VA to Waive Medical Copays for Native American, Alaskan Native Vets

The Southern Plains Native Veterans Training Summit
The Southern Plains Native Veterans Training Summit was held Aug 27 through 28, 2014 in Durant, Oklahoma. (Photo courtesy VA)

The Department of Veterans Affairs is following through with a congressional mandate to waive copayments for native American and native Alaskan veterans for most medical appointments.

The VA is to publish an interim rule Thursday in the Federal Register announcing its intention to drop copays for veterans with a known tribal affiliation and seek public comment on the plan.

The waiver is to be backdated to Jan. 5, 2022, but when exactly veterans can apply for reimbursement or see the change in billing remains to be determined. By law, the department has to give the public 30 days to offer comments on the interim proposal before publishing a final rule, VA officials said during a media roundtable Tuesday.

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The Johnny Isakson and Dr. David Roe Veterans Health Care and Benefits Improvement Act of 2020 prohibited the VA from collecting copayments from any veteran defined as an Indian under the Indian Health Care Improvement Act.

The legislation was to be enacted on Jan. 5, 2022, within a year of the law being signed. The VA missed the deadline, however, and intends to reimburse eligible veterans who have received care in the past year for any copayment costs.

VA officials said once the final rule is published, affected veterans will not make any copayments and a system will be in place so they can apply for and receive any retroactive copayments.

"I assure you that there will be a process and the goal is to make it as less onerous as possible and as quickly as possible," said Stephanie Birdwell, director of the VA's Office of Tribal Government Relations, during the event.

The VA estimates that there are 150,000 Native American and Alaska Native veterans in the U.S., many of whom are eligible for health care from the Indian Health Service or tribal health programs contracted with the IHS or urban organizations.

But the Indian Health Service and its programs, which do not require patients to make copayments, have been "historically underfunded," causing delays in health care, according to Birdwell.

The new rule aims to provide those eligible for health care through the IHS with the same fee waiver at the VA, according to Secretary Denis McDonough.

"This rule makes health care more accessible and allows us to better deliver to these Veterans the care and health benefits that they have earned through their courageous service," McDonough said in a statement.

Eligible veterans also will have access to urgent care, but like other veterans in the VA health system, they will be required to make copayments for urgent care after three visits within a calendar year -- the only copayments likely required under the new policy.

Officials warned that until the final rule is published, eligible Native American and Alaska Native veterans still will be required to make copayments for care. They added, however, that the VA will fast-track the intended changes to the policy once the comment period is over and would be "surprised if it goes more than three months."

"This has been a long time coming. I know there's been a lot of excitement around this. The Secretary has made a commitment to get this benefit out as soon as possible," said Travis Trueblood, a Navy veteran and member of the Air Force Reserve who serves as the VA's director of Tribal Health

-- Patricia Kime can be reached at Follow her on Twitter @patriciakime.

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