{"id":66256,"date":"2019-08-14T16:06:58","date_gmt":"2019-08-14T16:06:58","guid":{"rendered":"https:\/\/one.sightlinemg.com\/airforcetimes\/uncategorized\/2019\/08\/14\/investigators-find-53-million-in-improper-medical-bills-for-veterans\/"},"modified":"2026-08-08T12:49:50","modified_gmt":"2026-08-08T12:49:50","slug":"investigators-find-53-million-in-improper-medical-bills-for-veterans","status":"publish","type":"post","link":"https:\/\/one.sightlinemg.com\/airforcetimes\/veterans\/2019\/08\/14\/investigators-find-53-million-in-improper-medical-bills-for-veterans\/","title":{"rendered":"Investigators find $53 million in improper medical bills for veterans"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Lawmakers are demanding answers from Veterans Affairs officials after a new investigation found more than $53 million in <a href=\"https:\/\/www.militarytimes.com\/news\/pentagon-congress\/2018\/10\/31\/new-lawsuit-seeks-va-compensation-for-veterans-still-unpaid-emergency-room-costs\/\" target=_blank>emergency room costs<\/a> for veterans improperly rejected by department officials.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In a <a href=\"https:\/\/www.dropbox.com\/s\/oa9nq6zzlnk9hoy\/2019.8.12%20To%20SecVA%20re%20emergency%20care%20payments.pdf?dl=0\" target=_blank>letter to VA Secretary Robert Wilkie<\/a> this week, the bipartisan group of 35 House and Senate members asks for an explanation for how more than 17,000 veterans were left with unpaid, unjustified medical bills and what plans <a href=\"https:\/\/www.militarytimes.com\/news\/pentagon-congress\/2018\/09\/26\/wilkie-touts-a-calmer-reformed-va-in-his-first-congressional-test\/\" target=_blank>the federal bureaucracy<\/a> has to correct the mistakes.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cFacing a medical emergency can be stressful for any patient,&#8221; the letter stated. &#8220;However, the financial toll on veterans when VA erroneously denies or rejects payment can also be devastating. Hospitals may send veterans\u2019 emergency care bills to collection. Non-payment can bankrupt and destroy veterans\u2019 credit histories.\u201d<\/p>\n\n\n\t<aside class=\"smg-interstitial-link wp-block-smg-interstitial-link\">\n\t\t<a href=\"https:\/\/one.sightlinemg.com\/militarytimes\/news\/2019\/07\/31\/va-migrates-health-records-for-235-million-veterans-ahead-of-integration-with-the-militarys-system\/\" class=\"smg-interstitial-link__inner\">\n\t\t\t\t\t\t\t<div class=\"smg-interstitial-link__media\">\n\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"200\" src=\"https:\/\/one.sightlinemg.com\/wp-content\/uploads\/2026\/08\/3139743.jpg.jpg?w=300\" class=\"smg-interstitial-link__image wp-post-image\" alt=\"\" \/>\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"smg-interstitial-link__content\">\n\t\t\t\t<span class=\"smg-interstitial-link__kicker\">Related<\/span>\n\t\t\t\t<h3 class=\"smg-interstitial-link__title\">VA, DoD tout major progress in effort to join electronic health records systems<\/h3>\n\t\t\t\t\t\t\t\t\t<p class=\"smg-interstitial-link__excerpt\">The departments of Defense and Veterans Affairs are eyeing the end of the summer for significant advances in their efforts for a new, joint electronic health record, a move that both bureaucracies have made the long-term centerpiece of medical reforms for their patients.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/a>\n\t<\/aside>\n\t\n\n\n<p class=\"wp-block-paragraph\">At issue is a <a href=\"https:\/\/www.va.gov\/oig\/pubs\/VAOIG-18-00469-150.pdf\" target=_blank>report from the VA Inspector Genera<\/a>l released earlier this month which found $716 million in improperly processed payments in cases involving veterans who sought medical care outside the department\u2019s health system during the spring and summer of 2017.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Not all of the mistakes lead to denied payments, but investigators estimated about 7 percent of the total resulted in veterans receiving bills that should have been covered under existing VA rules.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Investigators found cases of claims being incorrectly rejected because paperwork was filed too late, because of errors in outside-care eligibility, and because processors missed clinical records ordering the outside care. They also found lax oversight within VA, with numerous cases of supervisors not reviewing decisions for quality or accuracy checks.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cIt is critical that VHA staff process claims for non-VA emergency care in an accurate and timely fashion,\u201d the report stated. \u201cInappropriately denied or rejected non-VA emergency care claims present a risk of substantial, undue financial burden on veterans.