From: Director, RAO Baguio [[email protected]]
Sent: Thursday, August 31, 2006 6:17 AM
Subject: RAO Bulletin Update 1 September 2006
RAO Bulletin Update
1 September 2006
THIS BULLETIN UPDATE CONTAINS THE FOLLOWING ARTICLES:
== Agent Orange Lawsuits [04] -------------- (Offshore Eligibility)
== VA Presumptive AO Illnesses [Vets] ---- (AO Impact on Vets)
== VA Presumptive AO Illnesses [Kids] ---- (AO Impact on Kids)
== Alzheimer�s [01]� --------------------------- (Early Treatment)
== TFL Claim Processing [02] ---------------- (Opt-out Providers)
== Recruiters ----------------------------- (Increase in Wrongdoing)
== Recruiters [01] ------------------------ (Sexual Misconduct)
== Social Security Name Change ------------� (New Rules)
== DFAS Contact Info [01] -------------------- (Keep Current)
== Computer Tip -------------------------------- (Email Print Size)
== American Amicable Refunds -------------- (70,000+ Vets Due)
== Expeditionary Warfare Pin [USN]� ------- (Approved 31 JUL 06)
== Air Force Enlistment -------------------- (Recruits Still Needed)
== Service Members� Rights Website� ------ (New Website)
==
== Medicare Part D [07] ----------------- (TFL Mistaken Enrollment)
== Medicare Part D [08] ----------------------- (Excluded Medicines)
== VA New York Hospitals:� ---------------- (Will Remain Open)
== COLA 2007 [05] ---------------------------- (3.4% to Date)
== TMOP [05] ------------------------- (Prescription Savings)
== Captioned Telephone:� ------------- (Hearing Impaired Vets)
== VA Claim Representation [03] ----------- (DAV Opposes S.2694)
== VA Data Privacy Breach [24] ------------- (Data to be Encrypted)
== FDA Assessment --------------------------- (Lower Enforcement)
== SBP Open Season [03] -------------------- (Last Chance)
== Tricare Allowable Charges:� -------------- (New Executive Order)
== Disabled Retiree Back Pay [02]----------- (Some in OCT)
== Medicare Physical Therapy Payments --- (Limited in 2007)
== Health Care Quality and Price ------------ (Medical Data Sharing)
== USMC Involuntary Recall --------- (Individual Ready Reserve)
== AHLTA Update [01] ---------------------- (Problem for VA)
== Beer Belly Control ------------------------- (1-2 beers a day OK)
== PI Tricare Provider Certification --------- (How to)
== Military Legislation Status ---------------- (Where we stand)
AGENT ORANGE LAWSUITS UPDATE 04:� Veterans who patrolled the waters
off
thousands of servicemen to seek medical coverage. The ruling was
handed down by the U.S. Court of Appeals for Veterans Claims in the
case of Haas v. VADC-Nicholson by a former sailor who served on an
ammunition ship during the Vietnam War but never stepped foot on
land. The court�s order, issued 16 AUG, reverses the Veterans Affairs
Department�s denial of benefits for Jonathan L. Haas, who blamed his
diabetes, nerve damage and loss of eyesight on exposure to Agent
(NVLS) argued that clouds of the toxic defoliate, which
the
sprayed on Vietnamese jungles, drifted out to sea, englfing his ship
and landing on his skin. Veterans officials said that to qualify for
coverage, Haas was required to have docked in
ashore.
���� The three-judge panel said regulations governing the benefits
were unclear. The court said it made no sense for veterans who
patrolled
the country to receive medical coverage while those serving at sea do
not. �Veterans serving on vessels in close proximity to land would
have the same risk of exposure to the herbicide Agent Orange as
veterans serving on adjacent land, or an even greater risk than that
borne by those veterans who may have visited and set foot on the land
of the
wrote. The Court did not actually award a disability to Haas, but
sent his case back to the Board for that determination.� If the Board
rules in his favor, the Court directed that his other Agent
Orange-related medical conditions also must be compensated.� The
Veterans Affairs Department said Friday that it was reviewing the
opinion and was not sure how many veterans would be affected or how
much the added coverage would cost.
���� This VCAA decision could eventually expand to cover more
veterans than the decision appears to now cover.��� During
was a short time frame where military service within the Theater of
Operations within the Vietnam War justified the Vietnam Service
Medal. This included waters off the coast {so called brown water},
deep waters for air operations {so called blue water operations},
which included loading the Agent Orange aircraft.� Most
combat veterans receive some medical benefits, but if their illnesses
are related to their service, they could receive full coverage and
their families might be eligible for benefits. David Houppert,
director of veteran�s benefits for the
said the ruling could allow thousands of veterans to seek coverage
for service-related illnesses. Most are Navy veterans, he said, but
some Marines and Army veterans could be affected. Houppert said his
group was encouraging these veterans to seek coverage quickly because
the ruling left it up to government officials whether to change
federal regulations in a way that could deny coverage.� Vets can
refer to www.vba.va.gov/bln/21/benefits/herbicide/#bm04 to review
what benefits they could be eligible for.
���� As of 20 AUG the VADC-legal office had not filed a request for a
stay order pending an appeal to the Supreme Court.� The Board of
Veterans' Appeals is sitting at the Phoenix VARO.� The senior judge
has agreed to contact his office in
guidance on implementation of this decision.� The VCAA ruling over
turned a BVA decision on Haas.� If the VADC-Sec Nicholson's office
does not appeal they have no choice but to grant service connected
for Agent Orange Presumptive Disabilities with military service with
in the theater of Vietnam war for those with the Vietnam Service
Medal.� This decision will mean a potential liability of millions of
dollars to the VA Medical budget and VA Administrative budget.
Potential claims from the wives of already deceased
could also mean considerable liability.� This helps explain why the
VADC has been slow to provide positive guidance about this VCAA
decision.� Haas is now the law of the land and therefore VA must
abide by it. However, it is possible that VA may amend their
regulations in such a way that it is adverse to veterans who
otherwise would have benefited from the court�s decision.� Service
organizations are recommending that other veterans like Mr. Haas who
served offshore but did not set foot in
diseases or conditions that they believe to be caused by exposure to
Agent Orange should consider filing a claim for disability.� Members
who have had such claims denied may wish to re-file based on the
Court's decision.� Veterans are encouraged to seek the advice and
assistance of an experienced veterans' service organization before
proceeding. [Source: Associated Press article 18 Aug� &
Department of Veterans' Services msg 23 Aug 06 ++]
VA PRESUMPTIVE AO ILLNESSES [VETS]:� The following health conditions
are presumptively recognized for service connection.
with any of these conditions do not have to show that the illness is
related to their military service to get disability compensation. A
current medical diagnosis of the condition and a DD Form 214 showing
Vietnam Service is normally all that is needed to accompany a
completed Veterans Application For Compensation or Pension VA Form
Number 21-526.
1. Chloracne (must occur within 1 year of exposure to Agent Orange).
Chloracne is a skin condition that looks like common forms of acne
seen in teenagers. The first sign may be excessive oiliness of the
skin. This is accompanied or followed by numerous blackheads. In mild
cases, the blackheads may be limited to the areas around the eyes
extending to the temples. In more severe cases, blackheads may appear
in many places, especially over the cheekbone and other facial areas,
behind the ears, and along the arms.
2. Non-Hodgkin�s lymphoma. A group of malignant tumors (cancers) that
affect the lymph glands and other lymphatic tissue. These tumors are
relatively rare compared to other types of cancer, and although
survival rates have improved during the past two decades, these
diseases tend to be fatal.
3. Hodgkin�s disease.� A malignant lymphoma characterized by
progressive enlargement of the lymph nodes, liver, and spleen, and by
progressive anemia.
4. Kaposi's sarcoma or mesothelioma
5. Soft tissue sarcoma other than osteosarcoma and chondrosarcoma. A
group of different types of malignant tumors (cancers) that arise
from body tissues such as muscle, fat, blood and lymph vessels, and
connective tissues (not in hard tissue such as bone or cartilage).
