From: Director, RAO Baguio [[email protected]]
Sent: Tuesday, February 27, 2007 9:11 PM
Subject: RAO Bulletin Update 1 March 2007
RAO Bulletin Update
1 March 2007
THIS BULLETIN UPDATE CONTAINS THE FOLLOWING ARTICLES:
AAFES Gas Pricing Overseas ----------------- (Weekly Adjustment)
Peanut Butter Advisory ------------------------- (Check Your Labels)
United Nations Memorial Wall [01] -----------------
(Korean
Chapter 61 Legislation ------------------------ (Overview)
USMC Reenlistment Offered ----------- (Former Marines Eligible)
Premium Conversion --------------------- (Pretax Health Premiums)
VA Handbook [02] ------------------------------------- (2007 Edition)
Military Survivor Benefits ------------------- (Survivor Benefit Plan)
Army Disability Ratings ------------------------------- (Why so Low?)
Military Health Care TF [02] ----------- (Health Budgeting Blasted)
Reserve Retirement Age [08] ---------------- (A Different Approach)
VDBC Update 14 ------------------------------------- (SBP/DIC offset)
VA Prosthetics ------------------------------------ (New
FEHBP Reserve Reimbursements [01] --- (Extended to 24 Months)
TRICARE Pharmacy Policy [01] -------- (Mail Order Inducements)
Medicare Part B premiums [01] ---------- ($109.40 Projected FY08)
VA Budget 2008 [04] ------------------------- (Fee Increase Unlikely)
NGB DOD Representation [03] --------------- (NG in JCS Opposed)
TFL History --------------------------------- (Why Part �B� Required)
Cervical Cancer [02] ----------------- (Tricare Covers Vaccinations)
VA Franchise Program [01] ----------------------- (What�s Available)
Enlistment Waivers -------------------- (On the Increase)
USFSPA Lawsuit [12] ------------------- (Supreme Court Petitioned)
WRAMC [04] ---------------------------------- (Medical Care Review)
Medicare [04] ---------------------- (Financing Trigger)
Retiree Health Ins Tax Deduction ----------- (H.R.1110 Introduced)
GI Bill [12] ------------------------ (S.0644 & H.R.1102)
Tricare User Fees [19] ----------------------------- (S.605 Introduced)
Gold Star Family License Plates ---- (Honoring Fallen Servicemen)
Unconditional Surrender Statue ------------------ (Now in
Agent Orange Lawsuits [09] ----------------- (Haas Appeal Delayed)
VA Diabetic Retinopathy Screening --------- (Tele-retinal Imaging)
TFL Facts & Tips ------------------------------------- (Need to Knows)
Military Blood Program [02] -------------------------- (New Web Site)
Cell Phone Tips --------------------------------------- (Did You Know?)
VA State Benefits Seamless Transition -------------- (New Program)
VA Data Breach [30] ----------------------- (VA Not Serious Enough)
VA Dependent Burial --------------------------------- (Who is Eligible)
Military Legislation Status 27 FEB 07 ------------- (Where we stand)
NOTE: I am transiting from the
AAFES GAS PRICING OVERSEAS:�� Army and Air Force Exchange Service officials began a new gas-pricing plan 1 FEB that should make buying gas overseas easier on a person's budget as prices are now updated on a weekly basis instead of monthly changes. The decision is based on customer feedback for more immediacy in the price changes. AAFES used to look at the way oil prices fluctuated during the previous month and deliver an average price. This kind of pricing means that at the end of the month there would be a drastic change that people weren't prepared for. Now the weekly changes make the differences in prices a little less. Prices are based on the current week's U.S. Department of Energy average price.� [Source:� Military.com 26 Feb 07 ++]
�
PEANUT BUTTER ADVISORY:�
Public health officials in multiple states, with the assistance of the
Centers for Disease Control and Prevention (CDC) and the U.S Food and Drug
Administration (FDA), are investigating a large multistate outbreak of
Salmonella serotype Tennessee infections. An epidemiologic study comparing
foods that ill and well persons said they ate showed that consumption of Peter
Pan peanut butter and Great Value peanut butter were both statistically
associated with illness and therefore the likely source of the outbreak.
Product testing has confirmed the presence of the outbreak strain of Salmonella
Tennessee in opened jars of peanut butter, obtained from ill persons. FDA has
advised consumers not to eat any Peter Pan peanut butter purchased since May
2006 and not to eat Great Value peanut butter with a product code beginning
with 2111 purchased since May 2006. Peter Pan peanut butter is made in a single
facility in
���� As of 21 FEB,
the last time when numbers were updated, 329 persons infected with the outbreak
strain of Salmonella Tennessee have been reported to CDC from 41 states. Among
249 patients for whom clinical information is available, 51 (21%) were
hospitalized. No deaths have been attributed to this infection. Onset dates,
which are known for 224 patients, ranged from 1 AUG 06 to 2 FEB 07 and 60% of
these illnesses began after 1 DEC 06. PulseNet (the national subtyping network
for food borne disease surveillance coordinated by CDC) detected a slowly
rising increase in cases of Salmonella Tennessee this fall. OutbreakNet (the
national network of public health officials coordinated by CDC that
investigates enteric disease outbreaks) then worked for several weeks to
identify this unusual food vehicle. Public health officials from several states
have isolated Salmonella from open jars of peanut butter of both Peter Pan and
Great Value brand. For four jars, the serotype has been confirmed as
���� FDA officials and the peanut butter manufacturer are working collaboratively to learn more about production of peanut butter to determine how it may have become contaminated. Persons who think they may have become ill from eating peanut butter are advised to consult their health care provider. Persons who have Peter Pan peanut butter purchased since MAY 06 or Great Value peanut butter with a product code beginning with 2111 purchased since May 06 should discard the jar. Local health departments no longer need to collect jars for testing.� Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts 4 to 7 days, and most persons recover without treatment. However, in some persons the diarrhea may be so severe that the patient needs to be hospitalized. The elderly, infants, and those with impaired immune systems are more likely to have a severe illness.� Refer to www.cdc.gov/ncidod/dbmd/diseaseinfo/salmonellosis_2007/outbreak_notice.htm to view a map indicating the number of cases by state. [Source:� CDC Advisory 22 Feb 07 ++]
UNITED NATIONS MEMORIAL WALL UPDATE 01:� In addition to the officially sponsored
Korean Veterans Association of Korea revisit program, in which the Korean
Government covers the Veteran�s hotel, meals and most ground expenses, the USO
has a program for American Veterans. The USO program covers air transportation,
three nights lodging at the Sofitel Ambassador Hotel, meals and
CHAPTER 61 LEGISLATION:� There are three House bills in the 100th Congress that would benefit Chapter 61 retirees:�
-� H.R.0089: Combat-Related Special Compensation Act.� A bill to amend title 10, United States Code, to extend eligibility for combat-related special compensation (CRSC) paid to certain uniformed services retirees who are retired under chapter 61 of such title with fewer than 20 years of creditable service. Sponsor: Rep Bilirakis, Gus M. [FL-9] (introduced 1/4/07). Cosponsors (9).
-� H.R.0303: Retired Pay Restoration Act.� A bill to amend title 10, United States Code, to permit certain additional retired members of the Armed Forces who have a service-connected disability to receive both disability compensation from the Department of Veterans Affairs for their disability and either retired pay by reason of their years of military service or Combat-Related Special Compensation (CRSC) and to eliminate the phase-in period under current law with respect to such concurrent receipt. Sponsor: Rep Bilirakis, Gus M. [FL-9] (introduced 1/5/07). Cosponsors (47).
-� H.R.0333: Disabled Veterans Tax Termination Act.� A bill to amend title 10, United States Code, to permit retired members of the Armed Forces who have a service-connected disability rated less than 50% to receive concurrent payment of both retired pay and veterans' disability compensation, to eliminate the phase-in period for concurrent receipt, to extend eligibility for concurrent receipt and combat-related special compensation to chapter 61 disability retirees with less than 20 years of service, and for other purposes. Sponsor: Rep Marshall, Jim [GA-8] (introduced 1/9/07). Cosponsors (12).
