Policy and Regulation News

VA Benefit Unawareness Leaves Vets Vulnerable to Healthcare Fraud

Healthcare fraud could catch any patient, but veterans who are unaware of their benefits are particularly at risk.

Veterans Affairs, patient education, healthcare literacy

Source: Getty Images

By Kelsey Waddill

- Veterans’ lack of awareness about their potential benefits under the Promise to Address Comprehensive Toxics Act (PACT Act) could lead to significant financial losses due to healthcare fraud, an AARP survey found.

The PACT Act, passed in 2022, enables Veterans Affairs (VA) to cover hospital care, medical care, and nursing home services for veterans who have been exposed to toxics under certain circumstances. Eligibility may vary based on a veteran’s discharge or release date and their assigned stations or missions. Veterans’ surviving family members are also eligible for benefits.

As of July 2023, the PACT Act program covered more than 3.8 million enrollees and had gained more than 103,730 enrollees since October 2022. Additionally, over 379,400 veterans and survivors had completed PACT Act-related claims, with more than 323,100 claims approved.

AARP’s survey asked almost 890 veterans and active-duty military personnel about their access to PACT benefits and any communications they received about these benefits to identify potential scams. NORC conducted the survey on behalf of AARP using its AmeriSpeak® Panel. The questions were delivered solely in English either online or by phone.

The veteran respondents were not aware of their PACT Act benefits, the survey found. Nearly two-thirds did not know that they could receive free coverage for certain services (63 percent).

Moreover, one in six respondents had received communications from a person claiming to offer assistance in accessing their PACT Act benefits, an accompanying fact sheet stated. Additionally, one in ten respondents said that scammers indicated the veterans would receive a payout if they enrolled for these benefits.

The lack of patient education and healthcare literacy around PACT Act benefits came at a high cost. A Federal Trade Commission (FTC) report stated that veterans and military adults were scammed out of over $414 million in 2022, a 195 percent increase from the previous year.

Veterans are aware of the need for better education around benefits and fraud. More than eight in ten veterans agreed that better outreach and more information about potential scams would help them protect themselves and their families.

"Our nation's veterans should not have to worry about being exploited by financial predators," Troy Broussard, senior advisor of AARP Veterans and Military Families Initiative, stated in the press release. "Scammers have a playbook to get us into a heightened emotional state that gets in the way of our ability to think logically. Knowing about these specific scams makes it far less likely that anyone will engage with them."

Health insurance is rife with potential fraud. In March 2021, two individuals were found guilty of falsely enrolling individuals in need of substance abuse care on the Affordable Care Act marketplace, specifically in states that have high reimbursement rates for such care. They falsified residential addresses and cell phone numbers and accrued around $1 million for their efforts.