H.R. 5932 (Introduced in House) — Claims Legitimacy and Evaluation Accountability Nationwide for VA Act

Section 1 Short title

This Act may be cited as the “Claims Legitimacy and Evaluation Accountability Nationwide for VA Act” or the “CLEAN VA Act”.

Sec. 2 Expedited procedures for employee accountability actions

(a)

Modification of disciplinary procedures for department of veterans affairs employees— Section 714 of title 38, United States Code, is amended—

(1)

in subsection (a)—

(A)

in paragraph (1), by inserting “by substantial evidence” after “the Secretary determines”; and

(B)

by adding at the end the following new paragraph:

“(3)

“(A) When making an initial decision under this subsection with respect to determining whether a covered individual should be removed, demoted, or suspended, the deciding employee of the Department shall exclusively apply the following factors:

“(i) The nature and seriousness of the offense, and its relation to the covered individual’s duties, position, and responsibilities, including whether the offense was intentional or technical or inadvertent, or was committed maliciously or for gain, or was frequently repeated.

“(ii) The covered individual’s job level and type of employment, including supervisory or fiduciary role, and prominence of the position.

“(iii) The covered individual’s past disciplinary record.

“(iv) The covered individual’s past work record, including length of service, performance on the job, ability to get along with fellow workers, and dependability.

“(v) Mitigating circumstances surrounding the offense such as unusual job tensions, personality problems, mental impairment, harassment, or bad faith, malice, or provocation on the part of others involved in the matter.

“(B) The Secretary shall review the initial decision and uphold such decision if it is supported by substantial evidence.”

(2)

in subsection (c)—

(A)

by striking paragraph (1)(D); and

(B)

in paragraph (3), by inserting before the period the following: “, and the Secretary may carry out such a removal, demotion, or suspension without first placing a covered individual on a performance improvement plan”;

(3)

in subsection (d)—

(A)

in paragraph (2), by adding at the end the following new subparagraph:

“(C) Except to the extent that an appeal under this subsection presents a constitutional issue, the administrative judge may not review a challenge to the penalty imposed against the covered individual.”

(B)

in paragraph (3), by adding at the end the following new subparagraph:

“(D) Except to the extent that an appeal under this subsection presents a constitutional issue, the Merit Systems Protection Board may not review a challenge to the penalty imposed against the covered individual.”

(C)

in paragraph (5), by adding at the end the following new subparagraph:

“(C) Except to the extent that an appeal under this subsection presents a constitutional issue, such Court may not review a challenge to the penalty imposed against the covered individual or mitigate such penalty.”

(D)

by striking paragraph (10); and

(4)

by redesignating subsection (h) as subsection (j).

(b)

Timing of disciplinary actions— Section 714 of title 38, United States Code, is further amended by inserting after subsection (a) (as amended by subsection (a) of this section) the following new subsection:

“(b) Timing

“(1) The aggregate period for notice, response, and final decision by the Secretary of an action under this section may not exceed 15 business days.

“(2) The period for the response of a covered individual to a notice under subsection (a)(2)(A) shall be 7 business days.

“(3) The final decision by the Secretary under subsection (a)(1)(B) shall—

“(A) be issued not later than 15 business days after notice is provided under subsection (a)(2)(A); and

“(B) be in writing and shall include the specific reasons for the decision.”

Sec. 3 Enhanced penalties for VA employee fraud and misconduct; whistleblower protections and incentives

(a)

Enhanced penalties for fraud and misconduct—

(1)

Public money, property, or records— Section 641 of title 18, United States Code, is amended by adding at the end the following: “If the offense under this section is committed by an employee of the Department of Veterans Affairs, acting in an official capacity or using access to veterans’ records or benefits systems, the term of imprisonment shall be not more than 15 years, and any fine imposed shall be not more than $500,000. The court shall order mandatory restitution to the Department of Veterans Affairs or the United States Treasury for any loss sustained.”.

(2)

False statements— Section 1001 of title 18, United States Code, is amended by adding at the end the following: “If the offense involves the falsification or concealment of material facts related to a claim for veterans’ benefits or the performance of duties by a Department of Veterans Affairs employee, the term of imprisonment shall be not more than 10 years, and any fine imposed shall be not more than $250,000.”.

(3)

Bribery of public officials and witnesses— Section 201 of title 18, United States Code, is amended by adding at the end the following: “If the public official is employed by the Department of Veterans Affairs, and the bribe or gratuity relates to the processing or awarding of veterans’ benefits or contracts, the maximum fine shall be twice the amount of the bribe or thing of value received, and the term of imprisonment shall be not more than 20 years.”.

(4)

False statements or fraud to obtain Federal employees’ compensation— Section 1920 of title 18, United States Code, is amended by adding at the end the following: “If a person convicted under this section is an employee of the Department of Veterans Affairs and the fraudulent conduct relates to veterans’ disability, compensation, or employment benefits, such person shall be fined not more than $250,000, imprisoned not more than 10 years, and shall forfeit any Federal pension or annuity benefits pursuant to section 8312 of title 5.”.