However, only HR 333 would correct almost all of what is now wrong with concurrent receipt.� HR 333 would:
a. Extend the benefits of CRDP to some 375,000 retired career veterans who are rated less than 50% disabled by the VA.� (HR 303 would do the same. No similar provision in HR 89.)
b. Repeal the 10 year phase in of CRDP for those 180,000 retired career veterans who are rated 50 to 90% disabled. It would also eliminate the diminishing returns of the 10 year schedule beyond 2007. Consider that with the 2007 increment, restoration is approximately 65% of full amount. In 2010, restoration will be approximately 95% of the full amount, leaving the last 4 years to restore the remaining 5% such that the average monthly increment in 2014 is $0.31 in 2005 dollars for a total budget outlay of some $23,500 for the entire year.� (No similar provision in HR 303 or HR 89.)
c. Extend the benefits of CRDP at 100% to those 28,000 retired career veterans who are rated less than 100% but who are considered �individually unemployable� (IU) and compensated at 100% by the VA.� (No similar provision in HR 303 or HR 89.)
d. Extend the
benefits of CRDP to 183,000 career veterans who were involuntarily retired with
less than 20 years of retirement service for medical disability to include
wounds received in combat. Currently those incurring combat inflicted
disabilities in
e. Extend the benefits of CRSC as an alternative to CRDP for those untold number of career veterans whose disabilities are considered to be combat related. (No similar provision in HR 303 or HR 89.)
HR 333 is the best concurrent receipt legislation to date. To support this bill and/or contact your Representative refer to
http://capwiz.com/usdr/issues/alert/?alertid=9226426&type=ML [Source: USDR Charlie Revie msg. 25 Feb 07 ++]
USMC REENLISTMENT OFFERED:� The Marine Corps is reaching out to former Marines in its effort to grow the service to 207,000 Marines by 2011.� Part of the effort to grow the force is to contact noncommissioned officers who have separated from the service and offer them the option of coming back in. The Marine commandant Gen. James Conway is sending a letter to every Marine who has gotten out in the last four years. It will say that, �You may have already served your nation, but the job's not done�. Everything is negotiable: four-year enlistments, two-year enlistments, airborne school, other military schools, and so on, plus NCOs should be able to come back on active duty with their former ranks.� The service will begin recruiting an extra 5,000 per year beginning this year without reducing standards. The corps will be competing against the other services and especially against the Army, which has been slated to grow by 62,000 over the same period. To meet their goal the corps will probably put between 300 and 400 more recruiters on the street.
���� Standards are
important to the Marine leadership,
PREMIUM CONVERSION:�
Since 2000, federal employees have been able to pay their health
insurance premiums on a tax-free basis. Many federal retirees think they should
get similar treatment. But extending "premium conversion," as it's
called, to retirees would require a change in tax law, and Rep. Thomas M. Davis
III [R-Va] and others, who have pushed for that change in the last three congressional
sessions, are back at it. "We're talking about a modest amount of money,
but to those on fixed income, this could have a real impact,"
���� The tax code
permits employees to pay for health insurance with deductions that are excluded
from income and Social Security payroll taxes. It does not, however, allow
employers to offer premium-conversion benefits to their retirees, the sore
point that the
VA HANDBOOK UPDATE 02:�
A new edition of the Federal Benefits for Veterans and Dependents
handbook by the Department of Veterans Affairs (VA) has been released.� It updates the rates for certain federal
payments and outlines a variety of programs and benefits for American
veterans.�� Most of the nation's 25
million veterans qualify for some VA benefits, which range from health care to
burial in a national cemetery.�� In
addition to health-care and burial benefits, veterans may be eligible for
programs providing home loan guaranties, educational assistance, training and
vocational rehabilitation, income assistance pensions, life insurance and��� compensation for service-connected illnesses
or disabilities.� In some cases,
survivors of veterans may also be entitled to benefits.�� The handbook describes programs for veterans
with specific service experiences, such as prisoners of war or those concerned
about environmental exposures in
MILITARY SURVIVOR BENEFITS:�� One of the biggest benefits is the Survivor Benefit Plan (SBP), created by Congress to take care of surviving spouses and children when retired pay stops upon a retiree�s death. The plan has undergone some fairly significant changes. Launched in 1972, the goal of SBP was to ensure survivors of military retirees would have reasonable and continuous income replacement, which Social Security alone does not provide. Congress intended that the value of Social Security and other entitlements would be considered when determining whether reasonable income replacement was achieved. When a military retiree dies, military pay stops on the date of death. Today, more than 250,000 survivors of military retirees continue to receive payments because their sponsor participated in SBP.� The program has a cost-of-living adjustment, is government-subsidized, and offers tax-free features to the retiree. Recently, Congress allowed an open enrollment season for SBP under a provision of the 2005 Defense Authorization Act. Basically, it was an opportunity for military retirees to enroll in SBP who had not done so when they first were eligible. This was only the fourth time that an open season was held in which retirees could get into the SBP after the fact. Each time, the open season coincided with major changes to the program.
�
��� The latest enrollment season began 1 OCT 05, and ended 30 SEP 06. The reason the program was opened up again to those who did not get in when they were first eligible is that Congress ordered a phasing out of the Social Security offset that reduced benefits for survivors at age 62, when they became eligible for Social Security. Instead of the 55% of a member�s retirement pay, SBP payments were reduced to 35% of retired pay, on the theory that Social Security would substitute for the other 20 percentage points. The offset began to be phased out in OCT 05, when the percentage of retired pay for survivors age 62 and older increased to 40%. Then in April, it increased again to 45%.� This April, it is due to go to 50%, and in APR 08, the last phase kicks in when the percentage is restored to 55% for all SBP beneficiaries age 62 and older.� Under current law, a retiree cannot reduce or decline spouse coverage without the spouse�s written consent. You may voluntarily elect to discontinue participation in the SBP only during the 25th through the 36th month after you begin drawing retired pay.� If you qualify to discontinue participation in the plan, you must complete DD Form 2656-2. Again, spousal concurrence is required, except in limited circumstances when your spouse is unavailable.
���� The cost of
SBP is 6.5% of the base amount of coverage. You can choose as your base amount
anything from your maximum monthly retirement pay to as little as $300 per
month. For example, with a base amount of $1,000 per month, the monthly cost
for spouse coverage is $65. Upon the retiree�s death, the annuity would be 55%
of $1,000, or $550 after 2008 before taxes. Since the retiree pays no tax on
the premiums the tax is collected from the payments.� Non-U.S. citizen spouses in most countries
outside the
ARMY DISABILITY RATINGS:�
According to veterans� advocates, lawyers and services members the Army
is deliberately shortchanging troops on their disability retirement ratings to
hold down costs. In support of this the Inspector General has identified 87
problems in the system that need fixing. �These people are being systematically
underrated,� said Ron Smith, deputy general counsel for Disabled American
Veterans. �It�s a bureaucratic game to preserve the budget, and it�s having an
adverse affect on service members.� The numbers of people approved for
permanent or temporary disability retirement in the Navy, Marine Corps and Air
Force have stayed relatively stable since 2001. But in the Army, while in the
midst of a war, the number of soldiers approved for permanent disability
retirement has plunged by more than two-thirds, from 642 in 2001 to 209 in
2005, according to a GAO report last year. That decline has come even as the
war in
���� The Army denies there is any intentional effort to push wounded troops off the military rolls. But critics say many troops being evaluated for possible disability retirement accept the first rating they are offered during their first informal board. Dennis Brower, legal advisor for the Army�s Physical Disability Agency, acknowledged as much, saying only 10% of soldiers request a formal board. If they were to request a formal board, and then appeal the decision of that board, they would receive higher ratings. The system is complicated, �unduly so� the Rand Corp. think tank said in a 2005 report, and the counselors who advise troops often have insufficient training or experience. Service members also assume that after months spent in a war zone, the military will look out for them, critics say. Those who try to navigate the process beyond their initial evaluation face long waits, lost paperwork and months or even years away from home as they try to complete the process. If they receive a rating of above 30%, they receive disability retirement pay, medical benefits, and commissary privileges. Those rated under 30% they receive severance pay and no benefits. Many eventually give up and take their chances with the VA, which may give a higher rating for the same disability.
