H. Rpt. 119-371 accompanies veterans affairs legislation titled "Stop Troubling Retroactive Invoices for Veteran Expenses Act of 2025". Veterans bills address VA healthcare, disability benefits, education assistance, home loans, mental health services, or military-to-civilian transition programs. The Veterans' Affairs Committee's report documents specific improvements to veterans' services, expansion of benefits, or responses to identified problems in VA programs. Veterans legislation frequently enjoys bipartisan support, though reports may still contain different views on implementation and funding.
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House Report 119-371 - STOP TROUBLING RETROACTIVE INVOICES FOR VETERAN EXPENSES ACT OF 2025
[House Report 119-371]
[From the U.S. Government Publishing Office]
119th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 119-371
======================================================================
STOP TROUBLING RETROACTIVE INVOICES FOR VETERAN EXPENSES ACT OF 2025
_______
November 7, 2025.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Bost, from the Committee on Veterans' Affairs, submitted the
following
R E P O R T
[To accompany H.R. 3812]
[Including cost estimate of the Congressional Budget Office]
The Committee on Veterans' Affairs, to whom was referred
the bill (H.R. 3812) to amend title 38, United States Code, to
prohibit the collection of a health care copayment by the
Secretary of Veterans Affairs from a veteran under certain
conditions attributable to a failure of the Department of
Veterans Affairs to process certain information within
applicable timeliness standards, and for other purposes, having
considered the same, reports favorably thereon with an
amendment and recommends that the bill as amended do pass.
CONTENTS
Page
Purpose and Summary.............................................. 2
Background and Need for Legislation.............................. 3
Hearings......................................................... 4
Subcommittee Consideration....................................... 4
Committee Consideration.......................................... 4
Committee Votes.................................................. 5
Committee Oversight Findings..................................... 5
Statement of General Performance Goals and Objectives............ 5
Earmarks and Tax and Tariff Benefits............................. 5
Committee Cost Estimate.......................................... 5
Budget Authority and Congressional Budget Office Estimate........ 5
Federal Mandates Statement....................................... 8
Advisory Committee Statement..................................... 8
Applicability to Legislative Branch.............................. 8
Statement on Duplication of Federal Programs..................... 8
Section-by-Section Analysis of the Legislation................... 8
Changes in Existing Law Made by the Bill, as Reported............ 9
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Stop Troubling Retroactive Invoices
for Veteran Expenses Act of 2025'' or the ``STRIVE Act of 2025''.
SEC. 2. PROHIBITION ON COLLECTION OF HEALTH CARE COPAYMENTS BY THE
SECRETARY OF VETERANS AFFAIRS UNDER CERTAIN
CONDITIONS; AUTHORITY OF THE SECRETARY TO WAIVE
HEALTH CARE COPAYMENTS.
(a) In General.--Subchapter III of chapter 17 of title 38, United
States Code, is amended by inserting after section 1722C the following
new section:
``Sec. 1722D. Copayments: prohibitions on collection under certain
conditions; waiver authority
``(a) In General.--Notwithstanding subsections (f) and (g) of section
1710 of this title, section 1722A(a) of this title, section 1725A of
this title, or any other provision of law requiring an individual to
make a copayment to the Secretary, the Secretary may not require a
veteran to make any copayment for the receipt of hospital care or
medical services under the laws administered by the Secretary after the
end of the two-year period beginning on the date such veteran received
such hospital care or medical services if the Secretary failed to
provide the veteran notice--
``(1) of the copayment within applicable timeliness standards
established by the Secretary; or
``(2) that the aggregate amount of copayments for such care
or services the veteran owes to the Secretary is greater than
the dollar amount described in paragraph (1) of subsection (b).
``(b) Dollar Amount Described.--(1) The dollar amount described in
this paragraph is $2,000.
``(2) On the first day of each fiscal year beginning after the date
of the enactment of the STRIVE Act of 2025, the Secretary shall,
increase the dollar amount described in paragraph (1) by a percentage
equal to the percentage by which the Consumer Price Index (all items,
United States city average) increased during the previous fiscal year.
In the event that such index does not increase during such period, the
Secretary shall maintain the dollar amount in effect under paragraph
(1) during the previous fiscal year.
``(c) Waiver Authority.--The Secretary may waive the requirement for
a veteran to make any copayment for the receipt of such hospital care
or medical services in any case in which the Secretary determines such
a waiver would be appropriate, without regard to whether the veteran
submits to the Secretary a request for such waiver.''.
