House BillHR 4077MedicareCivil actions and liability
GUARD Veterans’ Health Care Act
INTRO JUN 23· LAST ACTION DEC 3
READING
13MIN
COSPONSORS
7BIPARTISAN
READER REACTIONS0 TOTAL
NO VOTES YET · BE THE FIRST
Introduced only
LEGISLATIVE PROGRESS
STEP 2 / 8
Introduced
In Committee
Reported
Passed House
Passed Senate
Conference
To President
Became Law
WHAT THE BILL DOES
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This bill matters because it could significantly impact the financial health of the Department of Veterans Affairs. By enabling the VA to recover more costs from Medicare Advantage and prescription drug plans, as well as clarifying its ability to seek reimbursement from other responsible third parties, the VA could gain additional revenue. This could potentially free up federal appropriations for other VA needs or allow for an expansion of services without requiring new taxpayer money.
Voters should care because this bill aims to ensure that the appropriate entities bear the cost of healthcare for veterans, rather than relying solely on the VA's budget. If this bill becomes law, it could lead to a more financially sustainable VA healthcare system. If it doesn't pass, the VA would continue to absorb costs that, under this proposal, would otherwise be covered by private Medicare plans or other responsible parties, potentially straining its resources.
KEY PROVISIONS
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PROVISION 01
Requires Medicare Advantage and Medicare prescription drug plans to reimburse the VA for covered healthcare items and services provided to their enrollees.
This ensures that private Medicare plans contribute to the cost of care for veterans who are dually enrolled, rather than the VA solely bearing the cost.
PROVISION 02
Prohibits Medicare Advantage and prescription drug plans from imposing additional documentation or administrative requirements on the VA for these reimbursements.
This simplifies the reimbursement process for the VA, reducing administrative burden and making it easier to recover funds.
PROVISION 03
Modifies and clarifies the VA's authority to recover reasonable charges from third parties for care or services furnished to veterans for non-service-connected disabilities.
This strengthens the VA's ability to get paid back when another party (like an insurance company or an at-fault party) is responsible for a veteran's non-service-connected medical costs.
PROVISION 04
Specifies that amounts recovered from Medicare Advantage and prescription drug plans will be deposited into the Department of Veterans Affairs Medical Care Collections Fund.
This ensures that recovered funds are directly allocated to support VA healthcare services.
PROVISION 05
Sets a six-year time limit for the VA to pursue recovery actions for reasonable charges, with a three-year limit for tort-related claims.
This provides clarity and a defined timeframe for legal actions related to cost recovery.
Referred to the Committee on Veterans' Affairs, and in addition to the Committees on Ways and Means, and Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
This bill matters because it could significantly impact the financial health of the Department of Veterans Affairs. By enabling the VA to recover more costs from Medicare Advantage and prescription drug plans, as well as clarifying its ability to seek reimbursement from other responsible third parties, the VA could gain additional revenue. This could potentially free up federal appropriations for other VA needs or allow for an expansion of services without requiring new taxpayer money.
Voters should care because this bill aims to ensure that the appropriate entities bear the cost of healthcare for veterans, rather than relying solely on the VA's budget. If this bill becomes law, it could lead to a more financially sustainable VA healthcare system. If it doesn't pass, the VA would continue to absorb costs that, under this proposal, would otherwise be covered by private Medicare plans or other responsible parties, potentially straining its resources.
KEY PROVISIONS
AI-extracted
high
Requires Medicare Advantage and Medicare prescription drug plans to reimburse the VA for covered healthcare items and services provided to their enrollees.
This ensures that private Medicare plans contribute to the cost of care for veterans who are dually enrolled, rather than the VA solely bearing the cost.
med
Prohibits Medicare Advantage and prescription drug plans from imposing additional documentation or administrative requirements on the VA for these reimbursements.
This simplifies the reimbursement process for the VA, reducing administrative burden and making it easier to recover funds.
high
Modifies and clarifies the VA's authority to recover reasonable charges from third parties for care or services furnished to veterans for non-service-connected disabilities.
This strengthens the VA's ability to get paid back when another party (like an insurance company or an at-fault party) is responsible for a veteran's non-service-connected medical costs.
med
Specifies that amounts recovered from Medicare Advantage and prescription drug plans will be deposited into the Department of Veterans Affairs Medical Care Collections Fund.
This ensures that recovered funds are directly allocated to support VA healthcare services.
med
Sets a six-year time limit for the VA to pursue recovery actions for reasonable charges, with a three-year limit for tort-related claims.
This provides clarity and a defined timeframe for legal actions related to cost recovery.
Provisions regarding cost-recovery from Medicare Advantage and prescription drug plans apply to plan years beginning on or after
Six years from the last day care/services were furnished
Statute of limitations for recovery actions by the United States for care or services
Three years after the right of action first accrues
Statute of limitations for money damages actions by the United States founded upon a tort
GLOSSARY
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Medicare Advantage plan (MA plan)
A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. They often include prescription drug coverage (MA-PD).
Medicare prescription drug plan (PDP plan or Part D)
A standalone private insurance plan that covers prescription drugs for people with Medicare, usually obtained in addition to Original Medicare.
Service-connected disability
An illness or injury incurred or aggravated during military service, which can qualify a veteran for specific VA benefits.
Non-service-connected disability
An illness or injury that is not related to a veteran's military service, but for which the VA may still provide care under certain circumstances.
Medical Care Collections Fund
A special fund within the VA where certain healthcare-related collections, such as reimbursements from third-party insurers, are deposited to support VA medical care.
Subrogation
The legal right of an insurer or a healthcare provider (like the VA) to recover money from a third party that caused a loss or injury, after the insurer/provider has paid out for that loss or injury.
ACTION TIMELINE
3 EVENTS
DEC 3, 25
Committee Hearings Held
COMMITTEE
JUN 23, 25
Introduced in House
INTROREFERRAL
JUN 23, 25
Referred to the Committee on Veterans' Affairs, and in addition to the Committees on Ways and Means, and Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
