Veterans Medicare Access Improvement Act of 1998

Veterans Medicare Access Improvement Act of 1998 - Amends title XVIII (Medicare) of the Social Security Act to authorize the Secretary of Health and Human Services and the Secretary of Veterans Affairs to establish a program under which the former Secretary shall reimburse the latter Secretary out of the Medicare trust funds for Medicare health care services furnished to certain Medicare-eligible veterans whose closest Department of Veterans Affairs (VA) medical center is geographically remote or inaccessible. Authorizes the Secretaries to establish a demonstration project similar to such program for Medicare-eligible veterans whose closest VA medical center is not geographically remote or inaccessible. Amends the Balanced Budget Act of 1997 to repeal the requirement for an implementation plan for veterans subvention. Prohibits payments from the Medicare trust funds for items or services furnished under the program or demonstration project established under this Act before the Director of the Office of Management and Budget determines that: (1) certain legislation restricting entitlement to service-connected compensation for a tobacco-related disability has been enacted; and (2) the net amount of the reductions in expenditures achieved by reason of such legislation during the five fiscal year period beginning with FY 1999, that is available to offset the net aggregate increase in outlays (if any) under the Medicare program, is not less than the estimated net aggregate increase during such period. Directs the Secretary to report to the Congress on a method to phase-in the costs of military facility services furnished by VA or the Department of Defense to Medicare-eligible beneficiaries in the calculation of an area's Medicare+Choice capitation payment.