���� Under the separate disability payment systems of the Defense Department and the VA, a higher VA rating does not necessarily translate into more money, and forgoing military disability retirement also means giving up lifetime commissary and exchange privileges, military health care and other benefits.
While the number of soldiers placed on permanent disability retirement has declined in the past five years, the number placed on temporary disability retirement with medical conditions that officials rule might improve so they can return to work over time or worsen to the point that they must be permanently retired has increased more than fourfold, from 165 in 2001 to 837 in 2005. Troops on temporary disability leave convalesce for 18 months while receiving reduced basic pay. After that they are reevaluated and either returned to duty, or rated for separation or permanent disability retirement, or sent back to temporary disability for another 18 months up to five years. Along with paying them reduced wages during that time, the eventual reevaluation often leads to downward revisions in their disability ratings and lower disability payments. Service members� conditions must be deemed stable before they receive a permanent disability rating, unless they are rated at less than 30%. In that case, they are discharged with severance pay whether they are in stable condition or not. If their conditions then worsen, they�ll receive no more money from the military.
���� Compared to the overall size of the defense budget, disability retirement costs are relatively small. In 2004, the military paid more than $1.2 billion in permanent and temporary disability benefits to 90,000 people, the GAO said. That does not include the costs of lump-sum severance pay (up to 24 months of basic pay) given to 11,174 disabled troops that year in lieu of disability retirement pay. The Pentagon was unable to provide data on severance costs, the GAO said.� In 2005, Ellen Embrey, deputy assistant secretary of defense for force health protection and readiness, told House lawmakers the reason for the comparatively large numbers of troops placed on temporary disability was actually to keep end strength up. A premature medical evaluation board decision, she said, �may negatively impact the individual�s ability to continue serving.� Col. Andy Buchanan, the Army Physical Disability Agency�s deputy commander, said the system is not as bad as government reports have led people to believe. �It really is a fair process,� he said. �It�s wide open. We have nothing to hide.� Buchanan also said he had �no visibility� on the costs related to disability retirement pay, so he doesn�t know if the budget is going up or down. He said he gives medical evaluation board adjudicators one instruction: �Do the right thing. That�s the guidance I give them. There is absolutely no attempt on the part of the Army or this agency to deny soldiers any disability benefits or to push them off on the VA.� [Source: NavyTimes Kelly Kennedy article 24 Feb 07 ++]
MILITARY HEALTH CARE TF UPDATE 02:� Top service medical officers expressed their frustrations with the DoD health budgeting process at the 20 FEB hearing before the Task Force on the Future of Military Health Care.� Army Surgeon General LTG Kevin Kiley and Navy Surgeon General VADM Donald Arthur expressed their dissatisfaction with efficiency wedges or budget cuts, that DoD imposes on them each year. An efficiency wedge is a budget euphemism for, �We are cutting your budget by X amount and it�s up to you to find ways to stay within that lower amount by becoming more efficient�. VADM Arthur said there was no rational thought behind the cuts indicating they are simply a way to pay for private sector care and don�t actually make the services any more efficient.� The Surgeon Generals agreed that one way to make military health care more efficient would be for military hospitals and clinics to recapture more of the primary care workload that�s now being addressed in civilian care networks. There is capacity in military facilities that�s being paid for but not being used, they said.� Both the Navy and Army reiterated their support for a unified medical command. The Air Force Surgeon General said the joint command concept wouldn�t work with the Air Force�s current command and control structure.� VADM Arthur took issue with the current strategy of increasing fees and copays for the Tricare program. He offered a presentation entitled, �Can Not Break Promises�, and said he was uncomfortable with assuming savings from pushing retirees out of Tricare, which does nothing to address actual health care cost increases. LTG Kiley commented that fee/copay increases do not have to be so quick and should only be small increases.� [Source:� MOAA Leg Up 23 Feb 07 ++]
RESERVE RETIREMENT AGE UPDATE 08:� Two bills have been introduced in the 110th Congress to amend Title 10 to reduce the eligibility age for National Guard and Reserve retirees to receive military retirement pay. Congressman Jim Saxton (NJ) introduced H.R.0690 which would simply lower the eligibility age to 55 years. Identical Saxton bills introduced in previous sessions failed to pass because of their estimated cost. Senator Saxby Chambliss (GA) has introduced S.0648 which would reduce the eligibility age below 60 years by three months for each aggregate of 90 days of active duty performed by a member of the Ready Reserves after September 11, 2001with the eligibility age not to be reduced below 50 years. Under the Chambliss bill, active duty service qualifying for the reduction would include orders for active duty in support of a contingency operation during a war or national emergency under sections 101(a) (13((B) and 12301(d) title 10 or section 502(f) of title 32. Chambliss� office estimates that this bill, if passed, would cost $400 million over five years. [Sorce: NGAUS Leg Up 23 Feb 07 ++]
VDBC UPDATE 14:� The Veterans� Disability Benefits Commission held public hearings on 21 & 22 FEB. It covered possible Commission recommendations concerning the SBP/DIC offset and a time limit to file disability claims. The American Legion, Gold Star Wives, National Military Family Association, TREA, and the Veterans of Foreign Wars all testified in favor of ending the SBP/DIC offset and leaving unchanged the rules for when one can file a disability claim. The panel, across-the-board, called for the elimination of the SBP/DIC. The Commission members were grateful for the panel�s written and oral statements and were particularly moved when several representatives from the Gold Star Wives of America provided personal, compelling accounts of the impact of losing a spouse and the subsequent financial hardships many have endured.
���� The Commission is expected to settle on a recommendation concerning the deduction of DIC from SBP annuities during next month�s meeting. The Commission did make progress on several other staff-prepared research questions and provided the following tentative recommendations:
-� Claim-Filing Time Limit - endorse the current rule that allows unlimited time to file an original VA disability claim
-� Line of Duty - endorse the current definition that considers any disability incurred while on active duty, other than due to misconduct, as in the line of duty (e.g., members are considered on duty 24 hours a day, 7 days a week)
-� Lump Sum Payments - recommend against offering a lump sum payment option in lieu of monthly disability compensation
At its next meeting on 22 & 23 MAR, the Commission is
expected to deal with the questions of whether Pending Claims should end at
Death, possible Lump Sum Payments, and will consider recommendations on
concurrent receipt options, among other issues. For additional info refer the
Commission website: www.ha.osd.mil/dhb/fmhc/. [TREA
VA PROSTHETICS:� A new facility, part of the Miami VA Medical Center, has built a research and rehabilitation laboratory in partnership with its physical and occupational therapy department.� Nationally, VA has developed not only a wide array of rehabilitation research and treatment programs, but nearly 60 prosthetic laboratories providing customized devices and artificial limbs prescribed by VA clinicians. The number of veterans using VA for prosthetics, sensory aids and related services has increased more than 70% since 2000.� As demand has increased, so has VA�s budget for these services - from $532 million in 2000 to $1.3 billion in 2006.� The President�s budget for 2008 requests $1.4 billion.� The prosthetics research budget requests $411 million in 2008, nearly $3 million below current year funding and $70 million below the amount NAUS and a number of other major veterans organizations recommend for prosthetics research in the NAUS-endorsed Independent Budget.� [Source: NAUS Weekly Update 23 Feb 07 ++]
FEHBP RESERVE REIMBURSEMENTS UPDATE 01:� Federal employees now have one less thing to worry about when they are called to active duty military service. Last week the Office of Personnel Management published regulations in the Federal Register that will extend Federal Employee Health Benefits coverage from 18 months to 24 months for federal employees on active duty.� The regulations are effective April 16. To be eligible for the extension, federal employees must be:
--� Enrolled in the FEHB program.
--� A member of the reserve component of the armed forces.
--� Called or ordered to active duty in support of a contingency operation.
--� Placed on leave without pay or separated from service to perform active duty.
--� Serve on active duty for more than 30 consecutive days.
