[Congressional Record Volume 168, Number 175 (Monday, November 14, 2022)]
[House]
[Pages H8465-H8467]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  IMPROVING OVERSIGHT OF VETERANS COMMUNITY CARE PROVIDERS ACT OF 2022

  Mr. TAKANO. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 7277) to improve the methods by which the Secretary of 
Veterans Affairs identifies health care providers that are not eligible 
to participate in the Veterans Community Care Program, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 7277

       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 Oversight of 
     Veterans Community Care Providers Act of 2022''.

     SEC. 2. IDENTIFICATION OF HEALTH CARE PROVIDERS THAT ARE NOT 
                   ELIGIBLE TO PARTICIPATE IN VETERANS COMMUNITY 
                   CARE PROGRAM.

       (a) Plan.--
       (1) Requirement.--Beginning not later than 90 days after 
     the date of the enactment of this Act, the Secretary of 
     Veterans Affairs, acting through the Under Secretary for 
     Health, shall carry out a plan to improve the methods by 
     which the Secretary identifies health care providers that are 
     not eligible to participate in the Veterans Community Care 
     Program.
       (2) Matters included.--The plan under paragraph (1) shall 
     include the following:
       (A) Modifying the standard operating procedures of the 
     Office of Community Care of the Veterans Health 
     Administration regarding the exclusion of health care 
     providers from participating in the Veterans Community Care 
     Program to require the automated continuous matching of 
     health care providers in the Provider Profile Management 
     System of the Veterans Health Administration, or such 
     successor system, with covered data systems using multiple 
     unique identifiers, including taxpayer identification number, 
     national provider identifier, Social Security number, and 
     date of birth.
       (B) A fraud risk analysis conducted by the Office of 
     Community Care regarding the exclusion of health care 
     providers from participating in the Veterans Community Care 
     Program that includes--
       (i) an assessment of the likelihood and impact of inherent 
     fraud risks relating to the self-certification of State 
     licenses and addresses provided by health care providers;
       (ii) a determination of the fraud risk tolerance; and
       (iii) an examination of the suitability of existing fraud 
     controls.
       (C) Any other matters the Under Secretary determines will 
     improve the oversight of health care providers participating 
     in the Veterans Community Care Program.
       (b) Certification.--Not later than 270 days after the date 
     of the enactment of this Act, the Secretary shall certify to 
     the Committees on Veterans' Affairs of the House of 
     Representatives and the Senate that the Secretary has 
     implemented the plan under subsection (a).
       (c) Reports.--
       (1) Initial report.--Not later than one year after the date 
     of the enactment of this Act, the Secretary shall submit to 
     the Committees on Veterans' Affairs of the House of 
     Representatives and the Senate a report that--
       (A) describes the progress the Under Secretary has made in 
     carrying out the plan under subsection (a); and
       (B) includes recommendations for legislative action to 
     further improve the methods by which the Secretary identifies 
     health care providers that are not eligible to participate in 
     the Veterans Community Care Program.
       (2) Update.--Not later than two years after the date on 
     which the Secretary submits the report under paragraph (1), 
     the Secretary shall submit to the Committees on Veterans' 
     Affairs of the House of Representatives and the Senate an 
     update to the report.
       (d) Definitions.--In this section:
       (1) The term ``covered data systems'' means the following:
       (A) The List of Excluded Individuals/Entities of the Office 
     of Inspector General of the Department of Health and Human 
     Services.
       (B) The System for Award Management Exclusions list 
     described in part 9 of title 48, Code of Federal Regulations, 
     and part 180 of title 2 of such Code, or successor 
     regulations.
       (C) The monthly deactivation file of the National Plan and 
     Provider Enumeration System of the Centers for Medicare & 
     Medicaid Services.
       (D) The National Practitioner Data Bank established 
     pursuant to the Health Care Quality Improvement Act of 1986 
     (42 U.S.C. 11101 et seq.).

[[Page H8466]]

       (2) The term ``Veterans Community Care Program'' means the 
     program established under section 1703 of title 38, United 
     States Code.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
California (Mr. Takano) and the gentleman from Texas (Mr. Ellzey) each 
will control 20 minutes.
  The Chair recognizes the gentleman from California.


