Bill Overview
Title: Veterans' Emergency Care Claims Parity Act
Description: This bill modifies certain deadlines for the submittal of claims by a non-Department of Veterans Affairs (VA) individual or entity seeking reimbursement for the provision of emergency treatment to a veteran. Specifically, a non-VA individual or entity seeking such reimbursement must submit a claim not later than 180 days after the treatment was provided. (Under the VA's current policy, such claims for unauthorized emergency care must generally be submitted within 90 days for conditions that are not service-connected and within two years for conditions that are service-connected.) Veterans may not be held liable for payment if a claim was submitted by an individual or entity after the deadline due to an administrative error made by the individual or entity or by the VA. The VA must publish information regarding emergency care authorization for non-VA providers on a publicly available VA website.
Sponsors: Sen. Rounds, Mike [R-SD]
Target Audience
Population: Veterans in need of emergency medical services
Estimated Size: 19000000
- The bill focuses on emergency medical treatments for veterans, so the primary individuals affected are veterans who receive healthcare services, specifically emergency care, from non-VA providers.
- The change in deadlines for claim submissions will impact healthcare providers and entities that are not part of the VA but provide emergency services to veterans.
- The policy adjustment centers on reimbursement claims' processing, which implies that billing departments and financial administrators of healthcare facilities might also be affected.
- The stipulation that veterans are not held liable for payment due to administrative errors prevents additional financial burdens on veterans if claims are delayed, affecting veterans' economic wellbeing.
Reasoning
- The policy impacts primarily veterans and non-VA healthcare providers, so the interview sample should mostly include these groups.
- A significant amount of veterans rely on non-VA emergency care, thus a portion of the interviews should reflect this.
- The policy does not affect every veteran equally, as not all require emergency treatment or use non-VA services, so there will be varied impact levels.
- Financial administrators and billing staff at healthcare facilities are perturbed by administrative deadlines, affecting their work stress and error management strategies, and they should be included.
Simulated Interviews
Retired, Army veteran (Texas)
Age: 67 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 5/20
Statement of Opinion:
- I'm often worried about unexpected medical bills from emergency visits.
- This policy should give me more confidence that I won't end up paying due to a technical error.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Nurse in a non-VA hospital (California)
Age: 45 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- Easing submission deadlines helps us focus on patient care instead of paperwork.
- It should reduce frustrations for both us and veterans.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 5 |
Marine veteran, works part-time (Florida)
Age: 58 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 8/20
Statement of Opinion:
- I'm trying to balance multiple medical bills; this policy could help avoid unexpected expenses.
- It's reassuring to know errors won't cost me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 6 | 4 |
Health policy analyst (New York)
Age: 32 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 3/20
Statement of Opinion:
- Adjusting deadlines reflects a fairer system for veterans.
- Data will be key to identifying if disparities in care accessibility close.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
Retired Air Force veteran (Ohio)
Age: 81 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- My age and health mean I need quick and reliable healthcare financial support.
- This policy seems like a safety net for avoiding cost surprises.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 4 |
Administrative assistant at a non-VA emergency clinic (Colorado)
Age: 38 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- Easier deadlines mean less stress and fewer disputes over late submissions.
- It's beneficial for both our office and the veterans we serve.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 5 |
Veteran Affairs administrator (Virginia)
Age: 50 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- Simplifying deadlines will help our teams process claims more efficiently.
- It's a good step towards preventing veterans' financial liability.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 5 |
Healthcare advocate, non-profit (Illinois)
Age: 29 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- This policy makes emergency services financially safer for veterans.
- It could pave the way for more supportive healthcare policies.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 7 | 7 |
Policy advisor (Washington, D.C.)
Age: 36 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 2/20
Statement of Opinion:
- The bill is an important advocacy step for vets' rights.
- It balances provider needs with veterans' financial protection.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
Farmer, Vietnam veteran (Arizona)
Age: 62 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- I haven't always been able to get VA care for emergencies in time.
- This policy might help reduce financial anxieties if claims are mishandled.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 4 |
Cost Estimates
Year 1: $15000000 (Low: $12000000, High: $18000000)
Year 2: $15000000 (Low: $12000000, High: $18000000)
Year 3: $15000000 (Low: $12000000, High: $18000000)
Year 5: $15000000 (Low: $12000000, High: $18000000)
Year 10: $15000000 (Low: $12000000, High: $18000000)
Year 100: $15000000 (Low: $12000000, High: $18000000)
Key Considerations
- The policy extends the claims deadline to 180 days, facilitating more reimbursements for non-VA emergency care providers.
- Veterans are protected from being held liable for payment issues stemming from administrative errors, ensuring no undue financial burden.
- There may be initial administrative and IT costs associated with implementing this policy within the VA.
- The publishing of emergency treatment authorizations on the VA website could improve information access, promoting efficiency and service use.