I

104TH CONGRESS

1ST SESSION H. R. 1767

To amend title 38, United States Code, to provide for cost recovery by

the Department of Veterans Affairs of the cost of health care delivered

to veterans who are eligible for care under the Medicare program.

IN THE HOUSE OF REPRESENTATIVES

JUNE 7, 1995

Mr. HUTCHINSON (for himself, Mr. EDWARDS, and Mr. MONTGOMERY) introduced the following bill; which was referred to the Committee on Veterans’ Affairs, and in addition to the Committees on Commerce, and Ways

and Means, for a period to be subsequently determined by the Speaker,

in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL

To amend title 38, United States Code, to provide for cost

recovery by the Department of Veterans Affairs of the

cost of health care delivered to veterans who are eligible

for care under the Medicare program.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,
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1 SECTION 1. MEDICARE COST RECOVERY BY DEPARTMENT

2 OF VETERANS AFFAIRS.

3 (a) IN GENERAL.—(1) Chapter 17 of title 38, United

4 States Code, is amended by inserting after section 1729

5 the following new section:

6 ‘‘§ 1729A. Medicare coverage and reimbursement

7 ‘‘(a) In the case of care for a non-service-connected

8 disability that is provided by the Department to a veteran

9 who is a Medicare-eligible individual, the Secretary of

10 Health and Human Services shall reimburse the Depart11 ment health-care facility that (under subsection (b)) pro12 vides that care as a Medicare provider or Medicare HMO

13 in the same amounts and in the same manner as that Sec14 retary reimburses other Medicare providers or Medicare

15 HMOs, respectively. The Secretary of Health and Human

16 Services shall include with each such reimbursement a

17 Medicare explanation of benefits.

18 ‘‘(b)(1) For purposes of subsection (a)—

19 ‘‘(A) a Department health care facility provid20 ing care to a Medicare-eligible individual for which

21 there is a certification in effect under paragraph (2)

22 shall be deemed to be a Medicare provider; and

23 ‘‘(B) a Department health-care facility (or

24 group of facilities) providing care to a Medicare-eli25 gible individual for which there is a certification in
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1 effect under paragraph (2) shall be deemed to be a

2 Medicare HMO.

3 ‘‘(2) The Secretary shall certify to the Secretary of

4 Health and Human Services each year—

5 ‘‘(A) a list of all Department health care facili6 ties that are to be treated as Medicare providers for

7 purposes of this section; and

8 ‘‘(B) a list of all Department health-care facili9 ties (or groups of facilities) that are to be treated as

10 Medicare HMOs for purposes of this section.

11 ‘‘(3) The Secretary shall certify the lists under para12 graph (2) each year based solely upon criteria determined

13 by the Secretary.

14 ‘‘(4) The Secretary shall consult with the Secretary

15 of Health and Human Services in seeking ways to improve

16 health care delivery to veterans.

17 ‘‘(c) When the Secretary provides care to a veteran

18 for which the Secretary receives reimbursement under this

19 section, the Secretary shall require the veteran to pay to

20 the Department any applicable deductible or copayment

21 under this chapter for such care that is not covered by

22 the Medicare program.

23 ‘‘(d) For purposes of this section:
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1 ‘‘(1) The term ‘Medicare program’ means the

2 health insurance program under title XVIII of the

3 Social Security Act.

4 ‘‘(2) The term ‘Medicare-eligible individual’

5 means an individual who is entitled to benefits under

6 part A of the Medicare program.

7 ‘‘(3) The term ‘Medicare HMO’ means an eligi8 ble organization under section 1876 of the Social Se9 curity Act.

10 ‘‘(4) The term ‘Medicare provider’ means an in11 dividual or entity furnishing items or services for

12 which payments may be made under the Medicare

13 program.’’.

14 (2) The table of sections at the beginning of such

15 chapter is amended by inserting after the item relating

16 to section 1729 the following new item:

‘‘1729A. Medicare coverage and reimbursement.’’.

17 (b) EFFECTIVE DATE.—Section 1729A of title 38,

18 United States Code, as added by subsection (a), shall

19 apply with respect to care provided after the date of the

20 enactment of this Act.

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