H.R. 5261: Veterans Emergency Care Reimbursement Act of 2025

This bill, known as the Veterans Emergency Care Reimbursement Act of 2025, aims to modify how the U.S. Department of Veterans Affairs (VA) reimburses veterans for emergency medical care received outside of VA facilities. Here are the key points:

Short Title

The bill is officially titled the Veterans Emergency Care Reimbursement Act of 2025.

Modification of Reimbursement Limitations

The bill proposes amendments to existing law that regulates the reimbursement of emergency medical treatment costs for veterans. The specific amendments include:

• Changing the language to clarify responsibilities of the Secretary of Veterans Affairs.
• Adjusting payment thresholds by defining amounts eligible for reimbursement as those less than $100.
• Defining copayment in terms of fixed amounts paid by veterans for covered health services, excluding amounts for deductibles or coinsurance.

Application of the Amendments

The adjustments made in the bill will apply to any reimbursement claim filed with the VA for emergency treatment that occurred on or after February 1, 2012. This includes claims from veterans involved in a specific legal case (Wolfe v. McDonough) concerning emergency treatment reimbursements.

Definitions

The bill defines several key terms:

• Emergency treatment: Has the meaning specified in existing law.
• Health-plan contract: Also defined within existing regulations.
• Reimbursement claim: Refers to any claim submitted by a veteran for reimbursement of copayments, deductibles, coinsurance, or other costs for emergency treatment outside of VA facilities, including claims that may have been denied by the VA.

Overall Purpose

The intent of the bill is to enhance and clarify the reimbursement process for veterans who incur out-of-pocket costs for emergency medical treatment when they do not use VA services. By addressing these limitations and definitions, the bill aims to make the reimbursement process more effective for veterans.

Relevant Companies

• None found