These cancers are in the soft tissue that occurs within and between
organs.� The following conditions fall under the term "soft-tissue
sarcoma):
�� ������� a. Adult fibrosarcoma
b. Dermatofibrosacoma protuberans
c. Malignant fibrous histicytoma
d. Liposarcoma
e. Leiomyosarcoma
f. Malignant granular cell tumor
g. Alveolar soft part sarcoma
h. Rhabdomysarcoma
i. Ectomesenchymoma
j. Malignant glomus tumor
k. Malignant hemangiopericytoma
l. Malignant Schwannoma
m. Malignant mesenchymoma
n. Epithelioid sarcoma
o. Extraskeletal Ewing's sarcoma
�� ������ p. Congenital and infantile fibrosarcoma
������ q. Malignant ganglioneuroma
������ r.� Epitheloid Leiomysarcoma (malignant meiomyblastoma)
������ s. Angiosarcoma (hemangiosarcoma and lymphagiosarcoma)
������ t.� Proliferating (systemic) angioendotheliomatosis
������ u. Clear cell sarcoma of tendons and aponeuroses
������ v. Synovial sarcoma (malignant synovioma)
������ w. Malignant giant cell tumor of tendon sheath
6. Porphyria cutanea tarda (must occur within 1 year of exposure.)
Porphyria cutanea tarda is a
�� disorder characterized by liver dysfunction and by thinning and
blistering of the skin in sun-exposed areas.
7. Multiple myeloma.� A cancer of specific bone marrow cells that is
characterized by bone marrow
�� tumors in various bones of the body.
8. Respiratory cancers, including cancers of the lung, larynx,
trachea, and bronchus. (Previously
�� these conditions must have manifested within 30 years of the
veteran's departure from
limit has now been eliminated.
9. Prostate cancer. A cancer of the prostate and one of the most
common cancers among men.
10.�� Peripheral neuropathy (transient acute or subacute. It must
appear within 1 year of exposure and
�� resolve within 2-years of date of onset.) A nervous system condition
that causes numbness, tingling, and muscle weakness. This condition
affects only the peripheral nervous system, that is, only the nervous
system outside the brain and spinal cord. Only the transient acute
(short-term) and subacute forms of this condition (not the chronic
persistent form) have been associated with herbicide exposure.
11.�� Diabetes mellitus: Often referred to as Type 2 diabetes: A
condition characterized by high blood
�� sugar levels resulting from the body�s inability to respond properly
to the hormone insulin.
12.�� Chronic lymphocytic leukemia (Final rule and regulations
pending). A disease that progresses
slowly with increasing production of and older) who live in areas
where it�s offered.
VA health care providers occasionally see combat veterans with
multiple unexplained symptoms or difficult-to-diagnose illnesses that
can cause significant disability. Two VA centers offer specialized
evaluations for combat veterans with disabilities related to these
difficult-to-diagnose illnesses. The War Related Illness and Injury
Study Centers - WRIISCs (pronounced �risks�) are at the VA Medical
Centers in
deployed to combat zones, served in areas where hostilities occurred,
or were exposed to environmental hazards while on duty may be eligible
for services. [Source: NAUS Weekly Update for 22 AUG 03 & POVA VSO msg
28 JUL 04]
VA PRESUMPTIVE AO CONDITIONS [KIDS]:� The following health conditions
are presumptively recognized in children of veterans for service
connection.
do not have to show that their illness is related to their parent�s
military service to get disability compensation. A current medical
diagnosis of the condition and a DD Form 214 showing the parent�s
Vietnam Service is normally all that is needed to accompany a
completed Veterans Application For Compensation or Pension VA Form
Number 21-526.
�� Spina bifida (except spina bifida occulta): A neural tube birth
defect that results from the failure of the bony portion of the spine
to close properly in the developing fetus during early pregnancy.
�� Other (than spinal bifida) disabilities in the children of women
identified by VA as a birth defect associated with the service of
women
that has resulted, or may result, in permanent physical or mental
disability. However, the term does not include a condition due to a
familial (this is, inherited) disorder; birth-related injury; or
fetal or neonatal infirmity with other well-established causes.
Covered birth defects include, but are not limited to, the following
conditions:
1) achondroplasia,
2) cleft lip and cleft palate,
3) congenital heart disease,
4) congenital talipes equinovarus (clubfoot),
5) esophageal and intestinal atresia,
6) Hallerman-Streiff syndrome,
7) hip dysplasia,
8) Hirschprung�s disease (congenital megacolon),
9) hydrocephalus due to aqueductal stenosis,
10)�� hypospadias,
11)�� imperforate anus,
12)�� neural tube defects,
13)�� Poland syndrome,
14)�� pyloric stenosis,
15)�� syndactyly (fused digits),
16)�� tracheoesophageal fistula,
17)�� undescended testicle, and
18)�� Williams syndrome.
** Not covered are conditions that are congenital malignant
neoplasms, chromosomal disorders, or developmental disorders. In
addition, conditions that do not result in permanent physical or
mental disability are not covered birth defects. All birth defects
that are not excluded under the language above are covered birth
defects. (Source: Extracted from Agent Orange Review, Vol. 19, No 2,
Dated July 2003)
ALZHEIMER�S UPDATE 01:� If treatment to prevent Alzheimer's disease
is going to work, it may have to begin in middle age � or even
younger, new research by Seattle scientists suggests. The researchers
found that in people genetically prone to Alzheimer's, significant
amounts of a brain-clogging protein start moving from the spinal
fluid to the brain at about age 50 or younger.� Previous research has
indicated that Alzheimer's begins years before symptoms appear. But
this latest work by Dr. Elaine Peskind, associate director of the
University of Washington Alzheimer's Disease Research Center at the
VA Puget Sound Health Care System in Seattle and her colleagues is
the first to look at early signs across a wide range of ages � from
21 to 88. The research is particularly significant because scientists
predict a dramatic increase in Alzheimer's in the decades ahead. About
4.5 million people in the United States have the disease, and
researchers say that could increase to 16 million by 2050.
��� Peskind and scientists from five other medical centers analyzed
the effects of aging and the presence of a gene connected to
Alzheimer's, APOE4, on 184 adult volunteers with an average age of 50
and all mentally normal. People with the APOE4 gene have a higher
Alzheimer's risk because it produces a sticky protein, called beta
amyloid, in the form of a plaque that is thought to damage brain
cells.� Among the volunteers with the gene, the level of one
important form of the protein in the spinal fluid was dramatically
lower in participants 50 and older than in the younger ones. The
decline in levels possibly begins in young adulthood in those with
the gene, the scientists report in the July edition of the Archives
of Neurology. Among the volunteers without the gene, the protein
levels dropped slowly into old age. About a quarter of the population
has the APOE4 gene, though there are other physical factors that also
influence whether a person develops the disease.
���� Peskind said more research is needed to confirm the study's
findings. As part of that effort, the scientists will follow about
half of the participants, those older than 60, to see which ones
develop Alzheimer's and to analyze more spinal-fluid samples. She
predicts that spinal-fluid tests someday could help identify who will
develop Alzheimer's. Because there is no cure or vaccine for
Alzheimer's, such tests would be unwise now, because they could
affect whether someone could obtain health insurance or
long-term-care insurance, she said. The four prescription drugs now
available for Alzheimer's merely ease the symptoms for a few years.
Other drugs are under investigation, including two at the UW. One is
to remove the plaque. The other is to prevent its production. But
Peskind predicts it will be many years before a major drug will be
available to prevent or control the disease but believes that within
10 years, it will definitely be possible. [Source:� Seattle Times
medical reporter Warren King 11 JUL 06]�
TFL CLAIM PROCESSING UPDATE 02:� TRICARE For Life (TFL) beneficiaries
are strongly encouraged to find out what type of Medicare provider
they have prior to making an appointment with their health care
professional. If you don't, you may wind up paying more than you
think. Medicare currently has three types of providers:
-� Opt-out providers:� Opt-out providers have chosen to not see
Medicare patients and cannot submit claims to the Medicare program.
