WASHINGTON — The Department of Veterans Affairs must reimburse veterans for emergency medical care at non-VA facilities, a federal appeals court ruled Monday — a decision that could be worth billions of dollars to veterans.
The U.S. Court of Appeals for Veterans Claims said the VA has been wrongfully denying reimbursement to veterans who sought emergency medical care at non-VA facilities and struck down an internal VA regulation that blocked those payments.
“All of this is unacceptable,” said the ruling, which ordered the VA secretary to “re-adjudicate these reimbursement claims.”
Plaintiffs’ lawyers say that based on past estimates by the VA, the department is now on the hook for between $1.8 billion and $6.5 billion in reimbursements to hundreds of thousands of veterans who have filed or will file claims between 2016 and 2025.
Former Coast Guardsman Amanda Wolfe, one of the plaintiffs in the case, told NBC News on Tuesday, “I’m just overjoyed. I think it means change, it means that veterans don’t have to be afraid of receiving care, emergency care. They can have that sense of security that sense of peace knowing they are covered if they have emergency care.”
“I served side by side with some of these veterans who were impacted and to think that this is going to make a difference for them is what is most important to me.”
The VA did not immediately respond to a request for comment.
In 2015, the court struck down a previous version of the internal VA regulation that refused any coverage for an emergency claim when another form of insurance covered even a small part of the bill. The court said the regulation violated a 2010 federal law.
Monday’s ruling found the department had violated the same federal law with its revision of the reimbursement regulation. The panel saidthe new rule, issued in January 2018, actually created another obstacle for veterans by forbidding the VA from reimbursing medical expenses for emergency services at non-VA facilities.
In September 2016, Wolfe went to the emergency room because her appendix was about to burst. After a speedy recovery, she figured she was all set — she had two kinds of insurance, a private plan she paid for and her Veterans Affairs benefits.