HR4077-119

What This Bill Does

The GUARD Veterans' Health Care Act strengthens VA cost recovery when the Department of Veterans Affairs furnishes care to veterans who are enrolled in Medicare Advantage or Medicare Part D plans. Beginning with plan years on or after January 1, 2026, MA organizations and PDP sponsors must reimburse VA for covered items and services, including inpatient and outpatient care, prescription drugs, medical devices, lab testing, post-acute care, and long-term care, regardless of extra documentation, utilization-management, or administrative requirements the plan might otherwise impose. Recovered amounts go to the VA Medical Care Collections Fund. The bill also updates VA's broader recovery authority for non-service-connected disabilities, including tort-liability situations, subrogation enforcement, intervention or joinder in proceedings, and a six-year recovery period.

Who Benefits and How

Department of Veterans Affairs medical centers benefit because more reimbursement flows into the VA Medical Care Collections Fund for care already furnished to veterans. Veterans enrolled in Medicare Advantage plans benefit if VA can recover from their private Medicare plan without slowing care delivery. Veterans using Part D drug plans benefit because prescription drug coverage must reimburse VA when the item is covered by the plan. Federal taxpayers benefit if private Medicare plans and tort-liable third parties cover costs that would otherwise remain with VA appropriations.

Who Bears the Burden and How

Medicare Advantage organizations must reimburse VA for covered services without relying on additional utilization-management or documentation barriers. Part D prescription drug plan sponsors must reimburse VA for covered prescription drugs and related items. VA revenue offices must prescribe recovery procedures, pursue subrogation interests, and manage deposits into the Medical Care Collections Fund. Third-party tort defendants and insurers face broader VA collection rights for non-service-connected disability care.

Key Provisions

• Creates a new VA recovery section for Medicare Advantage and Part D plan reimbursement.
• Requires reimbursement for covered VA-furnished care beginning with plan years on or after January 1, 2026.
• Provides that recovered amounts are deposited in the VA Medical Care Collections Fund.
• Expands VA recovery rights for non-service-connected disability care, tort liability, subrogation, and six-year enforcement.