VA Preventing Duplicate Payments Act of 2022

To increase interagency cooperation and coordination and to require policies and procedures to detect and prevent duplicate payments for the same medical services by the Department of Veterans Affairs, Department of Health and Human Services, and Department of Defense, and for other purposes. 1. Short title This Act may be cited as the VA Preventing Duplicate Payments Act of 2022 2. Department of Veterans Affairs policies and procedures to detect and prevent duplicate payments for the same medical services (a) Policies and procedures required (1) In general The Secretary of Veterans Affairs shall establish policies and procedures for the detection and prevention of duplicate billings and payments by the Secretary of non-Department health care providers under section 1703 of title 38, United States Code, through the comparison of a billing or payment made by the Secretary for a medical service to a billing or payment made for the same medical service by— (A) the Administrator of the Centers for Medicare & Medicaid Services under the Medicare program under title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq. (B) the Secretary of Defense under the TRICARE program. (2) Capabilities The policies and procedures required under subsection (a) shall include— (A) the capability to use data exchanges; and (B) the capability to access and share the claims and payment data of other programs and agencies, if permitted pursuant to data-matching agreements entered into pursuant to subsection (b). (3) Deadline for implementation Not later than 90 days after the date of the enactment of this Act, the Secretary shall establish a plan to comply with the requirements of paragraph (1). (b) Data-Matching agreements (1) Agreements required The Secretary of Veterans Affairs, the Secretary of Defense, and the Administrator of the Centers for Medicare & Medicaid Services shall enter into data-matching agreements under which the Secretary of Defense and the Administrator agree to share and match relevant data in the systems of records of the Department of Defense and the Centers for Medicare & Medicaid Services, respectively, with the Secretary of Veterans Affairs for the purpose of implementing the policies and procedures required under subsection (a). (2) Nonapplicability of certain requirements Subsection (o) of section 552a of title 5, United States Code, shall not apply to an agreement described in paragraph (1). (c) Implementation of policy The Secretary of Veterans Affairs, in coordination with the Secretary of Defense and the Administrator of the Centers for Medicare & Medicaid Services, shall establish and implement policies that— (1) clarify which department or agency is financially responsible in a situation in which an individual is eligible, or potentially eligible, for payment or reimbursement of an expense relating to a medical service under the laws administered by the Secretary of Veterans Affairs and— (A) the TRICARE program; or (B) the Medicare program under title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq. (2) provide for the recoupment of payments if duplicate payments are made for the same medical service. (d) Report Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report that includes each of the following: (1) A description of the progress the Secretary has made in implementing this Act. (2) An analysis of the effect of any agreements entered into pursuant to subsection (b) on reducing duplicate payments. (3) Any recommendations of the Secretary for legislative action to eliminate duplicate billing and payment for the same medical services. (e) TRICARE program defined The term TRICARE program

Summary: VA Preventing Duplicate Payments Act of 2022 This bill requires the Department of Veterans Affairs (VA) to establish policies and procedures for the detection and prevention of duplicate billings and payments of non-VA health care providers under the Veterans Community Care Program Such policies and procedures should compare billings or payments made by the VA for a medical service to a billing or payment made for the same service by the Centers for Medicare & Medicaid Services (CMS) under the Medicare program or the Department of Defense (DOD) under the TRICARE program. The VA, the CMS, and DOD must (1) enter into data-matching agreements to share and match relevant data in the systems of records for the purposes of this bill, and (2) establish and implement policies that clarify which department or agency is financially responsible for payment or reimbursement for a medical service. The established policies must also provide for the recoupment of payments if duplicate payments are made for the same medical service.