[Source:� NAUS Weekly Update 23 Feb 07 ++]
TRICARE PHARMACY POLICY UPDATE 01:� Defense officials are weighing new initiatives to limit access to the TRICARE retail drug network, particularly for older beneficiaries who are using neighborhood drug outlets to get their maintenance medications. Proposals under review, some of which require congressional action to implement, were discussed 6 FRB at the second public meeting of the Task Force on the Future of Military Health Care. DoD wants help from the task force to drive a larger proportion of 6.7 million TRICARE pharmacy users into the mail-order program which is far more efficient. Prescriptions filled by retail outlets cost TRICARE about 40% more than drugs obtained by mail. After a yearlong marketing campaign, the number of beneficiaries using mail order rose by only 11%, a figure that disappointed officials. Meanwhile, users relying solely on the retail network, with its 59,000 participating pharmacy outlets, climbed by another 170,000 in 2006.Retail costs are $4.4 billion or 63% of the DoD pharmacy budget. Retail outlets, however, fill only 35% of all prescriptions. Mail-order costs are $740 million, or 12% of the budget, and handle 14% of pharmacy workload.
���� Rear Adm. Thomas McGinnis, chief of TRICARE pharmaceutical operations, told the task force that co-pays for the retail network are too low to drive beneficiaries into the mail-order option to help control costs. Of four initiatives McGinnis asked the task force to study and perhaps endorse, two would block beneficiaries who need maintenance drugs for chronic conditions from filling their prescriptions in the retail network. Maintenance drugs are medicines, McGinnis said, that patients likely will need for the rest of their lives. For that reason, they are seen as ideal for supplying conveniently to patients by mail order. Yet beneficiaries have been reluctant to make the shift from the retail network or even from base pharmacies which remain overworked, McGinnis said.� The initiatives he presented to the task force were:
1) Require that all "third tier" maintenance medications, those not on the department's uniform formulary of approved drugs, be available only by mail order, not in retail outlets.
2) Require that all other maintenance drugs, which means generic and brand-name drugs on the formulary, be available only by mail order or at base pharmacies, ending their availability in the retail network.
3) Revise retail and mail-order co-payments. As proposed last year, retail co-payments for generic drugs would rise to $5 from $3. The co-pay for brand-name drugs on the uniform formulary would climb to $15, from $9. The big change from last year's proposal might be to end the availability of non-formulary drugs in the retail network. The number of such drugs is 56 and climbing.� This would end the need for that "third tier" co-pay of $22.Regarding mail order co-pays, as proposed last year officials want the $3 charge for generic drugs reduced to zero. But the co-pay for a 90-day supply of a brand-name drug on the formulary would rise to $15, from $9. The big change on mail-order co-pays from last year also targets non-formulary drugs. McGinnis suggested the current co-pay of $22 could be replaced with 20% of the cost of the drug.� Such co-pays would be waived for medical necessity. McGinnis, a public health service officer, noted that government civilian employees enrolled in the Federal Health Benefits Program (FEHBP) face significantly higher drug co-pays than the military.
4) Selected over-the-counter medicines could be made a part of the uniform formulary and dispensed for free from all TRICARE points of service.� The idea here would be for TRICARE to absorb the relatively small additional cost of dispensing nonprescription medicines in place of more costly prescription drugs. The example McGinnis used is the over-the-counter medicine Prilosec, for acid reflux, versus Nexium, a heavily marketed drug for the same condition but which is far more costly.
No task force member challenged the proposals.� (Source: The SunHerald article 13 Feb 07 ++]
�
MEDICARE PART B PREMIUMS UPDATE 01:� According to a forecast released 13 FEB Medicare Part B premiums could increase by $15.90 a month next year to $109.40, a 17% increase from the current $93.50, The projection of the highest dollar increase in outpatient care premiums in Medicare's history was prepared by TREA Senior Citizens League, a nonpartisan association of about 1.2 million members that grew out of a military retirees organization about a decade ago. Medicare's trustees are expected to project a premium increase when they issue their annual report this spring, but final figures won't be released by the federal government until next year. Medicare Part B premiums cover outpatient care such as doctors' services, durable medical equipment, home health visits and preventive care.� The federal government pays roughly 75% of the total cost of Part B out of general revenues, and assesses a premium to cover the remaining 25%. Individuals with incomes above $80,000 and couples with incomes above $160,000 pay a larger portion of the premium. The analysis predicts that for about half of the 44 million Medicare beneficiaries, the premium increase will consume their entire Social Security cost-of-living adjustment.
���� The premium is automatically deducted from Social Security checks. The report notes that the Congressional Budget Office last month predicted that Social Security COLAs would increase next year by 1.5%, meaning the average beneficiary will receive a $15.70 monthly increase. Next year's projected high premiums are based on the rapidly growing deficit between what program was expected to cost and the actual costs.� For example, last year's premiums were based on an expected 5%reduction in physicians fees� which the 109th Congress rescinded in December as one of its last acts. Last spring, the Medicare trustees projected that Part B premiums would increase about 11% in 2007, but the administration adjusted the figures last fall to a 5.6% increase. The report said that if last year's projected increase had been enacted, next year's increase would only be about $5, rather than nearly $16. Physicians' fees are scheduled to be reduced next year by 10% and the trustees report, by law, must include that reduction in its calculations. But the TREA Senior Citizens League study assumes that Congress will again refuse to cut doctors' fees, resulting in higher Medicare costs and premiums.
�
�� The study notes
that Part B premiums have increased 60% over the past five years while the
Social Security COLA has increased 14%. If the 2008 projected increases occur,
premiums will have increased 77% in six years, compared to a 15% increase in
COLAs. "For years, we've been sounding the alarm bell that
VA BUDGET 2008 UPDATE 04:� The fiscal 2008 Department of Veterans Affairs budget request unveiled by the White House on 5 FEB proposes $36.6 billion in health care funding and seeks to establish new and higher fees for veterans that Congress has already rejected multiple times. The VA healthcare co-pay would almost double, moving to $15 from the current $8 according to Rita Reed, VA�s deputy assistant secretary for budget.� She also announced the VA is seeking to create enrollment fees of up to $750 for veterans with relatively robust family incomes in priority categories 7 and 8. Congress has shot down requests for such fees for three years running, and with Democrats now in control, the odds of approval are even longer. Last year, in the president�s budget, he proposed doubling the cost of prescription drugs and an increase in fees.�
��� The $36.6
billion for VA health care, which includes assumptions of $2.3 billion in
payments from third-party insurers, is part of a VA budget request of $87
billion that Veterans Affairs Secretary James Nicholson called a landmark.
Nicholson noted that the VA budget has grown by $37.8 billion since President
Bush took office, although that growth has been due less to largesse than to
the necessity of caring for aging veterans of previous wars as well as a
larger-than-anticipated influx of new veterans from the wars in
���� Reducing average process time is essential because troops who leave service with disability ratings of less than 30% are ineligible for Defense Department medical benefits, including counseling for post-traumatic stress disorder. They are still eligible for VA benefits but may have up to a six-month wait for services after leaving the military because of long processing times. Research has shown that service members who do not receive immediate care for PTSD may suffer the symptoms for far longer than those who get immediate care. Within the budget, $45 billion would go to pay for benefits such as education and home loans, and $167 million would go to operation and maintenance of veterans� cemeteries. VA plans to open six new national cemeteries.� However, some veterans would pay more out of pocket for VA health care under the plan. The Bush administration estimates the co-pay increase would raise $311 million in revenue in 2008, and the tiered annual enrollment fee would bring in another $138 million. The budget estimates 553,521 veterans will need acute hospital care in fiscal 2008, an increase over the 548,470 estimated to seek treatment this fiscal year. However, even as deployment surveys continue to report high numbers of troops with PTSD and other mental health issues, the budget assumes 1,287 fewer patients will seek mental health care in 2008. [Source: NavyTimes Kelly Kennedy/ Rick Maze article 19 Feb 07 ++]
NGB DOD REPRESENTATION UPDATE 03:� Congressional aides familiar with the independent panel�s report told CongressDaily 22 FEB that The National Guard and Reserves Commission (CNGR) will announce that it opposes a bipartisan effort in Congress to boost the Guard�s clout by making its leader a member of the Joint Chiefs of Staff.� The panel�s views, contained in a preliminary report to Congress that will be released 1 MAR, will likely bring denunciations from lawmakers who were hoping for an endorsement of the National Guard Empowerment bill, which would give the heavily deployed reserve force more power over its organization, operations and budgets. According to the aides, the commission will announce its preference for modest changes, including the promotion of the three-star Guard chief to four-star rank and designation of the chief as an adviser to the Joint Chiefs chairman. These changes resemble parts of a compromise Senate advocates proposed last fall.� That compromise passed the Senate as an amendment to the fiscal 2007 defense authorization bill but died in conference with the House, prompting Guard supporters to reintroduce the full measure last month.
