GUARD Veterans’ Health Care Act
Sponsored By: Senator Elizabeth Warren
Introduced
Summary
Would create a new framework that requires VA cost recovery from Medicare Advantage and Part D plans. It also expands VA authority to collect reasonable charges from third parties for non-service-connected care and adds deadlines, penalties, and enforcement tools.
Show full summary
- Veterans and Medicare enrollees: Veterans who receive care covered by a Medicare Advantage or Part D plan would trigger plan reimbursements to the VA when those items or services are covered. The MA/Part D reimbursement rule applies to plan years beginning on or after January 1, 2026.
- Medicare Advantage and Part D plans: MA organizations and prescription drug plan sponsors would be required to reimburse the VA under a new Section 1729C, and recovered amounts would be deposited into the VA Medical Care Collections Fund.
- Insurers and other third parties: The bill clarifies VA’s right to recover across tort and insurance claims, creates a 45-day payment window, allows interest on late payments, and authorizes civil penalties that can reach up to $50,000 per claim and treble damages for nonpayment.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 0 benefits, 1 costs, 1 mixed.
Stronger VA recovery and penalties
If enacted, the VA would get stronger tools to recover payments from third parties. Third parties must tell VA within 30 days if they know a person got VA care. Settlement money could not be paid out until VA is satisfied. Third parties would have 45 days to pay a clean claim, and interest would start after 45 days. The bill would allow daily civil penalties, big willful-payment penalties (the higher of triple the claim or up to $50,000), and it would let the government sue for double damages. The VA could enforce recoveries through subrogation and join or intervene in cases. You would generally have six years from the last day of care to start a recovery case and about three years for most tort claims.
Medicare Advantage and Part D pay VA
If enacted, Medicare Advantage plans and Part D sponsors would have to reimburse VA for covered items and drugs the VA gives to their enrollees. This would apply to plan years beginning January 1, 2026. Plans must reimburse even if they normally require extra paperwork. Amounts recovered would go to the VA Medical Care Collections Fund.
Sponsors & CoSponsors
Sponsor
Elizabeth Warren
MA • D
Cosponsors
Richard Blumenthal
CT • D
Sponsored 6/23/2025
Bill Cassidy
LA • R
Sponsored 6/23/2025
Roll Call Votes
No roll call votes available for this bill.
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