They are considered nonauthorized and nonparticipating. If you use a
nonauthorized provider, you will be responsible for the full bill,
including the portion TRICARE would have paid.
-� Participating providers:� Participating providers are
Medicare-authorized providers who agree to accept the
Medicare-allowable charge as payment in full, and who agree to file
claims.
-� Nonparticipating providers: A nonparticipating provider does not
agree to accept the allowable charge as payment in full, and may or
may not file claims.
Beginning 5 JUN 06, a small number of TFL beneficiaries who were
treated by providers who "opted-out" saw their claims denied by both
Medicare and Tricare. This was incorrect. The TFL claims processor
will automatically reprocess those claims that were improperly
denied. No action by the beneficiary is necessary. Tricare will
continue to pay claims at the Tricare Standard rate for any
Medicare-eligible beneficiary who is treated by a provider who has
opted-out of Medicare only until 30 SEP 06. After that date, a TFL or
Dual Eligible beneficiary who seeks care from a provider who has opted
out of Medicare will be responsible for the entire bill.
���� About 93% of all doctors accept Medicare patients (and therefore
also accept Tricare for Life). Although your present providers might
be participating at the moment, come 1 JAN 07 many could decide to
opt out of Medicare because of the scheduled 5.1% reduction in fees
to be paid by Medicare after that date. When Medicare fees are cut,
TFL payments are also reduced thus making it less desirable for
providers to see a military retiree/spouse/surviving spouse. An AMA
survey of providers in early 2006 indicated that if the payment cuts
kick in, 45% of physicians plan to either stop accepting or decrease
the number of new Medicare patients and 43% will either stop
accepting or decrease the number of new Tricare patients. This
government action and the recently implemented Tricare third tier
pharmaceutical copay upgrades is making the lifetime medical care
benefit of retirees much more restrictive and costly to users. To
find out what type of health care provider you have, call Medicare
toll-free at 1(800) 633-4227. The November elections will give
veterans an opportunity to show Congressional incumbents what they
think of their actions that have allowed this erosion of our health
care benefit. [Source: MOAA News Exchange 16 Aug 06 ++]
RECRUITERS:� As the military struggled to attract new troops to fill
its billets, instances of wrongdoing by recruiters skyrocketed
between fiscal 2004 and fiscal 2005, Government Accountability Office
(GAO) investigators concluded in a report released 14 AUG.� Ongoing
operations in Iraq and Afghanistan, coupled with low U.S.
unemployment rates, have made lining up new enlistments a challenging
duty, compelling some recruiters to employ illegal or unethical
tactics to meet their quotas.� Cases of wrongdoing vary widely,
ranging from paperwork errors to serious allegations, such as sexual
harassment, falsifying documents and concealing serious medical
conditions. In May, for instance, The Oregonian reported that the
Army had accepted an autistic recruit and signed him up to become a
cavalry scout. The recruit has since been discharged.� The GAO
reported last year, allegations of wrongdoing among the military's
22,000 recruiters grew by 50% over fiscal 2004 claims, while
substantiated cases increased by more than 50%. Criminal violations,
meanwhile, jumped by more than 100%,
����� The actual number of cases of wrongdoing may be even higher
than the number provided by GAO, whose investigators concluded that
many of the services do not have an effective way to track complaints
and allegations. They contend DoD is not in a sound position to assure
the general public that it knows the full extent to which recruiter
irregularities are occurring.� Its investigation follows two other
reports in 1997 and 1998 that recommended the military improve
performance among recruiters and reduce the number of violations by
rewarding recruiters for every enlistee's successful completion of
basic training rather than the number of enlistment contracts written
for applicants they attracted.
���� Rep. Fortney Stark (D-CA) said in a statement 14 AUG that, �DoD
has twice ignored GAO recommendations on how best to account for and
limit recruiters' violations. This third inquiry confirms the two
prior reports' findings and demands immediate action."� Stark, who
requested the report with House Armed Services Personnel Subcommittee
ranking member Vic Snyder (D-AR) urged the military to take overdue
steps to enforce the Uniformed Code of Military Justice and called on
the House Armed Services Committee to increase oversight on the
matter. In 2005, the Army, Army Reserve and Navy Reserve failed to
meet recruiting goals, however DoD reported last week that all
services met or exceeded their recruiting targets for JUL 06.
[Source: GOVEXEC.com Daily Briefing 14 Aug 06 ++]
RECRUITER MISCONDUCT UPDATE 01:� More than 100 young women who
expressed interest in joining the military in the past year were
preyed upon sexually by their recruiters. Women were raped on
recruiting office couches, assaulted in government cars and groped en
route to entrance exams. A six-month Associated Press investigation
found that more than 80 military recruiters were disciplined last
year for sexual misconduct with potential enlistees. The cases
occurred across all branches of the military and in all regions of
the country.� At least 35 Army recruiters, 18 Marine Corps
recruiters, 18 Navy recruiters and 12 Air Force recruiters were
disciplined for sexual misconduct or other inappropriate behavior
with potential enlistees in 2005, according to records obtained by
the AP under dozens of Freedom of Information Act requests. That�s
significantly more than the handful of cases disclosed in the past
decade. The AP also found:
�� The Army, which accounts for almost half of the military, has had
722 recruiters accused of rape and sexual misconduct since 1996.
�� Across all services, one out of 200 frontline recruiters - the ones
who deal directly with young people - was disciplined for sexual
misconduct last year.
�� Some cases of improper behavior involved romantic relationships,
and sometimes those relationships were initiated by the women.
�� Most recruiters found guilty of sexual misconduct are disciplined
administratively, facing a reduction in rank or forfeiture of pay;
military and civilian prosecutions are rare.
�� The increase in sexual misconduct incidents is consistent with
overall recruiter wrongdoing, which has increased from just over 400
cases in 2004 to 630 cases in 2005, according to a General Accounting
Office report released this week.
���� The Pentagon has committed more than $1.5 billion to recruiting
efforts this year. Defense Department spokeswoman Lt. Col. Ellen
Krenke insisted that each of the services takes the issue of sexual
misconduct by recruiters very seriously and has processes in place to
identify and deal with those members who act inappropriately. In the
Army 53 of 8000 recruiters were charged with misconduct last year.
Recruiting spokesman S. Douglas Smith said the Army has put much
energy into training its staff to avoid these problems.
���� For this story, the AP interviewed victims in their homes and
perpetrators in jail, read police and court accounts of assaults and
in one case portions of a victim�s journal. A pattern emerged. The
sexual misconduct almost always takes place in recruiting stations,
recruiters apartments or government vehicles. The victims are
typically between 16 and 18 years old, and they usually are thinking
about enlisting. They usually meet the recruiters at their high
schools, but sometimes at malls or recruiting offices. Not all of the
victims are young women. A former Former Navy recruiter is serving a
12-year sentence for molesting three male recruits. One of the
victims is suing him and the Navy for $1.25 million. The trial is
scheduled for next spring. All of the recruiters the AP spoke with
said they were routinely alone in their offices and cars with girls.
���� Although the Uniform Code of Military Justice bars recruiters
from having sex with potential recruits, it also states that age 16
is the legal age of consent. This means that if a recruiter is caught
having sex with a 16-year-old, and he can prove it was consensual, he
will likely only face an administrative reprimand. But not under new
rules set by the Indiana Army National Guard. There, a much stricter
policy, apparently the first of its kind in the country, was
instituted last year after seven victims came forward to charge a
National Guard recruiter with rape and assault. Now, the 164 Army
National Guard recruiters in Indiana follow a �No One Alone� policy.
