By Patricia Kime: For More Info, Go Here…
A federal court has ruled that the Department of Veterans Affairs wrongly denied reimbursements to veterans who received emergency medical care at non-VA facilities, a decision that could result in payouts to veterans totaling billions.
U.S. Court of Appeals for Veterans Claims judges wrote Monday that VA’s reimbursement regulations, which were instituted in 2018, violated a law that requires VA to approve veterans’ claims for emergency room expenses not covered by private insurance.
The case, Wolfe v. Wilkie, marked the second time VA has been overruled on its interpretation of its reimbursement policies. In 2015, the court ruled that a previous version of the VA regulation on emergency claims violated a 2010 law.
According to the appeals court judges, the 2015 ruling was intended to require VA to act as a secondary payer for expenses not covered by an individual’s primary private health insurance.
But VA has not been doing that, they said in the Wolfe v. Wilkie decision.
“VA was … informing veterans that they were not entitled to reimbursement for non-VA emergency medical care if they had any insurance covering the service at issue,” wrote the judges. “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.”