Sec. 222. Improving authority to collect

878 words·~4 min read·/bill/115/s/2184/is/section-222

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

Section 1729 is amended— in subsection (a)— in paragraph (2)(A)— by striking the veteran’s and inserting the individual’s ; and by striking the veteran and inserting the individual ; and in paragraph (3)— in the matter preceding subparagraph (A), by striking the veteran and inserting the individual ; and in subparagraph (A), by striking the veteran’s and inserting the individual’s ; in subsection (b)— in paragraph (1)— by striking the veteran and inserting the individual ; and by striking the veteran’s and inserting the individual’s ; and in paragraph (2)— in subparagraph (A)— by striking the veteran and inserting the individual ; and by striking the veteran’s and inserting the individual’s ; and in subparagraph (B)— in clause (i), by striking the veteran and inserting the individual ; and in clause (ii)— by striking the veteran and inserting the individual ; and by striking the veteran’s each place it appears and inserting the individual’s ; in subsection (e), by striking A veteran and inserting An individual ; and in subsection (h)— in paragraph (1)— in the matter preceding subparagraph (A), by striking a veteran and inserting an individual ; in subparagraph (A), by striking the veteran and inserting the individual ; and in subparagraph (B), by striking the veteran and inserting the individual ; and in paragraph (2)— by striking A veteran and inserting An individual ; by striking a veteran and inserting an individual ; and by striking the veteran and inserting the individual .

Such section is further amended— in subsection (a)— in paragraph (1), by striking

(1)Subject and all that follows through the period and inserting the following:

(1)Subject to the provisions of this section, in any case in which the United States is required by law to furnish or pay for care or services under this chapter for a non-service-connected disability described in paragraph

(2)of this subsection, the United States has the right to recover or collect from a third party the reasonable charges of care or services so furnished or paid for to the extent that the recipient or provider of the care or services would be eligible to receive payment for such care or services from such third party if the care or services had not been furnished or paid for by a department or agency of the United States. ; in paragraph (2)— in subparagraph (C), by striking the semicolon and inserting ; or ; by amending subparagraph

(D)to read as follows: that is incurred by an individual who is entitled to care (or payment of the expenses of care) under a health-plan contract. ; and by striking subparagraph (E); and by adding at the end the following new paragraph: In the case of a health-plan contract where the United States has a right to recover or collect reasonable charges, the Secretary shall collect from a veteran or responsible individual any copayment or cost-share required under this chapter. ; in subsection (b), by adding at the end the following new paragraph: The obligation of the third party to pay is not dependent upon an individual executing an assignment of benefits to the United States, nor is the obligation to pay dependent upon any other submission by the beneficiary to the third party, including any claim or appeal. In any case in which the Secretary makes a claim, appeal, representation, or other filing under the authority of this chapter, any procedural requirement in any third-party plan for the beneficiary of such plan to make the claim, appeal, representation, or other filing is deemed to be satisfied. ; and in subsection (f)— by inserting

(1)before No law ; and by adding at the end the following new paragraph: The absence of a participating provider agreement, Veterans Care Agreement, or other contractual arrangement with a third party described in subsection (i)(3)(D) shall not operate to prevent, or reduce the amount of, any such recovery or collection by the United States. For purposes of this section, the Department shall recover or collect as if it were a participating provider. ; and Subsection

(i)of such section is amended to read as follows: In this section: The term health-plan contract includes any of the following: An insurance policy or contract including any health maintenance organization, preferred provider organization, point of service organization, accountable care organization, or any other type of health insurance policy or contract, medical or hospital service agreement, membership or subscription contract, or similar arrangement under which hospital care or medical services for individuals are provided or the expenses of such services are paid. A workers’ compensation law or plan. The term payment includes reimbursement and indemnification. The term third party means any of the following: A State or political subdivision of a State. An employer or an employer’s insurance carrier. An automobile accident reparations or liability insurance carrier. A person or entity obligated to provide, or to pay the expenses of, health services under a health-plan contract. The term reasonable charges shall include the following: For hospital care or medical services furnished by the Department, charges established in accordance with this section. For hospital care or medical services paid for under subparagraphs

(A)and

(B)of subsection (a)(2), the amount paid to a non-Department entity or provider. .