Senate, House Leaders Demand VA Fix Emergency Care Claims Errors Impacting an Estimated 60,800 Veterans

OIG Report finds VA unfairly denied claims for emergency care totaling at least $53.3 million in 2017

Senate Committee on Veterans’ Affairs Ranking Member Jon Tester (D-MT), House Committee on Veterans’ Affairs Chairman Mark Takano (D-CA), Senate Committee on Veterans’ Affairs Member Senator Jerry Moran (R-KS), and House Committee on Veterans’ Affairs Ranking Member Dr. Phil Roe (R-TN) led a bipartisan, bicameral letter to VA today following a damning report from the Office of Inspector General (OIG), outlining errors in VA’s processing of non-VA emergency care claims. The OIG found in 2017 that VA inappropriately processed about 31 percent of emergency care claims totaling at least $716 million. The OIG also substantiated a whistleblower claim on this issue finding that VA incentivized value production targets for timely processing of emergency care claims over fairly and accurately issuing decisions. Among the inappropriately processed claims, the OIG estimated that VA was likely responsible for paying $53.3 million in emergency care claims for 17,400 veterans.

In their letter, Members expressed their disappointment that VA has not done enough to improve its claim processing following a 2014 GAO report on the same matter and demanded that “VA expeditiously and continuously implements the recommendations made by independent oversight bodies.”

They were joined by Senator Tammy Baldwin (D-WI), Senator Patty Murray (D-WA), Senator Bernard Sanders (I-VT), Senator Sherrod Brown (D-OH), Senator Richard Blumenthal (D-CT), Senator Joe Manchin III (D-WV), Senator Mazie Hirono (D-HI), Senator Kyrsten Sinema (D-AZ), Senator John Boozman (R-AR), Rep. Julia Brownley (D-CA), Rep. Chris Pappas (D-CT), Rep. Mike Levin (D-CA), Rep. Gregorio Sablan (D-MP), Rep. Gil Cisneros (D-CA), Rep. Anthony Brindisi (D-NY), Rep. Max Rose (D-NY), Rep. Conor Lamb (D-PA), Rep. Kathleen Rice (D-NY), Rep. Joe Cunningham (D-SC), Rep. Lauren Underwood (D-IL), Rep. Susie Lee (D-NV), Rep. Colin Allred (D-TX) Rep. Neal Dunn (R-FL), Rep. Jack Bergman (R-MI), Rep. Gus Bilirakis (R-FL), Rep. Aumua Amata Coleman Radewagen (R-AS), Rep. Jim Banks (R-IN), Rep. Andy Barr (R-KY), Rep. Daniel Meuser (R-PA), Rep. Mike Bost (R-IL), and Rep. Chip Roy (R-TX) in the letter.

The full text of the letter can be found HERE: