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Sep 13, 2019

Ranking Member Tester, Chairman Takano Urge VA to Quickly Implement Court Decision & Reimburse Veterans for Emergency Care Claim Errors

U.S. Court of Appeals demands VA reimburse billions of dollars to veterans whose emergency care was only partially covered by other insurance

Senate Committee on Veterans’ Affairs Ranking Member Jon Tester (D-MT) and House Committee on Veterans’ Affairs Chairman Mark Takano (D-CA) applauded this week’s federal court ruling in Wolfe v. Wilkie, which found the Department of Veterans Affairs (VA) unlawfully denied payment for hundreds of thousands of veterans whose other health insurance did not fully cover emergency care they received at non-VA facilities.

Ranking Member Tester and Chairman Takano today urged VA to expeditiously reimburse veterans for all past and future claims, notify previously affected veterans of their appeal rights, and correct future notices it sends to veterans about these claims.

“We applaud the federal court’s decision this week— by siding with our veterans, we are finally getting justice for those who were saddled with unfair financial burden after receiving emergency health care,” said Ranking Member Tester and Chairman Takano. “We demand answers from VA as soon as possible to explain how many veterans are affected, how VA intends to comply with the Court’s order, and what additional resources—if any—Congress will need to provide for the Department to carry this out. VA must drop its fight and implement the Emergency Care Fairness Act of 2010 as Congress has always intended.”

This decision marks the second time since 2016 that the court has struck down VA’s regulation, reaffirming VA must step in as a “secondary payer” to prevent emergency medical expenses from being unfairly passed on to veterans when their non-VA health insurance doesn’t cover the full cost.

In its scathing decision, the U.S. Court of Appeals for Veterans Claims wrote, “Even after [our previous decision], VA was affirmatively informing veterans that they were not entitled to reimbursement for non-VA emergency medical care if they had any insurance covering the service at issue. In other words, the Agency was telling veterans that the law was exactly opposite to what a Federal court had held the law to be.”

Last month, Tester, Takano and 33 other members of Congress sent a bipartisan, bicameral letter to the Secretary of Veterans Affairs after a damning VA Office of Inspector General (OIG) report found that VA had inappropriately rejected or denied emergency care payments for about 60,800 veterans during a 6-month period in 2017. The OIG found that VA likely should have paid claims for about 17,400 these veterans. In light of this week’s federal court ruling, the number of veterans who have incurred unnecessary financial burden could be in the hundreds of thousands, and based on past VA estimates, the Department will be required to pay between $1.8 billion and $6.5 billion in reimbursements for claims filed between 2016 and 2025.

Office Contact Information

Senator Tester's Montana staff serves the state from offices in Billings, Bozeman, Butte, Great Falls, Helena, Kalispell, and Missoula. Please bring your concerns with federal agencies, academy nominations, and other situations to one of these Montana offices.

Billings

Judge Jameson Federal Building
2900 4th Ave N, Suite 201
Billings, MT 59101
Phone: (406) 252-0550
Fax: (406) 252-7768

Bozeman

Avant Courier Building
1 E Main Street, Suite 202
Bozeman, MT 59715
Phone: (406) 586-4450
Fax: (406) 586-7647

Butte

Silver Bow Center
125 W Granite, Suite 200
Butte, MT 59701
Phone: (406) 723-3277
Fax: (406) 782-4717

Great Falls

119 1st Avenue N, Suite 102
Great Falls, MT 59401
Phone: (406) 452-9585
Fax: (406) 452-9586

Helena

Capital One Center
208 N Montana Avenue, Suite 202
Helena, MT 59601
Phone: (406) 449-5401
Fax: (406) 449-5462

Kalispell

8 Third Street E
Kalispell, MT 59901
Phone: (406) 257-3360
Fax: (406) 257-3974

Missoula

130 W Front St.
Missoula, MT 59802
Phone: (406) 728-3003
Fax: (406) 728-2193

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