(b) Clerical Amendment.--The table of sections at the beginning of
such chapter is amended by inserting after the item relating to section
1722C the following new item:
``1722D. Copayments: prohibition on collection of under certain
conditions; waiver authority; waiver authority.''.
SEC. 3. EXTENSION OF CERTAIN LIMITS ON PAYMENTS OF PENSION.
Section 5503(d)(7) of title 38, United States Code, is amended by
striking ``November 30, 2031'' and inserting ``February 29, 2032''.
Purpose and Summary
H.R. 3812, the ``Stop Troubling Retroactive Invoices for
Veteran Expenses Act of 2025'' or the ``STRIVE Act of 2025,''
was introduced by Representative Adam Gray of California on
June 6, 2025. This bill would prohibit the Department of
Veterans Affairs (VA) from collecting copayments after two
years of a veteran receiving care or services, if VA failed to
provide timely notices to the veteran of the copayment within
applicable timeliness standards established by the VA
Secretary. This bill would also give the VA Secretary the
authority to waive any copayment, even if the veteran did not
request a waiver.
Background and Need for Legislation
Section 1: Short Title
This Act may be cited as the ``Stop Troubling Retroactive
Invoices for Veteran Expenses Act of 2025'' or the ``STRIVE Act
of 2025.''
Section 2: Prohibition on collection of health care copayments by the
Secretary of Veterans Affairs under certain conditions;
authority of the Secretary to waive health care copayments
The Committee has received notice of several situations
where veterans facing potentially financially burdensome
copayments following a VA decision or error might have
benefitted from the policies that would be implemented under
this section. For example, in February 2023, the Program
Integrity Tool (PIT), a consolidated post-payment data
repository for community care claims data, was taken offline to
address issues with data integrity and accuracy. The PIT was
ultimately paused for 17 months, resulting in significant copay
amendments for some veterans for care dating back nearly two
years.
Further, in October 2020, VA deployed its new electronic
health record at the Mann-Grandstaff VA Medical Center. At the
time of deployment, the system was unable to collect certain
copayments, like those related to pharmacy charges. This issue
took over four years to rectify, potentially making veterans
liable for years' worth of copays. The Committee intends this
section to cover situations such as delayed payments from the
COVID copay relief expirations, delayed emergency bills, and
other IT system failures.
This section would prohibit the Secretary from collecting
copayments, or copays, from veterans (``first party copays'')
in specific situations where the collection delay is due to a
fault of VA. Such faults might include a policy proposal, like
a pause in collections, an IT system failure, or an employee
administrative error. The Committee believes that this would
protect veterans from paying copays that are 1) billed for care
that is over two years old; or 2) exceed $2,000. This section
would not cover copays that may accrue from the veteran not
paying their own bill--only cases where the copay bills were
paused due to a VA decision or error.
This section would also provide VA with the authority to
enter copay waivers for veterans. Under current law, veterans
must individually initiate a request for a waiver for
burdensome copay amounts. At the end of 2024, VA entered into
regulatory actions to allow VA to enter these waivers on the
veterans' behalf, though VA reports that this regulation is
still ``many months from potential enactment,'' and has
informed Congress that it would welcome ``direct legislative
action on this matter.'' This section would be responsive to
that request and provide the Secretary that authority. It is
important to note that the section, as written, would provide
the Secretary with the authority to waive copayments and
provide veterans with financial relief, but the use of this
authority would not be required.
Section 3: Extension of Certain Limits on Payments of Pension
Under current law (38 U.S.C. Sec. 5503(d)), the amount of
VA pension paid to a veteran with no spouse or child, a
veterans' surviving spouse with no child, or a veteran's child
who are admitted to a VA or Medicaid sponsored nursing facility
is capped at $90 a month. This section would cover the costs of
this bill by extending this pension limitation by one month to
February 29, 2032. Because they receive government sponsored
care in a nursing home, these pension beneficiaries do not
require the full amount of pension to cover their cost of
living. The Committee believes this short-term extension of the
current limit on pension payments is a reasonable way to cover
the costs associated with this bill.
Hearings
On June 11, 2025, the Committee on Veterans' Affairs
Subcommittee on Oversight and Investigations held a legislative
hearing on H.R. 3812 and other bills pending before the
subcommittee.
