I-Team: Lawmakers attempt to mandate VA pay for Veterans’ emergency bills

I-Team: Lawmakers attempt to mandate VA pay for Veterans’ emergency bills

ST CLOUD, MINN — As the 87-year-old Veteran at the center of a landmark 2016 military case ordering the VA to pay all Veterans non-VA emergency bills has been given months to live without his court ordered reimbursement, some federal lawmakers, including Ohio Sen. Sherrod Brown, are attempting to mandate payment.

Despite the VA losing two cases, including that 2016 case against Korean War Veteran Richard Staab, and a class action lawsuit last year attempting to replace rules put in place after the Staab decision, lawmakers say the VA is purposely appealing to avoid reimbursing more than 600,000 Veterans $1.8 to $6.5 billion who may have had their non-VA ER claims improperly denied.

That includes Staab’s nearly $48,000 after emergency open heart surgery.

Content Continues Below

“He’s now sitting here, nearing the end of his life. And still hasn’t been paid after over nine years of litigation,” Staab’s lawyer Jackie Schuh said.

As the VA moved forward with their appeal earlier this summer, Staab’s cancer returned. He was moved to a nursing home. Last week his hometown legal team, based out of St. Cloud, Minn., found out he only has one to three months to live.

While too sick to talk now, when the I-Team interviewed him last year about the nearly decade-long ordeal, at times, it was too difficult for him to talk.

“Let’s face it. You don’t like to talk about sadness. You’d rather talk about things that are cheerful,” Staab said in 2019.

“They’ll be a lot of tears shed when he passes anyway. But this just makes it all the more devastating,” Schuh said. “The more of these people that pass they (VA) don’t have to pay. And so thus is the case with Dick. If he passes his claim dies,” Schuh said.

Under federal law, if a Veteran dies their benefit dies with them. Even after the US Court of Appeals for Veterans Clams rulings, a VA spokesperson insisted the agency does not have the power.

“Per federal law, VA does not have authority to issue any additional payments to Mr. Staab due to the nature of his remaining medical bills,” VA Media Relations Director Susan Carter said in a statement.

Carter did not answer follow-up questions seeking clarification as to what that meant. However, the VA has insisted there are limits on their ability to provide non-VA emergency care reimbursements when a Veteran has other health insurance, including Medicare.

“Mr. Staab served his country as did nearly one million veterans living in Ohio today, served their country. And the VA shouldn’t be fighting,” Sen. Sherrod Brown, D-Ohio, told the I-team.

Brown is one of five senators who have proposed a bill to put into law language the lawmakers say would close all non-VA emergency reimbursement loopholes.  The potential law would remove limitations, including copays, deductibles and coinsurance.

“Mr. Staab, and others who thought this reimbursement applies to, assume some have died and others will. They’re not young men. They’re older men mostly. And the VA needs to get its' act together and do this,” Brown said.

Despite repeated requests to find out how many veterans from each state, including Ohio, make up the 600,000 veterans potentially owed refunds, the VA spokesperson said last week they were “not familiar” with that number. But last year the VA’s own Secretary told the court that was exactly how many veterans were affected.

“As for the number of claimants in each of the three categories, the Secretary supplied the following information from VHA,” part of last year’s Court decision read. “Thus, there are over 600,000 veterans affected just by VA’s past actions concerning the matters before the Court.”

Those who have spent most of the last decade battling for refunds insist, with billions on the line, that is why the VA continues to not issue the court ordered refunds.

“And there is no other logical reason I can conclude or reach other than they don’t want to pay the money. And they’re waiting for other people to pass like Dick. There just isn’t anything. And they haven’t offered any explanation to the contrary,” Schuh said.

A dying Greatest Generation.  Something Staab seemed to hint at as he plead with the court last year writing, “It is my hope my reimbursement will be paid before I die.”

Schuh, a veteran herself, is acutely aware the impact the death of the 87 year old Veteran who beat the VA in court, without a refund, would have for every Veteran.

