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Rep. Gallego Seeks Answers on Burdensome VA Prescription Reimbursement Requirements

September 13, 2019
Press Release

WASHINGTON, DC – Today, Rep. Ruben Gallego (D-AZ) sent a letter to the Medical Center Director of the Phoenix VA seeking answers regarding the burdensome reimbursement requirements imposed on certain veterans who pay out-of-pocket for prescriptions at non-VA pharmacies.

Eligible veterans participating in the Community Care Program (CCP) can receive up to a 14-day supply of prescription medication for an urgent or emergent condition by paying out-of-pocket for the medication at a non-VA pharmacy. However, the Phoenix VA has several onerous requirements for reimbursement, including not just proof of purchase and program certification, but also the original packaging of the drug purchased by the veteran – proof that is often discarded by those who are unaware that they will need to provide it.

This requirement does not appear to be a VA Office of Community Care policy and is not contained in the CCP final rule.

“I am concerned that requiring the veteran to provide the VA with the original packaging is burdensome, unnecessary, and increases the likelihood that veterans will be stuck paying for urgently needed prescriptions out-of-pocket,” Rep. Gallego wrote. “This requirement appears to be another layer of needless bureaucracy that is getting in the way of critical veteran health services.”

In addition to asking whether the Phoenix VA will eliminate this requirement, Rep. Gallego also requested that the Director disclose how many veterans’ claims had been denied due to failure to provide original prescription packaging, as well as the reason for implementing this requirement.

The full letter can be found here.