Veterans Care and Cost Coordination Act of 2026

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9524 Introduced in House (IH)]

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119th CONGRESS
  2d Session
                                H. R. 9524

  To direct the Secretary of Veterans Affairs to seek to enter into a
  memorandum of understanding with the Secretary of Health and Human
Services and to provide for coordination between the Secretaries in the
   administration of the Veterans Community Care Program and certain
    health plans under the Medicare program, and for other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                             June 29, 2026

  Mr. Murphy introduced the following bill; which was referred to the
 Committee on Veterans' Affairs, and in addition to the Committees on
      Ways and Means, and Energy and Commerce, for a period to be
subsequently determined by the Speaker, in each case for consideration
  of such provisions as fall within the jurisdiction of the committee
                               concerned

_______________________________________________________________________

                                 A BILL

  To direct the Secretary of Veterans Affairs to seek to enter into a
  memorandum of understanding with the Secretary of Health and Human
Services and to provide for coordination between the Secretaries in the
   administration of the Veterans Community Care Program and certain
    health plans under the Medicare program, and for other purposes.

    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 ``Veterans Care and Cost Coordination
Act of 2026''.

SEC. 2. MEMORANDUM OF UNDERSTANDING FOR RECIPROCAL ACCESS TO CERTAIN
              HEALTH CARE DATA BETWEEN THE SECRETARY OF VETERANS
              AFFAIRS AND THE SECRETARY OF HEALTH AND HUMAN SERVICES.

    (a) In General.--Not later than one year after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall, for
purposes of coordinating the costs, care, and management of hospital
care and medical services furnished under the laws administered by the
Secretary of Veterans Affairs, seek to enter into a memorandum of
understanding with the Secretary of Health and Human Services with
respect to reciprocal access between the Veterans Health Administration
and the Centers for Medicare and Medicaid Services to data and
information on veterans who are concurrently enrolled in the patient
enrollment system under section 1705(a) of title 38, United States
Code, and--
            (1) the Medicare program; or
            (2) a Medicare Advantage plan.
    (b) Agreement.--The memorandum of understanding required under
subsection (a) shall include an agreement through which--
            (1) the Secretary of Veterans Affairs transmits to the
        Secretary of Health and Human Services--
                    (A) information relating to veterans who are--
                            (i) enrolled in such system for patient
                        enrollment; and
                            (ii) in receipt of hospital care or medical
                        services under laws administered by the
                        Secretary of Veterans Affairs; and
                    (B) such other information as the Secretary of
                Veterans Affairs determines appropriate, including
                billing codes and diagnostic codes for such hospital
                care or medical services; and
            (2) the Secretary of Health and Human Services--
                    (A) uses information transmitted pursuant to
                paragraph (1) to identify veterans who are concurrently
                enrolled in such system for patient enrollment and--
                            (i) the Medicare program; or
                            (ii) a Medicare Advantage plan; and
                    (B) transmits to the Secretary of Veterans
                Affairs--
                            (i) a list of the veterans identified
                        pursuant to subparagraph (A); and
                            (ii) such other information as the
                        Secretary of Health and Human Services
                        determines appropriate.
    (c) Care Coordination Under Veterans Community Care Program for
Concurrently Enrolled Veterans.--The Secretary shall use information
transmitted to the Secretary by the Secretary of Health and Human
Services under the agreement required under subsection (b) to inform
utilization management under the Community Care Next Generation
Procurement Contract, or other successor contract awarded under the
Veterans Community Care Program under section 1703 of title 38, United
States Code, to--
            (1) avoid duplicative health care to such veterans;
            (2) avoid erroneous or duplicative payments for health care
        furnished to such veterans; and
            (3) inform veterans of beneficial or follow-up to services
        furnished pursuant to the Medicare program or a Medicare
        Advantage.
    (d) Calculation of Benchmark Payments.--Section 1853(c)(1)(D)(iii)
of the Social Security Act (42 U.S.C. 1395w-23(c)(1)(D)(iii)) is
amended by adding at the end the following new sentence: ``In
developing the estimate described in the preceding sentence, the
Secretary shall use the information transmitted to the Secretary by the
Secretary of Veterans Affairs pursuant to the memorandum of
understanding required under the Veterans Care and Cost Coordination
Act of 2026.''.
    (e) Report.--Not later than one year after the date on which the
Secretary of Veterans Affairs enters into the memorandum of
understanding required under subsection (a), and on an biennial basis
thereafter during the period such memorandum is effective, the
Secretary shall submit to the Committees on Veterans' Affairs of the
House of Representatives and the Senate a report that includes--
            (1) a summary of the activities of the Secretary carried
        out pursuant to such memorandum; and
            (2) an assessment of the Secretary with respect to the
        effectiveness of such memorandum in avoiding duplicative,
        improper, or erroneous billings or payments for hospital care
        and medical services furnished under the laws administered by
        the Secretary.
    (f) Medicare Advantage Plan Defined.--In this section, the term
``Medicare Advantage plan'' means a Medicare Advantage plan under the
program established under part C of title XVIII of the Social Security
Act (42 U.S.C. 1395w-21 et seq.).
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