Review of Alleged Payment Issues at Kerrville VA Hospital Kerrville, Texas

OIG received a complaint from a veteran alleging that Peterson Regional Medical Center (PRMC) in Kerrville, TX, canceled his sleep study appointment because VA owed PRMC more than $2 million, and PRMC was no longer accepting VA referrals for non-VA Care (NVC) as a result. There was insufficient evidence to substantiate the allegation that PRMC canceled the veteran’s scheduled sleep study because of non-payment by VA or that PRMC limited other veterans’ access to care. While PRMC continued to accept patients through the NVC program, OIG discovered that PRMC improperly informed the veteran that he might be responsible for payment if VA did not pay. OIG recommended the Director of the South Texas Veterans Health Care System (STVHCS) should instruct PRMC to stop advising veterans that they could be liable for pre-authorized NVC. The Director of the STVHCS concurred with our findings and recommendation and stated that STVHCS would implement the recommendation. We will monitor STVHCS’ progress and follow up on the implementation of our recommendation until the proposed action is completed.