RAO Bulletin

[boardman]

RAO Bulletin Update 1 December 2006


THIS BULLETIN UPDATE CONTAINS THE FOLLOWING ARTICLES:

== NORAD Santa Tracking ------------------ (51st Year)
== Veterans in Office -------------------------- (Overall Decrease)
== VA Retro Pay Project [04] ---------------- (Backlog to SEP 07)
== VA Retro Pay Project [05] ---------------- (DFAS FAQs)
== Wal-Mart Holiday Giveaway ------------- (DoD/Exchanges Nix)
== VDBC [08] ---------------------------------- (Surveys Began NOV 07)
== VDBC [09] ---------------------------------- (VA Disability Buyout)
== VA Budget 2007 [07] ----------- (Awaiting House Reconciliation)
== VA Budget 2007 [08] ----------- (Republicans Block Funding)
== COLA 2008 --------------------------------- (Decrease of 0.7%)
== DoD Mental Health Task Force ---------- (Input Requested)
== Veterans Benefits Act 2006 --------------- (New Spouse Benefit)
== VA Prescriptions ID Method -------------- (Upcoming Changes)
== Household Goods FRV -------------------- (Not till 2008)
== Eye Exams/Glasses [01] --------- (Military Community Options)
== Cancer Prevention -------------------------- (Guidelines)
== Cancer Prevention [01] -------------------- (Diet Impact)
== VA Registries Update [03] ---------------- (What’s Available)
== VA Registries Update [04] -------- (Enrollment Prerequisites)
== Marine Corps Museum -------------------- (Completion 2009)
== Certificate of Creditable Coverage ------- (How to obtain)
== Tricare Website ----------------------------- (Revamped)
== Tricare Providers --------------------------- (Types)
== Virginia Exam Reciprocity --------------- (Credit Verification)
== Indiana Vet Initiatives ------- (Proposed Benefit Improvements)
== Fraudulent On Base Sales [01] ----------- ($70 million in Refunds)
== DAV Transportation Network ------------ (Volunteer Drivers Needed)
== DSHS Veterans Project [01] -------------- (Older Vet Assistance)
== PTSD Reevaluation [08] ------------------ (Funds Not Spent)
== Agent Orange Lawsuits [06] -------------- (AFEM vs. VSM)
== Painkillers & Constipation ------- (Constipation Drug Study)
== Casualty Assistance [01] ------------------ (New VA Pamphlet)
== Test Prep Scams ---------------------------- (Red Flags)
== Tricare Reimbursement Rates ------------ (2007 Changes)
== Tricare Reimbursement Rates [01] ------- (Higher Copays)
== VA Outpatient Pharmacy [02] ------------ (Non-VA Pharmacy Use)
== Philippine Credit Card Surcharge -------- (No more)
== Medicare Part D [12] ----------------------- (Comparison Chart)
== VA Appointments [03] -------------------- (30+ Day Delay Status)
== Mobilized Reserve 29 NOV 06 ---------- (Net Decrease 4230)
== Military Legislation Status ---------------- (Where we stand)

NORAD SANTA TRACKING: The North American Aerospace Defense Command (NORAD) has launched its annual tracking of Saint Nick on his journey around the globe. On 19 NOV Norad’s web site www.noradsanta.org/index.php dedicated to the annual event was activated. The site features interactive games as well as information describing how NORAD tracks the world’s premier gift giver, officials say. On Christmas Eve beginning at 0200 MST (i.e. 0400 EST & 0900 Greenwich Mean Time) the site will feature a minute-by-minute update on Santa’s travels. All information will be available in English, French, German, Italian, Japanese and Spanish. This is the 51st year NORAD has tracked Santa Claus. The program began in 1955 after a child in Colorado Springs, Colo., accidentally dialed NORAD’s predecessor, the Continental Air Defense Command, and asked about Santa’s whereabouts. The commander who answered the phone was happy to oblige. Last year, the Web site received more than 900 million hits from 204 countries and territories worldwide. The “NTS” operations center, staffed by some 550 volunteers, answered nearly 55,000 phone calls and nearly 98,000 e-mails, according to reports. Island Web Studios, America Online, Akami, Analytical Graphics, Globelink Language and Cultural Services, Qwest Communications, Verizon, and Microsoft Virtual Earth help to make the program possible, NORAD officials said. [Source: NavyTimes Staff report 16 Nov 06 ++]

VETERANS IN OFFICE: Despite heavy media attention on Iraq and Afghanistan war veterans running for office this year, the number of veterans in Congress actually has declined in the wake of the recent midterm elections. In the 110th Congress the House of Representatives will have eight fewer veterans and the Senate one fewer after winning, losing and retiring lawmakers are all counted, said Shawn Olds, executive director of the Veterans for National Service Foundation. “Veterans did not do well,” Olds said. “Prior to the election, 25% of members of Congress had worn the uniform at some point in their life. When the new Congress sits, that number will be down to 23.5%.” Hundreds of veterans talked about running for office in 2006 and more than 100 filed, Olds said. But in the end, 20 made it through the primaries and only a handful won. Three veterans ran for governor, including combat veteran Rep. Jim Gibbons (R-NV) a retired Air National Guard colonel who won his race bid. Regarding the reminder:
- The seven retirements include Navy combat veterans Reps. Henry Hyde, (R-IL) and Jim Kolbe, (R-AZ) both former officers with active and reserve service.
- One combat veteran, Rep. Randy “Duke” Cunningham(R-CA) resigned earlier this year after being convicted of bribery charges. Cunningham is a retired Navy commander and Vietnam War fighter pilot.
- Five veterans were defeated in their re-election bids. Rep. Joe Schwarz (R-MI) a Navy combat veteran who served in the 1960s, lost in the primary. Four others were defeated in the general election, including Marine veteran Sen. Conrad Burns (R-MT) and Rep. Rob Simmons (R-CT), a combat veteran and retired Army Reserve colonel.
- The only female veteran in Congress, Rep. Heather Wilson (R-NM) narrowly won her re-election bid.

The number of veterans in Congress has been declining since 1994, largely as a result of the retirements and deaths of World War II veterans. That year, 44% of members of Congress had served in the armed forces. Olds said veterans, especially military retirees, have problems running for the House. “They may not have spent much time in the district because their military duties have taken them around the world,” he said. “They do not know the political game, and they don’t have resources.” The Veterans for National Service Foundation helps teach candidates about local politics, fundraising and other aspects of running for office, Olds said. [Source: NavyTimes Rick Maze article 14 Nov 06 ++]

VA RETRO PAY PROJECT UPDATE 04: If a retiree was awarded an increase in their disability percentage retroactively during a period of entitlement to combat-related special compensation (CRSC) or concurrent retirement and disability payments (CRDP), they likely are entitled to retroactive pay. The Defense Finance and Accounting Service (DFAS) and the VA now are making retroactive payments for those entitled to them. For the oldest cases, data is needed back to 1 JUN 03 (CRSC) or 1 JAN 04 (CRDP). In many cases, missing data is provided through exchanges with the VA. Project teams at DFAS were working through a backlog of approximately 133,000 cases to date with nearly 2,000 new cases received each month. As DFAS or the VA obtains the necessary data, the retiree receives his or her retroactive CRDP or CRSC pay. Nearly 40,000 retroactive pay cases have been paid since 1 SEP 06. Of these, more than 25,000 were paid by the VA alone. Some cases involved payments from both DFAS and the VA. More than 9,795 cases resulted in no payment, as either DFAS or the VA determined no payment was due. Some cases could result in a finding of debt to the government. DFAS is automating the payment of retroactive cases and is working through collecting the data needed to clear each case. The simplest cases already have been paid. Cases that require additional data or correction will be next. Complicated cases that must be paid manually or need significant work will take more time. Complicating factors include a change in dependency finding, garnishment, former spouse issues, casualty or collection of an overpayment of retired pay. DFAS anticipates the backlog will be cleared by September 2007. [Source: MOAA News Exchange 21 Nov 06]

VA RETRO PAY PROJECT UPDATE 05: Following are a number of Defense Finance and Accounting Service (DFAS) frequently asked questions and their answers regarding the retroactive payment of Combat-Related Special Compensation (CRSC) or Concurrent Retirement and Disability Pay (CRDP):
1. What do I need to do to receive my money? You do not have to do anything - no application is required. The Department of Veterans Affairs (DVA) is providing DFAS with eligible retirees’ Social Security Numbers. Both organizations are working together to provide eligible retirees with their full entitlements to both DVA compensation and CRSC or CRDP.
2. When will I receive my payment? The DFAS is planning to pay the accounts with the oldest retroactive award dates first. They ask that you be patient with them during this time as the payments are calculated utilizing a manual process. The DFAS has however developed some automated tools to assist in computing the payment. Every effort is being made to pay as many accounts as rapidly as possible without sacrificing correctness. A letter will be sent out shortly before any payment is released.
3. Who will pay me the money I am owed? Any monies owed may be paid by either DVA or the DFAS depending on account specific calculations. Retirees may be eligible for payment from the DFAS as a restoration of retired pay and/or from DVA as a part of disability compensation. The letter you will receive will indicate which agency will be making the payment.
4. I am rated at 100% due to individual unemployability. Am I eligible for a retroactive payment? You can only receive a payment for 100% with individual unemployability if the award is applied retroactively by the DVA.
5. I disagree with my rating. What should I do? Disability percentages do not come from the DFAS. Disagreements in disability percentages should be directed to the DVA. You can contact the DVA by calling toll free 1(800) 827-1000.
6. How do I contact the DVA for the money they owe me? Questions regarding any monies due to you from the DVA can be directed to their toll free number 1(800) 827-1000.
7. I received a letter in the mail from the DFAS but I never received the payment. What do I do now? If the letter indicated the payment was from the DVA, contact them by calling their toll free number. If the payment was from the DFAS, your payment was sent to the same address designated for your regular monthly payments. If your payment is delivered via electronic fund transfer (EFT) and it has not posted to your financial institution contact the DFAS telephone number contained in the letter you received. If your regular monthly payments are delivered via hard copy checks, please allow for mail times. If it has been at least 10 days since you received your letter and you still do not have your paper check write a letter including name, SSN, address, missing payment type, date and amount. Fax the letter to (216) 522-5898 or mail to: DFAS Cleveland Attn: Non-Receipt Department P.O. Box 998005, Cleveland , OH 44199.
8. Will I receive a separate 1099R for this payment? No. If your payment was issued by the DFAS for an increase in CRDP as a result of a retro DVA award, the DFAS is responsible for withholding and reporting taxes on a Form 1099R. The taxable income will be included in your annual 1099R. If your payment is issued by the DVA, DFAS is not responsible for any tax reporting and will not issue an additional or revised Form 1099R.
9. Is the retroactive payment taxable? Only payments made by the DFAS for CRDP are taxed. They will be taxed at the same rate as your normal monthly payment. If the VA retro payment was made by the DVA, contact them using their toll free number for taxability information.
10. Is the retroactive VA award pay subject to garnishment, former spouse, etc ? If you receive CRSC, you are subject to alimony and child support. Since CRDP is a restoration of retired pay, the same rules that would apply to your retired pay would also apply here.
11. How can I contact the DFAS if I have questions? DFAS has established the following toll free number 1(877) 327-4457 which is operational 0800 to 1630 EST M-F to answer questions from CRSC and CRDP recipients who believe they may qualify.
[Source: www.dod.mil/dfas/retiredpay/frequentlya ... pfaqs.html 25 Nov 06]

WAL-MART HOLIDAY GIVEAWAY: Defense officials have nixed Operation Homefront’s plans to partner with the Wal-Mart Foundation to bring truckloads of free toys and gift cards for families inside the gates of military bases. Operation Homefront is a nonprofit 501(c)3 organization which was founded after 911. It provides emergency assistance and morale to our troops, to the families they leave behind, and to wounded warriors when they return home. Their website is www.operationhomefront.net. Operation Homefront leads more than 2,500 volunteers in 26 chapters nationwide. Since its inception, it has provided critical assistance to more than 40,000 military families in need. Meredith Leyva, spokeswoman for Wal-Mart and founder of Operation Homefront, said that after defense officials interceded bases affected declined their offer to bring trucks onto bases for holiday activities between 22 NOV and 20 DEC. DoD’s alleged concern was security and logistical issues involving bringing those trucks on base.
Officials in the military exchanges and the industry that sells products to the exchanges found out about the scheduled "Operaton Christmas"events last week. Sources said members of both groups contacted lawmakers in Congress and defense officials, concerned that having a rival on post would detract from exchange sales. In the long term, the exchanges fear such arrangements would take away from the dividends that come from profits, and are provided to military bases for morale programs. Wal-Mart’s plan to provide $20,000 to each base through Operation Homefront for family and morale programs is now also in limbo. The status of that donation was unknown when this article was written and further information was not immediately available from Wal-Mart officials. The impact of DoD’s decision affects mostly service members and their families who are financially strapped. Many were counting n this additional holiday assistance.
Not to be dissuaded by DoD’ decision, alternate plans have been initiated by Operation Homefront to hold the parties outside the gates and they are making plans for the locations to do that at. They are handling all of the logistics and planning and the Wal-Mart Foundation is providing the toys and trimmings and the trucks to get them there. Events are scheduled for off base communities near Scott Air Force Base, Ill.; Hampton Roads, Va.; MacDill Air Force Base, Fla.; Naval Construction Battalion Center Gulfport, Miss.; Randolph Air Force Base, Texas; and Fort Stewart, Ga. The first event was scheduled to be held near Scott AFB on 22 NOV. Wal-Mart, which has built a number of stores outside military bases around the country, is generally acknowledged as the biggest competitor of the exchanges for the business of the military community. Although per Wal-Mart policy there were no plans to sell items on the bases, their press release said a Toyland of the latest toys and electronic games would have been available for children of all ages to try out. Appearances by Santa Claus, food, music, and tree-trimming craft tables were also planned.
Wal-Mart is an official partner in the Defense Department’s America Supports You program, and officials from that program were actively involved in this project. Leyva said, the original plan was to give $200 Wal-Mart gift cards to the first 200 families through Operation Homefront but Defense Department attorneys said the store chain could give no more than a $20 gift card under federal ethics rules. America Supports You officials suggested that Wal-Mart contact Operation Homefront for logistical help. Wal-Mart plans to contribute $100,000 to Operation Homefront for the purchase of voice-activated laptop computers for injured troops. The giant discount store has also been a contributor to the military community in other ways, including funding of a project for children of military personnel through Sesame Workshop, the nonprofit organization behind Sesame Street. [Source: NavyTimes Karen Jowers article 22 Nov 06 ++]

VDBC UPDATE 08: The Veterans’ Disability Benefits Commission is conducting a special survey of disabled veterans and a separate survey of survivors during the months of NOV 06 through APR 07. The purpose of these surveys is to ensure that a nationally representative sample of both groups is given the opportunity to share their views and experiences with the Commission and Congress. The surveys are being carried out by telephone interviews by ORC Macro, an independent research company that conducts surveys for the government and the private sector. Participants are contacted first in writing, followed by a phone call to either conduct the survey or arrange a more convenient time to talk. In some instances, participants may simply receive a phone call. The surveys ask questions about the individual’s health status, life satisfaction, health care and employment. Participation in the survey is voluntary and extremely important because everyone selected to take part will help to give us a clearer picture of the effects of service-connected disability in the lives of veterans and survivors.
The Commission will use the survey results to develop its report and recommendations to Congress about benefits for service-disabled veterans and survivors. This final report will be available after OCT 07. If you are contacted and asked to participate: please do! You will be the voice for many other veterans or survivors like yourself. If you are not contacted, please note that our sample was drawn randomly to represent all disabled veterans and surviving spouses. Volunteers cannot be accepted for the survey because they must assure accurate representation of all disabled veterans and survivors. Adding volunteers would bias this representation. VDBC appreciates your time and values your input. If you have questions or concerns about these surveys you are requested to email them at veterans@vetscommission.com. [Source: www.vetscommission.org/displayContents.asp?id=3 Nov 06 ++]

VDBC UPDATE 09: The 16 NOV 06 Veterans' Disability Benefits Commission (VDBC) hearing considered repeal of the law that reduces military SBP annuities by the amount of survivor benefits payable from the VA. Under current law, the surviving spouse of a retired member who dies of a service-connected cause is entitled to Dependency and Indemnity Compensation (DIC) from the VA. In the case of a military retiree enrolled in SBP, the surviving spouse's monthly SBP annuity is reduced by the amount of DIC – a little more than $1,000 a month. This offset also affects many survivors of members killed on active duty – including all active duty deaths since 11 SEP 01. Most active duty deaths occur among relatively junior servicemembers, whose survivors are eligible for only modest SBP payments. That means most survivors of members killed on active duty lose most or all of their SBP benefit. Commission members didn't come to a consensus on the issue, so VDBC Chairman LTG Terry Scott, USA (Ret) tabled it asking the commission staff to provide additional information.
Commissioners then tackled several staff-developed topics to include VA claim-processing time limits, lump-sum payments, and resolution of pending claims that end with veteran's death. However, they came to a final decision on only one issue. The Commission unanimously agreed to eliminate from their final report any recommendation for a buy-out or lump-sum payments of VA disability compensation. CNA Corp., formerly known as the Center for Naval Analyses, was hired by this commission to study and report on the advantages and disadvantages of a lump-sum option for VA. CNA reviewed how an option might be designed, who should be eligible and what savings might be gained. To better understand the implications, CNA tracked how VA disabilities in the year 2000 changed over the next five years. CNA found that by 2005 almost no veteran saw his or her disability rating drop and only five percent of disabilities had a rating increase. The average increase was between 20 and 30 percentage points. Skin, hearing, sight, gynecological and lymphatic conditions showed the smallest rating changes, an average of less than two percent. Ratings for post-traumatic stress disorder rose sharply, with that average between 30 and 40 percentage points.
To estimate both near-term costs and long-term potential savings from use of lump-sum settlements, CNA assumed they would be offered only to veterans rated 10 or 20 percent disabled and with conditions having no more than a two-percent probability of a rating increase over the next five years. Likely candidate conditions that fit the profile include tinnitus, thumb amputations, hypertension and scars on the face, neck or head. They calculated that offering lump sums to newly-rated veterans with these ratings and types of conditions would raise VA compensation costs by $545 million in the first year. More surprisingly, the VA wouldn't break even and begin to see net savings from this change for 25 years. Their final report concluded:
- Veterans might view lump sums as more useful in transitioning to civilian life. They also might enjoy having a choice.
- Because lump sum recipients would have fewer interactions with VA, the timeliness of the VA claims process might improve.
- VA compensation costs, over time would fall because total dollars paid in lump sums would be a lot less than paid over a lifetime as monthly compensation. Compensation savings, in time, could be 10 to 20%.
- The VA would save on administrative costs. That would be especially true if veterans who accepted lump-sum payments were prohibited from applying for a "re-rating" as their disabilities worsened.
- Lump-sum settlements raise new worries about the welfare of veterans who accept such deals. Some would use lump-sum payments foolishly, placing their financial futures in greater jeopardy. Another issue is what these veterans can do if their disabilities worsened.

Finally, the Commission reported that three previously discussed issues (i.e line of duty, character of discharge, and concurrent receipt) are now undergoing legal and technical review: The Commission stated these issue papers are expected to be released in December and stakeholders, including military associations, will be allowed to provide comments in January 07. [Source: MOAA Leg Up & USDR Action Alert 22 & 23 Nov 06 ++]

VA BUDGET 2007 UPDATE 07: Prior to Thanksgiving recess, the Senate passed a $77.65 billion Military Construction and Veterans appropriations bill, an increase of nearly $8.88 billion from last year. The bill (HR 5385) increases VA’s funding by $6.45 billion over last year’s enacted level of $77.9 billion. Approximately half this increase in VA funding goes to medical services operations, including hospital staff personnel. The legislation includes an amendment Sen. Craig offered which will enable the Department of Veterans to spend up $10 million on individual projects without having to seek specific Congressional authorization. The prior limit was $7 million. Also under this bill, the U.S. Court of Appeals for Veterans Claims would receive nearly $20 million for fiscal year 2007, a 6.4% increase over its 2006 appropriations. This level of funding would allow the Court to increase its staff, continue an electronic case-filing initiative, and continue studying the feasibility of constructing or obtaining a dedicated Veterans Courthouse and Justice Center. Significant spending accounts include:
- Compensation and Pensions: Provides $38.01 billion for compensation and pensions, which is $4.11 billion above the FY06 enacted level.
- Medical Services: Provides $28.69 billion for Medical Services, which is equal to the Administration’s request and $4.51 billion above the FY06 enacted level.
- Readjustment Benefits: Provides $3.26 billion for Readjustment Benefits, which fully funds the Bush Administration’s request. The readjustment benefits appropriation finances the education and training of veterans and servicepersons whose initial entry on active duty took place on or after July 1, 1985.
- Veterans Housing: Provides $196.7 million for the Veterans Housing Benefit Program Fund Program Account, which is $132.1 million above the FY06 enacted level.

The bill also contains $16.3 billion in funding for military construction. This amount includes funds for barracks, family housing units and rebasing efforts under military transformation and the most recent round of BRAC (Base Realignment and Closure). Before the vote, the White House issued a Statement of Administration Policy urging the Senate to consider increasing co-payments and enrollment fees for higher-income, non-disabled veterans. The administration’s advice, however, was rejected and the Senate passed the bill. To achieve the requested amount, the Senate appropriated $795 million in direct funding to replace the President’s request for new enrollment fees and increased copayments for prescription drugs, which the Senate denied. The VA spending bill still must be reconciled with the House version before it’s completed. Until then, VA continues to operate under a continuing resolution at last year’s lower enacted level. The House passed its version last May. [Source: NAUS Weekly Update 17 Nov 06 ++]

VA BUDGET 2007 UPDATE 08: The Military Construction/VA Appropriations funding bill has been put on hold after being passed last week on the Senate floor. The bill contains funding for FY 2007 veterans medical care, benefits, research, facilities construction and maintenance, as well as military housing and funding for the defense health care system. The outcome means VA and DOD health care must continue to run on last year’s inadequate funding levels. In a partisan maneuver Senators Tom Coburn (R-OK), Jim DeMint (R-SC), and Jeff Sessions (R-AL) with the blessing of the Republican Senate leadership, have held up the appointment of conferees effectively stopping the veteran’s funding package dead in its tracks. The group of Republican senators apparently combined to halt assignment of Senate conferees because they feared that the conference will attract too many extraneous measures and become the vehicle for last-minute pork barrel spending. It’s the type of thinking that comes as a result of a negligent Senate that failed to act on this critical spending bill or any of the others that fund the programs and policies of the federal government prior to the 1 OCT 06 start of the new fiscal year. Outgoing Senate Majority Leader Sen. Bill Frist (R-TN) has informed the 110th Congress Majority Leader Sen. Harry Reid (D-NV) that the Republican leadership plans to pass a stopgap spending measure (Continuing Resolution) that would last through JAN 07.
The national commander of the nation’s largest organization of combat veterans is furious that three Republican senators are holding hostage the passage of key fiscal year 2007 funding bills that prevent the federal government from improving upon the programs and services it provides to America’s veterans, servicemembers and their families. Gary Kurpius, the commander-in-chief of the Veterans of Foreign Wars of the U.S., said the actions this week by Sens. Coburn, DeMint and Sessions were “nothing short of pure partisan politics and sheer arrogance towards the new Democrat-controlled 110th Congress.” By holding up the process, the three senators are undercutting vital prosthetic and traumatic brain injury research for returning troops, delaying staffing increases and infrastructure improvements within the Department of Veterans Affairs, and exacerbating an already out of control VA backlog that exceeds 820,000 claims. The government’s fiscal year began 1 OCT.
Kurpius, a Vietnam veteran from Anchorage AK said, “There are 351,000 veterans in Oklahoma, 412,000 in South Carolina and 422,000 in Alabama who are going to be directly impacted by their senators who have put politics above their constituency. What occurred on 7 NOV was an exact reversal of what occurred in 1994 when Republicans swept control of both houses of Congress. These three senators obviously forgot that it is the will of the people that keeps them in office, not their political party.”
Kurpius is now calling on all veterans and servicemembers to contact their U.S. senators to bring pressure upon Coburn, DeMint and Sessions before the 109th Congress adjourns next month. Those desiring to do so can reach their Senators via contact information provided at www.senate.gov/general/contact_informat ... rs_cfm.cfm. [Source: VFW Legislative Alert 21 Nov 06 ++]

COLA 2008: This week, the Bureau of Labor Statistics announced the October 2006 monthly
Consumer Price Index (CPI), which is the metric used to calculate the annual cost-of-living adjustment (COLA) for military retired pay, VA disability compensation, survivor annuities, and Social Security. The Consumer Price Index indicates a downward start to a first quarter of the fiscal year by dropping 0.7% below the year's COLA base. The bulk of the downward fluctuation has been due to a 7.3% drop in energy
prices. [Source: MOAA Leg Action Center Nov 06]

DOD MENTAL HEALTH TASK FORCE: The Department of Defense (DoD) Task Force on Mental Health hosted an open meeting 21 NOV to hear concerns from San Francisco veterans, as well as local National Guard and Reserve members and families. The meeting was open to the public and provided an opportunity for all beneficiaries of DoD mental health care to share their experiences with Task Force members. According to the Task Force co-chairs, members wanted to hear from beneficiaries about all aspects of mental health care, including access, quality, and even the stigma associated with seeking this care. They are also interested in understanding how deployments impact children and spouses, and about care received from civilian practitioners. Beneficiaries who did not wish to speak publicly or who were unable to attend the meeting can send their testimony or comments directly to Cynthia.vaughan@us.army.mil. Comments should include the name, phone number, address and e-mail address of the writer. They will be forward directly to the Task Force members.
The Task Force was established at the direction of Congress and will submit a report to Secretary of Defense in May 2007 that will include an assessment of, and recommendations for improving the effectiveness of mental health services provided to service members. The Task Force consists of seven DoD members and seven non-DoD members. It is co-chaired by LTG Kevin Kiley, Army Surgeon General, and Dr. Shelley M. MacDermid, Associate Professor in the Department of Child Development and Family Studies, Purdue University and the Co-Director for the Military Family Research Institute at Purdue. The San Francisco meeting was the latest in a series of open events the Task Force sponsored on its visits to numerous installations, VA facilities, and communities worldwide. For more information on the Task Force, go to: http://www.ha.osd.mil/afeb/mhtf/default.cfm. [Source: NMFA Government & You E-News 15 Nov 06 ++]

VETERANS BENEFITS ACT 2006: One of the first orders of business for the “lame duck” House of Representatives after its return to Washington this week was to pass a stripped-down veterans’ benefits bill H.R.6314. The bill will be the final benefits bill passed this year, although Representative Steve Buyer (R-IN-04), the House Veterans’ Affairs Committee chairman, issued a plea for the Senate to dust off some larger proposals. H.R. 6314 sponsored by Buyer, would prevent the cutoff of some current programs and provide a new education benefit to spouses of severely injured active-duty service members. It must now be considered by the Senate. The bill, approved by the House on a 393-0 vote, prevents a cutoff of rehabilitation programs for homeless and seriously mentally ill veterans as well as grants for veterans’ programs. It also extends the VA advisory committee on homeless veterans and health care for veterans exposed to biological and chemical testing under Projects SHAD and 112 in the 1960s and ’70s. There is one new benefit, which is built upon a current survivor benefit: Spouses and children of service members who are permanently and totally disabled from service-connected causes would be allowed to use VA survivor education benefits while the member is still on active duty. Under current law, that is allowed only after the disabled service member is separated from active duty.
One major holdup on veterans’ bills has been the inability of Buyer and Sen. Larry Craig, R-Idaho, the Senate Veterans’ Affairs Committee chairman, to reach a compromise on details. Several sticking points have emerged, including Craig’s wish that the House change federal law to allow veterans to hire attorneys to represent them when filing benefits claims and Buyer’s insistence on changes in information technology oversight within the VA. Senate committee aides have been working with Buyer’s staff to try and write a compromise bill that would pass before the current session of Congress ends, but an agreement has proven elusive. Buyer’s concern about hard work being in vain results from the fact that neither he nor Craig will be veterans’ committee chairmen next year because Democrats won control of Congress in the Nov. 7 election. Sen. Daniel Akaka, D-Hawaii, was named Tuesday as Senate Veterans’ Affairs Committee chairman. No chairman has been named for the House committee.
[Source: ArmyTimes Rick Maze article 14 Nov 06 ++]

VA PRESCRIPTIONS ID METHOD: The VA started putting the last 4 of the SSN on prescription labels in the 1970’s as a way to identify the patient by asking the last name and last 4. This was not unique at a lot of places so they increased this to the last 6. Prior to 1984 SSNs were issued when requested with the result that number assignment was more random. Since 1984, SSNs are being issued at the Hospital at time of birth to allow entry into schools. This reduced the randomness of number assignment and if one knew the location of where a SSA holder was born it would be easier to pin down what number was assigned. When the issue of privacy first came up the VA Pharmacy Service checked with the VHA privacy officer and found that putting this limited amount of information was within the VA privacy rules plus it not violate HIPAA regulations either. However, identity theft is now a big issue with everyone going out and buying shredders and expressing their concerns. The VA is going to take a number of actions in the next few months to a final solution with the re-engineered pharmacy (PRE) software. The mail order pharmacy, which dispenses 80% of the prescriptions, will begin using the last 4 digits of the SSN in the near future. The current VISTA applications will be modified this summer and hopefully by the end of the fiscal year we will go back to the last 4 digits of the SSN. This will increase the number of potential combinations into the billions. In PRE, the VA will use the last name of the patient and the picture of the patient from the VIC card as the 2 identifiers for patient’s pickup of prescriptions. This solution will not be available until the 2009-11 timeframe. [Source: NAUS Weekly Update 17 Nov 06 ++]

HOUSEHOLD GOODS FRV: The fiscal 2007 defense authorization act requires the government to pay service members “full replacement value” (FRV) for damaged and lost household goods (HHG), but the new system may not kick in until March of 2008, the date set by the legislation. The Defense Department has been implementing “Families First,” a program that will include a goal of FRV, but Families First has fallen behind schedule. Implementation of FRV could occur earlier but must begin by 2008. Under current law, when a household item is lost or destroyed, the service member receives a depreciated value of 5% to 10% per year since it was new, depending upon the item. The new FRV formula also will cover the full cost of repairs. Exceptions to FRV payments will be cars, motorcycles and boats. [Source: Armed Forces News 17 Nov 06]

EYE EXAMS/GLASSES UPDATE 01: The Naval Ophthalmic Support and Training Command (NOSTRA) introduced its latest “Frames of Choice” program, offering an additional six choices of civilian-style frames for active-duty Navy, Marine Corps and Coast Guard personnel 1 NOV 06. The new frames will be rolled out incrementally with availability depending on the service member’s location. Military retirees are not eligible for the new frames under this program. Active-duty personnel or Reservists/Guardsmen serving on active duty more than 30 days may get frames of their choice by visiting their local optometry clinic or ordering on line at the Naval Ophthalmic Support and Training Activity Web site, http://nostra.norfolk.navy.mil/sending.cfm. A new Web sitehttp://nostra.norfolk.navy.mil will be up by Nov. 30. An order form (DD771) and instructions on how to complete the form are at the Web sites.
Tricare Standard/Extra and Medicare for non-active duty and dependents does not cover routine eye exams and most eyeglasses. However, care not considered routine such as cataracts or an eye injury is covered. Additional eye exams are authorized under the Well-Baby and Well-Child care benefit. Under the Clinical Preventive Services of Tricare Prime a comprehensive eye exam is allowed every two years without a co-pay for all Prime enrollees ages 3 to 64. TRICARE Prime enrollees who are diabetic are allowed an annual comprehensive eye examination. Medicare and Tricare will pick up their share of the bill if a patient has a disease impacting on the eyes. Glaucoma, cataracts, torn retinas, the variety of eye disorders related to diabetics, etc. would apply. If you report to your doctor or ophthalmologist that you are having a problem with your eyes and that you are not there for a routine or annual exam you/they should be able to submit the claim. It is advisable that you first check with the doctor/nurse to see if the exam qualifies for Medicare/Tricare reimbursement. If they indicate it will not, call your Medicare office or Regional Tricare contractor and ask why not. Inconsistent interpretations by providers and payers of claims regarding the regulations do occur. If the claim is filed and is not honored you can request a review.
If you are rated 10% disabled or more by the VA you can get one pair of free prescription glasses a year from the VA even if the eye glasses are not for a service connected disability. This does not apply overseas. If you are a 100% disabled veteran who lives more than 100 miles from the nearest VA medical care facility in the states you may be eligible for local eye care through their Fee Basis Care program. Check with them to see if you can apply for a fee basis card to meet your dental, eye care, eyeglass needs up to a specified amount paid for by the VA to local participating providers.
If you are a retiree check out your local military treatment facility MTF if given a new prescription in the course of your visit. They will fill optical prescriptions for retirees, subject to local capacity and funding. Retirees can obtain eyeglasses from DoD by mail without an examination by a military optometrist. Have your civilian optometrist complete and sign DD Form 771 and mail to NOSTRA/NWS, PO Box 350, Yorktown VA 23690-0350. This form can be obtained from your local RAO or downloaded in PDF fillable format at http://www.dtic.mil/whs/directives/info ... dd0771.pdf. Glasses provided will be standard brown frame and are only authorized for the retiree, not dependents. [Source: Armed Forces News 17 Nov 06 ++]

CANCER PREVENTION: The American Cancer Society (ACS) has updated its nutrition and physical activity guidelines for individual actions to reduce the incidence of cancer. The recommendations are consistent with the American Heart Association and American Diabetes Association guidelines for preventing coronary heart disease and diabetes, as well as for general health promotion as intended by the Department of Health and Human Services’ 2005 Dietary Guidelines for Americans. The ACS recommendations to reduce risk are:

1. Maintain a healthy weight throughout life.
** Balance caloric intake with physical activity.
** Avoid excessive weight gain throughout the life cycle.
** Achieve and maintain a healthy weight if currently overweight or obese.

2. Adopt a physically active lifestyle.
** Adults: engage in at least 30 minutes of moderate to vigorous physical activity, above usual activities, on 5 or more days of the week. Forty-five to 60 minutes of intentional physical activity are preferable.
** Children and adolescents: engage in at least 60 minutes per day of moderate to vigorous physical activity at least 5 days per week.

3. Consume a healthy diet, with an emphasis on plant sources.
** Choose foods and beverages in amounts that help achieve and maintain a healthy weight.
** Eat five or more servings of a variety of vegetables and fruits each day.
** Choose whole grains in preference to processed (refined) grains.
** Limit consumption of processed and red meats.

