GUARD Veterans’ Health Care Act

This bill amends title 38 of the United States Code and the Social Security Act to allow the Department of Veterans Affairs (VA) to recover costs from Medicare Advantage and Medicare prescription drug plans for health care items or services provided to veterans enrolled in those plans, and modifies the VA's authority to recover reasonable charges for care or services furnished to veterans for non-service-connected disabilities from third parties.

Sec. 2, Cost-recovery from Medicare Advantage and Medicare prescription drug plans: This section adds a new section 1729C to title 38, requiring Medicare Advantage organizations and prescription drug plan sponsors to reimburse the VA for any health care item or service (including for service-connected or non-service-connected disabilities) provided to an individual enrolled in such a plan, regardless of any additional documentation or utilization management requirements. The VA will recover these amounts using procedures similar to those under existing section 1729. This applies to plan years beginning on or after January 1, 2026, and reimbursed amounts are deposited into the VA Medical Care Collections Fund. It also makes conforming amendments to the Social Security Act.

Sec. 3, Modification of authority for recovery by United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities: This section amends section 1729 of title 38 to expand the United States' right to recover reasonable charges for care or services for non-service-connected disabilities from third parties, including in tort or under any policy or contract. It sets time limits for third parties to pay claims (45 days) or provide notice of refusal, with interest penalties for late payment. It requires third parties to determine if a recipient has received VA benefits and submit information to the VA. It prohibits third parties from distributing settlement proceeds without satisfying a VA claim. It imposes civil penalties for noncompliance, including up to $50,000 or triple the claim amount for willful failure to pay a clean claim. It defines "clean claim" and expands the definition of "non-service-connected disability" to include aggravations of service-connected disabilities and certain tort-related entities.