VA must pay vets billions back in ER bills, court rules

VA must pay vets billions back in ER bills, court rules

Court sides with vets in case of charges from non-VA hospitals

The federal government may have to pay billions of dollars in emergency care claims to veterans following a federal court ruling last week.

The U.S. Court of Appeals ruled that the Department of Veterans Affairs improperly denied reimbursements for such care received at non-VA facilities. The ruling for Veterans Claims said federal law mandated the VA to pay the emergency medical expenses if they are not covered by private insurance.

Three years ago this same panel of U.S. court of veterans appeals judges ordered the VA to follow the law and pay emergency care bills for vets who had other insurance and went to non-VA hospitals. But, the VA never started paying.

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“Three years. Nothing’s happened,” said Judge William S. Greenberg of the U.S. Court of Appeals for Veterans Claims.

Since the case was ruled a class action, the National Veterans Legal Services Program, which helped represent plaintiffs, said any affected veteran must be reimbursed.

It said based on the VA’s past estimates, the decision could cost the department $1.8 billion to $6.5 billion in reimbursements to hundreds of thousands of veterans with claims filed or pending from 2016 through 2025. It is unknown just how many veterans in Ohio may be impacted but the military has a large presence in the the Dayton region.

Wright-Patterson Air Force Base is the largest single-site employer in Ohio, employing more than 30,000 civilian and military personnel with an estimated economic impact of more than $15.54 billion. Ohio is also home to more than 864,000 veterans, according to the U.S. Census Bureau.

Richard Staab, an 86-year -old Minnesota veteran was one of those vets. He was left to pay bills totaling almost $48,000 for heart attack and stroke care he received at a non-VA hospital.

“You enlist with us. You get to have all health care taken care of. And this, and that,” Staab said. “That was the big thing back then.”

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The VA has until Oct. 24 to submit a plan to judges on how it wil pay back veterans.

The case stemmed in part from a reimbursement sought by Coast Guard veteran Amanda Wolfe, who had a bout of appendicitis in September 2016 and sought care at a nearby civilian hospital because the nearest VA hospital was three hours away.

She filed a claim for $2,558.54 of the $22,348.25 bill, representing the amount not covered by her employer-sponsored health insurance. The VA denied the claim, saying that amount was for co-payments, coinsurance and deductibles that it was not required to pay.

The court, in its ruling Monday, disagreed. It said the VA must reimburse veterans for out-of-pocket emergency medical bills not covered by private insurance, other than co-payments.

The VA said Wednesday it was aware of the decision and reviewing it. It was the second time the VA had been overruled on its interpretation of how veterans should be reimbursed on emergency claims, the first being in 2015.

“The court’s decision rights a terrible injustice and its order ensures that veterans who were unjustly denied reimbursement for critical emergency treatment at non-VA facilities will finally be reimbursed,” said NVLSP Executive Director Bart Stichman.

The Associated Press contributed to this story.

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