4. If you drink alcoholic beverages, limit consumption.
** Drink no more than one drink per day for women or two per day for men.
[Source: Consumer Health Digest 17 October 06]

CANCER PREVENTION UPDATE 01: Because people are interested in the relationship that specific foods, nutrients, or lifestyle factors have to specific cancers, research on health behaviors and cancer risk is often widely publicized. Health professionals who counsel patients should emphasize that no one study provides the last word on any subject, and that individual news reports may overemphasize what appear to be contradictory or conflicting results. In brief news stories, reporters cannot always put new research findings in their proper context. The best advice about diet and physical activity is that it is rarely, if ever, advisable to change diet or activity levels based on a single study or news report. Diet has an impact on the cause and degree of risk in getting cancer. Information on the use of dietary supplements, foods, food substances, and herbal products can be found at on the American Cancer Society (ACS) website http://caonline.amcancersoc.org/cgi/con ... t/56/5/254. Here you can find the latest authoritative answers to the following:

Does ingesting alcohol, aspartame, coffee, fluorides, food additives, irradiated foods, pesticides in foods saccharin, salt, and/or sugar cause or increase cancer risk?
What are antioxidants, and what do they have to do with cancer?
Does beta carotene reduce cancer risk?
What are bioengineered foods, and are they safe?
Is calcium related to cancer?
Does cholesterol in the diet increase cancer risk?
Will eating less fat lower cancer risk?
What is dietary fiber, and can it prevent cancer?
Does eating fish protect against cancer?
What is folate, and can it prevent cancer?
Can garlic prevent cancer?
If our genes determine cancer risk, how can diet help prevent cancer?
Will lycopene reduce cancer risk?
Should you avoid processed meats?
How does cooking meat affect cancer risk?
Does being overweight increase cancer risk?
Does olive oil affect cancer risk?
Are foods labeled organic more effective in lowering cancer risk?
Will increasing physical activity lower cancer risk?
What are phytochemicals, and do they reduce cancer risk?
What is selenium, and can it reduce cancer risk?
Can soy-based foods reduce cancer risk?
Can nutritional supplements lower cancer risk?
Can you get the nutritional equivalent of vegetables and fruits in a pill?
Can drinking tea reduce cancer risk?
Do trans-saturated fats increase cancer risk?
Will eating vegetables and fruits lower cancer risk?
What are cruciferous vegetables, and are they important in cancer prevention?
Is there a difference in the nutritional value of fresh, frozen, and canned vegetables and fruits?
Does cooking affect the nutritional value of vegetables?
Should you be juicing your vegetables and fruits?
Do vegetarian diets reduce cancer risk?
Does vitamin A, C, D, or D lower cancer risk?
How much water and other fluids should you drink?
[Source: http://caonline.amcancersoc.org/cgi/con ... t/56/5/254 Oct 06]

VA REGISTRIES UPDATE 03: One way VA tracks the special health concerns of veterans is with their Health Registries. All eligible veterans who want to be included in VA registries can get a health registry examination at most VA facilities and performed by a VA Environmental Health (EH) Clinician. Health examinations by a private physician may also be accepted as long as the VA registry examination protocol is followed. Most VA facilities have EH Coordinators assigned to assist veterans in obtaining health registry examinations. Contact the EH Coordinator at the nearest VA facility to request the registry examination in which you are interested. The names and telephone numbers of these EH Coordinators are listed on the Environmental Agents Service (EAS) Web site www.VA.gov/EnvironAgents. Another resource is VA’s toll-free special health issues helpline 1(800) 749-8387.
A health registry examination is not a claim, nor is it required, for VA benefits or compensation. It is a personalized and comprehensive examination which includes blood work, urinalysis, and, where medically indicated, a chest x-ray and EKG with answers to questions relating to any environmental exposures. The results of the health registry examination are maintained in the veteran’s medical record. This health registry exam provides an opportunity to enroll in the VA healthcare system but is not a prerequisite to submit a claim. This exam is available to all eligible veterans with no co-payment requirement. The demographic information (personal details), exposures, reported symptoms and diagnoses are all included in a computerized index or list of veterans located at the Austin Automation Center in Austin, TX. To learn more about these special programs refer to www.va.gov/EnvironAgents VA has the following registries for which the number of vets who have been examined is indicated in parenthesis:
- Agent Orange for Vietnam veterans and others exposed to Agent Orange and other herbicides used in Vietnam and other military locations. (403,046)
- Gulf War/Operation Iraqi Freedom (OIF) for veterans of the 1991 Gulf War or who served in OIF. (95,899)
- Depleted Uranium (DU) for veterans possibly exposed to DU. (557)
- Ionizing Radiation for veterans who participated in nuclear tests, the occupation of Nagasaki/Hiroshima, Japan and other radiation-risk activities or who received nasopharyngeal (NP) (nose and throat) radium irradiation treatments. (23,541)

Eligible veterans may receive follow-up (2nd, 3rd, etc.) registry examinations based on any new health problems they may develop. VA can only provide health care to veterans; hence, family members are not eligible for a health registry examination. Enrollee’s automatically receive or have access to VA’s newsletters with updates or special information on health care and other benefits for them. [Source: eVeteran News 31 Oct 06 ++]

VA REGISTRIES UPDATE 04: Following are the prerequisites for enrollment in the VA Registry program:

1. Agent Orange Registry is open to:
- Any U.S. male or female Vietnam era veteran who served in the Republic of Vietnam between 1962 and 1975, regardless of length of service (i.e., 1 hour, 1 day, 1 month, 1 year, etc.). Verification of service during the Vietnam era is required.
- Any U.S. veteran who served in Korea during 1968 or 1969.
- Any U.S. veteran who may have been exposed to dioxin, or other toxic substance in a herbicide or defoliant, during the conduct of, or as a result of, the testing, transporting or spraying of herbicides for military purposes.
Note: The Department of Defense (DoD) has provided a list (about 75% complete) of locations and dates where herbicides, including Agent Orange, were used. For those sites that are not listed, Vietnam vets should provide some proof of exposure to be able to obtain a registry examination.

2. Gulf War Registry is open to:
- Iraqi Freedom. Any veteran who served on active military duty in southwest Asia during the Gulf War which began in 1990, and continues to the present including operation Iraqi freedom.
- Those who served in the following areas are eligible for the lab test that measures Du in urine: Iraq, the Neutral Zone (between Iraq and Saudi Arabia), Saudi Arabia, Kuwait, Qatar, The United Arab Emirates, Oman, Gulf of Oman, Gulf of Aden, or waters of the Persian Gulf, Arabian Sea and Red Sea.

3. Depleted Uranium Registry is open to veterans who are identified by DoD because of possible DU exposure during military activities in the 1991 Gulf War, Bosnia, Operation Iraqi Freedom, or Operation Enduring Freedom. Veterans who came to VA because they are concerned about potential exposure to DU, are offered a Depleted Uranium evaluation. For more information refer to www.VA.gov/environAgents

4. Ionizing Radiation Registry is open to:
- On site participants of tests involving the atmospheric detonation of a nuclear device, whether or not the testing nation was the United States.
- Participants in the occupation of Hiroshima or Nagasaki from 6 AUG 45, through 1 JUL 46.
- Internees as POWs in Japan or service on active duty in Japan immediately following such internment during World War II which the Secretary of Veteran Affairs determines resulted in an opportunity for exposure to ionizing radiation comparable to that of veterans involved in the occupation of Hiroshima or Nagasaki.
- Service at Department of Energy gaseous diffusion plants at Paducah, KY, Portsmouth, OH, or the K25 area at Oak Ridge, TN, for at least 250 days before 1 FEB 92, if the veteran was monitored for each of the 250 days using dosimetry badges to monitor radiation to external body parts or if the veteran served for at least 250 days in a position that had exposures comparable to a job that was monitored using dosimetry badges;
- Service at Longshot, Milrow or Cannikin underground nuclear tests at Amchitka Island, AK, before 1 JAN 74.
- Veterans who received nasopharyngeal (NP) nose and throat radium irradiation treatments while in the active military, naval, or air service who are concerned about possible adverse effects of their NP radium treatments
[Source: eVeteran News 31 Oct 06 ++]

MARINE CORPS MUSEUM: Located in the Jacksonville Lejeune Memorial Gardens, the Marine Corps Museum of the Carolinas is slated to open late 2009. It will display the history of the Marines and the surrounding communities of North and South Carolina from 1941 into the future. The preliminary plans display a 40,000 square foot building with two floors consisting of three major exhibit galleries, which will be comprised of 8 to 10 subjects of interest and a great hall. Museum development will accommodate a wide audience. Chief patrons will be military personnel and their families, young Marine trainees, retired and former Marines and Sailors. Military reunions will be a significant audience for the museum and research center. Local civilians are anticipated to be a core visitor group, from school age on up. Organized tours, both military and civilian, along with general tourists, history buffs, and collectors, will be drawn to this venue.
The museum will contain displays illustrating the founding of each Carolina base, profiling the families whose land formed the bases. In addition, it will display World War II activities, including the training of the First Marine Division at Camp Lejeune. World War II exhibits will showcase the unique Marine Corps training that occurred in North Carolina, including the Women Marines, African American Marines, and the War Dogs. The heart of the museum will be II Marine Expeditionary Force and its elements which include the Second Marine Division, the Second Marine Aircraft Wing, the Second Force Service Support Group and the bases and their histories. The facility will also have a Hall of Honor designed as a place to recognize, honor, and reflect upon individual achievements and sacrifices of the Carolina Marines. Visitors can access information about these exemplary Marines through computers linked to a database of images, video footage, audio interviews, and written content about each honoree. The Museum is currently accepting donations which can be made online. For more information, visit the Museum's website at http://www.mcmuseum.com or call 910-937-0033. [Source: Veteran’s Report 23 Oct 06 ++]

CERTIFICATE OF CREDITABLE COVERAGE: A certificate of creditable coverage is a document that shows your prior health care coverage. This certificate usually reduces how long a health care plan may exclude you from coverage for a pre-existing health condition. For former Tricare beneficiaries, the certificate shows a new employer insurance company that you had previous Tricare health care coverage, for the period noted on the certificate. The Health Insurance and Portability Act (HIPAA) requires Tricare to issue you a Certificate of Creditable Coverage if you lose Tricare eligibility. Thus, If Tricare covered you before you lost your eligibility, even when you were an active duty member separating from the service, you are entitled to a certificate of creditable coverage. Retires do not get a certificate because they do not lose their eligibility Tricare eligibility. If needed, they must request one in writing. Tricare issues certificates when:
- The sponsor separates from active duty; the certificate lists all eligible family members.
- A member of the National Guard or Reserves demobilizes; the certificate lists all eligible family members.
- A dependent child (age 21, or 23 if a full-time student) loses eligibility; Tricare will issue a certificate to a dependent child.
- A former spouse loses eligibility after divorce.

A certificate reflects each period of continuous Tricare coverage that occurred within the 24 months before you lost eligibility. It identifies the sponsor’s or family member’s name for whom it is issued, the dates Tricare coverage began and ended, and the certificate issue date. If you are a former Tricare beneficiary who purchases or is offered health care coverage, the other insurance plan may require you to present a certificate of creditable coverage. For example, if you leave active duty and seek a job with a civilian employer, the new employer may require a certificate for reducing the time the new health plan may keep you from receiving health care for a preexisting condition.
All certificates are issued by the Defense Manpower Data Center Support Office (DSO), which manages the Defense Enrollment Eligibility Reporting System (DEERS). Anyone can request one in writing and it will be provided at no charge. To do so send the request to: Defense Manpower Data Center Support Office (DSO), Attn: Certificate of Creditable Coverage, 400 Gigling Road, Seaside, CA 93955-6771. The request must include the following:
- Sponsor's name and Social Security number
- Name of person for whom the certificate is requested.
- Reason for the request.
- Name and address to whom and where the certificate should be sent.
- Signature of the requester

If you urgently need a certificate of creditable Coverage, you may fax your request to the DSO at (831) 655-8317 or request that DSO fax it to a particular number. For questions about the certificate of creditable coverage, sponsors and family members may contact DSO at (800) 538-9552. For TTY/TDD, dial (866) 363-2883. You may also send questions via e-mail to the TRICARE Management Activity HIPAA Program Office at hipaamail@tma.osd.mil. Additional HIPAA information is available on the TRICARE Web site at www.tricare.osd.mil/certificate/index.cfm. [Source: Tricare Fact Sheet 2 Nov 06 ++]

TRICARE WEBSITE: The Department of Defense launched TRICARE.mil as the official website site for all TRICARE information on 10 NOV 06. Beneficiaries can now go to one site to look up benefit information, schedule an appointment or track claims. Everything's in one place making the site easier to use. TRICARE.mil comprises five main content areas:
- My Health (TRICARE Online) - personal health information and online appointment scheduling for TRICARE Prime enrollees;
- My Benefit - TRICARE benefit information;
- MHS Staff - resources for Military Health System staff members;
- TRICARE Providers - information for TRICARE network providers; and
- The Pressroom - the latest news about TRICARE and the military health system.
In the next phase of website improvements, beneficiaries will be able to enter their profile and receive benefit information tailored to them. TRICARE expects this feature to be available next year. [Source: FRA News Bytes 3 Nov 06]

TRICARE PROVIDERS: A provider is an individual, supplier, or institution that delivers health services, supplies, or equipment. For example, doctors, hospitals and ambulance companies are providers. Tricare authorizes providers, suppliers and institutions. Most hospitals and many doctors are Tricare-authorized (check with them to be sure). For other types of providers, check with your regional contractor, beneficiary counseling and assistance coordinator or Tricare Service Center before getting care. You can locate a Tricare-authorized provider at www.tricare.osd.mil/ProviderDirectory/. Tricare issues authorized providers a number, which allows them to file Tricare claims for services they deliver to you. Generally, Tricare doesn’t authorize active duty service members and federal government civilian employees to be providers. Tricare-Authorized Providers must have a state license, a national organization accreditation (if needed) and meet other medical community standards. They must also be listed as an individual provider or institution, as described below: A Medicare-certified provider is considered a Tricare-authorized provider. Tricare authorized providers are categorized as:
- Individual Providers who include, but are not limited to attending physicians, Certified nurse practitioners, Clinical nurse specialists (if state-approved), Certified psychiatric nurse specialists, Christian Science practitioners and nurses (listed in the Christian Science Journal), Dentists (DDSs or DMDs), most clinical psychologists (with Ph.D.s or Psy.D.s), Physician assistants, Podiatrists, Optometrists, independent laboratories, and medical equipment and supply firms. If you seek care from Audiologists, Mental health counselors, Occupational therapists, Pastoral counselors, Physical therapists, Registered nurses, or Speech therapists you must be referred by a physician, who must sign the claim form for Tricare to pay for part of the covered services.
- Institutions which include College or university infirmaries, Christian Science sanatoriums (if part of the First Church of Christ, Scientist), Hospitals, Skilled nursing facilities (not including retirement homes or homes for the aged or infirm, which Tricare doesn’t cover), Tricare-approved ambulatory surgery centers, Tricare-approved birthing centers (separate approval is required for care at a birthing center, even if the center is otherwise a Tricare-authorized provider), Tricare-approved residential treatment centers for emotionally disturbed children and adolescents, and Tricare-approved special treatment centers such as drug and alcohol treatment centers.
Note: Check with the individual provider or institution, and your regional contractor, to see if it’s Tricare-authorized. If it’s not, Tricare cannot pay for the services.
Tricare Network Providers contract with the regional contractor to deliver health services, supplies or equipment for all Tricare beneficiaries, including those who are also Medicare eligible. Network providers accept Tricare-negotiated rates as full payment for services. They file claims and Tricare pays them directly. Non-Network Providers are Tricare authorized providers who have not contracted with the Tricare regional contractor. Ask your providers if they are authorized and if they will participate on the claim for your care. Non-Network Providers are subcategorized as:
- Participating Providers who will accept the Tricare allowable charge as full payment for services, including your cost share and deductible. Individual providers may participate on a case-by-case basis. Hospitals that participate in Medicare must participate in Tricare for inpatient care. For outpatient care, hospitals may participate on a case-by-case basis. A participating provider will normally file Tricare claims for you.
- Non-Participating Providers who will not accept the Tricare allowable charge as the full payment for services. They may charge you up to 15% above the Tricare-allowable charge for services, and you must pay the additional charges. A non-participating provider may or may not file Tricare claims for you. You may have to pay for the services first and file your own Tricare claim. Tricare will not reimburse you for charges exceeding the allowable charge.

If you get medical care from providers not authorized by Tricare, it is likely that you will be responsible for all billed charges. For more information, you refer to the TricareWeb site at www.tricare.osd.mil. Individual providers, institutions, or suppliers interested in becoming Tricare-authorized should contact a regional contractor provider relations representative at one of the following:
• Tricare North Region: www.healthnetfederalservices.com, 1(877) 874-2273.
• Tricare South Region: www.humana-military.com, 1(800) 444-5445.
• Tricare West Region: www.triwest.com, 1(888) 874-9378.
[Source: TMA Fact sheet 23 Oct 06]

VIRGINIA HIGH SCHOOL EXAM RECIPROCITY: For many military families with school aged children, year end tests taken in one state under the No Child Left Behind (NCLB) requirements do not always count in the state of a new duty assignment. This issue becomes increasingly frustrating for high schools students who must pass certain exams in order to meet graduation requirements. Several years ago, on behalf of the 68,000 military connected students in the Hampton Roads area of Virginia, the Joint Military Services School Liaison Committee (JMSSLC) initiated discussions with state legislators, school district superintendents, and others, regarding granting credit for year end tests taken in other states under the NCLB requirements. The Virginia Board of Education and Virginia Department of Education administrators were briefed on the need for granting verified credits for high stakes testing reciprocity for mobile (military) students. With the support of many parties and organizations reciprocity is now a reality in Virginia. On 24 MAY 06 the Virginia Board of Education adopted revised Regulations Establishing Standards for Accrediting Public Schools in Virginia. This regulation became effective 7 SEP 06 and reads in part: “...to permit tests administered as a part of another state’s accountability program to be approved as substitute tests…” For a complete text of the revised regulation go to: www.doe.virginia.gov/VDOE/suptsmemos/2006/inf180.html. [Source: NMFA Government & You E-News 15 Nov 06 ++]

INDIANA VET INITIATIVES: Indiana Governor Mitch Daniels chose the Veterans' Day holiday to announce a set of initiatives designed to help the state’s veterans and military families as a part of his 2007 legislative agenda. The governor's proposals include:
- Exempt all military pay earned while serving in combat theater from Indiana state income tax for all active duty, National Guard, and Reserve personnel who file Indiana tax returns.
- Increase the maximum allowable state income tax deductions on military pay (including retirement pay and survivor's benefits) to $5,000 per year for individuals and $10,000 for couples filing jointly. The current allowable state income d

[boardman]

RAO Bulletin Update 15 November 2006


THIS BULLETIN UPDATE CONTAINS THE FOLLOWING ARTICLES:

== Military Holiday Mail 2006 --------------- (Deadlines)
== Senate Vet Action Report ----------------- (Vet Gains)
== Veterans Issues ----------------------------- (Looking Ahead)
== VA Data Privacy Breach [27] -------- (Another Computer Stolen)
== Medicare Wheelchair Availability ------- (Harder to Access)
== Navy Mobilization Plan ------------------- (9300 in 2007)
== Ft. McClellan Vets ------------------------- (Registry Development)
== Federal Student Aid ------------------------ (Retirees Eligible)
== Telemarketing Call Elimination [04] ---- (Using a Script)
== VA CLEP Reimbursement ---------------- ($60 Exam Fee)
== Vet Cemetery for Southern CA ----------- (Burials Begin)
== Depleted Uranium (DU) [01] ------------- (Guardsmen Sue)
== Terrorist Attack Preparation -------------- (What is Your Plan)
== TRICARE Reserve Select [06] --------- (TRS Publications Issued)
== DECA Scholarships 2007------------------ (Apply by 21 FEB)
== Tricare Survivor Benefits [01] ------------ (Enhanced Benefits)
== Military Airfare Discount ----------------- (BSMA Starts Petition)
== Medicare Part D [10] --------------- (TFL Involuntary Enrollment)
== Medicare Part D [11] ---------------------- (1 JAN Changes)
== Vet Disability Pension Suit --------------- (P&G Denies Pension)
== Social Security Scam ---------------------- (Data Update Request)
== WW1 Vet Search [01] --------------------- (Who is Left)
== Military Pay Raise ------------------------- (2008 Projection 3%)
== Knott's Berry Farm Vet Offer ------------ (Veterans Tribute)
== Agent Orange Nam Vet Study ------------ (Risk of Ills Higher)
== Diabetes [02] ------------------------- (New Medication Approved)
== Congressional Vet Committee Lineup -- (Major Changes)
== CBO FY 2006 Review -------------------- (DoD GDP Percentage)
== Tricare Retention at 65--------------------- (Medicare’s Impact)
== Vet Cemetery Shortage -------------------- (Projected Until 2009)
== Handicapped Vet Offer ------------------------- (Good Deal)
== USCG Cellphone *CG Use --------------- (Change in policy)
== HOS/ETS Extension Requests ----------- (6 Year Possibility)
== Military Legislation Status ---------------- (Where we stand)

Editor’s Note: I will be flying back to the Philippines on 15 NOV and do not anticipate being back on line until 18 or 19 DEC. Request hold any questions or comments you have until that time.


MILITARY HOLIDAY MAIL 2006: The deadline for sending holiday packages to troops stationed overseas using Parcel Post to all Air/Army Post Office (APO) or Fleet Post Office (FPO) zip codes was 13 NOV. Deadlines for Space Available Mail and Parcel Airlift Mail are 27 NOV and 4 DEC respectively. The U.S. Postal Service is encouraging early deadlines to make sure that packages reach their destination in time for the holidays. The U.S. Postal Service introduced a free Military Care Kit, or “Mili-kit” in 2004 to make it easier for military families and friends to send care packages overseas. Each kit contains four Priority Mail boxes, six Priority Mail Flat Rate boxes, 10 Priority Mail labels, one roll of Priority Mail tape and 10 customs forms with envelopes. This kit may be ordered by calling the USPS Expedited Package Supply Center at 1(800) 610-8734. The U.S. Postal Service has shipped more than 150,000 kits over the last two years. The Priority Mail Flat Rate boxes included in the kit can be shipped to any APO/FPO in the world, regardless of weight, for $8.10. All packages and mail must be addressed to individual service members, as required by U.S. Defense Department regulations. A complete APO/FPO holiday mailing deadline matrix and additional information are available at www.usps.com/communications/news/press/ ... 06_067.htm. [Source: NGAUS Notes 9 Nov 06 ++]


SENATE VET ACTION REPORT: With the Senate set to reconvene, the Chairman of the U.S. Senate Committee on Veterans' Affairs issued an action report on Congressional efforts on behalf of veterans. This report covers the past two years of the 109th session of Congress. Inflation for 2005, and so far in 2006, has gone up a total of 6.8%. Overall inflation has increased 12.9% since 2001. Congress has increased overall spending on veterans by 64% and increased spending on veterans' health care by 70%. The Senate Committee on Veterans' Affairs has held 52 hearings during the 109th session of Congress (2005 to 2006). Topics included reducing the backlog of veterans' benefits claims, VA research, homelessness among veterans, the theft and recovery of VA computers, Presidential nominations, employment concerns of young veterans and, the VA's budget. Following is a summary of the chairman’s report:

- Veteran bills passed: S. 1182 - Veterans Health Care Act of 2005, S. 1235 - Veterans' Housing Opportunity and Benefits Improvement Act of 2006, S. 2694 - Veterans' Choice of Representation and Benefits Enhancement Act of 2006, and H.R. 5037 - Respect for Fallen Heroes Act.
- Veterans Cost of Living Adjustment Increased 2.7% in 2005, 4.1% in 2006 and 3.3% for 2007.
- VA's Overall Budget up 27% to approximately $80 billion for 2007.
- VA's Health Care Budget up by 29% to approximately $35.8 billion for 2007.
- Mental Healthcare Funding to go up 30% to over $3 Billion in 2007.
- Homelessness Funding up for sixth straight year to $221 million.
- Reviews published in two national publications gave VA high marks for its medical care.
- SGLI and VGLI Increased to $400,000.
- Veterans employment numbers are at 96.5% with younger Vets trending better.
- Brain injury funds ($12 million) restored
- Wounded warrior benefit ranging from $25,000 to $100,000 created.
- Veterans' Housing and Benefits Act now gives disabled vets $2,000 to $14,000 grants.
- Promoting dignity at funerals of the fallen becomes Law

The Chairman’s entire press release can be seen at http://veterans.senate.gov. [Source: U.S. Senate Action Report 3 Nov 06 ++]


VETERAN ISSUES: It appears that the major issues on the burner now in Washington which impact the military community are the Tricare fee hike, Defense Authorization Bill, and defense and VA funding. That leaves a lot to be accomplished according to Capt. Donald C. Kent, USN (Ret). In his article published in the Naval Submarine Base Groton CT Dolphin Community News he highlights a number of issues which are summarized below:

- DoD has continued to insist that increasing health care fees is the only way they can stabilize the rising costs of health care. This is the word from the Pentagon's top doctor, William Winkenwerder Jr., assistant secretary of defense for health care. This continues to be his stance and that of the administration in spite of congressional opposition and the outcry from retirees. His stance is that the health care budget has roughly doubled this year to $38 billion, and if it continues to rise at a similar rate, would be at $65 billion by 2015. His plan is directed to retirees under age 65, with enrollment fees and deductibles for Tricare Standard and Prime to rise several hundred dollars over two years. Much criticism comes from the fact that annual retired pay raises are designed to roughly keep pace with inflation and such annual pay raises are in fact reduced by increases in health care costs - it is argued that retired pay and retiree health care are two separate things. Winkenwerder further states that some form of increase is necessary if the quality of health care is to be sustained.

- It appears now that based on legislation passed by Congress, it is safe to assume the following will be true: Tricare Prime enrollment fees or Tricare Standard deductible won't increase - Tricare mail-order pharmacy co-pays would be reduced to zero for most formulary drugs; a probable increase in retail co-pays, though this issue needs some compromise between the House and Senate; possible requirement of a $25 ($40 per family) enrollment fee in Tricare Standard, but the House and Senate also have to compromise on this issue. However, I do not think the administration has given up, and we shall just have to see what works it way out.

- As for the Defense Authorization Bill, there are a group of amendments, which have been adopted by the Senate: Senator Harry Reid's amendment to implement full concurrent receipt to "unemployable" disabled retirees; Senator Mike DeWine's amendment to expand eligibility of certain survivors to transfer SBP eligibility to children. Key issues which remain at issue are: Senate provision would implement 30 year paid-up SBP as of Oct. 1, 2006 instead of waiting for 2008 (nothing in House version); the Senate bill would end the deduction of the VA's Dependency and Indemnity Compensation from SBP when the member's death was caused by service (nothing in House version).

- By passing the FY-2007 Military Quality of Life Appropriation, the House Appropriations Committee tore a $735 million hole in the DoD Health Program by rejecting Rep. Chet Edwards amendment. Without these dollars, DoD health will certainly run out of money early. This still isn't a dead issue, as the Senate can take up this issue of funding gap. The House's Bill included funding VA Medical Services at $25.4 billion, $2.6 billion above last year's figure, but $100 million below the president's request.

- The Department of Veteran's Affairs says that the stolen laptop computer possibly containing personal data of millions of vets has been recovered. The FBI is at present trying to determine if the data had been compromised, The VA has just issued a new warning of a "phishing" scam that targets veterans who may be worried that their VA data was stolen. This involves Internet fraudsters who send mass e-mails or pop-up messages asking unsuspecting recipients to provide personal information like credit card numbers, bank account information, Social Security number, passwords or other sensitive information so that the scammer can check whether their data has been compromised. Some come from abuse@vba.va.gov and ask the recipient to check an account by clicking a link. The VA has no such e-mail address and the link in the e-mail is in Asia. Don't get caught. Everyone should know better than to give out such information. If you do receive a suspicious e-mail, do not open it, delete immediately.

- The new civilian commissary chief should have a longer term than his previous military chiefs. The newly named Director of the Defense Commissary Agency is Patrick Nixon. He had been acting director for two years and Chief Executive Officer since 2001. At the top of his priority list is to find ways to work more closely with other military stores, which could eventually come to having commissary and exchange in the same building (but not combined into one facility). He will be pushing for better produce, and will be capitalizing on technology. His plans include reshaping the commissary work force so its employees can perform a number of jobs. Nixon is from the A&P food stores originally, however since 1983 he has worked with the Army Troop Support Agency and the Marine Corps commissary operation before they were combined into the Joint Defense Commissary Agency. He feels ultimately responsible for making sure the commissary remains a viable benefit.

- The VA still seems to be having trouble getting patients in for their first medical exam. In APR 05 there were 15,211 waiting. Recently the number APR 06 the number was 372,328. This is the highest figure since 2003 for those waiting more than 180 days being 95,529. Critics are calling for increased funds to meet these demands, for our aging population as well as newest wounded and disabled veterans returning from conflicts. They say some of this delay is due to improper paperwork, however it appears that a major factor is that of insufficient funds to meet the demands.

- There is still an outcry from the American Medical Association and retiree groups about the proposed 4.7% cut in Medicare physician reimbursement rates. If something isn't done to stop this, it will cause beneficiaries more problems finding a physician willing to accept Tricare patients. These rates directly tie to Medicare rates by law, and Medicare and Tricare remain among the lowest-paying insurance plans in the country. As physician reimbursement rates lag farther and farther behind actual practice costs, the situation is just going to get worse. As an example, a survey run earlier in the year spelled the worrisome figure of 45% of physicians planning to decrease or stop seeing new Medicare and 43% plan the same action for Tricare patients if these payments do begin in 2007.

- More drugs are being moved to the third tier as follows: Anzamet, Seasonale, Ovacon-35, Ovacon-50, Estrostep FEG, Lyrica,Cmbatla, Lexapro, Paxil CR, Prozac Weekly, Sarafem, Wellbutin XL, Detrol, Oxytrol, Sanctura, Lexxel and Tarka. The list gets bigger and bigger, the formulary smaller and smaller.

- Quality of life is critical for disabled veterans to maneuver around their house. Even if they qualify for Department of VA assistance, the grants usually do not cover the expenses of modifying their home. The International Code Council Foundation has begun a nonprofit project called HERO (Homes Eliminated of Restrictions and Obstacles) free to veterans to help make their home more accessible. The project brings together building officials, architects, engineers, businesses and other volunteers to provide this benefit. Several groups are already helping build homes accessible for wounded veterans of the Iraq and Afghanistan wars. But the project does expand the concept to veterans of any wars who have disabilities that limit their way of life. Pilot programs are being started around the country by organizing state coordinators
[Source: The Dolphin Community News 2 Nov 06 ++]


VA DATA PRIVACY BREACH UPDATE 27: Veterans in the New York area, and perhaps elsewhere, have begun receiving notifications dated 20 OCT from the Veterans Administration about the possibility that they could be victims of identity theft due to yet another missing VA computer. A sample notification letter can viewed at http://maloney.house.gov/documents/vete ... DTheft.pdf). The stolen computer was used to record results from a particular pulmonary testing device, and did not contain medical records. Personal data of veterans - including names, Social Security numbers and medical diagnoses - may have been compromised when a computer went missing from the Manhattan VA hospital in New York on 6 SEP. The computer was locked onto a cart that was stored in a locked storeroom. VA, police, and the VA Office of the Inspector General are investigating the theft. In the interim video cameras are being installed in key locations within the facility and an inventory of all other equipment that stores patient data has been done. In the New York case, the laptop was not encrypted because it is a medical device. However, 82% of non-medical laptops managed by the healthcare system have been encrypted

The VA apparently only just recently sent letters notifying affected veterans. In its notice, the VA says free credit monitoring for those affected "should be available within the next month," and it encourages the veterans to obtain a free credit report by calling one of the three national credit bureaus at (877) 522-8228. Information about this and other protections, including a “fraud alert” on your credit account is available by calling the Federal Trade Commission at (877) 438-4338 or by visiting their website www.ftc.gov/bcp/edu/microsites/idtheft/. A VA call center open M-F 08-1600 has been established to help answer questions concerning this matter at 1(800) 436-8262. Or, you can write VA New York Healthcare System, 423 East 23rd St., NY, NY 10010 Attn: Peter Juliano, Privacy Officer N36.

Patients potentially in jeopardy will be notified by separate letter when the credit monitoring becomes available. Earlier this year, the VA faced scrutiny when laptops went missing in two separate incidents that put in jeopardy the identities of millions of veterans. Rep. Carolyn Maloney (D-Manhattan, Queens) chastised the Department of Veterans Affairs for its continuing failure to secure personal data and for waiting more than six weeks to notify New York City veterans. Maloney said, “This is not the kind of Halloween trick that our veterans want. The VA seems to be mishandling this situation at every step of the way - first they lost yet another computer, then they waited almost two months to tell veterans that their identities might be at risk. When is the VA finally going to get serious about protecting veterans’ personal data?” [Source: Rep. Maloney Press Release Nov 06 ++]


MEDICARE WHEELCHAIR AVAILABILITY: In AUG 06 Medicare issued a final local coverage determination (LCD) for power mobility devices (PMDs). The new LCD implements a series of new payment codes for power wheelchairs and scooters, and creates coverage standards for devices with functional capabilities that place them into either Groups 1(low functioning), Group 2, or Group 3 (high functioning) PMDs. Additionally, Medicare has recently issued new reimbursement levels for power wheelchairs that significantly cut payments to providers for Group 3 power wheelchairs. All of these changes are scheduled to take effect on 15 NOV 06. Implementation of these changes will generate three problems:

- The new LCD states that in order to qualify for a high-functioning, Group 3 device, a beneficiary must be “unable to independently stand and pivot to transfer due to a neurological condition or myopathy.” This is a problem because there are many individuals with disabilities who may be able to stand and pivot but will need a Group 3 device to participate in their daily activities. This standard fails to take into account the functional needs of the individual and will result in significant access problems for individuals with Multiple Sclerosis, Parkinson’s Disease, Cerebral Palsy and many other disabilities.
- The LCD would implement a new interpretation of the “in the home” restriction by denying access to wheelchairs that have capabilities which are deemed unnecessary for indoor use. Medicare currently covers wheelchairs that are needed by individuals for use in their homes but has not prevented individuals from using the devices outside of their homes. However, this new policy will not cover devices that have features that are useful for out-of-home use. This change will further confine Medicare beneficiaries with mobility impairments to the four walls of their homes.
- The new reimbursement levels for high-functioning (Group 3) wheelchairs represent up to a 40% cut in prices paid to providers. While this will mean lower co-payments for beneficiaries, these reimbursement cuts will likely translate into serious access problems for beneficiaries as providers and manufacturers are unable to provide these high-end devices to Medicare beneficiaries at the new reimbursement levels.

Overall, the changes will severely restrict access to the more technologically-advanced power wheelchairs which are often required by individuals with long-term disabilities and chronic conditions. On 18 OCT Representatives Ramstead (R-MN-03) and Langevin (D-RI-02), Co-chairs of the Bipartisan Disability Caucus, sent a letter to the Acting Administrator of the Centers for Medicare and Medicaid Services (CMS) expressing concern about the changes scheduled for 15 NOV. The United Spinal Association is asking citizens to contact their Congressional representative and ask them to press Medicare to rescind the new power wheelchair coverage policy (LCD) and stop reimbursement cuts for Group 3 wheelchairs. Also, to support the ‘Medicare Independent Living Act of 2006’ (S. 3677/H.R. 5983) to eliminate Medicare’s in the home restriction on mobility devices. Without enactment of this legislation, Medicare will continue to utilize this coverage restriction which prevents access to appropriate mobility devices for people with disabilities that are needed for them to live independent lives and participate fully in society. A sample letter is available at www.unitedspinal.org for mailing to representatives. [Source: OFFE msg 3 Nov 06 ++]


NAVY MOBILIZATION PLAN: According to briefing documents obtained by Navy Times and confirmed by Vice Adm. John G. Cotton, chief of the Navy Reserve they expect to mobilize 9,300 sailors during the next 12 months, That figure means that nearly one in three available reservists (not counting the 38,000 who have already been mobilized and the approximately 5,000 listed as not deployable for medical, dental, or other administrative reasons) will mobilize during the next year for deployments ranging from six months to more than one year. Cotton said he does not believe the rate of mobilizations will exhaust the pool of available reservists; that is because the Navy Reserve’s 26% yearly turnover creates a fresh supply of deployable sailors every year, according to Capt. David J. Wray, spokesman for the Navy Reserve. But most new reservists are prior-service sailors who enter from the active component as already deployable assets. Such sailors who have deployed within their last 12 months on active duty can ask that mobilizations be put off for their first year in the Navy Reserve. As of 31 OCT there were 71,300 people serving in the selected reserve.

Cotton said the number of reservists who will be contacted for possible mobilization will be higher than 9,300. That is because Navy officials have found that as many as 40% of reservists contacted for recent mobilizations could not deploy, despite being listed as deployable by their units. Cotton said the exact number of reservists who can expect a mobilization call next year is unknown because it is difficult to predict precisely how many sailors who are called will be determined to be deployable. The Navy Reserve had been authorized by Congress to have as many as 6,200 mobilized reservists throughout the year, a number that does not include a smaller number of reservists who count against active-duty billets or who have been mobilized for 30-day operational deployments to fulfill their annual drilling requirements. That 6,200 is a number Congress has specifically authorized for the Navy Reserve to bring sailors on full time but not have them count against the active-duty end strength. In the past, the Navy had to do a juggling act to ensure the number of activated reservists did not put the Navy over the end strength authorized by Congress. Cotton said he anticipated keeping no more than 6,000 reservists mobilized at any given time during the next 12 months. [Source: NavyTimes Chris Amos article 2 Nov 06 ++]


FT. MCCLELLAN VETS: Personnel who served at Ft McClellan AL and/or Anniston Army depot prior to 1978 who have health issues, claims, etc that may be related to PCB's, CARC Paint, Solvents, toxic or other chemical exposures are being asked to identify themselves for inclusion in notification lists for future recall of patients plus announcements on the DoD Health Registery. Send current name, service numbers, and other contact info to Dave Abbott, Compensation & Pension Service (21), Department of Veterans Affairs, Veterans Benefits Administration 810 Vermont Ave. NW, Washington, DC 20420 Tel: (202) 273-8947. If available include a copy of your DD 214 or a page from your DA Form 20 showing your assignment dates at McClellan. For questions or amplifying information email capdabbo@vba. va.gov or pcbveteran@yahoo. com. A search at www.google.com for Chemical exposure and FT McClellan and/or www.cma. army.mil/ anniston. aspx will bring up some info. Dave Abbot’s office is as an extension to VA’s Environmental Health Office where the Veterans Disability Commission will be coordinating their efforts on the notification announcements whenever that happens. Women Veterans especially need to come forward if their married names have changed over the years.

