Secretary’s response to the report submitted
by the Comptroller General under clause
(ii).
‘‘(D) ANNUAL REPORT BY THE COMPTROL-
LER GENERAL.—Not later than December 31 of
each year during which the program and dem-
onstration project is conducted, the Comptroller
General of the United States shall submit to the
administering Secretaries and to Congress a re-
port on the extent, if any, to which the costs of
the Secretary of Health and Human Services
under the Medicare Program under this title in-
creased during the preceding fiscal year as a re-
sult of the program or demonstration project.
‘‘(2) REQUIRED RESPONSE IN CASE OF INCREASE
IN COSTS.—
‘‘(A) IN
GENERAL.—If the administering
Secretaries find, based on paragraph (1), that
the expenditures under the Medicare Program
under this title increased (or are expected to in-
crease) during a fiscal year because of the pro-
gram or demonstration project, the administer-
ing Secretaries shall take such steps as may be
needed—
‘‘(i) to recoup for the Medicare Pro-
gram the amount of such increase in ex-
penditures; and
‘‘(ii) to prevent any such increase in
the future.
‘‘(B) STEPS.—Such steps—
‘‘(i) under subparagraph (A)(i) shall
include payment of the amount of such in-
creased expenditures by the Secretary of
Veterans Affairs from the current medical
care appropriation for the Department of
Veterans Affairs to the trust funds; and
‘‘(ii) under subparagraph (A)(ii) shall
include lowering the amount of payment
under the program or project under sub-
section (g)(1), and may include, in the case
of the demonstration project, suspending or
terminating the project (in whole or in
part).
‘‘(i) EVALUATION AND REPORTS.—
‘‘(1) INDEPENDENT EVALUATION BY GAO.—
‘‘(A) IN GENERAL.—The Comptroller Gen-
eral of the United States shall conduct an eval-
uation of the program and an evaluation of the
demonstration project, and shall submit annual
reports on the program and demonstration
project to the administering Secretaries and to
Congress.
‘‘(B) FIRST REPORT.—The first report for
the program or demonstration project under sub-
paragraph (A) shall be submitted not later than
12 months after the date on which the Secretary
of Veterans Affairs first provides services under
the program or project, respectively.
‘‘(C) FINAL
REPORT
ON
DEMONSTRATION
PROJECT.—A final report shall be submitted
with respect to the demonstration project not
later than 31⁄2 years after the date of the first re-
port on the project under subparagraph (B).
‘‘(D) CONTENTS.—The evaluation and re-
ports under this paragraph for the program or
demonstration project shall include an assess-
ment, based on the agreement entered into under
subsection (b), of the following:
‘‘(i) Any savings or costs to the Medi-
care Program under this title resulting from
the program or project.
‘‘(ii) The cost to the Department of
Veterans Affairs of providing care to cat-
egory A Medicare-eligible veterans under the
program or to category C Medicare-eligible
veterans under the demonstration project,
respectively.
‘‘(iii) An analysis of how such pro-
gram or project affects the overall accessibil-
ity of medical care through the Department
of Veterans Affairs, and a description of the
unintended effects (if any) upon the patient
enrollment system under section 1705 of
title 38, United States Code.
‘‘(iv) Compliance by the Department of
Veterans Affairs with the requirements
under this title.
‘‘(v) The number of category A Medi-
care-eligible veterans or category C Medi-
care-eligible veterans, respectively, opting to
participate in the program or project in-
stead of receiving health benefits through
another health insurance plan (including
benefits under this title).
‘‘(vi) A list of the health insurance
plans and programs that were the primary
payers for Medicare-eligible veterans during
the year prior to their participation in the
program or project, respectively, and the