En español | Delayed reimbursements from the Department of Veterans Affairs (VA) for medical care received outside its system resulted in some veterans’ referrals to collections agencies and termination of their care, a Department of Veterans Affairs investigation found.
The Office of Special Counsel (OSC) mandated the examination after a whistleblower who made the initial allegations of mishandled money tipped off officials.
"[The Mid-Atlantic region] failed to timely reimburse community health care providers, which resulted in some of those providers terminating services for veterans and referring veterans to collection agencies for nonpayment,” according to a report on the investigation, which was conducted in 2018.
Previous problems exposed
An August report from the department's Office of Inspector General found 31 percent of veterans had their private emergency care reimbursement claims wrongfully rejected or denied, largely because of insufficient quality control.
How to Appeal a Denied Claim
Call: As Congress puts pressure on the Department of Veterans Affairs to pay former service members who were denied reimbursement for emergency care outside of VA hospitals, veterans can call the Community Care National Center at 877-881-7618 toll free if they have questions related to a rejected claim.
Resubmit: If veterans think their claims were inappropriately turned down, the rejected claim may be resubmitted once any errors are fixed or additional information is provided. VA officials should have sent a letter explaining why a claim was refused.
Meet deadline: A denied claim can be appealed within a year from the date of the denial letter, according to the VA inspector general.
In 2017 alone, more than 2,500 veterans contacted the VA specifically about credit and collection issues related to its failure to pay claims, said the Office of Special Counsel, citing VA data.
In response to the findings, the report recommended automating the department's outdated payment process, educating providers on how to submit claims to the VA and ensuring payment centers have enough staff to process the claims.
Other flaws in VA payment processing were found in its Beneficiary Travel program that reimburses travel to and from VA facilities. In this instance, the VA's 2017 financial report showed $223.76 million in improper payments.
"I commend the whistleblower for coming forward to identify this gross waste of federal taxpayer dollars and the unwarranted hardships placed on veterans as a result of the VA's longstanding failure to properly pay provider claims,” Special Counsel Henry Kerner said in a letter with the findings to President Donald Trump.
Troubles as early as 2014
The counsel believes that the VA may have been aware of veterans’ accounts being sent to collections as early as 2014 because of the department's “antiquated repayment system."
"I am also disappointed that it has taken multiple reports and hundreds of millions of dollars in wasted taxpayer funds for the VA to address the flaws in its accounting software,” Kerner said.
A VA spokeswoman said the allegations “date to the previous administration” and department officials are pleased that the special counsel is satisfied that they are taking steps to address the problems.
"Since these allegations surfaced several years ago, VA has taken a number of steps to improve its provider reimbursement and beneficiary travel programs,” VA press secretary Christina Mandreucci said.
However, the House Committee on Veterans’ Affairs said it has been concerned about the report's findings and hopes to address longstanding concerns that also have been highlighted in other reports this year.
"The committee is planning to hold a hearing this spring to examine these issues and the undue financial burdens veterans face when their community care claims are inappropriately rejected or denied,” said Jenni Geurink, press secretary at the House Committee on Veterans’ Affairs.