The "Veteran Access to Neurosurgery Act of 2026" mandates the Department of Veterans Affairs (VA) to establish a five-year pilot program. This program aims to improve access to specialized surgical services, specifically neurosurgery , for veterans residing in rural or highly rural areas by allowing market-based rate adjustments for providers. Under this pilot, qualified providers , defined as board-certified surgeons, can negotiate these adjustments for furnishing services through the Veterans Community Care Program. Adjustments are permitted when the provider demonstrates necessity, the standard community care rate is insufficient to cover costs, and the veteran lacks access to VA-furnished neurosurgery within a 60-day wait time or 100-mile radius. The pilot program will be implemented in at least two Veterans Integrated Service Networks (VISNs) with significant rural veteran populations. The VA Secretary is required to issue regulations within 180 days and submit annual reports to Congress detailing patient numbers, service types, costs, and health outcomes. Additionally, the VA Inspector General will conduct annual reviews to ensure the program's compliance, efficiency, and effectiveness.