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American Legion lobbies for "Medicare at VA" bill

The Commander of the American Legion is urging Congress to pass a bill that would allow military veterans to pay for non-combat-related medical care received at VA hospitals with their Medicare coverage.

Under current law, the VA’s Veteran Health Administration is prohibited from seeking reimbursement from Medicare for the treatment of non-service-connected medical conditions even if the treatment is covered under Medicare. As a result, veterans with Medicare coverage who may prefer to receive care at VA hospitals and have their treatments paid for by Medicare must seek care elsewhere.

The bill, H.R. 814, is called the “Medicare VA Reimbursement Act of 2011."

"Veterans, like everyone else, pay into Medicare all their working lives," said Jimmie L. Foster, the American Legion's national commander. "So why should they not be able to use Medicare benefits at the medical facilities of their choosing – namely, VA medical centers – for all medical conditions, both service-connected and non-service-connected? VA medical care is considered by many to be the best there is, so it should be made available to as many veterans as possible. In our opinion, that is a privilege these men and women have earned through their selfless service to our nation.”

[See also: VA expands new model of healthcare billing; Medicaid patients 5.5 times more likely to get cataract surgery than VA patients, study finds]

Under current law, the VHA has the authority to bill private health insurers for the treatment of veterans’ non-service-related medical treatments, but does not allow billing of Medicare. The bill, if approved, would require the VA to develop a means to allow billing for veterans covered by Medicare Part A or Part B for these health services.

Veterans 'have earned Medicare benefits by contributing to the Medicare program during their working years. Because VA cannot bill Medicare, elderly veterans are unable to use their Medicare benefits, even if they may prefer to receive care at a VA facility among their fellow veterans,” said the bill’s sponsor, California Rep. Bob Filner, ranking Democratic member of the House Veterans’ Affairs Committee. “So for those veterans, they basically forgo the hard-earned dollars that they contributed towards Medicare benefits during their working years. This bill is important legislation that would allow elderly veterans to access both VA healthcare and their Medicare benefits.”

Foster also contends that by allowing for Medicare reimbursement at VA facilities, the money flowing in would have a broader benefit.

“It should be noted that VA's pioneering medical research and education is good not only for veterans, but for all Americans,” he said. “It's not unlike the benefits we have all derived from research and development done by NASA's space program.”

This isn't the first time a bill has sought to Medicare Funds to the VA. A similar measure in 2002 that would have required a transfer of monthly premium dollars for veterans with Medicare who received care at VA hospitals did not pass after encountering strong opposition from the administration of then-President George Bush.

That bill was estimated to have a price tag of $32 billion over 10 years. Robert H. Roswell, under secretary for Health Department of Veterans Affairs, testified before the Committee on Veterans' Affairs that the “Veterans Medicare Payment Act of 2002” might not improve veterans’ access to care at the VA. Further, he argued, the transfer of funds would not result in an overall increase in VHA funding.

“When the department accesses new funding streams, those increased funds are typically offset against the appropriations we would otherwise receive. We have no reason to believe that would not be the case with this bill,” Roswell testified. “In that event, VA would not gain permanent increased funding from the measure. In addition, if more veterans were encouraged to use VA as a result of this bill, the cost to VA would likely be significantly more than the transfer from the Medicare Trust Funds.”

One major difference between the current bill and the 2002 bill is how the program is funded. The 2002 bill was flawed, opponents argued, in that it funded care via a periodic transfer of money from the Federal Supplementary Medical Insurance Trust Fund equivalent to the cost of each Medicare recipients’ monthly premium – roughly $650 per year, per covered veteran – independent of whether treatment was sought. The current bill eliminates that provision, opting instead for a more straightforward payment of claims for services provided.

The bill, recently referred to the House Veterans Affairs Committee's Subcommittee on Health, has three House co-sponsors: Reps. Joe Baca (D-Calif.), Shelley Berkley (D-Nev.) and Madeleine Bordallo (D-Guam).

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