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HR 9524

Veterans Care and Cost Coordination Act of 2026

119th Congress Introduced by Greg Murphy

Coordinates VA and CMS data to reduce duplicative or erroneous payments for veterans enrolled in VA and Medicare/Medicare Advantage.

Introduced in House
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WeVote Research Nonpartisan
Bill Summary · HR 9524

Overview

  • Bill: HR 9524 (Veterans Care and Cost Coordination Act of 2026)
  • Session: 119th Congress
  • Purpose: Direct the Secretary of Veterans Affairs to pursue a memorandum of understanding (MOU) with the Secretary of Health and Human Services to coordinate data sharing and cost management between the Veterans Community Care Program and certain Medicare health plans (including Medicare Advantage), and to establish mechanisms to reduce duplicative or improper payments and improve care navigation for veterans enrolled in both programs.
  • Introduced: June 29, 2026 by Rep. Murphy; referred to Veterans’ Affairs, Ways and Means, and Energy and Commerce.

Key Provisions

  1. Memorandum of Understanding for Data Coordination (Section 2)
    • Timeline: Not later than 1 year after enactment.
    • Requirement: VA Secretary must seek an MOU with HHS to enable reciprocal data access between the Veterans Health Administration (VHA) and the Centers for Medicare & Medicaid Services (CMS).
    • Scope: Pertains to veterans enrolled in the VA patient enrollment system (38 U.S.C. 1705(a)) who are also in:
      • the Medicare program, or
      • a Medicare Advantage plan.
  • MOU Details (subsection (b)):
    • VA shall transmit to HHS information about veterans enrolled in VA’s patient enrollment system who are receiving VA hospital/medical services, plus other information deemed appropriate (including billing and diagnostic codes).
    • HHS shall identify veterans concurrently enrolled in VA and Medicare or Medicare Advantage and transmit back to VA:
      • a list of identified veterans, and
      • additional information deemed appropriate by HHS.

  1. Care Coordination for Concurrently Enrolled Veterans (Section 2, subsection (c))

    • VA shall use information provided by HHS to support utilization management under the Veterans Community Care Program (Next Generation Procurement Contract or successor) to:
      • Avoid duplicative care.
      • Avoid erroneous or duplicative payments for services.
      • Inform veterans about Medicare-related benefits or follow-up services.

  2. Benchmark Payments Calculation (Section 2, subsection (d))

    • The Social Security Act’s provision for calculating benchmarks (in the context of Medicare Advantage and related payments) is to be amended to require that the Secretary use information transmitted by VA under the MOU when developing the estimate described in that section.

  3. Reporting Requirement (Section 2, subsection (e))

    • Timeline: First report due within 1 year of the MOU and every two years thereafter while the MOU is in effect.
    • Content:
      • Summary of VA activities under the MOU.
      • Assessment of the MOU’s effectiveness in avoiding duplicative or erroneous billings/payments for VA-covered hospital and medical services.

  4. Medicare Advantage Plan Definition (Section 2, subsection (f))

    • Clarifies that “Medicare Advantage plan” refers to plans under Part C of title XVIII of the Social Security Act.

Who Would Be Affected

  • Veterans enrolled in the VA health care system who are concurrently enrolled in the VA patient enrollment system and in Medicare or a Medicare Advantage plan.
  • VA facilities and staff responsible for administering hospital care and medical services.
  • The Centers for Medicare and Medicaid Services (CMS) and other Medicare Advantage entities that would provide data back to VA.
  • The Veterans Community Care Program, including contractors and administrators handling procurement and utilization management.

Timeline and Procedural Aspects

  • Enactment triggers a requirement to enter into the MOU within one year.
  • Ongoing data-sharing arrangement subject to the MOU’s terms.
  • Biennial reporting to congressional committees starting one year after the MOU is in effect.
  • The bill also impacts how some Medicare benchmark payments are calculated by incorporating VA-provided data.

Potential Impacts and Considerations

  • Improved coordination between VA and CMS/Medicare to reduce duplicative care and prevent improper payments.
  • enhanced ability to guide veterans to appropriate Medicare-related follow-up and benefits.
  • Increased data sharing between federal health programs, potentially raising privacy and security considerations, though the bill specifies information transfer to support cost and utilization management.
  • Possible complexities in implementing data matching, privacy safeguards, and governance between VA and HHS/CMS systems.
  • Financial/administrative implications for the Veterans Community Care Program and its contracts due to improved utilization management.

If you’d like, I can provide a plain-language quick-read version or a side-by-side comparison with current law to highlight the exact changes.

Compiled from official sources — confirm details with the bill’s official record.

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