Veterans Administration Inspector General’s audit report
Dear Editor,
The VA Office of the Inspector General (Office of Audits & Evaluations) conducted an audit filed May, 24 2022, titled, “Veterans Health Administration (VHA) Continues to Face Challenges with Billing Private Insurers for Community Care”. Better known as the Choice program.
The audit found VA employees at the 7 different Consolidated Patient Account Centers (CPAC) had not timely billed private insurance companies. This was for outside medical care provided to Non-Service-Connected (NSC) Veterans who have health insurance. It was estimated that 1.3 million of 2.4 million claims (54%) were not timely submitted and were denied between April, 20 2017 & October, 31 2020. (3 1/2 yrs) resulting in a loss to the VA of an estimated $217 million. It was estimated that approximately $602 million in FY 2022 and $657 million in FY 2023 would be lost without any correction. This action or lack of action by CPAC has resulted in a loss of millions of dollars of medical care to all veterans. It is unbelievable that this could happen.
What was not included in the IG report was VA inpatient, outpatient and prescription drugs. CPAC is suppose to also timely bill these same insurance providers when NSC Veterans receive these services at the VA.
Concerning prescription drugs, VA Billing Form 10-0246 states, “Payments received by your insurance provider may be used to offset “dollar for dollar” your VA co-payment responsibility which may eliminate or reduce your VA co-payment bill”. I have been refunded over $1,100.00. This was only after I requested CPAC do an audit that went back to 1992. After reading this report, I can only imagine how much more I would have gotten if CPAC had made timely claims to my insurance provider. Also, I believe there may be thousands of other veterans owed refunds like myself. I feel congress should do something about what is being done to us veterans. This might be what nation wide government run health care would be like.
John Jarrett Peters
Ph 304 429 2033
5766 Hubbards Br. Rd.
Huntington, WV 25704
