The Central Alabama Veterans Healthcare System (CAVHCS) has racked up seven-figures worth of unpaid bills to local area hospitals who wanted to help the VA relieve its backlog of veterans waiting to receive care.
According to documentation obtained exclusively by Yellowhammer News, CAVHCS as of June 26, 2014 owed Jackson Hospital in Montgomery $1.6 million, more than $400,000 of which is over six months past due.
Upon further investigation, Yellowhammer learned that this is a pattern at CAVHCS that dates back several years and multiple VA administrations. Jackson Hospital even had to at one point reluctantly refuse to see any more non-emergency VA patients because they were risking the fiscal solvency of their hospital due to the VA’s refusal to pay.
VA hospitals have long been able to contract with private hospitals to care for veterans in cases of emergency or when specialty care is needed that is not provided at a local facility. Known as “fee-based” care, the private hospitals provide the services and are reimbursed by the local VA.
Donald G. Henderson, the CEO of Jackson Hospital in Montgomery, explained the process in a letter to Rep. Martha Roby (R-AL2) in February of 2011:
As you may know, Jackson Hospital provides specialized and emergency care to the patients of the Veteran’s Administration Hospital in Montgomery upon their request. Usually, a patient is sent to us from the VA because the service is urgently needed, and time does not allow an inter-VA transfer. When these transfers are made, a Letter of Authorization is sent from the VA with the patient, so that Jackson Hospital may bill the VA system for payment, based upon a fee schedule for payments to the private sector authorized by the U.S. Congress. For years, Jackson Hospital has been proud to provide these services to our Nation’s veterans.
Henderson’s letter goes on to reveal that the Central Alabama VA had at that point (Feb. 2011) racked up $1.1 million of unpaid bills.
Three months later (April 2011), then-Director of CAVHCS Glen E. Stuchtemeyer wrote to Rep. Roby, assuring her that they were working “expeditiously to process the reimbursements to Jackson Hospital.”
But five months after that (Sept. 2011), an internal memo to Jackson Hospital staff said the hospital would have to stop seeing non-emergency VA patients because they could no longer risk “bankrupt(ing) (their) facility by providing unlimited care with no compensation.”
At that point a new administration came in to run CAVHCS and convinced Jackson Hospital to begin seeing VA patients again. A final memo from Jackson Hospital’s CEO in November of 2011 indicated that CAVHCS appeared to have rectified their billing issues, meriting a return to regular service.
But as the documentation obtained by Yellowhammer News this week reveals, the VA’s billing problems are as bad now as they have ever been, if not worse.
What is particularly troubling is that while the Central Alabama VA was often making it impossible for local private hospitals to see VA patients, they also had the eighth longest average wait time of the entire national VA system.
Can CAVHCS payment problems be chalked up to lack of funding? Hardly. Overall, the Department of Veterans Affairs expects to carry over – or not spend – more that $450 million dollars in medical care funding this year. It carried over almost $1.5 billion from 2010-2011, $1.6 billion from 2011-2012, and $637 million from 2012-2013. So while the VA nationally can’t seem to spend all its money, the Central Alabama VA can’t seem to pay its bills.
Veterans had to wait an average of 51.5 days for an appointment at VA hospitals in Montgomery. The national average was 27.4. CAVHCS employees were also caught falsifying records to cover up the long wait times. And CAVHCS director James Talton lied about firing the offending staffers, but instead got rid of the whistleblowers who initially brought the wrongdoing to light.
Rep. Roby has been a vocal advocate of expanding access to timely and deserved care for veterans by allowing them to be seen by private physicians outside the VA network.
“I have long advocated for utilizing the many great doctors and hospitals in our communities to get veterans the care they need right away,” she said recently. “Mechanisms already exist within the VA to streamline veterans’ access to local, private sector care. I’ll continue to push for this commonsense solution as the House and Senate work out a final agreement on VA reforms.”
RELATED: Alabama doctors launch plan to help vets get timely care outside of VA system
Roby’s office has been vigorously investigating the Central Alabama VA scandal for the last several months, but declined to comment on the specific allegations outlined above. Her office did, however, verify the authenticity of the documentation obtained by Yellowhammer today.
Requests for comment from both Jackson Hospital and the Central Alabama VA were not immediately returned.
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