GUARD Veterans’ Health Care Act

This bill, known as the "GUARD Veterans' Health Care Act," aims to enhance the Department of Veterans Affairs' (VA) ability to recover healthcare costs. A primary provision allows the VA to seek reimbursement from Medicare Advantage and Medicare prescription drug plans when it provides covered healthcare items or services to veterans enrolled in these plans. This applies regardless of whether the disability is service-connected or not, and the plans must reimburse the VA without imposing additional administrative requirements, with these funds deposited into the VA Medical Care Collections Fund starting January 1, 2026. The legislation significantly modifies the VA's authority to recover reasonable charges from third parties for care provided to veterans for non-service-connected disabilities . It clarifies that the United States has a right to recover from third parties to the extent the recipient or provider would be eligible for payment, encompassing tort liabilities and various health benefit plans. The VA is empowered to enforce its subrogation interests, including through intervention in legal actions, and sets specific statutes of limitations for such recovery efforts. New provisions establish strict obligations for third parties, requiring them to pay " clean claims " within 45 days or provide detailed reasons for refusal or requests for additional information. Failure to comply incurs interest on unpaid amounts, and third parties are prohibited from distributing settlement proceeds without satisfying a VA claim. The bill also introduces significant penalties for non-compliance, including civil penalties for daily non-compliance and higher penalties (up to triple the claim amount or $50,000) for willful failure to pay clean claims, ensuring the VA's recovery rights are not limited by external fee schedules.