First-Party Billing Address Management Needs Improvement to Ensure Veteran Debt Notification before Collection Actions

The VA Office of Inspector General (OIG) reviewed a complaint that employees at the Central Plains Consolidated Patient Account Center (CPAC) in Leavenworth, Kansas, mismanaged veterans’ billing addresses at the Minneapolis VA Health Care System in Minnesota. The complainant claimed billing statements were mailed to outdated addresses, returned to the medical facility, and subsequently referred to debt collection without veterans’ knowledge.The OIG partially substantiated the allegation: VA billed veterans using outdated addresses from one file within its record system while newer information was available from another file in the same system. This may have resulted in bills intended for veterans being returned. Some of those accounts were previously referred for collection, but the OIG could not establish whether they were referred because veterans did not receive the bills.The Minneapolis healthcare system provided 284 examples of returned billing statements from the time noted in the allegations. The team reviewed 30 of the statements and determined 18 were mailed using an outdated address when a more current address was available. Beyond the examples provided, the facility did not maintain records of returned bills, and VA policy does not require it.The OIG found VHA lacked defined processes for managing returned billing statements and communicating incorrect addresses for correction. As a result, bills may continue to be sent to outdated addresses, and accounts may be referred for collection without notice to a responsible party. This can result in unanticipated financial demands on veterans and fees being added without proper notice.The OIG recommended the acting under secretary for health evaluate and correct address data for first party billing statements. VHA should also periodically review and reconcile address data. Finally, policies detailing roles, responsibilities, and procedures for remediating returned bills and steps for flagging and updating outdated addresses should be improved.