Protect Seniors and Veterans from Health Care Fraud Act of 2026

Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall, for purposes of avoiding duplicative, improper, or erroneous billings or payments for hospital care and medical services furnished under the laws administered by the Secretary of Veterans Affairs, seek to enter into a memorandum of understanding with the Secretary of Health and Human Services with respect to reciprocal access between the Veterans Health Administration and the Centers for Medicare and Medicaid Services to data and information on veterans who are concurrently enrolled in the patient enrollment system under section 1705(a) of title 38, United States Code, and—

(1) the Medicare program;

(2) the Medicaid program; or

(3) a Medicare Advantage plan.

The memorandum of understanding required under subsection (a) shall include an agreement through which—

(1) the Secretary of Veterans Affairs transmits to the Secretary of Health and Human Services—

(A) information relating to veterans who are—

(i) enrolled in such system for patient enrollment; and

(ii) in receipt of hospital care or medical services under laws administered by the Secretary of Veterans Affairs; and

(B) such other information as the Secretary of Veterans Affairs determines appropriate, including billing codes and diagnostic codes for such hospital care or medical services; and

(2) the Secretary of Health and Human Services—

(A) uses information transmitted pursuant to paragraph (1) to identify veterans who are concurrently enrolled in such system for patient enrollment and—

(i) the Medicare program;

(ii) the Medicaid program; or

(iii) a Medicare Advantage plan; and

(B) transmits to the Secretary of Veterans Affairs—

(i) a list of the veterans identified pursuant to subparagraph (A); and

(ii) such other information as the Secretary of Health and Human Services determines appropriate.

The memorandum of understanding required under subsection (a) shall be effective for a two-year period beginning on the date on which the Secretary of Veterans Affairs enters into such memorandum.

Not later than one year after the date on which the Secretary of Veterans Affairs enters into the memorandum of understanding required under subsection (a), and on a biennial basis thereafter during the period such memorandum is effective, the Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report that includes—

(1) a summary of the activities of the Secretary carried out pursuant to such memorandum; and

(2) an assessment of the Secretary with respect to the effectiveness of such memorandum in avoiding duplicative, improper, or erroneous billings or payments for hospital care and medical services furnished under the laws administered by the Secretary.

In this section:

(1) The term Medicaid program means the program of medical assistance established under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).

(2) The term Medicare Advantage plan means a Medicare Advantage plan under the program established under part C of title XVIII of the Social Security Act (42 U.S.C. 1395w–21 et seq.).

(3) The term Medicare program means the Medicare program under such title.