���� The commission, created by Congress to offer advice on issues affecting the Guard and Reserves, will also reject a provision in the bill that would give the National Guard its own budget authority. Currently, the Guard budget falls under the Army and Air Force budgets.� The commission suggests the National Guard communicate its homeland security equipping needs to the Homeland Security Department, which would relay them to the Pentagon, essentially adding another layer of bureaucracy to the Guard�s budget process.� The commission also favors creation of an advisory council of 10 governors appointed by the president who would report directly to the Defense and Homeland Security secretaries, the White House Homeland Security Council and the National Governors Association. That recommendation, according to the aides, would erode the power of the Guard Bureau, which essentially serves as a conduit between the states and federal government. The commission, meanwhile, agrees with congressional efforts to revise the Guard bureau�s charter, particularly to define its relationship with unified commands and Homeland Security. But commissioners want the Army and Air Force secretaries to take the lead and made no mention of the Guard�s involvement, aides said.
���� While the report rejects much of the Guard empowerment bill, the measure�s co-sponsors�Sens. Patrick Leahy [D-VT] and Christopher Bond [R-MO], and Reps. Tom Davis [R-VA] and Gene Taylor [D-MS] plan to move ahead. They are counting on the backing of dozens of lawmakers who supported the legislation last year. And pressure to back the bill is likely to come from National Guard units, which are descended from colonial-era militias and draw volunteers who live and work in every district.� Still, the commission�s findings might help some key lawmakers oppose the more radical changes proposed in the bill.� Among them House Armed Services Chairman Ike Skelton [D-MO], who has been awaiting the panel�s report before taking a position.� [Source: CongressDaily Megan Scully article� 22 Feb 07 ++]
TFL HISTORY:� Tricare for Life (TFL) is the product of a 2001 amendment to Tricare law that allows plain, ordinary Tricare Standard to act as a free supplement to plain, ordinary Medicare. Before 2001, retirees� Tricare eligibility ended if they became legally entitled to Medicare at age 65 regardless of whether they were enrolled in Part B of Medicare. In 1966, when it enacted the law creating what was then called CHAMPUS, Congress intended the plan to provide assistance with medical bills between the young retirement age of uniformed service personnel and their Medicare entitlement at 65.� CHAMPUS was not intended to provide lifetime coverage. The original 1966 law, as it applied to everybody except family members of active-duty troops, had a provision that if a CHAMPUS beneficiary became entitled to Part A of Medicare (the free part), he immediately lost all CHAMPUS eligibility. It was not until 1991 that Congress amended the law to allow Medicare beneficiaries to retain CHAMPUS eligibility if they enrolled in Part B of Medicare.
���� Regardless of Part B enrollment, retirees and their family members still lost CHAMPUS eligibility if they became legally entitled to Medicare at age 65. CHAMPUS became Tricare in 1995, but it was still governed by the same 1966 law, now as amended.� A law effective 1 OCT 01, made it possible for Tricare beneficiaries to retain their eligibility beyond age 64 despite Medicare entitlement, provided they were enrolled in both Part A and Part B of Medicare. That is the coverage now called Tricare for Life. Under that law, Medicare Part A and Part B become the primary health insurance. Tricare Standard, which is still free, acts as a Medicare supplement. After it processes a claim and pays the provider, usually 80% of the amount approved for covered services (after the Medicare deductible is met, if applicable), Medicare automatically forwards the claim to Tricare.
���� Tricare (i.e. TFL) will pay the amounts Medicare did not pay on each Tricare-covered service on that claim. That is usually the beneficiary�s Medicare co-payments and any Medicare deductibles applied on that claim. On the vast majority of Medicare claims, Tricare pays the unpaid balance on the claim. Thus, the provider�s claim and the bill are paid in full and nothing remains for the beneficiary to pay. But there are three unusual situations in which the beneficiary will have some out-of-pocket expenses not paid by either Medicare or Tricare.
-� First, if a particular service is covered by Medicare but not Tricare, Tricare will pay nothing. The beneficiary has sole responsibility for paying what Medicare did not. The most common example is chiropractic care. But similar situations are rare; there is little else that Medicare covers but Tricare does not.
-� Second, if an item on the Medicare claim is not covered under Medicare but is covered under Tricare, Tricare does something that no commercial Medicare supplement will do. It will separate that service from the rest of the Medicare claim and process it as if Tricare Standard were the beneficiary�s only health insurance. That bit of the Medicare claim will be subject to the usual Tricare Standard deductible and cost share. The beneficiary will be responsible for paying those amounts out of pocket.
-� Third, if the beneficiary receives a medical service that is covered by neither Medicare nor Tricare, he has sole responsibility for paying that charge. Under Medicare law, if you receive a service the provider knows, or should know, may not be covered by Medicare, the provider must make the beneficiary aware of that fact and have him sign a document to that effect. If the provider fails to do so, the beneficiary may escape financial responsibility for that bill.
Military retirees have been trying for years to obtain
the retirement health benefit they were promised upon enlistment into the armed
service. TFL is about as close as they have come. H.R.602 and S.407 Keep Our
Promise to
1. H.R.1110. A bill introduced by Rep. Tom Davis [VA-11] to amend the Internal Revenue Code of 1986 to allow Federal civilian and military retirees to pay health insurance premiums on a pretax basis and to allow a deduction for TRICARE supplemental premiums. To support this bill and/or contact your Representative refer to http://capwiz.com/usdr/issues/alert/?alertid=9408301&queueid=[capwiz:queue_id].
2. H.R.0343 Military Retiree Health Care Relief Act of 2007. A bill introduced by Rep Jo Ann Emerson, Jo Ann [MO-8] to amend the Internal Revenue Code of 1986 to allow a refundable credit to military retirees for premiums paid for coverage under Medicare Part B.
[Source: Tricare Help, Times News Service James Hamby article 19 Feb 07 ++]
CERVICAL CANCER UPDATE 02:� Human papillomavirus (HPV) infection is a
concern for girls and young women because it can lead to cervical cancer.� TRICARE wants its beneficiaries to know a
preventive vaccine is available, and that the vaccine is a TRICARE covered
benefit. The Centers for Disease Control and Prevention (CDC) reported that in
2006, approximately 9,700 cases of cervical cancer were diagnosed in the
VA FRANCHISE PROGRAM UPDATE 01: Franchising can make an excellent career transition for military veterans. Military life is rigorous, demanding, physically taxing, and undoubtedly regimented. A franchise system is an established module of rules, regulations, and procedures � a language that any veteran could understand.� Founded in 1991, the VA Franchise Program (VetFran) is the only program of its kind that helps veterans establish themselves in the franchise world by providing them with a numerous resources from informational to financial, and supported by a number of governmental and private groups. VetFran has over 200 franchisor members, all of which are members of the International Franchise Association and this membership continues to grow every year. These franchisors have agreed to help qualified veterans acquire franchise businesses by providing financial incentives not otherwise available to other franchise investors. Veterans will get the �best deal� from these companies. If you are a veteran and seeking to invest in a franchise opportunity, visit the franchising section of each company�s website.
���� Another resource available to veterans is The Veterans Business Outreach Program (VBOP), one of the many services provided by the Small Business Administration (SBA). This is a government-funded organization that can provide multiple levels of support to help veterans start their own business or grow an existing business.� What makes this program so good is that the services offered go beyond just include grant and loan administration. They help individuals integrate themselves into entrepreneurship and provide small business management training, advice, and mentorship after many years of military service. The VBOP offers the following:
-� Pre-Business Plan Workshops:� VBOCs conduct entrepreneurial development workshops dealing specifically with the major issues of self-employment. An important segment of these workshops entails the usage of the Internet as a tool for developing and expanding businesses. Each client is afforded the opportunity to work directly with a business counselor.
-� Concept Assessments:� VBOCs assist clients in assessing their entrepreneurial needs and requirements.
