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Veterans to Receive Reimbursement for Emergency Room Visits per Court Order

Veterans received some welcome news earlier this month from a federal appeals court. The Department of Veterans Affairs (VA) was ordered to reimburse veterans for their expenses associated with emergency care at non-VA medical centers. Prior to the ruling, the VA was informing veterans that they were not entitled to reimbursement.

According to the U.S. Court of Appeals for Veterans Claims, “The VA has wrongfully been denying veterans’ claims while also misrepresenting a regulation that entitles them to reimbursement.”

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.

The three-judge panel on the U.S. Court of Appeals for Veterans Claims was divided, but stated that the VA’s adoption of the previous reimbursement regulation for veterans, who seek non-VA emergency medical care, violates an existing 2010 federal law that was upheld by the recent appeal.

In addition to the VA not reimbursing disabled veterans’ claims, they were also informing veterans that they were not entitled to recover costs for non-VA emergency care when, in fact, they were.

The VA Inspector General uncovered in 2017 that incorrectly processed payments for veterans, who received medical treatment outside the VA’s health system, totaled $716 million. In addition, reimbursements that should have been paid to veterans under the current regulations, but were not, totaled another $53 million.

Twice in the past 3 years, the federal appeals court has overturned the VA’s payment policies for emergency medical services. In both instances, the VA was admonished for just partially covering veterans’ expenses. The ruling was lauded by advocates, as it also established a class of veterans eligible for reimbursement.

According to the ruling, the VA has 45 days to provide the court with its strategy to inform veterans who were denied claims from 2016 and those eligible claims will be reimbursed by the VA. The reimbursements would not include private insurance co-payments.

Department of Veterans Affairs officials stated they are reviewing the court’s decision, as the VA can appeal the ruling to a higher court, but they did not make any additional statements.

The Injured Veterans legal team at Gordon & Partners is here for military veterans and their families. Please contact us immediately, if you are having difficulty with your claim or you are not receiving the disability benefits to which you are entitled. Call us at 1-888-231-9144 or fill out the form on this website.

Read the full story here: https://www.militarytimes.com/news/pentagon-congress/2019/09/11/court-orders-va-to-cover-veterans-emergency-room-debts/

The Court of Appeals ruling can be read in its entirety here: https://efiling.uscourts.cavc.gov/cmecf/servlet/TransportRoom?servlet=ShowDoc&dls_id=01206134031&caseId=104163&dktType=dktPublic