Summary: The Department of Veterans Affairs (VA) is supposed to collect a fee, or a copayment, whenever it provides health care to veterans with incomes above a certain level. Vietnam veterans, however, are exempt from this requirement when being treated for medical conditions possibly related to Agent Orange exposure. The six medical centers GAO visited are not adequately evaluating the copayment status of Vietnam veterans claiming exposure to Agent Orange. This situation may be resulting in lost copayment revenues and unequal treatment of Vietnam veterans. Five of the centers routinely exempt all veterans who claim exposure without determining the validity of such claims. The other center routinely requires all veterans who claim exposure to comply with the copayment requirements, potentially depriving them of exemptions to which they are entitled. GAO estimates that the 159 centers could have collected as much as $2 million more in copayments in 1989 had physicians determined that treated conditions were unrelated to Agent Orange exposure.
