Joint Medical Facilities Fund Act of 2026

Summary of S. 3992 — Joint Medical Facilities Fund Act of 2026

Date introduced: March 4, 2026
Senators: Dan Sullivan (sponsor), Jim Banks (sponsor), Mazie Hirono (sponsor)
Committee: Veterans' Affairs

Purpose
- Codify and formalize the authority to create and operate the Joint Medical Facility Fund (the Fund), consolidating and jointly funding designated combined Federal medical facilities operated by the Department of Defense (DoD) and the Department of Veterans Affairs (VA).

Key Provisions

1) Establishment and Purpose of the Fund
- Creates the Joint Medical Facility Fund on the Treasury books under the VA.
- Purpose: Facilitate joint funding of designated combined Federal medical facilities used by both DoD and VA.

2) Transfers to the Fund
- Transfers to the Fund may come from:
- DoD appropriations (as determined by a jointly established methodology reflecting mission, workload, and costs for DoD facilities).
- VA appropriations (as determined by a jointly established methodology reflecting mission, workload, and costs for VA facilities).
- Additional transfers from medical care collections for health care provided at designated combined facilities, under authorities including:
- 10 U.S.C. § 1095
- 38 U.S.C. § 1729
- Federal Medical Care Recovery Act (Public Law 87-693; 42 U.S.C. 2651 et seq.)

3) Availability and Use of Fund Amounts
- Funds transferred to the Fund may be used to operate the designated combined facilities, including:
- Capital equipment
- Real property maintenance
- Minor construction projects not requiring separate authorization by law (per 10 U.S.C. § 2805 or 38 U.S.C. § 8104)
- Specific facility: Captain James A. Lovell Federal Health Care Center (North Chicago), including associated facilities designated as a combined Federal medical facility.

4) Limitations and Availability Periods
- Amounts remain available until the end of the first fiscal year after transfer (default rule).
- An exception allows up to 2% of a fiscal year transfer to remain available until the end of the second fiscal year after transfer.

5) Executive Agreement and Administration
- Administration of the Fund shall be governed by an executive agreement between the Secretary of Defense and the Secretary of Veterans Affairs.
- The agreement must align with provisions from the Duncan Hunter National Defense Authorization Act for FY 2009 and include:
- An independent review of the funding methodology.
- An integrated financial reconciliation process to reconcile DoD and VA accounting and workload metrics.
- Clear identification of fiscal contributions from DoD and VA, accounting for differences in financial management.

6) Repeal and Reporting
- Repeals Section 1704 of the FY2010 National Defense Authorization Act (as amended most recently by the 2025 NDAA Servicemember Quality of Life provisions).
- Reporting requirement: Within 180 days of enactment, DoD and VA must jointly report to House and Senate Veterans’ Affairs and Appropriations committees on which DoD or VA medical facilities (or both) should be designated as designated combined Federal medical facilities.

Who is Affected

• DoD and VA medical facilities that would participate as designated combined Federal medical facilities.
• DoD and VA financial and accounting offices responsible for funding allocations, reconciliations, and reporting.
• Patients receiving care at these joint facilities (beneficiaries of DoD/VA health care at designated sites).

Potential Impacts

• Enhanced joint funding framework for shared facilities, potentially improving efficiency and alignment of DoD/VA health services at co-located or jointly operated sites.
• Creation of a dedicated Fund with specific transfer rules and time-limited availability windows, ensuring targeted use for facility operations, maintenance, and minor construction.
• Administrative changes: requires an executive agreement and integrated financial reconciliation between DoD and VA, which could affect budgeting cycles and interagency coordination.
• Specific focus on the Captain James A. Lovell Federal Health Care Center as a defined example of a combined facility.

Notes

• The bill emphasizes jointly determined funding methodologies and independent reviews to ensure transparency and accountability in allocations between the two agencies.
• The proposed changes require congressional reporting to identify additional facilities for designation as combined DoD/VA facilities.