VA To Examine Health Payments To Veterans
Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content.
The Department of Veterans Affairs (VA) has announced a new partnership with the Centers for Medicare and Medicaid Services (CMS) aimed at eliminating duplicate health care billing.
The VA said on Tuesday that the agencies had identified $106 million spent on duplicate billings over the past six years for veterans enrolled in both VA health care and Medicare.
It added that it will start to send bills to overpaid providers to recover the money from this month.
Newsweek contacted VA and CMS for comment via email outside of regular working hours.
Stock image. The VA has announced a new partnership with the Centers for Medicare and Medicaid Services aimed at eliminating duplicate health care billing for veterans.
Stock image. The VA has announced a new partnership with the Centers for Medicare and Medicaid Services aimed at eliminating duplicate health care billing for veterans.
dangutsu/Getty Images
Why It Matters
Federal officials said the recovery effort will both recoup taxpayer funds and help redirect resources towards veterans and Medicare benefits.
Officials also said that the partnership will reduce waste and redundant paperwork.
What To Know
Approximately 5.9 million veterans are enrolled in both VA health care and Medicare, both of which pay for a variety of medical care from third-party providers.
Until now, there was no centralized system in place to prevent double billing, which enabled overpayments to go unnoticed.
The agencies have now established a data-matching agreement to spot when medical providers submit claims for payment to both VA and Medicare, aiming to prevent future overlapping claims.
In addition to payment reforms, the VA announced on Tuesday that it had awarded more than $2 million in new grants to seven educational and research organizations as part of the Veterans Legacy Program.
These grants aim to memorialize veterans through documentaries, digital storytelling, and educational projects that focus on veterans' contributions.
What People Are Saying
VA Secretary Doug Collins said in a statement: "We are proud to implement this commonsense reform, which should have been instituted years ago but is only happening now under the leadership of President Trump. The money we save as a result of this effort will be much better spent helping VA and Medicare beneficiaries get the benefits they've earned."
CMS Administrator Dr. Mehmet Oz said: "For too long, government programs have operated in silos, enabling improper payments to slip through the cracks at the expense of taxpayers. Under President Trump's leadership, CMS is proud to partner with the VA to root out duplicate billing, recover taxpayer funds, and reduce redundant paperwork and waste so American Veterans and seniors receive the care they deserve."
What Happens Next
The VA and CMS plan to recover improper payments from providers has already begun.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Forbes
2 hours ago
- Forbes
Changes In Prior Approval Coming To Traditional Medicare, Medicare Advantage
There were two major announcements recently regarding prior approval of treatments and services for Medicare beneficiaries. In most medical insurance, many treatments won't be covered unless it is approved first by the insurer. It's been a source of controversy for some time. Original Medicare hasn't required prior authorization of treatments and services, with a few exceptions. For most care, providers and the patient agree on a treatment. After the treatment, paperwork for approval and payment is submitted to Medicare. Medicare recently announced a new model program that will test pre-approval. The voluntary model program will test pre-approval for some services and treatments, according to a recent announcement from the Center for Innovation of the Centers for Medicare and Medicaid Services. The model program is seeking medical providers to volunteer for the program from Jan. 1, 2026 through Dec. 31, 2031. The model will be restricted to New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. Providers who volunteer and are accepted will agree to seek prior authorization for 17 items and services, including skin substitutes, deep brain stimulation for Parkinson's Disease, impotence treatment, and arthroscopy for knee osteoarthritis. A provider who volunteers for the program can choose not to seek prior approval for a case. There will be a post-treatment review of the case, and the provider will risk not being paid by Medicare for the treatment. CMS initiated the program and selected the services to be covered because of a series of reports showing waste, fraud or abuse in certain areas. For example, Medicare spent up to $5.8 billion in 2022 on unnecessary or inappropriate services that had no clinical benefit, according to the Medicare Payment Advisory Commission. Under the model, providers will submit the same information they currently submit for payment approval after a service is provided to a beneficiary. The difference is that under the model, the information will be submitted earlier and the provider will wait for approval before performing the services. CMS will select companies to receive and review the prior authorizations. It expects that they will use artificial intelligence and other tools in addition to medical professionals to review the submissions. The companies will be paid based on the extent to which they saved the government money by stopping unnecessary services. CMS said it will manage the program to avoid adverse impact on beneficiaries and providers. There was other news about pre-approval, this time involving Medicare Advantage plans. Pre-approval in Medicare Advantage plans has been controversial recently. There have been a number of recent reports and studies that found the authorization process was delaying treatment or causing patients to abandon treatment plans. Other reports indicated that a high percentage of treatments that initially were denied coverage eventually were approved if the patients or their providers appealed the than 50 major insurers who sponsor many types of insurance plans announced that they will voluntarily streamline prior authorization of treatments and services in all insurance markets, including Medicare Advantage plans. The insurers say they plan to have the new process in place by Jan. 1, 2027.
