|
VA is committed to maintaining a strong relationship with community providers, who are critical to ensuring Veterans receive timely, high-quality care, while also ensuring proper stewardship of public funds.
As required by federal law, in 2016 VA awarded a contract to perform an audit of community care payments to identify potential overpayments and recover funds. The audit, much like recovery audit contracts with Medicare or commercial insurances, is a review of claims and supporting medical documentation. VA subsequently became aware that certain claims were not being processed in accordance with VA’s payment regulations, resulting in overpayments; these claims were included in the recovery audit contract. Through the recovery audit contract, the VA recouped approximately $36M in overpayments for fiscal years 2013 and 2014, the majority of which was returned to VA Medical Centers to support Veteran care.
VA takes our relationships with community providers very seriously and, after listening to concerns raised by providers and evaluating VA’s internal processes and federal financial requirements, VA has decided that the current audit will cease. As a result, VA is temporarily suspending debt collections for Community Care payments through a third-party auditor while we pursue additional approaches that will take into account individual community provider circumstances and alternative payment options while also ensuring proper stewardship of public funds.
|
