WASHINGTON - A federal appeals court on Monday ordered the Department of Veterans Affairs to reimburse veterans for emergency care at non-VA facilities, after a class action lawsuit veterans brought against VA Secretary Robert Wilkie.
The ruling, which came from the U.S. Court of Appeals for Veterans Claims, invalidated an internal VA regulation that blocked reimbursements to veterans who sought emergency medical services at non-VA facilities, saying that the VA wrongfully denied the payments.
“All of this is unacceptable,” the ruling said.
The court decided that Wilkie’s decisions made under the internal VA regulation, to the extent they denied reimbursement to the defendant veterans “for medical expenses deemed deductibles or coinsurance, in whole or in part, are invalid.”
The court handed out a series of orders for the VA secretary.
The court ordered that “Secretary must readjudicate these reimbursement claims under section 1725’s proper interpretation.”
The court ordered that the “Secretary stop sending its corrective letters immediately because they contain incorrect statements of what the law is, namely: ‘It is important to note that VA has no legal authority to pay a Veteran’s cost shares, deductibles, or copayments associated with their other health insurance.’”
The court also ordered that within 45 days of the date of the order, the VA secretary submit to the court for approval a plan to provide notice to veterans affected by the provision. The notice should say the provision contained an incorrect statement of the law concerning reimbursement of costs for non-VA emergency care, the ruling said.
The defendants were veterans Amanda Jane Wolfe, of the U.S. Coast Guard, and Peter Boerschinger, a U.S. Navy sailor.
This story was reported from Los Angeles.