VA Health Care: Verifying Veterans' Reported Income Could Generate Millions in Copayment Revenues

Abstract

In 1990, VA may have incorrectly determined the copayment status of as many as 109,230 veterans who received medical care for conditions unrelated to military service. Tax records for these veterans showed that they had incomes above the threshold levels, but VA did not require them to make copayments. Unreported income was likely a major factor in VA misclassifying these veterans. VA relied solely on veteran-reported income without using alternative verification procedures. VA could have billed as much as $27 million for care provided to these veterans. Although VA had authority to access tax records from November 5, 1990, to September 30, 1992, it did not use tax data to verify veteran-reported income. VA officials cited database and staffing limitations as major factors for not using tax records. VA may have lost as much as $120 million in copayment revenues because it will not be able to implement an income-verification system before its tax record authorization expires on September 30, 1992. Copayment losses in 1991 and 1992 may greatly exceed the estimated 1990 losses because of significantly lower income thresholds and higher copayment rates in those years. Although VA has wasted its current opportunity to verify veterans incomes for its medical care programs, the Congress should extend VA's authority to use tax records. VA has recently drafted a preliminary plan that provides a general framework for an income-verification system using tax records. Although many critical policies and procedures must still be developed, VA expects the planned system to be fully operational within 2 years. VA should move as quickly as possible to implement a verification system so as to minimize the copayment revenue lost due to veterans' misreporting incomes.

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Document Details

Document Type
Technical Report
Publication Date
Sep 15, 1992
Accession Number
AD1152107

Entities

People

  • Daniel Garcia
  • John R. Kirstein
  • Melissa S. Harless
  • Paul R. Reynolds
  • Richard W. Jr Meehl
  • Thomas N. Bloom
  • Wayne J. Turowski

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  • United States Government Accountability Office

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