,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #djgg  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,june #bc1 #bjbe,mr4  
,doggett 7= himself1 ,mr4 ,murphy1 ,mr4 
,takano1 ,mr4 ,s*weik]t1 & ,mr4 ,joyce (
 ,p5nsylvania7 introduc$ ! foll[+ bill2 
:i* 0 ref]r$ to ! ,committee on         
,vet]ans' ,affairs1 & 9 addition to !   
,committees on ,ways & ,means1 & ,en]gy 
& ,comm]ce1 = a p]iod to be subsequ5tly 
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to am5d title #ch1 ,unit$     
,/ates ,code1 & ! ,social ,security ,act
 to p]mit recov]y f ! ,dep>tm5t (       
,vet]ans ,affairs ( co/s f ,m$ic>e      
,advantage & ,m$ic>e prescription drug  
plans & to modify ! au?ority = recov]y  
by ! ,unit$ ,/ates ( reasonable *>ges = 
c]ta9 c>e or s]vices furni%$ to vet]ans 
= non-s]vice-connect$ disabilities1 & = 
o!r purposes4  #a4 ,%ort title ,?is ,act
 may be cit$ z ! ,gu>antee ,utilization 
( ,all ,reimbursem5ts = ,deliv]y (      

,vet]ans' ,heal? ,c>e ,act or ! ,,gu>d  
,vet]ans' ,heal? ,c>e ,act4  #b4        
,co/-recov]y f ,m$ic>e ,advantage &     
,m$ic>e prescription drug plans  7a7    
,co/ recov]y  7#a7 ,9 g5]al ,sub*apt]   
,,iii ( *apt] #ag ( title #ch1 ,unit$   
,/ates ,code1 is am5d$ by ins]t+ aft]   
section #agbi;,b ! foll[+ new section3  
#agbi;,c4 ,co/-recov]y f ,m$ic>e        
,advantage & ,m$ic>e prescription drug  
plans  7a7 ,9 g5]al ,not)/&+ sections   
#ahad7;c71 #ahce7;d71 & #ahfb7;a77#c7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#acie;f7c71 #acien7d71 & #aciey7a77#c771
 if ! ,secret>y provides "u ?is *apt]   
any heal? c>e item or s]vice 7includ+ = 
a s]vice-connect$ disability or a       
non-s]vice-connect$ disability7 cov]$ "u
 ! ,m$ic>e program "u title ,,xviii ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#acie et seq471 includ+ outpati5t &     
inpati5t c>e1 prescription drugs1 m$ical
 devices1 lab te/+1 & items or s]vices  
deliv]$ 9 po/-acute & long-t]m c>e      
sett+s1 to any individual :o is enroll$ 

9 a ,m$ic>e ,advantage plan1 includ+ an 
,,ma-,,pd plan1 (f]$ by a ,,ma          
organization "u "p ,c ( su* title or a  
prescription drug plan (f]$ by a ,,pdp  
sponsor "u "p ,d ( su* title1 su*       
organization or sponsor %all1 to ! ext5t
 su* item or s]vice is cov]$ "u su*     
,m$ic>e ,advantage plan or prescription 
drug plan1 reimburse ! ,secret>y = su*  
item or s]vice reg>dless ( any          
additional docum5tation1 utilization    
managem5t1 or o!r adm9i/rative          
requirem5t ! plan may impose on ! item  
or s]vice4  7b7 ,recov]y ( am\nts  7#a7 
,9 g5]al ,! ,secret>y %all recov] am\nts
 requir$ to be reimburs$ "u subsection  
7a7 ?r\gh ! use ( proc$ures "u section  
#agbi ( ?is title to ! same ext5t z ^?  
proc$ures are us$ to recov] am\nts      
au?oriz$ to be recov]$ "u t section4    
7#b7 ,am\nt & process ,except z provid$ 
9 p>agraph 7#a71 recov]y "u t p>agraph (
 am\nts reimburs$ "u subsection 7a7 %all
 be 9 su* an am\nt1 & occur 9 accordance
 ) su* proc$ures1 z ! ,secret>y %all    

