VA Fraud Alert

The VA Office of Inspector General (OIG) has issued a fraud alert regarding VA being billed for care veterans did not receive. This alert advises veterans and their representatives to help detect health care fraud by carefully reviewing benefit explanations and bills they receive from VA. Anyone who sees potential evidence of fraud or has concerns about patient care should contact the VA OIG office at va.gov/OIG/hotline or call (800) 488-8244. Here are two examples:

    Compensation Benefit – Disability compensation is a tax-free monetary benefit paid to veterans with disabilities resulting from a disease or injury incurred or aggravated during active military service. Compensation may also be paid for post-service disabilities related to (or secondary to) disabilities occurring in service. Compensation benefits fraud involves individuals’ submission of fraudulent claims for payment. Indicators include the following:

• The beneficiary is observed engaging in physical activity or employment inconsistent with the nature of their claimed service-connected disability (e.g., maintains a commercial driver’s license when receiving disability compensation for blindness).
• The beneficiary has a disability rating at the highest level (100% for a service-connected disability) but appears to not be receiving any medical treatment for that condition.
• A deceased veteran’s benefits are being paid (due to lack of notice, concealment of the death, or administrative error) and appear to be used by ineligible individuals.
• The monthly benefits payments for multiple beneficiaries are being deposited into the same bank account.
• The beneficiaries’ method of payment is changed without their knowledge.

    Public Health Crisis –As seen during the COVID-19 pandemic, fraudsters have made intentional misrepresentations for illegal financial gain. Indicators of potential fraud schemes involving VA or veterans likely to continue or emerge during other public health crises include the following:

• Laboratories or other entities contend that additional tests were completed together with tests for COVID-19 or other targeted public health testing to bundle and bill them at higher rates.
• Treatments and/or testing kits are not approved or authorized by the Food and Drug Administration or do not carry approved/authorized manufacturer’s identifiers, such as legitimate lot numbers or QR codes (which can sometimes be confirmed on the manufacturer website).
• Advertisements are made on social media or links are included in texts from unknown senders.
• Offers are made to provide blank or manufactured documentation or vaccination cards.
• Promised treatments are canceled or not scheduled and/or testing kits never materialize, and help numbers or other contacts are disconnected or unresponsive.
• Personal identifiable information (PII), such as Social Security numbers or financial information, names and birthdates or passwords, are requested in order for the patient to receive a treatment or test, particularly if there is pressure to provide it immediately. These requests can come from individuals offering tests, treatment or vaccines; conducting surveys; and claiming to be contact tracers.
• Individuals are asked to pay out-of-pocket for vaccines or treatment medications or to pay a fee to be placed on a waiting list or to gain early access. These offers are often advertised through social media, emails that appear personalized, telephone calls or through other unsolicited sources.
• An entity or individual will offer to sell or ship doses of vaccines or medications.
• During a telehealth appointment, a care provider or vendor tries to sell additional products or services.

Blake Hyfield is the post service officer for the local VFW and American Legion posts. He can be reached at bhpegleg@yahoo.com.