VA staff did not apply sufficient scrutiny to non-VA medical care emergency transportation claims, leading to about $11 million in overpayments to transportation providers, according to an IG audit.
The Non VA Medical Care Program assists veterans who cannot feasibly receive care at a VA medical facility, including emergency transportation costs in some situations. In a review of 353 claims, 27 were paid to vendors that submitted a claim or required documentation untimely, seven were for care provided to ineligible veterans, and 95 were for an incorrect amount.
“These claims were improperly paid because staff did not conduct an adequate review to ensure that all documentation was received prior to processing the claim and did not correctly determine veterans’ eligibility for emergency transportation,” the IG said. “Staff also misunderstood the criteria for processing non-service and service-connected emergency transportation claims.”
Management agreed with recommendations to implement periodic training and systematic reviews of emergency transportation claims and to instruct the sampled facilities to seek to recoup the overpayments.