Fort McClellan covers over 45,000 acres in eastern Alabama, and was the site of weapons training and the U.S. Army’s Chemical Warfare School. Since closure in 1999, the post has undergone numerous environmental investigations for underground storage tanks, groundwater contamination, landfill locations and contents, soil contamination and unexploded ordnance (UXO. The base is the former national home of the Womens Army Corps (WAC), the Army Chemical Corps, and the Army Military Police School. Pelham Range consists of approximately 22,000 acres of land west of the main post, which is located adjacent to Anniston, Alabama. One of the uses of the Pelham Range was as a radiological training area for
simulated large area radioactive contamination (fallout) from the surface detonation of a small yield nuclear weapon. The training concept involved the raising and lowering of sealed radioactive sources. Students would then perform ground and aerial surveys to map the fallout pattern. This training occurred from the mid 1950s through May of 1973. The Army used locally fabricated Co-60 sources and higher activity commercially produced Cs-137 sources. A number of leaking locally fabricated Co-60 sources contributed to the formation of the burial mound. The Anniston Chemical Agent Disposal Facility in Alabama has destroyed nearly 18% of the chemical agent and over 15% of the munitions stored at Anniston Army Depot, including all GB M55 rockets, 8-inch and 155mm projectiles, which represents a 38% reduction in risk to the local community. [Source: VVA Alabama msg 2 Nov 06 ++]


FEDERAL STUDENT AID: The federal government offers several Financial Student Aid Programs which can be reviewed at http://education.military.com/money-for ... tudent-aid . These programs offer you extremely low interest loans and grants (free money). Every accredited school that is recognized by the Education Department will be eligible for some form of FSA. Unlike the GI Bill, these programs are paid through the school; however, like the GI Bill, Federal Student Aid is designed to assist you in meeting the cost of tuition, books, fees, and living expenses while you go to school. That means that once the school has taken its share, the remaining loan or grant balance goes to you. Federal Student Aid and your military education benefits can work together.

You are eligible for FSA if you are all of the following:
- A high school graduate, or have a General Education Development (GED) certificate;
- Working toward a degree or certificate;
- Enrolled in an eligible school or program;
- A U.S. citizen or eligible non-citizen (must have a valid Social Security Number);
- Registered with the Selective Service if required (you can use the paper or electronic FAFSA to register)

It does not matter whether you are active duty, reserve, veteran, retiree, on MGIB, or not -- you can take advantage of these programs. Once you have enrolled in college, you need to start the application process. You can apply for all of the available FSA by filling out the FAFSA form online. Once you have submitted the Free Application for Federal Student Aid (FAFSA), your school will notify you which types of loans, grants and the total amounts you are qualified to receive. When you get this notification from the school, simply select the loans and grants you want and the school will finish the loan process. Applying for FSA is easy if you use the FAFSA Pre-Application Worksheet available at www.fafsa.ed.gov/worksheet.htm to guide you. The FAFSA form only takes a relatively short time to complete. Without the worksheet the FAFSA process can be complicated. You will need to gather your tax forms from previous years, including W-2s, bank statements and investment statements to complete the form. FAFSA is a Free Application for Federal Student Aid; however there are some websites that offer to complete the FAFSA for you, for around $50. "Military Friendly" schools that are eager to send you free information on how to get the funding you need to cover your education goals can be located at http://schools.military.com/schoolfinde ... schools.do. [Source: Military.com 27 Oct 06]


TELEMARKETING CALL ELIMINATION UPDATE 04: In 1991 Congress passed an Act granting consumers rights to defend themselves against unwanted telemarketing calls. A summary of these rights can be found at www.junkbusters.com/self.html#telemarketing. The Act outlawed various offensive practices, such as the use of recorded messages for solicitations. It also called for the Dederak Communications Commission to “prescribe regulations to implement methods and procedures for protecting the privacy rights... in an efficient, effective, and economic manner and without the imposition of any additional charge to telephone subscribers” In other words, Congress wanted you to be able to stop telemarketers without having to pay. The next sentence of the Act said that this ``may require the establishment and operation of a single national database to compile a list of telephone numbers of residential subscribers who object to receiving telephone solicitations, and to make that compiled list and parts thereof available for purchase.'' In other words, Congress wanted you to be able to put your number on a list that makes calling your number illegal. The FCC decided against the idea of a single national database, preferring as more cost-beneficial what they called company specific do-not-call lists. In other words, FCC decided to burden people with the task of telling every company to put their number on that companies list. A decade later, a different agency, the FTC, did what the FCC would not. You can now register your phone number(s) in the National Do-Not-Call Registry at http://donotcall.gov or by calling 1-888-382-1222.

Telemarketers always use a script: why shouldn't you? Every time you get a call you consider junk, just ask the questions in the below script. You may want to print a copy and keep it next to your phone. If they answer no to any of the below you may be able to sue them. Information on how to do this can be found at www.junkbusters.com/self.html#remedy. Questions you should ask and document if called are:
- Are you calling to sell something?'' (or, is this a telemarketing call)
- Could you tell me your full name please? **
- And a phone number, area code first? **
- What's the name of the organization you're calling for? **
- Does that organization keep a list of numbers it's been asked not to call? **
- I would like my number(s) put on that list. Can you take care of that now? **
- Does the company you work for also make telemarketing calls for any other organizations? (If they answer no, skip the next question.) (If yes)
- Can you make sure your company won't call me for any other organization? **

You may need to ask to speak with a supervisor if they sound lost. When you're ready to let them off, you might close with, “Is it clear that I never want telemarketing calls from anyone?” and just say goodbye. If you feel like making them pay more for the phone charges, keep going:
- Will your company keep my number on its do-not-call list for at least 10 years? **
- Does your company have a written policy that says that on paper? **
- Can you send me a copy of it? **
- What's your supervisor's first and last name?
- What is your employer's business name, address and main telephone number?
- Are you calling for a tax-exempt nonprofit organization?'
- Is this call based on a previously established business relationship?'

Before hanging up, check you have all their answers written down, then say goodbye. Add the date and time to your record (i.e. only between 08-2100 local time allowed). Nothing here should be taken as legal advice. If they answer no to any question ending in ** you may be able to sue them for $500-$1500 under the Telephone Consumer Protection Act. But if the answer to either of the last two questions is yes, then the Act doesn't consider the call to be a solicitation, so it's not covered by many of its regulations. Also excluded are calls to business numbers. For more details, refer to www.junkbusters.com. [Source: NCPOA Tips n' Topics, 28 Oct 06 ++]


VA CLEP REIMBURSEMENT: Military veterans can now receive full reimbursement for CLEP (College-Level Examination Program) testing fees, thanks to a recently implemented law that enhances veterans' educational benefits. The Veterans Administration will reimburse veterans for the $60 CLEP examination fee as well as test-center administration fees. CLEP has been a critical part of the education services program for active-duty servicemembers since 1974. This new funding option provides continuity in benefits for those transitioning out of the military. Nearly 3,000 colleges and universities grant credit or advanced standing based on CLEP exam performance. By earning satisfactory scores on CLEP exams, veterans earn college credit in subject areas they have already mastered as a result of training or independent learning. Earning credit by exam saves a significant amount of time as veterans avoid taking courses in subject areas for which they already have knowledge. Veterans earning credit can make the most of their GI Bill tuition benefit by applying those funds toward needed coursework.

The 90-minute CLEP exams are administered on computers at 1,300 college test centers across the country. Veterans will receive their scores immediately after completion of the exam. CLEP exams are offered in 34 subjects ranging from English Composition to U.S. History, Spanish, and College Algebra. Since the program's inception in 1967, more than 6 million CLEP exams have been taken. For more information about CLEP and the benefits available to veterans, visit www.collegeboard.com/clepveterans.

The College Board is a not-for-profit membership association whose mission is to connect students to college success and opportunity. Founded in 1900, the association is composed of more than 5,000 schools, colleges, universities, and other educational organizations. Each year, the College Board serves 7 million students and their parents, 23,000 high schools, and 3,500 colleges through major programs and services in college admissions, guidance, assessment, financial aid, enrollment, and teaching and learning. Among its best-known programs are the SAT, the PSAT/NMSQT, and the Advanced Placement Program (AP). [Source: Military.com 27 Oct 06]


VET CEMETERY FOR SOUTHERN CA: The new Sacramento Valley National Cemetery, the nation's 124th VA-managed national cemetery, began burials in mid-OCT 06. The 561-acre site is located at 5810 Midway Road, Dixon, CA 95620 in Solano County, approximately 27 miles southwest of Sacramento along Interstate 80, between Dixon and Vacaville CA. It is intended to meet veteran needs for the next 50 years. About 346,000 veterans live within the service area of the cemetery. The cremated remains of Alvin Hayman and those of his wife were placed in the Cemetery, fulfilling Hayman's wish and consecrating land that he once owned. Hayman, who served in occupied Japan and later in the Reserves, was the first of eight veterans to be buried on the cemetery's opening day. The native San Franciscan died in July 2004 a few days after he sold his land to the VA. His family kept his cremated remains at home, so that they could honor his wish to be placed in the new cemetery when it opened.

Although the cemetery has opened for burials, construction will continue at the cemetery until July 2009. The construction contract calls for the development of an initial area of 14 acres, which will provide 8,466 gravesites consisting of 4,712 full casket and 3,754 in-ground burial sites for cremated remains. Initial operations will be conducted utilizing a temporary office, committal service shelter and equipment shed. . For information on the Sacramento Valley VA National Cemetery, call the cemetery office at (707) 693-2460. To schedule burials call 1(800) 535-1117. Sacramento was one of 10 areas VA identified in a report to Congress in 1994 as having a large veteran population not served by either a national or state veterans cemetery within a reasonable distance. In 1999 and 2003, with the passage of two laws, Congress directed VA to establish 12 new national cemeteries. Five have opened in the areas of Fort Sill, Oklahoma, Pittsburgh, Detroit, Atlanta, and Sacramento. The rest – one in Alabama and California, three in Florida, one near Philadelphia and one in South Carolina – will be located near large populations of veterans who currently do not have access to a burial option.

Including the new Sacramento Valley VA National Cemetery, there are seven national cemeteries in California. Three of these national cemeteries, Riverside, San Joaquin Valley and Sacramento Valley VA National Cemetery are open. Ft. Rosecrans National Cemetery currently has space for the burial of cremated remains. The other three, Los Angeles, San Francisco, and Golden Gate National Cemeteries can offer burial only to family members of those already interred. In addition to the Sacramento Valley VA National Cemetery, VA is planning another new national cemetery in the Bakersfield area. Information on VA burial benefits can be obtained from national cemetery offices, from the Internet at www.cem.va.gov or by calling VA regional offices at 1(800) 827-1000. [Source: DVA National Cemetery Admonistration Press Release Oct 06 ++]


DEPLETED URANIUM (DU) UPDATE 01: A Manhattan federal judge has ruled that a group of New York Army veterans who fell ill after inhaling depleted uranium dust from exploded U.S. shells can sue the federal government - but only for medical malpractice after their discharge. A 1950 Supreme Court decision - commonly known as the Feres Doctrine - has long prohibited suits against the federal government by soldiers. In his 29-page opinion U.S. District Judge John Koeltl ruled, "To the extent that the injuries asserted in the plaintiffs' complaint arise out of their military service ... the court is without jurisdiction to hear those claims." George Zelma, the plaintiffs' lead lawyer, had argued during a 6 SEP hearing that despite the broad prohibition of the Feres Doctrine, Congress had never intended our government to betray its own troops. Koeltl rejected Zelma's argument, but he did allow the eight former National Guardsmen to sue the government for medical malpractice they allege was committed by Veterans Administration doctors after they were discharged back into civilian life.

In APR 04, the New York Daily News revealed in a series of articles that several soldiers from the 442nd Military Police Company had been exposed to depleted uranium, a low-level radioactive heavy metal that has been used by the Pentagon since the 1991 Persian Gulf War in artillery penetrators and in the plating for M-1 tanks. Several soldiers from the 442nd - most of them policeman, firefighters and correction officers in civilian life - had been sent home from Iraq in late 2003 with a variety of ailments that included constant headaches, blood in their urine, blurred vision, numbness in their hands and persistent rashes. The Army doctors could not account for any of the ailments. The men claimed they were never warned about possible uranium exposure while in Iraq, and when they returned home military doctors either refused to test them for exposure to the radioactive metal or in some cases lost their test results. Independent exams and analyses of urine samples arranged by The Daily News for nine of the sick soldiers showed that at least four had inhaled depleted uranium dust, according to a nuclear medicine expert who conducted the tests. Another test on a soldier from another National Guard unit, Gerard Matthew, revealed in SEP 04 that he also had signs of depleted uranium exposure. In MAY 04 Matthew's wife gave birth to a girl who was missing three fingers on one hand.

Critics of the military's use of depleted uranium say the microscopic dust released by exploding shells can lodge in a person's lungs for years and cause physical or genetic damage from either the low-level radiation it emits or from its chemical toxicity. Pentagon officials have repeatedly defended its use as safe. The government says there have been virtually no illnesses documented among soldiers exposed to depleted uranium, even among those wounded with fragments from depleted uranium shells. The Daily News' articles led the Pentagon to tighten testing procedures for all soldiers, and they sparked efforts in more than a dozen state legislatures to require testing of all returning National Guard troops. But the debate over depleted uranium continues to rage. Pentagon officials insist that depleted uranium shells, because of their incredible penetrating power, are an essential weapon that saves lives in combat. Opponents, on the other hand, say our military is spreading radioactive contamination. [Source: NY Daily News Juan Gonzalez Article 4 Oct 06 ++]


TERRORIST ATTACK PREPARATION: According to a new survey released 13 OCT during the annual meeting of the American College of Emergency Physicians (ACEP) in New Orleans, American citizens are unprepared for a terrorist attack or natural disaster, and there are no significant differences among military, retired military and civilian families regarding preparedness for disasters, Drs. Richard Dagrosa and John McManus, both emergency physicians in the military, surveyed people in San Antonio, Texas, including patients in two military hospital emergency departments. The survey results show no significant differences among military, retired military and civilian families in regard to having a disaster plan, designating a meeting place or having a disaster kit. Only half the families in the survey had prepared any kind of disaster plan, and only one-third possessed a disaster kit. According to the study authors, all the groups indicated disaster plans were important and reported feeling less prepared after completing the survey. Dr. Dagrosa, an Air Force Captain stationed at Wright-Patterson Air Force Base in Ohio said, “After all the attention focused on disaster preparedness since 9/11, it is surprising to find families lacking plans or supplies for a terrorist attack or natural disaster. It is scary to think about preparing for the worst case scenario, but the alternative is doing nothing. Yes the local emergency departments will be there in a disaster, but so will all of the people who didn't prepare their families for a large scale disaster. The best possible thing families can do to prepare themselves for a terrorist attack or a natural disaster is to be as self-sufficient as possible. And that goes for families in the military as well as civilians."

The disaster kit portion of the survey was based on recommendations of the Department of Homeland Security and the American Red Cross. The study authors said information on family readiness and recommendations for creating a household disaster kit are readily available, but an overall lack of personal preparedness is evident. Drs. Dagrosa and McManus concluded that more education and perhaps government subsidized disaster kits may be possible solutions to the preparedness problem. Information on what a disaster kit should consist of can be found at www.fema.gov/areyouready/assemble_disas ... s_kit.shtm. The preparedness survey is being presented in New Orleans at ACEP's annual Scientific Assembly where emergency physicians from the around the country and many other nations gather to share research and learn the latest developments in emergency care and patient safety. More than 400 poster presentations are scheduled to be presented this year. For more information about the research, visit www.acep.org. ACEP is a national medical specialty society representing emergency medicine with more than 25,000 members. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. [Source: ACEP Press Release 16 Oct 06]


TRICARE RESERVE SELECT UPDATE 06: The week the Tricare Management Activity (TMA) has issued 2 new publications to help explain the TRS benefit. One is a 40 page handbook (Tricare Reserve Select Handbook) and the other is a flyer explaining the programs costs to beneficiaries (Tricare Reserve Select: Summary of Beneficiary Costs Flyer). The Handbook provides information on what is covered and what is not under the plan. It also tells how to make and appointment, how to file claims etc. The flyer explains the costs of TRS, as well as Pharmacy costs, deductibles and claim filings. Both can be read and downloaded at the Tricare Web site: http://tricare.osd.mil/reserve/reserves ... oducts.cfm.


DECA SCHOLARSHIPS 2007: The Scholarship for Military Children Program sponsored by the Defense Commissary Agency (DECA) has started giving out applications at DOD’s 264 Commissaries. The $1500 scholarships are primarily funded by the manufactures and suppliers selling goods to the commissaries. The scholarship program has also made inroads to increasing support from the “nonmilitary” community. California high school students sponsoring golf tournaments in 2006 raised thousands of dollars to donate to the program, and already for 2007, a private foundation has made a substantial donation. Donations can be made through the link at www.militaryscholar.org, the official program Web site. Every dollar donated to the program by industry or the general public goes to fund the scholarships. The program, administered by the Fisher House Foundation, was founded in 2001 and has given out nearly 3,000 scholarships worth a total of $4 million. A significant number of scholarships, about 10% every year, go to high school students at DoD schools overseas.

Completed applications along with an essay explaining “how and why” an applicant would change a historical event must be turned into a commissary by 21 FEB. At least one $1,500 scholarship will be awarded at every commissary location with qualified applicants. The program is open to unmarried children under the age of 21 (23 if enrolled in school) of military active-duty, Reserve, Guard and retired personnel. Eligibility will be determined using the Defense Enrollment Eligibility Reporting System database. Applicants should ensure that they, as well as their sponsor, are enrolled in the DEERS database and have a current ID card. The applicant must be attending or planning to attend full time an accredited 4 year college or university in the fall term of 2007 (or in a program designed to directly transfer into a 4 year program). Application forms can be picked up at the commissaries or downloaded at www.commissaries.com, www.militaryscholar.org, or www.dodea.edu. [Source: TREA News Flash 3 No 06 ++]


TRICARE TRANSITIONAL SURVIVOR PROGRAM UPDATE 01: Effective 1 NOV 06 children of servicemembers who died while serving on active duty for more than 30 days on or after 7 OCT 01 now will remain in the transitional survivor status according to Section 715 of the National Defense Authorization Act for fiscal year 2006. In the past, the children converted to retiree status after three years, which meant higher copayments and deductibles. Minor children and unmarried dependent children now will remain in transitional survivor status, at the active duty payment rate, until they reach age 21, or up to age 23 if they are enrolled full time in an accredited university. Tricare will automatically reprocess medical claims originally processed and paid at the retiree payment rate for affected surviving family members and refund the difference in enrollment fees, cost shares or copayments paid at this rate and the transitional survivor active duty family member payment rate that now applies. Tricare also will mail letters beginning 20 OCT to the homes of all active duty survivors, children, and former active duty survivors listed in the Defense Enrollment Eligibility System (DEERS) whose active duty sponsor died between 7 OCT 01, and 31 OCT 06. The letter notifies family members of their retroactive eligibility for transitional survivor benefits. It also asks them to contact their Tricare regional contractor for guidance on reprocessing medical claims and any potential refunds due.

For surviving spouses, the transitional survivor status at the active duty family member payment rate ends three years from the date of death of their active duty sponsor. Until then Transitional survivors are eligible to enroll in Tricare Prime, the Tricare Prime Remote for Active Duty Family Members program, Overseas Prime, and Global Remote. Transitional survivors also are eligible for active duty-specific programs such as the Extended Care Health Option (ECHO) and hearing aids. Once they shift to the retiree payment rate this will cease. After the transitional survivor period ends, surviving spouses and incapacitated dependent children who become entitled to Medicare Part A due to age (65), disability or end stage renal disease, must purchase Medicare Part B in order to remain Tricare eligible. To avoid the Medicare surcharge for late enrollment, surviving active duty family members must purchase Medicare part B coverage when they first become eligible. For additional Tricare information for active duty transitional survivors refer to the Tricare Survivor Web page at www.tricare.osd.mil/survivors/default.cfm. [Source: MOAA News Exchange 8 Nov 06 ++]


MILITARY AIRFARE DISCOUNT: Blue Star Moms, a chapter of Blue Star Mothers of America, is circulating a petition that asks for a congressional resolution requesting 11 major airlines to provide discounted airfares for active duty troops. Blue Star Moms wants the carriers (Alaska, America West, American, Continental, Delta, Hawaiian, Jet Blue, Northwest, Southwest, United and US Airways) to reinstate the Military Standby airfare that was offered to active duty military personnel during the Vietnam War. They also want the airlines to provide military travelers on leave with their lowest fares, regardless of short notice, and to waive fees or penalties for refunds if military travelers receive a change of orders. The petition can be signed online at http://www.petitiononline.com/bsmmil/. [Source: Armed Forces News 3 Nov 06]


MEDICARE PART D UPDATE 10: The Medicare prescription drug program launched 1 JAN 06 promised coverage for all Medicare beneficiaries, regardless of income, health status or prescription drug use. It was a voluntary program, and people were urged to sign up for the plan of their choice, beginning 15 NOV 05. But for reasons that remain unclear, officials with the Department of Health and Human Services took it upon themselves to sign up large numbers of Medicare patients. Speculation is this was done in the interest of ensuring that people too old and infirm to jump on the opportunity would not be left out. Regardless of the reason there were unintended consequences. Thousands of military retirees already enrolled in Tricare for Life (TFL) suddenly were also enrolled in Medicare Part D. And all this was done without their knowledge and/or notification. For many, the first they heard of this was when they were standing in line at their pharmacy. The fallout in terms of paperwork, bureaucratic hassles and headaches is enormous. It means unnecessary costs for many Tricare patients and more paperwork to obtain partial refunds.

HHS officials say there is no easy remedy, and Tricare beneficiaries must disenroll themselves. When Medicare enrolls a TFL beneficiary in Part D, it automatically notifies DEERS it had done so. From that time on, the beneficiary's DEERS record reports that he/she has other health insurance (OHI). Tricare pharmacy coverage is not lost, but the beneficiary suddenly has some problems. For example, by being enrolled in OHI, the beneficiary may incur monthly premiums for the Part D commercial policy. By law, Tricare must be the last payer to all other coverage. So if a TFL beneficiary is enrolled in Medicare Part D, he/she has to use Medicare Part D first and many of the plans under that program require a deductible in addition to co-payments. Tricare will reimburse most of the deductibles and co-payments, but that requires filing a separate claim with Tricare. Under the current rules DEERS, Tricare and Humana are powerless to remedy the impact of involuntary enrollment in Part D. According to the federal law that created Part D, it is a voluntary program. Thus, enrollment in the supposedly voluntary program bears the consequences of its associated costs. Corrective action must originate with Medicare because:
- Only Medicare can cancel your Part D enrollment; and
- Only Medicare can provide official notification to DEERS confirming that action.
Affected TFL user’s DEERS records must be corrected to show that they have no other coverage than Tricare for their pharmacy services. Only then can they use their Tricare pharmacy program as the primary coverage for their pharmacy needs. There apparently is no provision for elimination of any costs associated with erroneous or involuntary enrollment.

Part D enrollees can cancel their membership for any reason. The process is supposedly quick and hassle-free. All you have to do is call Medicare, toll-free, at (800) 633-4227, and ask that your Part D enrollment be canceled. According to Medicare, the beneficiary's Part D enrollment will be terminated as of the last day of that month. Medicare will then notify the commercial Part D insurance plan's carrier and DEERS. When DEERS receives official notification from Medicare that a beneficiary is no longer enrolled in Part D, it will correct records to show eligibility for the Tricare pharmacy program as the TFL user’s primary coverage. As of the date that his DEERS record is updated, coverage will be as if the beneficiary had never been enrolled in Part D. To learn when that has been done beneficiaries can call the Tricare Support Office at (800) 538-9552 to inquire about the status of their DEERS record. That is also the number to call to make minor DEERS record changes (such as an address change), or to ask for instructions about making major changes. This should be done at least once a year, as a matter of course.

The Military Officers Association of America is lobbying Medicare and the Pentagon to make canceling Part D enrollment and notifying DEERS of the change as painless as possible. But there is word that HHS and the Defense Department are being prickly with each other slowing the process. They need to get over it and make this happen. And Congress needs to hold a hearing on:
- How can the military community be automatically enrolled in a voluntary system?
- How can they be forced to incur fees until they clear up the problem themselves?
- How can those in charge allow this to happen without any thought of notifying those affected?
[Source: ArmyTimes Jim Hamby article & NavyTimes Editorial 6 Nov 06 ++]


MEDICARE PART D UPDATE 11: Seniors need to watch upcoming changes in their Medicare Part D coverage carefully. Ralph McCutchen, Chairman of TREA Senior Citizens League (TSCL) is warning Seniors that failure to learn about and understand those changes could lead to some expensive surprises at the pharmacy in JAN 07. Specifically, Seniors should watch for new and higher premium and co-insurance costs, and the possible loss of coverage for some drugs. Some beneficiaries, especially those with lower incomes, but who are no longer eligible for Medicaid, are particularly at risk. McCutchen warns, “Some folks could lose their drug coverage altogether if they don't pay attention. We are especially concerned that Notch Babies will be affected, particularly those who rely on Social Security for most of their income". Notch babies are seniors born from 1917 through 1926 who receive lower Social Security benefits than other seniors with similar work and earnings records. The Notch refers to a sudden drop in benefits this group experienced when Congress enacted changes to the Social Security benefit formula in 1977. Studies for TSCL have found that today those Notch Babies with few savings who depend on Social Security for almost all of their income are likely to live at, or below, the federal poverty level.

Recently, the federal government notified some 632,000 lower income Medicare beneficiaries who automatically received federal "Extra Help" in the past that they would have to apply individually to get such assistance in 2007. McCutchen is urging those seniors or their family caregivers who received such notices to immediately contact Social Security to re-apply for 'Extra Help'. All Medicare beneficiaries are eligible for Medicare Part D drug coverage, regardless of income. Thus, if seniors or their families do not reapply for 'Extra Help,' they will still remain in their drug plans, but they may be charged a monthly premium for the first time, and may pay much higher co-insurance costs at the pharmacy in JAN 07. In addition, if their drug plan premium is automatically deducted from their Social Security, those affected will receive less in Social Security next year - a situation none of them can afford. Affected seniors who received notices may still be eligible for "Extra Help." According to the government's 2007 Medicare and You, beneficiaries with annual incomes of less than $14,700 (single) and savings of less than $11,500, or married couples with annual incomes of less than $19,800 and resources of $23,000 may be eligible. The federal government does not count the value of a person's home, car, or personal effects in determining resources. The ‘Extra Help’ open enrollment period is 15 NOV to 31 DEC. In order to ensure that federal assistance will continue uninterrupted starting 1 JAN, seniors can apply now for 'Extra Help' by calling Social Security at 1(800) 772-1213, or by visiting www.socialsecurity.gov. [Source: TREA Social Security and Medicare Advisor 9 Nov 06 ++]


VET DISABILITY PENSION SUIT: The U.S. District Court in New Haven ruled 6 NOV that Procter & Gamble, which had turned down a veteran’s request for a disability pension because of his military injuries, did not give his case the full review it deserved and ordered the multinational corporation to reconsider the request. Carl MacLeod, 45, of West Haven, was diagnosed with chronic solvent encephalopathy in 2004, a condition that can be traced back to his two-decade tenure in the service, where he had a long history of exposure to hazardous materials and cleaning solvents. MacLeod worked at the Clairol plant in Stamford as a maintenance supervisor for three years starting in 2001, a company that later was bought by P&G. Physical injuries incurred during his military career left him with back and shoulder problems, exacerbated by arthritis, but he continued to work until the neurological deficits brought on by the chronic solvent encephalopathy became apparent in OCT 04, according to medical records. CSE is a neurological disease that affects memory and cognitive functioning and, in MacLeod's case, has also affected his balance and ability to walk, according to his records. The decline is gradual and is expected to end in dementia and death.

U.S. District Judge Mark Kravitz found that P&G, which earned $2.7 billion in profits in the quarter ending Sept. 30, improperly amended its disability plan to exclude personnel with military injuries and also did not give Macleod, as required, a review of the facts in his case. Kravitz said the court would defer to the P&G trustees' "reasonable exercise" of their discretion in awarding or not awarding benefits to MacLeod, after it properly reviews his claims. But he noted in his ruling that MacLeod's "personal situation is compelling." Kravitz awarded attorney's fees to MacLeod because he said it may deter the company from litigating a position "that is clearly at odds" with the language of its pension plan. Also, he said MacLeod's suit ultimately will benefit a large class of individuals, namely those denied benefits because of military injuries. There is no timetable under which P&G has to act. A spokeswoman for P&G did not return a request for comment, and has said in the past it's against company policy to discuss issues in litigation. [Source: New Haven Register Mary O’Leary article 13 Nov 06 ++]


SOCIAL SECURITY SCAM: Jo Anne Barnhart, Commissioner of Social Security, and Patrick O'Carroll, Jr., Inspector General of Social Security, have issued a warning about a new email scam that has surfaced recently. The Agency has received several reports of an email message being circulated with the subject "Cost-of-Living for 2007 update" and purporting to be from the Social Security Administration (SSA). The message provides information about the 3.3% benefit increase for 2007 and contains the following "NOTE: We now need you to update your personal information. If this is not completed by November 11, 2006, we will be forced to suspend your account indefinitely." The reader is then directed to a website designed to look like Social Security's Internet website. Once directed to the phony website, the individual is asked to register for a password and to confirm their identity by providing personal information such as the individual's Social Security number, bank account information and credit card information. Inspector General O'Carroll recommends people always take precautions when giving out personal information. "You should never provide your Social Security number or other personal information over the Internet or by telephone unless you are extremely confident of the source to whom you are providing the information," O'Carroll said. To report receipt of this email message or other suspicious activity to Social Security's Office of Inspector General, please call the OIG Hotline at 1(800) 269-0271. If you are deaf or hard of hearing, call the OIG TTY number at 1(866)501-2101. A Public Fraud Reporting form is also available online at OIG's website www.socialsecurity.gov/oig. [Source: TREA TSCL Fraud Alert 13 Nov 06 ++]


WW1 VET SEARCH UPDATE 01: Here is a look at the last known living veterans of World War I. There are only a dozen known living American World War I veterans. For a profile of each person refer to www.shns.com/shns/g_index2.cfm?action=d ... S-11-08-06. Their average age is 108. Those still living are:

* Lloyd Brown, 106, lives in Bethesda, Md.
* Russell Buchanan, 106, lives in Watertown, Mass.
* Frank Buckles, 105, lives near Charles Town, W.Va.
* Russell Coffey, 108, lives in North Baltimore, Ohio.
* Samuel Goldberg, 106, lives in Greenville, R.I.
* Moses Hardy, 112 or 113, lives in Aberdeen, Miss.
* Emiliano Mercado del Toro, 115, lives in Isabella, Puerto Rico.
* Antonio Pierro, 110, lives in Swampscott, Mass.
* Ernest Pusey, 111, of Bradenton, Fla.
* Howard Ramsey, 108, lives in Portland, Ore.
* Albert Wagner, 107, lives in Smith Center, Kan.
* Charlotte Winters, 109, lives in Boonsboro, Md.

Once they stood 4.7 million strong: American farm boys, factory hands and tradesmen itchy for adventure, all called by their country to fight “the war to end all wars.” Now, on the 88th anniversary of the armistice that ended World War I there are not enough surviving U.S. veterans of that defining conflict to fill a platoon. When 2006 began, an unofficial roster of known remaining American WWI vets listed only about 24 names. , Scripps Howard News Service has confirmed that eleven months later, those ranks have dwindled to 12. Perhaps another dozen, who joined the armed forces after Armistice Day and served in the immediate aftermath of the war, still live, as well. With an average age of 108, it is unlikely these numbers will hold for long. All are pushing the envelope of human longevity, especially Emiliano Mercado del Toro, of Isabella, Puerto Rico, who at 115 is both the world’s oldest living man and the longest-lived U.S. veteran in history.

In an era that seems ancient by today’s standards, many of these vets were born under a U.S. flag with just 45 stars and have witnessed three centuries. They have seen 19 presidents lead the nation through seven wars. Their lives began be

[boardman]

RAO Bulletin Update 1 November 2006


THIS BULLETIN UPDATE CONTAINS THE FOLLOWING ARTICLES:

== USFSPA Lawsuit [11] ----------------- (Supreme Court Appeal Next)
== NDAA 2007 [16] -------------------------- (Authorization Act Signed)
== Veterans Day ------------------------------- (History)
== Veterans Day [01] -------------------------- (Wear Your Medals)
== Veterans Day [02] -------------------------- (Free Offers to Vets)
== Agent Orange Lawsuits [06] ------------- (Awaiting VA Appeal)
== Tricare/CHAMPUS Fraud [02] ---------- (Health Visions Indictment)
== Tricare/CHAMPUS Fraud [03] ----- (Medco $155 million Settlement)
== VA Claim Delay Causes [01] ------------- (New Vet Impact)
== VA COLA 2007 [03] ---------------------- (Increase of 3.3%)
== SSA COLA 2007--------------------------- (3.3% Increase)
== CSRS COLA 2007-------------------------- (2.3% &3.3% Increases)
== VA Mental Health Care [02] ------------- (Escalating Demand)
== VA Budget 2007 [06] ----------------- ($10 billion Underestimated)
== VA Health Care Enrollment [01] -------- (Are You eligible?)
== VA Copay [04] ----------------------------- (2006 Rates)
== VDBC Update 07--------------------------- (OCT Meeting Summary)
== VA Disability Buyout [02] ---------------- (CNA Report Conclusions)
== Health Care Quality/Price [01] ----------- (DoD Improvements)
== Medicare Reimbursement Rates [02] ---- (Tricare Users Impacted)
== Navy Electronic Service Record --------- (Paper Phase Out)
== Mobilized Reserve 25 OCT 06------------ (Net Decrease 362)
== Tricare Uniform Formulary [15] ----------(More Tier Changes)
== VA "IU" Growth [02] ---------------------- (GAO Conclusions)
== PTSD Reevaluation [07] ------------------ (Heart Disease Risk)
== Tricare Overseas Programs --------------- (Point-of-service)
== Gulf War Syndrome [01] ------------------ (DoD Report Available)
== Purple Heart Museum --------------------- (Debut on 10 NOV)
== Military Bank Scam ----------------------- (BOA Users Targeted)
== VA Data Privacy Breach [26] ------------ (Legal Data Loss)
== USMC Personal Data Breach ------------ (Another Laptop Lost)
== Vet Benefits – FL [01] -------------------- (Tax Exemption)
== Credit Card Offers ------------------------- (How to Reduce)
== NEXCOM Telephone Call Rates -------- (1 NOV Reduction)
== Daylight Savings Time -------------------- (Different in 2007)
== TSP Update 07 ------------------------ (Legislative Agenda 2007)
== Military Legislation Status ---------------- (Where we stand)


USFSPA LAWSUIT UPDATE 11: A 1982 law that allows state courts to divide military retirement as marital property in divorce proceedings has grown a skin of armor, making it impenetrable to court challenge or legislative change. That, at least, is how it must seem to long-time critics of the Uniformed Services Former Spouses Protection Act (USFSPA) and to bureaucrats seeking changes just to improve how the law is administered. Last month, a federal appeals court rejected a host of constitutional challenges to the USFSPA brought by 58 divorced retirees and active-duty members. Also last month, Congress declined to allow the first minor adjustments to the ex-spouse law in 14 years, shelving three Senate-passed provisions. The reason said a congressional staff member was that Lawmakers were peppered with complaints from divorced members and ex-spouses, some saying more than planned should be done to ease their grievances and others wanted the law be left alone. There is still power going through the third rail from the wave of complaints. He was comparing the political hassle of amending the USFSPA to the deadly third rail that lawmakers believe they touch when they try to change the Social Security program.

Divorced members who continue to challenge the legality of the USFSPA in court suffered their latest disappointment 18 SEP 06 when the U.S. Court of Appeals for the Fourth Circuit, in Richmond VA ruled in the Adkins v. Rumsfeld case. The three-judge panel upheld a district court judge’s rejection of the lawsuit, examining the various constitutional challenges raised and finding none has merit. The plaintiffs in this case raised money for their legal challenge through a limited liability corporation they established called the USFSPA Legal Support Group. The ULSG has almost 2,500 members of which half donated money to pursue the case. Their lawsuit argued:
- The ex-spouse law violates divorced members’ rights to due process and equal protection. Plaintiffs argued persons who joined the military before the law was enacted should be protected from its effect because they served with the expectation of receiving full retired pay, not of seeing it divided as marital property.
- States do not apply the law uniformly, which steps on Congress” authority to raise and support armies.
- The law is discriminatory toward female servicemembers. Their reasoning on this point is that the law was enacted so that ex-spouses are not left destitute after military marriages dissolve. Yet the 24-year-old law fails to recognize the number of women now in service, and the reality that their male ex-spouses are more likely to have independent incomes that lessen their financial need to share in military retired pay.

