[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3483 Introduced in House (IH)]

<DOC>






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.
                                 <all>