The U.S. Department of Veterans Affairs (VA) announced that it has, through a Federal Register notice, revised its regulations concerning payment or reimbursement for emergency treatment for non-service connected conditions at non-VA facilities.
VA will begin processing claims for reimbursement of reasonable costs that were only partially paid by the Veteran’s other health insurance. Those costs may include hospital charges, professional fees and emergency transportation, such as ambulances.
This change comes on the heels of an earlier announcement that the VA was taking immediate action to address delayed payments to community providers.
Effective Jan. 9, the VA updated a portion of its regulations in response to an April 2016 U.S. Court of Appeals for Veterans Claims decision that stated the VA could no longer deny reimbursement when other health insurance pays a portion of the treatment expenses.
The VA will apply the updated regulations to claims pending with VA on or after April 8, 2016, and to new claims. By law, the VA still may not reimburse Veterans for the costs of copayments, cost shares and deductibles required by their health insurance.
The VA will work directly with community providers to get additional information needed to review and process these claims. Previous claims do not have to be resubmitted unless requested by the VA.
More information on the amended regulation along with guidance may be found here.