Writing for the appeals court majority opinion, Judge M. Blane Michael considered and dismissed each of these arguments. He wrote:

- It is incorrect to allege that before the USFSPA was enacted that Congress had promised to shield military retirement from valid court orders. Some states were dividing retired pay until 1981 when the Supreme Court ruled in its McCarthy decision that such division was not back by law. Congress promptly nullified that decision by passing the USFSPA so it can not be held that a promised benefit was taken in violation of due process of law.
- The appeals court found, because USFSPA gives state courts the option to divide military retirement upon divorce, it tolerates variation among the states in how that pay is actually divided between spouses in individual cases. Congress can prescribe uniformity regarding treatment of service personnel but with this law it chose not to do so. Therefore, there is no constitutional encroachment by state courts on federal authority.
- Regarding the law’s impact on the guarantee of equal protection he noted that the USFSPA does not distinguish between men and women but between retired servicemembers and their former spouses. That distinction, he concluded, is based on a legitimate government interest in the personal and economic sacrifices of spouses to sustain marriages through the rigors of service life.
- The argument that the USFSPA is inequitable because it allows ex-spouses access to retired pay without the same service obligation that retirees continue to face including possibility of recall to duty presupposes that the retirement pay can only be characterized as compensation for service rendered during retirement. The presupposition is false. Although military retirement pay has some unique features, it also resembles an ordinary civilian pension in many respects, and Congress grasped that resemblance in passing the Act.”

The ULSG intends to appeal the decision to the Supreme Court..Congress, meanwhile, refuses to make any change to the USFSPA or even to hold hearings. Those Senate-passed provisions knocked from the final defense authorization bill would have repealed the 10-year rule that dictates what court orders the Defense Finance and Accounting Service deems eligible for automatic payment of retired pay to former spouses. Another provision would have directed DFAS to honor all valid court orders involving making cost-of-living adjustments to ex-spouse shares of retirement. A third change would have ended a DFAS requirement to notify retirees when DFAS receives a court order directing division of retired pay. [Source: Stars & Stripes Tom Philpott article 26Oct 06 ++]


NDAA 2007 UPDATE 16: On 17 OCT President Bush signed into law H.R. 5122, the “John Warner National Defense Authorization Act for Fiscal Year 2007.” The annual authorization act addressed a number of priorities for the military community, including some very good and long needed provisions.
• The conference report prohibits DoD from increasing any premiums, deductibles, copayment, or other charges under Tricare medical care for retirees, dependents, survivors or members of the Selected Reserve until 30 SEP 07.
• The conference report rejects the Pentagon Plan to double current pharmaceutical copays.
• The conference report makes all drilling reserve members eligible for Tricare coverage at the lowest current premium (28% of cost).
• The bill adopted the minimum 2.2% military pay raise as requested in the administration’s budget.
• The conference report authorizes $23.8 billion immediate replacement of Army and Marine Corps supplies and equipment.
• The bill contains a number of provisions to end predatory payday lending practices that trap servicemembers in uncontrollable debt.

Provisions not adopted and/or not put made law by the 109th Congress:
• No action on ending the dollar-for-dollar offset in the military Survivor Benefit Plan (SBP) against the Department of Veterans Affairs Dependency and Indemnity Compensation (DIC), which presently provides 55,000 survivors a flat monthly payment after a service-connected death.
• No action to accelerate the date for termination of the SBP paid-up plan. Thus, 327,000 Military retirees age 70 and older, who have paid into the plan for more than 30-years, will be required to continue to pay until OCT 08.
• Conferees did not accelerate the phase-in of concurrent receipt for 28,000 retirees rated 100% disabled and unemployable by the VA.
• The conference dismissed provision of a new postal benefit program for members of the Armed Forces serving in Iraq and Afghanistan or hospitalized as a result of such service.
• The conference also dropped a provision to lower the age reservists can start drawing retired pay by 3 months for every 90 days deployed since 9/11.
• 17,000 POW who died in captivity will be denied the Purple Heart
• 188,000 Chapter 61 retirees with less than 20 years were denied CRDP/CRSC
• 4 million military & civilian retirees were denied pretax payment of their Tricare & FEHB premiums

One of the provisions of the NDAA directs the Secretary of Defense to establish a task force on the future of military health care. He is supposed to establish the task force within 90 days after the bill is enacted (signed) and to report no later than 31 MAY 07. The establishment of this task force is one of the best solutions to make DoD really look at the overall picture of health care. One of the major items it is to consider is the utility of a universal enrollment fee. The military and veterans community will be represented, as at least one of the members will be an MSO/VSO representative who has experience in health care. Providing that DoD completes the study in time as directed, the timing could be excellent as many of the budget appropriations and authorization hearings for 2008 should still be ongoing and maybe they can be positively influenced by the report. When it is released a summary will be provided in an update. [Source: NAUS Weekly Update 20 Oct & USDR Action alert 29 Oct 06 ++]


VETERANS DAY: World War I – known at the time as “The Great War” - officially ended when the Treaty of Versailles was signed on 28 JUN 19 , in the Palace of Versailles outside the town of Versailles , France. However, fighting ceased seven months earlier when an armistice, or temporary cessation of hostilities, between the Allied nations and Germany went into effect on the eleventh hour of the eleventh day of the eleventh month. For that reason, 11 NOV 18, is generally regarded as the end of “the war to end all wars.” In November 1919, President Wilson proclaimed 11 NOV as the first commemoration of Armistice Day.

The original concept for the celebration was for a day observed with parades and public meetings and a brief suspension of business beginning at 11 a.m. Congress officially recognized the end of World War I when it passed a concurrent resolution on 4 JUN 26, with these words:
Whereas the 11th of November 1918, marked the cessation of the most destructive, sanguinary, and far reaching war in human annals and the resumption by the people of the United States of peaceful relations with other nations, which we hope may never again be severed, and
Whereas it is fitting that the recurring anniversary of this date should be commemorated with thanksgiving and prayer and exercises designed to perpetuate peace through good will and mutual understanding between nations; and
Whereas the legislatures of twenty-seven of our States have already declared November 11 to be a legal holiday: Therefore be it Resolved by the Senate (the House of Representatives concurring), that the President of the United States is requested to issue a proclamation calling upon the officials to display the flag of the United States on all Government buildings on November 11 and inviting the people of the United States to observe the day in schools and churches, or other suitable places, with appropriate ceremonies of friendly relations with all other peoples.

An Act approved 13 MAY 38, made the 11NOV of each year a legal holiday - - a day to be dedicated to the cause of world peace and to be thereafter celebrated and known as “Armistice Day.” This was primarily a day set aside to honor veterans of World War I, but in 1954, the 83rd Congress, at the urging of the veterans service organizations, amended the Act of 1938 by striking out the word “Armistice” and inserting in its place the word “Veterans.” With the approval of this legislation (Public Law 380) on 1 JUN 54, November 11th became a day to honor American veterans of all wars. Later that same year, on 8 OCT President Eisenhower issued the first “Veterans Day Proclamation” which stated: “In order to insure proper and widespread observance of this anniversary, all veterans, all veterans’ organizations, and the entire citizenry will wish to join hands in the common purpose. Toward this end, I am designating the Administrator of Veterans’ Affairs as Chairman of a Veterans Day National Committee, which shall include such other persons as the Chairman may select, and which will coordinate at the national level necessary planning for the observance. I am also requesting the heads of all departments and agencies of the Executive branch of the Government to assist the National Committee in every way possible.”

In 1958, the White House advised VA’s General Counsel that the 1954 designation of the VA Administrator as Chairman of the Veterans Day National Committee applied to all subsequent VA Administrators. Since MAR 89 when VA was elevated to a cabinet level department, the Secretary of Veterans Affairs has served as the committee’s chairman. The Uniforms Holiday Bill (Public Law 90-363)) was signed on 28 JUN 68, and was intended to insure three-day weekends for Federal employees by celebrating four national holidays on Mondays: Washington’s Birthday, Memorial Day, Veterans Day, and Columbus Day. It was thought that these extended weekends would encourage travel, recreational and cultural activities and stimulate greater industrial and commercial production. Many states did not agree with this decision and continued to celebrate the holidays on their original dates.

The first Veterans Day under the new law was observed with much confusion on 25 OCT 71. It was apparent that the commemoration of this day was a matter of historic and patriotic significance to a great number of our citizens, and so on 20 SEP 75 President Ford signed Public Law 94-97 which returned the annual observance of Veterans Day to its original date of 11 NOV, beginning in 1978. This action supported the desires of the overwhelming majority of state legislatures, all major veterans service organizations and the American people. Veterans Day continues to be observed on 11 NOV, regardless of what day of the week on which it falls. The restoration of the observance to 11 NOV not only preserves the historical significance of the date, but helps focus attention on the important purpose of Veterans Day: A celebration to honor America’s veterans for their patriotism, love of country, and willingness to serve and sacrifice for the common good. [Source: http://www1.va.gov/opa/vetsday/ NOV 05]


VETERANS DAY UPDATE 01: The Honorable R. James Nicholson, Secretary of Veterans Affairs, and leaders of major veterans organizations on 18 OCT called on America's veterans to help kindle a new spark of patriotism on Veterans Day 11 NOV by wearing the medals they earned during military service. "We are announcing a Veterans Pride Initiative to remind Americans of the pride and honor in the hearts of those who have served," Nicholson said. "We expect Americans will see our decorated heroes unite in spirit at ceremonies, in parades and elsewhere as a compelling symbol of courage and sacrifice on Veterans Day, the day we set aside to thank those who served and safeguarded our national security. The campaign is modeled after a tradition in Australia and New Zealand, countries who honor the Australian and New Zealand Army Corps (ANZAC) on 25 APR. ANZAC Day sees veterans wearing their military decorations whatever they are doing on that day.” Nicholson said he hopes a U. S. tradition will ensue to emulate this pride in being a veteran and in honoring our veterans. VA is offering information about the campaign on its Web page, http://www.va.gov/veteranspride/ where veterans also can obtain information on the correct order of precedence for each military service's award, about how to replace mislaid medals, and learn how to confirm the decorations to which they are entitled. [Source: VA News Release 18 Oct 06]


VETERANS DAY UPDATE 02: In their annual salute to all veterans McCormick & Schmick’s Seafood Restaurants will again provide free meals in honor of Veterans Day. All veterans can receive a free lunch or dinner entrée at McCormick & Schmick’s Seafood Restaurants nationwide on Sunday, 5 NOV 06. Vets should show proper identification (VA card, VFW card, veterans ID, discharge papers, etc.) Reservations Are Strongly Encouraged! In a show of thanks to our nation’s veterans, Bill McCormick and Doug Schmick offer to serve those who’ve served at their McCormick & Schmick’s Seafood Restaurants. Last year the company served nearly 15,000 vets nationwide. This year’s event is taking place on the Sunday before Veterans Day so that families can participate. McCormick & Schmick’s annual veterans program began as a small effort in just one restaurant in 1999. Due to its overwhelming popularity and positive response received from veterans the program has expanded nationwide. A complete list of participating restaurants may be found at www.McCormickandSchmicks.com .

Also thanking active duty and veterans, the Golden Corral restaurants will be having their annual salute to the military on Monday November 13, from 5-9pm. Military Appreciation Monday (First Monday after Veteran’s Day) is set aside for Golden Corral to honor all active duty and retired military personnel with a free “thank you” dinner and beverage at any Golden Corral restaurant. No identification is required. Since 2001, Golden Corral has served 1,230,960 free meals to active duty and retired military personnel. For more information go to their website http://www.goldencorral.net/.

The U.S. Department of the Interior and Department of Agriculture have announced a waiver for fees on Veterans Day. On 11 NOV, soldiers and their families will be allowed to use selected lands and parks without being charged the customary fees. This is a gesture of support for the men and women of the U.S. Armed Services, and will be repeated every Veterans day hereafter as well. Participating facilities include recreation lands under control of the National Park Service (www.nps.gov), areas under the Fish and Wildlife Service (www.fws.gov), and the U.S. Forest Service (www.fs.fed.us). Refer to their respective web sites to locate a facility near you. [Source: NAUS weekly Update 20 Oct & Military.com 30 Oct 06 ++]


AGENT ORANGE LAWSUITS UPDATE 06: The U.S. Court of Appeals for Veterans' Claims in the case of Haas v. VADC-Nicholson slapped-down the VA's "boots on the ground" definition of who served in Vietnam...thus opening up the area of Agent Orange claims to "Blue Water Navy," "Fly-Through Air Force" and troops serving in nearby countries. DVA announced they were going to appeal the Court's decision and asked the Department of Justice (DOJ) to appeal the Haas decision for which they have until 7 NOV to act. In the interim the Secretary of Veterans Affairs implemented a stay on the adjudication of Haas-like claims contrary to the VA’s "benefit of the doubt" policy when it comes to filing claims. A recent decision of the Court of Appeals for Veterans Claims made it clear that the VA had not followed the proper procedure for taking such action. Richard V. Spataro Staff Attorney for the National Veterans Legal Services Program (NVLSP) on 28 SEP filed a Writ of Mandamus with the Court, requesting that the Court order the VA to rescind its illegal stay of proceedings on Haas-like claims. The judge then ordered the VA to file an answer to NVLSP’s Writ by 26 OCT.

As of 30 OCT the precise grounds of the VA appeal was not known and will not until since VA files their brief. The deadline to do this will be in about three months. NVLSP recommends all veterans who fall into this category go ahead and file their claims now since the VA has not asked the Court to stay its decision. This way they will be on file and, should this all shake out in favor of veterans, the claim will be dated from the day it was received by the VA. VA Regional Offices are not presently processing the new claims while the Central Office considers appealing the Court's decision. Regional Offices have not been given any legal guidance in order to adjudicate the claims. Their hands are tied in this matter. Since VA has not released any special procedure to be followed on how claims should be submitted normal VA claim filing procedures for submitting claims should be followed. NVLSP is an independent, nonprofit, veterans service organization dedicated to ensuring that the U.S. government honors its commitment to our veterans by providing them the federal benefits they have earned through their service to our country. Additional info on them and this subject can be found at www.nvlsp.org. [Source: NVLSP memorandum 30 Oct 06 ++]


TRICARE/CHAMPUS FRAUD UPDATE 02: Erik C. Peterson, United States Attorney for the Western District of Wisconsin, announced the unsealing of a seventy-five count indictment yesterday charging Thomas Arthur Lutz, DOB 04/24/1967, of Olongapo City, Republic of the Philippines, and the Health Visions Corporation, a Philippine corporation, with defrauding the federal Tricare program. The indictment had been previously returned by a federal grand jury sitting in Madison on 13 JUL 05, and was unsealed in conjunction with the appearance of Lutz in Guam, after his arrest in the Republic of the Philippines.

According to the indictment, between OCT 98 and AUG 04, Lutz and the Health Visions Corporation devised a scheme to defraud the federal Tricare program. Specifically, as part of the scheme, Lutz on behalf of the Health Visions Corporation entered into a kickback agreement with a medical provider in the Philippines in which the provider, at the request of Lutz, paid 50% of the amount of the bills for medical services rendered to Tricare patients referred by Health Visions back to the corporation. In addition, Health Visions and Lutz inflated the bills of other providers by one hundred percent or more before submitting the bills for payment by the United States Government. The defendants also created a sham insurance program to circumvent Tricare’s requirement that beneficiaries pay a deductible and cost share, and they also submitted fictitious and fraudulent Tricare claims falsely claiming that beneficiaries had been hospitalized and had been rendered services when, in fact, they had not.

Lutz and Health Visions Corporation are specifically charged with 32 counts of mail fraud, 41 counts of filing a false claim, one count of conspiracy to violate the laws of the United States, and the forfeiture count. If Lutz is convicted, each violation of the mail fraud statute carries a maximum sentence of twenty years imprisonment and a $250,000 fine. The conspiracy and false claim counts each carry a maximum sentence of five years imprisonment and a $250,000 fine. The Health Visions Corporation, if convicted, is subject to a fine on each count of conviction of $500,000, or, in the alternative, potentially two times the amount of gain to the defendant or two times the loss to the government. The indictment seeks forfeiture of more than $900,000 owed to the government.

The charges were the result of an investigation by the Defense Criminal Investigative Service (DCIS) of the Department of Defense’s Office of Inspector General, the Naval Criminal Investigative Service, the U.S. Postal Inspection Service, and the Internal Revenue Service. The charges were brought in the Western District of Wisconsin because Wisconsin Physicians Service, the fiscal intermediary which processed and paid these alleged fraudulent claims, is located in Madison, Wisconsin which is in the Western District of Wisconsin. The prosecution is being handled by Assistant U.S. Attorneys Peter M. Jarosz and Daniel J. Graber. Readers are advised that a charge is merely an accusation and that a defendants are presumed innocent until and unless proven guilty. Those previously involved with Health Visions who want to determine their status or to participate in the Federal Witness/Victim Program can call Barb Williams at (888) 415-9821 or (608) 264-5158, write United State’s Attorney’s Office, Western District of Wisconsin, PO Box 1585, Madison WI 53701-1585, or email usawiw.webmaster@usdoj.gov. [Source: Office of the U.S. Attorney, Western District of Wisconsin Press Release 18 Oct 06 & www.usdoj.gov/usao/wiw ++]


TRICARE/CHAMPUS FRAUD UPDATE 03: A prescription drug provider used by federal employee health insurance plans agreed in Late OCT to pay the government $155 million to settle multiple claims of fraud. Medco Health Solutions of Franklin Lakes, N.J., allegedly paid kickbacks to health plans to gain their business, took money from drug manufacturers to favor their drugs and destroyed prescriptions to avoid penalties for delays in filling them. The U.S. Attorney's office in Philadelphia announced the settlement 23 OCT, several months before the case was scheduled to go to court. Medco did not acknowledge any wrongdoing in the settlement. Medco is the second largest pharmacy benefit management company in the country, handling prescriptions for more than 60 million Americans. The Office of Personnel Management, which administers the Federal Employees Health Benefits Program, promised not to bar Medco from future participation in government contracts.

Medco has contracts with Blue Cross Blue Shield, the Government Employees Hospital Association, the National Association of Letter Carriers, and several other FEHBP insurers to provide prescription drugs. The $155 million settlement involves more than just the FEHBP, though. Medco also provided drugs for the Defense Department's TRICARE health insurance program, and for Medicare. "Millions of federal employees and Medicare beneficiaries rely on pharmacy benefit managers such as Medco for their prescription drugs," Assistant Attorney General Peter Keisler said. "Hidden financial agreements between [pharmacy benefit managers] and drug manufacturers and health plans...can influence which drugs patents receive, the price we all pay for drugs, and whether pharmacists serve patients with their undivided professional judgment."

This settlement is not the first of its kind for OPM. In JAN 06, the agency's inspector general announced several multimillion-dollar settlements for pharmaceutical wrongdoings as part of his semiannual report to Congress. A similar case ended in a $54.6 million settlement from AdvancePCS, another pharmacy benefit manager. OPM's IG claimed that AdvancePCS took money from pharmaceutical manufacturers in return for favorable treatment of its drugs in FEHBP contracts. The government also alleged that the company illegally paid health insurance plans to ensure its selection as their pharmacy benefit manager. The IG uncovered $1.5 million in improper rebates to Group Health Inc., a New York area medical plan. GHI, the inspectors claimed, also was late in repaying another $5 million in rebates. The company did not respond to requests for comment.

The JAN IG report noted that two FEHB physicians were found to have unethically prescribed painkillers. One, a Washington state psychiatrist, over-prescribed oxycodone and hydrocodone to patients so that he could keep some for himself. A Virginia doctor overly prescribed similar, highly addictive painkillers. Several of his patients died of overdoses, although it was not clear that his prescriptions were the source. Both physicians were debarred from practicing under the FEHB. In an effort to step up its investigations into FEHB drug providers, IG Patrick McFarland said his group is in the process of auditing multiple firms that manage pharmacy benefits and he was focusing more resources on prescription drug fraud. The OPM IG also is investigating some cases involving drugs that are prescribed for uses other than their Food and Drug Administration-approved purpose. [Source: GOVEXEC.com Daily Briefing 12 Jan & 26 Oct 06]


VA CLAIM DELAY CAUSES UPDATE 01: The National Security Archive, a nonpartisan research organization affiliated with George Washington University, has obtained figures about claims made by veterans of Iraq and Afghanistan that portend an inundation of the VA claims system. The figures, obtained through a Freedom of Information Act (FOIA) request, indicate 32% of veterans of the 1991 Persian Gulf War have filed disability claims over 15 years, while five years into the Afghanistan and Iraq campaigns, 27% of newly discharged veterans already have filed nearly 153,000 claims. The current deluge of claims is adding to a large existing backlog. To counter this, Rep. Steve Buyer, R-Ind., chairman of the House Veterans’ Affairs Committee, proposed earlier this year to hire 200 more claims adjudicators and provide $400,000 for training The VA has reduced its average processing time for initial benefits to 174 days, but the two wars continue to increase claims.

Veterans' groups have criticized the VA for using emergency appropriations to fund veterans' benefits rather than realistically planning and budgeting for the veterans' needs. According to Veterans for America (VFA) the newly released data suggests official estimates dramatically understate the future cost of the current Iraq and Afghanistan Wars. If the current trend continues, then VA could receive as many as 400,000 disability claims from the 1.6 million deployed active duty and reserve service members in the Global War on Terrorism. Jonathan Powers, Associate Director of Veterans for America and an Iraq War veteran, warned, "VA already has a backlog, and the claims process is only going to get worse unless VA takes action now. VA has no plan or funding to process and pay existing and future claims to ensure our veterans promptly receive the disability benefits and healthcare care they earned."

Veterans for America (VFA) posts FOIA documents at www.veteransforamerica.org/moduleid/114 to inform the public about the causes, conduct, and consequences of the Iraq and Afghanistan wars. The first FOIA law was enacted in 1966 to promote learning and understanding about government programs and policies. Congressman John Moss thought FOIA was essential to equip the American public with information so they could be responsible citizens. In its most recent FOIA annual report available at www.va.gov/foia/report/FY2005/Terms.html, the VA purported to process 1.9 million FOIA requests during FY 2005, with a median processing time of 11 days. For further information on FOIA refer to www.gwu.edu/~nsarchiv/NSAEBB/NSAEBB194/index.htm, For further information on VFA refer to /www.veteransforamerica.org/. For further information on the National Security Archive refer to www.gwu.edu/~nsarchiv/index.html. [Source: Armed Forces News 27 Oct 06 ++]


VA COLA 2007 UPDATE 03: Military retired pay and veterans’ disability compensation will increase by 3.3% on 1DEC, marking an annual cost-of-living adjustment that is both less than expected and smaller than last year’s 4.1% increase. The 3.3% increase will first appear in January checks. For the second straight year, it is larger than ` JAN increase in military basic pay, which will be just 2.2%. The main reason the retirement COLA is below 4% is that energy prices and transportation costs have dropped in the last three months, according to statistics provided by the U.S. Labor’s Department’s Bureau of Labor Statistics, which compiles consumer prices. In the past year, some consumer costs have risen by more than 4%. Health care costs increased an average of 4.2% and housing costs jumped by 4.1%, according to the BLS. Food price, on the other hand, rose by just 2.5%. At the same time, transportation costs have dropped by 3.2% from a year ago and overall energy costs have declined by 4.3%.

Annual increases in military and federal civilian retired pay and military survivor benefits are automatic, linked by law to the increase in Social Security benefits. All the benefits are tied to a comparison of consumer prices from the last three months of each fiscal year, which ends on 30 SEP, to the same period of the previous fiscal year. Veterans’ disability benefits, veterans’ dependency and indemnity compensation for survivors and veterans’ pensions do not automatically increase. But Congress passed and President Bush signed a bill guaranteeing they would get the same 1 DEC increase. Military pay raises also are approved only by an act of Congress, but that is not the reason why the 1 JAN basic pay increase will be less than the retirement adjustment. Military and federal civilian pay raises are computed by law to keep pace with private-sector wage growth, not with inflation. Often, such as in 2002 through 2005, this results in military raises that are larger than retirement increases. But the 1 JAN 06 military raise and now the coming 1 JAN 07 military increase will be lower because private-sector wage growth has been lower than inflation. [Source: NavyTimes Rick Maze article 18 Oct 06]


SSA COLA 2007: The Social Security Administration announced 18 OCT Tat the monthly Social Security and Supplemental Security Income benefits for more than 53 million Americans will increase 3.3% in 2007. Social Security and Supplemental Security Income benefits increase automatically each year based on the rise in the Bureau of Labor Statistics' Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W), from the third quarter of the prior year to the corresponding period of the current year. This year's increase in the CPI-W was 3.3%. The 3.3 percent Cost-of-Living Adjustment (COLA) will begin with benefits that nearly 49 million Social Security beneficiaries receive in JAN 07. Increased payments to more than 7 million Supplemental Security Income beneficiaries will begin on 29 DEC. Some other changes that take effect in January of each year are based on the increase in average wages. Based on that increase, the maximum amount of earnings subject to the Social Security tax (taxable maximum) will increase to $97,500 from $94,200. The retirement earnings test exempt amount applicable to earnings for months prior to attaining full retirement age will rise from $33,240 to $34,440 a year. For those who are fully retired this will rise from $12,480 to $12,950. Exceeding these limits will result in one dollar in benefits being withheld for every $3 or $2 in earnings respectively above the limit. Of the estimated 163 million workers who will pay Social Security taxes in 2007, about 11 million will pay higher taxes as a result of the increase in the taxable maximum in 2007. Information about Medicare changes for 2007 can be found at www.cms.hhs.gov. [Source: SSA.gov press release 18 Oct 07]


CSRS COLA 2007: Federal retirees in the Civil Service Retirement System will receive a 3.3% percent larger pension check in 2007. The government unveiled next year's cost-of-living allowance 18 OCT. It is based on the change in the Labor Department's Consumer Price Index for urban wage earners from the third quarter of one year to the same quarter of the next. The 3.3% boost is smaller than the 4.1% increase for 2006, which was the highest since 1991. But the 2007 rate still is bigger than the several years before 2006. In 2005 the increase was 2.7%, in 2004 it was 2.1%, in 2003 it was 1.4% and in 2002 it was 2.6%. The COLA will not be the same for retirees in the newer Federal Employees Retirement System. If the change in the CPI is more than 3%, FERS retirees get the COLA minus 1%. So FERS members will get a 2.3% adjustment next year. FERS is more dependent on government matching contributions to the Thrift Savings Plan, a 401(k)-style retirement investment vehicle for federal employees. As a result, FERS retirees sometimes get smaller COLAs, and they only receive the cost-of-living allowance if they are 62 or older. CSRS annuitants must have been retired one full year to receive the full COLA. If they do not meet that threshold, they will receive prorated annuities, encompassing one-twelfth of the applicable increase for each month they've received their pension. Federal retirees will receive their first checks reflecting the increase in JAN 07. Current employees in the civil service will get a different annual increase altogether which is based on a pay hike determined by Congress and approved by the president. Lawmakers still are debating between a 2.2% raise, which they already approved for the military, and a 2.7% raise, which they included in initial drafts of legislation for civilians. If civilians get a 2.2% raise, the Federal Salary Council recommended it be allocated between a 1.7% across-the-board boost and a 0.% locality hike. With a 2.7% raise, the breakdown would be 1.7& and 1%. [Source: GOVEXEC.com Daily Briefing 19 Oct 06]


VA MENTAL HEALTH CARE UPDATE 02: A network of community-based walk-in veterans’ treatment centers is under increasing pressure as more and more former troops who served in Iraq and Afghanistan have come looking for help. A report to be issued 19 OCT from the House Veterans Affairs Committee’s Democratic staff says that nearly a third of all Vet Centers have seen the demand rise for outreach and other services. The report surveyed Vet Centers operated by the Department of Veterans Affairs. It found that the number of Iraq and Afghanistan veterans who have sought help for post-traumatic stress disorder (PTSD) doubled, from nearly 4,500 to more than 9,000 from October 2005 through June 2006. The number of veterans with other types of possible mental health and readjustment problems also doubled, and in some cases tripled, the report said. Half of the Vet Centers sampled reported that their expanding caseloads have affected their ability to treat their current clientele. “The administration’s failure to increase staffing and other resources for Vet Centers has put their capacity to meet the needs of veterans and their families at risk,” the report said. Among the other findings in the report:
- 40% of the centers have sent veterans with readjustment issues who should be receiving individualized therapy into group therapy.
- 30% said they need more staff.
- 25% has taken or will take some action to manage their increasing workload, including limiting services and establishing waiting lists.
- 20% said they have either limited or no capability to provide counseling or therapy for families dealing with veterans suffering from PTSD or other mental health problems.

Rep. Michael Michaud, D-Maine, the House VA Committee member who requested the report said, “The Vet Centers’ staff are dedicated and deeply committed to meeting the needs of veterans and their families, but without additional resources, even dedicated staff has limits.” The study was obtained on the afternoon of 18 OCT and efforts to contact the VA for comment were unsuccessful. It was unclear when the VA received the report which can be viewed at http://veterans.house.gov/democratic/of ... enters.pdf. It is the result of a confidential survey of Vet Center staffs. The committee’s Democratic staff contacted a sample of 64 centers in all 50 states, the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands. Urban and rural areas were represented. Sixty centers responded. In addition to this report, the GAO recently reported that the Administration failed to fund $300 million in resources which the Administration previously touted for veterans’ mental health services in 2005 and 2006 (GAO-06-1119T).

The centers, part of the VA’s Readjustment Counseling Service, were created in 1979 under then-VA Administrator Max Cleland, a triple-amputee Vietnam veteran. They were designed to be accessible, storefront clinics where veterans could be seen almost immediately by a staff largely composed of combat veterans. Vet Centers provide a host of readjustment counseling services to assist veterans in successfully transitioning from military service to civilian life. There are currently 207 Vet Centers located throughout the 50 states, Puerto Rico, the Virgin Islands, the District of Columbia, and Guam. Their core mission is to help veterans suffering from mental and emotional concerns. PTSD, which wasn’t even recognized as a medical condition at the centers’ founding, is the most widespread mental health problem experienced by soldiers in combat. It can cause nightmares, flashbacks, depression, survivor’s guilt and other types of anxiety. Paul Sullivan, director of programs for Veterans for America (a veterans advocacy group) said, “ The Vet Center report was disturbing but not surprising. We’ve been saying that VA is in crisis. It shows that VA does not have a plan. This is additional evidence.”

The VA vastly underestimated the number of PTSD cases it expected to see this year, predicting it would see 2,900 cases. As of JUN 06, it has seen more than 34,000 Iraq and Afghanistan veterans for PTSD. A recent VA report shows that more than 1 in 3 Iraq and Afghanistan veterans who’ve gone to the agency for medical help report that they’re under stress or have mental problems. A top Walter Reed Army Medical Center official told Congress last month that 41% of National Guard and Army Reservists reported mental health concerns up to six months after deployment, compared with 32% of the active-duty force. 15% of the Guard and reservists were at risk for PTSD, compared with 9% of active-duty troops. [Source: McClatchy Newspapers Kansas City Star David Goldstein article 19 Oct 06 ++]


VA BUDGET 2007 UPDATE 06: In JAN 06 the National Security Archive (NSA) asked the Department of Veterans Affairs for records about the number of disability claims filed by veterans who served in the Iraq and Afghanistan wars. The NSA is an independent, nongovernmental research group located at George Washington University. Researchers there use the Freedom of Information Act to obtain declassified government documents and make them available to the public. In response to their initial request the VA made the pronouncement that no documents existed. The archive’s researchers were asked to believe that the government had no records of claims by Iraq and Afghanistan veterans. Of course, this could not be true. For the next nine months, the NSA made repeated requests and finally threatened to sue the VA if it did not turn over the records. This month, the government relented and complied. There were plenty of reports and plenty of documents. "For the agency to take nine months to find information that is of current public interest in the context of the ongoing global war on terrorism is astounding," said Meredith Fuchs, the NSA’s general counsel. "It is one thing for the VA to be reluctant to deliver bad news but another thing entirely to deny the existence of the information."

The news definitely was bad. The records show that about one in five service members leaving the military after serving in Iraq and Afghanistan has been disabled to some degree. More than 104,000 of the 567,000 returning veterans from the two wars have been given disability compensation so far, and more are applying for it each day. At least 1.5 million U.S. troops will serve in Iraq and Afghanistan, which suggests the possibility of 400,000 disabled veterans if current proportions hold. The potential burden to U.S. taxpayers is staggering. The Bush administration last year had to send the VA Secretary to ask Congress for $2 billion more for veterans’ care because of an embarrassing series of inadequate budget requests. Senate Republicans are pushing a bill that would appropriate $26 billion for veterans medical services next year - about 15% more than the administration proposed. “Failure to do otherwise,” says Sen. Olympia Snowe, R-Maine, “would be an open invitation to returning to the budget shortfalls of the past that contributed to historic primary care backlogs.” The Congressional Budget Office estimates that the administration’s 2007 veterans’ health budget is $10 billion below what’s needed. Backlogs in claims processing and appointments with physicians have increased during the past two years, due to the troops returning from the battlefields.

The administration admits that the year began with 52,000 people stuck on waiting lists to receive care at VA hospitals, but veterans groups believe the number is much higher now. The White House cannot begin to defend its budget requests if all the numbers are put on the table. The numbers will only get worse, as healthy veterans develop symptoms of service damage years later. About 30,000 Iraq and Afghanistan vets already have sought treatment for post-traumatic stress, and that number could increase exponentially as war-related psychological problems develop. Now that the Pentagon is making contingency plans to keep 140,000 troops in Iraq through 2010 raises the ominous prospect of creating a generation of disabled veterans that would rival those from the Vietnam War. Were it not for the Freedom of Information Act and the NSA, Americans might be tempted to believe that the White House has a plan to care for the nation’s veterans. [Source: Palm Beach Post Dan Moffett article 15 Oct 06 ++]


VA HEALTH CARE ENROLLMENT UPDATE 01: Many veterans believe if they lose their job and its associated health care insurance they will be able to get health care at their local Veterans’ hospital. Primarily because they were told upon discharge that, as veterans, they were eligible to use these facilities. But under federal rules blamed on budget constraints, millions of middle-class veterans who weren't injured in the military can no longer enroll in the U.S. Department of Veterans Affairs health-care system. The change occurred in 2003, and news of it has gradually trickled down to veterans. Under the 2003 enrollment policy, a single veteran in who earns $32,600 or more, and doesn't have a service-connected injury or illness, is not allowed to enroll in the VA medical system. Those enrolled before 17 JAN 03 are grandfathered in, and there's a special provision for veterans returning from Iraq or Afghanistan. The Washington Post has reported that as many as 10 million veterans who aren't in the system will not be allowed to enroll under the new rule. In just the past three years, more than 250,000 veterans who sought care at the nation's VA hospitals have been turned away because of the new rule.

VA officials contend the changes were necessary, given limited funds, the growing numbers of veterans seeking care, and the need to focus on those with service-connected disabilities and the poor. Nondisabled, higher-income veterans made up much of the rapid growth in its health-care enrollment between 1996 and 2003, hindering the system's ability to care for the disabled and poor. This growth is reflected in the VA's medical budget, which reached $30.7 billion this year. Generally those who are turned away state they had not heard of the rules change. There have been no mass mailings or other wider effort to inform all veterans. Information is available on the internet and at local VA offices and there is a pamphlet that describes enrollment policies. Recent veterans returning from war do receive letter notification from the VA.

