A whistleblower recently revealed that the Department of Veterans Affairs is illegally spending billions on non-VA care. But a new hearing indicates that even when the VA does allocate funds to non-VA care, providers are finding it almost impossible to obtain reimbursement.
Medical providers gathered Wednesday before the House Veterans’ Affairs Subcommittee on Health to detail their frustrations with a VA that consistently takes advantage of their good will.
These companies often take on mountains of debt in order to ensure no veteran is turned away from services.
According to Asbel Montes, vice president of reimbursement and government affairs for Acadian Ambulance Service, attempting to obtain payment from the VA is a trying task. In one example, AAS sent appropriate claim documentation to the VA by certified mail in 2014, and five days after it was sent, the VA confirmed receipt. Not until that Louisiana veteran appeared on two different local TV stations a year later did VA representatives get in contact with the veteran. Even when that initial contact took place, the claim was not actually processed and paid until April of 2015. The entire process from start to finish lasted a year and three months.
“We’ve heard every excuse,” Montes told the committee. “It’s the wrong VA location, we don’t provide that service, we don’t have enough people.”
Montes thinks that because the VA is so incompetent at processing non-VA care claims, Congress should transfer responsibility to a third party. “Several other government programs, including Medicare and Tricare, utilize this strategy successfully,” Montes noted.
This problem is especially acute for ambulance services that cannot by law refuse service.
Subcommittee chairman Rep. Dan Benishek reiterated a theme familiar to hearings, in which VA officials testify about alleged negligence and abuse. “It’s never anyone’s fault, and there’s no one who takes responsibility.” For some reason, Benishek added, VA officials always seem to have the perfect answers to penetrating questions, and yet these problems continue unabated, hearing after hearing.
Other providers have similar stories.
Vince Leist, president and CEO of North Arkansas Regional Medical Center (NARMC), said that since 2011, the VA has not paid 215 claims totaling over $750,000 dollars. Despite NARMC’s best efforts, limited VA personnel and long wait times over the phone, as well as mysteriously missing medical records, have made it tremendously difficult to continue offering quality care to veterans.
Other medical centers in Arkansas have experienced similar problems. Data provided by the Arkansas Hospital Association indicates the VA has not reimbursed 4,400 claims to 60 hospitals in the region. These claims total $24 million dollars. Although lawmakers in Congress have taken an interest in the plight of these companies, the VA hasn’t budged.
As of March, VA data indicates a national backlog of $878 million dollars in delayed payments for non-VA providers. In some regions of the country, the VA pays only 8 percent of claims within 30 days.
For four years, the VA has declined to reimburse NARMC for various emergency services. NARMC still provides them, but that situation may soon change.
“If the VA does not pay claims promptly and further reductions in payments for hospital care continue, NARMC would be forced to reduce or eliminate services offered to patients or seek assistance from already-strapped counties in Arkansas,” Leist noted. “We want to continue to provide essential health care services to our communities, including our veterans, but will not be able to do so without the proper resources, including prompt payment from the VA.”
Sam Cook, president of the National Mobility Equipment Dealers Association, a group that offers transportation services to veterans with disabilities, argued that NMEDA members are often small businesses, and these owners simply “cannot keep this kind of debts on their books.”
“They are not paid interest on these past due invoices in most cases,” Cook added. “The lack of any timely effort by the VA to address slow payment leads to a potential outcome of unsafe vehicles placing them and their families and the driving public at risk.”
The proposal to strip the VA of claims processing received support from much of the committee. When asked whether it was a good idea, Gene Migliaccio, deputy chief business officer for purchased care at the Veterans Health Administration, answered that the department would have to complete a cost-benefit analysis first, but admitted that the VA hasn’t done a very good job making timely payments to medical care providers.
“VA acknowledges that claims processing timeliness must improve,” Migliaccio said. “As a result, we are in the process of refining and implementing standard processes and performance targets, and monitoring to ensure processing activities are performed and measured consistently across VA.”
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