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May 2015

Are Hospital Providers Now Footing the Bill for Veteran Healthcare?

We have all heard the complaints about the veteran’s administration (VA). Veterans, after giving their lives to protect our country, often find themselves at the mercy of the VA’s medical program where long waiting periods are the norm when dealing with treatment for their physical and mental issues. Further, the reimbursement provided to non-VA hospitals for their treatment is generally low compared to other governmental payors thus creating a loss for those hospital providers who render medical care to them.

As of last year, the VA’s Accelerating Care Initiative created a policy where VA facilities must offer veterans a referral to a non-VA provider for new patients who have been on a waiting list or have a pending appointment for more than 30 days. This new process gives veterans the opportunity to obtain medical care at private clinics and hospitals if their own facility is overbooked.

What does this mean for hospital reimbursement? The VA is expected to reimburse hospitals at Medicare rates. Medicare reimbursement has been reduced in recent years, and sometimes does not even cover the hospital’s costs. On the other hand, for hospitals that have empty beds, Medicare rates can be a good thing.

Perhaps the most difficult aspect of treating veterans is dealing with the VA’s reporting process. Unfortunately, a complicated reporting system can be a barrier in getting payment for any medically necessary care rendered. Additionally, the VA has been known to not pay claims for long periods of time, claiming that claims are “lost.”  Keep up-to-date with issues related to veterans and medical care to insure your rights are protected both as a health care consumer and provider..

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