December 9, 2016
Washington, DC – Led by U.S. Sens. Mike Rounds (R-S.D.) and Amy Klobuchar (D-Minn.), 22 senators, including six from the Senate Veterans’ Affairs Committee, wrote to U.S. Department of Veterans Affairs (VA) Secretary Robert McDonald to urge him to comply with the Emergency Care Fairness Act (ECFA). The ECFA was enacted in 2010 and directed the VA to cover veterans with private health insurance when that insurance doesn’t cover the full amount of non-VA emergency care. Yet since 2010, the VA has not complied with the law, denying hundreds of thousands of veterans’ reimbursement claims for emergency care.
Earlier this year, a federal court ordered the VA to write regulations that comply with the ECFA. In addition to urging the VA to comply with the law, the senators also requested that the agency fix its mistake and re-open all previously denied claims.
“Congress’s clear intent in passing the ECFA was to expand veteran eligibility for reimbursement for emergency treatment furnished to veterans in non-department facilities,” wrote the senators. “Specifically, congressional intent was to require the VA to act as a secondary payer for emergency treatment costs not covered by the veteran’s third-party insurance. It is evident that the VA has ignored congressional intent. Most troubling is the fact that those who are most affected by the VA’s non-compliance with the ECFA are our elderly veterans, many of whom are living on fixed incomes and have limited resources to pay medical bills.”
In addition to Rounds and Klobuchar, the letter was signed by Sens. Chuck Grassley (R-Iowa), Claire McCaskill (D-Mo.), Mark Kirk (R-Ill.), Jon Tester (D-Mont.), John Boozman (R-Ark.), Sherrod Brown (D-Ohio), Steve Daines (R-Mont.), Patty Murray (D-Wash.), Shelley Moore Capito (R-W.Va.), Tammy Baldwin (D-Wisc.), Jim Inhofe (R-Okla.), Elizabeth Warren (D-Mass.), Jerry Moran (R-Kan.), Kirsten Gillibrand (D-N.Y.), Joni Ernst (R-Iowa), Brian Schatz (D-Hawaii), Kelly Ayotte (R-N.H.), Al Franken (D-Minn.), John Cornyn (R-Texas) and Jeff Merkley (D-Ore.). The letter is supported by The American Legion, Veterans of Foreign Wars, Disabled American Veterans and the Paralyzed Veterans of America.
Full text of the letter is below:
The Honorable Robert McDonald
Secretary of Veterans Affairs
Department of Veterans Affairs
810 Vermont Avenue, NW
Washington, D.C. 20420
Dear Secretary McDonald:
We write today to express our support for the Veterans Emergency Care Fairness Act of 2009 (ECFA). Six years after enactment of the ECFA, our nation’s veterans continue to bear the burden of emergency treatment costs not covered by veterans’ third-party insurance. The U.S. Department of Veterans Affairs’ (VA) continued denial of these claims is deeply troubling.
Congress’s clear intent in passing the ECFA was to expand veteran eligibility for reimbursement for emergency treatment furnished to veterans in non-department facilities. Specifically, congressional intent was to require the VA to act as a secondary payer for emergency treatment costs not covered by the veteran’s third-party insurance. It is evident that the VA has ignored congressional intent. Most troubling is the fact that those who are most affected by the VA’s non-compliance with the ECFA are our elderly veterans, many of whom are living on fixed incomes and have limited resources to pay medical bills. Often, these veterans find themselves dealing with collection agencies as a result of emergency care received in the community. This potentially increases stress for these veterans, causes them to lose faith in the VA and keeps them from seeking future medical attention out of fear of acquiring additional medical bills for which they would be financially responsible.
As you are aware, on April 8, 2016, in the case of “Staab v. Secretary McDonald,” the United States Court of Appeals for Veterans Claims agreed with the appellant’s contention that the VA’s application of 38 U.S.C. § 1725 frustrates the intent of Congress to reimburse veterans who are not wholly covered by a health-plan contract or other third-party recourse. In its decision, the court ruled that “Congress clearly intended that the VA be responsible for the cost of the emergency treatment which exceeds the amount payable or paid by the third-party insurer.” The court further found the VA’s regulations regarding the ECFA to be invalid and wholly inconsistent with the statute. As a result, the court ruled that 38 C.F.R. § 17.1002(f) is held invalid and directed it to be set aside.
Based upon this ruling, we strongly urge you to bring the VA into compliance with P.L. 111-137 and to amend any policy, regulation or other barrier that results in denial of veterans’ claims for reimbursement for non-department emergency care. We further urge you to re-open all previous claims of veterans that were denied because of the VA’s non-compliance with congressional intent and the law.
Thank you for your attention to our concerns regarding this important issue. We look forward to working closely with you to fully serve the veterans of our great nation.