PRESIDENT SIGNS VETERANS’ EMERGENCY CARE FAIRNESS ACT
Chairman Akaka introduced Senate bill to cover gaps in emergency care for veterans with limited insurance
WASHINGTON, D.C. – Senate Veterans’ Affairs Committee Chairman Daniel K. Akaka (D-HI) today praised President Barack Obama’s signing of the Veterans’ Emergency Care Fairness Act of 2009.
“For veterans with limited insurance, a trip to the emergency room should not result in financial ruin,” said Chairman Akaka, who introduced the bill in the Senate last year. “With this new law, VA will be positioned to help veterans who are enrolled in VA care whose insurance does not cover the full cost of emergency treatment.” The Veterans’ Emergency Care Fairness Act, signed into law by President Obama last night, will enable the Department of Veterans Affairs to reimburse veterans enrolled in VA health care for the remaining cost of emergency treatment if the veteran has outside insurance that only covers part of the cost. Previously, VA could reimburse veterans or pay outside hospitals directly only if a veteran has no outside health insurance.
In addition to reimbursing veterans for emergency care in the future, the bill allows the Secretary of Veterans Affairs to provide retroactive reimbursements for care received prior to the passage of this bill. Akaka has received correspondence from veterans who were unable to receive financial assistance under the previous rules, and plans to share their information with Secretary Shinseki.
The Congressional Budget Office estimates that this legislation will cover approximately 700 future claims per year and as many as 2,000 veterans retroactively.
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Veterans’ Emergency Care Fairness Act of 2009 (Introduced in Senate)
S 404 IS
111th CONGRESS
1st Session
S. 404
To amend title 38, United States Code, to expand veteran eligibility for reimbursement by the Secretary of Veterans Affairs for emergency treatment furnished in a non-Department facility, and for other purposes.
IN THE SENATE OF THE UNITED STATES
February 10, 2009
Mr. AKAKA (for himself and Mr. BURRIS) introduced the following bill; which was read twice and referred to the Committee on Veterans’ Affairs
A BILL
To amend title 38, United States Code, to expand veteran eligibility for reimbursement by the Secretary of Veterans Affairs for emergency treatment furnished in a non-Department facility, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the `Veterans’ Emergency Care Fairness Act of 2009′.
SEC. 2. EXPANSION OF VETERAN ELIGIBILITY FOR REIMBURSEMENT BY SECRETARY OF VETERANS AFFAIRS FOR EMERGENCY TREATMENT FURNISHED IN A NON-DEPARTMENT FACILITY.
(a) Expansion of Eligibility- Subsection (b)(3)(C) of section 1725 of title 38, United States Code, is amended by striking `, in whole or in part,’.
(b) Limitations on Reimbursement- Such section 1725 is further amended–
(1) in subsection (c), by adding at the end the following new paragraph:
`(4)(A) If the veteran has contractual or legal recourse against a third party that would, in part, extinguish the veteran’s liability to the provider of the emergency treatment and payment for the treatment may be made both under subsection (a) and by the third party, the amount payable for such treatment under such subsection shall be the amount by which the costs for the emergency treatment exceed the amount payable or paid by the third party, except that the amount payable may not exceed the maximum amount payable established under paragraph (1)(A).
`(B) In any case in which a third party is financially responsible for part of the veteran’s emergency treatment expenses, the Secretary shall be the secondary payer.
`(C) A payment in the amount payable under subparagraph (A) shall be considered payment in full and shall extinguish the veteran’s liability to the provider.
`(D) The Secretary may not reimburse a veteran under this section for any copayment or similar payment that the veteran owes the third party or for which the veteran is responsible under a health-plan contract.’; and
(2) in subsection (f)(3)–
(A) in subparagraph (A), by inserting before the period at the end the following: `, including the Secretary of Health and Human Services with respect to the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) and the Medicaid program under title XIX of such Act (42 U.S.C. 1396 et seq.)’; and
(B) in subparagraph (B), by inserting before the period at the end the following: `, including a State Medicaid agency with respect to payments made under a State plan for medical assistance approved under title XIX of such Act (42 U.S.C. 1396 et seq.)’.
(c) Effective Date-
(1) IN GENERAL- The amendments made by subsections (a) and (b) shall take effect on the date of the enactment of this Act, and shall apply with respect to emergency treatment furnished on or after the date of the enactment of this Act.
(2) REIMBURSEMENT FOR TREATMENT BEFORE EFFECTIVE DATE- The Secretary may provide reimbursement under section 1725 of title 38, United States Code, as amended by subsection (a) and (b) for emergency treatment furnished before the date of the enactment of this Act if the Secretary determines that, under the circumstances applicable with respect to the veteran, it is appropriate to do so.