Saturday, November 18, 2017

Staab: the Underfunded VA is about to explode

Staab appealed the VA's decision to the Court of Appeals for Veterans Claims. He pointed out that the VA's regulation conflicted with a change in the law made by Congress in 2010. That change modified the language of 38 U.S.C. § 1725, which is the statute upon which the VA's regulation is based. As noted by the court, the purpose of this amendment was to "allow the VA to reimburse veterans for treatment in a non-VA facility if they have a third-party insurer that would pay a portion of the emergency care."

More

H.R. 1377 would modify current law so that a veteran who has outside insurance would be eligible for reimbursement in the event that the outside insurance does not cover the full amount of the emergency care. VA would be authorized to cover the difference between the amount the veteran's insurance will pay and the total cost of care. In essence, VA would become the payer of last resort in such cases. This would keep the veteran from being burdened by medical fees with no insurance with which to pay them.

/different article (https://militaryadvantage.military.com/2017/06/va-chief-withdraws-staab-appeal-vows-to-replace-iu-pay-cut-too/):

JUNE 15, 2017: VA Secretary David Shulkin made two surprise announcements Wednesday before the Senate Veterans Affairs Committee that should relieve some financial stress for more than 600,000 veterans.

First, Shulkin said he was dropping VA's appeal of the Staab case decided last year by the U.S. Court of Appeals for Veterans Claims. Only last week he said Staab had been wrongly decided, exposing VA to at least $2 billion in veteran claims for outside emergency care, money VA needed to provide promised services.

Pulling the appeal means VA intends to begin covering private sector emergency care for any VA-enrolled veteran, even if they have alternative health insurance that pays part of their emergency care costs. As many as 370,000 veterans with pending claims could benefit too, explained Sen. Mike Rounds (R-S.D.), who thanked Shulkin for changing his mind. Shulkin said Rounds and Sen. Richard Blumenthal (D-Conn.) were right to sharply criticize the decision to appeal.

In Staab the appeals court ruled that VA intentionally failed to implement a 2010 law expanding outside emergency care coverage. It did so by continuing to deny reimbursement for non-VA emergent care if a veteran had any sort of alternative health insurance. Veterans with no health insurance routinely are reimbursed the full cost of outside emergency care if VA care isn't available.

Comments

this will destroy me. i just read it.

i was just having lots of family talk, sorta...in my head, planning on moving 1000mi (Virginia) to where my 2 grandchildren are.

even thinking ... already been approved for a "non traditional" VA bank loan.

even the license plate would come off my "gifted" car. i will have to move into an even lesser ---- hole than now.
wanna see my rat picture? i took it today.
photos.app.goo.gl

this would be DEVASTATING.

holy ----.

#1 | Posted by ichiro at 2017-11-18 11:40 PM

Fighting over who pays the bills sure does drive up health care cost!

#2 | Posted by snoofy at 2017-11-18 11:48 PM

so looks like it's going to happen. a "vow" to replace. omg.

www.stripes.com
ftfa: First, Shulkin said he was dropping VA's appeal of the Staab case decided last year by the U.S. Court of Appeals for Veterans Claims. Only last week he said Staab had been wrongly decided, exposing VA to at least $2 billion in veteran claims for outside emergency care, money VA needed to provide promised services.

Pulling the appeal means VA intends to begin covering private-sector emergency care for any VA-enrolled veteran, even if they have alternative health insurance that pays part of their emergency care costs. As many as 370,000 veterans with pending claims could benefit too, explained Sen. Mike Rounds, R-S.D., who thanked Shulkin for changing his mind. Shulkin said Rounds and Sen. Richard Blumenthal, D-Conn., were right to sharply criticize the decision to appeal.

#3 | Posted by ichiro at 2017-11-19 12:08 AM

from article linked at #2:
So, Blake said, "we have a $3.2 billion IU hole for Choice. We have approximately a $1 billion hole for Staab. And then we have the Cerner issue and don't even know what that hole looks like. Right now, VA could be staring at a huge hole in its budget for 2018" even as appropriations committees begin to mark up VA funding bills taking no account of the changes Shulkin just announced.

"VA is left with billions of dollars in unanswered questions," Blake said. "And it's not enough to simply say," as he suggested Shulkin did, " ‘We have enough money. We can move it around.' That's simply not true."

The worry for vet groups is that VA will come to look so costly that taxpayers will demand its prized health system be dismantled in favor of private-sector care.

#4 | Posted by ichiro at 2017-11-19 12:23 AM

President Hillary Clinton and the Democratic Congress strike again!

-- Sean Hannity

#5 | Posted by MrSilenceDogood at 2017-11-19 02:04 AM

Ted(Ichiro), you are thinking about moving to VA?

Are you crazy?

#6 | Posted by boaz at 2017-11-19 09:11 AM

Ichiro, you where wounded while in the military?

#7 | Posted by HeliumRat at 2017-11-19 10:39 AM

6 grandchildren;
7 ...no.

#8 | Posted by ichiro at 2017-11-20 03:04 AM

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