Problems w/Payment for Day Care from the VA?

Marp

I'm not a spouse caregiver (care for my sister), but I thought this issue with the VA would be of interest to spousal caregivers:

For about 8 months, my sister has been receiving adult day care services paid for by the VA.  Apparently, there has been a problem for at least a couple of years with the authorization numbers the VA assigns when they approve a veteran for these services in that the numbers don't work in the billing system.  That's what I've been told anyway. 

The VA contracted day cares in my congressional district met with our congressman and he has, apparently, gotten on the horn because in December, the VA shut down processing all these authorizations.

What does this mean to veterans?  Possibly confusion over whether the care they are currently receiving will be paid by the VA.  I think this is only an issue if the veteran is newly set up with day care services or if the veteran's case is up for annual/bi-annual review and needs re-authorization.   If a veteran is receiving day care services on an authorization that was processed before the shut down, they might be okay until their case comes up for review and the need for re-authorization.

From what I was told this past week, this is a nationwide problem which means many veterans could be impacted in the coming months.

Has anyone else encountered this problem or know anything about it?

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Marp

Victoria2020 wrote:

Don't know which state your sister is in but see:

https://spectrumlocalnews.com/nys/buffalo/news/2022/02/02/adult-day-programs-cut-for-some-veterans-in-new-york-after-change-in-how-services-provided

ADDED https://myarmybenefits.us.army.mil/Benefit-Library/Federal-Benefits/VA-Caregiver-Support-Comprehensive-Assistance-for-Family-Caregivers?serv=126

Thanks.  I was told by the Social Worker @ our local VA that there is a backend problem getting her day care slotted into the correct billing category. 

I was also told by someone in the department that coordinates with these day cares that they can't process the authorization because of a billing problem - the day care said the VA has had a billing problem since 2019 at least because they hadn't been paid since 2019 until they got some payments just a month ago. The person I spoke with in the coordinating department mentioned the billing problem too.  So it all sounded like a billing glitch, but maybe there's more to the story.  I wish we could get a straight answer so we can plan.

The day care said the authorization may end at the end of March because their contract w/the VA ends then and getting the contract reauthorizd requires the VA to come in and inspect, audit books, etc.  Once that's done, the contract rolls back over for another few years.

Maybe it won't this time if this Third Party Administrator is not entering into new contracts.