The Department of Veterans Affairs and Centers for Medicare & Medicaid Services plan to address a long-running problem of both agencies getting billed and paying for the same health care services, essentially doubling up on payments at the expense of taxpayers.
The Department of Veterans Affairs launched a partnership with the Centers for Medicare & Medicaid Services this week to eliminate instances in which both agencies are billed for the same health care episode. VA and CMS reviewed medical billings going back six years for veterans enrolled in both VA health care and Medicare and found $106 million that was improperly spent on duplicate billings.
“For too long, government programs have operated in silos, enabling improper payments to slip through the cracks at the expense of taxpayers,” CMS Administrator Dr. Mehmet Oz said.
VA Secretary Doug Collins said the savings would help those enrolled in both programs.
“The money we save as a result of this effort will be much better spent helping VA and Medicare beneficiaries get the benefits they’ve earned,” he said.
Officials plan to try to claw some of that money back. Both VA and CMS will begin sending bills to overpaid providers to recover improper payments.
The double billing problem has existed for decades. A 1979 report from the Government Accountability Office found the same thing was happening in 1976.
“Because the Medicare and VA programs both operate under national program guidelines, it is likely that the practices we found during our review are occurring throughout the nation,” the 1979 report found.
About 5.9 million Veterans are enrolled in VA health care and Medicare, and both VA and CMS pay for medical care from third-party providers. Despite knowing about the problem for decades, VA and CMS had no system in place to prevent double billing. VA and CMS have now established a data-matching agreement to identify medical providers who have submitted claims for payment to both VA and Medicare, helping eliminate overpayments and future instances of double billing.
