http://worldcat.org/entity/work/id/2211693771

VA health care, actions needed to improve administration and oversight of Veterans' Millennium Act emergency care benefit : report to congressional requesters

VA spent an estimated $418 million on Millennium Act emergency care claims in fiscal year 2012 and projects spending will increase to $580 million by fiscal year 2015. GAO was asked to review VA's administration of the emergency care benefit under the act. This report examines the extent to which (1) selected VA facilities complied with applicable requirements, in particular when denying claims; (2) VA's oversight activities ensure that Millennium Act claims are not inappropriately denied; and (3) veterans understand the Act's emergency care benefit and how VA communicates with non-VA providers about Millennium Act claims. To do this work, GAO reviewed 4 VA facilities out of 142 based on variations in Millennium Act spending levels and geographic location. GAO also reviewed VA documents, including 128 denied Millennium Act claims from these four facilities, and interviewed officials from VA, non-VA providers, and veterans service organizations. These results cannot be generalized across VA but provide insights. GAO recommends that VA take a number of actions, including steps to ensure facilities comply with applicable requirements, notify veterans of denials, improve oversight of claims processing, and collect better data on denials and veterans' understanding of eligibility for Millennium Act coverage. VA agreed with the recommendations and described its plans to implement them. However, as described in the report, GAO believes that some of VA's proposed actions do not fully address the issues identified.

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