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Found 375 Letters.

VHA Appeal – Medical Necessity – Qualified Reviewers

Letter Type: Appeals | Jurisdiction: VHA | Last Updated: November 23, 2021

IMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the VA Under Secretary for Health for the VA’s failure to reimburse medically necessary services as required by Federal law. Our investigation has concluded the following: Please be advised that 38 CFR §17.1006 states: “The Chief of the... View more

VHA Appeal – No Authorization for ER Services and Care

Letter Type: Appeals | Jurisdiction: VHA | Last Updated: November 23, 2021

IMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the VA Under Secretary for Health for the VA’s failure to reimburse emergency services as required by Federal law. Our investigation has concluded the following: As you are aware, “to the extent allowable the VA will issue payment... View more

VHA Appeal – Notice Requirements for Adverse Determinations

Letter Type: Appeals | Jurisdiction: VHA | Last Updated: November 23, 2021

IMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the VA Under Secretary for Health for the VA’s failure to reimburse medically necessary services as required by Federal law. Our investigation has concluded the following: Please be advised that 38 CFR §17.1006 states: “The Chief of the... View more

VHA Appeal – Poststabilization Timeframe

Letter Type: Appeals | Jurisdiction: VHA | Last Updated: November 23, 2021

IMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the VA Under Secretary for Health for the VA’s failure to reimburse post-stabilization services as required by Federal law. Our investigation has concluded the following: THIS CLAIM IS NOW DAYS IN VIOLATION OF THE STATUTORY TIMEFRAMES. The VA... View more

VHA Appeal – Retroactive Denial for Authorized Care

Letter Type: Appeals | Jurisdiction: VHA | Last Updated: November 23, 2021

IMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the VA Under Secretary for Health for the VA’s failure to reimburse authorized services and care as required by Federal law. Our investigation has concluded the following: Under existing federal law, the VA has a duty to reimburse... View more