Under the current enrollment policy, veterans fall into one of eight priority groups established in 1998. The highest-priority veterans are those with service-connected disabilities considered 50% or more disabling, and those determined to be unemployable because of service-related conditions. Those no longer eligible for care as a result of the 2002 policy change are in the lowest-priority group -- Priority Group 8, which includes veterans without service-connected injuries or illnesses and with an income above a geographically specific cutoff. The VA calls the change a suspension but does not say when it will end.
The new rule isn't the only way the VA has tried to limit enrollment. In 2002, rising demand for services prompted the VA to issue a national memo that discouraged recruiting veterans for enrollment. A similar directive issued in 2004 for the VA MidSouth Healthcare Network, said "facilities may not aggressively take steps to recruit new enrollees or new workload." There are an estimated 24 million veterans in the United States, and about 5.4 million are expected to seek care from the VA this year, compared with 2.9 million a decade ago. [Source: Louisville Courier-Journal Laura Ungar article 15 Oct 06 ++]


VA COPAY UPDATE 04: There is no monthly premium required to use VA care. You may, however, have to agree to pay copays. If you have insurance, it may cover the cost of copays. Veterans are categorized into Priority Groups 1 through 8 by the VA to establish their eligibility to receive VA medical care. These groups plus a few other factors determine the amount of copay they must pay for their medicine or medical care. Following is a breakdown of who must pay what:

- For 2006 an annual Medication copayment cap of $960 was established for veterans enrolled in priority groups 2 thru 6. Medications will continue to be dispensed when the copayment cap is met. Medication provided for treatment of nonservice-connected (NSC) conditions is $8 per prescription. An annual medication copayment cap was not established for veterans enrolled in priority group 7 or 8.
- Veterans in Priority Group 1 (50% or more) are not subject to copayments.
- Veterans in Priority Group 2 (30% & 40%) and below are subject to copayments. Basic and specialty outpatient care is $15 & $50 per visit respectively. Inpatient care is $10 per day per diem charge or $953 for first 90 days and $465 for each subsequent 90 days. Nursing Home or Day Care/Inpatient Respite Care/Geriatric Evaluation is $97 & $15 per day respectively. Domiciliary care is $5 per day.
- Veterans in Priority Group 3 (10% & 20%) are subject to copayments. Those in receipt of a Purple Heart or are former POWs are also placed in this priority group. Veterans who have been POWs are exempt from Medication Copays.
- Veterans in Priority Group 4 are subject to copayments. Catastrophically Disabled veterans placed in this priority group can be subject to full medical care copayments or to reduced inpatient copayments under the Geographic Means Test criteria.
- Priority Group 6 Health insurance and all applicable copayments will be billed when the care is for conditions not related to the veteran's exposure or experience. Veterans in this priority group are subject to full medical care copayments or to reduced inpatient copayments under Geographic Means Test criteria and to medication copayments.
- Veterans in special Categories are subject to copayments when their treatment or mediation is not related to their exposure or experience. The initial registry examination and follow-up visits to receive results of the examination are not billed to the health insurance carrier and are not subject to copayments. However, care provided that is not related to exposure, if it is NSC will be billed to the insurance carrier and copayments can apply.
- All veterans receiving prescriptions for NSC conditions who meet the low-income criteria (income limits for the VA NSC pension program) are exempt from the medication copayment.
- Veterans enrolled in priority group 7a and 7c have income above the VA Means Test threshold but below the Geographic Means Test threshold and are responsible for 20% of the inpatient copayment and 20% of the inpatient per diem copayment. The geographic means test copayment reduction does not apply to outpatient and medication copayments and veterans will be assessed the full applicable copayment charges. Note that reduced inpatient copayments can apply to veterans in Priority Groups 4 and 6 based upon the income of the veteran.
- Veterans assigned to Priority Group 7e or 7g are not eligible for enrollment if a decision to restrict enrollment of new Priority Group 7 veterans has been made. These veterans are eligible for care of their NSC conditions on a humanitarian emergency basis and are charged the applicable tortuously liable billing rate for services provided. Veterans in Priority Group 7e are eligible for care of SC conditions at no charge.
- Veterans enrolled in this priority group 8a and 8c are responsible for the full inpatient copayment and the inpatient per diem copayment for care of their NSC conditions. Veterans in this priority group are also responsible for outpatient and medication copayments for care of their NSC conditions.
- Veterans assigned to Priority Group 8e or 8g are not eligible for enrollment. These veterans are eligible for care of their NSC conditions on a humanitarian emergency basis and are charged the applicable tortuously liable billing rate for services provided. Veterans in Priority Group 8e are eligible for care of SC conditions at no charge.
[Source: www.va.gov/healtheligibility/costs/ Nov 06 ++]


VDBC UPDATE 07: At the Oct. 19 Veterans' Disability Benefits Commission hearing, military and veterans' organizations joined in opposing the concept of offering disabled veterans a single lump-sum payment rather than monthly disability compensation. The Commission had asked for association inputs on a draft report on this subject by the Center for Naval Analyses (CNA). The AUG 06 report can be viewed at https://www.1888932-2946.ws/vetscommiss ... ug2006.pdf. The report explored the advantages and disadvantages of a lump-sum program to both the veteran and VA and raised its own questions about the idea. Joseph Violante, Legislative Director for the Disabled American Veterans, testifying for the group of associations, said any savings to the government would necessarily come at the expense of the disabled veterans. He highlighted potential inequities for veterans whose disabilities worsened in the future and the difficulty and expense of building administrative systems to consider such appeals. After hearing the testimony, the commissioners unanimously agreed to table consideration of a lump-sum, buy-out plan. Commissioners intend to approve that decision formally at a future meeting, said Ray Wilburn, spokesman for the commission.

The commission then turned to consider line-of-duty rules, concurrent receipt, and characters of discharge. Concurrent receipt generated the most animated crosstalk. The four preliminary options the commission plans to address are:
* Endorse the current tiered approach;
* Endorse an offset of military retired pay by VA disability compensation;
* Endorse full concurrent receipt of both military retirement and VA disability compensation; and
* Endorse expansion of Concurrent Retirement and Disability Pay to include 10-40%.

During the public comment period, MOAA's Col. Mike Hayden (USAF-Ret) noted that there may be some uncertainty about what is considered "full" concurrent receipt, and urged the commissioners to ensure they consider an option that vests earned retired pay for "Chapter 61" retirees who are forced into medical retirement before attaining 20 years of service. The next scheduled meeting of the VDBC will be 16-17 NOV 06 at the Embassy Suites Hotel Washington DC. The commission, created by Congress in 2004, is conducting the first comprehensive review of veterans’ disability benefits in 50 years. Its recommendations are to be delivered to lawmakers next fall. Information about the VDBC inclusive of minutes of all previous meetings and future schedules can be found at www.vetscommission.org. [Source: MOAA Update 20 Oct 06 ++]


VA DISABILITY BUYOUT UPDATE 02: The idea of lump-sum offers for lower-rated disabled veterans was raised in 1956, the last time the VA disability system was overhauled. It has been endorsed periodically since then, by various studies. The Department of Defense uses lump sums under its own disability retirement program. Service members rated 30% disabled or more qualify for monthly disability retirement. But those rated 10 or 20% by DoD can only get a lump-sum disability severance. Most DoD disabled retirees apply for a VA rating after leaving service. That can result in a higher rating and better benefits. Those with DoD ratings of 10 or 20% typically see their monthly VA compensation delayed until an amount equal to their lump sum from DoD is recouped.

CNA Corp., formerly known as the Center for Naval Analyses, was hired by the Veterans’ Disability Benefits Commission to study and report on the advantages and disadvantages of a lump-sum option for VA. CNA reviewed how an option might be designed, who should be eligible and what savings might be gained. In their completed report CNA said veterans might view lump sums as more useful in transitioning to civilian life. They also might enjoy having a choice. And because lump sum recipients would have fewer interactions with VA, the timeliness of the VA claims process might improve. VA compensation costs, over time, also would fall because total dollars paid in lump sums would be a lot less than paid over a lifetime as monthly compensation. Compensation savings, in time, could be 10 to 20%.

CNA concluded the VA also would save on administrative costs. That would be especially true if veterans who accepted lump-sum payments were prohibited from applying for a “re-rating” as their disabilities worsened. But CNA acknowledged that lump-sum settlements raise new worries about the welfare of veterans who accept such deals. Some would use lump-sum payments foolishly, placing their financial futures in greater jeopardy. Another issue is what these veterans can do if their disabilities worsened. To better understand the implications, CNA tracked how VA disabilities in the year 2000 changed over the next five years. CNA found that by 2005 almost no veteran saw his or her disability rating drop and only five percent of disabilities had a rating increase. The average increase was between 20 and 30 percentage points. Skin, hearing, sight, gynecological and lymphatic conditions showed the smallest rating changes, an average of less than two percent. Ratings for post-traumatic stress disorder rose sharply, with that average between 30 and 40 percentage points.

To estimate both near-term costs and long-term potential savings from use of lump-sum settlements, CNA assumed they would be offered only to veterans rated 10 or 20 percent disabled and with conditions having no more than a two-percent probability of a rating increase over the next five years. Likely candidate conditions that fit the profile include tinnitus, thumb amputations, hypertension and scars on the face, neck or head. CNA calculated that offering lump sums to newly-rated veterans with these ratings and types of conditions would raise VA compensation costs by $545 million in the first year. More surprisingly, the VA wouldn’t break even and begin to see net savings from this change for 25 years. The Veterans’ Disability Benefits Commission has examined and rejected a proposal that the VA begin offering veterans with lower-rated disabilities a lump-sum payment instead of lifetime monthly compensation [Source: NavyTimes Tom Philpott article 26 Oct 06 ++]


HEALTH CARE QUALITY/PRICE UPDATE 01: The Assistant Secretary of Defense for Health Affairs, Dr. William Winkenwerder held a press conference 12 OCT to point out how DoD is supporting the President’s Executive Order to “Promote Quality and Efficient Health Care in Federal Government Administered or Sponsored Health Care Programs.” The Executive Order called for creating transparency in health care, which means providing more information to beneficiaries about issues such as health care costs. Dr. Winkenwerder highlighted the following examples of DoD’s leadership on this mandate:

- DoD created an informational link on the TRICARE website at http://tricare.osd.mil/tricarecost.cfm. to help educate beneficiaries regarding what TRICARE will cover for certain medical visits and procedures.
- Development of the Armed Forces Health Longitudinal Technology Application (AHLTA). This is an electronic military medical record on a secure database that is available worldwide 24/7. Currently, 8.6 million medical records are stored in AHLTA, out of a possible 9.2 million beneficiaries. This system allows the military to capture information in real time, which can be stored permanently and also be retrieved from another location. This method of capturing and transferring of medical data is especially beneficial when dealing with injured service members on the battlefield. Imagine
- Implementation of a wireless handheld device, known as Battlefield Medical Information System Tactical (BMIST), which enables the medical personnel to enter data that is recorded and immediately transmitted electronically to the AHLTA system. With this a medic or corpsman who evaluates the service member’s condition at the site of injury can place their medical assessment and the type of treatment received on-site into the database, which allows the information to be readily available for the healthcare provider when the injured service member arrives at the medical triage center. There are approximately 30,000 BMIST’s currently being used in OEF and OIF.
- Testing another medical collection device to be used when the BMIST signals can not be sent. With this medical information can transferred from the BMIST to a microchip placed into a type of dog tag, which is than physically transferred with the injured service member. The chip is then downloaded into the AHLTA system upon the injured service member’s arrival to the triage center.
- These new systems allow for a quick seamless transfer of medical information that significantly improve the method(s) in which military medicine does business and how they are saving lives during time of war.
- Deployment of the Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE) which is encrypted into AHLTA systems. ESSENCE allows 24/7 worldwide monitoring of DoD medical data for patterns of medical conditions that present in an unusual manner. For example, if a large number of DoD personnel are experiencing flu- like symptoms at different hospitals and health clinics at one or multiple geographical location(s), ESSENCE would allow for these cases to be analyzed as a whole rather than as viewing them as non-related individual cases. This program has the potential to determine whether there is an outbreak, such as the flu or food poisoning, that warrants an alert and increases the response time by the DoD and the Centers of Disease Control (CDC).
- Deployment of the Military Health System Population Health Portal M

[boardman]

RAO Bulletin Update 15 October 2006


THIS BULLETIN UPDATE CONTAINS THE FOLLOWING ARTICLES:

== NDAA 2007 [14] ----------------------- (Additional Provisions)
== NDAA 2007 [15] -------------------------------- (Pay Increases)
== GI Bill [11] --------------------------- (Modest Rate Increase)
== Tricare Skilled Nursing & LTC --------------- (What They Are)
== Generic Drug Prices [02] ------- (WalMart Expands Program)
== Vet Cemetery New Jersey [01] ---------- ($3.8 Million Grant)
== Medicare Rates 2007 [03] ------------------- (Lower SS checks)
== SSA Fund Depletion [03] ------------ (Totalization Agreement)
== Military Insurance/Investment Predators [01] ---- (Bill Signed)
== SAT/ACT Offer Extended ------------------- (Retirees eligible)
== Reserve GI Bill [03] --------------------- (DoD Opposes Raise)
== Reserve GI Bill [04] ------------------------------ (New Bill)
== WW1 Vet Search ----------------------------- (VA Looking For)
== Veterans Recruitment Office ------------ (2nd Office Opening)
== Tricare Handbook [01] ------------------------------ (New Issue)
== Mobilized Reserve 11 OCT 06---------- (Net Decrease 9,426)
== VA Health Care Funding [06] ------------ (Increase in Claims)
== Medicare Part D [09] ----------------------(2007 Cost Increase)
== ID Card (CAC) [02] ------------------------ (Available OCT 07)
== TSP [06] --------------------------------------- (September Gains)
== Tricare Newborn/Adoptee Registration ------ (Action to Take)
== Questionable Email -------------------------- (Don’t Be Fooled)
== Veterans Educational Assistance Program [01] ---- (New Bill)
== Tricare Rx Drug Dispute [01] ------------ (No 2007 Discount)
== FEMA Mobile Homes ---------------------------- (Sale to Vets)
== Tricare WIC Overseas Program -------------------- (What it is)
== Sole Surviving Child ---------------- (Assignment Limitations)
== Medical Mistakes ----------------------------- (Being proactive)
== Medicare Scam ------------------------------- (Seniors targeted)
== Business Opportunity Scams --------------------- (FTC action)
== Elderly Cold Prevention ------------------- (Vitamin E impact)
== Skin Cancer -------------------------------- (Cause & treatment)
== Military Legislation Status ------------------ (Where we stand)


NDAA 2007 UPDATE 14: The 1600-page FY2007 Defense Authorization Act that Congress passed on 30 SEP and the President signed into law included hundreds of provisions, large and small, that affect nearly all members of the military community one way or another. A sampling of some not previously mention in the Bulletin are:

Retiree Eligibility for Army Referral Bonus: Makes Army retirees (including Gray Area Reserve retirees) and Department of the Army civilians, as well as any active member of the Army, Army National Guard or Army Reserve, eligible for a $2,000 bonus for each recruiting referral that results in the referred recruit completing basic training and individual advanced training. Excludes JROTC administrators and instructors.

Employer Incentives to Take TRICARE: Prohibits civilian employers from providing cash or other incentives to their TRICARE-eligible employees to opt out of the company health plan and use TRICARE instead. The effective date of this provision is delayed until JAN 08. It also directs the Secretary of Defense to report to Congress by next spring on how this would affect situations in which employee coverage is through a cafeteria plan or when employers provide a generic token payment to all employees who use alternative coverage, only a small minority of which may be Tricare eligibles. Concerns are that the provision, as written, would unfairly penalize retired members whose employers only offer cafeteria plans (in which the employee receives a set amount of cash to buy whatever health care he or she uses) or who provide $100 a month to any employee already using some other plan through a spouse or previous employer. In many cases, there may be one eligible employee who uses TRICARE and 20 who use a spouse's federal civilian insurance or other coverage. The advance report requirement will allow Congress time to change the law if they do not like the answer in the Pentagon report.

Mortuary Affairs in Combat Theater: Requires expanded transportation and escort/honors considerations for members who die in a combat theater, and requires comprehensive Pentagon review and report to Congress on improving mortuary affairs procedures at forward locations and improving assistance to survivors.

Physical Evaluation Board (PEB) Reform: Requires Secretary of Defense to establish regulations to improve timeliness and consistency of physical evaluation board results for all services, and improved communications/explanations for members on PEB decisions and rationale.

Housing Allowance for Mobilized Members: Authorizes additional housing allowance for mobilized Guard and Reserve members and recalled retirees who are assigned to a location remote from their permanent residence and without government housing.

Voluntary Separation Incentive: Authorizes payment of voluntary separation pay, up to four times the amount of involuntary separation pay, to members in categories identified by service secretaries as requiring force reductions. This provision is intended mainly for the use of the Air Force and Navy, which must reduce their manpower levels by 23,000 and 12,000, respectively, in the coming year.

Survivor Benefits for Active Duty Deaths: Allows surviving spouses of members who died on active duty since 7 OCT 01 the option of transferring Survivor Benefit Plan (SBP) coverage to a child or children, if any. This effectively allows the survivor to receive both Dependency and Indemnity Compensation (DIC) from the VA and SBP from the military, without having the former deducted from the latter. However, transfer to the child is irrevocable, and eligibility is not restored to the spouse when the youngest child loses dependent status.

Chiropractic Services: Requires Pentagon to provide a report by March 31, 2008 on the feasibility and cost vs. benefit of providing chiropractic coverage for all military beneficiaries.
Health Care Options for Families of Mobilized Reservists: Requires Pentagon study (due in April 2007) of allowing family members of Guard/Reserve members the option of retaining their civilian employer coverage, with premiums subsidized at some level by the Defense Department, during periods when the member is mobilized.

For a more detailed summary of personnel and benefit provisions of the FY2007 Defense Authorization Bill, check out www.moaa.org/lac_resources_07ndaa_matrix.htm. A complete list of provisions can be found on the websites of the Senate Armed Services - http://armed-services.senate.gov/press.htm\ and/or
House Armed Services - http://www.house.gov/hasc/pressreleases/. Congress recessed and headed home to their home states to campaign before the November elections. Leaving all but the Defense and Homeland Security funding bills unfinished, they are expected back in Washington the week of 13 NOV. A continuing resolution was passed to keep the government running until 17 NOV. [Source: MOAA Leg Up 6 Oct 06 ++]


NDAA 2007 UPDATE 15: The approved 2007 defense authorization bill will bring better pay and benefits to large segments of the military community. Drilling reservists who lack affordable health-care coverage will be pleased. So will medical scholarship students seeking stipend increases. Others will be upset to see prized initiatives fail again. Reservists will not see an increase in GI Bill benefits or an easing of the age-60 threshold for retired pay. Disabled retirees rated as “unemployable” will not see full retired pay restored before 2009. Survivor benefits will continue to be reduced by VA dependency and indemnity compensation. And there will be no change to the 2008 effective date of the paid-up rule on premiums for Survivor Benefit Plan participants. But the undisputed champions of compensation for 2007 appear to be the military’s top 161 officers. There is no evidence these officers lobbied for dramatic pay gains. Yet their lifetime compensation is about to get a pleasant jolt.

In JAN 07, when most service members will receive a 2.2% basic-pay raise, their smallest in 12 years, America’s 36 four-star generals and admirals and its 125 lieutenant generals and vice admirals will see basic pay climb by 8%, or $1,100 a month. More significant are changes in the way their retired pay will be calculated. To use one prominent officer as an example, Army Gen. John Abizaid, commander of U.S. Central Command, could see his future retired pay jump by almost $37,000 a year. The pay gains voted for the most senior officers’ flow from a four-part packet of changes designed by the Senate Armed Services Committee. The first provision raises the executive pay cap that now affects only officers in pay grades O-9 and O-10. Currently their basic pay can’t exceed Executive Level III for federal civilians (i.e. $12,667 a month). On 1 JAN that will change to Executive Level II which will boost the basic-pay ceiling to $13,767 a month. The ceiling could go even higher when Congress returns after November elections and decides on 2007 federal civilian pay levels.

The three other bill provisions of the Senate Armed Services Committee packet that will affect future annuities for three and four-star officers are:
- If Abizaid were to retire today, with 33 years of service, he would get retired pay equal to 75% of his $12,667 a month basic pay. That would total $9,500 a month or $114,000 a year. But if Abizaid, with more than 30 years of service, retires later, his retired pay multiple might no longer max out at 75%. The Secretary of Defense will have authority to add 2.5% for each year served past 30. So with 33 years, he could receive 82.5% of basic pay in retirement.
- Effective 1 OCT, senior officers who retire no longer will have their annuities based on capped basic pay. Instead pay officials will apply the basic-pay levels shown for O-9 and O-10 in the military pay chart. This change alone will be substantial using the 2006 pay chart.
- In April the military will move to a new 40-year pay chart. It sets new, higher basic-pay levels for members who have served more than 30 years, 34 years and 38. This will also raise the retired pay of long-serving senior enlisted members.

Thus, returning to the Abizaid example, his retired pay after 33 years could be 82.5% of the new basic-pay rate of $15,234 a month for a O-10 with at least 32 years’ service. His monthly retirement check could be $12,568, instead of $9,500, and annual retired pay $150,816, not $114,000. Two other key changes Congress embraced in its final 2007 defense authorization bill are:

- On 1 APR, warrant officers and some middle-grade enlisted will get a second basic-pay raise, the latest in series of adjustments to keep the pay table competitive. Warrant officers’ raises will range from 0.8% to 8.3%, depending on grade and years of service.
- Enlisted grades E-5 with 8 or more years of service, and E-6 and E-7 grades with 12 years or more of service will see April raises of 1.2% to 2.5%.
- Increase of medical education loan repayment authority from $22,000 to $60,000.
- Increase the stipend under the Health Professions Scholarship Program from $579 a month to a maximum of $30,000 a year.
- Triple the maximum grant under the Health Professions Scholarship Program from $15,000 to $45,000.
- Increase the reserve critical health skill special pay from $10,000 to $25,000.
- Increase the accession bonus for dentists from $30,000 to $200,000.
- Allow eligibility for those with critical physician and dentist skills for a new $400,000 accession bonus.
- Authorizes voluntary separation pay as high as four times the amount of the separation pay given a member of the same grade and years of service who is being involuntarily separated.
[Source: SunHerald.com article 8 Oct 06 www.sunherald.com/mld/sunherald/news/local/15707408.htm ++]


GI BILL UPDATE 11: Monthly GI Bill benefits increased 4% 1 OCT, while fees for four-year public schools jumped 7.1% and four-year private school costs rose 5.9%. With the GI Bill increase, the maximum payment for full-time students with three or more years of active-duty will reach $1,075 per month, or $38,700 for the full 36-month limit on payments. Reservists who have not been mobilized for more than a year since 911 will receive up to $309 a month. The Reserve Education Assistance Program (REAP) will be up to a maximum of $806 a month and the GI Bill Apprenticeship and On The Job Training program will pay as much as $913 a month. Students will see the new rates in their November checks. . The Montgomery GI Bill (MGIB) was created to help veterans of active duty military service pay for their education and training. However, it is good for only 10 years after the date of your last discharge from active duty service. Only about 50% of veterans use their GI Bill. [Source: Armed forces News 6 Oct 06 ++]


TRICARE SKILLED NURSING & LTC: At some point in your life, you or a family member may need skilled nursing care, long-term care or both. You should understand what each term means and how they affect you. For skilled nursing care and long term care issues contact your Tricare Service Center which can be found at www.tricare.osd.mil/tricareservicecenters/default.cfm or your regional contractor listed on www.tricare.osd.mil/Factsheets/viewfactsheet.cfm?id=92:

Skilled Nursing Facilities: Under Tricare, this is a facility with the staff and equipment to provide skilled nursing, skilled rehabilitation or other medically necessary healthcare services, including prescription medications. Skilled nursing care isn’t typically provided in a nursing home or a patient's home. For Tricare to cover your facility admission you must meet the following criteria: You must be treated in a hospital for at least three consecutive days, not including the day of discharge; you must be admitted within 30 days of your hospital discharge (with some exceptions) to a skilled nursing facility; your doctor’s treatment plan must demonstrate your need for medically-necessary rehabilitation and skilled services; and the facility must be Medicare-certified and a participating provider.
Under skilled nursing care, TRICARE typically covers: Medically-necessary skilled nursing care; Rehabilitative (physical, occupational and speech) therapies; Room and board; Prescribed drugs; Laboratory work; Supplies; Appliances; and Medical-equipment. You are responsible for Tricare beneficiary cost shares. The amount you pay varies, depending on your eligibility status and Tricare option. For more information, please see the chart at www.tricare.osd.mil/tricarecost.cfm. If you are Medicare and TRICARE eligible for days 1 to 20, Medicare pays 100%; For days 21 to 100, Medicare covers all costs, except for the required Medicare copayment. TRICARE covers the copayment; and
after day 100, TRICARE is the primary payer and you pay TRICARE beneficiary cost shares. Medicare and TRICARE have the same benefits, skilled nursing facility decision process and payment calculation method, except TRICARE doesn’t limit the benefit to 100 days (after obtaining a Medicare claim denial).

Long Term Care (LTC): LTC includes support services for patients with a degenerative condition (Parkinson’s, stroke, etc.), a prolonged illness (cancer) or cognitive disorder (Alzheimer’s). A trained professional doesn’t have to provide long term care and it may be given in nursing homes, assisted living facilities, adult day care centers or in your home. LTC services include help with the walking; personal hygiene; sleeping; using the bathroom; dressing; cooking/feeding; medication; and moving from a bed to a chair. Tricare and Medicare do not cover LTC—it’s your financial responsibility. Ask the facility whether you are getting skilled nursing care or long term care. If LTC ask your regional contractor or case manager about exceptions or partial exceptions to the "no coverage" guidance. You may buy long term care insurance through commercial companies. Most plans let you choose how much coverage you need and where you will use it. Another option is the Federal Long Term Care Insurance Program (FLTCIP). Nearly 20 million people are eligible to apply for FLTCIP, including all active duty and National Guard members activated for more than 30 days, retired uniformed service members and members of the Selected Reserve. For more information, refer to www.opm.gov/insure/ltc/index.htm or call 1-800-582-3337.

Medically necessary equipment: Tricare covers medically necessary equipment costing more than $100, such as wheelchairs, hospital beds and respirators. You may buy or rent the equipment (whichever costs less). Send your doctor's prescription with your claim, specifying the type of equipment, why you need it and for how long. Tricare won’t cover general use equipment, such as air cleaners or whirlpool baths. Before getting durable medical equipment, check with your region’s toll free call center listed on www.tricare.osd.mil/tricareservicecenters/default.cfm about rules and coverage limitations.

Hospice: Hospice care is available for terminally ill patients expected to live six months or less if the illness runs its normal course. A Medicare-approved program must provide the hospice care, which may include the Physician services; Nursing care; Counseling; Inpatient respite care; Medical supplies; Medications; Home health aide services; and Short-term acute patient care. Tricare Standard pays the full cost of covered hospice care services, except for small cost-share amounts the hospice may collect for drugs and inpatient respite care. Check with your regional contractor or the Tricare for Life and Medicare Fact Sheet at www.tricare.osd.mil/factsheets/viewfactsheet.cfm?id=294 for details.
[Source: TMA Fact Sheet 5 Oct 06]


GENERIC DRUG PRICES UPDATE 02: In early OCT 06 Wal-Mart announced that due to demand they are expanding their $4 generic drug pricing for over 300 medicines from Tampa, Florida only, to the entire State of Florida starting today, October 6. They also announced that they will be expanding this pricing nationwide as soon as possible but there was no timetable given. A spokesman said that the overwhelming success of the program and the thousands of requests including one from Florida Governor Jeb Bush, to expand the program more quickly had lead to their decision. Wal-Mart also raised the number of generic prescription drugs offered under the $4 price for a month's supply plan to 314 from 291. The new number comprises 143 drugs in a variety of dosages and solid or liquid forms that together make up the total, up from about 125 drugs when the program started.
DoD failed in their attempt to raise Tricare user’s generic drug cost for a 30 day supply from $3 to $6 in FY 2007. However, it is expected that his issue will be brought to the table again by DoD for inclusion in the 2008 National Defense Authorization Act (NDAA). This proposed increase was included in the 2007 NDAA which the full House passed on 11 MAY 06 before sending it to the House/Senate Compromise Committee. The House members who supported this increase are up for reelection. One more issue for vets to consider when they cast their vote in NOV. [Source: USDR Weekly Update 6 Oct 06 ++]


VET CEMETERY NEW JERSEY UPDATE 01: Recently the Department of Veterans Affairs announced the award of a $3.8 million grant to the state of New Jersey to expand the Brig. Gen. William C. Doyle Veterans Memorial Cemetery in North Hanover Township. The grant will cover the cost to develop approximately seven acres, which will result in an additional 1,556 single and 3,392 double-crypt gravesites. Also included will be improvements to roads and landscaping. The Doyle Cemetery has received more than $20 million in VA grants for development, expansion and improvements since its dedication in 1986. The last VA grant to Doyle Cemetery was for $6.1 million in 2005. The cemetery is available to New Jersey's approximately 592,000 veterans and their dependents.

VA's State Cemetery Grants Program is designed to complement VA's 123 national cemeteries across the country. VA state cemetery grants have helped establish, expand or improve 70 state veterans cemeteries in 35 states, Saipan and Guam, which provided more than 20,000 burials in fiscal year 2005. Since the program began in 1980, VA has awarded 151 grants totaling more than $262 million.
Information on VA burial benefits can be obtained from national cemetery offices, from the Internet at http://www.cem.va.gov or by calling VA regional offices toll-free at 1(800) 827-1000. Information about the New Jersey state veterans cemetery can be obtained from the New Jersey Department of Veterans Affairs, if calling within the state, at 1(888) 8NJ-VETS or from the Doyle Cemetery at (609) 758-7250. Information is also available online at www.state.nj.us/military/veterans. [Source: USDR Weekly Update 6 Oct 06 ++]


MEDICARE RATES 2007 UPDATE 03: Some social security recipients will see lower monthly checks in 2007 as a result of two recent changes. Most beneficiaries have their Medicare Part B (doctors’ and hospital outpatient) premiums automatically deducted from their Social Security check. Few know that SEC 1839 (f) of the Social Security Act protects most Social Security recipients from reduction in benefits when the annual increase in Medicare Part B premium exceeds the Cost-of-Living Adjustment (COLA) dollar amount that a person receives. The law adjusts the premium increase so that benefits don’t get cut when the Medicare Part B premium increase is higher than the COLA. That provision of law will have implications for two groups of beneficiaries starting in 2007; enrollees of Medicare Part D prescription drug plans who have their drug plan premiums automatically deducted from their Social Security, and beneficiaries with annual incomes higher than $80,000.

With the implementation of the new Medicare Part D coverage Congress didn’t extend this same protection to the Part D drug premiums. If you have new Medicare Part D premiums deducted from your Social Security, any increase in your drug premium starting 1 JAN 07 that’s greater than the amount of your COLA increase will come straight out of your Social Security benefit. You could wind up with a lower Social Security check next year than what you receive now. Also, in 2007 for the first time since Medicare began, the government will determine Medicare Part B premium based on income. The government calls it income relating, or income based premiums. It’s also referred to as "means testing." Seniors with annual incomes of $80,000 and more will be affected. These individuals will pay significantly higher premiums than other seniors, and the higher premiums will come right out of Social Security benefits. The special protection that currently prevents Social Security benefits from reduction will not apply to persons affected by means testing. These change will have the greatest impact on beneficiaries whose Social Security benefits are average or below average, but whose other income subjects them to the highest Medicare Part B premiums.

The government estimates that beneficiaries with incomes of less than $80,000 will pay a monthly premium of at least $93.50 in 2007. This is based on the latest 13 SEP estimate by CMS of an increase of 5.6% vice 11.2%. Beneficiaries with incomes $80,000 and higher will likely pay a monthly Part B premium that ranges from $106.00 to as much as $162.00. Retirees having incomes higher than $80,000, but with only average Social Security benefits (about $1,002 in 2006), may see reductions in their Social Security starting in January of next year to cover higher Medicare Part B premiums. If Medicare premiums continue to grow at the current annual pace of about 12%, the average rate of growth since 2002, the impact on the Social Security benefits of persons affected by means testing will grow proportionally. Seniors with incomes of $100,000 a year will see their premiums skyrocket $232.90 or 279% by 2009. For those with incomes of %200,000 or greater the increase to $372.60 will be 320%. Those persons affected will eventually need most of their Social Security check just to cover the Medicare Part B premium. If Medicare premiums become too high beneficiaries may be driven out of the program. The Centers For Medicare and Medicaid Services estimates that some 50,000 seniors may drop their enrollment in Medicare Part B in 2007 alone. There is no guarantee that the $80,000 cutoff will not be lowered in future years making Medicare Part B less and less attractive to seniors. .Since only the oldest and sickest will not be in apposition to drop the coverage, in time their medical care requirements will rise up program costs and future premiums for everyone, no matter what their income. [Source: TREA Senior Citizens League alert 7 Oct 06 ++]


SOCIAL SECURITY FUND DEPLETION UPDATE 03: TREA Senior Citizens League (TSCL) has filed two Freedom of Information Act lawsuits intended to force the federal government to release information about the costs of the Social Security Totalization Agreement with Mexico and to the U.S. Social Security Trust Fund. Despite repeated requests by TSCL under the Freedom of Information Act (FOIA), the Department of State, and the Social Security Administration have refused to release an actual copy of the Agreement or provide all pertinent information. A 1986 law rarely enforced makes it illegal to employ immigrants without valid work-authorized Social Security numbers. Illegal immigrants who are working under fake, or non-work authorized, Social Security numbers can receive credit towards benefits for work they performed while illegal if they later gain a valid, work-authorized Social Security number. TSCL believes that a Totalization Agreement with Mexico would allow millions of illegal Mexican workers to draw hundreds of billions of dollars from the U.S. Social Security Trust Fund.

The Agreement between the U.S. and Mexico was signed in JUN 04, and is awaiting President Bush's signature. Many critics believe he intends to sign it shortly after the 2006 mid-term elections. Once the President approves the Agreement, which would be done without Congressional vote, either the House or Senate would have only 60 legislative days to stop it from taking effect by voting to reject it. The U.S. currently has 21 totalization agreements in effect with other nations, which are intended to eliminate dual taxation for persons who work outside their native countries. The agreements are with nations having economies similar to that of the U.S. But Mexico's retirement system is radically different, since only 40% of non-government workers participate, as opposed to 96% of America's workers. In addition, the U.S. system is progressive, meaning lower wage earners get back much more than they put in. But in Mexico, workers get back only what they put in, plus accrued interest. Adding millions of illegal Mexicans to the Social Security system would mean the retirement program would run out of money even sooner than already predicted and trigger benefit cuts for citizens who earned their benefits legally. Guest worker immigration amnesty legislation presently being considered by Congress would legitimize an even greater number of worker’s eligibility to draw on the fund. Without constituent input to congressional representatives on this subject Congress is not likely to oppose this Totalization Agreement. [Source: TREA Senior Citizens League alert 7 Oct 06 ++]


MILITARY INSURANCE/INVESTMENT PREDATORS UPDATE 01: Organizations concerned about the lending practices of payday loan businesses operating in Virginia verbally sparred with industry supporters last week at a hearing of the Commerce and Labor Committee of the Virginia House of Delegates. Members of the Committee looked for ways to understand the effects of the industry on state residents and the patterns of use by Virginians who seek short term loans from these establishments. Representatives from the NMFA, NAACP, AARP, the Center for Responsible Lending, the Consumer Federation of America, and the Virginia Joint Leadership Council of Veterans Service Organizations testified in favor of curbing payday lending practices in the state. Legislators were urged to provide more protections for state consumers, especially military families. The hearing was in preparation for the next General Assembly session, which will feature legislation to tighten controls on payday lenders. Since 2002, when lawmakers decided to regulate the industry, Virginia payday loan shops have doubled, now numbering 756. Virginia law exempts payday lenders from the 36% annual interest cap that governs other Virginia lenders. As a result, payday lenders may charge 391% annual interest for their loans. When a person takes out a payday loan in Virginia, they write a check in the loan's amount to the lender plus $15 for each $100 borrowed—$575, for example, for a two-week $500 loan. On the borrower's next payday, the loan company can cash the check to recover the loan principal and fees.

Representatives of the payday lending industry countered opponents by arguing that payday lending serves a consumer need, pointing out that 445,000 Virginians took out 3,372,000 separate payday loans last year. They asserted that many of these state residents would not have other alternatives for fast cash if payday lenders were driven from the state by more stringent regulations. They could not, however, document negative effects on potential borrowers in nearby states—North Carolina, Maryland, and West Virginia—that have either banned payday lenders or imposed lower rate caps. They rejected the efforts by Delegate John M. O'Bannon III (R-Henrico), who had unsuccessfully sponsored a bill at the behest of Henrico County government that would have placed payday loans back under the 36% annual interest cap. Committee members also had questions about the provision in the NDAA mandating a 36% rate cap for all loans to military members and their dependents. While payday lenders stated they would go out of business if limited to charging 36%, a representative of the Langley Federal Credit Union spoke of its program to provide short-term small loans carrying a maximum interest rate of 18%. While the loans are not a money maker for the credit union, he said, it does break even on them.