prescribe = purposes ( ?is section4  7c7
 ,application ,! provisions ( subsection
 7a7 %all apply to ,m$ic>e ,advantage & 
prescription drug plan ye>s beg9n+ on or
 aft] ,janu>y #a1 #bjbf4  7d7 ,treatm5t 
( am\nts ,am\nts reimburs$ to !         
,secret>y "u subsection 7a7 %all be     
deposit$ 9 ! ,dep>tm5t ( ,vet]ans       
,affairs ,m$ical ,c>e ,collections ,fund
 "u section #agbi;,a ( ?is title4  4    
7#b7 ,cl]ical am5dm5t ,! table (        
sections at ! beg9n+ ( su* *apt] is     
am5d$ by ins]t+ aft] ! item relat+ to   
section #agbi;,b ! foll[+ new item3     
#agbi;,c4 ,co/-recov]y f ,m$ic>e        
,advantage & ,m$ic>e prescription drug  
plans4  4  7b7 ,m$ic>e con=m+ am5dm5ts  
7#a7 ,"p ,a ,section #ahad7;c7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#acie;f7c77 is am5d$ by ins]t+ & section
 #agbi;,c ( title #ch1 ,unit$ ,/ates    
,code aft] section #ahhj4  7#b7 ,"p ,b  
,section #ahce7;d7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acien7d77 is am5d$
 by ins]t+ & section #agbi;,c ( title   

#ch1 ,unit$ ,/ates ,code aft] section   
#ahhj4  7#c7 ,exclusions f cov]age      
,section #ahfb7;a77#c7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#aciey7a77#c77 is am5d$ by ins]t+ 9 !   
case ( items & s]vices & prescription   
drugs = :i* reimbursem5t is made "u     
section #agbi;,c ( title #ch1 ,unit$    
,/ates ,code1 aft] section #ahhj7;e714  
#c4 ,modification ( au?ority = recov]y  
by ,unit$ ,/ates ( reasonable *>ges =   
c]ta9 c>e or s]vices furni%$ to vet]ans 
= non-s]vice-connect$ disabilities      
,section #agbi ( title #ch1 ,unit$      
,/ates ,code1 is am5d$--  7#a7 9        
subsection 7a7-- 7,a7 by am5d+ p>agraph 
7#a7 to read z foll[s3  7#a7  7,a7      
,subject to ! provisions ( ?is section1 
! ,unit$ ,/ates has ! "r to recov] or   
collect ! reasonable *>ges = c>e or     
s]vices t ! ,unit$ ,/ates is requir$ by 
law to furni% or pay = "u ?is *apt] = a 
non-s]vice-connect$ disability4  7,b7 ,!
 ,unit$ ,/ates has ! "r to recov] or    
collect f a ?ird p>ty ! reasonable *>ges

 = c>e or s]vices furni%$ z describ$ 9  
subp>agraph 7,a7 to ! ext5t t ! recipi5t
 or provid] ( ! c>e or s]vices w\ld be  
eligible to receive paym5t f a ?ird     
p>ty4  7,c7 ,! "r to recov] or collect  
reasonable *>ges = c>e or s]vices "u ?is
 section %all apply to any & all causes 
( action or recov]y rights 9 tort or "u 
any policy1 plan1 or contract provid+   
b5efits = heal? c>e or injury1 :i*      
accrue to ! individual to :om ! c>e or  
s]vices 7 furni%$1 or to ! legal        
repres5tatives ( ! individual1 z a      
result ( ! non-s]vice-connect$          
disability t necessitat$ ! c>e or       
s]vices4  2 &  7,b7 9 p>agraph 7#b7--   
7i7 9 subp>agraph 7,d71 by /rik+ 2 or & 
ins]t+ a semicolon2  7ii7 9 subp>agraph 
7,e77#b71 by /rik+ ! p]iod at ! end &   
ins]t+ 2 or2 &  7iii7 by add+ at ! end !
 foll[+ new subp>agraph3  7,f7 t is     
incurr$ by an individual :o is entitl$  
to c>e 7or paym5t ( exp5ses ( c>e7 "u   
circum/ances creat+ a tort liability ^u 
a ?ird p>ty4  2  7#b7 9 subsection 7b71 

