By Debbie Gregory.
VA Secretary David Shulkin said he was dropping VA’s appeal of the Staab case decided last year by the U.S. Court of Appeals for Veterans Claims.
The case, filed by Richard W. Staab, appealed a December 6, 2013, Board of Veterans’ Appeals decision that denied Staab reimbursement of medical expenses incurred for emergency medical services provided at non-VA medical facilities.
Shulkin said Staab had been wrongly decided. In Staab’s case, the court agreed with lawyers for the 83-year Air Force veteran who was forced to pay $48,000 in healthcare costs following open-heart surgery in December 2010.
For a number of years, the VA has maintained that, by law, it can only reimburse VA-enrolled veterans for outside emergency care if they have no alternative health insurance. That includes Medicare, TRICARE, employer-provided health insurance or contracted health plans of any kind.
Unfortunately for veterans with other health insurance, they are often stuck paying hefty out-of-pocket costs that their plans won’t cover, while veterans with no other insurance see the VA routinely pick up their entire emergency care tab.
Pulling the appeal means VA intends to begin covering private sector emergency care for any VA-enrolled veteran, even if they have alternative health insurance that pays part of their emergency care costs.
As many as 370,000 veterans with pending claims could benefit from the decision to appeal.
The VA has completed draft regulations to implement the new emergency care benefit. The benefit must clear the Office of Management and Budget (OMB) and be published in the Federal Register for comment before VA can begin reimbursements. could take nine months or more.