“It sends Veterans the perspective that the VA can hold out long enough - and stall long enough - that we’ll lose a bunch of other Veterans who would be entitled to receive refunds to get reimbursements. That simply aren’t going to get it. And the VA will get away with it with little to no consequence.”

In 2017, former VA Secretary David Shulkin said he would not fight the Staab ruling. After Shulkin’s firing, and the VA continuing not to pay non-VA emergency bills, current VA Secretary Robert Wilke was sued. Despite the VA’s second loss in that class action case, one year later the Veterans Administration continues appealing, citing federal law.

In a statement, the executive director for the National Veterans Legal Services Program, who represented Staab and later the class action plaintiffs in court, endorsed the proposed law change.

“Hundreds of thousands of veterans who have been suffering extraordinary financial hardships, some for many years, due to the VA’s illegal mishandling of their reimbursement claims,” NVLSP Executive Director Bart Stichman said in a statement.

Advice For Veterans Fearful of an ER Visit

“I’m going to tell them to go - because of course you have to,” Schuh said.  “Because if it’s a life threatening question issue you’ve got to do it. Then my advice would be you call the VA immediately, or have a family member do it so you get your authorization within the timelines, hang onto them. And don’t until you go to the VA. And your satisfied that the VA has taken the appropriate time to pay those bills. But we have to temper that - because as long as they drag their feet, we’re talking about vigorous claims and aggressive collection by private entities who are owed what they billed to be paid for Veterans services in non-VA care clinics or emergency settings.”

Full Sen. Brown Statement

“The last thing veterans should have to worry about during a health emergency is whether they will be stuck with the bill for their medical expenses. Instead of reimbursing veterans, VA is hurting those it swore to protect. It is unacceptable that VA has repeatedly ignored court rulings and Congressional direction to cover emergency medical care for Veterans like Mr. Staab, who has experienced serious financial hardship as a result of VA mishandling his case,” said Brown. “We should pass the bill I introduced with Sen. Blumenthal now – to ensure Ohio veterans do not shoulder this cost when they’ve earned benefits that should cover them.”

Full VA Answers: Susan Carter, Director, Office of Media Relations

Q: Lawyers representing veterans and lawmakers say the VA is now appealing again to avoid paying veterans.  They accuse the VA of breaking federal law. How do you all respond?

A: VA does not typically comment on pending litigation.

Q: The VA has been asked repeatedly for a state by state breakdown of how man vets in each state make up the 600,000 vets cited in Wolfe as being owed refunds. Why has that information not been provided to members of congress and the public? Can you provide that information as part of this request.

A: We are not familiar with the 600K quoted here; however, VA is adjudicating claims in accordance with the Wolfe decision.

Q: A VA Office of Inspector General report last month found that the non-VA emergency room claims of some 17,400 veterans were denied or rejected primarily due to a VA work culture that favored speed over accuracy, a number that accounts for nearly a third of the 60,800 claims examined during the IG’s six-month nationwide audit in 2017.  How does the VA respond?

A: Please see VA’s response on page 30 of the report.  VA is in the final stages of completing the corrective actions related to this audit.

Q: Mr. Staab has been given one to three months to live.  Despite two court rulings the VA has not repaid Mr. Staab for medical care nearly one decade ago.  Does the VA plan to repay Staab?  If he dies before repayment is made, will the VA pay the nearly $48,000 federal judges say he is owed? A: VA addressed this issue with the court in Wolfe v. Wilkie, during an oral argument.

Per federal law, VA does not have authority to issue any additional payments to Mr. Staab due to the nature of his remaining medical bills.

Q: Lawmakers are now proposing a bill that would order the VA to pay for non-VA emergency care when a Veteran has other health insurance (OHI). This bill would remove the limitations on reimbursement for emergency treatment of amounts owed to a third party, or for which the veteran is responsible under a health-plan contract. This includes reimbursement for copays, deductibles, coinsurance and applies to any treatment in a non-VA emergency setting. What is your reaction to this legislation.   A: VA does not have a position on the referenced legislation.