Clarity on Care Options Act

Bill Number

H.R. 6526

Origin Chamber

House

Congress

119th Congress, Session 1

Policy Area

Armed Forces and National Security

Status

Introduced

Latest Action

2026-01-13: Subcommittee Hearings Held

Last Updated

2026-05-11T14:06:46Z

AI-Generated Summary

Purpose

The "Clarity on Care Options Act" (H.R. 6526) aims to improve access to healthcare information for beneficiaries of the CHAMPVA program—a health insurance program for certain family members of veterans, such as spouses and children, who are not eligible for other VA benefits. It requires the Department of Veterans Affairs (VA) to create and maintain a public online directory of healthcare providers who agree to accept CHAMPVA payments as full payment for services (known as "accepting assignments"), making it easier for beneficiaries to find in-network care.

Key Provisions

• Annual Queries of Providers: Entities that manage networks of healthcare providers for the VA (under section 1703 of title 38, U.S. Code) must annually ask each provider in their network whether they accept CHAMPVA assignments and report the results to the VA Secretary.
• Public Directory: The VA Secretary must use these reports, along with other available data, to build and keep updated a publicly accessible online directory listing providers who accept CHAMPVA assignments.
• Implementation Timeline:
• First provider queries and reports due within 90 days of the bill's enactment.
• Initial directory must be public within 180 days of enactment.
• Annual Reports to Congress: For five years starting one year after enactment, the VA must submit reports detailing CHAMPVA acceptance rates among network providers. These reports break down data by state and Veterans Integrated Service Network (VISN—a regional VA organizational structure) and include:
• Number of accepting providers.
• Percentages of providers who accept or do not accept assignments.
• Geographic areas with CHAMPVA beneficiaries but no accepting providers.
• Definitions:
• "Accept assignment" means a provider agrees to treat a CHAMPVA beneficiary and accepts the program's approved payment amount as full compensation, without billing the beneficiary extra.
• "CHAMPVA program" refers to the Civilian Health and Medical Program of the Department of Veterans Affairs, governed by specific U.S. laws and regulations.

Significant Changes to Existing Law

This bill amends title 38 of the U.S. Code by adding new requirements for the VA to collect, maintain, and report on CHAMPVA provider participation. Previously, there was no mandated public directory or systematic annual querying of providers for CHAMPVA acceptance, though the program already exists to cover eligible dependents' healthcare costs. It introduces administrative obligations on network-managing entities and the VA without altering CHAMPVA eligibility or payment rules.

Potential Impacts

• On Government Agencies: The VA will face new administrative tasks, including overseeing queries, building and updating the directory, and preparing annual reports, which could increase operational costs and workload but enhance program transparency.
• On Citizens: CHAMPVA beneficiaries (primarily families of veterans) will gain easier access to in-network providers, potentially reducing out-of-pocket costs and improving healthcare navigation. It may highlight underserved areas, prompting future expansions in coverage.
• On International Relations: No direct impacts, as the bill focuses on domestic VA healthcare programs.

Main Stakeholders Affected

• CHAMPVA Beneficiaries: Spouses, children, and survivors of veterans who rely on the program for health coverage; they benefit from better information on available providers.
• Healthcare Providers: Those in VA-contracted networks, who must respond to annual queries; accepting assignments could increase their patient base but requires agreement to CHAMPVA payment limits.
• Department of Veterans Affairs (VA): Responsible for implementation, reporting, and maintenance, affecting VA staff and budget.
• Network Administrators: Private or public entities managing VA provider networks, now required to conduct and report on annual surveys.
• Congress: Receives annual reports to monitor program effectiveness, potentially influencing future VA funding or policy.

Notable Legal, Constitutional, or Political Implications

• Legal: Strengthens VA accountability under title 38 by mandating data collection and public disclosure, aligning with broader federal efforts to promote healthcare transparency (e.g., similar to Medicare provider directories). No challenges to existing CHAMPVA regulations.
• Constitutional: No apparent issues; it involves standard congressional authority over veterans' benefits and does not infringe on individual rights.
• Political: Could appeal to veterans' advocacy groups by addressing access gaps, potentially reducing complaints about fragmented care options. The five-year reporting requirement allows for ongoing evaluation, which might lead to partisan debates on VA efficiency or funding during appropriations cycles.

This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.

Sponsor

Rep. Kiggans, Jennifer A. [R-VA-2]

Cosponsors (1)

Rep. Brownley, Julia [D-CA-26]

Recent Actions

• 2026-01-13: Subcommittee Hearings Held
• 2025-12-10: Referred to the Subcommittee on Health.
• 2025-12-09: Referred to the House Committee on Veterans' Affairs.
• 2025-12-09: Introduced in House
• 2025-12-09: Introduced in House

Bill Versions

• Clarity on Care Options Act — issued 2025-12-09 — PDF (4 pages)