GUARD Veterans' Health Care

Summary#

This bill changes how the Department of Veterans Affairs (VA) can get paid back for health care it provides. It adds a new rule letting the VA recover costs from Medicare Advantage organizations and Medicare prescription drug plans (Part D) for items and services those plans cover. Reimbursements must be paid to the VA and are placed in the VA Medical Care Collections Fund. The change for Medicare Advantage and Part D plans applies to plan years starting January 1, 2026. The bill also updates the VA's existing recovery rules for non-service-connected disabilities. It broadens the kinds of third-party payments the VA can collect, allows the VA to join or intervene in legal actions, sets time limits for bringing claims, defines a “clean claim,” requires third parties to respond within set deadlines, allows interest on late payments, and creates penalties for noncompliance including civil fines and higher damages for willful refusal to pay.

What it means for you#

  • If you are a veteran who gets care from the VA and also has a Medicare Advantage or Part D plan, the VA may seek reimbursement from that plan for covered items or services the VA provided.
  • Medicare Advantage organizations and Part D sponsors must reimburse the VA for covered items or services regardless of extra plan documentation or utilization rules.
  • Third parties (for example, insurers or parties responsible in tort) will have set deadlines to pay or explain refusals. They may owe interest on late payments and face penalties for failing to comply.
  • The new Medicare-related rule takes effect for plan years beginning January 1, 2026.

Expenses#

No publicly available information on overall budgetary costs or savings from this bill. The bill directs amounts the VA recovers from Medicare Advantage and Part D plans to be deposited into the VA Medical Care Collections Fund.

Proponents' View#

The bill’s stated purpose is to allow the VA to recover reimbursements from Medicare Advantage and Medicare prescription drug plans and to strengthen the United States' recovery rights for non-service-connected care. Supporters framed the changes as clarifying recovery rights, setting clear timeframes and rules for claims, requiring timely payment or explanation, adding interest for late payments, and creating penalties to improve collections.

Opponents' View#

No publicly available information on opponents' views in the provided text or metadata.