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Posted by william h. Heino Sr. on 10/3/2006, 3:11 pm I just checked as to the status of my claim which is presently docketed at the Board of Veterans Appeals. I was told they are presently working on the December 2004 docket schedule. They really don't care. To remind you of my claim, I always believed the reason for the “less than 30-day medication supply” (38 USC 1722a) was meant for those emergency room type visits, one shot deals. I kept wondering what if the Board of Veterans' Appeals, interpret paragraph 1 according to established VA billing practices, which I am arguing. Determining, as they do, that my 15 split pill, 30-day supply, is less than a 30-day supply.....period. End of story. No if, or and's about it! 38 USC 1722a, requires a co-pay cost of $8, "..for each 30-day supply.." outpatient prescription. No matter what the supply amount. But, I wonder no more. The Veterans' Medical Care Appropriations and Funding Process, dated 9/30/2004. Congressional Research Service (CRS) report for Congress supports further my BVA claim, and this 30-day or less cost, stated..... The Veterans Millennium Health Care and Benefits Act of 1999 (P. L. 106-117) 26 "This law allowed VA to increase the co-payment amount for each 30-day or less supply of medication provided on a outpatient basis (other than medication administered during treatment) for treatment of a non-service-connected condition." "Other than medication administered during treatment", CRS documentation describing the co-pay charge, and how it is to be applied. This is of further significance in understanding 38 USC 1722a. Meaning medication required in the treatment of more than one 30-day supply of 15 pills (split), this law does not allow an increase in the co-payment for, "..an amount in excess of the cost to the Secretary for medication as described in paragraph 1." If the cost to the Secretary for a 45 pill, or more, 30-day monthly supply is $8.00, as described in paragraph 1, why then are veterans' being charged $24.00 (split pill) for an $8.00 30-day supply? If a veteran receives a 30 pill, two month supply (split pill), it is for a medication administered for a treatment of a condition. Therefore, is 15 pills, less than 30-day supply? I don't think so. Do you see the contradiction? Plus, charges for a co-pay cost are beyond the amounts of what has been established for like, or greater 30 pill, 30-day monthly medication co-payment costs. Resulting in continuation of over-charges to well over 1.1 million veterans. Having refused my request for an advance on the docket, the BVA could care less. Veterans' who fall under the 30-day or less $8 co-payment description (as described in this report to Congress), are for treatment of a non-service connected condition such as a bad cold, dizziness, don’t feel well, cut my finger, etc., visits. As veterans’ who visit the VA for periodic checkups, and receive , for example, Simvastatin, Atenolol, prescriptions for medication administered during the treatment of a condition these are not 30-day or less supplies.
172.133.47.158
10/3/06
authorized VA to increase the medication co-payment amount and to establish annual
caps on the medication co-payment amount.26
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