[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7277 Referred in Senate (RFS)]
<DOC>
117th CONGRESS
2d Session
H. R. 7277
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
November 17, 2022
Received; read twice and referred to the Committee on Veterans' Affairs
_______________________________________________________________________
AN ACT
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.
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.).
(2) The term ``Veterans Community Care Program'' means the
program established under section 1703 of title 38, United
States Code.
Passed the House of Representatives November 17, 2022.
Attest:
CHERYL L. JOHNSON,
Clerk.