S. 4131 — Veteran Access to Neurosurgery Act of 2026

This section establishes a pilot program under the Veterans Community Care Program (i.e., the program under 38 U.S.C. § 1703 that furnishes hospital care, medical services, and extended care services to covered veterans—generally those enrolled under VA's patient enrollment system or otherwise eligible—through non-VA providers such as Medicare-participating providers) to permit qualified providers (i.e., board-certified surgeons) to negotiate market-based rate adjustments for qualifying specialized surgical services (i.e., neurosurgery). The Secretary of Veterans Affairs must commence the pilot program not later than one year after enactment of this Act, conduct it for a five-year period in at least two Veterans Integrated Service Networks with a large number of veterans in rural or highly rural areas, and provide rate adjustments if (1) the provider demonstrates necessity, (2) the standard rate is insufficient to cover costs, and (3) no VA care (direct or through the program) is available within a 60-day wait time or 100 miles for the veteran. The Secretary must issue implementing regulations within 180 days after enactment via notice-and-comment rulemaking; the VA Inspector General must conduct and report on annual compliance reviews starting one year after enactment; and the Secretary must submit annual reports to the congressional Veterans' Affairs Committees starting one year after enactment that include the number of patients served, types and numbers of services furnished, total costs, health outcomes, policy recommendations (including on extension or permanency), and other relevant information.