Enhancements to Veterans Healthcare Coordination Needed
Officials from the Department of Veterans Affairs (VA) have communicated to Congress their support for enhancing care coordination through a new legislative proposal. However, unresolved legal issues continue to hinder effective data sharing necessary to prevent duplicate healthcare payments.
During a recent session of the House Committee on Veterans’ Affairs, the VA elaborated on a draft House bill, the Veterans Care and Cost Coordination Act of 2026. This proposed legislation aims to improve data sharing between the VA and the Department of Health and Human Services (HHS) by mandating a memorandum of understanding (MOU). The goal is to better coordinate patient data, manage healthcare costs, and curtail unnecessary billing or payments.
Despite agreeing with the bill's objectives, VA representatives indicated the bill lacks the legal framework necessary for comprehensive data sharing. Lisa Arfons, acting assistant under secretary for health in the Veterans Health Administration Office of Integrated Veteran Care, informed the committee that effective information exchange is essential to eliminating duplicate payments. She emphasized the need for each department to share pertinent billing and payment details.
The draft outlines a requirement for a reciprocal data-sharing agreement between the VA and the Centers for Medicare & Medicaid Services (CMS) for veterans under VA healthcare and those enrolled in Medicare or Medicare Advantage plans. Although the VA supports the bill’s purpose, Arfons voiced concerns over the current language, stating it does not extend the VA's authority needed to enhance coordination effectively.
Arfons mentioned an existing 2025 agreement between the VA and CMS aimed at reducing duplicate billing through claims data comparison. This agreement seeks to identify health providers billing both VA and Medicare, thereby preventing overpayments. However, the draft legislation, in its current form, does not legally enable broader data sharing.
In her comments, Arfons suggested including the War Department (DOW) in the bill, considering that many veterans eligible for VA benefits are also covered under TRICARE. A coordinated approach involving the VA, DOW, and HHS could more effectively address billing duplications and errors.
The VA also expressed concerns that the bill's scope might be too extensive, obligating data sharing for all VA enrollees, not just those with Medicare or Medicare Advantage. Arfons pointed out the VA’s limited capacity to advise veterans on Medicare follow-up care. She assured Congress that the VA would collaborate with the committee to refine the legislative language, granting appropriate authority to achieve the intended benefits.
In closing, Arfons acknowledged the bill’s potential for improvement through further collaboration and that addressing billing inefficiencies could lead to significant savings for the VA, DOW, and HHS.