Sen. Hirono Urges VA to Honor Emergency Care Claims

Sens. Mazie K. Hirono and Jon Tester (D-Mont.), members of the Senate Veterans’ Affairs Committee, are calling on the Department of Veterans Affairs to ensure that it is reimbursing veterans who were billed for emergency treatment at private hospitals.

In January, the VA announced that it would not retroactively reimburse veterans for their emergency treatment, despite a court decision that ruled the VA is responsible for emergency medical costs at private, non-VA hospitals.

Since Hawai‘i does not have a VA emergency room, 46,000 veterans who are enrolled in the VA healthcare system in Hawai‘i could be affected by this ruling.

In response, the Senators wrote to VA Secretary David Shulkin, urging him to reimburse veterans who filed a claim for emergency medical costs before the court ruling.

“Between 2010 and April 16, 2016, the VA erroneously denied thousands of veterans’ claims for emergency treatment,” the Senators wrote. “With the VA’s recent interpretation of this ruling, veterans who filed claims before April 16, 2016 would see no relief from the VA’s wrongful application of the law and would be stuck paying medical bills that Congress intended that the VA pay. We ask that the VA include those veterans whose claims were decided before April 16, 2016, so that all veterans can fully take advantage of a benefit Congress intended they receive.”

The Expansion of Veteran Eligibility for Reimbursement Act, enacted in 2010, directed the VA to pay for veterans’ emergency treatment at non-VA facilities unless the veteran has another form of insurance that entirely covers their medical costs. Since 2010, the VA has denied thousands of claims because a veteran’s other insurance partially paid for their treatment, leaving veterans to cover the difference for costly emergency care.

The U.S. Court of Appeals for Veterans Claims ruled on April 16, 2016, that the VA’s interpretation of its responsibility for non-VA emergency treatment was wrong and ordered the VA to begin paying these claims. Despite that, the VA has chosen not to pay veterans who filed before the 2016 court ruling.

Since 2013, Sen. Hirono has worked to further cut red tape by waiving a requirement that only allowed veterans to get reimbursed for non-VA emergency care if they had received VA care in the past 24 months.

The VA released its new policy regarding payment or reimbursement for emergency treatment at private hospitals on Jan. 9, 2018. The VA will only pay for new claims or those not decided prior to April 16, 2016.

Sens. Mike Rounds (R-S.D.), Tammy Baldwin (D-Wis.), Thom Tillis (R-N.C.), Patty Murray (D-Wash.), Sherrod Brown (D-Ohio), Richard Blumenthal (D-Conn.), Joe Manchin (D-W.Va.), Amy Klobuchar (D-Minn.), Bernie Sanders (I-Vt.), and Steve Daines (R-Mont.) also signed the letter to Secretary Shulkin.

The Senators’ letter to Secretary Shulkin can be downloaded here.