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) intro-
duced the following bill; which was referred to the Committee on Veter-
ans’ 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 juris-
diction 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.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. MEDICARE COST RECOVERY BY DEPARTMENT
OF VETERANS AFFAIRS.
(a) IN GENERAL.—(1) Chapter 17 of title 38, United
States Code, is amended by inserting after section 1729
the following new section:
‘‘§ 1729A. Medicare coverage and reimbursement
‘‘(a) In the case of care for a non-service-connected
disability that is provided by the Department to a veteran
who is a Medicare-eligible individual, the Secretary of
Health and Human Services shall reimburse the Depart-
ment health-care facility that (under subsection (b)) pro-
vides that care as a Medicare provider or Medicare HMO
in the same amounts and in the same manner as that Sec-
retary reimburses other Medicare providers or Medicare
HMOs, respectively. The Secretary of Health and Human
Services shall include with each such reimbursement a
Medicare explanation of benefits.
‘‘(b)(1) For purposes of subsection (a)—
‘‘(A) a Department health care facility provid-
ing care to a Medicare-eligible individual for which
there is a certification in effect under paragraph (2)
shall be deemed to be a Medicare provider; and
‘‘(B) a Department health-care facility (or
group of facilities) providing care to a Medicare-eli-
gible individual for which there is a certification in
effect under paragraph (2) shall be deemed to be a
Medicare HMO.
‘‘(2) The Secretary shall certify to the Secretary of
Health and Human Services each year—
‘‘(A) a list of all Department health care facili-
ties that are to be treated as Medicare providers for
purposes of this section; and
‘‘(B) a list of all Department health-care facili-
ties (or groups of facilities) that are to be treated as
Medicare HMOs for purposes of this section.
‘‘(3) The Secretary shall certify the lists under para-
graph (2) each year based solely upon criteria determined
by the Secretary.
‘‘(4) The Secretary shall consult with the Secretary
of Health and Human Services in seeking ways to improve
health care delivery to veterans.
‘‘(c) When the Secretary provides care to a veteran
for which the Secretary receives reimbursement under this
section, the Secretary shall require the veteran to pay to
the Department any applicable deductible or copayment
under this chapter for such care that is not covered by
the Medicare program.
‘‘(d) For purposes of this section:
‘‘(1) The term ‘Medicare program’ means the
health insurance program under title XVIII of the
Social Security Act.
‘‘(2) The term ‘Medicare-eligible individual’
means an individual who is entitled to benefits under
part A of the Medicare program.
‘‘(3) The term ‘Medicare HMO’ means an eligi-
ble organization under section 1876 of the Social Se-
curity Act.
‘‘(4) The term ‘Medicare provider’ means an in-
dividual or entity furnishing items or services for
which payments may be made under the Medicare
program.’’.
(2) The table of sections at the beginning of such
chapter is amended by inserting after the item relating
to section 1729 the following new item:
‘‘1729A. Medicare coverage and reimbursement.’’.
(b) EFFECTIVE DATE.—Section 1729A of title 38,
United States Code, as added by subsection (a), shall
apply with respect to care provided after the date of the
enactment of this Act.
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