by am5d+ p>agraph 7#b7 to read z foll[s3
  7#b7 7,a7 ,! ,unit$ ,/ates may take   
any action necess>y to en=ce !          
subrogation int]e/s ( ! ,unit$ ,/ates "u
 ?is section1 includ+ by int]v5+ or jo9+
 9 an action or proce$+4  7,b7 ,a       
proce$+ "u ?is section may n be br\ght  
aft] ! end ( ! six-ye> p]iod beg9n+ on !
 la/ day on :i* ! c>e or s]vices = :i*  
recov]y is s\ght are furni%$4 ,not)/&+ !
 previ\s s5t5ce1 subject to section     
#bdae ( title #bh1 & except z o!rwise   
provid$ by law1 any action = money      
damages "u ?is section br\ght by !      
,unit$ ,/ates or an (fic] or ag5cy !re( 
t is f\nd$ ^u a tort %all be b>r$ unless
 ! compla9t is fil$ )9 ?ree ye>s aft] ! 
"r ( action fir/ accrues4  2  7#c7 9    
subsection 7c77#a71 by ins]t+ or p5alty 
aft] claim2  7#d7 by r$esignat+         
subsections 7h7 & 7i7 z subsections 7l7 
& 7m71 respectively2  7#e7 by ins]t+    
aft] subsection 7f7 ! foll[+ new        
subsections3  7g7  7#a7 ,n lat] ?an #de 
days aft] receipt ( a claim to recov] or

 collect ! reasonable *>ges = c>e or    
s]vices describ$ 9 subsection 7a71 or 9 
! case ( a tort1 n lat] ?an #de days    
aft] settlem5t1 judgm5t1 aw>d1 liability
 det]m9ation1 or resolution relat+ to ! 
cause ( action1 a ?ird p>ty %all-- 7,a7 
pay a clean claim = reimbursem5t 9      
accordance ) ?is section2  7,b7 pay !   
am\nt agre$ to 9 writ+ by ! ,dep>tm5t2  
or  7,c7 provide notice ( ! date ! ?ird 
p>ty receiv$ ! claim & include a /atem5t
 t--  7i7 ! ?ird p>ty refuses to        
reimburse all or "p ( ! claim & specify 
ea* reason = ! refusal to pay2 or  7ii7 
additional in=mation is necess>y to     
det]m9e if all or "p ( ! claim w be     
reimburs$ & :at specific additional     
in=mation is necess>y4  7#b7 ,p>agraph  
7#a7 %all n apply to a claim if !re is a
 good fai? dispute ab\t ! legitimacy ( !
 claim4  7#c7 7,a7 ,if any ?ird p>ty    
fails to comply ) p>agraph 7#a71 su*    
?ird p>ty %all be requir$ to pay int]e/ 
to ! ,unit$ ,/ates at ! rate e/abli%$ by
 ! ,secret>y ( ! ,treasury "u section   

#cgag ( title #ca p] mon? on ! am\nt ( !
 claim t rema9s unpaid at ! end ( !     
#de-;day p]iod specifi$ 9 su* p>agraph4 
7,b7 ,! int]e/ paid pursuant to         
subp>agraph 7,a7 %all be includ$ 9 any  
late reimbursem5t f a ?ird p>ty )\t     
requir+ ! ,secret>y to make any         
additional claim = su* int]e/4  7#d7    
7,a7 ,^u receiv+ a reque/ = additional  
in=mation by a ?ird p>ty pursuant to    
p>agraph 7#a77;,c77ii71 ! ,secret>y %all
 provide ! additional in=mation1 if     
det]m9$ relevant by ! ,secret>y1 n lat] 
?an #de days aft] receipt ( ! reque/ =  
additional in=mation4  7,b7 ,failure to 
furni% relevant in=mation )9 ! "t       
requir$ "u subp>agraph 7,a7 %all n      
invalidate or r$uce any claim 9         
connection ) su* in=mation4  7,c7 7i7 ,n
 lat] ?an #ae days aft] receipt (       
additional relevant in=mation "u        
subp>agraph 7,a71 a ?ird p>ty %all pay a
 clean claim 9 accordance ) ?is         
subsection or s5d a writt5 or electronic
 notice t--  7,i7 su* ?ird p>ty refuses 

