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S. 2145IntroducedSenate · nowHousePresidentLawIn committee
Sec. 2 · S. 2145

Cost-recovery from Medicare Advantage and Medicare prescription drug plans

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(a) Cost recovery (1) In general Subchapter III of chapter 17 of title 38, United States Code, is amended by inserting after section 1729B the following new section: 1729C. Cost-recovery from Medicare Advantage and Medicare prescription drug plans (a) In general Notwithstanding sections 1814(c), 1835(d), and 1862(a)(3) of the Social Security Act (42 U.S.C. 1395f(c), 1395n(d), and 1395y(a)(3)), if the Secretary provides under this chapter any health care item or service (including for a service-connected disability or a non-service-connected disability) covered under the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.), including outpatient and inpatient care, prescription drugs, medical devices, lab testing, and items or services delivered in post-acute and long-term care settings, to any individual who is enrolled in a Medicare Advantage plan, including an MA–PD plan, offered by a MA organization under part C of such title or a prescription drug plan offered by a PDP sponsor under part D of such title, such organization or sponsor shall, to the extent such item or service is covered under such Medicare Advantage plan or prescription drug plan, reimburse the Secretary for such item or service regardless of any additional documentation, utilization management, or other administrative requirement the plan may impose on the item or service. (b) Recovery of amounts (1) In general The Secretary shall recover amounts required to be reimbursed under subsection (a) through the use of procedures under section 1729 of this title to the same extent as those procedures are used to recover amounts authorized to be recovered under that section. (2) Amount and process Except as provided in paragraph (1), recovery under that paragraph of amounts reimbursed under subsection (a) shall be in such an amount, and occur in accordance with such procedures, as the Secretary shall prescribe for purposes of this section. (c) Application The provisions of subsection (a) shall apply to Medicare Advantage and prescription drug plan years beginning on or after January 1, 2026. (d) Treatment of amounts Amounts reimbursed to the Secretary under subsection (a) shall be deposited in the Department of Veterans Affairs Medical Care Collections Fund under section 1729A of this title.. (2) Clerical amendment The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 1729B the following new item: 1729C. Cost-recovery from Medicare Advantage and Medicare prescription drug plans.. (b) Medicare conforming amendments (1) Part A Section 1814(c) of the Social Security Act (42 U.S.C. 1395f(c)) is amended by inserting and section 1729C of title 38, United States Code after section 1880. (2) Part B Section 1835(d) of the Social Security Act (42 U.S.C. 1395n(d)) is amended by inserting and section 1729C of title 38, United States Code after section 1880. (3) Exclusions from coverage Section 1862(a)(3) of the Social Security Act (42 U.S.C. 1395y(a)(3)) is amended by inserting in the case of items and services and prescription drugs for which reimbursement is made under section 1729C of title 38, United States Code, after section 1880(e),.

Sec. 2: Cost-recovery from Medicare Advantage and Medicare prescription drug plans · Public Law Tracker