H.R. 9524: Veterans Care and Cost Coordination Act of 2026

This bill would require the Department of Veterans Affairs (VA) to work with the Department of Health and Human Services (HHS) to share certain health care information about veterans who are enrolled in both VA health care and either Medicare or a Medicare Advantage plan.

What the bill would do

• Within one year, the VA would have to try to enter into a formal agreement with HHS to allow each agency to access relevant data about veterans who use both systems.
• The VA would send HHS information about veterans receiving VA hospital care or medical services, including any billing or diagnosis codes the VA thinks are appropriate.
• HHS would use that information to identify veterans who are also enrolled in Medicare or Medicare Advantage and send the VA a list of those veterans, along with other information HHS thinks is appropriate.

How the VA would use the information

The bill says the VA would use the information from HHS to help manage care under the Veterans Community Care Program. The stated goals are to:

• avoid veterans getting the same care more than once,
• avoid paying twice or making other billing errors for the same care, and
• help inform veterans about follow-up care or other services connected to their Medicare or Medicare Advantage care.

Effect on Medicare payment calculations

The bill would also require Medicare officials to use the VA-shared information when estimating certain Medicare Advantage benchmark payments. In plain terms, this means Medicare would factor in the shared veteran data when calculating payment rates used for Medicare Advantage plans.

Reporting requirement

The VA would have to report to congressional veterans’ committees within one year after the agreement is made, and then every two years after that while the agreement is in effect. The report would describe what the VA has done under the agreement and assess whether it has helped reduce duplicate, improper, or incorrect billing or payments.

Relevant Companies

• HUM — Humana operates Medicare Advantage plans and could be affected by changes in how veteran enrollment data is used for coordination and payment calculations.
• UNH — UnitedHealth Group, through its Medicare Advantage business, could be affected by changes in data sharing and Medicare Advantage payment estimates.
• CVS — CVS Health, through Aetna, offers Medicare Advantage plans and could be affected by coordination requirements involving plan enrollment and payment administration.
• CNC — Centene offers Medicare Advantage plans in some markets and could be affected by Medicare data-sharing and payment-related changes.
• EHTH — eHealth is a broker and marketplace for Medicare plans and could be indirectly affected if coordination changes influence Medicare Advantage enrollment or plan administration.