to reimburse all or "p ( ! claim2 &     
7,,ii7 specifies ea* reason = refusal to
 pay4  7ii7 ,any ?ird p>ty t fails to   
comply ) clause 7i7 %all pay int]e/ to !
 ,unit$ ,/ates on any am\nt ( ! claim t 
rema9s unpaid at ! rate e/abli%$ by !   
,secret>y ( ! ,treasury "u section #cgag
 ( title #ca4  7#e7 ,a ?ird p>ty %all n 
be entitl$ to reque/ a refund to correct
 a paym5t error to ! ,dep>tm5t if !     
reque/ by ! ?ird p>ty = su* paym5t      
correction is submitt$ m ?an #ah mon?s  
aft] ! date t ! ,dep>tm5t receiv$ paym5t
 f ! ?ird p>ty4  7#f7 ,any claim by !   
,dep>tm5t "u ?is section %all n be      
subject to non-,dep>tm5t claims         
processes1 policies1 or =ms4  7h7 ,!    
recov]y rights ( ! ,unit$ ,/ates "u ?is 
section are n limit$ to ! am\nts paid to
 non-,dep>tm5t provid]s & are n subject 
to non-,dep>tm5t fee s*$ules or         
non-,dep>tm5t reimbursem5t rates1       
includ+ ^? adm9i/]$ "u work]s'          
comp5sation plans or automobile accid5t 
rep>ations insurance4  7i7  7#a7 ,a ?ird

 p>ty %all-- 7,a7 det]m9e :e!r a        
recipi5t ( c>e or s]vices cov]$ by ?is  
section 7includ+ a recipi5t ^: claim is 
unresolv$7 has receiv$ b5efits "u ?is   
*apt]2 &  7,b7 submit ! in=mation       
describ$ 9 p>agraph 7#b7 ) respect to ! 
recipi5t to ! ,secret>y 9 a =m & mann]  
7includ+ frequ5cy7 specifi$ by !        
,secret>y4  7#b7 ,! in=mation requir$ to
 be submitt$ "u ?is p>agraph ) respect  
to a recipi5t ( c>e or s]vices is--     
7,a7 ! id5tity ( ! recipi5t2 &  7,b7 su*
 o!r in=mation z ! ,secret>y %all       
specify 9 ord] to enable ! ,secret>y to 
make an appropriate det]m9ation conc]n+ 
coord9ation ( b5efits1 includ+ any      
applicable recov]y claim4  7#c7 ,a ?ird 
p>ty %all submit ! in=mation requir$ "u 
p>agraph 7#a77;,b7 ) respect to a       
recipi5t ( c>e or s]vices cov]$ by ?is  
section 7includ+ a recipi5t ^: claim is 
unresolv$7 n lat] ?an #cj days1 or su*  
o!r "t p]iod z prescrib$ by ! ,secret>y1
 aft] ! date on :i* ! ?ird p>ty kn[s or 
has reason to "k t ! recipi5t has       