-� Business Plan Preparations:� VBOCs assist clients in developing and maintaining a five-year business plan. The business plan includes such elements as the legal form if the business, equipment requirements and cost, organizational structure, a strategic plan, market analysis, and a financial plan. Financial plans include financial projections, budget projections, and funding requirements.
-� Comprehensive Feasibility Analysis:� VBOCs provide assistance in identifying and analyzing the strengths and weaknesses of the business plan to increase the probability of success. The results of the analysis are utilized to revise the strategic planning portion of the business plan.
-� Entrepreneurial Training and Counseling:� VBOCs, working with other SBA resource partners, target entrepreneurial training projects and counseling sessions tailored specifically to address the needs and concerns of the service-disabled veteran entrepreneur.
-� Mentorship:� VBOCs conduct, as appropriate, on-site visits with clients to ensure adherence to their business plans. Additionally, VBOCs review monthly financial statements to determine whether a revision of the business plan is warranted or that desired results are being attained.
VBOCs also provide assistance and training in such areas as international trade, franchising, Internet marketing, accounting, etc. A representative from the Veterans Business Development Office can help you prepare and plan for your entrepreneurial venture.� You can locate your nearest representative by going to www.sba.gov/vets/reps.html and clicking on your hone state.� For additional information refer to www.sba.gov/vets.� [Source: www.sba.gov/vets Feb 07 ++]
ENLISTMENT WAIVERS:�
According to a just-released Pentagon report, the Army is approving
significantly more criminal history waivers for enlistment than it has in years
past. The Army granted more than double the number of such waivers in 2006 than
it did in 2003.� In 2006, the Army
approved 901 waivers for felony convictions, compared to 411 such waivers in
2003. About 10% of the moral waivers approved in 2006 were for felony
convictions. Serious criminal history waivers also grew, from 2,700 in 2003 to
more than 6,000 in 2006. The report was obtained by the California-based
military think tank,
���� Lawmakers are
concerned that continuing war in
���� According to the Pentagon report, almost 25% of military recruits in 2006 needed some type of waiver, up from 20% in 2003. Roughly 30,000 moral waivers were approved each year between 2003 and 2006.
The report divides moral waivers into six categories: felonies, serious and minor non-traffic offenses, serious and minor traffic offenses and drug offenses.� According to the report, �the waiver process recognizes that some young people have made mistakes, have overcome their past behavior, and have clearly demonstrated the potential for being productive, law-abiding citizens and members of the military.�� Waiver percentage by service in 2006 were:
-� Approximately 20% of Army recruits needed a waiver in 2006. This is up from 12.7% in 2003.
-� More than 50% of Marine Corps recruits were given a waiver in 2006. However, the report explains that this is because the Marine Corps has a more strict policy on previous drug use than the other services. A single use of marijuana requires a waiver for Marine Corps service. This is not true of the other services.�
-� About 18% of Navy recruits required a waiver. This is a slight increase from 2003.
-� About 8% of Air Force recruits had waivers, a small decrease from 2003.
[Source:� Your Guide to U.S. Military article 19 Feb 07 ++]
USFSPA LAWSUIT UPDATE 12:� On February 12, 2007, over four dozen divorced veterans petitioned the United States Supreme Court to overturn a law that permits veterans� retired pay to be divided as marital property in divorce court.� The case (Adkins v. Rumsfeld) has been officially received and docketed as case 06-1132.� Henceforth, developments in the case can be monitored by following www.supremecourtus.gov/docket/06-1132.htm. On February 20, 2007, the Department of Justice (DOJ) filed a motion for an enlargement of time of nine days within which to file their brief.� The primary reason cited was for the DOJ to confer with the Office of the Solicitor General and obtain final authorization for the appeal.� The Court granted the motion. Now the Government's brief is due on March 2, 2007. According to the Court, the Government has until March 16 to reply to the petition, but often they will seek one (if not more) 30-day extensions of time to respond. The Uniformed Services Former Spouses� Protection Act (USFSPA) was enacted in 1982 at a time when most ex-spouses of veterans were women. By now, a substantial and growing number of women fill the ranks of active-duty military members and veterans.�
���� The veterans in this lawsuit are represented by Constitutional lawyer Jonathan L. Katz of Silver Spring, Maryland�s Marks & Katz, and David Bederman in Atlanta. Katz said: �The USFSPA adversely affects nearly one million veterans whose marriage have ended or may end in divorce. It is particularly unconscionable at this time when tens of thousands of service members are placing their lives at risk during wartime, career military members also face financial ruin at the hands of their own government due to this law.� said Katz.� Katz added that �with divorce rates on the rise, it is estimated that over half of today�s career military force will not receive the full retirement benefits for which they contracted.�
���� After years of
lobbying efforts failed to overturn or curb the USFSPA, a group of divorced
veterans formed the USFSPA Litigation Support Group (ULSG) to challenge the law
in court. Backed by over 3000 members, the ULSG and over four dozen divorced
veterans first went to the federal trial court in
���� The divorced veterans� challenge in the Supreme Court includes their contention that the law has been applied retroactively to persons who were already in the military�and some even were already retired�well before the USFSPA empowered divorce courts to divide their retired pay. Their petition also asserts that the USFSPA is unevenly applied in numerous state courts, resulting in wildly varying treatment of divorced veterans� retired pay depending on the state where the divorce proceedings are handled. The lawsuit also contends that the USFSPA and the government do not sufficiently protect divorced veterans against the government�s implementation of court orders issued without sufficient basis in law.�
� ���ULSG officer and retired Army Master Sergeant Ronald King said: �The USFSPA is a political hot potato that members of Congress are afraid to touch, lest they be seen as insensitive to ex-spouses of veterans. However, this was a badly-written law in the first place that has caused financial devastation to countless veterans. Although the USFSPA was enacted with good intentions, decades of controversy in this arena has wounded military morale and driven good men and women out of the military just when we need them the most. We hope that the Supreme Court will recognize the impact this law has, and that it will agree to hear our appeal.� For further information, contact [email protected] or ULSG, LLC,� PO Box 270337, Tampa, FL 33688-0337 www.usfspa-lawsuit.info.� [Source: USFSPA� Litigation Support Group News Release 20 Feb 07 ++]
WRAMC UPDATE 04:�
The Secretary of the Army and the Secretary of the Navy have begun a
review of the medical care provided at
����� The
Washington Post expose obviously has caught the attention of Army
officials.� On 19 FEB repairs began on
Bldg. 18. The facility's commander, Maj. Gen. George W. Weightman, said Army
staff members inspected each of the 54 rooms at the building and discovered
that outstanding repair orders for half the rooms had not been completed. He
said that mold removal had begun on several rooms and that holes in ceilings,
stained carpets and leaking faucets were being fixed. A broken elevator in the
building had been repaired and soldiers were working to improve the outside of
the building, including removing ice and snow. The slippery conditions have
kept some soldiers in their rooms. A garage door that has been broken for
months will soon be repaired.� Weightman
said Walter Reed and Army officials have been meeting continuously for three
days since the articles began appearing. Social workers will now be stationed
around the clock at Mologne House, the 200-room hotel on the post where many of
the outpatients live. Plans are being developed to better train other staff
members who deal with outpatient needs.�
The Army will also consider moving some outpatients to its other medical
centers throughout the
MEDICARE UPDATE 04: Recently numerous e-mails have been received addressing some problems that have a common reason for Congress not wanting to address them such as:
-� Why can�t we get Medicare Subvention for Military Treatment Facilities?
-� Why can�t the Veteran�s Health Service get Medicare to make payments for eligible Medicare patients?
-� Why can�t we get doctor�s fees raised who accept Medicare?
-� Why do they want to keep reducing the Medicare fees paid to doctors?
The answer to all is that as an entitlement, Medicare has no cap and it is financed in two ways: beneficiary premiums, deductibles and co-pays; and general revenues. When Congress passed the Medicare Modernization Act in NOV 03 (this is the bill that created the Part D drug benefit), one provision in the legislation inserted a trigger into the financing of the Medicare program. Since the portion of spending covered by general revenues has been growing over time; the point of inserting the trigger was to limit the extent to which general revenues could be used to finance Medicare.� The trigger was structured such that whenever general revenues were used to finance more than 45% of expenditures for two consecutive years, Congress is mandated to open up the Medicare program and find ways to curtail spending.
