II 111th CONGRESS 1st Session S. 404 IN THE SENATE OF THE UNITED STATES February 10, 2009 Mr. Akaka (for himself and Mr. Burris) introduced the following bill; which was read twice and referred to the Committee on Veterans' Affairs A BILL To amend title 38, United States Code, to expand veteran eligibility for reimbursement by the Secretary of Veterans Affairs for emergency treatment furnished in a non-Department facility, and for other purposes.

1.

Short title

This Act may be cited as the Veterans' Emergency Care Fairness Act of 2009.

2.

Expansion of veteran eligibility for reimbursement by Secretary of Veterans Affairs for emergency treatment furnished in a non-Department facility

(a)

Expansion of eligibility

Subsection (b)(3)(C) of section 1725 of title 38, United States Code, is amended by striking , in whole or in part,. (b)

Limitations on reimbursement

Such section 1725 is further amended— (1)in subsection (c), by adding at the end the following new paragraph: (4)(A)If the veteran has contractual or legal recourse against a third party that would, in part, extinguish the veteran’s liability to the provider of the emergency treatment and payment for the treatment may be made both under subsection (a) and by the third party, the amount payable for such treatment under such subsection shall be the amount by which the costs for the emergency treatment exceed the amount payable or paid by the third party, except that the amount payable may not exceed the maximum amount payable established under paragraph (1)(A). (B)In any case in which a third party is financially responsible for part of the veteran’s emergency treatment expenses, the Secretary shall be the secondary payer. (C)A payment in the amount payable under subparagraph (A) shall be considered payment in full and shall extinguish the veteran’s liability to the provider. (D)The Secretary may not reimburse a veteran under this section for any copayment or similar payment that the veteran owes the third party or for which the veteran is responsible under a health-plan contract. ; and (2)in subsection (f)(3)— (A)in subparagraph (A), by inserting before the period at the end the following: , including the Secretary of Health and Human Services with respect to the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) and the Medicaid program under title XIX of such Act (42 U.S.C. 1396 et seq.); and (B)in subparagraph (B), by inserting before the period at the end the following: , including a State Medicaid agency with respect to payments made under a State plan for medical assistance approved under title XIX of such Act (42 U.S.C. 1396 et seq.). (c)

Effective date

(1)

In general

The amendments made by subsections (a) and (b) shall take effect on the date of the enactment of this Act, and shall apply with respect to emergency treatment furnished on or after the date of the enactment of this Act. (2)

Reimbursement for treatment before effective date

The Secretary may provide reimbursement under section 1725 of title 38, United States Code, as amended by subsection (a) and (b) for emergency treatment furnished before the date of the enactment of this Act if the Secretary determines that, under the circumstances applicable with respect to the veteran, it is appropriate to do so.