Veterans Care and Cost Coordination Act of 2026
- Sponsor
- Rep. Murphy, Gregory F. [R-NC-3]
- Committees
- Energy and Commerce Committee (primary)
- Last action
- Jul 17, 2026
Bottom line
The bill aims to improve efficiency and reduce costs in veteran healthcare by enabling data sharing between the VA and Medicare programs to better coordinate care for veterans enrolled in both systems.
What it actually does
This bill directs the Secretary of Veterans Affairs to establish a memorandum of understanding (MOU) with the Secretary of Health and Human Services within one year. The MOU will facilitate reciprocal data sharing between the Veterans Health Administration and the Centers for Medicare and Medicaid Services to identify veterans concurrently enrolled in VA healthcare and Medicare or Medicare Advantage plans. This data will be used to coordinate care, avoid duplicative services and payments within the Veterans Community Care Program, and inform veterans about follow-up services. Additionally, it amends the Social Security Act to require CMS to use this VA data when calculating Medicare Advantage benchmark payments.
Proponents argue
Proponents would argue that this bill is a common-sense measure to improve efficiency, reduce waste, and enhance the quality of care for veterans. By sharing data, both agencies can ensure veterans receive appropriate care without duplication, leading to better health outcomes and significant cost savings for taxpayers. It addresses a known issue of fragmented care and billing that often burdens veterans and the federal budget.
Opponents contend
Potential opponents might raise concerns about data privacy and security, arguing that sharing sensitive health information between two large federal agencies could increase the risk of breaches or misuse. They might also question the administrative burden and cost of establishing and maintaining such a data-sharing agreement, suggesting that the benefits might not outweigh the operational complexities and potential privacy risks.
The bill is concise and its core purpose is clear, making it accessible for a quick but informed read.
Section 1
Short Title
This section establishes the official short title of the Act as the 'Veterans Care and Cost Coordination Act of 2026,' providing a common and easily recognizable name for the legislation. This title reflects the bill's primary goals of improving veteran healthcare coordination and managing associated costs.
Supporters argue
Supporters would argue that a clear short title makes the bill easier to reference and discuss in legislative and public discourse, aiding in its understanding and tracking.
Critics contend
No specific opposition is typically raised against short titles, as they are standard legislative practice and serve a practical purpose.
Section 2(a)
VA-HHS Data Sharing MOU Mandate
This provision directs the Secretary of Veterans Affairs to seek to enter into a memorandum of understanding (MOU) with the Secretary of Health and Human Services within one year of the bill's enactment. The primary purpose of this MOU is to establish reciprocal access to health care data for veterans who are concurrently enrolled in the VA's patient enrollment system and either the Medicare program or a Medicare Advantage plan, aiming to coordinate costs, care, and management of services.
Section 2(b)
Data Transmission Requirements
This subsection specifies the content of the data-sharing agreement. It requires the VA to transmit information relating to enrolled veterans receiving VA care, including billing and diagnostic codes, to HHS. In turn, HHS must use this information to identify veterans concurrently enrolled in Medicare or Medicare Advantage and transmit a list of these identified veterans, along with other relevant information, back to the VA.
Section 2(c)
Data Utilization for Community Care Management
This provision mandates that the VA use the data received from HHS to inform utilization management within the Veterans Community Care Program (VCCP), specifically under current or successor contracts. The explicit goals are to avoid duplicative health care services for veterans, prevent erroneous or duplicative payments for care furnished, and inform veterans about beneficial or follow-up services related to their Medicare or Medicare Advantage plans.
Section 2(d)
Medicare Advantage Benchmark Payment Adjustment
This section amends Section 1853(c)(1)(D)(iii) of the Social Security Act, which governs the calculation of Medicare Advantage benchmark payments. It requires the Secretary of Health and Human Services (HHS) to use the information transmitted from the VA, via the new MOU, when developing the estimate described in the preceding sentence of that section. This means VA healthcare utilization data for dual-enrolled veterans will now factor into how Medicare Advantage plans are reimbursed by the federal government.
Section 2(e)
Biennial Report to Congress
This section requires the VA Secretary to submit a report to the House and Senate Committees on Veterans' Affairs within one year of the MOU's enactment, and biennially thereafter for as long as the MOU is effective. The report must summarize the activities carried out pursuant to the MOU and include an assessment of its effectiveness in avoiding duplicative, improper, or erroneous billings or payments for VA hospital care and medical services.
Amends Section 1853(c)(1)(D)(iii) of the Social Security Act to require the Secretary of Health and Human Services to use VA data from the new MOU when estimating Medicare Advantage benchmark payments.
Section 2(d)
Why it matters:This is standard legislative practice for amending existing law, but it makes the fiscal implications for Medicare Advantage plans and federal spending less immediately apparent to a casual reader who is not intimately familiar with the referenced statute.
Case for: Proponents argue that this ensures Medicare Advantage plans are not overpaid for services that veterans may already be receiving through the VA, leading to more accurate federal outlays and better stewardship of taxpayer money by reducing potential overpayments.
Case against: Critics might argue that this adds significant complexity to an already intricate payment system and could potentially lead to unintended consequences for Medicare Advantage plans, especially those serving a high proportion of veterans, if the data integration and calculation are not perfectly executed, potentially impacting plan benefits.
Estimated impact: Potentially significant fiscal impact on federal Medicare spending and Medicare Advantage plan reimbursements, aiming to reduce duplicative payments. The exact scale is unknown without a CBO score.