Yahoo
3 hours ago
- Yahoo
Labcorp Holdings Second Quarter 2025 Earnings: Revenues Beat Expectations, EPS Lags
Labcorp Holdings (NYSE:LH) Second Quarter 2025 Results Key Financial Results Revenue: US$3.53b (up 9.5% from 2Q 2024). Net income: US$237.9m (up 16% from 2Q 2024). Profit margin: 6.7% (up from 6.4% in 2Q 2024). The increase in margin was driven by higher revenue. EPS: US$2.85 (up from US$2.44 in 2Q 2024). Trump has pledged to "unleash" American oil and gas and these 15 US stocks have developments that are poised to benefit. All figures shown in the chart above are for the trailing 12 month (TTM) period Labcorp Holdings Revenues Beat Expectations, EPS Falls Short Revenue exceeded analyst estimates by 1.2%. Earnings per share (EPS) missed analyst estimates by 12%. Looking ahead, revenue is forecast to grow 4.5% p.a. on average during the next 3 years, compared to a 6.3% growth forecast for the Healthcare industry in the US. Performance of the American Healthcare industry. The company's shares are up 8.7% from a week ago. Risk Analysis You should learn about the 2 warning signs we've spotted with Labcorp Holdings. Have feedback on this article? Concerned about the content? Get in touch with us directly. Alternatively, email editorial-team (at) article by Simply Wall St is general in nature. We provide commentary based on historical data and analyst forecasts only using an unbiased methodology and our articles are not intended to be financial advice. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your financial situation. We aim to bring you long-term focused analysis driven by fundamental data. Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material. Simply Wall St has no position in any stocks mentioned.
Business Insider
7 hours ago
- Business Insider
UnitedHealth (UNH) Is About to Report Q2 Earnings on July 29. Here Is What to Expect
UnitedHealth (UNH), one of the prominent players in the health insurance space, is scheduled to announce its second-quarter earnings on July 29. The stock has dropped 43.8% year-to-date, hit by several issues, including the suspension of its guidance, escalating medical costs, and a leadership shakeup that included the sudden departure of its CEO, Andrew Witty. Wall Street analysts expect the company to report earnings per share of $4.48, representing a 34% decrease year-over-year. Elevate Your Investing Strategy: Take advantage of TipRanks Premium at 50% off! Unlock powerful investing tools, advanced data, and expert analyst insights to help you invest with confidence. Meanwhile, revenues are expected to increase by 13% from the year-ago quarter to $111.5 billion, according to data from the TipRanks Forecast page. It's important to note that UNH has an impressive track record with earnings, having exceeded EPS estimates in eight out of the past nine consecutive quarters. On July 24, UnitedHealth Group (UNH) revealed in an SEC filing that it is under formal investigation by the Department of Justice (DOJ) over its Medicare billing practices. The company said it is cooperating with both civil and criminal probes into whether it improperly raised patient diagnoses to secure higher payments from the government. J.P. Morgan analyst Lisa Gill remains optimistic ahead of UnitedHealth's earnings, viewing the DOJ probe as part of a broader industry trend. She maintained an Overweight rating on the stock, expecting a potential rebound despite near-term uncertainty. Analyst's Views Ahead of UNH's Q2 Earnings Heading into the Q2 print, Deutsche Bank analyst George Hill lowered his price target to $328 from $362 but reiterated a Buy rating. The analyst noted that investor sentiment 'has deteriorated significantly' due to a series of unfavorable news. The top-rated analyst lowered his estimates, citing ongoing concerns around Optum Health, the company's healthcare services unit. Also, Leerink Partners analyst Whit Mayo lowered the price target for UNH stock to $340 from $355 and reiterated a Buy rating. He remains 'cautiously optimistic' about the stock heading into Q2 earnings, given the challenging backdrop. Options Traders Anticipate a Large Move Using TipRanks' Options tool, we can see what options traders are expecting from the stock immediately after its earnings report. The expected earnings move is determined by calculating the at-the-money straddle of the options closest to expiration after the earnings announcement. If this sounds complicated, don't worry; the Options tool does this for you. Indeed, it currently says that move in either direction. Is UNH a Good Buy Now? Turning to Wall Street, UNH stock has a Moderate Buy consensus rating based on 18 Buys, five Holds, and one Sell assigned in the last three months. At $348.12, the average UnitedHealth stock price target implies a 23.86% upside potential.