���� Many members of Congress were very concerned at the time that the trigger was structured so as to lead to a massive round of benefit cuts, simply to reduce spending - without requiring a more fundamental evaluation/overhaul of the program. This trigger now means that everything Congress does with respect to Medicare takes on a different light because general revenues are already covering about 40% or more of Medicare expenditures. It is expected that very shortly because of the drug benefit being implemented, we could hit the 45% cap. This is one reason that many reforms from fixing the reimbursement rates for doctors to Medicare subvention are hitting roadblocks.� [Source: NCPOA Newsletter Editor 16 Feb 07 ++]
RETIREE HEALTH INS TAX DEDUCTION:� Legislation introduced 16 FRB in the House would allow retired military and civilian federal workers to pay their monthly health care premiums with pre-tax dollars.� The bill (H.R. 1110), introduced by Rep. Tom Davis (R-VA) also would enable active-duty military personnel to use what he called a "pre-tax rebate" to pay for the supplemental insurance most purchase to cover gaps in TRICARE, the Defense Department's health insurance program. Specifically, the bill would let retirees subtract the amount they pay for health insurance premiums from the income they report to the Internal Revenue Service, resulting in a lower taxable income. Though a section of the Internal Revenue Code enables employees in the public and private sectors to pay for health insurance with pre-tax dollars, it does not authorize employers to make this so-called "premium conversion" benefit available to retirees.����� Passage of the legislation would result in average savings of $820 per year for federal annuitants, according to government estimates.� The measure received praise from the National Active and Retired Federal Employees Association and the Military Coalition, which is made up of 35 organizations representing military personnel and veterans.� The bill, initially introduced in the 106th Congress, has received strong bipartisan support. The Government Reform Committee unanimously approved it in the 109th Congress, but it stalled in the Ways and Means Committee because it was overshadowed by the president's top two domestic priorities: strengthening Social Security and improving the tax code. This session, however, nearly half the members of the Ways and Means Committee have signed on as original co-sponsors of the bill.� [Source:� GOVEXEC.com Daily Briefing 16 Feb 07 ++]
GI BILL UPDATE 12:� On 15 FEB Senator Blanche Lincoln (D-AR) and Representatives Vic Snyder (D-AR), Stephanie Herseth (D-SD), John Boozman (R-AR), and Loretta Sanchez (D-CA) unveiled companion bills S.0644 & H.R.1102 to modernize educational benefits under the Montgomery GI Bill (MGIB).� The bills are intended� to make adequate and equitable benefits for the Guard and Reserve components of our Armed Forces. Their "Total Force Montgomery GI Bill" legislation would:
-� Consolidate active duty and Selected Reserve MGIB programs under the jurisdiction of the Veterans Affairs Committee and the Veterans Administration. Reserve benefits are now overseen by the Armed Services Committee and the Department of Defense, and the split oversight has led to inconsistent and inequitable structuring of the two programs.
-� Ensure that Selected Reserve MGIB benefits rise in proportion with active duty MGIB rate increases. This would help address the growing inequity of benefits between the two.
-� Provide a 10-year period after leaving service to use Reserve Educational Assistance Program (REAP) benefits. Unlike active duty members, Guard and Reserve members forfeit all education benefits once they separate from service.
-� Allow mobilized members of the Selected Reserve to accrue active duty level benefits on a month-by-month basis during the time they're mobilized -- up to the maximum allowable benefit (36 months of benefits at $1,075 per month). Since September 11, 2001, reserve MGIB rates have risen only 13.6%, while active duty rates have gone up 60%.
More than 550,000 Guard and Reserve troops have served on
active duty in the war on terror and over 85,000 have pulled two or more tours
of duty. Since WWII Guard and Reserve veterans of
TRICARE USER FEES UPDATE 19:� At a House Armed Services Military Personnel Subcommittee hearing on 13 FEB, Chairman Vic Snyder (D-AR) admonished Dr. William Winkenwerder, the Pentagon's chief health official, concerning the nearly $1.9 billion in funding cuts to the Defense Health Program. DoD has previously indicated the savings would come from forcing retirees under age 65 to pay substantially higher Tricare fees and requiring all Tricare beneficiaries to pay higher retail pharmacy copayments. Last year's budget request projected that most of the savings came from the assumption that the higher fees would deter retirees from using their earned Tricare benefits. Winkenwerder said the new proposed budget offers no specifics on where the $1.9 billion would come from. The cut is just a "placeholder", he said, and it's up to the ongoing Task Force on the Future of Military Health Care to decide what fee increases or other initiatives would generate the savings.� Snyder objected to that characterization, saying the budget cut has "poisoned the water for the task force", effectively forcing them to come up with at least equal fee increases or program cuts. The subcommittee's senior Republican, Rep. John McHugh, (R-NY), voiced similar concerns, asking how DoD would address the shortfall if the task force doesn't support at least equal fee increases. Winkenwerder acknowledged that the Pentagon would have to make some "fairly dramatic" program cuts in that event.
���� With the soon to expire provisions of the NDAA 2007 that held in abeyance the DoD proposal to double and triple Tricare fees and premiums for military retirees, the DoD has again announced similar proposals. This week Senators Frank Lautenberg (D-NJ) and Chuck Hagel (R-NE) held a press conference to announce the roll out of their bill Military Retirees Health Care Protection Act S.0604. This bill would stop DoD from enacting its proposed increases in enrollment fees and co-payments for military retirees, their families and survivors under the age of 65 in TRICARE Prime and Standard. It would also stop the proposed increases in the TRICARE Pharmacy Plan for all TRICARE Beneficiaries, except active duty members. The bill differs in many ways from Representative Edwards� H.R.0579 in the House bill. That bill would limit any co-pay, deductible and fee increases to no more than the percentage of the most recent retired pay increase.� In short S.0604 would:
� Recognize in law the unique role of military health benefits in offsetting the extraordinary demands inherent in a military career.
� Establish that, in addition to their cash cost-shares, military people pre-pay large up-front premiums for their lifetime health coverage through decades of service and sacrifice.
� Prohibit the TRICARE Prime enrollment fee and TRICARE pharmacy copays from being increased in any year by a percentage that exceeds the percentage increase in military retired pay.
� Prohibit TRICARE Reserve Select premiums from being increased by a percentage that exceeds the most recent basic pay increase.
� Prohibit any enrollment fee for TRICARE Standard or any increase in the TRICARE Standard inpatient copay.
�[Source: TREA, USDR, & MOAA Updates Feb 07 ++]
GOLD STAR FAMILY LICENSE PLATES:� On 15 FEB state Senator Jeff Denham
(R-CA-Merced), a 16 year USAF veteran, introduced legislation that would
establish a special recognition vehicle license plate to honor a member of the
Armed Forces who was killed while serving on active duty in the military.
California Senate Bill 287 would allow the surviving family member to obtain a
"Gold Star Family" license plate.�
Under SB 287, a family member includes all of the following individuals:
widow, widower, biological parent, adoptive parent, stepparent, foster parent,
biological child, adoptive child, step child, sibling, half-sibling,
grandparent and grandchild.� This license
plate would contain a gold star and the words "Gold Star Family."
Currently,
UNCONDITIONAL SURRENDER COMMEMORATIVE STATUE:�� �Unconditional Surrender,� a 25-foot, 6,000
pound statue by world-renowned artist J. Seward Johnson commemorating a famous
World War II photo was unveiled 10 FEB 07 at Mole Park in San Diego.
