A new study published today in the Journal of the American Medical Association (JAMA) found that the federal government made about $13 billion in duplicative payments to provide health-care services to veterans who were simultaneously enrolled in Medicare Advantage plans from 2004-2009. The study was conducted by researchers at Brown University, VA Palo Alto Medical Center and the Institute for Population Health Improvement at UC Davis Health System.
Some veterans are entitled to health-care coverage through both the U.S. Department of Veterans Affairs Health Care System and Medicare. But under current law, the federal government often ends up paying twice for care of veterans when they are also enrolled in Medicare Advantage managed-care plans. And with the growing popularity of Medicare Advantage plans among all seniors, including veterans, the annual duplicative costs are rising. Nearly 30 percent of Medicare beneficiaries are now enrolled in Medicare Advantage plans.
"These 'dual eligible' veterans earned the right to receive care through both VA and Medicare, but that does not mean that the government has to pay twice for their care," said Kenneth W. Kizer, a former VA Under Secretary for Health and now a professor and director of the Institute for Population Health Improvement at the University of California, Davis, Health System."The problem could be fixed without reducing benefits to veterans."
"Duplicative costs occur because of way the federal government pays for Medicare Advantage services for veterans, not because veterans are receiving unnecessary care or doing anything wrong," he added.
Veterans who are disabled or over age 65 and have been paying into the Medicare program are eligible for Medicare just like any other American. Veterans who live far from a VA hospital or clinic may especially rely on Medicare coverage for acute or emergency care. But unlike the traditional Medicare fee-for-service program, Medicare Advantage plans are paid in advance to provide all needed care for the beneficiary. If the person enrolled in the Medicare Advantage plan then gets his or her medical care in another federal health plan such as the VA, it means that the federal government has paid twice for care of the same person. Most of the Medicare Advantage plans are for-profit health plans.