VA Home and Community-Based Services Reimbursement

Current understanding

The Department of Veterans Affairs pays outside providers for home and community-based services (HCBS) — such as home health aide, homemaker, adult day health care, and respite services — furnished to eligible veterans as an alternative to institutional long-term care. Reimbursement rates and rate-setting methodology for these services have drawn legislative attention over concerns that current payment levels do not keep pace with market wages, potentially limiting provider participation and veteran access.

Evidence log

• 2026-07-16 — To amend title 38, United States Code, to ensure fair reimbursement rates for home and community-based services furnished by the Department of Veterans Affairs, and for other purposes.: 2025 — HR9752 (introduced): would amend title 38 to ensure fair reimbursement rates for home and community-based services furnished by the VA, a House companion/parallel to S5027 targeting VA HCBS payment policy. (novelty: 2)
• 2026-07-16 — A bill to require the Secretary of Veterans Affairs to carry out a pilot program to use amounts under the Veteran-Directed Care program to provide care to veterans with acquired brain injury, and for other purposes.: 2025 — S5013 (introduced): pilot program directing Veteran-Directed Care funds (a participant-directed HCBS option) to veterans with acquired brain injury, expanding the population served under this VA HCBS delivery model. (novelty: 2)

Open questions

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