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FLvetwife

"millenium Act" Effect On Vietnam Vet?

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The "Millenium Act"

we are looking for any information on this and how it would effect a Vietnam Veteran's

"non-authorised" hospitalization claim.

If while a vet is waiting on a determination rating, he is admitied to the ER on a Saturday nite (can't get into a VA facility), for an apparent service connected condition, will the Millenium Act help with the bills even tho the rating has not yet been determined?

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Chances are that the VA regs concerning notification timeframe and insurance stand.

The "Millenium Act"

we are looking for any information on this and how it would effect a Vietnam Veteran's

"non-authorised" hospitalization claim.

If while a vet is waiting on a determination rating, he is admitied to the ER on a Saturday nite (can't get into a VA facility), for an apparent service connected condition, will the Millenium Act help with the bills even tho the rating has not yet been determined?

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While waiting for VA decisions Veterans are stuck in Limbo. I think that you should consider talking to the Hospital they can get their money from the Federal Government if you have not tried that before. They are also obligated to take minimum payments whiile you attempt to have your claim approved.

Once Service Connection is established it is not easy but the VA Fee Services will have to take care of the bill.

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x

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Authority would issue from US Code, Title 38, Chapter 17. ~Wings

http://www.law.cornell.edu/uscode/html/usc...0_II_20_17.html

CHAPTER 17 — HOSPITAL, NURSING HOME, DOMICILIARY, AND MEDICAL CARE

TITLE 38 > PART II > CHAPTER 17 > SUBCHAPTER III >

§ 1725 Reimbursement for emergency treatment

(a) General Authority.—

(1) Subject to subsections (c ) and (d), the Secretary may reimburse a veteran described in subsection (b) for the reasonable value of emergency treatment furnished the veteran in a non-Department facility.

(2) In any case in which reimbursement is authorized under subsection (a)(1), the Secretary, in the Secretary’s discretion, may, in lieu of reimbursing the veteran, make payment of the reasonable value of the furnished emergency treatment directly—

(A) to a hospital or other health care provider that furnished the treatment; or

(B) to the person or organization that paid for such treatment on behalf of the veteran.

(b) Eligibility.—

(1) A veteran referred to in subsection (a)(1) is an individual who is an active Department health-care participant who is personally liable for emergency treatment furnished the veteran in a non-Department facility.

(2) A veteran is an active Department health-care participant if—

(A) the veteran is enrolled in the health care system established under section 1705 (a) of this title; and

(B) the veteran received care under this chapter within the 24-month period preceding the furnishing of such emergency treatment.

(3) A veteran is personally liable for emergency treatment furnished the veteran in a non-Department facility if the veteran—

(A) is financially liable to the provider of emergency treatment for that treatment;

(B) has no entitlement to care or services under a health-plan contract (determined, in the case of a health-plan contract as defined in subsection (f)(2)(B) or (f)(2)©, without regard to any requirement or limitation relating to eligibility for care or services from any department or agency of the United States);

( C) has no other contractual or legal recourse against a third party that would, in whole or in part, extinguish such liability to the provider; and

(D) is not eligible for reimbursement for medical care or services under section 1728 of this title.

( C) Limitations on Reimbursement.—

(1) The Secretary, in accordance with regulations prescribed by the Secretary, shall—

(A) establish the maximum amount payable under subsection (a);

(B) delineate the circumstances under which such payments may be made, to include such requirements on requesting reimbursement as the Secretary shall establish; and

( C) provide that in no event may a payment under that subsection include any amount for which the veteran is not personally liable.

(2) Subject to paragraph (1), the Secretary may provide reimbursement under this section only after the veteran or the provider of emergency treatment has exhausted without success all claims and remedies reasonably available to the veteran or provider against a third party for payment of such treatment.

(3) Payment by the Secretary under this section on behalf of a veteran to a provider of emergency treatment shall, unless rejected and refunded by the provider within 30 days of receipt, extinguish any liability on the part of the veteran for that treatment. Neither the absence of a contract or agreement between the Secretary and the provider nor any provision of a contract, agreement, or assignment to the contrary shall operate to modify, limit, or negate the requirement in the preceding sentence.

(d) Independent Right of Recovery.—

(1) In accordance with regulations prescribed by the Secretary, the United States shall have the independent right to recover any amount paid under this section when, and to the extent that, a third party subsequently makes a payment for the same emergency treatment.

