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H.R. 5261IntroducedHouse · nowSenatePresidentLawIn committee
Sec. 2 · H.R. 5261

Modification of limitation on reimbursement for emergency treatment of amounts owed to a third party or for which the veteran is responsible under a health-plan contract

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(a) In general Section 1725(c)(4)(D) of title 38, United States Code, is amended— (1) by striking The Secretary and inserting (i) The Secretary; (2) in clause (i), as designated by paragraph (1), by striking or similar payment and inserting of less than $100; and (3) by adding at the end the following new clause: (ii) In this subparagraph, the term copayment means a fixed amount paid by an individual for a covered health service received by the individual and does not include any amount paid for a deductible or coinsurance.. (b) Application of amendment The amendments made by subsection (a) shall apply with respect to any reimbursement claim under section 1725 of such title submitted to the Department of Veterans Affairs for emergency treatment furnished on or after February 1, 2012, including any such claim submitted by a member of the certified class seeking relief in Wolfe v. McDonough, No. 18–6091 (U.S. Vet. App.). (c) Definitions In this section: (1) The terms emergency treatment and health-plan contract have the meanings given those terms in section 1725(f) of title 38, United States Code. (2) The term reimbursement claim includes any claim by a veteran for reimbursement of a copayment, deductible, coinsurance, or any other type of cost share for emergency treatment furnished to the veteran in a non-Department of Veterans Affairs facility and made by a veteran who had coverage under a health-plan contract, including any claim for the reasonable value of emergency treatment that was rejected or denied by the Department of Veterans Affairs, whether the rejection or denial was final or not.