FRAUD Act of 2025

This proposal would require the Department of Veterans Affairs to use a computer system to spot fake or wasteful medical claims in the Veterans Community Care Program. It would check claims from private doctors and hospitals that treat veterans through VA’s community care network and flag fraud, overpayments, and overuse of services. The system would monitor claims continuously, analyze past and real-time data, use ready-made models and machine learning to reduce false alarms, review payments after they’re made, work with current VA systems, and keep logs and reports on what it finds.

VA would have one year after the bill becomes law to put this system in place. Starting two years after it becomes law, VA would report each year on how well the system works, how much money it saves, and any planned upgrades. The requirement would end seven years after it takes effect, and VA would pay for it using the department’s franchise fund.

• Who is affected: Veterans who use community care, private health providers who submit claims to VA, and VA staff who process claims.
• What changes: Claims are automatically screened for fraud, waste, and overuse; results are logged and reported; the system is updated over time and integrated with existing VA systems.
• When: VA must implement within 1 year; annual reports begin 2 years after enactment; the requirement ends after 7 years.