H.R. 5261 — Veterans Emergency Care Reimbursement Act of 2025

This section revises the limitation on Department of Veterans Affairs (VA) reimbursement for emergency treatment costs that a veteran owes under a health-plan contract (38 U.S.C. §1725(c)(4)(D)), restricting non-reimbursement to copayments of less than $100 (previously, copayments or similar payments) and defining copayment as a fixed amount for a covered health service, excluding deductibles or coinsurance. (As background, VA's emergency treatment reimbursement program compensates veterans for non-VA care received when VA facilities are unavailable, subject to conditions including the veteran's health-plan coverage.) The changes apply retroactively to reimbursement claims—including denied claims—for treatment furnished on or after February 1, 2012, including those from the certified class in Wolfe v. McDonough, No. 18-6091 (U.S. Vet. App.). (Thus, VA must reimburse copayments of $100 or more, deductibles, coinsurance, and other cost-sharing.)