,,ib ,union ,calendar ,no4 #cjj #aaith  
,,congress  #ast ,session  ,h4 ,r4 #cdhc
 ,report ,no4 #aai-cdh ,,in ,,the       
,,house ,,of ,,representatives  ,may    
#ai1 #bjbe,mr4 ,barrett introduced the  
following bill2 which was referred to   
the ,committee on ,veterans' ,affairs   
,october #ba1 #bjbe;,additional sponsor3
 ,mr4 ,haridopolos  ,october #ba1       
#bjbe,reported with an amendment1       
committed to the ,committee of the      
,whole ,house on the ,state of the      
,union1 and ordered to be printed,strike
 out all after the enacting clause and  
insert the part printed in italic,for   
text of introduced bill1 see copy of    
bill as introduced on ,may #ai1 #bjbe   
,a ,,bill  ,to amend title #ch1 to      
direct the ,secretary of ,veterans      
,affairs to use an information          
technology system to detect fraud1      
waste1 and abuse regarding claims for   
payment submitted to the ,secretary     
under the ,veterans ,community ,care    
,program4  #a4 ,short title ,this ,act  

may be cited as the ,forcing ,real      
,accountability for ,unlawful           
,distributions ,act of #bjbe or the     
,,fraud ,act of #bjbe4  #b4 ,detection  
of fraud1 waste1 and abuse in programs  
of the ,veterans ,health ,administration
  7a7 ,in general ,subchapter ,i of     
chapter #ag of title #ch1 ,united       
,states ,code1 is amended by inserting  
after section #agjf;,a the following new
 section 7and amending the table of     
sections at the beginning of such       
chapter accordingly73  #agjf;,b4        
,management of health care3 detection of
 fraud1 waste1 and abuse  7a7 ,in       
general ,to detect fraud1 waste1 and    
abuse in programs of the ,veterans      
,health ,administration1 the ,secretary 
shall use processes and systems1        
including the information technology    
system described in subsection 7b71 to--
 7#a7 analyze a claim submitted to the  
,secretary by a health care entity or   
provider that furnishes hospital care1  
medical services1 or extended care      

services under this chapter2 and  7#b7  
reanalyze a claim1 described in         
paragraph 7#a7 that the ,secretary      
determines may be fraudulent1 after     
paying such claim4  7b7 ,information    
technology system ,the information      
technology system described in this     
subsection shall include the following  
functions3 7#a7 ,continuous monitoring  
of claims to detect patterns that may   
indicate fraud1 waste1 or abuse4  7#b7  
,analysis of historical and real-time   
claims data to identify and predict     
potential fraudulent claims4  7#c7      
,ready-made analytic models to identify 
and analyze fraudulent claims4  7#d7    
,post-payment analysis for overuse of   
services or other practices that create 
unnecessary costs to the ,department4   
7#e7 ,integration with existing claims  
processing systems and technologies of  
the ,department4  7#f7 ,logging1        
storage1 analysis1 and reports regarding
 the nature1 frequency1 and financial   
impact of detected fraudulent claims4   

7#g7 ,identification of1 and machine    
learning that is based on1 patterns of  
fraudulent claims in order to reduce    
false positives and predict new forms of
 fraud4  7#h7 ,updates to detect new    
models of fraud1 waste and abuse4  7#i7 
,any other function determined necessary
 by the ,secretary4  7c7 ,use of        
franchise fund ,to carry out this       
section1 the ,secretary shall use funds 
from the ,department of ,veterans       
,affairs franchise fund established     
under title ,i of ,public ,law #ajd-bjd 
7#ch ,u4,s4,c4 #cja note74  7d7 ,report 
,not later than two years after the date
 of the enactment of the ,,fraud ,act of
 #bjbe1 and annually thereafter for five
 additional years1 the ,secretary shall 
submit to the ,committees on ,veterans' 
,affairs of the ,senate and ,house of   
,representatives a report regarding the 
operation of the processes and systems  
under subsection 7a7 during the         
preceding year4 ,each such report shall 
include the determination of the        

,secretary regarding the following      
elements3 7#a7 ,the effectiveness of    
such processes and systems in detecting 
fraud1 waste1 and abuse described in    
subsection 7a74  7#b7 ,the estimated    
savings to the ,department arising from 
the use of such processes and systems4  
7#c7 ,any plans to enhance1 modify1 or  
add new capabilities to such processes  
and systems4  4  7b7 ,implementation    
date ,the ,secretary of ,veterans       
,affairs shall carry out section        
#agjf;,b of such title1 as added by     
subsection 7a71 not later than one year 
after the date of the enactment of this 
,act4  #c4 ,extension of certain limits 
on payment of pension ,section          
#eejc7;d77#g7 of title #ch1 ,united     
,states ,code1 is amended by striking   
,november #cj1 #bjca and inserting      
,january #cj1 #bjcd4  ,october #ba1     
#bjbe,reported with an amendment1       
committed to the ,committee of the      
,whole ,house on the ,state of the      
,union1 and ordered to be printed