Male recruiters cannot be alone in offices, cars, or anywhere else
with a female enlistee. If they are, they risk immediate disciplinary
action. Recruiters also face discipline if they hear of another
recruiter�s misconduct and don�t report it. At their first meeting,
National Guard applicants, their parents and school officials are
given wallet-sized �Guard Cards� advising them of the rules. It
includes a telephone number to call if they experience anything
unsafe or improper. [Source: Military.com AP article 21 Aug 06 ++]
SOCIAL SECURITY NAME CHANGE:� A new law, the Intelligence Reform and
Terrorism Prevention Act, includes several provisions that change
rules for assigning a Social Security number and issuing a Social
Security card. This Social Security changes became effective 17 DEC
05. It is important to know the rules for getting a replacement
Social Security card before you apply. If you need to change your
name on your Social Security card, you must show proof of your legal
name change. SSA can accept the following documents as proof of the
legal name change: marriage document, divorce decree stating you may
change your name, Certificate of Naturalization showing your new
name, or a court order for a name change.
���� In the past, you could change the name by showing your driver's
license with the old name and the document giving the reason for the
name change.� The change now requires an extra step. You must change
your name on your driver's license first so that SSA can see a
document with the new name already on it. You can then use your old
license, the new license (not the temporary license), and the
document authorizing the name change.� If the document authorizing a
name change has enough information on it to identify you, then you
can get the name changed on your Social Security card without having
to change it on your driver's license first. Proof of identification
must include the applicant�s name and date of birth, Social Security
number, age, parents� names, or a photograph. Some name change
documents do not contain this information, so people will have to
change the name on their driver's license before changing it on their
Social Security card. SSA must see original or certified copies of
your documents. Photocopies are not accepted.
���� These new rules help ensure that only those who should receive a
Social Security number do so.� They make Social Security numbers less
accessible to those with criminal intent and prevent individuals from
using false or stolen birth records or immigration documents to obtain
a Social Security number. SSNs have never been reissued after their
owner�s death even though over 420 million SSNs have been issued to
date.� The current numbering system will provide enough new numbers
for several generations into the future with no changes in the
numbering system. [Source: www.seniorjournal.com 14 Aug 06]
DFAS CONTACT INFO UPDATE 01:� The Defense Accounting and Finance
Service (DFAS) reminds all military retirees and annuitants to review
their retirement or annuitant pay account status to ensure all
information is up-to-date. DFAS relies on current personal
information to provide their customer service. Officials emphasize
that it�s imperative that retirees notify the agency as soon as
possible about any change in marital or family status, beneficiaries,
mailing address and bank account information.� This ensures that the
individual�s retirement pay is processed correctly and on time. If
beneficiary information needs to be updated, customers can access the
new Designation of Beneficiary form online at
http://www.dod.mil/dfas/retiredpay/beneficiarycard.html. Changes to
much of a retiree�s pay account can be made via myPay AT
http:/mypay.dfas.mil or by calling the Retired/Annuitant Pay Customer
Service Center at 1(800) 321-1080.� Retirees may also send an e-mail
via myPay or by regular mail to: DFAS, U. S. Military Retirement Pay,
�P. O. Box 7130, London, KY 40742-7130. Any account changes must be
completed and submitted by the end of November 2006 in order to be
effective for the end-of-year processing (1099R�s, RAS�s, etc.). This
includes both retired and annuitant pay accounts. [Source: Air Force
Retiree News Service 17 Aug 06]
COMPUTER TIP:� Having trouble reading the small print in the text of
your oncoming messages.� If so, hold down the Ctrl key on your key
board and turn the small wheel in the middle of your mouse.� This
will change the print size to either larger or smaller depending on
which way you turn the wheel.� [Source Tom Kelly, Las Vegas msg 14
Aug 06]
AMERICAN AMICABLE REFUNDS:� More than 70,000 service members and
former service members are due some $70 million in refunds or policy
upgrades based on a settlement between American Amicable Insurance
Co. on one side and the Justice Department, insurance commissioners
from 42 states, Washington, D.C., and Guam, and the Securities and
Exchange Commission on the other. American Amicable does not have to
admit to or deny allegations that it improperly marketed and sold
insurance to junior ranking service members.� However, American
Amicable may not do business on U.S. military bases for five years.
In addition, the company is barred from:
-� Using allotment or MyPay forms for insurance premium funding;
-� Accepting applications from soldiers in pay grades E-1 through E-3
without proof they have been counseled according to Army regulations;
and
-� Offering gifts worth more than $5 to those with direct authority
over service members in pay grades E-1 through E-4.
[Source: Armed Forces News 18 Aug 06 & www.gainsurance.org. ]
EXPEDITIONARY WARFARE PIN:� The Navy�s Enlisted Expeditionary Warfare
(EXW) Specialist qualification program and pin were approved 31 JUL
06. The pin, which will be equivalent to the Navy�s other warfare
qualification designations, could be initially awarded to as many as
40,000 Sailors within six months. The EXW pin will be available to
Sailors assigned to SEAL units under Navy Special Operations Command
if the units institute a qualification program to be mandated by a
pending Navy instruction. According to Command Master Chief (EWS/SW)
of the Naval Expeditionary Combat Command (NECC). the pin will not be
available initially to Sailors on individual augmentee (IA) tours with
the Army because it is being established for Sailors qualifying with
expeditionary skills involved with maritime security. That exclusion
could change if the IA program moves to the NECC.� [Source: Armed
Forces News 18 Aug 06]
AIR FORCE ENLISTMENT:� The Air Force says that, despite rumors to the
contrary, the service is still recruiting. Next year�s recruiting
goals have been reduced by nine percent in comparison to the numbers
sought in 2006. Nevertheless, according to the Air Force Recruiting
Service Operations Division superintendent, the Air Force is still
hiring a mix of people in all of its career fields.� The service is
seeking 27,760 high school graduates or the equivalent, ages 17-28,
to join its enlisted ranks from October to September 2007. The Air
Force is also looking for 482 college graduates to join its officer
corps. The most available positions are pilot, combat systems officer
(navigator), air battle management and electrical engineering. After
the 482 Officer Training School positions are filled, additional
applications will move out to fill the following year�s jobs. For
more information about Air Force careers, visit www.airforce.com.
[Source: Armed Forces News 18 Aug 06]
SERVICE MEMBERS� RIGHTS WEBSITE:� Attorney General Alberto R.
Gonzalez announced 14 AUG a new Web site that would help the Justice
Department keep civil rights laws for American service members a
priority.� The Justice Department Web site, www.servicemembers.gov,
outlines the rights service members have under the Uniformed Services
Employment and Reemployment Rights Act, the Uniformed and Overseas
Citizens Absentee Voting Act and the Service Members Civil Relief
Act.� The attorney general said these are not just �pie in the sky�
rights, but issues that directly affect people. Mr. Gonzales urged
any service member with questions to go to the Justice Department Web
site. Military lawyers can help service members and their families
navigate through the laws. [Source: NGAUS NOTES 18 Aug 06]
WALTER REED ARMY MEDICAL CENTER:� Officials at Walter Reed Army
Medical Center announced 16 AUG the construction of a temporary
medical annex at the hospital to provide better facilities for
wounded troops undergoing post-amputation care. The
30,000-square-foot addition is being built onto Walter Reed�s general
medical facility building and will be called the U.S. Army Amputee
Patient Care Center. According to retired Col. Charles Scoville, the
future director of the annex upon completion will improve the
capabilities to return soldiers to the highest level of function. The
annex will provide better facilities and equipment as well as
additional room. Groundbreaking for the facility has been initiated
with completion slated by OCT 07.� Walter Reed�s amputee care
facility mostly treats wounded soldiers since the war on terror
began, as well as some Marines transferred from the National Naval
Medical Center, in Bethesda, MD. The daily amputee care caseload
averages eight to 10 inpatients and around 75 to 100 outpatients.
The facility admits 10 to 15 new patients each month. Walter Reed
will close in 2011 as part of the 2005 Base Realignment and Closure
Act. Amputee recovery services at Walter Reed will be moved into a
new joint medical facility to be built in Bethesda, and other
patients will be moved to Fort Belvoir VA. [Source: NGAUS NOTES 18
Aug 06]
MEDICARE PART D UPDATE 07: Per Express Scripts, some people that are
Tricare For Life members were automatically enrolled in Part D and
are now experiencing difficulties getting their prescriptions. The
number automatically enrolled is unknown but there are 129,000
Tricare beneficiaries that are enrolled in Part D. Very few actually
benefit from Part D unless they qualify for Part D with no premiums.