\u201d<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Complicating the problem was mistakes in VA\u2019s process of notifying veterans about their rejected medical payment claims, which lead to thousands of veterans missing out on a chance to appeal the decisions.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">VA officials in response to the report said they have already put numerous fixes in place to deal with the problems from two years ago and should implement the rest of the Inspector General\u2019s recommendations later this year.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">They also promised to review patient cases as far back as April 2016 to ensure that veterans improperly denied medical coverage are helped. Letters informing those veterans of possible avenues of appeal or redress will be sent out in coming months.<\/p>\n\n\n\t<aside class=\"smg-interstitial-link wp-block-smg-interstitial-link\">\n\t\t<a href=\"https:\/\/one.sightlinemg.com\/militarytimes\/news\/pentagon-congress\/2019\/01\/31\/new-va-health-care-rules-trump-overreach-or-more-choice-for-vets\/\" class=\"smg-interstitial-link__inner\">\n\t\t\t\t\t\t\t<div class=\"smg-interstitial-link__media\">\n\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"203\" src=\"https:\/\/one.sightlinemg.com\/wp-content\/uploads\/2026\/08\/RYW32DW23VCERNJQSYTDCRN7KA.jpg.jpg?w=300\" class=\"smg-interstitial-link__image wp-post-image\" alt=\"\" \/>\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"smg-interstitial-link__content\">\n\t\t\t\t<span class=\"smg-interstitial-link__kicker\">Related<\/span>\n\t\t\t\t<h3 class=\"smg-interstitial-link__title\">New VA health care rules: Trump overreach or more choice for vets?<\/h3>\n\t\t\t\t\t\t\t\t\t<p class=\"smg-interstitial-link__excerpt\">Debate over how to expand veterans health care choices connects to larger national fights over the role of government and private-sector partnerships.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/a>\n\t<\/aside>\n\t\n\n\n<p class=\"wp-block-paragraph\">Lawmakers in their letter say they want more details of that promise, to ensure similar mistakes aren\u2019t made in the future.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">They also asked department officials to report \u201cwhether VA is appropriately resourced \u2014 in terms of staffing and technology \u2014 to implement requirements associated with emergency care claims adjudication.\u201d<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Inspector General officials said if proper fixes aren\u2019t fully implemented, the unexpected costs to veterans seeking outside care could grow to more than $500 million over the next five years.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Lawmakers want a clear answer on how VA plans to help the thousands of veterans hurt by the mistakes.<\/p>\n","protected":false},"author":7,"featured_media":31014,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_yoast_wpseo_meta-robots-noindex":"","_yoast_wpseo_meta-robots-nofollow":"","_yoast_wpseo_canonical":"","_acf":"","_yoast_wpseo_primary_category":21,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","_smg_distribution_targets":[]},"categories":[101,24,89,16,26,65,21],"tags":[],"coauthors":[3328],"class_list":["post-66256","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-daily-news-roundup","category-home","category-middle-column","category-news","category-newsletters","category-pentagon-congress","category-veterans"],"acf":{"subheadline":"","legacy_arc_id":"HT5IVIWXVFG6VCQ2FZI7HK3FQE","arc_canonical_url":"\/news\/pentagon-congress\/2019\/08\/14\/investigators-find-53-million-in-improper-medical-bills-for-veterans\/","remove_feature_photo":false,"is_sponsored":false,"subtype":"","redirect_url":"","disable_inline_ads":false,"native_logo_pretext":"Presented By:"},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v26.0 (Yoast SEO v28.1) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Investigators find $53 million in improper medical bills for veterans - Air Force TImes<\/title>\n<meta name=\"description\" content=\"Lawmakers want a clear answer on how VA plans to help the thousands of veterans hurt by the mistakes.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Investigators find $53 million in improper medical bills for veterans\" \/>\n<meta property=\"og:description\" content=\"Lawmakers want a clear answer on how VA plans to help the thousands of veterans hurt by the mistakes.\" \/>\n<meta property=\"og:url\" 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