The following witnesses testified:
Ms. Laura Duke, Chief Financial Officer, Veterans
Health Administration, U.S. Department of Veterans
Affairs; Dr. Jennifer McDonald, Director, Community
Care Division, Office of Audits and Evaluations, Office
of Inspector General, U.S. Department of Veterans
Affairs; Dr. Toni Phillips, Chief Nurse Informatics
Officer, Electronic Health Record Management
Information Office, U.S. Department of Veterans
Affairs; Ms. Cherri Waters, Acting Deputy Chief
Information Officer and Executive Director, Health
Portfolio, Office of Information and Technology, U.S.
Department of Veterans Affairs; Mr. Cody Carbone, Chief
Executive Officer, The Digital Chamber; Mr. Cole T.
Lyle, The American Legion; and Dr. Edward O'Bryan,
Chief, Veterans and Corrections ICCE, Associate
Professor of Medicine Medical, University of South
Carolina.
The following individuals and organizations submitted
statements for the record:
Representative Scott Franklin of Florida,
Representative Ken Calvert of California, and Concerned
Veterans for America.
Subcommittee Consideration
There was no subcommittee consideration of H.R. 3812.
Committee Consideration
On July 23, 2025, the full Committee met in an open markup
session, a quorum being present to consider H.R. 3812. During
consideration of the bill, the following amendments were
considered:
An amendment in the nature of a substitute was
offered by Representative Ramirez of Illinois that
would create a new section 1722D under Title 38 that
would prohibit the Secretary from collecting copays
from veterans under certain conditions of monetary
value and timeliness. The amendment in the nature of a
substitute also would index the monetary copayment
limit of $2,000 to annual inflationary changes in the
Consumer Price Index, and would offset the cost of the
bill using the pension offset. This amendment in the
nature of a substitute was agreed to by voice vote.
A motion by Ranking Member Takano of California to report
H.R. 3812, as amended, favorably to the House of
Representatives, was agreed to by voice vote.
Committee Votes
In compliance with clause 3(b) of rule XIII of the Rules of
the House of Representatives, no recorded votes were taken on
amendments or in connection with ordering H.R. 3812, as
amended, reported favorably to the House.
Committee Oversight Findings
In compliance with clause 3(c)(1) of rule XIII and clause
(2)(b)(1) of rule X of the Rules of the House of
Representatives, the Committee's oversight findings and
recommendations are reflected in the descriptive portions of
this report.
Statement of General Performance Goals and Objectives
In accordance with clause 3(c)(4) of rule XIII of the Rules
of the House of Representatives, the Committee's performance
goals and objectives of H.R. 3812, as amended, are to protect
veterans from substantial and unexpected financial burdens that
may be placed on them due to delayed copayment bills following
a Departmental decision or error.
Earmarks and Tax and Tariff Benefits
H.R. 3812, as amended, does not contain any Congressional
earmarks, limited tax benefits, or limited tariff benefits as
defined in clause 9 of rule XXI of the Rules of the House of
Representatives.
Committee Cost Estimate
The Committee adopts as its own the Congressional Budget
Office cost estimate on this measure.
Budget Authority and Congressional Budget Office Cost Estimate
Pursuant to clause 3(c)(3) of rule XIII of the Rules of the
House of Representatives, the following is the cost estimate
for H.R. 3812, as amended, provided by the Director of the
Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974:
The bill would:
Prohibit the Department of Veterans Affairs
(VA) from collecting copayments more than two years
after a veteran receives health care services
Extend the reduction of pensions that VA
pays to veterans and survivors residing in Medicaid
nursing homes
Estimated budgetary effects would mainly stem from:
Reducing collections of copayments
Reducing pension payments
Bill summary: H.R. 3812 would generally prohibit the
Department of Veterans Affairs (VA) from collecting copayments
more than two years after a veteran receives health care
services. The bill also would extend a temporary limitation on
certain pension payments through February 29, 2032.
Estimated Federal cost: The estimated budgetary effects of
H.R. 3812 are shown in Table 1. The costs of the legislation
fall within budget functions 550 (health) and 700 (veterans
benefits and services).
TABLE 1.--ESTIMATED BUDGETARY EFFECTS OF H.R. 3812
--------------------------------------------------------------------------------------------------------------------------------------------------------
By fiscal year, millions of dollars--
-------------------------------------------------------------------------------------------------
2026- 2026-
2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2030 2035
--------------------------------------------------------------------------------------------------------------------------------------------------------
Increases in Spending Subject to Appropriation
Estimated Authorization............................... 1 1 1 1 1 1 1 1 1 1 5 10
Estimated Outlays..................................... 1 1 1 1 1 1 1 1 1 1 5 10
Decreases (-) in Direct Spending
Estimated Budget Authority............................ 0 0 0 0 0 0 -12 0 0 0 0 -12
Estimated Outlays..................................... 0 0 0 0 0 0 -12 0 0 0 0 -12
--------------------------------------------------------------------------------------------------------------------------------------------------------
Basis of estimate: For this estimate, CBO assumes that H.R.
