Reimbursement for Medical Expenses

GAO was asked whether the Air Force is required to reimburse a State department of public welfare for payment made on behalf of a former airman for medical care received in a civilian hospital. The airman had been admitted to an Air Force hospital in premature maternity labor, but was transferred to a civilian hospital due to the complications of her case. Since the former airman was unemployed and medically indigent, the medical bills were submitted to the public welfare department under Medicaid for payment. The State made the payment and submitted a voucher for reimbursement to the Air Force. Maternity care for members of the armed services who are pregnant at the time of their separation from active duty is provided by the services unless their pregnancy predates their entrance on active duty. The Air Force has implemented this policy by promulgating a regulation designating such individuals as eligible for maternity care on a capability/space available basis in Air Force medical facilities. Regulations preclude payment by the Government for care rendered in civilian medical facilities, and GAO was unaware of any statutory authority that would enable the Air Force to provide reimbursement for medical care in civilian facilities. Accordingly, the payment of the voucher was not authorized. GAO also found that the Air Force has no authority to amend this regulation. Thus, to allow the Air Force to provide for the payment or reimbursement of medical care of former members received in civilian facilities would require special legislation.