[Congressional Record Volume 155, Number 118 (Friday, July 31, 2009)]
[Extensions of Remarks]
[Page E2122]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 MEDICARE VA REIMBURSEMENT ACT OF 2009

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                            HON. BOB FILNER

                             of california

                    in the house of representatives

                        Thursday, July 30, 2009

  Mr. FILNER. Madam Speaker, I recently introduced H.R. 3365, the 
Medicare VA Reimbursement Act of 2009. This legislation authorizes the 
establishment of a Medicare VA reimbursement program where HHS 
reimburses the VA for the provision of health care to Medicare eligible 
veterans for the treatment of non-service-connected conditions at VA 
medical facilities.
  Today, there are veterans who have earned VA health care benefits 
with their service to our country, as well as Medicare benefits, by 
paying into the Social Security system during their working years. Even 
though these individuals have clearly earned both of these benefits, 
current law unfairly prohibits them from using their Medicare benefits 
at VA facilities even though they may feel more comfortable seeking 
care among their fellow veterans from VA providers who specialize in 
caring for veterans.
  This is also inconsistent with the authorities granted to other 
Federal entities such as the Indian Health Service (IHS) and the 
Department of Defense's (DoD) TRICARE for Life that are allowed to bill 
Medicare. IHS and DoD are able to augment their resources with Medicare 
collections and reinvest the extra funding back into their programs and 
services. H.R. 3365 would provide equity in such billing practices 
among the Federal entities. In other words, the VA would be able to 
access an important new source of revenues from Medicare which may be 
reinvested to further strengthen the VA's health care system.
  In detail, this legislation requires the Secretaries of VA and HHS to 
establish a Memorandum of Understanding (MOU) no later than six months 
after the date of the enactment of the Act. The MOU must establish such 
program elements as the frequency of reimbursement, the billing system, 
the data sharing agreement, and the payment rate.
  H.R. 3365 also provides some guidelines on setting the payment rate 
so that the terms that contributed to the failure of the Medicare DoD 
Subvention Demonstration Project are not repeated again. For example, 
this legislation prohibits setting a reimbursement rate which is less 
than 100 percent of the amount that Medicare would pay a participating 
provider. It also prohibits annual caps on reimbursement and does not 
allow for a maintenance of effort requirement, which refers to the 
requirement that VA maintain a certain level of spending before they 
can be reimbursed from HHS.
  Finally, H.R. 3365 requires an annual report to Congress providing 
program data, as well as a triennial GAO report assessing the program 
impact.
  I urge the support of all Members for this important legislation.

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