H.R. 9524

119 HR 9524 IH: Veterans Care and Cost Coordination Act of 2026
 U.S. House of Representatives
 2026-06-29
 text/xml
 EN
 Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
 I  119th CONGRESS  2d Session  H. R. 9524  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.
1.
Short title
This Act may be cited as the   Veterans Care and Cost Coordination Act of 2026  .
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. ).