Express Scripts is recommending the pharmacy process the Rx under
Part D and then it will go to Tricare for the balance.� Beneficiaries
are told to contact Medicare to disenroll from Part D and obtain a
letter from Medicare. The letter then should be faxed to (831) 583
2340 Defense Manpower Data Center (DMDC) (formerly DSO) and the Part
D will be removed from DEERS within 24 hours. DMDC can also
accommodate DEERs change of address inputs at
www.dmdc.osd.mil/udpdri/owa/change.address.� Express Scripts is
working with TMA to determine the best resolution of the inadvertent
TFL user�s automatic Part D signup. [Source: NAUS Weekly Update 18
Aug 06 ++]
MEDICARE PART D UPDATE 08: Under the 2003 Medicare drug legislation,
coverage was provided for most medically necessary drugs.� Yet
millions of seniors are learning which prescription medications are
covered under their drug plans and which are not.� Considerable
attention has been devoted to the fact that Part D plans are
permitted to limit the coverage of drugs through the use of
formularies, �step therapy� (requiring that patients first try less
expensive drugs), prior authorization, and quantity limits. Less well
known, however, is the fact that nine entire categories of drugs were
excluded under the Medicare Modernization Act of 2003 Part D
legislation.� Medicare will not cover them under any circumstance.
These excluded drugs include:
1. Agents when used for anorexia, weight loss, or weight gain
2. Agents when used to promote fertility
3. Agents when used for cosmetic purposes or hair growth
4. Agents when used for the symptomatic relief of cough and colds
5. Prescription vitamins and mineral products, except prenatal
vitamins and fluoride preparations
6. Nonprescription drugs
7. Outpatient drugs for which the manufacturer seeks to require
associated tests or monitoring services be purchased exclusively from
the manufacturer or its designee as a condition of sale
8. Barbiturates
9. Benzodiazepines
Some of the drugs have been the subject of controversy for years, and
this no doubt led to their exclusion.� Those drugs have significant
side effects that may be exacerbated in older patients, such as
over-sedation causing falls and hip fractures, and addiction.� In
addition, when Congress considered legislation to add a prescription
drug benefit, many of the major bills advanced by both Democrats and
Republicans adopted some or all of the categories of drugs that are
excluded under state Medicaid programs, and excluded them from
coverage under Medicare.� The TRAS Senior citizens League (TSCL)
questions some of the exclusions.� Particularly those of drugs that
are currently covered under most state Medicaid programs.� The
blanket exclusion of medically necessary drugs could result in
serious harm to Medicare beneficiaries who really need them.� TSCL is
studying the issue and believes that certain categories could be
legitimately modified by the Secretary of the Department of Health
and Human Services, for coverage under Part D.� [Source: TSCL Social
Security Advisor 26 Aug 06]
VA NEW YORK HOSPITALS:� VA Secretary Nicholson announced that the VA
will keep both the Manhattan and the Brooklyn VA medical centers open
and will make major renovations and improvements at the St. Albans VA
Medical Center in Queens. There has been an ongoing 2 year analysis
studying if the centers should be consolidated. The decision was
based both for the convenience of the veterans and the VA�s desire to
continue retain its close ties with NYU�s Medical School and the
medical school of the State University of New York. The Secretary
also said he wanted to personally thank the local advisory panels for
the Manhattan/Brooklyn study and the St. Albans study, along with many
others, including the New York congressional delegation, veterans
groups, city and state leaders, other stakeholders and VA employees
which have guided VA in these decisions [Source:� TREA Leg Up 18 Aug
06]
COLA 2007 UPDATE 05:. In mid-August, the Bureau of Labor Statistics
announced the JUL 06 monthly Consumer Price Index (CPI), which is
used to calculate the annual cost-of-living adjustment (COLA) for
military retired pay, VA disability compensation, survivor annuities,
and Social Security. The CPI continued its upward trend, rising
another 0.3% in July -- for a cumulative increase of 3.4% so far this
fiscal year.� Once again, a large share of the increase was due to a
jump in energy prices. The July CPI-W contained a 3.1% increase in
energy costs and a 1.8% increase in transportation costs which
influenced the increase in inflation. Last year, the CPI had risen
3.2% through the month of July and ended up the year at 4.1%. With
inflation running slightly ahead of last year's pace so far, it would
seem likely that we'll end this year in the same ballpark. We can
still hope that inflation in the last two months of this year may not
match last year's experience, when Hurricane Katrina sent energy
prices soaring. For more information, For more information, visit
www.moaa.org/controller.asp?pagename=lac_issues_second_career_cola
[Source: MOAA Leg Up 18 Aug 06]
TMOP UPDATE 05:� Tricare's mail-order pharmacy (TMOP) is getting a
lot of legislative attention, and military beneficiaries would do
well to pay attention.� Each prescription dispensed through the
mail-order system saves the Pentagon an average of $50 to $150
dollars, depending on what's counted.� Also, those who use TMOP save
67% because they get a three-month supply for the same copayment that
buys only a one-month supply in a retail pharmacy. But for whatever
reason, only 6% of prescriptions are currently filled through the
mail-order system, and the most rapid growth is in the retail system
� the one that's most expensive for both the government and
beneficiaries.
MOAA believes there are several reasons for underutilization of the
TMOP, including a lack of publicity about it by the Defense
Department and beneficiaries' reluctance to change what has worked
for them in the past, even if the change would save them a modest
amount of money.
���� The cost difference is a big deal for the government, and
Congress is determined to do all it can to encourage use of the
much-cheaper mail-order program. One way is to significantly sweeten
the program for beneficiaries, and both the House and the Senate put
provisions in the FY2007 Defense Authorization Bill that will
eliminate any copayment for most drugs obtained through the
mail-order system. That should make using the mail-order system a
no-brainer for the vast majority of people who use long-term
maintenance medications.� Why pay a copayment or make an extended
trip to a military installation if you can get the same medications
delivered right to your doorstep -- for free? But some in Congress
aren't convinced that voluntary incentives will generate enough
migration to TMOP.� So the Senate also passed a provision that would
require military beneficiaries to obtain all refill prescriptions of
maintenance medications through TMOP.� The Military Coalition (TMC)
thinks that's going too far.� There are some instances when the
mail-order system isn't appropriate or efficient - such as when the
doctor changes the dosage or when replacing lost medication.
�
������ Another way to reduce government costs is to require drug
companies to provide the defense department the same prices through
the retail system that it charges for drugs dispensed through
military and VA facilities.� The Senate version of the defense bill
would do that, but the Administration's Office of Management and
Budget is opposing that provision - seemingly putting the interests
of the drug companies ahead of the Defense Department's. TMC supports
the Senate provision requiring reduced retail drug prices and heartily
endorses elimination of any beneficiary copayments for drugs obtained
through the mail-order system.� TMC opposes mandatory refills of
maintenance medications through the mail-order system.� That doesn't
allow enough latitude for individual circumstances - especially when
White House budgeteers are taking the drug companies� side in
opposing consistent price discounts for all military-purchased drugs.
Our legislators need to be told by their constituents how they feel
about the NDAA proposed changes.� It is not too late to influence the
Compromise Committee�s vote on the 2007 NDAA content.� [Source: MOAA
Leg Up 18Aug 06]
CAPTIONED TELEPHONE:� Captioned Telephone (CapTel) service is
available in the vast majority of states, for the hearing impaired.
