VA As Partial Secondary Insurance Staab 14-0957 Private Pay Litigation

On April 8, 2016 the U.S. Court of Appeals for Veterans Claims ruled in favor of Richard W. Staab.  The litigation is titled Richard W. Staab verses Robert A. McDonald (Secretary of Veteran's Affairs).

In, 2009 Congress enacted the Emergency Care Fairness Act which required the VA to step in as a secondary payer where typical health plans (Medicare) only cover a portion of the billed treatment.  Now Veterans who file claims for care outside the VA System in urgent situations can view the VA as a partial secondary insurance. 

From this litigation readers can expect the Department of Veterans Affairs to:

   1. Update (amend) guidelines to meet regulations

   2. Re-train staff on updated guidelines

   3. Evaluate process to assure families receive the reimbursement that they are legally entitled to for emergency medical expenses

This is beneficial for the entire community who understands how Veterans often have to receive urgent medical treatment outside the VA delivery system. 

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