receiv$ b5efits "u ?is *apt]4  7#d7 ,a  
?ird p>ty %all n di/ribute proce$s ( a  
settlem5t1 judgm5t1 aw>d1 or o!r paym5t 
9 connection ) a recipi5t ( c>e or      
s]vices cov]$ by ?is section 7includ+ a 
recipi5t ^: claim is unresolv$71        
reg>dless ( :e!r !re has be5 a          
det]m9ation or admission ( liability1   
)\t satisfaction ( a claim by !         
,dep>tm5t4  7j7  7#a7 ,a ?ird p>ty t    
fails to comply ) ! requirem5ts "u ?is  
section1 includ+ any regulations        
prescrib$ to implem5t ?is section1 )    
respect to any individual receiv+ c>e   
furni%$ or paid = by ! ,dep>tm5t z      
describ$ 9 ?is section1 %all be subject 
to a civil p5alty 9 an am\nt publi%$ on 
a website ( ! ,dep>tm5t = ea* day (     
noncompliance ) respect to ea* claim    
violation4 ,a civil p5alty "u ?is       
p>agraph %all be 9 addition to any o!r  
p5alties prescrib$ by law4  7#b7 7,a7 ,a
 ?ird p>ty t willfully fails or refuses 
to pay a clean claim "u ?is section1    
includ+ any regulations prescrib$ to    

implem5t ?is section1 ) respect to any  
individual receiv+ c>e furni%$ or paid =
 by ! ,dep>tm5t z describ$ 9 ?is        
section1 %all be subject to pay+ ! high]
 ( triple ! am\nt ( ! claim or an am\nt 
n to exce$ #ej1jjj1 :i* may be adju/$ = 
inflation1 = ea* claim violation4  7,b7 
,a p5alty "u subp>agraph 7,a7 is 9      
addition to any o!r p5alty "u ?is       
subsection & any o!r p5alty prescrib$ by
 law4  7,c7 ,be=e en=c+ any p5alty "u   
?is p>agraph ) respect to a ?ird p>ty1 !
 ,secret>y %all provide to ! ?ird p>ty  
writt5 notice ( ! am\nt due & a #cj-;day
 opportunity to pay ! clean claim1      
includ+ p5alties1 int]e/s1 & co/s4  7#c7
 ,not)/&+ any o!r applicable civil or   
crim9al rem$ies1 ! ,unit$ ,/ates %all h 
a cause ( action = damages 7:i* %all be 
9 an am\nt d\ble ! am\nt o!rwise        
provid$7 9 ! case ( a ?ird p>ty t fails 
to provide paym5t1 or appropriate       
reimbursem5t1 = ! reasonable value ( !  
c>e or s]vices furni%$1 to be furni%$1  
paid =1 or to be paid = 9 accordance ) a

 clean claim4  7k7 ,not)/&+ any o!r     
provision ( law1 ! ,secret>y may        
implem5t ?is p>agraph by prescrib+      
regulations1 program in/ructions1 or    
o!rwise4  2 &  7#f7 9 subsection 7m71 z 
r$esignat$ by p>agraph 7#d7-- 7,a7 9    
p>agraph 7#c7--  7i7 9 subp>agraph 7,c71
 by /rik+ 2 or & ins]t+ a semicolon2    
7ii7 9 subp>agraph 7,d71 by /rik+ !     
p]iod at ! end & ins]t+ a semicolon2 &  
7iii7 by add+ at ! end ! foll[+ new     
subp>agraphs3  7,e7 a p]son or entity   
responsible 9 tort = damages incurr$ z a
 result ( neglig5ce2 or  7,f7 a p]son or
 entity responsible = paym5t ( m$ical   
exp5ses o!r ?an "u a heal?-plan         
contract1 includ+ m$ical exp5ses        
cov]age1 m$ical paym5ts cov]age1 or     
und]9sur$ motori/ cov]age4  2 &  7,b7 by
 add+ at ! end ! foll[+ new p>agraphs3  
7#d7 ,! t]m clean claim means a claim to
 recov] or collect reasonable *>ges "u  
subsection 7a7 t c be process$ )\t      
obta9+ additional in=mation4  7#e7 ,!   
t]m non-s]vice-connect$ disability      

includes--  7,a7 a non-s]vice-connect$  
disability1 injury1 illness1 heal? c>e  
ne$1 or condition2 &  7,b7 an           
aggravation or exac]bation ( a          
s]vice-connect$ disability4  4