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Health Care Eligibility for
Veterans Awarded the Purple Heart

July 6, 2000

In Reply Refer To: 216 Directors (00/21) Fast Letter 00-55

All VA Regional Offices and Centers

SUBJ: Health Care Eligibility for Veterans Awarded the Purple Heart

1. The attached VHA Directive outlines a recent change in policy as mandated by Public Law 106-117, the Veterans Millennium Health Care and Benefits Act, which places veterans awarded the Purple Heart in enrollment category 3, and exempts those veterans from co-payment requirements associated with the provision of hospital care and outpatient medical service.

2. Prescription co-payments will continue to be charged to veterans awarded a Purple Heart unless they meet the low-income exemption criteria, are service connected 50 percent or greater or the medication is for a service-connected condition.

3. This information should be shared with all employees who have public contact and provide VA benefit information to veterans.

4. This letter self rescinds March 1, 2005.

/s/
Robert J. Epley, Director
Compensation and Pension Service

Enclosure

1. PURPOSE: Change 1 to the Veterans Health Administration (VHA) Directive 2000-006 clarifies co-payment requirements under paragraph 3c and 3d for veterans awarded the Purple Heart.

2. POLICY: Public Law 106-117, the Veterans Millennium Health Care and Benefits Act, which amended the law to place veterans awarded the Purple Heart in enrollment priority group 3, and to exempt those veterans from co-payment requirements associated with provision of hospital care and outpatient medical services.

1. Veterans awarded the Purple Heart may submit appropriate documentation (i.e., DD 214 annotating receipt of the Purple Heart, DD 215, official service records, and military orders of award) for inclusion into the veteran’s Consolidated Health Record (CHR) folder. Health care facilities are also to fax these documents to the Health Eligibility Center at (404) 235-1355. Note: A certificate of award, in and of itself, will not suffice for verification purposes without the submission of supporting documentation.

2. As an interim measure, the Health Eligibility Center will provide each Department of Veterans Affairs (VA) health care facility with a partial listing of Purple Heart recipients to assist facilities in manually exempting these veterans from co-payment requirement associated with hospital care and outpatient medical services. The Office of Information (19) will develop software to capture data on veterans awarded a Purple Heart and effect other changes in the VHA information systems necessary to accommodate provisions to Public Law 106-117 relating to Purple Heart Award recipients.

3. Health care facilities must ensure that those veterans awarded a Purple Heart who were previously, or would be, classified in enrollment priority groups 4 through 7 are placed in enrollment priority group 3 and not charged co-payments for their medical care.

4. Prescription co-payments will continue to be charged to veterans awarded the Purple Heart unless they meet the low-income exemption criteria, are service-connected 50 percent or greater or the medication is for a service-connected condition.

5. Manual tracking is necessitated until Veterans Health Information Systems and Technology Architecture (VistA) software modifications are implemented to ensure these veterans are not inappropriately billed medical care co-payment charges.

6. Veterans awarded the Purple Heart are to be reimbursed for any medical care co-payments paid for VHA care provided on or after November 30, 1999.

7. VHA officials must have verifiable evidence that veterans received the Purple Heart before reimbursing any co-payments or changing veterans' enrollment status.

4. REFERENCE: Public Law 106-117, dated November 30, 1999.

5. FOLLOW-UP RESPONSIBILITY: Health Administration Service (10C3) is responsible for the content of this directive.

6. RESCISSION: This Change and VHA Directive 2000-006 will expire March 1, 2005.

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