On 29 SEP 06 President Bush signed into law the Military Personnel Financial Services Protection Act (S.418). The law shields military personnel from abusive sale practices, bans the sales of inferior investment products, and ensures regulatory oversight of financial services sales on military installations. The new law, sponsored in Congress by Representative Geoff Davis (R-KY-04), Senator Michael Enzi (R-WY) and Senator Hilary Clinton (D-NY), is intended to help protect service members from companies selling risky financial products, including expensive and unnecessary life insurance, as well as mutual funds with excessive fees. The law originated as H.R. 458 and was overwhelmingly approved in the House of Representatives before being modified by the Senate and approved again by the House as S. 418. Provisions included in the Military Personnel Financial Services Protection Act will:
• Ban the sales of contractual plans,
• Require disclosures before the sale of private life insurance to military personnel,
• Require military personnel be informed of life insurance available through the federal government before the sale of private life insurance,
• Clarify state jurisdiction for insurance sales on military bases located within their borders, as well as military installations overseas,
• Establish a list of barred brokers and agents to be made available to installation commanders and state and federal financial regulators, and
• Provide investors with online access to information, including disciplinary actions, regarding broker-dealers.
[Source: NMFA Government and You E-News 10 CT 06 ++]


SAT/ACT OFFER EXTENDED: The Scholastic Assessment Test (SAT) and the American College Testing Assessment (ACT) are designed to provide college admissions officers with two things: a predictor of first-year academic achievement in college, and a common yardstick to use in comparing students from a wide range of educational backgrounds. While SAT and ACT are very different tests, they both fulfill the same role in the admissions process. For additional info on the composition, scoring, and use of these tests refer to www.act-sat-prep.com. A group of NFL, NFL Europe, AFL, and CFL football players have announced they are extending and enhancing their sponsorship of $200 SAT/ACT training to all military families. The sponsorship allows any military person (active, National Guard, Reserve, or retired) to request as many programs as they need for the students in their lives. DoD has created a secure website to confirm a person’s military status before directing the user to the software order site. Instructions for ordering the software are available at: http://www.militaryhomefront.dod.mil/po ... .0.0.0.0.0. Personnel can also access the confirmation and request pages through several military related associations and organizations, including the education page of the NMFA website: www.nmfa.org/site/PageServer?pagename=home_education.

The sponsorship will last through the entire 2005-07 school years, which will end 1 JUL 07. Families may use the program for an entire year even if the program is requested the last day of the sponsorship. Programs are shipped to domestic U.S. and APO addresses. The sponsorship covers the regular purchase price of $199 and the family pays only the shipping and handling of $9.95. The programs have a one-year license and are intended for the individual use on students’ personal home or laptop computer and are not intended for group or classroom instruction through the schools. The SAT & ACT test prep training programs come in either a single DVD or two CD-ROM sets and include more than eleven (11) hours of training video and 25-40 hours of student participation. They can be used as a stand-alone complete course or as a supplement to other SAT & ACT prep materials. The students select the training they most need and can study at their own pace by picking which of the 120 video lessons they want to view. The program also provides progress tracking and much more. To view a flyer that has been made to assist in the effort, go to: http://sat.eknowledge.com/military.asp. [Source: NMFA Government and You E-News 10 CT 06 ++]


RESERVE GI BILL UPDATE 03: During an unusually testy joint hearing of the House armed services subcommittee on military personnel and the veterans’ affairs subcommittee 27 SEP on economic opportunity proponents for strengthening Montgomery GI Bill (MGIB) benefits for the National Guard and Reserve said the critical issue is fairness. Reserve rates, frozen for years, need to be raised. Reserve benefits need to be made as portable as MGIB for active forces, their wartime deployment partners. The two panels share oversight responsibility for MGIB programs. The Republican chairman and ranking Democrat on the personnel subcommittee John McHugh (NY) and Vic Snyder (AR) were in sync laying out their a case for raising reserve MGIB benefits perhaps next year. Snyder in particular sees two major inequities that need correction. The first, he said, is that MGIB for reservists ends when they separate after a typical six-to-eight-year service obligation. That’s true even now, in wartime, with Reserve and National Guard members being mobilized routinely for 16-to-18 months, and spending a year in Iraq or Afghanistan. When active duty members leave service, they take along MGIB benefits. Reserve benefits can only be used while they remain in drill status. A second inequity is the level of benefits under MGIB for Selected Reserves. Payments used to be set to equal 47%of benefits for active duty MGIB users. But cost of living increases to active duty MGIB, which the Department of Veterans Affairs administers and VA committees oversee, have not been applied to Reserve benefits since the attacks of 9-11. The armed services committees are responsible for Reserve MGIB and so can be blamed for letting benefits slip. Snyder said it is not fair and unconscionable when two members serve side by side in combat, they return home together, both leave the service, but one will have education benefits and the other will not have any.

The Bush administration has not asked for money to adjust Reserve MGIB. On 1 OCT when active duty benefits go up once again, Reserve MGIB benefits will stay frozen and their value, relative to active duty MGIB, will fall to 27%. Snyder asked Michael L. Dominguez, principal deputy under secretary of defense for personnel and readiness why Congress should not bring that benefit up to where it was at the time the program was established. Dominguez refused to concede the point, instead providing what he described as a number-crunching, bean-counter view. Reserve MGIB was designed primarily as a retention tool to keep members in drill status. He said, “If we look at our recruiting and retention numbers, we’re achieving the purposes for which the program was intended”. Following that logic, an angry Snyder told Dominguez, “If the Reserve MGIB deteriorates to 3% of the [active duty] benefit…or 1%, you’re going to be perfectly satisfied as long as Americans are stepping forward and signing enlistment contracts for reasons for patriotism, family heritage, for love of country. You don’t care where that benefit deteriorates to…I think you stepped in it, Mr. Secretary.” Dominguez refused to retract his statement and countered, “If people understand what we offer in return for their service, and they know that up front and they agree to that service, under those conditions I think that needs to be honored”. Retired Navy Vice Adm. Norbert Ryan, testifying on behalf of the partnership, warned that three of six reserve components won’t make their recruiting goals for fiscal 2006

The Senate, in its version of the 2007 NDAA, adopted an amendment from Sen. Blanche Lincoln (D-AR) that would give Reserve MGIB benefits the same portability as active duty MGIB, a 10-year window to use benefits after separation. The House bill was silent on the issue. Odds were seen as slim the Lincoln provision would survive a House-Senate conference committee ironing out differences between the two bills. The Bush administration, in opposing the Lincoln provision, also pointed to projected costs of $1.5 billion over 10 years and urged a delay on any changes to benefits until a joint VA-Department of Defense task force completes a comprehensive review of MGIB issues. Among proposals under review is a Total Force MGIB conceived by the Partnership for Veterans Education, a coalition of military, veterans and educational associations. The Total Force MGIB would end the inequities cited by Snyder, move responsibility for all GI bill benefits under the Department of Veterans and raise benefits to mobilized reservists. They would earn a month of active duty MGIB benefits for every month of activation beyond 90 days. Dominguez said that if given an extra $1.5 billion for reserve forces, he would recommend spending it on Reserve equipment not MGIB benefits. [Source: Military.Com Tom Philpott article 29 Sep 06 ++]


RESERVE GI BILL UPDATE 04: Since 9/11, more than 550,000 members of the National Guard and Reserve have been called to federal active duty. But Congress has neglected to adjust Reserve Montgomery GI Bill benefits, either to keep pace with active duty benefit improvements or to acknowledge the vastly greater burden of sacrifice imposed on our "warrior-citizens" in the war on terror. The Ranking Member of the Military Personnel Subcommittee of the House Armed Services Committee (HASC) and a senior member of the Veterans Affairs Committee (HVAC) Rep. Tom Snyder is trying to correct this inequity though his new ‘Total Force G.I. Bill’ legislation H.R.6250. He said it was unconscionable that Guard and Reserve veterans are not entitled to any post-service use of the benefits they earn during a call-up. H.R.6250 would combine active duty and reserve MGIB benefits under the same law (to ensure equal increases) and allow Guard and Reserve servicemembers activated for a "contingency operation" to use their mobilization benefits for up to 10 years following satisfactory completion of a reserve service agreement or retirement from the Selected Reserve. At present, reserve MGIB benefits can only be used while a soldier continues to serve in the Guard or Reserve. H.R.6250 is a first step towards realizing a total force approach to the Montgomery GI Bill. To send a message of support for Rep. Snyder’s bill to your representative refer to http://capwiz.com/moaa/issues/bills/ [Source: MOAA Legislative Action Center 14 Oct 06 ++]


WW1 VET SEARCH: Time is running out to find and recognize the last remaining veterans of "The Great War." The rolls of World War I veterans have declined so rapidly that the day is fast approaching when there will be one remaining, then none. The VA, with assistance from historians, state agencies and others, is keeping a roster of those veterans. Three years ago, there were about 250 remaining WWI American veterans. Yet, there may be other WWI veterans out there, perhaps in private nursing homes or in the care of family members, who have not been identified by VA. If you know of any WWI veterans in your area it is requested hat you contact VA's Office of Public Affairs in Washington, DC, at opaweb@va.gov. [Source: Military Report 10 Oct 06]


VETERANS RECRUITMENT OFFICE: The Office of Personnel Management announced 5 OCT that it is opening the second of three outreach offices intended to boost recruitment of veterans into federal jobs. The new part-time office will be located at Brooke Army Medical Center in San Antonio. The first such center, also part-time, opened in DEC 05 at Walter Reed Army Medical Center in Washington; the location of a third has not been determined. Brooke and Walter Reed are separation points for service members about to leave the military. They also serve as rehabilitation centers for disabled veterans -- a subset to which the federal government gives an extra edge in hiring. Federal agencies are required to give some preference to all veterans when filling job openings and when choosing who to lay off. The office will be staffed two or three days a week, and will provide soldiers with information about federal job opportunities and guidance for the sometimes confusing application process. It also will provide a contact point for agency representatives trying to recruit veterans.

Even though veterans' preference in federal hiring is required by law, many advocacy groups have criticized the government for circumventing the rule. In March, the Senate Homeland Security and Governmental Affairs Subcommittee on Oversight of Government Management, the Federal Workforce and the District of Columbia held a hearing to examine potential violations. One of those critics, Richard Weidman, director of government relations for Vietnam Veterans of America, said the new Brooke center is a step in the right direction, but is hardly adequate. He pointed out that up to now, despite the size of the federal service, OPM has only have one-and-a-half people doing the whole recruitment for the entire federal government. This opening will raise that to only two part time offices. Weidman said, “Returning veterans are the perfect candidates for hard-to-fill slots, especially in less populated areas. In his group's experience, returning veterans will move home if they are single and unemployed, move to their wife's hometown if they are married and unemployed, or move to where they have a job. It needs to be much more methodical. It needs to be built in once a person has determined they're going to leave the military. That's when the recruitment needs to start." In fiscal 2004, the most recent year for which figures are available, 33.6% of employees hired into full-time federal positions were veterans. The total number of veterans in the federal workforce at that time was 453,725, out of about 1.8 million employees. [Source: GOVEXEC.com Daily Briefing 6 Oct 06 ++]


TRICARE HANDBOOK UPDATE 01: TRICARE is making a handbook available to all beneficiaries covered under Tricare Standard. This new manual goes into much greater detail than the old booklet, making it as useful as the Tricare Prime and Prime Remote handbooks. The handbook is full of useful data from what’s covered to how to file a claim. However, because of annual cost changes it does not include cost information. Tricare created a separate summary of beneficiary costs flyer that contains costs for all Tricare programs, including dental and pharmacy. Tricare will update the flyer whenever the rates change. Starting in early OCT 06, beneficiaries may ask for copies of the Tricare Standard handbook or the summary of beneficiary costs flyer from their regional contractors or from a local Tricare Service Center , or view the documents on the Tricare Smart Site, www.tricare.osd.mil/TRICARESmart. Basic information on Tricare Standard is available at www.tricare.osd.mil/Factsheets/viewfactsheet.cfm?id=318. [Source: TMA News Release 11 Oct 06]


MOBILIZED RESERVE 11 OCT 06: The Army, Navy, Air Force, Marine Corps and Coast Guard announced the current number of reservists on active duty as of 11 OCT 06 in support of the partial mobilization. The net collective result is 9,426 fewer reservists mobilized than last reported for 13 SEP 06. Total number currently on active duty in support of the partial mobilization for the Army National Guard and Army Reserve is 80,234; Navy Reserve, 6,053; Air National Guard and Air Force Reserve, 6,925; Marine Corps Reserve, 7,217; and the Coast Guard Reserve, 265. This brings the total National Guard and Reserve personnel, who have been mobilized, to 100,694, including both units and individual augmentees. At any given time, services may mobilize some units and individuals while demobilizing others, making it possible for these figures to either increase or decrease. A cumulative roster of all National Guard and Reserve personnel, who are currently mobilized, can be found at http://www.defenselink.mil/news/Oct2006 ... 011ngr.pdf. [Source: DoD News Release 11 Oct 06]


VA HEALTH CARE FUNDING UPDATE 06: A newly released report finds 42% of recently discharged combat veterans are filing service-connected disability claims, a trend that could overwhelm the Department of Veterans’ Affairs budget and claims process. The 20 JUL report, based on data obtained by the National Security Archive through a Freedom of Information Act request, shows that more than 104,000 disability claims from veterans of the wars in Iraq and Afghanistan have been approved, with all but about 18,000 involving the granting of monthly disability pay and automatic eligibility for lifetime care of the service-connected injury or illness. The National Security Archive, a non-partisan research group, made the report available on its Web site. A House Veterans’ Affairs Committee aide who asked not to be identified because the report is still being studied said, “What this really shows is the long-term cost of war”.

Aides believe the number of claims and the fact that so many been filed and processed while combat operations in Iraq and Afghanistan continue are a signal of several trends that are good for veterans but could lead to long-term funding problems for the VA. Everyone being separated from service is receiving a complete postwar physical that makes it possible for them to immediately file disability claims for minor problems that might in the past has escaped immediate notice or might not have been worth the trouble for a separating service member to pursue, aides said. The VA also is providing two years of medical care, no questions asked, for all veterans of the current wars. For treatment to continue beyond two years, an OIF or OEF veteran must have a proven service-connected disability. The cutoff date is well known to separating service members. Thus, there is a incentive for them to get a disability rating approved so they can keep getting VA care.

A contributing factor to the number of claimants is that improvements in armored protection and combat medicine have resulted in more service members surviving what would have been fatal injuries in past conflicts. The flood of claims comes at a time when VA officials have been losing ground as they try to eliminate a backlog of claims for disabilities and other benefits. With no near-term reductions planned in U.S. troop levels in Iraq, and no end to the violence there in sight, congressional aides said the VA has to be prepared to spend more money on claims and on hiring personnel to process the claims. About 1.3 million people have deployed to Afghanistan and Iraq since the wars began, with about 567,000 now discharged. As of 20 JUL, some 152,669 of the discharged combat veterans had filed VA claims. The VA had processed 118,264 of those claims, granting 108,819 and denying 13,445, with 34,405 still pending. [Source: NavyTimes Rick Maze article 11 Oct 06 ++]


MEDICARE PART D UPDATE 09: Seniors and disabled beneficiaries are likely to pay more next year for Medicare Part D drug benefits. Even while Initial Enrollment for Part D was still underway, Medicare officials announced the higher 2007 costs of the government standard drug benefit. Out-of-pocket costs before reaching the catastrophic level of coverage are expected to increase from $3,600 to $3,850. But that amount doesn’t include the increase in drug plan premiums. Beneficiaries will learn those costs soon, as drug plans notify enrollees this month of 2007 premiums and other coverage changes. Medicare’s Open Enrollment period starts 15 NOV and runs through 31 DEC 06 for beneficiaries wanting to shop for, and switch, supplemental Part B health and Part D drug plans.

Here are the cost increase details of the 2007 standard Medicare drug benefit. Note, that, if you are enrolled in a Medicare Part D drug plan, the details of your actual plan may vary. Insurers are allowed wide latitude to offer plans of their own design, as long as the value of the coverage is equal to or greater than the Medicare standard benefit.
- Standard Benefit 2006 eductible $250; Initial Coverage Limit* $2,250; Out-of-Pocket Maximum** $3,600
- Standard Benefit 2007: Deductible $265; Initial Coverage Limit* $2,400; Out-of-Pocket Maximum** $3,850

*Amount in retail drug costs, meaning the amount both you and your drug plan pay, not just co-pays, before you reach the "doughnut hole" gap in coverage.
** Total amount you pay out-of-pocket (a.k.a doughnut hole), before you reach catastrophic coverage when your plan covers 95% of your drug costs, and you pay 5%.
[Source: USDR Action Alert 7 Oct 06 ++]


ID CARD (CAC) UPDATE 02: The Pentagon will begin issuing millions of next-generation common access cards (CAC) to every service member in an effort to heighten the effectiveness and security of the cards, make them more interoperable and allow them to be more useful in more places. The new cards, officially called “Next Generation CAC” will be issued to service members and other government employees over the next three years. Mary Dixon, Deputy Director of the Defense Manpower Data Center in Arlington VA said, “There are no security guarantees, but the card’s technology is far more secure than anything to come before it. There is nothing that cannot be broken into, given enough time, dollars and resources, but we believe that this is as good as it gets, and will only get better over time.”

The front of the new card looks slightly different than the original, with a vertical, rather than horizontal, identifying stripe to indicate that it is the new model and a larger expiration date that will help security personnel more easily identify which cards are still valid. The cards will come in different colors for different populations of people, including green and red. They will contain bar codes, computer chips and magnetic strips, all very high-tech. But it is what’s under the hood that really distinguishes this card from the existing CAC. The new cards have been re-engineered with a contactless capability that will allow them to be used like a subway card in that people can wave them over card readers at a distance of up to about four inches. That capability could raise concern that personal data could be removed from the card, but Dixon said the chip within the card and the card’s magnetic strip are encrypted, making the data almost impossible to remove. Data to be placed on the cards include an individual’s name, gender, card expiration date, blood type, government agency and branch of service, duty status, paygrade, date of birth plus other information. The chip also will include two encrypted fingerprints.
The magnetic strip will include an individual’s Social Security number and physical security information. The card will be used to authenticate someone’s identity serving as an identity credential while the bulk of information on a particular person is stored elsewhere. The card also will give holders logical access to computers, eliminating some of the need to manually enter a computer name and password to log on. Ultimately, the switchover will mean that those who have the new cards will not need additional cards to access sites within other governmental organizations. Someone with authority to access both the Pentagon and the National Security Agency, for example, would need only the one card.

Creation of the new card is part of a broader security initiative led by President Bush called Homeland Security Presidential Directive 12, which aims to increase the security of employees and government agencies by creating a more recognizable card with a single security standard. More than 4 million of the new cards eventually will be issued to federal employees. But the military, often the guinea pig for many such programs and initiatives, has the lead on this one. All active-duty, Selected Reserve, Defense Department civilian employees and other contractors will get the card. Individual Issuance will start Oct. 27 and will proceed by attrition as older cards expire. The new cards are now being tested at 10 locations around the country, including Maxwell Air Force Base, Ala.; Wright-Patterson Air Force Base, Ohio; Redstone Arsenal, Ala.; Fort Belvoir, Va.; Fort Hood, Texas; and Marine Corps Base Quantico, Va. Spouses and military retirees will not get new cards, but will continue to use the ID cards they have now, officials said. [Source: NavyTimes Gordon Lupold article 9 Oct 06 ++]


TSP UPDATE 06: The TSP is a 401(k)-style retirement savings plan for federal employees and some members of the military. At last count, it had $191 billion in its funds. The five basic funds making up the Thrift Savings Plan made incremental gains in September. None lost any ground, but only one gained more than 1%.
- The C Fund, composed of common stocks on the Standard & Poor’s 500 Index of the largest domestic companies, earned 2.58% last month. That gain brought the C Fund’s 12-month earnings to 10.78%.
- The S Fund, which is invested in small- and mid-sized American companies, was the next highest earner. The S Fund gained 0.88% in September for a 12-month gain of 8.77%
- The F Fund, invested in fixed-income bonds, earned just less, at 0.82%. For the year, the F Fund lagged behind other investment options, with the lowest 12-month earnings at 3.68%.
- The G Fund, which is TSP’s most popular investment,, is made up short-term Treasury securities specially issued to provide a higher return than inflation without any serious risk from market fluctuations. It gained 0.35%last month which brought the fund to a 4.90% 12-month total.
- The I Fund made up of international stocks and previously the star performer in the TSP earned the least last month, at 0.15%. Still, the I Fund had the highest 12-month earnings at 19.23%.

TSP participants also can invest in a mix of the five underlying funds, called the life-cycle funds. This option automatically shifts participants’ money from riskier to more conservative allocations as they age. These funds, too, made incremental gains, with those geared toward younger, more aggressive investors earning slightly more. L 2040, intended for employees with a target retirement date around the year 2040, gained 1.41% last month. The L 2030 Fund earned 1.33%; the L 2020 gained 1.17%; the L 2010 increased 1.01%; and the L Income, designed for employees with planned retirements in the very near future, grew 0.73%. Over the last 12 months, the L Funds with riskier allocations also earned more. L 2040 gained 11.52%, L 2030 grew 10.72%, L 2020 gained 10.07%, L 2010 earned 8.72% and L Income made 6.50%. [Source: GOVEXEC.com Daily Briefing 5 Oct 06]


TRICARE NEWBORN/ADOPTEE REGISTRATION: It is important to register newborns and adoptees in DEERS to establish TRICARE eligibility for essential well-baby and pediatric health care. By registering your newborn or adopted child in DEERS, you may avoid potential claims problems. To establish a newly-born, adopted or pre-adoptive child’s TRICARE eligibility in DEERS, you must submit the following to the registration activity.
- A certified birth certificate or certificate of live birth (authenticated by the attending physician or other responsible person from a U.S. hospital or military treatment facility);
- A record of adoption or a letter of placement of the child into the home by a recognized placement/adoption agency or the court in anticipation of the final adoption; and
- A copy of the DD Form 1172 (signed by the sponsor). If a sponsor can’t sign the DD Form 1172, then a family member must submit a notarized copy of the form for enrollment.

It is important for you to apply for your child’s social security number by visiting the Social Security Administration Web site, www.ssa.gov or by calling (800) 772-1213. Once you receive your child’s social security number, be sure to go to your nearest identification (ID) card-issuing facility to update their DEERS information.

Children are eligible for coverage under all Tricare programs. With Tricare Prime as long as another family member is enrolled in Prime, it covers Newborns for 60 days beginning from the date of birth;
Adopted children for 60 days beginning from the effective date of the actual adoption; and Pre-adoptive children for 60 days beginning on the date of placement of the court or approved adoption agency. To continue Prime coverage past the first 60 days, you must enroll your newborn or adoptee in either TRICARE Prime or TRICARE Prime Remote for Active Duty Family Members (TPRADFM) within the 60 day window. On the 61st day and after, if your child isn’t enrolled in Prime or TPRADFM, TRICARE processes all future claims under Standard (higher costs) until you enroll them in Prime or TPRADFM. Your child loses all TRICARE eligibility 365 days after birth or adoption unless they are registered in DEERS. It s important for you to apply for your child’s social security number by visiting the Social Security Administration Web site www.ssa.gov or by calling (800) 772-1213. Once you receive your child’s social security number, be sure to update their DEERS information.

For additional information on newborn or adoptee DEERS registration, you can contact or visit your military personnel office, uniformed service ID card-issuing facility, or call the Defense Manpower Data Center Support Office telephone center at (800) 538-9552. A list of ID card facilities is available at www.dmdc.osd.mil/rsl/owa/home. DEERS eligibility information is also available on the TRICARE Web site, www.tricare.osd.mil/deers/default.cfm. [Source: TMA Fact sheet 12 Oct 06 ++]


QUESTIONABLE EMAIL: Ever wonder about the truth of all those emails you receive with enticing or warning messages. You can usually get the straight skinny on those stories and fraud attempts at www.snopes.com. This is a Web site that is known as the Urban Legends Reference Pages. Here you can visit to find out if something is true or not. It is 100% dedicated to finding out the truths and falsities of urban legends, modern day myths and any other stories that travel around the Internet and the realistic world. For example, maybe you heard a story from one of your friends, but you're just not sure whether it's reputable or not. Well, to clear up your suspicions, you can visit Snopes and put your wonderings to rest. Snopes.com is hosted by Barbara and David Mikkelson, a married couple from California. They are very determined to provide the complete truth to their Web site visitors. They don't want anyone leaving Snopes feeling like they still don't know the facts. They spend most of their time doing extensive researching on their topics. They also try to include references with their findings when they can. A few examples of the truth of topics that can be found on the site are:

- Ashley Flores is not missing. It's a hoax.
- Shopping center parking lots across America have not been overrun by thieves who trick women into sniffing perfume that is actually a knock-out drug.
- The e-mail warning about the dangers of outdated pancake mix is true.
- The phone number 1-800-FREE-411 does offers free directory assistance service.
- Dialing #77 or *677 is not a surefire way of reaching the local highway patrol. The service is in place in some regions, but not in others. If in need of assistance, dial 911 instead for the sure thing.
- The e-mail asking for help in locating 9-year-old missing Penny Brown is a hoax. Photo of a cute redheaded kid or not, there is no such child. This hoax has been running since 2001.
- Beware of the 809 area code scam. Unsuspecting phone customers have been gulled by con artists into placing calls to area codes in the Caribbean that result in hefty phone charges.
- While Venezuela president Hugo Chvez did make nasty remarks about the U.S., boycotting Citgo brand gasoline is not necessarily an effective protest.
- While it's true a consortium of wireless providers is planning to create a 411 (directory assistance) service for cell phone numbers, you need not register your cell phone with the national "Do Not Call" directory to prevent your number from being provided to telemarketers.
- The warning about gang member inductees killing motorists who flash their headlights is false.
- Someone has confused Pepsi with Dr Pepper. Dr Pepper's "one nation" can design that omitted "under God" from a quote from the Pledge of Allegiance was used for only a short time ending in February 2002. The cans haven't been on the shelves since. Newer versions of incitements to boycott name Pepsi as the culprit responsible for Godless cans, but this is just a garbling of the Dr Pepper story - Pepsi has nothing to do with this.
- The Target Corporation's chain of retail stores is the subject of a number of e-mailed items, some true, some not.
- It is true that during a 1972 trip to North Vietnam, Jane Fonda propagandized on behalf of the North Vietnamese government, declared that American POWs were being treated humanely and condemned U.S. soldiers as "war criminals" and later denounced them as liars for claiming they had been tortured. She was profiled in 1999 in ABC's A Celebration: 100 Years of Great Women. It is not true that she handed over to their captors the slips of paper POWs pressed upon her.
- It is technically true that pressing #-9-0 on your telephone could allow scammers to make long-distance calls and charge them to your phone bill dependent upon the phone system you have. However, there is practically no chance that the scam could affect the average residential or cell phone customer.
- The email warning of Identity thieves tricking the unwary into revealing their personal details by telling them they've failed to report for jury duty and warrants for their arrest are being issued is a fraud attempt.
- While the potentially deadly illness Leptospirosis can be caught by exposure to the urine of diseased a

[boardman]

RAO Bulletin Update 1 October 2006


THIS BULLETIN UPDATE CONTAINS THE FOLLOWING ARTICLES:

== NDAA 2007 [12] ----------------------------- (Debate continues)
== NDAA 2007 [13] ----------------- (Appropriations Act Passed)
== VA Claim Denial [01] ----------- (Multiple Claim Submission)
== VA Data Privacy Breach [25] ---- (2nd Computer Recovered)
== VA Retro Pay Project [03] ------------------------- (Pay Begins)
== Cervical Cancer [01] ---------------- (WRAMC Offers Vaccine)
== TFL Claim Processing [03] ---------------- (Opt-out Providers)
== VA Disability & SSDI ------------------------- (Who is eligible)
== TRICARE Reserve Select [05] ---------------- (Begins 1 OCT)
== VA Mental Health Funding -- (Administration Shortchanging)
== FEHBP Premiums 2007------------------------ (2.3% Increase)
== GI Bill Inequities --------------------------- (Low DoD Priority)
== Tricare Uniform Formulary [14] ------- (90 Days Insufficient)
== Tricare Catastrophic Cap Update 03------------- (1 OCT Reset)
== Generic Drug Prices Update 01----------- (WalMart Decrease)
== Hurricane Safety ---------------------------- (Are You Prepared)
== Sole Surviving Child (Enlistment): --------- (Who Must Serve)
== Military Ins/Investment Predators -- (S.418 Sent to President)
== Military Payday Lenders [01] ----------------- (How they do it)
== Military Payday Lenders [02] --------------- (One less Lender)
== VA GAO Findings [01] --------------------- (Room to Improve)
== Commerce Dept Privacy Breach ---- (Lost/stolen Computers)
== VA COLA 2007 [01] ------------------------ (Potentially 2.9%)
== VA Disability Buyout [01] ------------------- (Buyout Origins)
== VA Disability Buyout [02] ------------------- (VDBC Studying)
== AHLTA [02] ------------------------------- (USAF to go Online)
== VA Facility Funding ----------------------- (Sharing Resources)
== VA Claim Error Rate [01] ----- (House Oversight Committee)
== Agent Orange Cancer Study [01] --------- (Ranch Hand Ends)
== Mobility System ------------------------------- (VHA Coverage)
== GI Bill Update 10---------------------- (Payment Rate Increase)
== COLA 2007 Update 06--------------------------- (3.6% to Date)
== Gulf War Syndrome -------------------------- (Still Not defined)
== Vet Cemetery Florida Update 03----- (New Jacksonville Site)
== VA Clinic Florida ----------------------- (Cape Coral New Site)
== Equal Justice for Servicemen -------- (Supreme Court Access)
== Legislative Process ---------------------------------- (Bill to Law)
== Military Legislation Status ------------------- (Where we stand)


NDAA 2007 UPDATE 12: Work continues on the 2007 Defense Authorization Bill (S. 2766/H.R.5122). While information on progress in the conference committee remains tightly held, conversation with conferees and congressional staff indicates that the steep increase in TRICARE fees proposed by DoD has been rejected. However, it is reported that language dealing with pharmacy issues remains under negotiation. The House bill contains a provision to increase pharmacy costs from $3 to $6 for generic drugs and from $9 to $16 for brand name. The Senate language would keep copays at current levels. Also at stake in the conference is advance on the SBP/DIC offset, military pay raises, concurrent receipt changes and a number of other issues important to veterans. Though most of the bill apparently has already been settled, nothing is finished until the conference report is filed.

It appears that the House provision on providing postal assistance to families with loved ones overseas may not make the final cut. The provision would help families and friends with troops deployed in Iraq and Afghanistan get limited free mail privileges to send letters and care packages to those defending our freedom. Although a letter or package from home is always appreciated by troops stationed overseas, lifting morale and bringing a welcomed reminder of home this does not seem sufficient to allow approval. Evidently, DoD and the Senate think there is a possibility that the free postage could result in transportation complications due to the upswing in mail that would result from the proposal.

From an article in USA TODAY, it appears that the chairman of the Senate Armed Services Committee Sen. John Warner (R-VA) has rejected House Speaker Dennis Hastert (R-IL-14) and Sen. Bill Frist (R-TN) effort to add amendments to his bill on Military Pay. Hastert wanted to add an amendment to the NDAA that would allow all judges to carry handguns and another amendment that pertained to Homeland security. First wanted to add an amendment that would curb internet gambling. Among other things Warner said in a memo to Frist that he is "Firmly Opposed" to including unrelated items to the Defense Bill. Hastert's spokesman said that after agreeing in July to remove the court security provisions from the Child Protection and Safety Act, the speaker received a promise from the Senate leadership that the legislation would be added to a legislative vehicle prior to the November elections. With Hastert sticking to his guns, the defense authorization bill appears primed to be delayed into November's lame-duck session
Warner rejected these proposals since they had nothing to do with the NDAA. [Source: NAUS Weekly Update 22 Sep 06 ++]


NDAA 2007 UPDATE 13: The House and Senate conference committee on 21 SEP agreed to a final version of H.R. 5631, the Defense Appropriations bill and on 26 SEP voted overwhelmingly, 394-22 to approve the final version. Acceding to reported pressure from the White House to limit any cuts in the Presidents request, the final amount of $447.6 billion includes $70 billion in emergency supplemental spending for the wars in Iraq and Afghanistan. Additionally the bill includes a continuing resolution that will fund programs in bills not completed by the start of the new fiscal year on 1 OCT. This measure, known as a “stop-gap” will fund those programs at their 2006 levels through 17 NOV. Delay is anticipated since Congress will recess for the NOV elections. The conference report was completed on 25 SEP and the Senate passed 100-0 the Defense Appropriations Act, which the House had already approved earlier in the week. The measure now goes to the President for signature into law. For defense, this action represents one-half of the equation. Yet to be completed is passage of the 2007 National Defense Authorization Act.

An initial scan of the Preliminary Appropriations Compromise Report received by NAUS indicates:
- There are provisions in the bill to stop any DoD requested Tricare enrollment fees or pharmacy co-pay increases. This favorable action is only in place for the new fiscal year and it is expected to be brought up again by DoD next year.
- It restricts unscrupulous lending practices by imposing 36-percent annual interest rate cap on loans to servicemembers, along with other It provides a 2.2% pay raise for military personnel vice the 2.7% sought. This is the smallest military pay raise in more than a decade.
- It does not mention the SBP/DIC Offset or the "paid-up" provision for SBP for those 70 years and older and who have paid premiums for 30 years or more.
- There is no mention of the Mail Voucher provision that would provide a monthly postal benefit to families with loved ones overseas in combat or recovering from wounds as a result of actions in Afghanistan or Iraq.
- It contains changes to improve Tricare benefits for Guard and Reserves.
- It dropped the Senate-recommended provision to provide full, immediate concurrent receipt for disabled retirees designated "unemployable" by the VA.
- It dropped the Senate-recommended provision to reduce retirement age by 3 months for every 90 days mobilized since 9/11.
- It dropped Senate-recommended provision requiring additional incentive payments to doctors to take TRICARE patients in areas with physician shortages.
- It provides $400,000 free SGLI coverage for members assigned to Iraq and Afghanistan.
- It authorizes permanent ID cards for permanently disabled dependents of retirees, and requires a Pentagon report on giving members an option to have their Social Security numbers removed from ID cards
- It makes all drilling reserve members eligible for Tricare coverage at the lowest current premium (28% of cost) and requires a Pentagon study of partially subsidizing continuation of a private employer's coverage of family members during periods of mobilization.
- It dropped a proposal to mandate use of the mail-order pharmacy for all refills of maintenance medications.
- It dropped initiatives to eliminate copays for most drugs dispensed through the mail-order system and to require drug companies to give TRICARE equal price discounts on drugs dispensed through retail pharmacies.

If issues not funded in the above are not included in the final report veterans will need to raise them again in the 110th Congress which starts in January 2007. [Source: NAUS Weekly Update 29 Sep 06 ++]


VA CLAIM DENIAL UPDATE 01: A new case decided on 27 JUL 06 by the U.S. Court of Appeals for the Federal Circuit could have negative ramifications for veterans and their dependents. The Court held that "where the veteran files more than one claim with the VA Regional Office at the same time, and that office's decision acts (favorably or unfavorably) on one of the claims but fails to specifically address the other claim, the second claim is deemed denied, and the appeal period begins to run." The case was Andrews v. Nicholson, 421 F.3d 1278 (Fed. Cir. 2005)] which can be viewed at www.fedcir.gov/opinions/05-7155.pdf. This means, in contravention of 38 U.S.C. Sec. 5104 and 38 U.S.C. Sec. 3.103, that:
- VA does not have to provide the claimant with notice of the claim or claims that have been deemed denied or the reasons for the denial; and
- The period in which to submit a notice of disagreement with the claims deemed denied begins to run from the date of the decision on any of the other simultaneously submitted claims; and
- An unrepresented or poorly represented claimant could have the time to appeal the deemed denied claims run out without even knowing that the claims had been denied!

The new ruling also puts in question existing sections of 38 U.S.C. which state:
(a) In the case of a decision by the Secretary under section 511 of this title [38 USCS § 511] affecting the provision of benefits to a claimant, the Secretary shall, on a timely basis, provide to the claimant (and to the claimant's representative) notice of such decision. The notice shall include an explanation of the procedure for obtaining review of the decision.
(b) In any case where the Secretary denies a benefit sought, the notice required by subsection (a) shall also include (1) a statement of the reasons for the decision, and (2) a summary of the evidence considered by the Secretary.
(c) Statement of policy. Every claimant has the right to written notice of the decision made on his or her claim, the right to a hearing, and the right of representation. Proceedings before VA are ex parte in nature, and it is the obligation of VA to assist a claimant in developing the facts pertinent to the claim and to render a decision which grants every benefit that can be supported in law while protecting the interests of the Government. The provisions of this section apply to all claims for benefits and relief, and decisions thereon, within the purview of this part 3.
(d) The right to notice -- (1) General. Claimants and their representatives are entitled to notice of any decision made by VA affecting the payment of benefits or the granting of relief. Such notice shall clearly set forth the decision made, any applicable effective date, the reason(s) for the decision, the right to a hearing on any issue involved in the claim, the right of representation and the right, as well as the necessary procedures and time limits, to initiate an appeal of the decision.

