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HRD-85-24 1 (1985-02-26)

handle is hein.gao/gaobabexy0001 and id is 1 raw text is: 

BY THE COMPTROLLER: GENERAL



Report To The Congress


OF THE UNITED STATES



Legislation To Authorize VA Recoveries From

Private Health Insurance Would Result In

Substantial Savings


Most health insurance policies will not pay for non-
emergency care provided to the companies' policyholders
byVeteransAdministration medical facilities. Such policies
have exclusionary clauses which state that the insurance
companies will not pay for care for which the policyholder
has no obligation to pay. GAO analyzed concerns raised
by the insurance industry and others about a legislative
proposal to prevent health insurance companies from
refusing payment for treatment of non-service-con-
nected disabilities in VA medical facilities.

GAO concludes that no overriding legal or administrative
problems are preventing the enactment and implemen-
tation of a VA cost recovery program. GAO estimates,
based on a questionnaire survey, that VA could have
recovered at least $98 million to $284 million from
private health insurance in fiscal year 1982 with minimal
impact on health insurance premiums.

GAO recommends that the Congress enact recovery
legislation to enable VA to recover the costs of care
provided to privately insured veterans for non-service-
connected medical conditions.











A0     0                                                     126301


                                                            GAO/HR D-85-24
                                                         FEBRUARY 26, 1985

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