3812 will be enacted near the beginning of fiscal year 2026 and
that outlays will follow historical spending patterns for
affected programs.
Spending subject to appropriation: H.R. 3812 would reduce
VA's collections of copayments and thereby increase spending
subject to appropriation. Copayments are deposited into the
Medical Care Collections Fund and are classified as
discretionary offsetting collections (that is, as reductions in
discretionary spending).
The bill would prohibit VA from collecting copayments more
than two years after a veteran receives care if the department
fails to provide timely notification of the veteran's
obligation or if their outstanding balance exceeds $2,000.
According to VA, most copayments are billed and paid within two
years. On the basis of information about annual collections of
copayments, CBO estimates that, under H.R. 3812, those
collections would decrease by $1 million annually.
Those forgone copayments, which would be recorded as
increases in discretionary spending, would total $10 million
over the 2026-2035 period. The authority to collect copayments
is subject to the enactment of appropriation legislation.
Direct spending: H.R. 3812 would extend a temporary
limitation on certain VA pension payments. CBO estimates that
enacting the bill would decrease net direct spending by $12
million over the 2026-2035 period.
Under current law, VA reduces pension payments to veterans
and survivors who reside in Medicaid nursing homes to $90 per
month. That required reduction expires November 30, 2031. The
bill would extend that reduction for three months, through
February 29, 2032. CBO estimates that extending that
requirement would reduce VA benefits by $10 million per month.
As a result of that reduction in beneficiaries' income,
Medicaid would pay more of the cost of their care, increasing
spending for that program by $6 million per month. Thus,
enacting the bill would reduce net direct spending by $12
million over the 2026-2035 period.
Pay-As-You-Go considerations: The Statutory Pay-As-You-Go
Act of 2010 establishes budget-reporting and enforcement
procedures for legislation affecting direct spending or
revenues. The net changes in outlays that are subject to those
pay-as-you-go procedures are shown in Table 1.
Increase in long-term net direct spending and deficits: CBO
estimates that enacting H.R. 3812 would not increase net direct
spending or on-budget deficits in any of the four consecutive
10-year periods beginning in 2036.
Mandates: The bill contains no intergovernmental or
private-sector mandates as defined in the Unfunded Mandates
Reform Act.
Estimate prepared by: Federal Costs: Noah Callahan (for
veterans' health care); Logan Smith (for pensions and
Medicaid); Mandates: Brandon Lever.
Estimate reviewed by: David Newman, Chief, Defense,
International Affairs, and Veterans' Affairs Cost Estimates
Unit; Kathleen FitzGerald, Chief, Public and Private Mandates
Unit; Christina Hawley Anthony, Deputy Director of Budget
Analysis.
Estimate approved by: Phillip L. Swagel, Director,
Congressional Budget Office.
Federal Mandates Statement
Section 423 of the Congressional Budget and Impoundment
Control Act (as amended by Section 101(a)(2) of the Unfunded
Mandate Reform Act, P.L. 104-4) is inapplicable to H.R. 3812,
as amended.
Advisory Committee Statement
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act would be created by H.R.
3812, as amended.
Applicability to Legislative Branch
The Committee finds that H.R. 3812, as amended, does not
relate to the terms and conditions of employment or access to
public services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
Statement on Duplication of Federal Programs
Pursuant to clause 3(c)(5) of rule XIII of the Rules of the
House of Representatives, the Committee finds that no provision
of H.R. 3812, as amended, would establish or reauthorize a
program of the Federal Government known to be duplicative of
another Federal program, a program that was included in any
report from the Government Accountability Office to Congress
pursuant to section 21 of Public Law 111-139, or a program
related to a program identified in the most recent Catalog of
Federal Domestic Assistance.
Section-by-Section Analysis of the Legislation
Section 1: Short title
This Act may be cited as the ``Stop Troubling Retroactive
Invoices for Veteran Expenses Act of 2025'' or the ``STRIVE Act
of 2025.''
Section 2: Prohibition on collection of health care copayments by the
Secretary of Veterans Affairs under certain conditions;
authority of the Secretary to waive health care copayments
This section would amend subchapter III of chapter 17 of
title 38, United States Code, to include certain prohibitions
on when the VA Secretary may collect copayments from veterans.
