairs submitted this 
legislation to the President of the Senate by letter dated February 21, 
1996.
  My introduction of this measure is in keeping with the policy which I 
have adopted of generally introducing--so that there will be specific 
bills to which my colleagues and others may direct their attention and 
comments--all administration-proposed draft legislation referred to the 
Veterans' Affairs Committee. Thus, I reserve the right to support or 
oppose the provisions of, as well as any amendment to, this 
legislation.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record, together with the transmittal letter and the 
enclosed analysis of the draft legislation.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                S. 1752

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled, That 
     except as otherwise expressly provided, whenever in this Act 
     an amendment is expressed in terms of an amendment to a 
     section or other provision, the reference shall be considered 
     to be made to a section or other provision of title 38, 
     United States Code.
       Sec. 2. Section 7423 is amended--
       (a) in subsection (b) by striking paragraph (1) and 
     redesignating paragraphs (2), (3), (4), (5), and (6) as 
     paragraphs (1), (2), (3), (4), and (5);
       (b) by redesignating subsections (c), (d), (e), and (f) as 
     subsections (d), (e), (f), and (g); and
       (b) by inserting after subsection (b) the following new 
     subsection (c):
       ``(c) A physician, dentist, podiatrist, or optometrist 
     appointed as a full-time employee under this title (other 
     than an intern or resident appointed pursuant to section 7406 
     of this title) may not assume responsibility for the medical 
     care of any patient other than a patient admitted for 
     treatment at a Department facility, except in those cases 
     where the appointee, upon request and with the approval of 
     the Under Secretary for Health, assumes such responsibilities 
     to assist communities or medical practice groups to meet 
     medical needs which would not otherwise be met for a period 
     not to exceed 180 calendar days, which may be extended by the 
     Under Secretary for Health for additional periods not to 
     exceed 180 calendar days each.''.
                                                                    ____



                            The Secretary of Veterans Affairs,

                                    Washington, February 21, 1996.
     Hon. Al Gore,
     President of the Senate,
     Washington, DC.
       Dear Mr. President: We are transmitting a draft bill, ``To 
     amend title 38, United States Code, to exempt full-time 
     registered nurses, physician assistants, and expanded-
     function dental auxiliaries from restrictions on remunerated 
     outside professional activities.'' We request that it be 
     referred to the appropriate committee for prompt 
     consideration and enactment.
       This draft bill would amend section 7423 to exempt VHA 
     full-time registered nurses, physician assistants (PA's) , 
     and expanded-function dental auxiliaries (EFDA's) from the 
     restriction on moonlighting applicable to all title 38 
     employees. Specifically, the draft bill would exempt these 
     professional groups from the prohibition in subsection (b) of 
     that section against assuming responsibility for the medical 
     care of any patient not admitted to a VA facility. The 
     registered nurses, PA's, and EFDA's would continue to be 
     subject to conflict of interest restrictions on outside 
     remuneration for the performance of official duties. In 
     addition, the draft bill would correct a technical flaw in 
     the recodification of title 38 by reimposing the remunerated 
     outside activity restriction on VA Central Office executive 
     physicians, dentists, podiatrists and optometrists.
       Congress enacted the outside professional activities 
     restrictions to assure the availability of health care 
     professionals who are responsible for around the clock care 
     of VA patients. This availability primarily concerns 
     physicians, who must be on-call 24 hours a day, 7 days a 
     week, to meet patient care needs. The moonlighting 
     restriction is unnecessary as to nurses, PA's and EFDA's 
     because VA has considerable flexibility to assure adequate 
     coverage by these professional groups without it.

                           *   *   *   *   *

       The Office of Management and Budget has advised that there 
     is no objection to the submission of this draft bill and that 
     its enactment would be consistent with the Administration's 
     program.
           Sincerely yours,
     Jesse Brown.
                                                                    ____


                         Analysis of Draft Bill

       The draft bill would amend section 7423 by: 1. adding a new 
     subsection (c); 2. in subsection (b), deleting paragraph (1), 
     and redesignating paragraphs (2), (3), (4), (5), and (6), as 
     paragraphs (1), (2), (3), (4), and (5), and respectively; and 
     3. redesignating subsections (c), (d), (e), and (f) as 
     subsections (d), (e), (f), and (g), respectively.
       The new subsection (c) would exempt full-time registered 
     nurses, physician assistants, and expanded-function dental 
     auxiliaries from restrictions on remunerated outside 
     professional employment. Instead, new subsection (c) would 
     apply the restrictions on remunerated outside professional 
     employment only to physicians, dentists, podiatrists and 
     optometrists. The registered nurses would continue to be 
     subject to restrictions on outside remuneration for the 
     performance of official duties. New subsection (c) also would 
     correct a technical flaw in the recodification of title 38 by 
     reimposing these restrictions on VA Central Office executive 
     physicians, dentists, podiatrists and optometrists, by 
     broadening its application so as to cover all title 38 
     Veterans Health Medical Administration professionals. Current 
     law limits the restrictions to Veterans Health Administration 
     professionals appointed under Chapter 74. Executive medical 
     professionals are appointed under Chapters 3 and 73.
                                 ______