Appeals court rules VA must pay vets' ER bills at non-VA hospitals
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The Department of Veterans Affairs has been ordered to reimburse veterans for the cost of their emergency care at non-VA hospitals - something the agency has actively told veterans they are not entitled to, an appeals court ruled this week.
The VA has wrongfully been denying veterans’ claims while also misrepresenting a regulation that entitles them to reimbursement, the U.S. Court of Appeals for Veterans Claims said Monday.
A previous regulation ended up excluding “nearly every type of expense a veteran could have incurred if he or she had insurance covering the non-emergency VA medical service at issue” from reimbursement, the court said, which violates a 2010 federal law.
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“The Agency has effectively rolled back the clock and, with no transparency, essentially readopted a position we have authoritatively held inconsistent with Congress's command,” the judges said, according to court documents. “Recognizing this is what has happened is — quite frankly — startling enough.
“It's difficult to conceive how an agency could believe that adopting a regulation that mimics the result a federal court held to be unlawful is somehow appropriate when the statute at issue has not changed,” they said.
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Not only was the VA not reimbursing veterans’ claims, but the agency was actively telling veterans they weren’t entitled to payments for non-VA emergency care when, in fact, they are.
“In other words, the agency was telling veterans that the law was exactly opposite to what a federal court had held the law to be. Who knows how many veterans relied on such a misrepresentation — for that is what it was — in deciding not to appeal VA decisions that denied reimbursement for non-VA emergency medical care,” the judges said. “All of this is unacceptable."
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The judges ruled that the VA can’t send out its “corrective” notices that contain the following language: "It is important to note that VA has no legal authority to pay a veteran's cost shares, deductibles or copayments associated with their other health insurance,” as that isn’t a correct interpretation of the regulation.
The VA told Fox News the agency " is aware of this decision and reviewing it."