View Rule

This proposal addresses a problem elevated to the Office of Management and Budget in 2020, where approximately $12 million in duplicate payments were made by the Department of Defense (DoD) and the Department of Veterans Affairs (VA) for DoD/VA dual-eligible patients who received healthcare services in the private sector. This change to the current definition of double coverage plans allows DoD to recoup payments made once informed that the beneficiary was referred for care by the VA to the private sector and that the corresponding claim was rightfully paid by the VA. The revised language would provide DoD with the relief necessary to recoup duplicate payments if a VA authorization/referral is present, thereby maximizing Federal appropriations in support of patient care.