This is a new telephone technology that allows people to receive
word-for-word captions of their telephone conversations. It is
similar in concept to Captioned Television, where spoken words appear
as written text for viewers to read. The CapTel phone looks and works
like any traditional phone, with callers talking and listening to
each other, but with one very significant difference of captions
being provided live for every phone call. The captions are displayed
on the phone's built-in screen so the user can read the words while
listening to the voice of the other party.� Thus, if the CapTel phone
user has difficulty hearing what the caller says, he can read the
captions for clarification. In many states, CapTel equipment is
provided free or at a reduced rate to people with hearing loss. You
can check the specifics of your state at
www.captionedtelephone.com/availability.phtml. There is no cost for
using the CapTel captioning service which is provided free as part of
your state's relay service. Veterans and retired federal (civilian &
military) employees can qualify for a free CapTel phone if they:
-� Have a hearing loss; and
-� Complete an application form availble at
www.captionedtelephone.com/Federal_CapTel_Vet_App.pdf; and
-� Submit offical verification of their retirement status (i.e.
DD-214, SF50 or other official verification)
Signed applications should be mailed to: Sprint-Federal Relay, Attn:
Free CapTel Phone, 401Ninth St., NW, Ste 400, Washington DC or via
Fax to (202) 585-1841.� Federally recognized U.S. Tribal member are
also eligible. For additional information refer to
www.captionedtelephone.com.� [Source: Paul Hart msg 15 Aug 06]
VA CLAIM REPRESENTATION UPDATE 03:� According to Disabled American
Veterans National Commander Bradley S. Barton, federal legislation
that would allow lawyers to charge veterans for helping them file a
claim for benefits from the Department of Veterans Affairs is
unnecessary and would increase costs to veterans.� Barton, who is
himself an attorney and a veteran�s advocate, said veterans should
not have to hire and pay a lawyer to help them with the largely
administrative claims process which is designed to be open, informal
and helpful to veterans.� He disagrees with what the Senate passed
Veterans� Choice of Representation Act would do because:
-� Involvement of lawyers would increase costs to veterans and to the
VA without significantly improving the process.
-� The VA is required to assist veterans in completing and filing the
relatively informal application for benefits and then takes the
initiative to advance the claim through the appropriate steps.
-� Veterans can get free help from the DAV�s professionally trained
National Service Officers or other organizations in navigating the VA
claims process.
���� The VA is also opposed to the legislation, noting that attorney
fees would consume significant amounts of payments under programs
meant to benefit veterans.� If enacted the VA would have to create a
substantial new bureaucracy to perform the additional accreditation
and oversight responsibilities. Instead the VA should use its scarce
resources to hire more claims adjudicators and provide them with the
training needed to improve the quality as well as timeliness of
decisions.� Unfortunately there has been no indication that the VA
would take this tack and the backlog of claims continues to grow.
Congress placed the duty on the VA to ensure all alternative theories
of entitlement are exhausted and all laws and regulations pertinent to
the case are considered and applied. Under present regulations
veterans may hire an attorney for advice and counseling prior to
filing a claim for benefits or after the VA administrative
proceedings have been completed.
���� There does not appear to be any evidence that attorneys would
provide service superior to that rendered by veterans service
organization (VSO) representatives. In fiscal year 2005, the Board of
Veterans� Appeals granted one or more of the benefits sought in 21.3%
of the appeals in which claimants were represented by attorneys, who
have the luxury of hand picking their clients. The board granted one
or more of the benefits sought in 22.3% of the cases in which a
claimant was represented by a veterans� service organization.� The
1.3 million-member Disabled American Veterans, a non-profit
organization founded in 1920 and chartered by the U.S. Congress in
1932, represents this nation�s disabled veterans. Its sole purpose is
building better lives for our nation�s disabled veterans and their
families.� [Source: DAV News Release 18 Aug 06 ++]
VA DATA PRIVACY BREACH UPDATE 24:� Although some might think of it as
locking the barn door after the horse got out, the VA announced 14 AUG
it will be improving data encryption on its computer systems to make
it harder to copy or misuse personal information. VA Secretary R.
James Nicholson announced a $3.7 million contract was signed 1 AUG
with a Syracuse, N.Y., business, SMS Inc., which is a small business
owned by a disabled veteran.�� Under the contract, all computers will
receive encryption programs, starting with laptops and then desktops.
Devices that transfer data, such as compact discs, portable hard
drives and flash drives, also will have security encryption. The VA
announcement said. two software programs will be used which are now
undergoing final tests. Program installation on laptops could start
as early as 18 AUG. The statement estimates it will take four weeks
for installation on all VA laptop computers. [Source: NavyTimes staff
writer Rick Maze article 14 Aug 06 ++]
FDA ASSESSMENT:� Timed to coincide with the Food and Drug
Administration�s (FDA) 100th anniversary, a new report by Rep. Henry
A. Waxman (D-CA) examines how the Bush Administration has carried out
FDA�s enforcement responsibilities.� The report is based on a 15-month
investigation that included a review of thousands of pages of internal
agency records. Concluding that FDA enforcement has dropped
precipitously over the last five years, the report states:
**The number of warning letters issued by the agency for violations
of federal requirements has fallen by over 50%, from 1,154 in 2000 to
535 in 2005, a 15-year low. During the same period, the number of
seizures of mislabeled, defective, and dangerous products has
declined by 44%.
**In at least 138 cases over the last five years involving drugs and
biological products, FDA failed to take enforcement actions despite
receiving recommendations from agency field inspectors describing
violations of FDA requirements.
**Although the Federal Records Act and internal agency procedures
require FDA to keep records that document agency enforcement
decisions, FDA does not appear to comply with these requirements.
FDA�s response to Committee requests for relevant enforcement
documents was haphazard, incomplete, and untimely.
���� FDA officials explained that FDA could not provide prompt and
complete responses because the agency lacks a system that enables it
to track enforcement recommendations from field offices. The report
entitled Prescription for Harm: The Decline in FDA Enforcement
Activity. U.S.� House of Representatives Committee on Government
Reform Minority Staff Special Investigations Division, June 2006� can
be viewed at www.casewatch.org/fda/waxman/prescription_for_harm.pdf .
For additional documents, refer to
www.democrats.reform.house.gov/story.asp?ID=1074&Issue=Prescription+Drugs
.� [Source: Consumer Health Digest Weekly Update 22 Aug 06]
SBP OPEN SEASON UPDATE 03:� SBP Open Enrollment period signup for
increased SBP coverage terminates 30 SEP 06 and none of the services
have experienced any great influx of applications.� T he less than
staggering numbers is attributed to the significant buy-in costs
faced by retired members who have been retired a long time. Even with
large buy-in costs mandated by Congress to ensure the integrity of the
fund is maintained, officials still feel that the SBP is a tremendous
bargain.� To match the SBP would take a high-dollar insurance policy
with premiums beyond the reach of most. In addition, retired members
don�t have to take physical exams to get into the SBP. Two provisions
enacted in recent years make the SBP even more attractive:
1. Phased in elimination of the Social Security offset, which
previously meant a widow�s annuity payment dropped from 55% of the
selected base amount to 35% when the surviving spouse reached the age
of 62. Payments to surviving spouses increased to 40% on the base
amount on 1 OCT 05 and to 45% 1 APR 06 SBP payments will go to 50% on
` APR 07 and 55% on 1 APR 08.
2. Enactment of a paid-up provision which means that beginning 1 OCT
08, retired members who are age 70 and older and who have paid into
the SBP for 30 years will no longer have to pay premiums.� Retired
members, who buy-in during the current SBP enrollment period, GAIN
CREDIT BACK TO THE TIME THEY FIRST BECAME ELIGIBLE TO ELECT SBP
COVERAGE, meaning that some will pay monthly premiums for just over
two more years.
���� Those who took SBP coverage and later elected to terminate that
coverage are not eligible to make an open enrollment election. Open
enrollment elections require a lump sum buy-in premium as well as
future monthly premiums.� The lump sum equates to all back premiums,
plus interest, from the date of original eligibility to make an
election plus any amount needed to protect the Military Retirement
Fund.� The latter amount applies almost exclusively to those paying
fewer than seven years of back payments. The lump sum buy-in premium
can be paid over a two-year period.� Monthly premiums for spouse or
former spouse coverage will be 6.5% of the coverage elected, the same
premium paid by those currently enrolled. Reserve component members
under age 60 and not yet eligible for retired pay do not pay back
premiums or interest, but must pay a monthly SBP premium �add-on�
once their retired pay starts. Elections are effective the first day
of the month after the election is received.
