Lawmakers demand VA fix emergency claims after report shows vets wrongly paid $53 million

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U.S. service members stand beneath the U.S. flag in this Jan. 17, 2019, file photo.

Lawmakers are demanding answers in the wake of a Department of Veterans Affairs (VA) watchdog report that found $53 million in veterans’ medical claims were wrongly denied over just a six-month period.

The bipartisan group of 35 lawmakers wrote VA Secretary Robert Wilkie this week calling the VA inspector general’s report “damning” and asking him to reconsider claims that should have been paid to veterans.

The inspector general report released last week showed that thousands of emergency care claims were denied between April 1 and Sept. 30 of 2017. An estimated 17,400 veterans were stuck paying medical bills totaling $53.3 million.{mosads}

The watchdog report suggested one reason for the millions in rejected claims was due to the VA prioritizing speed over accuracy and offering incentives including overtime pay for claims processed quickly. The report found approximately 31 percent of denied or rejected claims were not properly processed.

“Facing a medical emergency can be stressful for any patient; however, the financial toll on veterans when VA erroneously denies or rejects payment can also be devastating,” the lawmakers’ letter reads. “Nonpayment can bankrupt and destroy veterans’ credit histories. These administrative errors can remain with veterans for the rest of their lives.”

A spokesperson for the VA said in a statement that the agency “appreciates the lawmakers’ concerns and will respond to them directly.”

“VA appreciates the inspector general’s oversight, which in this case highlights claims processed up to more than two years ago,” the spokesperson continued.

“Prior to the report’s release, VA had self-identified the majority of the IG’s concerns, starting numerous efforts to fix them more than a year ago,” the statement said.

“VA is reviewing the sample claims related to other health insurance highlighted in the report and will notify affected Veterans regarding their options for corrective payments and/or financial reporting revisions.”

The recent findings followed a 2014 Government Accountability Office (GAO) report that detailed similar issues involving the VA.

In their letter this week, lawmakers questioned why past issues raised by the GAO had not been addressed.

“This is not new territory for the VA,” the lawmakers wrote. “More than five years ago, GAO found that VA’s weak oversight of emergency care claims adjudication could lead to inappropriate denial of claims. It is disappointing the department has not done enough to improve.”

Read lawmakers full letter below: 

– This story was updated Aug. 17 at 10:45 a.m. with the VA’s statement

Tags Robert Wilkie

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