(2) Any amount paid by the United States to the veteran (or the veteran’s personal representative, successor, dependents, or survivors) or to any other person or organization paying for such treatment shall constitute a lien in favor of the United States against any recovery the payee subsequently receives from a third party for the same treatment.

(3) Any amount paid by the United States to the provider that furnished the veteran’s emergency treatment shall constitute a lien against any subsequent amount the provider receives from a third party for the same emergency treatment for which the United States made payment.

(4) The veteran (or the veteran’s personal representative, successor, dependents, or survivors) shall ensure that the Secretary is promptly notified of any payment received from any third party for emergency treatment furnished to the veteran. The veteran (or the veteran’s personal representative, successor, dependents, or survivors) shall immediately forward all documents relating to such payment, cooperate with the Secretary in the investigation of such payment, and assist the Secretary in enforcing the United States right to recover any payment made under subsection (C )(3).

(e) Waiver.— The Secretary, in the Secretary’s discretion, may waive recovery of a payment made to a veteran under this section that is otherwise required by subsection (d)(1) when the Secretary determines that such waiver would be in the best interest of the United States, as defined by regulations prescribed by the Secretary.

(f) Definitions.— For purposes of this section:

(1) The term “emergency treatment” means medical care or services furnished, in the judgment of the Secretary—

(A) when Department or other Federal facilities are not feasibly available and an attempt to use them beforehand would not be reasonable;

(B) when such care or services are rendered in a medical emergency of such nature that a prudent layperson reasonably expects that delay in seeking immediate medical attention would be hazardous to life or health; and

( C) until such time as the veteran can be transferred safely to a Department facility or other Federal facility.

(2) The term “health-plan contract” includes any of the following:

(A) An insurance policy or contract, medical or hospital service agreement, membership or subscription contract, or similar arrangement under which health services for individuals are provided or the expenses of such services are paid.

(B) An insurance program described in section 1811 of the Social Security Act (42 U.S.C. 1395c) or established by section 1831 of that Act (42 U.S.C. 1395j).

( C) A State plan for medical assistance approved under title XIX of such Act (42 U.S.C. 1396 et seq.).

(D) A workers’ compensation law or plan described in section 1729 (a)(2)(A) of this title.

(E) A law of a State or political subdivision described in section 1729 (a)(2)(B) of this title.

(3) The term “third party” means any of the following:

(A) A Federal entity.

(B) A State or political subdivision of a State.

( C) An employer or an employer’s insurance carrier.

(D) An automobile accident reparations insurance carrier.

(E) A person or entity obligated to provide, or to pay the expenses of, health services under a health-plan contract.

Notes to Myself (abbreviated)

Public Law 106-117, 106th Congress

This Act may be cited as the ``Veterans Millennium Health Care and Benefits Act''.

SEC. 111. REIMBURSEMENT FOR EMERGENCY TREATMENT IN NON-DEPARTMENT OF VETERANS AFFAIRS FACILITIES.

(a) Authority To Provide Reimbursement.--Chapter 17 is amended by

inserting after section 1724 the following new section:

``Sec. 1725. Reimbursement for emergency treatment

Edited by Wings

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"Secretary may reimburse"

Leaves the decision to the VA. It's a very poor phrase to put in an entitlement law, since it does not require the VA to do anything.

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With my experience the answer is "probably not". These are but some of the reasons the VA has a financial incentive to delay claims as long as possible. Another financial incentive the Va has for delaying claims is that there is never any interest paid on money owed the Veteran. For example, say you were owed money for claims put in by the VA 5 years ago, while gas was still $1.50 per gallon. They delay your claim until now, and you finally get your money. You dont get the rates in effect for 2007. You get the lower rate paid in 2002..even tho you dont get the money until 2007. By delaying the claim as long as possible, there are at least 3 financial incentives for the VA.

1. You may die or abandon the claim, such as if you win the lottery.

2. In the interim period, they pay NO Ch. 35 benefits, NO other benefits either..that relate to P&T such as the benefits you mentioned. That saves em money.

3. Inflation. They pay you at the lower rate with todays inflated dollars. Had you had those dollars 5 years ago, you could have earned interest on them to keep up with inflation. The VA keeps your interest money. Naturally, to save money, VA delays the claim as long as possible...requiring proof..requiring appeals (they hope you will give up or die) because their is significant financial incentive for them to do so.

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