Regarding VA violation of 38 USC 1722a.

The Board of Veterans' Appeals, denial, Conclusion of Law, states, "The appellant is obligated to pay VA copayment for each 30-day or less supply of medication provided by VA on an outpatient basis. 38 U.S.C.A. Sec. 1722a; 38 C.F.R. Sec. 17.110 (2006)."

Finally, after the Criteria and Analysis, and references to other law statutes, the Board, in concluding states, “38 USCA 1722a clearly pertains to VA’s cost in dispensing the medication, not the cost to the appellant... The Federal register of July 16th, 2001; Also under U.S.C. 1722A, VA may not require a veteran to pay an amount in excess of the actual cost of medication and pharmacy administrative costs related to the dispensing of the medication. VHA conducted a study...and found that the VA incurred a cost of $7.28 to dispense an outpatient medication....under these circumstances, we believe that a $7 copayment would not exceed VA’s cost.”

Clearly, dispensing of medication is the key to the Board’s argument, as well as mine.

The VA pharmacy dispenses a supply of 30 pills, the copay cost, whether the amount is 15, 30, 60, or 90 pills the copay is $8. A 30 pill prescription may require that the supply be split. Now becoming a 2 month supply. VA’s copayment charge is $16.

A supply of 30 pills carries the maximum copayment charge of $8, for a 30-day supply, and a veteran is not required to pay an amount in excess of the cost to the Secretary, as described in 38 USC 1722a paragraph 2, and noted in the Decision of the Board of Veterans Appeals reference. The Board citing the Federal register, 12/6/2001. “The VA incurred a cost of $7.28 to dispense an outpatient medication..” (rounded out to $8). Why is it, that a veteran is charged $16 for the exact same $8 prescription, 30 pill supply?

The BVA in denying the appeal, they cite, “.. 1722a clearly pertains to VA‘s cost in dispensing the medication...,The VA incurred a cost...to dispense medication..”, providing the answer to their apperception. Dispensing! The VA charges the veteran twice, or double, as claimed, for the same dispensing cost required to dispense the exact same, one(1) 30-day, $8 supply. Exceeding the cost a veteran is not required to pay. I, like the Board, I am, “..unable to find any authority allowing for a deviation from the standard copayment.” As well, “The Board has no authority to act outside the constraints of the statutory and regulatory criteria.”

VA violation of 38 USC 1722a update

Here is an updated example of how veterans' are treated by our government, and how a veterans' due process, is again being denied. I have been working on this since March of 2002. After my withholding of medication co-payment over-charges, the VA turned over this alleged indebtedness to the Department of the Treasury. This action was taken without explanation, the denied due process.
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In April 2005 I filed a claim against the Veterans Administration in violation of 1722a, VA prescription over-charges with the Board of Veterans' Appeals. They denied my claim, and at some point, they conveniently lost the original.
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I then went to the United States Court of Appeals for Veterans' Claims. My claim was remanded back to the BVA. I was notified of this remand on July 16, 2007. The reason for the remand, the USCAVC would work with a rebuilt claim.
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Seven (7) months later, on Feb. 11, 2008, I called the BVA inquiring about my claim. I was told it was "coming back from the Court, but hasn't reached us yet." On 4/10/2008, I called again asking for it's status. "Still at the Court of Veterans Appeals." For this advisement, 4/30/2008 I called the Board of Veteran Affairs again. My claim has still not been returned to the court. It's been now over nine (9) months! Because it has not been returned, the courts either, have lost my claim a second time, or are intentionally delaying, stalling, and awaiting my death.
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Are they not in the same town? Is my claim such a hot item that the VA does not want to adjudicate it? Apparently so. I know they want me to die! Then my claim dies. This is how the VA works. How our courts work. And how veterans' are continually being treated. There is no due process. Think this is bad? You haven't seen nothing yet. Wait till our men and women return from Iraq and Afghanistan.

VA prescription copayment studies

The following study is from “Reforming VA’s Medication Copayment Statute” by Timothy J. McDonald. “..graduate of the Health Law Certificate Program at the University of Pittsburgh School of Law and is currently serving as a Presidential Management fellow in the Patient Care Services Office of the Veterans Health Administration.” A link follows. This is followed by studies showing the effect of the VA copay increases.

“The limitation imposed by the copayment legislation that prevents VA from charging the veteran more than the cost of the medication to VA has led to at least one case before the Board of Veterans’Appeals (Board). 31 This case involved “pill splitting,” a practice where VA provides medication in a dosage that is higher than needed, and then has the patient split a single pill into two separate doses”

“However, the current medication copayment that many veterans are charged is based on outdated legislation…”

“This problem is not limited to cases where the veteran is splitting tablets. In fact, based on VA’s increased efficiency and price negotiation in the pharmaceutical arena, it seems very likely that under the current copayment plan many veterans are charged excessive copayments by VA.44”
http://www.va.gov/vbs/bva/manuals/vlr1mcdonald.pdf


Co-Payment Increases Result in Gaps in Veterans' Prescription Usage
American Heart Association rapid access journal report:
Study highlights: -- Cholesterol-lowering drug adherence drops with an increase in VA prescription co-payments.

DALLAS, Jan. 13, 2009 — Fewer veterans filled their prescriptions for cholesterol-lowering drugs after an increase in co-payment costs for prescription drugs, researchers report in Circulation: Journal of the American Heart Association.
http://www.reuters.com/article...Jan-2009+PRN20090114

Impact of a prescription copayment increase on lipid-lowering medication adherence in veterans.
http://www.ncbi.nlm.nih.gov/pubmed/19139387

The Effect of a Medication Copayment Increase on Metformin Adherence by Veterans with Diabetes

Rationale: Copayment increases have been shown to affect health care demand in many settings, and adherence to essential medications may decrease when medication copayments rise. In 2002, the Veterans Administration (VA) increased medication copayments from $2.00 to $7.00 per 30-day prescription fill.
http://www.allacademic.com/met.../4/p90444_index.html