JACKSONVILLE, Fla. – A hotline tip led to a full blown investigation into how Florida VA facilities were paying non-VA care providers. It reveals millions of dollars in overpayments were made for years, due to failure to follow guidelines.
The Department of Veterans Affairs Office of Inspector General released its findings this week, after an allegation that facilities were paying full price for physician services to a non-VA care provider rather than paying lower contract rates. OIG says once its initial investigation determined the original 2014 complaint was accurate, it broadened its probe to include dates from October 1, 2012 through March 21, 2016.
A review of 73,124 payments to non-VA care providers for physician-administered drugs during that more than three-year period identified 26,178 overpayments totaling approximately $17.2 million. Of that amount, the Veterans Health Administration overpaid approximately $6.9 million to the provider identified in the original allegation.
OIG says these overpayments occurred because VHA did not use Medicare rates for physician administered drugs, as published by the Centers for Medicare & Medicaid Service. The report stated, “These funds could have been more effectively spent on veteran care.”
“We recommended the Under Secretary for Health ensure that all payments for non-VA physician-administered drugs are made in accordance with the Code of Federal Regulations for all Veterans Integrated Service Networks,” OIG said. “We also recommended the Under Secretary develop a plan for uploading Medicare rates into the Fee Basis Claims System (to enable the proper payment of physician-administered drug claims) and issue Bills of Collection for overpayments to non-VA care providers.”
According to OIG, VHA concurred with its recommendations and did provide an action plan to address the recommendations. VHA also stated it would provide the OIG with documentation to support completion of the action plans.
“Bureaucratic errors at the VA often end up wasting millions in taxpayer dollars — money that should obviously be going to urgent health care needs for our veterans. It underscores the idea that the VA doesn’t have a resource problem, it has a management problem,” Concerned Veterans for America Communications Director Rebecca Coffman told News4Jax.
CVA has spent years advocating, not only for better care for veterans, but also meaningful legislation that will hold VA executives accountable for bad management that trickles down to negative impacts on those who have served. Tuesday, the watchdog group applauded the U.S. Senate for passing the VA Accountability and Whistleblower Protection Act of 2017 – a bill that was introduced by Sen. Marco Rubio (R-Florida) – calling it a victory for veterans across the nation.
“This bill will give Secretary Shulkin the authority he needs to fire bad employees quickly while protecting the whistleblowers who have the courage to speak up. We applaud Senator Rubio for championing this legislation and Senator Nelson (D-Florida) for boldly supporting it. We urge the House to work quickly to send this bill to President Trump’s desk so veterans can finally rest assured the staff entrusted with their care are being held responsible for their actions,” said CVA Florida Coalitions Director Diego Echeverri.
President Donald Trump has indicated he will sign this legislation when it reaches his desk.