Aug 8, 2019 - Health

Veterans face surprise medical bills from non-VA hospitals

More veterans are able to get more care outside the VA system, but improper billing oversight has put thousands at risk for unanticipated hospital bills.

By the numbers: A report this week from the VA’s Office of Inspector General found that many veterans’ claims were improperly denied after they sought care in the emergency rooms of non-VA facilities.

  • The OIG estimated that about 17,400 veterans were billed for care the VA should have covered, totaling about $53 million.
  • The universe of potential effects is even bigger. Not every hospital ended up billing veterans for their denied claims, but roughly 61,000 veterans were at risk for such a bill, the OIG found.

What happened: The part of the VA that handles these claims prioritized speed — making a lot of decisions as quickly as possible — over accuracy, the OIG said.

  • The inappropriate denials were largely a product of processing errors, and when claims are processed incorrectly, patients who do get a bill may not have the accurate information they need to contest it.

My thought bubble: There’s a practical, non-ideological argument for expanding veterans’ options outside VA facilities, and that case is especially intuitive for emergency care. But the VA is still dropping the ball if it’s not actually covering that care the way it should.

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