���� To make an open enrollment election, a retiree must complete and
submit a DD Form 2656-9, �Survivor Benefit Plan (SBP) and Reserve
Component Survivor Benefit Plan (RCSBP) Open Enrollment Election.�
available at
www.dtic.mil/whs/directives/infomgt/forms/eforms/dd2656-9.pdf. For
assistance with the form, retired members should contact the office
managing the SBP for their Service. Air Force retirees should call 1
(800) 531-7502 anytime between 0730 & 1630 CST, M-F except holidays.
Those residing outside the CONUS may need to obtain an AT&T direct
access number to call the SBP toll-free number. If someone other than
the retired member calls for information, that person should have the
retiree�s most recent retiree pay statement available.� Privacy Act
restrictions do not permit SBP counselors to access the retiree�s
account for a second party. Mail the completed form to the address
specified on the form.� Applicants will be formally notified of their
cost and have 30 days from the date of the notice to cancel the
election by notifying the Defense Finance and Accounting Service or
the reserve component, as applicable, in writing. [Source:
Afterburner� Aug 06 ++]
TRICARE ALLOWABLE CHARGES:� President Bush signed an Executive Order
on 22 AUG titled �Promoting Quality and Efficient Health Care in
Federal Government Administered and Sponsored Health Care Programs,�
directing federal agencies that administer health care programs to
take steps to promote quality care. It also states that agencies must
do these three things: create incentives for beneficiaries to care
about the quality and price of their health programs; address
interoperability of health information technology products; and make
health information more transparent to consumers.� To support this
and other health initiatives in the President�s Management Agenda,
the Department of Defense has initiated several activities intended
to realize the promise of improved and more efficient health care for
all beneficiaries of the Military Health System (MHS).
��� �In one initiative, Tricare is partnering with industry, current
health managers and providers, who contract with DoD in developing
robust measures of quality health care that can be consistently
applied by the MHS as a unified effort. These ongoing �data quality
summits� are developing a core set of metrics that will enable both
MHS leaders and beneficiaries in making sound decisions about health
choices.� In another initiative, the MHS is actively engaged in
strategic partnerships with both the public and private sectors to
advance health care information science and to promote and define
standards for health information technology systems interoperability.
DoD has made significant progress advancing health care information
technology through large-scale adoption and deployment of AHLTA which
is nearing full implementation
�
��� In still another initiative to promote transparency of health
care pricing and quality, TRICARE has posted its allowable charges on
an easy-to-use� site at www.tricare.osd.mil/allowablecharges. The cost
of medical care varies widely across the country. Neither hospitals
nor doctors� offices typically post their charges for various
procedures, making it hard for patients to judge if they are being
charged a reasonable amount for operations or examinations. By making
its charges easily available to the public, Tricare is leveling the
playing field between medical service providers and users. The new
Web site shows the Tricare maximum allowable charge tables, listing
the most frequently used procedures - more than 300 of them - and the
amount Tricare is legally allowed to pay for them. These charges are
tied to Medicare allowable charges, effectively making them a federal
standard for health care costs.� [Source: DoD News Release 22 Aug 06]
DISABLED RETIREE BACK PAY UPDATE 02:� If all goes as planned some
disabled retirees due retroactive pay could start to see their
payments in mid-October according to DoD and VA (VA) sources.� A
small number may see payments before that; however, VA officials
caution that, if any unexpected glitches crop up, the payments will
be delayed until the second half of January.� That's because they'll
have their hands full at the end of the year reprogramming and
implementing new pay rates for 2007.
Over 100,000 retirees now drawing either Combat Related Special
Compensation (CRSC) or Concurrent Retirement and Disability Pay
(CRDP) ultimately will receive back payments and that number is
growing daily with new awards.� Because of the complexity of
calculating who is due how much the majority of the payments will
likely be phased in from January through next summer. This is because
individual circumstances vary widely and many cases require manual
review.
���� Why is retroactive pay due?� While the VA disability award
letter usually establishes a retroactive effective date, the VA
doesn't initially make retroactive payments for retirees with less
than a 100% disability rating.� That's because there's usually at
least some offset required for retired pay already received.� If the
VA paid all retroactive awards immediately, it would cause major
headaches for many disabled retirees, who would then have to pay back
large amounts of their military retired pay.� Only if and when a
disabled retiree is awarded CRDP or CRSC can the VA find out whether
back disability pay is due � but it needs a ton of data from the
Defense Department to figure out how much.� On the other hand,
retirees who experience changes in their disability awards may also
be due retroactive CRSC/CRDP payments from the Defense Department.
���� The bottom line is that the new and complicated CRSC and CRDP
programs have created major administrative and budgetary headaches
for Pentagon and VA administrators.� Their first priority has been to
get the pays started while minimizing confusion or aggravation for
disabled retirees.� Now, they've invested months of combined effort
to change their policies, systems, and budgets to finish the hard
part � figuring out who is due how much in retroactive payments.
Defense Finance and Accounting Service (DFAS) sources say the
affected retirees will receive specific details at the time their
retroactive payment is made.� DFAS expects to publish a detailed news
release later this month.� [Source: MOAA Leg Up 25 Aug 06]
MEDICARE PHYSICAL THERAPY PAYMENTS:� Barring congressional action
before the end of 2006, Medicare payments for outpatient physical
therapy will be limited to a flat $1,740 a year, starting in JAN 07.
But a bipartisan effort is underway in the House to change the law and
suspend the payment cap.�
The cap on outpatient physical, speech-language and occupational
therapy services by any providers other than hospital outpatient
departments was put in law by the Balanced Budget Act of 1997.�� That
law required a combined cap for physical therapy and speech-language
pathology, and a separate cap for occupational therapy, but Congress
delayed its implementation for several years. The $1,740 annual cap
went into affect in JAN 06, but Congress authorized an exception if
such services are determined to be "medically necessary" -- which
most certainly are.� But this exception is due to expire at the end
of 2006.
���� In May, Reps. Benjamin Cardin (D-MD) and Philip English (R-PA)
authored a bipartisan letter urging the leaders of the Ways and Means
and Energy and Commerce Committees, which oversee the Medicare payment
issue, to repeal the cap.� At the very least, the letter said, the
medical necessity exception should be extended through 2007.� 177
representatives joined Cardin and English in signing the letter.
Absent a repeal of the cap or extension of the exception, Tricare For
Life (TFL) beneficiaries will experience more out-of-pocket expenses
and may have to seek these services in a hospital setting.� Military
eligibles will have some protection in that TFL will become primary
payer after the Medicare cap is reached, but Tricare deductibles and
copays apply after that point. H.R.916 & S.438 have been introduced
in Congress to repeal the increase. To support these bills refer to
http://capwiz.com/moaa/issues/bills/?bill=7103976 to contact your
Representative or to
http://capwiz.com/moaa/issues/bills/?bill=7103896 to contact your
Senator. [Source: MOAA Leg Up 25 Aug 06]
HEALTH CARE QUALITY AND PRICE:� On 22 AUG President Bush signed an
Executive Order designed to promote more efficient sharing of medical
data between government agencies. In the executive order, the
President said, �It is the purpose of this order to ensure that
health care programs administered or sponsored by the federal
government promote quality and efficient delivery of health care
through the use of health information technology, transparency
regarding health care quality and price, and better incentives for
program beneficiaries, enrollees and providers.� In effect, the
President tells providers in order to do business with the federal
government have to show the government their prices.� It requires
that four major government agencies, DoD, Department of Health and
Human Services, OPM and the VA, gather and share information about
the quality and price of medical care.� These four agencies provide
coverage to nearly 25 percent of all Americans with health
insurance.
