A federal court ordered Veterans Affairs to reimburse veterans for all expenses at non-department emergency medical centers. The ruling was ordered in September. This could mean thousands of dollars of payouts to veterans. The move would immensely help those experiencing financial hardship from medical bills.
The ruling will also add billions in medical care costs to the department’s budget in coming years.
A divided three-judge panel on the U.S. Court of Appeals for Veterans Claims said that VA’s current reimbursement regulation for veterans who seek non-department medical care violates existing federal law.
The ruling will allow emergency medical expenses not covered by veterans’ private medical insurance to be paid for by the agency.
In August of this year, the VA Inspector General found $716 million in improperly processed payments in cases involving veterans who sought medical care outside the department’s health system in 2017, including about $53 million that should have been refunded under existing rules.
This is the second time in three years that the VA has been sued over medical bills.
Veteran advocates are praising the ruling in hopes that it will assist even more veterans with their medical bills, something many believe should have already been taken care of by the VA.
The latest case centered on two veterans who were denied several thousand dollars in unpaid emergency room expenses under existing VA policy. The majority of one plaintiff’s bills were paid for by private insurance. The other’s was mostly covered by Medicare.
In both cases, VA insisted they did not need to handle the unpaid balance because the veterans were primarily covered under other insurance plans. The court ruled that violates both existing law and past legal precedent.
The ruling gives 45 days for VA to submit to the court plans to contact veterans with denied claims since 2016 and develop a criteria for reimbursing eligible claims. Those would not include the costs of co-payments related to private insurance.
Contact your local VA to see if you are eligible for medical cost reimbursements.
Source: Military Times