A legal opinion on whether this applies to both related and unrelated claims was that it did. For example, if a veteran files claims for a back disability, tinnitus and a psychiatric disability, all at the same time, and only one of those claims is adjudicated, the others are deemed denied under the holding of this case. If no notice of disagreement is submitted within 1 year, the decision becomes final, and the veteran would have to submit new and material evidence in order to reopen those claims. If any of those claims are eventually granted, the effective date of compensation could only be from the date of the request to reopen those claims, rather than the date of filing for the original claims. This also generates the problem of how a veteran could submit a claim for CUE (clear and unmistakable error) with specificity, as the law requires, when there has been no reason given for the denials. VA has not yet released a press release or clarification on how they intend to proceed with present or future multiple claims. Veterans in this situation who receive notice of denial on any of their claims are advised to seek clarification from the VA on how to proceed. However, since DVA has not yet promulgated guidance to their ROs on how to proceed those inquiring may have to wait for an answer. [Source: VAWatchdog.Org - VA NEWS FLASH - 08-01-06 #1 ++]


VA DATA PRIVACY BREACH UPDATE 25: The stolen desktop computer containing sensitive data on about 16,000 patients at Veterans Affairs Department medical centers has been recovered, and a suspect has been arrested. Washington DC resident 21 year old Khalil Abdullah-Raheem was charged in federal court 13 SEP with the theft of government property and released on a $50,000 personal recognizance bond, according to the VA Inspector General’s Office. Abdullah-Raheem was employed by a company that provides temporary labor to VA contractor Unisys Corp. Unisys was hired by VA to assist in insurance collections for various VA medical centers. Officials do not believe Abdullah-Raheem targeted the data, but the FBI is conducting a forensics analysis to determine if the data was compromised. The computer, owned by Unisys, contained insurance claim information for about 16,000 living patients treated in VA medical centers in Pittsburgh and Philadelphia. The computer just recovered was not encrypted.

VA Secretary James Nicholson praised the investigative work of the IG and the FBI. Senate Veterans’ Affairs Committee Chairman Larry Craig, R-Idaho, called the recovery a shining moment for both organizations. Craig said, “This is the second time law enforcement has come through. Let’s hope there is no need for a third time.” The computer was stolen from a Unisys facility in Reston, VA. Abdullah-Raheem was working there temporarily as a building maintenance employee. The company had been offering a reward of up to $50,000 for information leading to the equipment’s recovery. Investigators think the computer was taken in order to record music. Since a separate early May incident endangering personal information on 26.5 million veterans, Nicholson has vowed to make VA’s information security the best in the government by instituting a series of reforms of what critics say is a dysfunctional IT organization. One month ago, the VA announced that it will begin encrypting all agency computers through a $3.7 million contract to Systems Made Simple Inc. in Syracuse, N.Y. All agency laptops were to be encrypted by 15 SEP 06. As of 26 SEP VA had installed encryption software on nearly 15,000 laptop computers. In testimony before the Senate Veterans' Affairs Committee the department's acting chief information officer Robert Howard, said this represents most of VA's laptops. However, his office was unable to encrypt fewer than 100 laptops because they would not accept software from GuardianEdge, a San Francisco-based data security company and these will not be used until they are properly secured. Desktop computers are next on the list for encryption.

VA also is working to provide agency-owned computers to employees who currently use their personal machines for work purposes. Howard said the agency plans to wait for fiscal 2007, which begins 1 OCT because of the cost. In the meantime, employees who use their personally owned computers for work have been informed that they are required to protect any sensitive information. He added VA is conducting an inventory to get an idea of the cost of replacing what could potentially be thousands of personally owned computers, many of them used by the Veterans Health Administration's doctors. VA can track when employees log on to its network from personally owned computers, but cannot require the installation of security patches or see what employees are working on. Accomplishing VA Secretary James Nicholson's goal of making the department the "gold standard" for the government in information security will entail completing 322 actions listed in the department's Data Security-Assessment and Strengthening of Controls Program. A document outlining the status of those actions indicates that the Veterans Health Administration and the Veterans Benefits Administration have yet to finish assessing their contractors’ IT activities. The document also states that the VA is 20% finished implementing standardized IT directives and 27% of the way toward enhancing IT management security controls. VA officials also are working to fill 500 full-time positions created in the department's IT reorganization aimed at centralizing control over technology networks. In the interim the House passed HR 5835 a bill by voice vote 26 SEP. The bipartisan bill would reorganize information technology operations at the Veterans Affairs Department, would create an Office of the Undersecretary for Information Services at the Veterans Affairs Department, and offer credit monitoring in the event of a data breach. [Source: GOVEXEC.com Daily Briefing 15 & 26 Sep 06 ++]

VA RETRO PAY PROJECT UPDATE 03: Retirees do not need to apply. All retirees who may be eligible for additional money are expected to be identified by 1 OCT 06. Once all eligible retirees have been identified, DFAS will publish a general schedule on their Web site. DFAS says a small group of disabled military retirees in SEP will be the first of 133,000 to receive lump-sum back payments, which are tied to start-up challenges for two concurrent receipt programs enacted since 2003. The trickle of back payments will become a small geyser at the end of October. By then, officials say, another 40,000 retirees will see their catch-up payments deposited electronically in their bank accounts by either the VA, DFAS or by both. Back payments will vary in size from several hundred dollars up to $10,000 or more. The average payment, by one estimate, will be $3700. Almost all retirees in line for the back pay served 20 or more years and all have disabilities that made them eligible for Concurrent Retirement and Disability Pay (CRDP) or Combat-Related Special Compensation (CRSC).

DFAS’ deputy director for operations Pat Shine said that a majority of the back payments will be made within the next six months, with DFAS focusing first on older cases. It could take up to six more months to calculate and pay the most complex retro pay file. These involve multiple VA rating adjustments since CRSC and CRDP began, shifts by retirees between these two types of payments, ex-spouse pay entitlements and any other issues that requires lengthy record searches. DFAS officials are calling the $500 million back pay effort the "VA Retro Pay Project." A VA Retro Award hotline at 1(877) 327-4457. has been set up by DFAS to field questions M-F 08-1600 EST from CRSC and CRDP recipients who believe they might qualify. DFAS has also assembled a Frequently Asked Questions page on its Web site. It can be found at www.dod.mil/dfas/retiredpay/frequentlya ... pfaqs.html. By late SEP, DFAS officials hope to have posted a detailed explanation of the back pay program on its website at: www.dod.mil/dfas. The assistant director for policy with VA's Compensation and Pension Service in Washington D.C., Thomas J. Pamperin said, "We have been working with DFAS for almost 18 months. The back pay issue is something where neither one of us can do it by ourselves. We need a lot of information exchanged. DFAS and VA now are testing files that have been transferred back and forth between us. We are going to have a final test the last week in September to make sure that all the [software] logic is working to identify eligible retirees and calculate retro payments."

VA figures to pay 80% of money owed. Some retirees will receive two checks, one from the VA and another from DFAS. Before payments are deposited, affected retirees will get letters explaining reasons for the back pay and how the amounts were calculated. Most of the shortfalls resulted from VA withholding too much disability compensation after CRSC and CRDP began. Traditional VA and DFAS rules on withholding failed to take account of changes to concurrent receipt law. This resulted in a situation where people's entitlement to disability pay had a [start] date prior to the date we actually started paying it. The pay shortfalls can be blamed in part on the considerable complexity of CRDP and CRSC. Congress designed the programs to alleviate, but only for certain career retirees, a century-old ban on concurrent receipt of both military retirement and VA disability compensation. Until CRSC began on 1 JUN 03 and CRDP began on 1 JAN 04 all military retirees with service-related disabilities had to accept a dollar-for-dollar reduction in taxable retired pay in order to receive tax-free VA compensation for their service-related injury or illness. CRSC allows retirees with at least 20 years of service to receive tax-free pay to replace any offset in taxable retired pay required on receipt of VA disability compensation. For CRSC, retirees must have combat-related injuries or ailments and apply to their service to establish eligibility. CRDP, on the other hand, is paid automatically if the retiree served 20 years and has service-related disabilities rated 50 percent or higher by VA. The full CRDP is being phased in for most of its 170,000 recipients, adding another layer of complexity to the back payment effort. Retirees can be eligible for both CRSC and CRDP but can receive only one.

Before these programs took effect, Shine said, VA and DFAS didn't need to worry about tracking retroactivity of payments. When a retiree's VA rating was approved or raised, VA knew to withhold the additional compensation from the retiree until it got word from DFAS that military retirement had been reduced. This avoided government overpayments. Retirees impacted by such withholding simply notified the IRS, on their next tax return, to treat any portion of their retired pay received after their VA benefits kicked in as non-taxable compensation. This arrangement between VA and DFAS no longer worked after CRSC and CRDP took effect and indeed it created compensation shortfalls. Of 220,000 retirees now drawing one of these payments, 60% are owed back pay, and most can of that be traced to over withholding by VA. Retirees who received retroactive pay in SEP represent the sampling of files that DFAS and VA used test their revised pay software and data exchange processes. Back payments owed to the remaining 133,000 retirees have been separated by levels of difficulty. The easiest to calculate, using only computers, are 40,000 files prepared for OCT 06 delivery to VA. VA back payments will be made near the end of the month. DFAS can make batches of back payments weekly, starting in October. "Our target is to get the majority of the [back pay] population done within six months," said Shine. "But we also recognize that, because some of these cases are just a lot more difficult and involved, it could take as much as 12 months to get all payments completely satisfied. To be eligible, you must:
- Be a military retiree (Army, Navy, Air Force or Marine Corps); and
- Meet all the requirements for either CRSC or CRDP eligibility; and
- Have received payment(s) of either CRSC on or after 1 JUN 03 for CRSC and/or CRDP on or after 1 JAN 05; and
- Have been awarded one or more increase(s) in your percentage of disability by the VA on or after 1 JUN 03.
[Source: Tom Philpott article 15 Sep 06 ++]


CERVICAL CANCER UPDATE 01: Women patients at Walter Reed Army Medical Center can now get vaccinated against certain subtypes of the virus that can lead to cervical cancer, a deadly cancer in women. Walter Reed is one of the first military hospitals to begin using a Food and Drug Administration-approved “breakthrough” vaccine that can be administered to women ages 11 to 26 to protect them against human papillomavirus (HPV) type 6, 11, 16, and 18. The vaccination is offered in the Pediatric Clinic and the Allergy and Immunology Clinic. Vaccinating against HPV type 6, 11, 16, and 18 is a three-step process given over a six-month period. The HPV vaccine is only effective for patients who don’t have an active ongoing HPV infection in one of the effected strains. However it’s not likely that if you’re infected with one, you’re infected with all four, so it’s still effective against three of the four even if you have one of the strains. HPV infection is not necessarily an indication that an infected woman will get cervical cancer. If infected it’s very common that it will regress on its own within six to 12 months. If it does go away you can then get vaccinated against it. It’s the HPV infections that don’t go away; those which are persistent, that cause doctors to be particularly concerned. Persistence can lead to cervical dysplasia, or abnormal cells on the cervix which can lead to pre-invasive cervical cancer and invasive cervical cancer.

Regular gynecological exams are important for early detection and potential treatment of cervical cancer. Women who have regular Pap tests are least likely to get cervical cancer, according to the American Cancer Society. Cervical cancer can result in loss of fertility, because it requires either the removal of the uterus or treatment with chemo radiation. Genital warts are a physically and socially debilitating disease in the sense that when somebody gets tagged with the moniker of having warts, not only are they visible, but it’s psychologically impairing to the patient. The vaccine that can prevent 90% percent of all vulvar warts. Parents with teenage daughters tend to become defensive when the vaccination option is offered for teenage girls. They insist their daughters aren’t having sex. But the denial is pointless, because the vaccine can protect them whether they are sexually active now or in the years to follow. Eighty-five percent of all college-aged students and high school seniors have been or are currently sexually active.

The vaccine was approved for use by the FDA in JUN 06 and is the first vaccine designed to prevent cervical cancer. According to the American College of Obstetrics and Gynecologists, studies suggest that three out of four people will get an HPV infection during their lifetime. Although more than 100 subtypes of HPV have been identified to date, the ones most commonly associated with cervical cancer and genital warts are covered by this vaccine. Women and parents of girls should discuss HPV and vaccination options with their gynecologists. At Walter Reed, vaccinations are given to female patients age 11 to 26 in the medical center’s Allergy and Immunology Clinic. Pediatric patients get the vaccination in the Pediatric Clinic. For more information on HPV, go to: www.fda.gov/bbs/topics/NEWS/2006/NEW01385.html. (Source: http://www.dcmilitary.com/stories/09140 ... 7936.shtml 27 Sep 06)


TFL CLAIM PROCESSING UPDATE 03: Military associations received word on 24 SEP that the Tricare Management Activity (TMA) has postponed implementation of a policy that would deny claims from beneficiaries who enter into private contracts with providers who have opted out of Medicare. Certain providers are allowed to “opt out” of Medicare for a period of two years and enter into private contracts with their patients who are Medicare-eligible beneficiaries. When a provider “opts out” of Medicare, Medicare will not make any payment to the provider or the beneficiary except for services provided in an emergency/urgent care situation. A private contract must be signed by both parties prior to delivery of services, and must include the following statements:
• The beneficiary (or legal representative) agrees not to bill Medicare or to ask the provider to bill Medicare for services.
• The beneficiary (or legal representative) agrees to give up any Medicare coverage and payment for services furnished by the opt-out provider, even though the services may have otherwise been covered by Medicare.
• The beneficiary (or legal representative) agrees to be liable for the full billed amount without regard to any limits that would otherwise apply under Medicare.
• The beneficiary acknowledges that Medigap plans will not make payments to opt-out providers, and other supplemental plans may elect not to make payment.
Since the beginning of the current Tricare contracts, Tricare has been acting as primary payer for these opt-out claims. In other words, Tricare has been paying as if the beneficiary was in Tricare Standard. Paying these claims as primary payer is contrary to long-standing Tricare policy, which requires Tricare to pay second to Medicare for any Medicare-covered services. As a rule, Tricare beneficiaries may not elect to waive benefits under a double coverage plan and shift the costs to Tricare. To comply with these requirements, TMA recently announced it had decided to modify the payment process for claims from opt-out providers and Medicare beneficiaries who have entered into private contracts. Military associations and others raised many questions about this policy change to senior DoD Health Affairs officials. Due to the concern about this issue, several different alternatives are being explored and TMA will announce its final decision in the near future. While this proposed policy change is being analyzed, beneficiaries may continue to see Medicare opted-out providers. However, they are strongly encouraged to seek Medicare participating providers. Additionally, Tricare beneficiaries should review any papers they sign in a provider’s office to rule out that they are agreeing to see a provider who has opted out of Medicare. However, Tricare will continue to pay claims as primary payer of beneficiaries continuing to see providers who have opted-out of Medicare if they would otherwise be covered by Tricare until a final decision regarding this issue is made. [Source: NMFA Government & You E-News 27 Sep 06 ++]


VA DISABILITY & SSDI: In a recent statement made to the Veterans’ Disability Benefits Commission, Allison Percy, principal analyst at the Congressional Budget Office (CBO), reported only 15% of veterans who are receiving VA disability compensation also receive Social Security Disability (SSDI). Federal law grants disability payments through the Social Security Act on top of veterans disability benefits. Disabled veterans are the only group of individuals who are permitted to receive SSA disability in addition to Veterans Administration disability benefits. Ms. Percy invited the Veterans Disability Benefits Commission to provide the answers on the following since there is no data available:
- The extent to which SSDI payments are received by veterans with service-connected disabilities rated at 100% or by those with lower-rated service-connected disabilities who also have additional disabilities unrelated to their military service
- The likelihood that veterans will receive both types of payments depending on the type of disability.

In response to the latter, Frederick Johnson, author of “How To Apply For & Win Social Security Disability Benefits,” says that at least in the 9th Circuit, the Administration has made note of the similarity of the standards of judgment for disability for both veterans and SSDI claimants by ruling that those who have been awarded disability by the Veterans Administration, should also be granted SSDI. As to the other questions, the research that the commission is undertaking now has the potential to provide far better information about the role that SSDI plays in providing income support for some disabled veterans. The CBO agency takes as a premise that the clearest view of any policy question can best be found by seeking accurate and unbiased data sources and by examining those data in an objective manner. Consequently, CBO sees only advantages to learning more about the degree to which the totality of federal benefits (including SSDI payments) enables veterans with service-connected disabilities to have a standard of living comparable to that of other veterans. Mr. Johnson added, “If the comments I’ve heard from vets is any indication, the military branches do a very poor job of letting disabled veterans know about the SSDI program.”

The Veterans Disability Benefits Commission was established in 2004 with the purpose of studying the federal benefits available to disabled veterans and the survivors of fallen veterans. The commission’s 13 members are appointed by the President and Congress, but it is independent of any government agency, and welcomes comments from the public. Reportedly, the Commission is most interested in finding out how well benefit programs are meeting adequate standards of living for those who are not able to be rehabilitated. It has denied it is interested in cutting benefits. The Commission’s Web site has details about the time and location of its town meetings planned around the U.S. [Source: Veterans of Modern Warfare, Nancy Rekowski msg 15 SEP 06 ++]

TRICARE RESERVE SELECT UPDATE 05: On October 1 TRS will begin Tiers 2 and 3 coverage of this three their program. The tiers will cover all members of the National Guard and reserves at different levels of premiums depending on the member’s status and their access to other health insurance. These are:
- Tier 1 for those who deploy for a contingency operation and are entitled to participate at a cost share of 28/72 (those previously eligible for TRS);
- Tier 2 for those who are unemployed or are not offered employer sponsored health care, are now eligible to participate at a cost share of of 50/50; and
- Tier 3 for all others at a cost share of 15/85.

Full activation of the program now makes nearly all members of the Selected Reserve eligible for military Tricare coverage. TRS features are:
1. Comprehensive health care benefits with covered benefits of Tricare Standard and Tricare Extra cost sharing, deductibles, and catastrophic caps that apply to active-duty family members (including the TRS member, him/herself)
2. Two types of coverage - TRS member-only coverage & TRS member and family coverage
3. Worldwide availability (as long as you continue in the SelRes under a TRS Service Agreement)
The price is steep for those who haven't been mobilized since 911. Monthly premium costs for the 3 tier levels in calendar year 2006 are $81.00, $145.29, & $247.00 for TRS member only and $253.00, $451.42, & $767.41 for TRS member & family. Premiums are paid monthly, in advance. There is no annual or quarterly billing available. Premium costs are adjusted 1 JAN every year with the December premium payment reflecting the next year’s premium costs. Additional information on TRS is available at www.tricare.osd.mil/reserve/reserveselect/index.cfm. [Source: TREA Leg Up 28 Sep 06 ++]


VA MENTAL HEALTH FUNDING: The Department of Veterans Affairs (VA) provides mental health services to veterans with conditions such as post-traumatic stress disorder (PTSD) and substance abuse disorders. To address gaps in services needed by veterans, VA approved a mental health strategic plan in 2004. VA planned to increase its fiscal year 2005 allocations for plan initiatives by $100 million above fiscal year 2004 levels. VA also planned to increase its fiscal year 2006 allocations for plan initiatives by $200 million above fiscal year 2004 levels---composed of $100 million for continuation of fiscal year 2005 initiatives and an additional $100 million identified in the President’s fiscal year 2006 budget request. GAO was asked by Rep. Michael Michaud (D-ME) and Rep. Lane Evans (D-IL), to provide preliminary information on VA’s allocation and use of funding for mental health strategic plan initiatives in fiscal years 2005 and 2006. GAO reviewed VA reports and documents on mental health strategic plan initiatives and conducted interviews with VA officials from headquarters, 4 of 21 health care networks, and 7 medical centers. VA delegates decision making to its health care networks for most budget and management responsibilities regarding medical center operations, and medical centers receive most of their resources from the networks.

According to Government Accountability Office (GAO) findings delivered to a House committee 28 SEP the Bush Administration failed to fully fund its promised $300 million to address gaps in access and quality of mental health services for veterans over the last two years. Preliminary findings of the GAO study show that the VA actually budgeted only half (approximately $53 million) of the $100 million it had committed to mental health care initiatives in fiscal year 2005. VA also claimed to allocate another $35 million in FY 2005 through a general fund, but GAO found VA did not notify networks that these funds were to be used for [mental health] plan initiatives and that medical center officials were unaware that any portion of their general allocation was to be specifically used for mental health strategic plan initiatives. GAO said VA did not distribute the remaining $12 million of the promised $100 million because VA officials claimed there was not enough time to distribute the monies. For fiscal year 2006, GAO found that VA failed to distribute all of the promised $200 million for additional mental health care staff, allocating only $92 million for new initiatives and $66 million to continue efforts from FY 2005. GAO reported that it is unclear whether VA medical centers will actually spend all of the FY 2006 mental health care strategic plan funds.

GAO’s preliminary findings reveal that, contrary to the Administration’s claims, there is no accountability for spending the resources required to fulfill VA’s own mental health plan and to address the mental health care needs of veterans. Ranking Member of the Veterans’ Affairs Subcommittee on Health Michaud said, “The Administration has critically shortchanged veterans by failing to spend needed funds to address gaps in access and quality of mental health care, instead offering false claims that VA is ready and able to provide these services. Clearly, our oversight of the VA’s implementation and delivery of mental health services will have to be more vigorous.” Chairman Brown said, “We will exercise greater oversight on this issue now to determine what VA is spending and how it is being spent, to ensure that funds allocated by the American people are used as intended.” One in three veterans returning from Iraq and Afghanistan who come to the VA has mental health care concerns. A copy of GAO’s testimony regarding its findings is available at http://veterans.house.gov/democratic/pr ... -06gao.pdf. The full report will be released later this fall. [Source: Veterans Advocate Carl Young msg 28 Sep 06 ++]


FEHBP PREMIUMS 2007: In JAN 07 federal employees will see their health insurance premiums rise an average of 2.3% -- a much smaller increase than in years past. Individual enrollees in the Federal Employees Health Benefits Program (FEHBP)will pay an extra $1.45 every two weeks for a total of $58.45. Those with family plans will pay $3.13 more for a total of $131.64, on average. And in the biggest plan, Blue Cross Blue Shield, premiums won't go up at all. They will even decrease under certain options. More than 50% of the 8 million FEHBP participants belong to Blue Cross Blue Shield. Local plans, such as those operated by health maintenance organizations, will get more expensive. Officials at the Office of Personnel Management (OPM), which oversees the FEHBP, said the primary reason for a lower premium hike this year is a more liberal use of reserve funds. Those are taken from participants' premiums each year and hoarded to cover unexpected medical costs.

OPM Director Linda Springer said at a press briefing 26 SEP that the insurance companies themselves first floated the idea of dipping into reserves this year, and her financial team found the circumstances were right. OPM will use $500 million from an $11 billion pot of reserves -- less than 5%. Springer said Performance was good enough, and OPM did not have to build the reserve. However, Jacqueline Simon, public policy director for the American Federation of Government Employees said, “ The reserves are being used improperly. What we know is true is that enrollees' premiums will go up by more than the government's premiums. And the reason for that is that OPM manipulated the allocation of the so-called excess reserves to give themselves a greater subsidy." According to Nancy Kichak, OPM's associate director for strategic human resources policy, the government's contributions will go up 1.6% next year. That's smaller than the enrollee increase because of a technical matter involving timing differences in calculating the two portions. Last year, enrollees had a 10% average premium increase, while the government's hike was 5.2%. Premium increases peaked in fiscal 2002, when they reached 12.7% between employees and the government. The last time they were this low was in 1997, when there was a 1.6% hike divided between enrollees and the government.

Federal employees and retirees will be able to pick their insurance plan for 2007 during open season, which starts 13 NOV. About a week before that, OPM will post brochures on its Web site detailing costs and coverage in each plan. For the first time, current and retired federal employees will be able to choose supplemental vision and dental insurance during the open season. Biweekly premiums for family dental plans range from around $20 to $55 and feature 100% coverage for preventative dental work and varying coverage for other procedures. Family vision insurance will range from about $8 to $16 every two weeks. There is no government subsidy for the dental and vision insurance. Also for the first time, OPM is publicizing specific insurance plans that meet its standards for cost transparency. The 18 companies will let enrollees get cost information for certain procedures including cataract repair, caesarean birth and knee replacement to allow participants to shop for the best deal. OPM will feature the companies during open season. [Source: GOVEXEC.com Daily Briefing 20 Sep 06]


GI BILL INEQUITIES: On 27 SEP MOAA President VADM Norb Ryan, Jr. (USN-Ret) represented MOAA and The Partnership for Veterans Education - a broad-based group of military, veterans and higher education associations at a Montgomery GI Bill (MGIB) hearing before two House Armed Services and Veterans Affairs subcommittees. He recommended that Congress combine the reserve and active duty MGIB programs, which are now separately overseen, respectively, by the Armed Services and Veterans Affairs Committees. Ryan highlighted that today's Reserve benefit is only 27% of the active duty benefit - down from 50% when it was first enacted. He noted that Guard-Reserve members can only use their benefits while in service - which can negate much of the benefit in a high-mobilization environment. He likened the situation to a car out of alignment that might run the All-Volunteer Force into a ditch if not fixed. Ryan proposed a total force GI Bill to better support recruiting, retention, and readjustment for all servicemembers. The first witness, Sen. Blanche Lincoln (D-AR), promoted her bill to let activated reservists use their GI Bill benefits for 10 years following completion of service, just as active duty veterans already can. Her measure was adopted in the Senate version of the defense authorization bill for fiscal year 2007 but it was dropped in final negotiations with the House.

Principal Deputy Assistant Secretary of Defense for Personnel and Readiness Mike Dominguez said DoD opposes any changes, saying education benefits aren't that important to reservists, and that he would rather spend money on equipment. He took the position of dismissing any inequity, saying Guard/Reserve GI Bill upgrades are not a cost-effective way to support recruiting and retention. That did not go down well with the legislators, who expressed frustration that a year-long DoD study of consolidating the GI Bill was still not completed. Rep. Vic Snyder (D-AR), Ranking Minority Member of the Military Personnel Subcommittee, said he felt strongly about the Guard and Reserve inequity. Many Guard and Reserve members have served two tours in Iraq, and he contrasted their relatively skimpy education benefit with the 45 months of GI Bill benefits he earned in the Vietnam era in return for 21 months of active service (including a 13-month deployment). Snyder said he will introduce total force MGIB legislation and work to get it passed next year. [Source: MOAA Leg Up 29 Sep 06 ++]


TRICARE UNIFORM FORMULARY UPDATE 14: A panel of beneficiary advisors has concurred with a DoD pharmacy panel's recommendation to move Crestor and Caduet, which lower so-called "bad cholesterol" (LDL), to Tricare’s "third tier" of medications. The change could affect about 44,000 beneficiaries. Tricare will continue to cover 12 other cholesterol-lowering drugs, including the popular Lipitor and Zocor, at the lower $3 (generic) or $9 (brand name) copay. The proposed plan is to implement the change within 90 days. MOAA believes 90 days is not enough time to notify beneficiaries and allow them to discuss alternative options with their doctors. DoD provides beneficiaries no notice at all of such changes, but depends on military associations to spread the word. But associations typically have 60-to-90-day lead times for their magazines, which makes timely notification impossible for most beneficiaries, even if they belong to an association. The practical reality is that this prevents most affected beneficiaries from finding out about the change until they get charged $22.

Third-tier drugs can still be obtained at the regular $9 copay if the doctor specifies the drug is medically necessary for the patient (e.g., works better or avoids side effects associated with other drugs) and the medical necessity determination is approved by DoD. Dr. William Winkenwerder, Assistant Secretary of Defense for Health Affairs, will make the final decision on moving the drugs to the third tier. For more information, contact the Tricare Retail Pharmacy (TRRx) customer service line at 1(866) 363-8779. For the TRICARE mail order pharmacy (TMOP) call 1(866) 363-8667. Information on both programs can be found at www.express-scripts.com/TRICARE. [Source: MOAA Leg Up 29 Sep 06 ++]


TRICARE CATASTROPHIC CAP UPDATE 03: The Tricare Catastrophic Cap Resets on 1 OCT 06. The catastrophic cap limits the amount of out-of-pocket expenses a family will have to pay for Tricare-covered medical services. The cap applies to all covered services—annual deductibles, pharmacy copays, Tricare Prime enrollment fees and other cost shares based on Tricare-allowable charges. The cap applies to the fiscal/enrollment year (1 OCT to 30 SEP) and is a total amount per family. The cap is $1,000 for active duty families and $3,000 per family for all other beneficiaries. After you meet the catastrophic cap, Tricare will pay your portion of the Tricare-allowable amount for all covered services for the rest of the fiscal/enrollment year. The cap does not apply to services not covered by Tricare or to any amount that nonparticipating providers may charge above the Tricare maximum allowable charge for services. Tricare will not apply out-of-pocket expenses paid under the Prime point-of-service option (deductibles and cost shares) to the annual fiscal/enrollment year catastrophic cap. The beneficiary is responsible for any point-of-service charges incurred both before and after meeting the catastrophic cap. For more information about the Tricare catastrophic cap, you may call your regional contractor, visit or call or visit a local beneficiary counseling assistance coordinator (BCAC) or Tricare service center. A BCAC directory is available online at www.tricare.osd.mil/BCACDirectory.htm. [Source: NAUS Weekly Update 22 Sep 06 ++]


GENERIC DRUG PRICES UPDATE 01: Wal-Mart announced it is selling nearly 300 generic drugs for $4 per prescription, whether or not a customer has insurance. The new pricing began 22 SEP 06 at Wal-Mart’s 65 stores in Tampa, Florida, and will be in place in all Florida stores in JAN 07, expanding to many more states by the end of 2007. The $4 price is for a 30-day supply of many generic versions of popular prescription medications. Insured customers will be allowed to pay the $4 per prescription price even if that is less than the co-payment required by their plan. The administrator of the federal Centers for Medicare and Medicaid Services, does not expect beneficiaries of the Medicare drug benefit (Part D) to switch because of the coverage for generics provided already by Part D plans. He said that the Wal-Mart plan does provide a way for Medicare recipients to save money after they reach the "doughnut hole," the gap in annual drug costs at which Medicare does not subsidize these costs. According to Wal-Mart, it started the program to help families and retirees, especially those on Medicare. It is likely, however, that Wal-Mart is also banking on increased traffic in its stores to offset the substantially lower prices on some of the generic drugs on its list. Stock prices for competitors CVS and Walgreen fell 7 and 8 percent respectively the day after Wal-Mart’s announcement. Generic drugs continue to be available under Tricare for $3 per 30-day supply. However, a proposal under consideration at the conference committee on the 2007 National Defense Authorization Act would increase the price of generics to $6. [Source: NAUS Weekly Update 22 Sep 06 ++]


HURRICANE SAFETY: Have a good plan prepared when hurricanes threaten your area. Don't wait until your radio blares out a hurricane warning. There's a lot you can do to protect yourself, your family, your pets, and your home -- if you act in time. Last year’s devastation from Hurricane Katrina and Hurricane Rita has made more Americans appreciate the wrath of Mother Nature. The effects of that disaster brought home the message that these storms touch everyone's lives. One in six Americans live in a county on the Atlantic or Gulf coasts where hurricanes pose yearly threats. Even if we don't live in these areas, many of us vacation in areas of the U.S., the Caribbean, or Mexico where hurricanes habitually hit. Unfortunately, it may have taken the impact of Katrina and Rita to make people realize that riding out a hurricane is always a big mistake. In case of an emergency, TRICARE will provide you with up-to-date, critical information on TRICARE and DoD related matters that may affect your health benefits. Updates will include information gathered from a variety of sources, including other federal agencies and departments, state and local government, and the news and media. For tips on protecting your family and property visit: www.fema.gov/plan/index.shtm. U.S. hurricane season runs from June through November. Mid-August to late October is peak season.

Before Hurricane Season:
• Put together a disaster supplies kit. It should contain: 1) A first-aid kit. 2) Canned food & a can opener. 3) Three gallons of water per person. 4). Clothing, rain gear, and bedding or sleeping bags. 5) One flashlight per person, with extra batteries. 6) Any special items or medicines needed for infants or people with disabilities.
• Learn whether you live in a flood zone. Call your local emergency management or planning/zoning office to find out. If you are in a flood zone, it's a good idea to buy flood insurance -- normal homeowners' policies don't cover floods. Remember, most policies don't take effect for 30 days.
Learn how to turn off your home's water, electricity, and gas. Don't turn the gas back on without professional help.
• If you live in a county near the coast, make sure your house is hurricane resistant. If you're not sure, have a licensed engineer check it.

During Hurrican Season Stay Informed:
• Get a weather radio and keep its batteries fresh. The National Weather Service suggests that people have a weather radio equipped with a Specific Area Message Encoder (SAME) feature. This automatically broadcasts an alert when there's hurricane information for your area.
• People with hearing or visual impairments can get weather radios that connect to strobe lights, pagers, bed-shakers, home computers, and printers.
• If you don't have a special weather radio, keep a battery-operated radio handy. Know how to tune it to a local station that broadcasts severe-weather warnings.
• Know what to listen for: A hurricane WATCH means that conditions are right for a hurricane to hit. It's time to check your hurricane preparations and review your evacuation plan. A hurricane WARNING means a hurricane is expected to hit your area within 24 hours. Leave the area if local officials say to do so.

What to Expect:
• Hurricanes pack sustained high winds of 74 mph or more. Gusts can be much faster. Hurricane Camille in 1969 set the record for the highest wind speed ever to hit the Western hemisphere. It had sustained winds of 190 mph at landfall. Items such as toys left in the yard, signs, and construction materials become deadly missiles in hurricane-force gales.
• When a hurricane hits expect a storm surge (i.e. a dome of water topped by battering waves) to sweep the coastline the shore. At the water's edge, it's the greatest threat to life and property. Storm surges can be 50 or even 100 miles wide. A 15-foot storm surge is not unusual for a major storm.
• If it's high tide when a hurricane hits, the storm surge adds to the water's height. In 1989, Hurricane Hugo caused a 20-foot storm tide in South Carolina.
• Hurricanes carry lots of rain. These rains often cause flash floods, landslides, and mud slides hundreds of miles from the coast. In 1969, Hurricane Camille dropped 27 inches of rain on Virginia causing severe flash floods that killed 150 people. Slow-moving hurricanes cause the most flooding.
• Hurricanes often spawn tornadoes far from the center of the storm.
[Source: Web MD www.webmd.com Sep 06 ++]


SOLE SURVIVING CHILD (ENLISTMENT): Contrary to popular belief only sons, the last son to carry the family name, and sole surviving sons must register for the draft, they can be drafted, and they can serve in combat. However, they may be entitled to a peacetime deferment if there is a military death in the immediate family. Provisions regarding the survivors of veterans were written into Selective Service law after World War II. Details have varied over the years, but the basic premise remains the same; where a family member has been lost as a result of military service, the remaining family members should be protected insofar as possible. It is important to keep in mind that the provisions are directly related to service-connected deaths. The mere fact that a man is the only child or only son does not qualify him for consideration - he must be the survivor of one who died as a result of military service. The present law provides a peacetime exemption for anyone whose:
- Parent or sibling was killed in action, died in line of duty, or died later as a result of disease or injury incurred in line of duty while serving in the armed forces of the United States; or
- Parent or sibling is in a captured or missing status as a result of service in the armed forces during any period of time. This is known as the "surviving son or brother" provision. A man does not have to be the only surviving son in order to qualify; if there are four sons in a family and one dies in the line of duty, the remaining three would qualify for surviving son or brother status under the present law. The surviving son or brother provision is applicable only in peacetime. It does not apply in time of war or national emergency declared by the Congress.

The original law, passed in 1948, exempted the sole surviving son of a family where one or more sons or daughters died as a result of military service. No restriction existed at that time to limit the exemption to peacetime. The provision was intended to protect families which had lost a member in World War II.
In 1964, recognizing that sons of World War II veterans were reaching draft age, Congress changed the law to include the sole surviving son of a family where the father, or one or more sons or daughters, died as a result of military service. At this time the peacetime-only restriction was also added to the law. A further change was made in 1971, expanding the exemption to any son, not necessarily the sole surviving son, of a family where the father, brother or sister died as a result of military service. This provision was recently expanded to include mothers.

