Citation Nr: A21019177 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 210210-187918 DATE: December 2, 2021 ORDER The appeal concerning entitlement to payment for non-VA medical services provided to the Veteran from February 3, 2020 to February 11, 2020 is dismissed. The appeal concerning entitlement to payment for non-VA medical services provided to the Veteran from February 11, 2020 to February 18, 2020 is dismissed. The appeal concerning entitlement to payment for non-VA medical services provided to the Veteran from March 6, 2020 to March 13, 2020 is dismissed. The appeal concerning entitlement to payment for non-VA medical services provided to the Veteran from October 24, 2019 to November 1, 2019 is denied. The appeal concerning entitlement to payment for non-VA medical services provided to the Veteran from November 7, 2019 to November 18, 2019 is denied. The appeal concerning entitlement to payment for non-VA medical services provided to the Veteran from November 19, 2019 to November 26, 2019 is denied. The appeal concerning entitlement to payment for non-VA medical services provided to the Veteran from January 8, 2020 to January 16, 2020 is denied. FINDINGS OF FACT 1. Subsequent to the appeal of the denials of payment for non-VA medical services provided to the Veteran from February 3, 2020 to February 11, 2020, from February 11, 2020 to February 18, 2020, and from March 6, 2020 to March 13, 2020, the Agency of Original Jurisdiction (AOJ) administratively reversed the denials and approved the episodes of care for payment. 2. The request for payment for the non-VA medical services provided to the Veteran from October 24, 2019 to November 1, 2019 was filed on August 20, 2020, more than 180 days after the service was provided. 3. The request for payment for the non-VA medical services provided to the Veteran from November 7, 2019 to November 18, 2019 was filed on August 20, 2020, more than 180 days after the service was provided. 4. The request for payment for the non-VA medical services provided to the Veteran from November 19, 2019 to November 26, 2019 was filed on August 20, 2020, more than 180 days after the service was provided. 5. The request for payment for the non-VA medical services provided to the Veteran from January 8, 2020 to January 16, 2020 was filed on August 20, 2020, more than 180 days after the service was provided. CONCLUSIONS OF LAW 1. As the benefit sought on appeal has been granted and resolved by administrative action, there remains no allegation of error of fact or law concerning the issues on appeal related to non-VA medical services provided to the Veteran from February 3, 2020 to February 11, 2020, from February 11, 2020 to February 18, 2020, and from March 6, 2020 to March 13, 2020; therefore, dismissal is appropriate. 38 U.S.C. § 7104; 38 C.F.R. § 20.104. 2. The criteria for the appeal concerning entitlement to payment for non-VA medical services provided to the Veteran from October 24, 2019 to November 1, 2019 have not been met. 38 U.S.C. §§ 1703, 1703D. 38 C.F.R. § 17.102. 3. The criteria for the appeal concerning entitlement to payment for non-VA medical services provided to the Veteran from November 7, 2019 to November 18, 2019 have not been met. 38 U.S.C. §§ 1703, 1703D. 38 C.F.R. § 17.102. 4. The criteria for the appeal concerning entitlement to payment for non-VA medical services provided to the Veteran from November 19, 2019 to November 26, 2019 have not been met. 38 U.S.C. §§ 1703, 1703D. 38 C.F.R. § 17.102. 5. The criteria for the appeal concerning entitlement to payment for non-VA medical services provided to the Veteran from January 8, 2020 to January 16, 2020 have not been met. 38 U.S.C. §§ 1703, 1703D. 38 C.F.R. § 17.102. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The appellant in this matter is the vendor that provided the non-VA medical services to the Veteran from October 2019 to March 2020. The decisions on appeal were issued in September 2020 by the Veterans Health Administration and constitute initial decisions; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. The appeal concerning entitlement to payment for non-VA medical services provided to the Veteran from February to March 2020 In the September 2020 decisions on appeal, the AOJ denied payment of the charges billed by the appellant for medical services provided to the Veteran from February 3, 2020 to February 11, 2020, from February 11, 2020 to February 18, 2020, and from March 6, 2020 to March 13, 2020, under 38 U.S.C. § 1703 on the basis that the appellant did not submit the charges for payment within the time limit allowed by law. Prior to the Board issuing a decision on these appeals, a note was added to the claims file indicating that these claims were denied in error, and that there is proof of a timely filing of the charges. New transaction control numbers were assigned, and it was noted that they are set to be paid. The claims file also contains a new Explanation of Benefits (EOB) for each claim paid. In this case, the record indicates that the AOJ has reviewed and administratively approved payment for the non-VA medical services provided to the Veteran from February 2020 to March 2020, representing a full grant of the benefits sought in this appeal. As a result, there is no remaining allegation of error of fact or law for appellate consideration in the present appeal. See 38 C.F.R. § 20.104. Accordingly, the Board no longer has jurisdiction over the appeal, and it is therefore dismissed. See 38 U.S.C. § 7104. If a later decision/EOB concerning this episode of care results in payment in an amount disagreeable to the appellant, the vendor may file a separate/additional appeal of that subsequent decision. The appeal concerning entitlement to payment for non-VA medical services provided to the Veteran from November 2019 to January 2020 A health care entity or provider that furnishes hospital care, a medical service, or an extended care service under this chapter shall submit to the Secretary a claim for payment for furnishing the hospital care, medical service, or extended care service not later than 180 days after the date on which the entity or provider furnished the hospital care, medical service, or extended care service. 38 U.S.C. § 1703D(b). In this case, the appellant submitted claims for service from October 24, 2019 to November 1, 2019, November 7, 2019 to November 18, 2019, November 19, 2019 to November 26, 2019, and January 8, 2020 to January 16, 2020, on August 20, 2020, which is more than 180 days after any of these dates of service. In filing the appeal, the appellant noted that the claims were submitted late because they had billing software issues and were unable to submit claims for those dates of service any earlier. However, the legal authority pertaining to payment of non-VA medical services is prescribed by Congress and implemented via regulations enacted by VA, and neither the agency of original jurisdiction nor the Board is free to disregard laws and regulations enacted for the administration of VA programs. See 38 U.S.C. § 7104(c); 38 C.F.R. § 20.105. In other words, the Board is bound by the governing legal authority, and is without authority to grant benefits on an equitable basis. As, on these facts, there is no legal basis to award entitlement to payment for non-VA medical services, the appellant's claim must be denied as a matter of law. See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994). A. ADAMSON Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Uller, Associate Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.