More than one million veterans will soon be receiving instructions from Veterans Affairs officials on how to check if they are eligible for thousands of dollars in medical cost reimbursements as part of a court decision last fall.
Starting today, department staffers will send letters to tens of thousands of veterans who were rejected for financial relief in recent years for bills they received for non-department emergency medical care. That move comes over VA objections concerning an ongoing lawsuit over the issue, which could add billions in new costs to the department’s budget.
Last fall, the U.S. Court of Appeals for Veterans Claims ruled that the department’s current regulation for veterans who seek non-department medical care violates existing federal law. They ordered VA officials to re-examine more than 72,000 rejected claims and update their rules, arguing the department has a responsibility to cover the costs of the unexpected medical visits.
The ruling could cost the department up to $6.5 billion in past and future reimbursement expenses.
The case centers on veterans whose unpaid emergency room expenses were denied by VA officials under existing policies. The plaintiffs’ both had part of their bills paid for by other insurance, but were left with several thousand in personal costs.
VA officials argued in court that 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.
A VA Inspector General report last summer 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.
VA officials are considering appealing the ruling, and asked that any action on the cases be postponed until higher courts weigh in on the matter.
But earlier this month, the appeals court rejected that motion and ordered letters be sent out starting April 13. Advocates praised the decision.
“Hundreds of thousands of veterans affected by this class action have suffered far too long and endured severe financial hardships due to VA’s wrongful handling of their reimbursement claims,” said said Bart Stichman, executive director of the National Veterans Legal Services Program.
Previous attempts to force the department to respond to a large group of veterans complaints instead of individual cases failed to meet the court's standards.
VA officials have estimated that full compliance with the court order could cost between $1.8 billion and $6.5 billion. Reimbursements may date back to cases decided by the department in 2016.
The ruling also invalidated all VA decisions denying reimbursement for deductibles and co-insurance costs not covered in emergency visits at non-VA facilities.
The letters come as many veterans are facing new debts related to work interruptions and other financial problems related to the ongoing coronavirus pandemic. However, processing of the claims is likely to take several months, and may be stalled further by ongoing legal appeals.