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Va Prescription Drugs And Copay

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Chuck75

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  • HadIt.com Elder

Well, here I go again!

The VA has been charging "copay" for drugs associated with the "proper" and "correct" treatment of DMII and conditions associated with it.

In my case, drugs for the control of blood pressure and cholesterol, as well as Nicotine gum.

The VAMC bean counters assure me that this is typical.

Everybody points to everyone else as to correcting the problem.

With the language in the below VA reference, how can the VA do this?

Reference (extracts)

VA/DOD CLINICAL PRACTICE GUIDELINE FOR THE

MANAGEMENT OF

Guideline Summary

DIABETES MELLITUS (DM)

IN PRIMARY CARE

from VA Management of Diabetes Mellitus in Primary Care Summary

page 30

MODULE R – KIDNEY FUNCTION

SCREENING

1. Patients with type 1 DM should be screened for

kidney disease after puberty and at a minimum of

every five years. Patients with type 2 DM should be

screened for kidney disease at the time of DM

diagnosis, since the onset of type 2 DM occurs on

average 10 years before a clinical diagnosis is made.

Page 1

RECOMMENDATIONS WITH THE HIGHEST EVIDENCE: The highest

evidence for recommendations is A, defined as “a strong recommendation

based on randomized controlled trials that the intervention is always

indicated and acceptable.”

The following practices are strongly recommended based on evidence reviews:

8. Prescribe aspirin therapy (75 to 325 mg/day) for all adult patients with diabetes and

evidence of cardiovascular disease. [R=A]

Page 2

GUIDELINE KEY ELEMENTS

Secondary Prevention

• Achieve individualized HbA1c target through diet, exercise, medication, and patient

education to prevent micro- and macrovascular complications.

• Reduce and control blood pressure to improve quality and length of life, and prevent

micro- and macrovascular complications.

• Control cholesterol to reduce risk of cardiovascular disease.

Page ??

Health Preventive Measures

• Consider aspirin therapy to reduce the risk of cardiovascular fatal events.

• Advise tobacco use cessation.

• Provide influenza vaccination in season.

• Provide pneumonia vaccine, if indicated.

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  • HadIt.com Elder

They will charge your insurance or you for whatever they think they can get away with including for SC conditions if you don't raise hell. I am SC'ed for a heart conditon and I bet they bill my insurance for my stress tests and echocardiograms.

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John, I don't know if the Nashville VA bills my private insurance or not. When I see my other Dr's I always get a statement from my insurance provider showing what they paid and what I owe. If this going on you can bet I will raise hell from the bottom of the ladder to the top rungf it takes it. This is not right for a sc condition. The gov. made the rules and should live up to them. After all veterans are responsible for them being where they are since they had friends in high places or a lot of money to keep them from serving their country. I know a couple who did just that during the Vietnam war. What a dam waste.

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  • HadIt.com Elder

I expect to see a Story like this one soon.

News Flash, VA Ripping OFF insurance Companies.

Insurance companies are mostly crooks themselves and when it comes to money you can bet that they also like to keep it.

I wonder what would happen if a couple of Vets proved they were charging them for Service connected disabilitied and they paid event hgeough they didnt have too.

It be pure pandemonemum. There would be more lawyers barking up the VA's backside than there are listening to police scanners.

NAH, we wouldnt do that to the VA, Would WE?

Edited by jbasser
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  • HadIt.com Elder
I expect to see a Story like this one soon.

News Flash, VA Ripping OFF insurance Companies.

Insurance companies are mostly crooks themselves and when it comes to money you can bet that they also like to keep it.

I wonder what would happen if a couple of Vets proved they were charging them for Service connected disabilitied and they paid event hgeough they didnt have too.

It be pure pandemonemum. There would be more lawyers barking up the VA's backside than there are listening to police scanners.

NAH, we wouldnt do that to the VA, Would WE?

I believe that it is a law that the VA can bill your private insurance for various services and meds. I know it happens with us and when we asked, the insurance company told us that, not the VA. My hubby is 100% P&T and occasionally we get the receipt from our insurance showing what they pay.

fanaticbooks

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