[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3483 Introduced in House (IH)]
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119th CONGRESS
1st Session
H. R. 3483
To amend title 38, to direct the Secretary of Veterans Affairs to use
an information technology system to detect fraud, waste, and abuse
regarding claims for payment submitted to the Secretary under the
Veterans Community Care Program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 19, 2025
Mr. Barrett introduced the following bill; which was referred to the
Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To amend title 38, to direct the Secretary of Veterans Affairs to use
an information technology system to detect fraud, waste, and abuse
regarding claims for payment submitted to the Secretary under the
Veterans Community Care Program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Forcing Real Accountability for
Unlawful Distributions Act of 2025'' or the ``FRAUD Act of 2025''.
SEC. 2. INFORMATION TECHNOLOGY SYSTEM TO DETECT FRAUD, WASTE, AND ABUSE
CLAIMS UNDER THE VETERANS COMMUNITY CARE PROGRAM.
(a) In General.--Subsection (f) of section 1703D of title 38,
United States Code, is amended--
(1) in paragraph (1)--
(A) by striking ``paragraph (1)'' each place it
appears and inserting ``subparagraph (A)'';
(B) by inserting ``(A)'' before ``The Secretary'';
and
(C) by redesignating paragraphs (2) and (3) as
subparagraphs (B) and (C), respectively; and
(2) by adding at the end the following new paragraph:
``(2)(A) The Secretary shall use an information technology system
to--
``(i) analyze a claim submitted to the Secretary--
``(I) by a health care entity or provider that
furnishes hospital care, medical services, or extended
care services under this chapter; and
``(II) through the health care claims enterprise
solution
``(ii) detect whether such claim is a fraudulent claim, an
overpayment, or other fraud, waste, or abuse.
``(B) The information technology system under this paragraph shall
include the following functions:
``(i) Continuous monitoring of claims to detect patterns
that may indicate fraud, waste, or abuse.
``(ii) Analysis of historical and real-time claims data to
identify and predict potential fraudulent claims.
``(iii) Ready-made analytic models to identify and analyze
fraudulent claims.
``(iv) Post-payment analysis for overuse of services or
other practices that create unnecessary costs to the
Department.
``(v) Integration with existing claims processing systems
and technologies of the Department.
``(vi) Logging, storage, analysis, and reports regarding
the nature, frequency, and financial impact of detected
fraudulent claims.
``(vii) Identification of, and machine learning that is
based on, patterns of fraudulent claims in order to reduce
false positives and predict new forms of fraud.
``(viii) Updates to detect new models of fraud, waste and
abuse.
``(ix) Any other function determined necessary by the
Secretary.
``(C) To carry out this paragraph, the Secretary shall use funds
from the Department of Veterans Affairs franchise fund established
under title I of Public Law 104-204 (38 U.S.C. 301 note).
``(D) Not later than two years after the date of the enactment of
the FRAUD Act of 2025 and annually thereafter through the day described
in subparagraph (E), the Secretary shall submit to the Committees on
Veterans' Affairs of the Senate and House of Representatives a report
regarding the operation of such information technology system during
the preceding year. Each such report shall include the following
elements:
``(i) The effectiveness of the information technology
system in performing the functions described in subparagraph
(B).
``(ii) The estimated savings to the Department arising from
the use of the information technology system.
``(iii) Any plans to enhance, modify, or add new
capabilities to the information technology system.
``(E) This paragraph shall cease to be effective on the day that is
seven years after the date of the enactment of the FRAUD Act of 2025.
``(F) In this paragraph:
``(i) The term `Community Care Network' means a network
established under section 1703(h) of this title.
``(ii) The term `health care claims enterprise solution'
means the information technology used by the Secretary to
process a claim submitted under this chapter by a health care
entity or provider that is not part of a Community Care
Network.''.
(b) Implementation Date.--The Secretary shall carry out the
amendments made by this section not later than one year after the date
of the enactment of this Act.
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