Sponsor
Gregory Francis Murphy
Representative · R-NC
Representative · R-NC
The bill improves detection of duplicate VA/Medicare enrollment and payments and can enhance care coordination and Medicare program data, but it increases data-sharing risks, operational burdens, and the chance of downstream payment or service disputes.
Veterans: VA will be able to identify veterans enrolled in both VA and Medicare to reduce duplicative care and better coordinate follow-up services.
Taxpayers and payers: Sharing VA billing data with CMS enables detection and prevention of erroneous or duplicate Medicare payments, reducing wasteful spending.
Medicare program and beneficiaries: CMS will gain VA care data that can improve benchmark estimates, program planning, and the accuracy of Medicare payment models.
Veterans: Sharing detailed VA medical and billing data with CMS raises privacy and data-security risks for veterans whose sensitive health information is being exchanged more widely.
Veterans, providers, and payers: Implementation complexity and mismatched or incomplete data could produce incorrect determinations about duplicate enrollment or payments, triggering billing disputes, denials, or delays in services.
Medicare beneficiaries and plans: Broader VA–CMS data use could enable CMS to change benchmark calculations or influence Medicare Advantage payments and plan behavior, producing indirect effects on beneficiaries.
Based on analysis of 2 sections of legislative text.
Requires VA and CMS to execute an MOU to exchange enrollment and care data for veterans enrolled in both VA and Medicare to reduce duplicate care/payments and adjust a Medicare benchmark rule.
Official title: To direct the Secretary of Veterans Affairs to seek to enter into a memorandum of understanding with the Secretary of Health and Human Services and to provide for coordination between the Secretaries in the administration of the Veterans Community Care Program and certain health plans under the Medicare program, and for other purposes.
Introduced June 29, 2026 by Gregory Francis Murphy · Last progress June 29, 2026
Requires the Department of Veterans Affairs to arrange a formal data-sharing agreement with HHS/CMS so VA and Medicare can exchange enrollment and care data for veterans who are enrolled in both VA health care and Medicare or Medicare Advantage. The goal is to identify veterans with concurrent enrollment, avoid duplicative care and payments under the Veterans Community Care Program, improve utilization management, and adjust a Medicare benchmark provision to incorporate VA data. The bill also requires reporting to congressional Veterans’ Affairs committees after the agreement is executed and every two years thereafter. The MOU must be executed within one year of enactment and cover transmission of VA enrollment and care information to CMS and CMS use and return of lists and other data to VA for program management purposes.