in subsection (a)(2), by striking the reason for denying the claim and what, if any, additional information is required to process the claim and inserting the reason for denying the claim and request additional missing information, if any, that is required to process the claim ;
by amending subsection (b) to read as follows:
(b) Submittal of claims by health care entities and providers
A health care entity or provider that furnishes hospital care, a medical service, or an extended care services under this chapter pursuant to a contract, agreement, or other arrangement shall submit to the Secretary a claim for payment for furnishing the hospital care, medical service, or extended care service not later than one year after the date on which the entity or provider furnished the hospital care, medical service, or extended care service.
No health care entity or provider may seek payment from a patient if the health care entity or provider failed to comply with the timely filing requirement set forth in paragraph (1).
in subsection (c), by adding at the end the following new paragraph:
If the Secretary determines, based on reliable evidence, that a health care entity or provider has submitted or caused to be submitted a fraudulent claim for payment under this chapter, the Secretary may suspend such entity or provider from furnishing hospital care, medical services, or extended care services under this chapter.
Before imposing a suspension under subparagraph (A) with respect to an entity or provider, the Secretary shall—
provide written notice to the entity or provider identifying the basis for the proposed suspension;
afford the entity or provider an opportunity to respond within a period of 30 days; and
consider any evidence or explanation submitted by the entity or provider.
The Secretary shall take all necessary actions to resolve a suspension under subparagraph (A) as soon as possible but not longer than within one year of the date of the beginning of the suspension, unless the Secretary determines and provides a written determination that an extension beyond one year is strictly necessary to protect the interests of veterans and taxpayers and to preserve the integrity of the health care delivery system of the Department.
Any extension under clause (i) of a suspension shall—
The Secretary shall establish procedures for reinstatement of an entity or provider suspended under subparagraph (A) following the resolution of any fraud-related investigation or proceeding.
The Secretary shall coordinate actions under this paragraph with the Office of Inspector General of the Department.
The Secretary shall prescribe regulations to carry out this paragraph, including standards of evidence, notice, and appeal procedures.
Not less frequently than quarterly, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a written notification of the suspensions entered into, if any, during the preceding quarter that includes—
The Secretary shall provide to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives, upon request, all records, memoranda, and communications relevant to any suspension or reinstatement action taken under this paragraph, in accordance with applicable laws related to privacy, ongoing investigations, or sensitive law enforcement information.
Failure by the Secretary to provide notice under clause (i) shall be treated as a failure to comply with a statutory reporting requirement.