VA Health Care:

Medical Centers Need to Improve Collection of Veterans' Copayments

HRD-90-77: Published: Mar 28, 1990. Publicly Released: May 4, 1990.

Additional Materials:


David P. Baine
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Pursuant to a congressional request, GAO assessed whether the Department of Veterans Affairs (VA) implemented a cost-effective copayment billing and collection process.

GAO found that: (1) in fiscal year (FY) 1988, 159 VA medical centers' collections exceeded costs, which yielded a return of $1.36 for each $1 spent; (2) the centers achieved a 174-percent inpatient care return rate, compared to a 108-percent return rate for outpatient care; (3) five medical centers collected only half of the owed copayments mostly due to their failure to bill veterans; (4) centers' collection difficulties were attributed to billing delays; and (5) in FY 1988, VA centers collected about $9.9 million, with a net return of $2.6 million.

Recommendation for Executive Action

  1. Status: Closed - Implemented

    Comments: VA has mandated that medical centers collect copayments for outpatient care provided to veterans, has developed a manual of procedures, and is training all relevant staff on identifying and billing veterans. Billing procedure software was shipped to each VA facility in August and September 1992.

    Recommendation: The Secretary of Veterans Affairs should require VA medical centers to collect copayments from veterans or make payment arrangements while veterans are still at the centers.

    Agency Affected: Department of Veterans Affairs


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