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S 2145119th CongressIn Committee

GUARD Veterans’ Health Care Act

Introduced: Jun 23, 2025
HealthcareVeterans Affairs
Standard Summary
Comprehensive overview in 1-2 paragraphs

The GUARD Veterans’ Health Care Act would (1) require Medicare Advantage (MA) plans and Medicare prescription drug plans (Part D) to reimburse the Department of Veterans Affairs (VA) for covered health care items and services the VA provides to veterans, and (2) expand the federal government’s authority to recover reasonable charges from third parties for care provided to veterans with non-service-connected disabilities. The cost-recovery from MA/Part D would apply to items and services that are covered by the Medicare program and provided by VA, and the collected funds would go to the VA Medical Care Collections Fund. The bill also broadens and modernizes the government’s right to recover reasonable charges from third parties in tort or other situations, with new procedures, timelines, penalties, and definitions to encourage prompt payment. The changes would take effect for MA/Part D years beginning in 2026 and would modify related Medicare and Social Security Act provisions to align with these new authorities.

Key Points

  • 1Cost-recovery from Medicare Advantage and Medicare prescription drug plans
  • 2- Creates a new 38 U.S.C. 1729C allowing VA to bill MA organizations and PDP sponsors for items/services VA provides that are covered under a veteran’s MA or Part D plan, with reimbursement due to the VA to the extent the item/service is covered by the plan.
  • 3- Recovered amounts are deposited into the VA Medical Care Collections Fund (1729A).
  • 4- Applies to MA/MA-PD and Part D plan years starting on or after January 1, 2026.
  • 5- Requires conforming amendments to the Social Security Act to recognize this new recovery pathway.
  • 6Modifications to federal recovery for non-service-connected disability care
  • 7- Expands the United States’ right to recover or collect reasonable charges for care or services VA furnishes for non-service-connected disabilities, including recovery from third parties when applicable.
  • 8- Broadens the scope to include tort recoveries and reimbursements from other payers, with specific timing, coordination-of-benefits, and settlement rules.
  • 9- Introduces a robust “clean claim” process with deadlines (typically 45 days for third parties to pay or respond) and procedures for disputes, information requests, and penalties for noncompliance.
  • 10- Establishes penalties for nonpayment (civil penalties, possible triple damages or up to a statutory cap with inflation adjustment) and allows the U.S. to seek damages doubled for certain failures to reimburse.
  • 11- Allows the VA to intervene in or join third-party actions and imposes time limits on lawsuits (with certain exceptions and coordination with other law).
  • 12- Defines key terms like “clean claim” and “non-service-connected disability,” and clarifies that recovery can occur regardless of existing non-Department claim processes.

Impact Areas

Primary group/area affected- Veterans enrolled in Medicare Advantage or Medicare Part D plans who receive care from VA facilities or providers.- VA health care operations and financing, via the new cost-recovery streams and the VA Medical Care Collections Fund.Secondary group/area affected- MA organizations and PDP sponsors (insurers) that administer MA/Part D plans.- Private sector providers and third-party payers involved in paying for veterans’ care, including tortfeasors and other liable parties.Additional impacts- Potential changes to VA budgeting and cash flow due to new revenue streams from MA/Part D reimbursements and third-party recoveries.- Administrative and IT enhancements needed at VA and with private payers to process clean claims, track recoveries, and report the required information on benefits coordination.- Possible shifts in care-access dynamics if coordination of benefits or third-party recoveries affect timing of payments or coverage determinations.- Increased leverage for the federal government in pursuing reimbursements from providers, insurers, or liable parties for veteran care.
Generated by gpt-5-nano on Oct 7, 2025