Sponsor
Gregory Francis Murphy
Representative · R-NC
Representative · R-NC
Requires VA and CMS to exchange data on veterans enrolled in both VA and Medicare/Medicare Advantage to reduce duplicate care/payments and improve utilization management.
The bill improves detection of duplicate enrollment/payments and care coordination by sharing VA billing data with CMS, but increases veterans' privacy risks and creates administrative and implementation challenges that could produce billing disputes or downstream effects on Medicare program behavior.
Veterans: VA-CMS data sharing lets VA identify veterans enrolled in both systems to reduce duplicative care and coordinate follow-up services.
Taxpayers and payers: Access to VA billing data helps detect and prevent erroneous or duplicate Medicare payments, reducing wasteful spending.
Medicare program and beneficiaries: CMS receiving VA care data improves benchmark estimates and program planning, which can lead to better-managed Medicare administration.
Veterans: Sharing detailed VA medical and billing records with CMS increases risks to privacy and data security for veterans whose sensitive health information is more widely accessible.
Veterans and providers: Implementation complexity and potential mismatches in data could lead to incorrect duplicate-enrollment or payment determinations, risking denial of services or billing disputes.
Federal employees and agencies: Negotiating, implementing, and maintaining the memorandum of understanding and reporting creates ongoing administrative burden and requires staff/time/resources at VA and CMS.
Based on analysis of 2 sections of legislative text.
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 memorandum of understanding with HHS/CMS within one year so VA and CMS can exchange data about people enrolled in both VA health care and Medicare or a Medicare Advantage plan. The data exchange is meant to help identify veterans enrolled in both systems, reduce duplicate care and payments, support utilization management under the Veterans Community Care Program, and inform veterans about follow-up services. The bill also amends Medicare law to require CMS to use VA-provided enrollment and care information when developing a benchmark estimate and requires VA to report to congressional veterans committees after the MOU and every two years thereafter.