                             General Leave

  Mr. TAKANO. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days in which to revise and extend their remarks and 
include extraneous material on H.R. 7277, as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  Mr. TAKANO. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of H.R. 7277, the Improving Oversight 
of Veterans Community Care Providers Act, as amended, a bill that will 
take important steps toward ensuring that healthcare providers meet the 
eligibility requirements and standards of VA's Community Care Program.
  I thank Representative Chris Pappas, chairman of the Veterans' 
Affairs Committee's Oversight and Investigations Subcommittee, for his 
work on this bipartisan bill.
  I was disturbed by a recent Government Accountability Office report 
requested by Chairman Pappas and Ranking Member Tracey Mann, which 
identified approximately 1,600 healthcare providers who were deceased, 
ineligible to work with the Federal Government, or who had revoked or 
suspended medical licenses, yet were still listed as active providers 
in VA's Community Care networks.
  While the number of ineligible providers was a small fraction of the 
roughly 1.2 million active providers in VA's Community Care networks, 
they still represented a potential threat to veteran health and safety, 
and a risk for financial fraud.
  Congressman Pappas' bill would require VA to implement GAO's 
recommendations to ensure veterans and taxpayers are not put at risk.
  The bill will modify standard operating procedures at the VA Health 
Administration and require continuous matching of providers' 
information against several data sources in order to verify 
eligibility, such as the List of Excluded Individuals and Entities that 
the Department of Health and Human Services, Office of Inspector 
General maintains, the National Practitioner Data Bank, and the monthly 
deactivation file of the Centers for Medicare and Medicaid Services.
  This will go a long way toward ensuring that physicians and other 
providers in VA's Community Care networks meet the basic and necessary 
standards, such as proper and current licensing requirements.
  This bill has the support of the American Legion, Disabled American 
Veterans, and the Veterans of Foreign Wars. The Congressional Budget 
Office estimates that it will have no significant impact on direct 
spending or deficits.
  Mr. Speaker, I urge all my colleagues to support this legislation, 
and I reserve the balance of my time.

                              {time}  1545

  Mr. ELLZEY. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of H.R. 7277, as amended, the 
Improving Oversight of the Veterans Community Care Providers Act.
  This is a bipartisan bill led by Chairman Pappas and Ranking Member 
Mann of the Oversight and Investigation Subcommittee.
  H.R. 7277 would implement recent recommendations from the Government 
Accountability Office on how to improve oversight of community care. 
Community care is VA care, and it should be timely and of the highest 
quality.
  Unfortunately, our committee has heard repeated complaints of delays 
in community care. Long wait-times at VA medical centers and delays in 
community care are unacceptable, and we take these complaints very 
seriously.
  The committee will continue our strict oversight of the program to 
ensure veterans are getting the care they need when and where they need 
it. It is vital to protect this important option for veterans, and I 
encourage all my colleagues to support the bill.
  Mr. Speaker, I reserve the balance of my time.
  Mr. TAKANO. Mr. Speaker, I yield 5 minutes to the gentleman from New 
Hampshire (Mr. Pappas), my good friend, who is the author of this 
legislation and who serves as the chairman of the Subcommittee on 
Oversight and Investigations of the Veterans' Affairs Committee.
  Mr. PAPPAS. Mr. Speaker, I thank Chairman Takano for yielding.
  I rise today in support of my bipartisan legislation, H.R. 7277, the 
Improving Oversight of Veterans Community Care Providers Act.
  This legislation will help ensure that the Department of Veterans 
Affairs does a better job overseeing its Community Care Program, which 
many veterans in my State of New Hampshire and all across the country 
rely on to access high-quality care in their communities.
  When veterans visit a community healthcare provider, they should be 
assured, at a minimum, that the provider has a medical license and is 
eligible to do business with the Federal Government. Unfortunately, as 
a December 2021 GAO report detailed, this has not always been the case.
  GAO identified approximately 1,600 community care providers who were 
deceased, ineligible to work with the Federal Government, or who had 
revoked or suspended medical licenses at the time of the review.
  That is 1,600 physicians and other healthcare providers who failed to 
meet some of the program's most basic requirements. This poses a 
potential threat to veteran health and well-being, and risks wasting 
tax dollars on inappropriate medical charges. My legislation will 
strengthen oversight of these community care providers.
  Now, to VA's credit, the Department has updated several data systems 
to improve the credentialing process and to continuously monitor the 
eligibility of providers. But progress has been too slow, and this 
legislation is needed to hold the Department fully accountable.
  This bill will require VA to implement a detailed plan with required 
milestones for identifying healthcare providers who are no longer 
eligible to participate in the Community Care Program.
  Under the plan, VA will automatically check whether providers are 
designated as ineligible on other critical lists managed by the 
Department of Health and Human Services and CMMS.
  VA will also be required to analyze the efficacy of allowing 
community care providers to self-certify their eligibility to 
participate in the program. We need VA to adopt a more complete method 
for credentialing providers that has ample checks and balances.
  I thank Ranking Member Tracey Mann for working with me on this 
bipartisan legislation, which has also been endorsed by VFW, the 
American Legion, and Disabled American Veterans.
  Once enacted, it will give much-needed protection to veterans to 
ensure they have high-quality healthcare they earned through their 
service to our Nation, without fear that they may be receiving care 
from an ineligible provider. So I urge all colleagues to support this 
legislation today.
  Mr. TAKANO. Mr. Speaker, I reserve the balance of my time.
  Mr. ELLZEY. Mr. Speaker, I encourage my colleagues to support this 
bill, and I yield back the balance of my time.
  Mr. TAKANO. Mr. Speaker, I have no further speakers, and I am 
prepared to close.
  I urge all of my colleagues to join me in passing this important 
piece of legislation, H.R. 7277, as amended, and I yield back the 
balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from California (Mr. Takano) that the House suspend the rules 
and pass the bill, H.R. 7277, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. ROSENDALE. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.

[[Page H8467]]

  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this motion will be postponed.

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