���� The agencies covered by the order must establish programs
designed to measure quality of care. The beneficiaries must also be
able to see the prices these agencies pay for common medical
procedures, to develop and identify practices that encourage high
quality care, and whenever possible, use compatible computer systems
and electronic health records to help track a beneficiary�s medical
care and condition.� These changes and new procedures must be
underway by 1 JAN 07. The Executive Order should have the effect of
improving quality and efficiency and ensure �Seamless Transition�
from active to inactive service is given a higher priority than it
currently enjoys. The entire Executive Order may be seen on the web
at
�www.whitehouse.gov/news/releases/2006/08/20060822-2.html. [Source:
NAUS Weekly Update 25 Aug 06]
USMC INVOLUNTARY RECALL:� Due to projected shortages in some
specialties such as engineers, intelligence, military police and
communications, the Marine Corps on 22 AUG announced that they will
shortly begin involuntary recalls. They will begin by calling up 2500
members at a time, of the Individual Ready Reserve. They have decided
to exempt those who are either in the first or last year of their
reserve status. Marines can expect to be deployed for an average of
12-18 months but could be for as long as two years. They will receive
five months to prepare before having to report for duty. [Source: NAUS
Weekly Update 25 Aug 06]
AHLTA UPDATE 01: William Winkenwerder Jr., assistant secretary of
defense for health affairs, took time during a 23 AUG teleconference
with journalists to tout his department�s ability to transfer
electronically the medical records of separating service members to
the VA.� His comments came in unveiling a new DoD instruction on
deployment health which is a compilation of policy decisions taken
over the last four years to enhance force health protection
dramatically. Two of the initiatives are new.�
-� First, DoD is committed, as capabilities allow, to collecting data
daily on the location of every service member deployed.� This will
allow officials to link environmental monitoring data to individual
deployments and, over time, correlate exposure data to veterans�
health.
-� Second, DoD will extend all health protection measures to deployed
DoD civilian employees and contractors as well as service members.
In praising DoD�s system, Winkenwerder ignored a rising chorus of
critics who say AHLTA, the Department of Defense�s digitalized
medical record system, is a problem for the VA and for veterans
because, in fact, it doesn�t allow electronic record transfers
outside the military network. The critics include the Government
Accountability Office, senior VA officials and, most recently, the
chairmen of the both the House and Senate veterans� affairs
committees. GAO reported last month that the biggest obstacle
remaining for severely wounded troops to experience �seamless
transition� from military care to VA trauma centers is the inability
to transfer AHLTA records.
���� Through June, more than 19,000 service members had been wounded
in Iraq and Afghanistan.� Sixty-five percent had blast injuries,
which often result in trauma requiring comprehensive rehabilitation.
GAO said that nearly 200 severely wounded members, while still on
active duty, have been transferred to a VA poly-trauma centers for
care and rehabilitation.� Most of these cases involve brain injury,
missing limbs and spinal cord injuries. GAO acknowledges that VA and
DoD have strengthened procedures for transferring war-injured members
and veterans. Their joint programs have eased hassles for patients and
families. VA social workers are assigned to large military treatment
facilities to coordinate transfers.� Military liaisons have been
added to VA staff at poly-trauma centers to handle transition issues
raised there. But GAO said there are problems electronically sharing
the medical records VA needs to determine whether service members are
medically stable enough to participate in vigorous rehabilitation
activities. DoD radiological images, vision and hearing tests, and
anesthesia notes cannot be transferred electronically.� Also, DOD has
no system-wide approach to electronic medical record management..
Information is maintained and stored at individual treatment
facilities or in networks of facilities rather than system wide. GAO
noted, for example, that health care providers at Walter Reed Army
Medical Center and the National Naval Medical Center can access each
other�s electronic medical records but cannot access medical records
from Landstuhl Regional Medical Center in Germany.
���� Perhaps the most obvious weakness of AHLTA, said GAO, is it
captures outpatient records only.� VA needs inpatient records to
provide follow-care and rehabilitation.� As of APR 06, Walter Reed
Army Medical Center still had to fax records to VA poly-trauma
centers. Rear Adm. John M. Mateczun, Navy�s deputy surgeon general,
said military patients transferred to the VA can arrive with a
digitized medical record.� It must be brought over on a computer disk
and read by an offline computer. But the record can�t be transmitted
by AHLTA nor can it be integrated into the VA�s VISTA record system.
Winkenwerder suggested AHLTA is the more sophisticated system. Asked
to reconcile his rosy view of AHLTA with such criticism, Winkenwerder
said DoD is working with VA to be able to share images of x-rays, MRIs
and CAT scans electronically.� That might happen within 18 months, he
said.� Next year, work will begin on closing other gaps in electronic
transfer capability raised by GAO.
���� Sen. Larry Craig (R-ID), chairman of the Senate Veterans� Affair
Committee, told Government Health IT that the VA has an award-winning,
highly touted electronic health records system while the DoD is still
talking about requirements.� This leaves him wondering whether DoD is
just trying to justify building its own system. Rep. Steve Buyer
(R-Ind.), Craig�s counterpart in the House, also complained to the IT
industry newsletter.� He said AHLTA is less capable than VISTA in its
ability to share data between its own hospitals. VISTA�s architecture
and software do not meet the requirements of DoD. It�s sort of a
hospital by hospital system and DoD�s need was to be able to move the
information globally, from the battlefield of Iraq or Afghanistan to
Landstuhl, Germany to anywhere in the world. The Senate
appropriations committee has urged DoD to switch to VA�s record
system.� However, Defense officials say VISTA would need significant
modification to meet military needs and the switch would be long and
costly. [Source: Military Update Tom Philpott article 24 Aug 06 ++]
BEER BELLY CONTROL:� Over 90 million Americans enjoy drinking beer!
Drinking moderately has been proven by many doctors, as well as the
New England Journal of Medicine, to be a healthy component of
longevity. In fact, moderate consumption of alcohol, including beer,
has been proven to reduce the effects of high cholesterol, heart
disease, some forms of cancer and even impotence. Anything done in
excess is naturally unhealthy. Moderation is defined by most doctors
as 1-2 beers a day. And NO, you cannot save up through the week and
catch up on the weekend drinking 10-12 beers in an evening. That is
NOT moderation. There is even a U.S. Beer Drinking Team
(www.usbdt.com) that links beer enthusiasts and promotes moderation,
responsibility, and healthy living.
���� The average can of beer has over 100 calories. Drinking one beer
is equivalent to eating a chocolate chip cookie. Drinking four is
equal to eating a Big Mac Hamburger. In order to lose weight, you
have to burn off these extra calories as well as the other calories
that you ate for breakfast, lunch and dinner. Even the lightest of
beers has the empty calories of alcohol, which is the cause of poor
health if done in excess and without a regular exercise routine.
Unfortunately, too many Americans live under one of the worst
stereotypes placed on a human being - the BEER BELLY. This is caused
by excess calories in your diet and lack of activity to burn the
extra calories. The solution to lose your beer belly is as simple as
calories in must be less than calories out or� Calories IN < Calories
Out (burned thru exercise) = Weight Loss.� If you can add exercise
into your schedule for 20-30 minutes a day, your daily consumption of
alcohol (1-2 beers) will not have any additional impact on your gut.
To lose your beer belly, you REALLY have to watch your food and
beverage intake, drink 2-4 quarts of water a day, and fit fitness
into your world. There is no other healthy answer!� The exercise and
workout ideas below can get you started on your calorie burning plan.
For more tips on burning calories refer to
www.military.com/NewContent/0,13190,Smith_Index,00.html:
1.� Workout #1: This is a great full body calorie burner: Walk, run
or for 5 minuted +� 20 squats + 10-20 Pushups +� 20 situps or
crunches.� Repeat 3-5 times.
2.� Workout #2: Swimming and elliptical gliding (cross country
skiing) burn the most calories per hour (This workout can burn up to
1000 calories in one hour). Swim 20-30 minutes non-stop or elliptical
glide 20-30 minutes.
[Source: Military.com Weekly News 21 Aug 06]
PI TRICARE PROVIDER CERTIFICATION:� There are two types of provider
certification. The first is an �institutional� certification for
hospital, clinics, pharmacy, etc., and the second is for
�non-institutional� providers, which are essentially independent
doctors and specialists. Those already certifiedin the Philippines