Mass. Congressmen: Law has caused ‘profound harm for veterans’

Three Democratic Massachusetts congressmen are calling for a change to a law that led the Veterans Administration to deny more than 2,648 claims for emergency room visits at non-VA hospitals in Massachusetts over the last five years, leaving veterans to pay $6.37 million for those visits because they had not seen their doctor in the previous 24 months.

Rep. Bill Keating said veterans “regularly” contact his office for help because of problems including the so-called “24-month rule,” which led the VA to deny 413,152 claims totaling $1.58 billion nationally over the same period, according to VA statistics.

“Our veterans do not deserve the stress of navigating the VA bureaucracy as collection notices pile up on top of their medical issues,” Keating said in a statement. “I pledge my full support to my colleagues … who have demanded answers from the VA on how this situation came about in the first place, including whether VA employees were incentivized to deny claims, and how the VA plans to implement reforms …”

Each municipality’s veterans service officer is responsible for telling veterans about the 24-month rule. But some veterans agents contacted by the Herald said they were unfamiliar with the mandate.

A VA spokeswoman said the 24-month rule is part of a 1999 Millennium Bill, which Congress passed to try to keep veterans healthy. But Rep. Joe Kennedy III called the rule “misguided.”

“Even if well-intentioned to incentivize treatment, this rule has caused profound harm for veterans in our commonwealth and across the country,” Kennedy said. “I will work closely with my colleagues to increase awareness about this misguided rule until the day we fix it.”

An August 2019 report by the Department of Veterans Affairs Office of Inspector General found that nearly 80% of unauthorized and Millennium Bill claims were denied or rejected, and that 31% of denied or rejected non-VA emergency care claims were “inappropriately processed,” leaving many claimants to pay out of pocket for their care.

The audit found that the VA “placed more emphasis on the number of claims processed than the accuracy of the claims decisions,” even awarding overtime and bonuses to staff who met or exceeded production targets.

“The VA’s mission is to serve veterans and keep the promise that the country has their backs. Period,” Rep. Seth Moulton said in a statement: “No veteran should go broke because they got sick or had a health emergency. Congress must fix this.”