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Proposed Change to VA Payment Methodology

May 30, 2017

In March, the Veterans Reimbursement for Emergency Ambulance Services Act (VREASA) was introduced by U.S. Representative Mike Coffman (R - CO).  

Every year, approximately 150,000 veterans are faced with out-of-pocket expenses for emergency ambulance services because the Department of Veterans Affairs (VA) denies emergency ambulance claims due to its interpretation of regulation.

The VREASA is intended to update the VA’s reimbursement evaluation methodology, so that veterans are not held responsible for an emergency ambulance bill.  

At issue is how Medicare, Medicaid, and other major payers adhere to the “prudent layperson” standard for the reimbursement of emergency ambulance services.  The VA is the only major payer to not follow this standard.  

As it stands today, the VA requires all medical records be provided prior to payment, including the records of treatment after the emergency service has taken place.  In the event those records are interpreted in such a way that the incident was not deemed to be a life-threatening emergency, the claim is denied.

As we know, the VA is in distress.  It will be interesting to monitor this proposal, as well as the changes the new administration implements, and what effect those changes will have. 
In March, the Veterans Reimbursement for Emergency Ambulance Services Act (VREASA) was introduced by U.S. Representative Mike Coffman (R - CO).  

Every year, approximately 150,000 veterans are faced with out-of-pocket expenses for emergency ambulance services because the Department of Veterans Affairs (VA) denies emergency ambulance claims due to its interpretation of regulation.

The VREASA is intended to update the VA’s reimbursement evaluation methodology, so that veterans are not held responsible for an emergency ambulance bill.  

At issue is how Medicare, Medicaid, and other major payers adhere to the “prudent layperson” standard for the reimbursement of emergency ambulance services.  The VA is the only major payer to not follow this standard.  

As it stands today, the VA requires all medical records be provided prior to payment, including the records of treatment after the emergency service has taken place.  In the event those records are interpreted in such a way that the incident was not deemed to be a life-threatening emergency, the claim is denied.

As we know, the VA is in distress.  It will be interesting to monitor this proposal, as well as the changes the new administration implements, and what effect those changes will have. 


In March, the Veterans Reimbursement for Emergency Ambulance Services Act (VREASA) was introduced by U.S. Representative Mike Coffman (R - CO).  


Every year, approximately 150,000 veterans are faced with out-of-pocket expenses for emergency ambulance services because the Department of Veterans Affairs (VA) denies emergency ambulance claims due to its interpretation of regulation. 


The VREASA is intended to update the VA’s reimbursement evaluation methodology, so that veterans are not held responsible for an emergency ambulance bill.  


At issue is how Medicare, Medicaid, and other major payers adhere to the “prudent layperson” standard for the reimbursement of emergency ambulance services.  The VA is the only major payer to not follow this standard.   


As it stands today, the VA requires all medical records be provided prior to payment, including the records of treatment after the emergency service has taken place.  In the event those records are interpreted in such a way that the incident was not deemed to be a life-threatening emergency, the claim is denied. 


As we know, the VA is in distress.  It will be interesting to monitor this proposal, as well as the changes the new administration implements, and what effect those changes will have. 

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