From: "\"Doc\" Bruce K. Melson" <>



Department of Veterans Affairs addresses care needs for uninsured veterans

By RICHARD L. SMITH/Tribune-Herald staff writerThe financial burden of
emergency medical care is being lifted for some uninsured military veterans.
Since May 2000, the law allowed veterans without insurance who were patients
in the federal Department of Veterans Affairs system to receive emergency
care in non-VA hospitals. The only problem was that the agency had no rules
in place to implement the law. That has changed and VA officials say the
benefit will be honored beginning this month. It also will be retroactive to
May 29, 2000. But just what is considered an emergency may prove confusing.
The benefit is limited to veterans who use the VA medical system, have been
seen by a VA health care professional and have no other form of insurance,
including Medicare or Medicaid. The benefit also is for use only when a VA or
other federal health facility is not available. Kent Simonis, the VA's
director of Health Administration Services, said it was the regulatory
process that slowed down the process of getting the benefit into place.
Still, he said that getting the benefit into use 14 months after it had been
originally authorized was relatively speedy. "We actually expedited the
process," he said. Simonis also said that former Veterans Affairs secretary
Togo West had insisted that once the benefit was ready for use, it would be
applied retroactively to the May 2000 date. The VA will soon begin processing
the past claims. Ronald McClure, a spokesman for the Central Texas Veterans
Health Care System, said those who qualify for the emergency care most of all
must have a "true emergency." But just what is a true emergency? VA rules say
emergency evaluation and treatment the government will pay for is "of such a
nature that a prudent layperson would have reasonably expected that delay in
seeking immediate medical attention would have been hazardous to life or
health." The VA's standards would be met, says their policy, if the prudent
layperson could expect the absence of immediate medical attention to put an
individual in "serious jeopardy, serious impairment to bodily functions, or
serious dysfunction of any bodily organ or part." However, the definition of
an emergency on paper and how it is looked upon in an emergency room may not
necessarily be the same. "It's pretty much anything a person thinks is an
emergency," said Dr. Dennis Plante, a board certified emergency physician at
Hillcrest Baptist Medical Center in Waco. "And we treat it as such." Insurers
may have a different definition, Plante said. VA officials said that if a
private hospital bills the qualified veteran, then he or she should contact
the local VA health care facility to resolve the issue. Richard L. Smith can
be reached at or at 757-5745.




"When the way comes to an end, then change - having changed, you pass through."

      I. Ching


 Bruce "Doc". Melson