Dozens of uninsured and disabled veterans owed compensation for emergency health care costs were erroneously turned down by the Department of Veterans Affairs, federal investigators say.
Even as the Obama administration works to provide health coverage to millions of uninsured Americans, government investigators uncovered dozens of cases where the VA failed to cover emergency hospital costs for uninsured disabled veterans.
Government Accountability Office investigators say the series of errors committed by the VA could be examples of a broader problem in a specialized area of compensation.
The Department of Veterans Affairs must reimburse non-VA hospitals that provide emergency care to disabled veterans — such as for car accident injuries — if the veteran is uninsured, enrolled in VA health care and has received recent treatment at VA.
Federal law requires that such emergency expenses be covered by the federal government even if the injury or illness is not related to the veteran's service-connected disability.
But when GAO looked at a sample of 128 of these claims brought by non-VA hospitals in 2012 seeking reimbursement and that were later denied by the VA, investigators discovered mistakes in half of them, the report says.
The claims were brought to four VA hospitals — Washington D.C. VA Medical Center, White River Junction VA Medical Center in Vermont, Black Hills VA Health Care System in South Dakota and the North Texas VA Health Care System.
The GAO said its investigation "raises concerns about the extent to which other VA facilities nationwide may be inappropriately denying claims."
VA spokeswoman Victoria Dillon said the department is taking steps to better educate employees about handling these claims and better informing veterans about the benefit and how it works.
The VA has since gone back and paid claims in 25 of the cases uncovered by GAO.
In two-thirds of the claims GAO examined, there was evidence the VA never informed disabled veterans that their health care expenses would not be paid by the VA, leaving them unaware of appeal rights.
When private hospitals were not reimbursed by the VA, they were left to bill the uninsured veterans directly.
"These are not wealthy veterans," says Randall Williamson, the supervising GAO investigator for the report.
Some of the mistakes by VA staff included failing to promptly date-stamp claims, sending them to the wrong payment office, routing them to the wrong VA facility and incorrectly concluding that veterans were not eligible.
"They were sloppy," Williamson said of the VA processors.
A 15-year-old law known as the Millennium Act was designed to discourage disabled veterans from racing long distances to the nearest VA hospital when they need emergency treatment, the GAO report says.
The VA estimates it will spend $580 million on this benefit in 2015.
"This report confirms what we've suspected for some time: VA's weak oversight of veterans' Millennium Act claims is placing an undue burden on veterans," says Rep. Jeff Miller, R-Fla., chairman of the House Veterans' Affairs Committee, which requested the investigation.
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