This section would prohibit the VA Secretary from
collecting copayments from hospital care or medical services
from veterans that have occurred more than two years prior, or
exceed an amount of $2,000, and allows the threshold for claims
relief to increase with inflation.
Finally, this section would authorize the VA Secretary to
waive copays for hospital care or medical services on behalf of
impacted veterans.
Section 3: Extension of certain limits on payments of pension
This section would extend the termination date of
limitations on VA pension payments to institutionalized
beneficiaries by amending 38 U.S.C. Sec. 5503(d)(7), changing
the expiration from November 30, 2031, to February 29, 2032.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, existing law in which no change
is proposed is shown in roman):
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, and existing law in which no
change is proposed is shown in roman):
TITLE 38, UNITED STATES CODE
* * * * * * *
PART II--GENERAL BENEFITS
* * * * * * *
CHAPTER 17--HOSPITAL, NURSING HOME, DOMICILIARY, AND MEDICAL CARE
SUBCHAPTER I--GENERAL
Sec.
1701. Definitions.
* * * * * * *
SUBCHAPTER III--MISCELLANEOUS PROVISIONS RELATING TO HOSPITAL AND
NURSING HOME CARE AND MEDICAL TREATMENT OF VETERANS
* * * * * * *
1722D. Copayments: prohibitions on collection under certain conditions;
waiver authority.
* * * * * * *
SUBCHAPTER III--MISCELLANEOUS PROVISIONS RELATING TO HOSPITAL AND
NURSING HOME CARE AND MEDICAL TREATMENT OF VETERANS
* * * * * * *
Sec. 1722D. Copayments: prohibitions on collection under certain
conditions; waiver authority
(a) In General.--Notwithstanding subsections (f) and (g) of
section 1710 of this title, section 1722A(a) of this title,
section 1725A of this title, or any other provision of law
requiring an individual to make a copayment to the Secretary,
the Secretary may not require a veteran to make any copayment
for the receipt of hospital care or medical services under the
laws administered by the Secretary after the end of the two-
year period beginning on the date such veteran received such
hospital care or medical services if the Secretary failed to
provide the veteran notice--
(1) of the copayment within applicable timeliness
standards established by the Secretary; or
(2) that the aggregate amount of copayments for such
care or services the veteran owes to the Secretary is
greater than the dollar amount described in paragraph
(1) of subsection (b).
(b) Dollar Amount Described.--(1) The dollar amount described
in this paragraph is $2,000.
(2) On the first day of each fiscal year beginning after the
date of the enactment of the STRIVE Act of 2025, the Secretary
shall, increase the dollar amount described in paragraph (1) by
a percentage equal to the percentage by which the Consumer
Price Index (all items, United States city average) increased
during the previous fiscal year. In the event that such index
does not increase during such period, the Secretary shall
maintain the dollar amount in effect under paragraph (1) during
the previous fiscal year.
(c) Waiver Authority.--The Secretary may waive the
requirement for a veteran to make any copayment for the receipt
of such hospital care or medical services in any case in which
the Secretary determines such a waiver would be appropriate,
without regard to whether the veteran submits to the Secretary
a request for such waiver.
* * * * * * *
PART IV--GENERAL ADMINISTRATIVE PROVISIONS
* * * * * * *
CHAPTER 55--MINORS, INCOMPETENTS, AND OTHER WARDS
* * * * * * *
Sec. 5503. Hospitalized veterans and estates of incompetent
institutionalized veterans
(a)(1)(A) Where any veteran having neither spouse nor child
is being furnished domiciliary care by the Department, no
pension in excess of $90 per month shall be paid to or for the
veteran for any period after the end of the third full calendar
month following the month of admission for such care.
(B) Except as provided in subparagraph (D) of this paragraph,
where any veteran having neither spouse nor child is being
furnished nursing home care by the Department, no pension in
excess of $90 per month shall be paid to or for the veteran for
any period after the end of the third full calendar month
following the month of admission for such care. Any amount in
excess of $90 per month to which the veteran would be entitled
but for the application of the preceding sentence shall be
deposited in a revolving fund at the Department medical
facility which furnished the veteran nursing care, and such
amount shall be available for obligation without fiscal year
limitation to help defray operating expenses of that facility.
(C) No pension in excess of $90 per month shall be paid to or
for a veteran having neither spouse nor child for any period
after the month in which such veteran is readmitted for care
described in subparagraph (A) or (B) of this paragraph and
furnished by the Department if such veteran is readmitted
within six months of a period of care in connection with which
pension was reduced pursuant to subparagraph (A) or (B) of this
paragraph.
