Improving Oversight of Veterans Community Care Providers Act of 2022

Floor Speech

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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.).

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

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Mr. TAKANO. 7277, as amended.

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.

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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.

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