VA Preventing Duplicate Payments Act of 2022
Bill: H.R.7275 | Sponsor: Rep. Luria, Elaine G. (D-VA)
Policy area: Armed Forces and National Security

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.

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.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``VA Preventing Duplicate Payments Act 
of 2022''.

SEC. 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.); or
                    (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'' has the 
meaning given that term in section 1072 of title 10, United States 
Code.
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