Regarding Va Violation Of 38 Usc 1722a.

[toimi]

The Board of Veterans' Appeals, denial, Conclusion of Law, states, "The appellant is obligated to pay VA copayment for each 30-day or less supply of medication provided by VA on an outpatient basis. 38 U.S.C.A. Sec. 1722a; 38 C.F.R. Sec. 17.110 (2006)."

Finally, after the Criteria and Analysis, and references to other law statutes, the Board, in concluding states, “38 USCA 1722a clearly pertains to VA’s cost in dispensing the medication, not the cost to the appellant... The Federal register of July 16th, 2001; Also under U.S.C. 1722A, VA may not require a veteran to pay an amount in excess of the actual cost of medication and pharmacy administrative costs related to the dispensing of the medication. VHA conducted a study...and found that the VA incurred a cost of $7.28 to dispense an outpatient medication....under these circumstances, we believe that a $7 copayment would not exceed VA’s cost.”

Clearly, dispensing of medication is the key to the Board’s argument, as well as mine.

The VA pharmacy dispenses a supply of 30 pills, the copay cost, whether the amount is 15, 30, 60, or 90 pills the copay is $8. A 30 pill prescription may require that the supply be split. Now becoming a 2 month supply. VA’s copayment charge is $16.

A supply of 30 pills carries the maximum copayment charge of $8, for a 30-day supply, and a veteran is not required to pay an amount in excess of the cost to the Secretary, as described in 38 USC 1722a paragraph 2, and noted in the Decision of the Board of Veterans Appeals reference. The Board citing the Federal register, 12/6/2001. “The VA incurred a cost of $7.28 to dispense an outpatient medication..” (rounded out to $8). Why is it, that a veteran is charged $16 for the exact same $8 prescription, 30 pill supply?

The BVA in denying the appeal, they cite, “.. 1722a clearly pertains to VA‘s cost in dispensing the medication...,The VA incurred a cost...to dispense medication..”, providing the answer to their apperception. Dispensing! The VA charges the veteran twice, or double, as claimed, for the same dispensing cost required to dispense the exact same, one(1) 30-day, $8 supply. Exceeding the cost a veteran is not required to pay. I, like the Board, I am, “..unable to find any authority allowing for a deviation from the standard copayment.” As well, “The Board has no authority to act outside the constraints of the statutory and regulatory criteria.”

[SLEDGE]

Beat the system,

Order the 16-dollar-2-month prescription ever other month.

Or, ask the doctor to change the prescription.

By giving you an answer that contradicts itself, they are letting you know just how important your concerns are to them.

If you like stress, appeal.

If not, realize that you are going to be fighting the system for a long time.

sledge

[USMCVeteranChic77]

I am confused by this.

I am charged my $8.00 for meds for each bottle in each seperate package....

So... are they saying that we should ask our docs to fill the prescriptions at 2 month intervals to save ourselves money since the VA is only supposed to be charging us the cost of shipping the meds?

[toimi]

[quote name='USMCVeteranChic77' I am confused by this.

Edited August 2, 2007 by toimi

[SLEDGE]

Let me add,

If they send you one months worth, order every month.

If they send you enough for 2 months, order once every 2 months.

sledge

[toimi]

Let me add,

If they send you one months worth, order every month.

If they send you enough for 2 months, order once every 2 months.

sledge

Sounds like you are familiar with the VA pharmacy somewhat. However, my experience is the VA pharmacy does not work that way. I can't believe the VA sets up prescriptions at everybody's convenience. As far as I know, they set up prescriptions on a 3 month basis, for veterans who are undergoing treatment for an continuing medical problem, that is , a heart condition, diabetes,etc. Now if your experience with the VA pharmacy, and advising your VA doctors how to schedule your medication is different, please let us know.