For seven years the VA has been denying reimbursement to veterans who required emergency medical care outside the VA system if they had other coverage that paid for such care in whole or in part. Obviously, if an eligible veteran has other health insurance that picks up the whole bill it’s a “no harm, no foul” situation – not that many of us have such coverage. But what about the “in part” issue? For many people, including the veteran in this case, that “part” was substantial. Mr. Staab was stuck with a $48,000 bill for the portion of his heart attack treatment not covered by Medicare. This decision of the Court of Appeals for Veterans’ Claims fixes Mr. Staab’s issue, but there are probably thousands of other veterans out there who have had the same problem. What is especially troubling about the conduct of the VA here is that its regulation was clearly inconsistent with the actual law. Further, the VA’s position was nonsensical in the modern world of healthcare where almost no one has 100% coverage. If a veteran is entitled to free health care through the VA why shouldn’t it make him or her whole when emergency care is needed and a VA facility is not available? That was the intent of the law passed in 2008. Apparently, the VA saw it differently and undoubtedly many veterans suffered. The good news or silver lining is that, yes, the VA can be challenged whether it is with regard to situations such as this one or it is with regard to poor care rendered at a VA hospital. The system can be challenged – and the challengers can and do win. It needs to keep happening. To view the original article, please click here.
top of page
bottom of page