(D) In the case of a veteran being furnished nursing home
care by the Department and with respect to whom subparagraph
(B) of this paragraph requires a reduction in pension, such
reduction shall not be made for a period of up to three
additional calendar months after the last day of the third
month referred to in such subparagraph if the Secretary
determines that the primary purpose for the furnishing of such
care during such additional period is for the Department to
provide such veteran with a prescribed program of
rehabilitation services, under chapter 17 of this title,
designed to restore such veteran's ability to function within
such veteran's family and community. If the Secretary
determines that it is necessary, after such period, for the
veteran to continue such program of rehabilitation services in
order to achieve the purposes of such program and that the
primary purpose of furnishing nursing home care to the veteran
continues to be the provision of such program to the veteran,
the reduction in pension required by subparagraph (B) of this
paragraph shall not be made for the number of calendar months
that the Secretary determines is necessary for the veteran to
achieve the purposes of such program.
(2) The provisions of paragraph (1) shall also apply to a
veteran being furnished such care who has a spouse but whose
pension is payable under section 1521(b) of this title. In such
a case, the Secretary may apportion and pay to the spouse, upon
an affirmative showing of hardship, all or any part of the
amounts in excess of the amount payable to the veteran while
being furnished such care which would be payable to the veteran
if pension were payable under section 1521(c) of this title.
(b) Notwithstanding any other provision of this section or
any other provision of law, no reduction shall be made in the
pension of any veteran for any part of the period during which
the veteran is furnished hospital treatment, or institutional
or domiciliary care, for Hansen's disease, by the United States
or any political subdivision thereof.
(c) Where any veteran in receipt of an aid and attendance
allowance described in subsection (r) or (t) of section 1114 of
this title is hospitalized at Government expense, such
allowance shall be discontinued from the first day of the
second calendar month which begins after the date of the
veteran's admission for such hospitalization for so long as
such hospitalization continues. Any discontinuance required by
administrative regulation, during hospitalization of a veteran
by the Department, of increased pension based on need of
regular aid and attendance or additional compensation based on
need of regular aid and attendance as described in subsection
(l) or (m) of section 1114 of this title, shall not be
effective earlier than the first day of the second calendar
month which begins after the date of the veteran's admission
for hospitalization. In case a veteran affected by this
subsection leaves a hospital against medical advice and is
thereafter admitted to hospitalization within six months from
the date of such departure, such allowance, increased pension,
or additional compensation, as the case may be, shall be
discontinued from the date of such readmission for so long as
such hospitalization continues.
(d)(1) For the purposes of this subsection--
(A) the term ``Medicaid plan'' means a State plan for
medical assistance referred to in section 1902(a) of
the Social Security Act (42 U.S.C. 1396a(a)); and
(B) the term ``nursing facility'' means a nursing
facility described in section 1919 of such Act (42
U.S.C. 1396r), other than a facility that is a State
home with respect to which the Secretary makes per diem
payments for nursing home care pursuant to section
1741(a) of this title.
(2) If a veteran having neither spouse nor child is covered
by a Medicaid plan for services furnished such veteran by a
nursing facility, no pension in excess of $90 per month shall
be paid to or for the veteran for any period after the month of
admission to such nursing facility.
(3) Notwithstanding any provision of title XIX of the Social
Security Act, the amount of the payment paid a nursing facility
pursuant to a Medicaid plan for services furnished a veteran
may not be reduced by any amount of pension permitted to be
paid such veteran under paragraph (2) of this subsection.
(4) A veteran is not liable to the United States for any
payment of pension in excess of the amount permitted under this
subsection that is paid to or for the veteran by reason of the
inability or failure of the Secretary to reduce the veteran's
pension under this subsection unless such inability or failure
is the result of a willful concealment by the veteran of
information necessary to make a reduction in pension under this
subsection.
(5)(A) The provisions of this subsection shall apply with
respect to a surviving spouse having no child in the same
manner as they apply to a veteran having neither spouse nor
child.
(B) The provisions of this subsection shall apply with
respect to a child entitled to pension under section 1542 of
this title in the same manner as they apply to a veteran having
neither spouse nor child.
(6) The costs of administering this subsection shall be paid
for from amounts available to the Department of Veterans
Affairs for the payment of compensation and pension.
(7) This subsection expires on [November 30, 2031] February
29, 2032.
* * * * * * *