(5)

Forfeiture of Federal pension and annuity benefits— Section 8312 of title 5, United States Code, is amended by adding at the end the following new subsection:

“(e) An individual convicted of an offense under section 641, 1001, 201, or 1920 of title 18, United States Code, as amended by the Claims Legitimacy and Evaluation Accountability Nationwide for VA Act, if such individual is an employee of the Department of Veterans Affairs and the offense relates to their duties, shall forfeit any entitlement to annuity or retired pay under this chapter or chapter 84 of this title.”

(b)

Whistleblower protections and incentives—

(1)

Expedited retaliation investigations— Section 2303 of title 5, United States Code, is amended by adding at the end the following new subsection:

“(e) In the case of a retaliation claim involving an employee of the Department of Veterans Affairs, the Office of Accountability and Whistleblower Protection shall complete investigations within 60 days of filing. The Office shall provide written justification to Congress for any delay beyond 60 days and shall ensure interim protections against reassignment or adverse personnel actions while claims are pending.”

(2)

Transparency and oversight of settlements— The Secretary of Veterans Affairs shall report annually to the Inspector General of the Department of Veterans Affairs and the Committees on Veterans’ Affairs of the Senate and House of Representatives on the number of whistleblower retaliation claims filed, investigated, and settled; the total settlement amounts; and whether settlement obligations were fulfilled. The Secretary shall publish an anonymized summary of this report on the Department’s website.

(3)

Incentive awards for valid disclosures— The Secretary of Veterans Affairs is authorized to provide monetary awards up to $10,000 for substantiated internal disclosures that prevent or uncover significant fraud, waste, or abuse valued over $100,000. Such awards shall be funded from recovered amounts when practicable and shall not be considered compensation for pension or benefit purposes.

(4)

Independent review and reporting— The Comptroller General of the United States shall review the implementation of the provisions of this subsection within 2 years of the date of enactment of this Act and submit a report to Congress on the timeliness of investigations, settlement compliance, and effectiveness of incentive provisions.

Sec. 4 Review of the VA disability rating schedule

(a)

Comprehensive review— The Secretary of Veterans Affairs shall conduct a comprehensive review of the Department of Veterans Affairs schedule for rating disabilities to—

(1)

identify vulnerabilities to fraudulent, exaggerated, or duplicative claims;

(2)

assess whether existing rating criteria accurately reflect current medical standards and functional impairment measures; and

(3)

recommend updates to ensure consistency, integrity, and fairness in disability determinations.

(b)

Integration of artificial intelligence and data analytics tools—

(1)

The Secretary shall, in consultation with the Inspector General of the Department of Veterans Affairs and the Comptroller General of the United States, develop and implement a program utilizing data analytics and artificial intelligence systems to proactively identify irregularities or high-risk indicators within disability claims.

(2)

Such systems shall be modeled, to the extent practicable, after the Waste, Fraud, and Abuse Identification and Reporting system utilized by the Centers for Medicare & Medicaid Services.

(3)

All findings generated through automated or algorithmic processes shall be subject to human review and validation before any administrative or disciplinary action may be taken.

(4)

The Secretary shall ensure that the use of such systems respects all due process protections and privacy safeguards afforded to claimants under Federal law.

(c)

Coordination and oversight— The Secretary shall coordinate with the Office of Inspector General and the Government Accountability Office to—

(1)

evaluate the effectiveness of the tools described in subsection (b);

(2)

identify risks of over-flagging or under-detection of improper claims; and

(3)

recommend best practices to ensure balanced oversight and prevention of misuse.

(d)

Reporting requirement— Not later that 180 days after the date of enactment of this Act, the Secretary shall submit to the Committees on Veterans’ Affairs and Oversight and Accountability of the House of Representatives and the Committees on Veterans’ Affairs and Homeland Security and Governmental Affairs of the Senate a report detailing—

(1)

the results of the review conducted under subsection (a);

(2)

vulnerabilities identified and corrective measures proposed;

(3)

the status of data analytics and artificial intelligence integration under subsection (b); and

(4)

recommendations for further modernization of the disability rating process.

Sec. 5 Mandatory ethics and fraud prevention training

(a)

Requirement for annual training— Subchapter II of chapter 77 of title 38, United States Code, is amended by adding at the end the following new section:

“7735. Mandatory ethics and fraud prevention training

“(a) Requirement—The Secretary shall require all employees of the Department to complete annual training on ethics, fraud prevention, and compliance with applicable laws and regulations.

“(b) Oversight—The Inspector General of the Department shall oversee compliance with the training requirement under subsection (a) and submit an annual report to the Committees on Veterans’ Affairs of the Senate and House of Representatives on training completion rates and any identified deficiencies.”

(b)

Clerical amendment— The table of sections at the beginning of chapter 77 of title 38, United States Code, is amended by inserting after the item relating to section 7734 the following new item:

Sec. 6 Review of the VA disability rating schedule

(a)

Comprehensive review— The Secretary of Veterans Affairs shall conduct a comprehensive review of the Department of Veterans Affairs Schedule for Rating Disabilities to—

(1)