Study: Defense Dept. Didn't Bill
Insurers
by MALIA RULON - Associated Press Writer
March 5, 2004 Friday
WASHINGTON DC - The
Defense Department is failing to collect at least $44 million a year from
private insurance companies for health care services provided to
military-related patients, according to congressional findings obtained Friday
by The Associated Press.
Investigators with the General Accounting Office examined billing practices at
the largest 35 of 132 military treatment facilities, and said third-party
insurance companies often aren't billed because the necessary information is
not properly collected or recorded.
The Defense Department acknowledged that "additional funds could have been
collected," but said that staff has been working over the past three years to
strengthen its billing practices.
"We had previously identified the issues outlined by the GAO and have
aggressively implemented business process improvements," said William
Winkenwerder, assistant secretary of Defense for health affairs.
Military soldiers and their families are eligible for free or less-expensive
health care at military facilities, but if patients have private health
insurance, the government is allowed by law to seek reimbursement.
Investigators found that from 2000-2002, officials collected about $122
million a year from private insurance companies. However, that number should
be millions higher, investigators said.
For example, investigators found that the five Army treatment facilities had
identified 4.5 percent of patients as having additional health insurance when
there were actually double that amount, or 96,000 patients, who had extra
insurance coverage.
That oversight cost taxpayers $8.7 million, the report said.
"Managed effectively, DOD's Third Party Collections Program could collect tens
of millions of dollars more each year to offset the cost of providing health
care to DOD retirees and their dependents and active duty dependents," said
the report, which was expected to be released next week.
Winkenwerder took exception to that statement, saying in his written response
to the audit that the money collected from private insurance companies goes,
by law, to "supporting the maintenance and operation" of the facilities, not
to determine their budget.
Rep. Dennis Kucinich, the ranking Democrat on the Government Reform
subcommittee on national security, emerging threats and international
relations, called the audit another example of the Defense Department failing
to account for millions of taxpayer dollars.
"The complete failure of the DOD to keep accurate records is allowing private
insurance companies to gouge the military health care system, reducing
resources to provide care to those who need it most," said Kucinich, D-Ohio,
who asked for the audit along with Rep. Janice D.
Schakowsky, D-Ill.
A similar audit of three medical treatment facilities done in 2002 had
revealed a pattern of failing to bill and collect from private insurance
companies.
Kucinich remains a long-shot candidate in the Democratic presidential primary,
although Sen. John Kerry of Massachusetts already is expected to be the
party's nominee.