The VA: Administrative medical malpractice?

It is a day off. Like so many days off I have had over the past year or two, I have to spend it somehow with the Department of Veterans Affairs.

Last year it seemed as if I was going to a specialist at the Houston VA every off day I could take. This time, I am trying to fight what I call a grand instance of administrative medical malpractice.

I know medical malpractice is a serious charge. I also know the VA really gets its panties in a bunch when malpractice is alleged. Rightfully so for the VA go in to conniption fits over any kind misdeed. It seems so many problems have beset the nationally socialized medicine outfit that is supposed to help military veterans.

As I have written for many years, a great number of problems experienced by the VA are institutional. The funding from Congress is sporadic and with each presidential administration the Department often floats to hither and yon, often times in directions that just seem impossible to fathom. Likewise, when some big media expose on wrongdoing at the VA surfaces, the Department often trips over its own feet in what is essentially over-correcting screw-ups of its own doing.

All of this may have led to my case which involves what I call administrative medical malpractice. As is the case more times than not, in any situation, money is the root of the evil.

Since leaving my full-time job almost 11 years ago, the VA has been my only medical provider. Although, my pay has gone up over the years, I am still a part-time worker. My earnings per year aren’t particularly stellar despite my gross pay — not the amount you get after this deduct or the other — being about $2,000 over the threshold for a single person to avoid prescription co-pays. Over the years, with various medical problems my medical co-pays now run about $100 a month or more. But because my gross salary exceeded some magical amount, the VA told me out of the blue that I must now pay past co-payments on prescription drugs. Such news was a shock. This is because the VA basically said for the past four years or so that I need not take the so-called “means test” to determine one’s eligibility for VA health care. I asked several people at the VA if I should take a means test and they said, in essence, “Don’t worry about it.”

I was quite surprised when I got a bill a few months ago for nearly $3,000 in back co-payments. The bills I had seen during the recent years showed charges being written off. You would think written off would mean “you don’t have to pay it.”

More than $1,000 was eventually written off after I sent a waiver request. But I was told I still must pay about $1,200 plus the $100 a month for new charges. Although I have had a few thousand dollars in savings that I planned to use to purchase a cheap piece of land and a used, cheap, camping trailer, I make barely enough to do more than sit around the place where I reside, getting older. I have followed the VA’s prescribed methods to settle the charges, though waivers, request for charges to be written off, and finally I offered what I thought was a decent settlement.

I never heard from the VA until receiving another letter and bill saying that because I make too much in gross salary, I will now have to pay back co-payments for medical visits as well as those for future ones. In most cases over the last several years I have been seen  by physicians assistants instead of doctors or even specialists. Sometimes I would be seen by a nurse rather than a doctor and still be charged as if I was seeing a doctor. Finally, I decided last month to dispute my bill.

The “Notice of Dispute” was sent in to the Michael E. DeBakey Medical Center in Houston. I told them what had gone on over the years and that I now disputed the bills in total because I was never given any idea that I would have to pay those past bills. Had I known that, I would have sent in waiver applications each month as I once proposed to a billing person at the Houston VA. But they said I wouldn’t have to do that.

I received a letter from the Houston VA the other day signed by the interim director of the facility, a Christopher R. Sandies, MBA, FACHE.

The letter acknowledged my letter of a month ago, which was actually the dispute notice. The letter told me the reason why I must pay a co-payment for prescriptions — but didn’t address the co-payments for medical visits. Nor was their any mention of my previous settlement offer. Then the missive listed a couple of the options I had: either pay or waive the balance, such measures which I had already tried ad nauseam. I was told I could talk to the facility billing manager who I’ve tried to contact for more than a month and still cannot reach.

In the meantime, I owe more than $2,600 which I suppose may be collected soon from my salary if I don’t do something quick. I am planning to file for disability soon and will likely have to reduce my working time to between 16 and 20 hours a week. I may need to stop working at all because of my disabilities. At least I will likely need not worry about paying for my VA care then.

I consider it ironic that some people are happy to get work just to acquire health benefits for their family. It seems I will have to leave work soon in order to obtain health care benefits.

(Oh, I also once filed a complaint about my problems with my local congressman Republican U.S. Rep. Randy Weber of Texas. My situation seemed to deteriorate as time marched on and I never heard anything from his office.  Thanks for nothing congressman!)