DOD and VA Health Care: Access for Dual Eligible Beneficiaries

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Correspondence issued by the General Accounting Office with an abstract that begins "The Department of Defense (DOD) reported that under its current policy, beneficiaries eligible for both TRICARE and the Department of Veterans Affairs' (VA) health care (dual eligible beneficiaries) are not allowed to utilize the services offered by both health care systems for treatment for the same episode of care. For example, if a beneficiary experiences back pain and seeks treatment from VA, the beneficiary must then receive all care related to that back pain from VA. Should the beneficiary then decide to seek treatment for the back pain ... continued below

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United States. General Accounting Office. June 13, 2003.

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Description

Correspondence issued by the General Accounting Office with an abstract that begins "The Department of Defense (DOD) reported that under its current policy, beneficiaries eligible for both TRICARE and the Department of Veterans Affairs' (VA) health care (dual eligible beneficiaries) are not allowed to utilize the services offered by both health care systems for treatment for the same episode of care. For example, if a beneficiary experiences back pain and seeks treatment from VA, the beneficiary must then receive all care related to that back pain from VA. Should the beneficiary then decide to seek treatment for the back pain from TRICARE, any claims related to that care would be denied. According to DOD, this policy was established to ensure continuity of care for beneficiaries and to ensure that there was no duplication of care or of payments from TRICARE or VA. Under the policy, if beneficiaries are dissatisfied with the care provided by VA, they are unable to switch to TRICARE to receive services for the same episode of care. On April 16, 2003, DOD reported to the Congress on a proposal to change its policy and promulgate regulations for coordinating care between DOD and VA. As agreed, we focused our review on the reasonableness of DOD's process. To do so, we reviewed the report submitted to the Congress and TRICARE policies, and interviewed agency officials from DOD and VA. Our work was conducted in June 2003 in accordance with generally accepted government auditing standards."

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Government Accountability Office Reports

The U.S. Government Accountability Office (GAO) is an independent, nonpartisan agency that works for the U.S. Congress investigating how the federal government spends taxpayers' money. Its goal is to increase accountability and improve the performance of the federal government. The Government Accountability Office Reports Collection consists of over 13,000 documents on a variety of topics ranging from fiscal issues to international affairs.

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  • June 13, 2003

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  • June 12, 2014, 7:50 p.m.

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United States. General Accounting Office. DOD and VA Health Care: Access for Dual Eligible Beneficiaries, text, June 13, 2003; Washington D.C.. (digital.library.unt.edu/ark:/67531/metadc301288/: accessed July 19, 2018), University of North Texas Libraries, Digital Library, digital.library.unt.edu; crediting UNT Libraries Government Documents Department.