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Legion assist VA to investigate third-party insurance claims

In the spring of 2009, The American Legion was instrumental in reversing the decision of the Department of Veterans Affairs (VA) to bill veterans’ third party insurances for their serviceconnected medical conditions. Peter S. Gaytan, Executive Director of The American Legion Washington D.C. Office stated, “Our nation has an obligation to care for those men and women who have served this country with distinction and were left with wounds and scars of that service.”

The Department of Veterans Affairs (VA) has the authority to bill health insurance companies for health care provided to non-service connected veterans who have private health insurance and service-connected Veterans treated for non-service connected conditions. VA can also collect copayments from non-service connected veterans based on income. Veterans serviceconnected at a 50 percent or higher rating are eligible for cost- free care and medication (no copayments) when treated for any condition.

The American Legion National Headquarters was notified by several veterans through calls and e-mail correspondence that VA was incorrectly billing them for their service-connected illnesses and injuries. The American Legion’s Veterans Affairs and Rehabilitation Division began collecting documented cases of veterans whose third-party insurances were improperly billed by VA for their service-connected medical conditions.

On November 18, 2009, The American Legion recommended that VA’s Chief Business Office investigate and correct any cases of improper billing. The American Legion National Commander, Clarence E. Hill, “applauded VA’s Chief Business Office investigation of these cases to ensure our nation’s veterans are not being billed for the care that they’ve earned.”

The Chief Business Office (CBO) represents a single accountable authority for the development of administrative processes, policy, regulations, and directives associated with the delivery of VA health benefit programs. As a principal health benefits administration advisor to the Under Secretary for Health, the Chief Business Officer develops, implements, and supports various aspects of administrative health care issues. CBO core values are based upon offering quality Veteran services, implementing innovative business solutions, and a commitment to excellence in the development and management of all initiatives and programs.

If a veteran feels that their third-party insurance has been improperly billed, please have them contact The American Legion Department Service Officer in their state. To find the state directory, please go to: http://www.legion.org/departmentofficers. If the Department Service Officer has any questions, or a veteran has additional questions, they can contact Jacob Gadd at (202)263-2991 or via email at jgadd@legion.org. The National VA&R Division will contact VA’s Chief Business Office to follow-up on cases for verification and assistance. If a billing error has occurred, the CBO will issue refunds to the veteran’s third party insurance.

 

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