Unconditional Surrender is a three-dimensional interpretation of a photo taken
by Alfred Eisenstaedt of a Sailor kissing a nurse in
AGENT ORANGE LAWSUITS UPDATE 09: On 16 AUG 06, the U.S. Court of Appeals for Veterans' Claims (CAVC) in the case of Haas v. VADC-Nicholson determined that Vietnam veterans who served in the waters off Vietnam and did not set foot in Vietnam are entitled to a presumption of exposure to herbicide agents, to include Agent Orange.� This class of veterans is generally known as blue water Navy veterans; but any claim, regardless of branch of service, may be a Haas case.� Prior to this decision, VA�s interpretation of 38 CFR 3.307(a)(6)(iii) was that a service member had to have actually set foot on Vietnamese soil or served on a craft in its rivers (also known as brown water) in order to be entitled to the presumption of exposure to herbicides.� VA appealed the Haas decision to the U.S. Court of Appeals for the Federal Circuit. Richard V. Spataro, Staff Attorney for the National Veterans Legal Services Program (NVLSP), has reported that the VA has been granted an extension of time from 8 JAN 07 until 21 FEB 07 to file their Federal Circuit Brief in Haas. The National Veterans Legal Services (who are representing Hass) brief will be due to be filed 40 days after the Secretary�s brief is served on NVLSP.
���� In the interim veterans who could be affected by this suit are encouraged to contact their legislators and the president by letter regarding the inequity of excluding them from Agent Orange related veteran benefits.� Following are excerpts from one such letter that has been sent which could be tailored to each veteran�s concerns:
President George W. Bush
The White House
February 06, 2007
Dear Mr. President,
���� � I am writing
to you as a fellow veteran, to enlist your assistance in righting a very
serious wrong being committed against tens of thousands of
���� Late last summer
the
���� During the decade that the Department of Veterans Affairs has been prohibiting members of this class of veterans from receiving presumptive benefits under Agent Orange legislation, thousands of veterans in this class died fighting for their benefits as well as their lives. They left behind wives, and children who went through the sad, frustrating, and agonizingly slow process of fighting for their survivors� benefits according to the VA�s rules, only to have them coldly rejected on the basis of not having set foot on the ground in the Republic of Vietnam. The withholding of these benefits from this class of veterans has created an enormous hardship on the veterans, and their families that extends beyond the mere lack of financial benefits. The hardship includes not being able to afford needed medications that could possibly have kept them alive, or at least made their last days more comfortable. The hardship includes the creation and aggravation of subsidiary conditions, especially in the case of those who suffer from Type II Diabetes, which affects the heart, lungs, kidneys, liver, eyes, nervous system, and arterial system. Type II Diabetes is a particularly insidious disease that if not treated properly will kill anyone who has it in short order.
���� There is something wrong with the logic of not taking care of an entire class of our nation�s war veterans who were presumed to be harmed by our own actions while they served in that war. To claim an inability to process the claims and an inability to pay the claims is simply un-American. For the country of �can do� to say it �can�t do� is a very grave wrong. It also sets a dangerous precedent for future generations of our nation�s warriors. I ask you to assist and support the Secretary in correcting this grave wrong. Have him stop wasting money and resources in fighting Haas on appeal, and fighting the writ of mandamus ordered by the United States Court of Appeals for Veterans Claims (Ribaudo v. Nicholson). I ask you to have him go to Congress to request emergency funding to comply with the Haas decision, and to immediately begin processing the claims of the veterans now eligible. Perhaps the Secretary could even save money by outsourcing the processing of claims for the �Blue Water Veterans.� By doing the right thing, Mr. President, you will lighten the load of tens of thousands of �Blue Water Veterans� and their families.
Thank you.
Respectfully,
[Source:� VVA Chap 602 msg dtd 14 Feb 07 ++]
VA DIABETIC RETINOPATHY SCREENING:�� Many veterans with diabetes are getting initial screening for possible eye disease during their Department of Veterans Affairs (VA) primary care appointments, thanks to a national tele-retinal imaging program now in place at the majority of VA hospitals and clinics. One out of every five VA patients has diabetes and early detection of retinal abnormalities is essential in preventing vision loss from diabetes.� This new procedure, which screens patients for diabetic retinopathy, does not take the place of a dilated eye exam.� Veterans with known retinopathy or laser treatment will be seen in eye clinics, along with high risk patients such as those with pregnancy or renal disease.� The new procedure is a good initial way, however, to identify patients at risk for visual loss from diabetes. Patients are scheduled for the imaging via the computerized patient record system (CPRS). The images taken of the retina at the clinics are sent to an image reading center, where an eye care specialist determines the need for further care.
���� Diabetic
retinopathy causes 12,000 to 24,000 new cases of blindness each year in the
TFL FACTS & TIPS:� If you�re nearing retirement, transitioning health care coverage shouldn�t be a hassle. As you�re preparing to switch to Tricare for Life (TFL), the following facts and tips will help you make a seamless transition to Tricare for Life (TFL) coverage:
-� Enroll in Medicare Part B when first eligible. TFL enrollment hinges on enrollment in Medicare Part B. You must remain enrolled in Medicare Part B (medical care) in order to maintain Tricare eligibility.
-� Keep DEERS up to date. Although Medicare provides data to DEERS, you must maintain your Tricare eligibility by keeping DEERS up to date any time there is a life changing event, like becoming eligible for Medicare. Contact DEERS online at www.dmdc.osd.mil/rsl or call 1(800) 538-9552.
-� Enrollment in TFL is seamless. If you are receiving Social Security benefits, you will transition smoothly to TFL upon your 65th birthday; if you are not receiving Social Security benefits at the time of your 65th birthday, you will need to visit the nearest Social Security office and enroll in Medicare.
-� Medicare authorized providers are also Tricare authorized. You can visit any Medicare provider for care since all Medicare providers are also TRICARE authorized. Simply show your Medicare card and Uniformed Services ID card at your appointment.
-� Claims are paid automatically between Medicare and TFL. As a TFL beneficiary, you will not need to submit a paper claim when you have a doctor�s visit (in most cases). The provider will submit the claim to Medicare. Medicare will then submit the claim to Tricare once the Medicare portion is paid.
-� TFL is considered a second payer to Medicare. For services covered by Medicare and Tricare, Medicare will pay its portion of the claim and Tricare will pay the remainder. For services that are covered by Medicare and not by Tricare (such as chiropractic care) Tricare will not make a payment and the beneficiary will be responsible.
-� Services covered by Tricare but not Medicare (such as overseas claims) may be billed directly to Wisconsin Physicians Services (WPS) and Tricare will pay as primary insurer. You will be responsible for any cost shares. Payments for services that are not covered by either program remain your sole responsibility.
-� Other health
insurance (OHI) coordinates differently with TFL and Medicare. TFL
beneficiaries who have OHI need to submit their Medicare Summary Notice with a
paper claim and OHI explanation of benefits (EOB) to Wisconsin Physician
Services. The paper claims may be sent to: Wisconsin Physician Services,
TRICARE for Life,
-� Enrollment in Medicare Part D is not necessary. The Tricare pharmacy benefit is considered creditable coverage and pays equally to Medicare. TFL beneficiaries may continue to use any of the Tricare pharmacy programs. You may fill prescriptions at any military treatment facility pharmacy, through the Tricare� Mail Order Pharmacy or through any Tricare� network or non-network pharmacy.
-� Tricare coverage continues for eligible family members after the death of a sponsor. Surviving spouses remain eligible for Tricare unless they remarry. If they remarry, they lose Tricare eligibility and cannot regain eligibility later, even in cases of divorce or death of the new spouse. Unmarried surviving children remain eligible for Tricare� until their 21st birthday (or 23rd birthday if enrolled in college full time and if at the time of the sponsor�s death, the sponsor provided more than 50% of the child�s financial support.) For more information on Tricare for Life, refer to www.tricare4u.com or call Wisconsin Physicians Services at 1(866) 773-0404.
[Source: USDR Action Alert 15 Feb 07 ++]
MILITARY BLOOD PROGRAM UPDATE 02:� The Armed Services Blood Program (ASBP) Web
site has been redesigned, offering updated content as well as a new look.� The new site, www.militaryblood.dod.mil,
features information on how to join a "Life Force" team of donors,
volunteers and supporters with topics including blood facts, donor eligibility
criteria, and donor center locations. The ASBP collects blood only from
servicemembers, government civilians, retirees and their family members. The
CELL PHONE TIPS: Things that you can do with your cell phone:
-� Emergency: The
Emergency Number worldwide for
-� Remote Keyless Entry: This may come in handy someday if your car is so equipped. If you lock your keys in the car and the spare keys are at home, call someone at home on their cell phone from your cell phone. Hold your cell phone about a foot from your car door and have the person at your home press the unlock button, holding it