In addition to peace-time draft deferrment, DoD authorizes discharges for any son or daughter in a family in which the father or mother or one or more sons or daughters:
1. Have been killed in action or have died when serving in the U.S. Armed Forces from wounds, accident, or disease, or
2. Are in a captured or missing-in-action status, or
3. Have a permanent 100% Service-related disability (including 100% mental disability), as determined by the Veterans' Administration or one of the Military Services, and are not gainfully employed because of the disability.
[Source: About U.S. Military Rod Powers article 26 Sep 06 ++]


MILITARY INSURANCE/INVESTMENT PREDATORS: On 21 SEP, the House of Representatives passed the Military Personnel Financial Services Protection Act (S.418) by a vote of 418 to 3, and presented it to the President on 25 SEP for signature. This act was created to be an important first step to protecting service members and their families from certain insurance and investment products that are deceptively expensive and have virtually disappeared from the civilian market. Investment companies that offer these products tend to prey primarily on military personnel and family members by using abusive and misleading sales practices. Additionally, sellers of life insurance products will be required to disclose to military customers that their policies and products do not have the endorsement of the federal government Sellers must give potential military customers an honest assessment of whether they could benefit from the product. Military personnel already have access to subsidized life insurance policies through the Servicemembers Group Life Insurance Program. The House companion bill H.R.458 to S.418 had also included a provision addressing abusive lending practices by check cashing stores and other short term loan companies. The provision to curb these predatory practices was included in the Senate version of the FY 2007 National Defense Authorization Act, which is still being considered by a House and Senate Conference Committee. [Source: NMFA Government & You E-News 27 Sep 06 ++]


MILITARY PAYDAY LENDERS UPDATE 01: A Defense Department report issued last month found that as many as one in five U.S. service members are being preyed on by loan centers set up near military bases,? which can charge annual interest rates of 400% or more. Increasingly, soldiers have debt levels so high they are barred from serving overseas; others suffer from bankruptcies, divorces and ruined careers due to the strain and stress of debt. The Pentagon has joined consumer, military, and veterans groups in backing a bipartisan amendment from Sens. Jim Talent (R-MO) and Bill Nelson (D-FL) that places a cap of 36 percent on high interest rates for short-term payday loans to military members. But two conservatives -- Reps. Geoff Davis (R-KY) and Steve Buyer (R-IN) -- have been working to block Congress from making this bill law.

Payday lenders offer high-cost, short-term loans marketed as cash advances on the borrower's next paycheck to cover an emergency need. Lenders charge roughly $15 to $25 per $100 loan for two weeks, and "most loans are extended for several weeks" because the borrower is unable to pay back the original loan amount. The average loan is $350 and has an annual interest rate of 390% to 780% meaning the average borrower pays back $834 for a $339 loan. Between 13% and 19% of U.S. servicemembers -- roughly 175,000 people -- took out such loans last year. Because of the high-risk terms, borrowers often get caught in a vicious cycle of chronic debt. When they cannot afford to pay back the fees plus the principal at the end of the two week period, borrowers are forced to pay another high fee to roll over the loan for an additional two weeks or take out another loan to pay off the first loan, thereby getting trapped in a costly and often devastating cycle of 'back-to-back' loans."

Payday lenders systematically target military families, who are an ideal demographic for payday lenders because they usually have a steady government paycheck with little to spare at an average of $1,200 a month for new recruits. A 2005 report found that in 19 of 20 states studied, payday lenders were located in counties and ZIP codes adjacent to military bases in significantly greater numbers and densities than other areas. The Pentagon states that payday lending undermines military readiness, harms the morale of troops and their families, and adds to the cost of fielding an all volunteer fighting force.. Debt can distract service members from their duties or cause them to become security risks open to compromise. The Navy and Marine Corps denied security clearance to about 2,000 service members nationwide last year because of concerns that their indebtedness could compromise key operations. The Pentagon report outlines current efforts to combat abusive practices through education and credit counseling for service members, but also acknowledges that education is only part of the solution. The report states unequivocally that our men and women in uniform can only be adequately protected by strong legislative action.

Lending and banking industry lobbyists have moved aggressively to try to block a national cap on payday loans. The lending industry's main lobbying group, the Community Financial Services Association, called the Defense Department report nothing but a re-hash of flawed data, biased analysis and anti-business philosophy pushed by fringe activists. One member of Congress, Rep. Geoff Davis (R-KY), has taken up their cause. Davis recently proposed language, praised by the payday lending industry that would gut the Talent/Nelson amendment and set no real limits on predatory lenders. One of Davis's aides admitted that he consulted on the legislation with CNG Financial of Mason OH, one of his top campaign donors and owner of national payday lender Check-n-Go. After facing intense local criticism for aiding and abetting predatory lenders, Davis announced that he no longer opposes the 36% cap on payday loans. But few have seen Davis's compromise language, which is being negotiated behind closed doors, and the Center for Responsible Lending (CRL) www.responsiblelending.org says it will remain worried about loopholes until we see the actual language and get a final vote. The CRL is a nonprofit, nonpartisan research and policy organization dedicated to protecting homeownership and family wealth by working to eliminate abusive financial practices. CRL is affiliated with Self-Help www.self-help.org,, one of the nation's largest community development financial institutions. The complete DoD report can be found at www.defenselink.mil/pubs/pdfs/Report_to ... _final.pdf. [Source: DoD Report on Predatory Lending Practices dtd 9 Aug 06 ++]


MILITARY PAYDAY LENDERS UPDATE 02: Advance America, Cash Advance Centers, Inc. announced on 25 SEP that it will respectfully and voluntarily refrain from making any payday advanc

[boardman]

RAO Bulletin Update 15 September 2006


THIS BULLETIN UPDATE CONTAINS THE FOLLOWING ARTICLES:

== NDAA 2007 [11] -------------- (House Conferees Assigned)
== Tricare Pacific Registration --------- (On Line Registration)
== AF Combat Action Award ----------------- (Study Ongoing)
== Social Security Card ------ (New Assignment Rules)
== Congressional Cola 2007------------------- ($3300 Increase)
== VA Claim Denial [01] ------- (Multiple Claim Submission)
== Voter Registration --------------------------- (Make it Count)
== IRS Private Debt Collection ------- (Opposed by Congress)
== POW VA Benefits [03] -------------- (29,350 Vets Eligible)
== TRICARE Plus [01] ------------------ (Primary Care Only)
== USFHP [01] ----------------------- (TRICARE Prime option)
== Pregnancy Resource Centers ---- (Abortion Risks Misstated)
== Unified Medical Command ------------ (Jan 07 Target Date)
== Fake Heroes [01] ------------------------- (Senate passes Bill)
== AOL Advisory [07] ----------------------- (Business as Usual)
== Military Awards Review ------------------------ (All Services)
== Mobilized Reserve 13 SEP 06---------- (Increased by 6,168)
== Airline Carry-On Restrictions ----------------- (Be Prepared)
== Agent Orange Lawsuits [05] --- (Compliance Impact)
== Grandparents Day --------------------------- (Did You Know)
== VA Homeless Vets [02] --------------- (Bed Shortage in 07)
== VA Home Loan [ 06] -------------------- (Beneficial to Vets)
== Thrift Savings Program [05] --------- (Retirement Cashout)
== Military Payday Lenders ------------ (1000% Interest Rates)
== KDSM [03] --------------------------- (AF Automates Award)
== Military Housing Utility Bills ----- (Army Initiates Billing)
== VA ID Card -------------------------------- (Card Upgrading)
== Tricare Rx Drug Dispute ----------- (Mail Order vs. Retail)
== VA Chiropractic Care ----------------- (Beginning this Fall)
== Recall to Active Duty Update 02------------------ (All Vets)
== AFRH Gulfport [03] --------------- (Ready for Demolition)
== VetJobs Veteran Eagle --------------------- (Vet Job Source)
== Tricare Pacific Authorizations -- (Mental/Physical Therapy)
== VA Appeals [03] -------------------- (Dealing with Backlog)
== Military Legislation Status ---------------- (Where we stand)


NDAA 2007 UPDATE 11: Without a negative vote, the Senate agreed 7 SEP by a vote of 98-0 to approve the fiscal 2007 Defense appropriations bill (NDAA). Included in the Senate approved appropriations was Senators George Allen (R-VA) and Dick Durbin (D-IL) amendment to increase critical funding for care and research for Traumatic Brain Injury (TBI) from $7 to $19 million. Now, House and Senate leaders must resolve the differences between their respective bills in hopes of passing a final bill before the new fiscal year starts on 1 OCT. The Senate bill is substantially larger -- $469.7 billion vs. the $427.6 billion approved by the House. Some of the difference is due to organizational differences between the House and Senate. For example, the Senate bill covers defense health care, while that is covered in a separate funding bill in the House. The Senate bill also provides about $13 billion more than the House for replacement of worn-out military equipment and an additional $2 billion for border security.

The House officially received the Senate version of the NDAA and asked for a conference with the Senate to sort out differences. In taking this action, the following 66 House Members were appointed to the conference committee on the bill from the Committee on Armed Services for consideration of the House bill and the Senate amendment, and modifications committed to conference: Hunter (R-CA), Weldon (R-PA), Hefley (R-CO), Saxton (R-NJ), McHugh (R-NY), Everett (R-AL), Barrett (R-SC), Thornberry (R-TX), Hostettler (R-IN), Jones (R-NC), Ryun (R-KS), Gibbons (R-NV), Hayes(R-NC), Calvert (R-CA), Simmons (R-CT), Drake (R-VA), Davis (R-KY), Skelton (D-MO), Spratt (D-SC), Ortiz (D-TX), Taylor, (R-MS), Abercrombie (D-HI), Meehan (D-MA), Reyes (D-TX), Snyder (D-AR), Smith (D-WA), Sanchez (D-CA), Tauscher (D-CA), Brady (D-PA), Andrews (D-NJ), Hoekstra (R-MI), LaHood (R-IL), Harman (D-CA), McKeon (R-CA), Kline (R-MN), Miller (D-CA), Barton (R-TX), Gilmor (R-OH), Dingell (D-MI), Davis (R-VA), Shays (R-CT), Waxman (D-CA), King (R-NY), Reichert (R-WA), Thompson (D-MS), Hyde (R-IL), Leach (R-IA), Lantos (D-CA), Sensenbrenner (R-WI), Coble (R-NC), Conyers (D-MI), Pombo (R-CA), Walden (R-OR), Grijalva (D-AZ), Boehlrt (R-NY), Sodrel (R-IN), Gordon (D-TN), Manzullo (R-IL), Kelly (R-NY), Velazquez (D-NY), Young (R-AK), LoBiondo (R-NJ), Oberstar (D-MN), Buyer (R-IN), Boozman (R-AR), & Herseth (D-SD). The Chair of the House also appointed to the conference numerous other members from other committees on specific sections of the bill. The Senate had previously appointed their 19 representatives to the conference Committee who have been meeting unofficially for several weeks. Apparently, several items, including pharmaceutical pricing and copays, remain in disagreement.

The Defense Authorization Bill (H.R. 5122) should not be confused with the Defense Appropriations Bill (H.R. 5631). Congress considers both bills at about the same time. The authorization bill includes the law changes needed to authorize troop levels, weapons procurement, new programs, and changes in pay and benefits (including pay raises, health coverage, concurrent receipt, and survivor benefits). The appropriations bill, on the other hand, provides the funding to pay for the things that are approved in the authorization bill. The final authorization bill may be ready for congressional passage as early as next week. There are expectations of winning a conference agreement prior to elections. A conference report could be filed as early as next week. [Source: NAUS Weekly Update 8 Sep 06 ++]


TRICARE PACIFIC REGISTRATION: Beneficiary registration on TRICARE4u.com has gone paperless. A beneficiary is now able to log into www.TRICARE4u.com within minutes of registering. By registering beneficiaries will be able to check claim status, update or add Other Health Insurance (OHI), change physical addresses, verify eligibility, check deductibles and cost shares and retrieve duplicate Explanation of Benefits (EOB) for themselves and any dependents under the age of 18, except in custodial situations. Beneficiaries are also able to grant access to any individual that is enrolled on TRICARE4u.com and DEERS under the same sponsor number. Simply go to www.TRICARE4u.com and click on register as a beneficiary. Follow the instructions and answer all questions. A registration notice will be sent to your email address with log in information. The TRICARE Area Office-Pacific is located in Okinawa Japan. To contact them refer to their website http://tpaoweb.oki.med.navy.mil, Email: tpao.csc@oki10.med.navy.mil, call toll free (from CONUS): 888-777-8343 Option 4 or Commercial phone: (81) 6117-43-2036 or DSN: (315) 643-2036, or write TRICARE Area Office-Pacific, PSC 482 Box 2749, FPO AP 96362. The TAO-P offers assistance in TRICARE benefits, eligibility, claims resolutions, and debt collections for all Western Pacific areas of Asia. [Source: TAO-P Newsletter 1 Jun 06]


AF COMBAT ACTION AWARD: Although soldiers, sailors and marines can earn ribbons or devices showing they have been in ground combat, the Air Force’s closest corollary is a gold border “combat marker” on its Expeditionary Service Ribbon. That border signifies either that the wearer has participated in combat or that the airman has spent at least 45 consecutive days supporting combat operations in a designated combat zone. All this could change, depending upon results of a preliminary study by Air Force personnel officials. Their report would include what the award might be as well as what it would take to be eligible. [Source: Armed Forces News 24 Aug 06]


SOCIAL SECURITY CARD: A new law, Public Law 108-458, includes several provisions that change rules for assigning a Social Security number and issuing a Social Security card. To get a Social Security number or a replacement card, you must prove your citizenship or immigration status and your identity. Under the new law, only certain documents can be accepted as proof of citizenship. These include your U.S. birth certificate, a U.S. passport, a Certificate of Naturalization or a Certificate of Citizenship. If you are not a U.S. citizen, different rules apply for proving your immigration status, and those rules have not changed. Also under the new law, only certain documents can be accepted as proof of identity. An acceptable document must show your name, identifying information about you and preferably a recent photograph. For example, if you are a U.S. citizen, Social Security will ask to see your U.S. driver’s license, state-issued non-driver identification card or U.S. passport as proof of your identity. If you are not a U.S. citizen, Social Security will ask to see your current U.S. immigration documents.
Acceptable documents include your From I-551, I-94 with your unexpired foreign passport, or your work permit card I-766 or I-688B.

If you need to change your name on your Social Security card, you must show proof of your legal name change. Documents Social Security may accept to prove a legal name change are your marriage document, divorce decree stating you may change your name, Certificate of Naturalization, or a court order for a name change. If the documents do not give enough information to identify you, then you must also show two identity documents. One document must show your new name, and the other must show your old name.
Under the new changes, you are now limited to three replacement cards in a year and 10 during your lifetime. Legal name changes and other exceptions do not count toward these limits. For example, changes in non-citizen status that require card updates may not count toward these limits. Also, you may not be affected by these limits if you can prove you need the card to prevent a significant hardship. These rules, prescribed by law, help ensure that only those who should receive an SSN do so. They make SSNs less accessible to those with criminal intent and prevent individuals from using false or stolen birth records or immigration documents to obtain an SSN.

Lamination of Social Security number (SSN) cards is discouraged because lamination would prevent detection of certain security features. To deter potential fraud and misuse involving SSNs, SSA currently issues SSN cards that are both counterfeit-resistant and tamper-resistant. For example, the card contains a marbleized light blue security tint on the front, with the words "Social Security" in white; intaglio printing in some areas on the front of the card; and yellow, pink, and blue planchets--small discs--on both sides. SSA cannot guarantee the validity of a laminated card. You may, however, cover the card with plastic or other material if the material could be removed without damaging the card. SSA recommends that as a security precaution, you carry your Social Security card only when you expect to need it, for example, to show to an employer or other third party. Otherwise, you should keep your card in a safe place.

Depending on your circumstances, you can take or mail your application (SS-5) and evidentiary documents to your local Social Security office. First-time applicants age 12 or older must apply in person at a Social Security office while all others may mail their application materials. People who live or receive mail in Brooklyn, N.Y., Queens, N.Y., or Las Vegas, Nev. must apply at one of the following Social Security Card Centers. These offices serve both U.S. citizens and noncitizens applying for new or replacement Social Security cards.
- Brooklyn Social Security Card Center, 625 Fulton Street, 6/F, Brooklyn, NY 11201 M-F 07-1630 except Thur 07-1900.
- Queens Social Security Card Center, 155-10 Jamaica Avenue, 2/F, Jamaica, NY 11432
M-F 07-1630 except Wed 07-1900
- Las Vegas Social Security Card Center, 1250 South Buffalo Drive, Suite 100, Las Vegas, NV 89117
[Source: www.seniorjournal.com 14 Aug 06]


CONGRESSIONAL COLA 2007: Many years ago Representatives and Senators had to hold hearings and take a vote before they could raise their own salaries. Back then Congress not surprisingly had to go for long stretches between pay raises, and on a few occasions even took a pay cut. Ever since 1989 they’ve been able to avoid all that. Under the system now in place, House and Senate Members automatically get a pay raise every year, unless Congress votes to reject it. Since 1998 they’ve never done so. That year, party leaders agreed that neither side would make or condone campaign attacks against members of the other party who support or accept the raise. There are a few spoilsports. Rep. Jim Matheson (UT) has been defeated six years in a row in his attempt to seek a straight vote on the pay hike. Senator Russell Feingold (WI) has for several years introduced an amendment to stop the pay raise, but each time has seen it tabled without being debated or voted on.

Last year Hurricane Katrina threw a monkey wrench into things. In October, when the public was beginning to learn the full extent of the federal government’s disaster response failures, the Senate wisely decided timing was bad and agreed to kill their Cost-of-Living Adjustment (COLA) for 2006. But prior to recessing for Thanksgiving, Congress called a brief late-night truce during a particularly acrimonious session to assure a raise of $3,100 for 2006. This year the average recipient’s Social Security COLA may only raise benefits by about $40 a month come January 07. However, despite record low approval ratings, House members felt they deserved a raise which will increase their monthly salaries by $275 or $3,300 annually. Their pay will increase to $168,500 making it the seventh straight COLA since 1998. The Senate is very likely to follow suit. [Source: TSCL Social Security Advisor 26 Aug 06]


VOTER REGISTRATION: Next NOV one-third of our Senators and all of our Representatives will be up for election. Veterans will then have an opportunity to express their satisfaction with their legislators at the ballot box. A number of web sites provide fast and easy access to voter registration forms, absentee ballots, and a wealth of voter educational information on the issues. A few important things to remember are:
• If you’ve moved since the last election, even within your current election jurisdiction, you will need to update your registration, and determine where you will vote. If you moved outside of your previous jurisdiction, you will need to reregister before the deadline in your state.
• Although state registration deadlines vary, most states require that you register no later than the first week of October. Check with your state for the deadline.
• To register to vote, you can start by printing out a voter registration form for your state at one of the web sites listed below. (Residents of North Dakota, Wyoming and some areas of New Hampshire are not permitted to use these forms.) You can also contact your local election office by checking your phonebook for your local board of elections.
• If you have trouble writing or know someone who does, state agencies are required to provide assistance in filling out the voter registration form if asked.
• After you mail or hand in your registration application, you should get a voter registration card or notice in the mail. Hold on to that notice. Check it for accuracy, and call your local board of elections if it needs correcting. Remember to take your voter registration card and photo identification along with you to vote.
• If you or someone you know is homebound, and cannot get to the polls to vote, contact your local election officials for information on absentee voting. You may need to request an absentee ballot at least 30 days prior to the election, but check with your state for the exact deadline.
Here are three web sites where you can print out a registration application for your state.
- JustVote! — http://www.justvote.org/ JustVote! is one of the most popular voter registration websites. The web site is simple and straight - forward.
- Congress.org — https://ssl.capwiz.com/congressorg/e4/nvra/ In addition to providing registration forms for your state, this web site provides an online “Soapbox,” giving you an opportunity to raise an issue or read issues raised by other visitors to the site. In addition, this web site allows you to email your concerns to your Members of Congress.
- League of Women Voters — http://www.lwv.org//AM/Template.cfm?Section=Home
This website has a considerable amount of useful voter information. In addition to online registration forms, you can find deadline and contact information, candidate information and voter guides.
[Source: TSCL Social Security Advisor 26 Aug 06]


IRS PRIVATE DEBT COLLECTION: The Internal Revenue Service has published guidance on an initiative to turn some tax debt collection over to private contractors, paving the way for three companies to begin receiving taxpayer data. Some uncollected tax debts will be assigned to three private collection firms starting 7 SEP. The IRS said 12,500 taxpayers will be included in the first group, with about 40,000 accounts to be outsourced by the end of the year. The three companies were selected in MAR 06 to perform the work. The agency plans to expand the program to 10 companies in 2008. But the initiative is facing stiff opposition. The initiative has attracted controversy with critics including the National Treasury Employees Union, an IRS-appointed taxpayer advocacy panel and members of Congress arguing that:
- It costs far more for contractors to collect outstanding tax debts than for IRS employees to do so, and,
- Outsourcing exposes taxpayers to a greater risk of identity theft and privacy loss.


In 1996, IRS officials argued against a similar initiative in Congress, expressing concern that taxpayer rights would be sacrificed. But in recent statements, the agency has put a positive face on the effort. The agency’s announcement specifies that private collection firms will work only on cases where the amount of debt is not in dispute. They will be authorized to make payment arrangements, but cannot use or threaten measures such as filing liens or seizing property. Nor can they handle cases involving bankruptcies, unusual hardship, litigation or partial payments. Contractor employees will be subject to strict rules on how they use taxpayer information, and taxpayers can request in writing to work directly with the agency rather than a collection company.

Along with the general rules, IRS last week published a tip sheet for taxpayers on avoiding scams that could arise in connection with the initiative. This can be seen at www.irs.gov/newsroom/article/0,,id=161301,00.html. People should be aware that they will first be notified directly by the IRS if their case has been turned over to a collection agency and legitimate collection firms will never ask for cash or for checks written to individuals. IRS spokesman Terry Lemons
said only 60 to 75 people would be working as collectors for the companies, though he acknowledged that a greater number could have some access to taxpayer data. Right now, these are collections cases that IRS can’t get to so this allegedly will be getting to money that wouldn’t be collected otherwise.

In June, the House passed a Transportation-Treasury spending bill H.R.5576 that would bar IRS from using 2007 funds to sign or administer contracts under the initiative. The Senate has not passed corresponding legislation. A Senate Finance Committee staffer said his committee would strongly oppose such legislation, having worked to design a program that would protect taxpayers. He highlighted language in the 2004 law authorizing the IRS to outsource tax collections that allows the agency to keep up to 25% of the amount private collectors bring in to finance collection activities. He said the agency now will be able to increase collections both by handing off backlogged cases to private firms and using some of the funds they generate to hire more staff of its own. On 28 AUG, Rep. John Olver (R-MA) sent a letter to the IRS Commissioner saying the IRS would be “clearly disregarding the will of the House of Representatives” if it proceeded with the plan to turn taxpayer files over before Congress completed its 2007 appropriations work. Whatever happens with the provisions in the conference report and whatever happens at the IRS, Congressman Olvert doesn’t plan to let this issue go. [Source: GOVEXEC.com Daily Briefing 31 Ag 06]


POW VA BENEFITS UPDATE 03: Former American prisoners of war (POWs) are eligible for special veterans benefits, including enrollment in Department of Veterans Affairs (VA) medical care for treatment in VA hospitals and clinics without copayments as well as disability compensation for injuries and diseases that have been associated with internment. These benefits are in addition to regular veterans benefits and services to which they, as veterans, are entitled. Congress has defined a prisoner of war as a person who, while serving on active duty, was forcibly detained by an enemy government or a hostile force, during a period of war or in situations comparable to war. Records show that 142,246 Americans were captured and interned during World War I, World War II, the Korean War, the Vietnam War, the Gulf War, the Somalia and Kosovo conflicts, and Operation Iraqi Freedom. There were no servicemembers reported missing in action from the Bosnia deployment nor from recent Afghanistan operations. Of the 125,214 Americans surviving captivity, about 29,350 were estimated to be alive at the end of 2005.

As of AUG 06, there were 16,884 former POWs receiving compensation benefits from the VA. Approximately 13,000 of them are rated as 100%disabled. Studies have shown that the physical hardships and psychological stress endured by POWs have life-long effects on health and on social and vocational adjustment. These studies also indicate increased vulnerability to psychological stress. The laws on former POW benefits recognize that military medical records do not cover periods of captivity. For many diseases, unless there is evidence of some other cause, VA disability compensation can be paid on the basis of a presumption that a disease present today is associated with the veteran’s captivity or internment. For POWs detained for 30 days or more, such eligibility covers any of the following illnesses that are found at a compensable level (at least 10% disabling): avitaminosis; beriberi; chronic dysentery; cirrhosis of the liver; helminthiasis; irritable bowel syndrome and malnutrition, including associated optic atrophy. Also covered are: pellagra and any other nutritional deficiency; peptic ulcer disease; and peripheral neuropathy, except where directly related to infectious causes. Several categories of diseases are presumptively associated with captivity without any 30-day limit: psychosis; any anxiety state; dysthymic disorders; cold injury; post-traumatic arthritis; strokes (new); and common heart diseases (new).

The rate of VA monthly compensation, according to degree of disability, ranges from $112 to $2,393 per month. Veterans rated as 30% or more disabled qualify for additional benefits based upon the number of dependents. Dependents of those rated 100% disabled may qualify for educational assistance. Spouses of veterans who die as a result of service-connected disabilities are eligible for dependency and indemnity compensation (DIC). Spouses of former POWs who were rated 100% disabled and who died of a condition unrelated to their service also may be eligible, depending on the date of death and how long the veteran held the 100% disability rating. Those non-service-connected deaths prior to October 1999 are covered if the former POW had been 100% disabled for at least 10 years. More recent non-service-connected deaths are covered under a law that provides the benefit when the former POWs was 100% disabled for a year or more.

Former POWs receive special priority for VA health-care enrollment, even if their illness has not been formally associated with their service. Former POWs are exempt from making means test copayments for inpatient and outpatient medical care and medications, but they have the same copay rules as other veterans for extended care. They also are now eligible for dental care without any length-of-interment requirement. VA periodically has provided training for its medical staff about former POWs, and an online curriculum is maintained at http://www1.va.gov/VHI/page.cfm?pg=9. POW coordinators are assigned to each VA regional office and medical center and are available to provide more information. Former POWs may contact VA regional offices with general benefits questions at (800) 827-1000. Medical eligibility questions may be directed to (877) 222-8387. Additional information for former POWs also is available from VA’s Web site at http://www.vba.va.gov/bln/21/Benefits/POW/. [Source: VA News Release 31 Aug 06 ++]


TRICARE PLUS UPDATE 01: Tricare Plus is a primary care enrollment program offered at selected military treatment facilities. Only beneficiaries eligible for care in military treatment facilities may enroll in Plus. If you are enrolled in Tricare Prime or Medicare Advantage HMO, you are not eligible for Plus because you already have a primary care relationship. Plus isn’t a comprehensive health plan. It is a primary care enrollment program ONLY and has no effect on the enrollees’ use or payment of civilian health care benefits. Tticare Plus enrollment is noted on your records in the Defense Enrollment Eligibility Reporting System (DEERS).

Benefits of Tricare Plus are:
1. Your primary care manager at the military treatment facility is your principal health care provider.
2. You may still get care from civilian and/or Medicare providers. Tricare Standard/Extra or Medicare rules apply. Tricare will be second payer to Medicare for Tricare-covered services for beneficiaries who are entitled to Medicare Part A and who have Medicare Part B coverage.
3. You are not locked into an HMO-like program.
4. There are no enrollment fees.
5. You get primary care appointments with the same access standards as Tricare Prime enrollees.

Limitations of Tricare Plus are:
1. You get primary care appointments with the same access standards as Tricare Prime enrollees.
2. Plus is not available at all military treatment facilities. Local commanders may continue or discontinue Tricare Plus at their military treatment facilities depending on their capacities, capabilities and missions.
3. Plus is a military treatment facility primary care access program, not a health plan, so it has no effect on civilian provider care, and Tricare Standard/Extra rules will apply for most enrollees.
4. Plus does not guarantee access to specialty care at the military treatment facility where you are enrolled.
5. Plus is not a portable benefit. Your enrollment at one facility does not guarantee access at another facility.

Tricare Plus enrollees are encouraged to get all their non-emergency primary care at the military treatment facility where they are enrolled. The local military treatment facility reviews enrollment in Tricare Plus annually. You can be disenrolled if capacity is no longer available. In times of enhanced security at military installations it may be difficult for Tricare beneficiaries to access uniformed services hospitals and clinics. Tricare guidance for beneficiaries seeking emergency, urgent and routine care at uniformed services facilities under these conditions is:
1 Beneficiaries who believe they are experiencing a serious medical condition that requires immediate treatment should go to the nearest emergency room. This is true whether or not they are enrolled in TRICARE Prime. TRICARE will assist in paying for the cost of their care. This is true for beneficiaries who use Tricare Standard or Extra or who are enrolled in Prime.
2 TRICARE beneficiaries who become ill but don’t require emergency care as described above need urgent care. Those enrolled in Tricare Prime who have a primary care provider who works out of a uniformed services facility that is inaccessible because of increased security are encouraged to call their provider for assistance. Providers or staff members at military treatment facilities can inform beneficiaries of their best options for necessary care. In many circumstances, this may include taking care of oneself under the advice of a provider or a change in timing of the needed visit as appropriate. Beneficiaries may contact their regional Health Care Information Line for information on self-care.
3 During times of increased security, routine appointments should be rescheduled if access to a military treatment facility is restricted. As with urgent care, beneficiaries should call ahead to their providers’ offices for guidance.
For more information about Tricare Plus, call 1 (888) 363-5433, or visit the Tricare Web site www.tricare.osd.mil. [Source: TMA Fact Sheet 14 Sep 06 ++]


USFHP UPDATE 01: The Uniformed Services Family Health Plan (USFHP) is a TRICARE Prime option available to active duty dependents, retirees and retiree family members through not-for-profit health care systems in six areas of the United States. If enrolled, you must get all care through the USFHP network in your area. You may not use military treatment facilities, military treatment facility pharmacies or other TRICARE-authorized providers. By using USFHP you get the TRICARE Prime program benefits, plus premium advantages and features at no extra cost. If you are eligible in DEERS and live in one of the six service areas, you may enroll in USFHP. The lists of eligible beneficiaries include all active duty family members; Uniformed Services retirees and their eligible family members, including those ages 65 and over; and qualifying re-activated reservist family members. For more information about eligibility, you can visit the USFHP Web site at www.usfhp.com/portal/faq.asp?s=76, or the TRICARE Web site at www.tricare.osd.mil/faqs/Default.aspx.

You may enroll in the USFHP at any time during the year by completing an application for the provider in your area. To download an application, visit www.usfamilyhealthplan.org. The USFHP provider contact info for the six service areas are:

- Massachusetts and Rhode Island: Brighton Marine Health Center P.O. Box 9195, Watertown, MA 02471-9195 Tel: 1 (800) 818-8589. Brighton Marine Health Center includes a network of 28 hospitals. For a complete listing of locations and services provided, visit www.usfhp.org/facility/site_content.asp?s=63.
- Southeast Texas and southwest Louisiana: CHRISTUS Health P.O. Box 924708
Houston, TX 77292-4708 Tel: 1 (800) 678-7347. A network of 150 primary care physicians and more than 500 specialists plus CHRISTUS St. Joseph Hospital, CHRISTUS St. Catherine's Hospital, CHRISTUS St. John's Hospital and CHRISTUS St. Mary's Hospital.. For a complete listing of locations and services, visit www.usfhp.com/html/providers_set.html.
- Maryland, Washington, D.C. and parts of Pennsylvania, Virginia and West Virginia: Johns Hopkins Medical Services Corporation 6704 Curtis Court, Glen Burnie, MD 21060 Tel: 1 (800) 808-7347. Johns Hopkins Community Physicians includes 17 primary care practices, a network of more than 120 primary care providers and more than 2,000 specialists plus Johns Hopkins Hospital, Johns Hopkins Bay View Medical Center, Howard County General Hospital and other community hospitals. For a complete listing of locations and services, visit www.hopkinsmedicine.org/USFHP/where/ index.html.
- Maine and southern New Hampshire: Martin's Point Health Care P.O. Box 9746 Portland, ME 04104-5040 Tel: 1 (888) 241-4556. Martin's Point Health Care includes four primary care practices and a network of more than 460 primary care providers, 19 hospitals and more than 1,600 specialists. For a complete listing of locations and services, visit www.martinspoint.org/body.cfm?id=54&oTopID=19.
- Puget Sound area of Washington: Pacific Medical Centers (PacMed Clinics) 1200 12th Ave. S., Seattle, WA 98144-1936 Tel: 1 (888) 958-7347. A network of seven clinics, 60 primary care physicians and more than 300 specialists. For a complete listing of locations and services, visit www.pacificmedicalcenters.org/usfhp.
- New York, New Jersey, eastern Pennsylvania and southern Connecticut: Saint Vincent Catholic Medical Centers of New York (SVCMC) 450 West 33rd St., 12th Floor, New York, NY 10001Tel: 1 (800) 241-4848. A network of 6700 participating providers, 20 participating hospitals and more than 100 subsidiary providers plus three USFHP Saint Vincent Catholic Medical Center owned primary care sites. For a complete listing of locations and services, visit www.usfhp.net/practices_default.asp.

USFHP Services include: Outpatient surgical procedures, anesthesia and outpatient care; Hospitalization (inpatient care); Office visits to all specialists with a primary carephysician referral; Pharmacy services and prescription medicines; Eye exams (one person/year, including retirees, as a self-referral to an in-network optometrist/ophthalmologist); Maternity and infant care; World-wide emergency services; Urgent care services (general health problems requiring attention but are not life threatening); Physical, occupational and speech therapies; Home health care; Durable medical equipment; Inpatient and outpatient mental health care; Preventive care, including annual physicals and well-child care. To learn more, visit the USFHP Web site at www.usfamilyhealthplan.org. [Source: TMA Fact Sheet 12 Sep 06]


PREGNANCY RESOURCE CENTERS: Pregnancy Resource Centers provide counseling to pregnant women and alternatives to abortion. They can be located on line at www.pregnancycenters.org/advantage.asp. A new study released by Rep. Henry A. Waxman (D-CA-30) found that federally funded pregnancy resource centers often mislead pregnant teens about the medical risks of abortion, telling investigators who posed as pregnant 17-year-olds that abortion leads to breast cancer, infertility, and mental illness. Under the present Administration, pregnancy resource centers, which are also called “crisis pregnancy centers,” have received over $30 million in federal funding. The new report assesses the scientific accuracy of the information they provide. Female investigators, who posed as pregnant 17-year-olds seeking advice about an unintended pregnancy, telephoned the 25 pregnancy resource centers that have received capacity-building funds from the Department of Health and Human Services. Twenty of the 23 centers reached by the investigators (87%) provided false or misleading information about the health effects of abortion. According to the report false and misleading information provided by centers was the:

1. Link between abortion and breast cancer. There is a medical consensus that induced abortion does not cause an increased risk of breast cancer. Despite this consensus, eight centers told the caller that having an abortion would in fact increase her risk. One center said that “all abortion causes an increased risk of breast cancer in later years," while another told the caller that an abortion would “affect the milk developing in her breasts” and that the risk of breast cancer increased by as much as 80% following an abortion.
2. Effect of abortion on future fertility. Abortions in the first trimester, using the most common abortion procedure, do not pose an increased risk of infertility. However, seven centers told the caller that having an abortion could hurt her chances of having children in the future. One center said that damage from abortion could lead to “many miscarriages” or to “permanent damage” so “you wouldn’t be able to carry,” telling the caller that this is “common” and happens “a lot.”
3. Mental health effects of abortion. Research shows that significant psychological stress after an abortion is no more common than after birth. However, thirteen centers told the caller that the psychological effects of abortion are severe, long-lasting, and common. One center said that the suicide rate in the year after an abortion “goes up by seven times.” Another center said that post-abortion stress suffered by women having abortions is “much like” that seen in soldiers returning from Vietnam and “is something that anyone who’s had an abortion is sure to suffer from.” [Source: Committee on Government Reform 16 Jul 06 www.democrats.reform.house.gov/story.as ... c%2BHealth]


UNIFIED MEDICAL COMMAND: The Defense Business Board met on 6 SEP regarding the creation of a unified medical command. The board is a group of outside management experts that advises Defense Secretary Donald Rumsfeld. It unanimously recommended that Rumsfeld immediately appoint a task force to oversee establishment of a unified medical command by 1 JAN - a year sooner than defense officials planned. The command would take charge of all direct-care health services of the Army, Navy and Air Force. It would streamline medical logistics; purchasing; information technology; research and development; facility operations; and the education, training and assignment of medical personnel. The services would continue to control medical care in support of front-line units and field hospitals. But Level III operational medicine (which includes all fixed military hospitals and clinics) would be run by the new command, which would report directly to the defense secretary. At present the Air Force is the only service opposed to the concept. The board endorsed the most sweeping reorganization of military medicine in 60 years. It also recommended that:

- The TRICARE Management Activity - which oversees the triple-option health plan for military families and retirees - be realigned to function alongside a unified command, with a new focus on policy and oversight. In time, management of the TRICARE benefit would be moved to the private sector.
- A transition team for establishing the unified command be created and given milestones of 30, 60 and 90 days to ensure a 1 JAN startup. The board thinks legislation isn’t required because the Department of Defense already has authority to streamline health services.

The Defense Business Board is an advisory panel, governed by sunshine laws, so the 6 SEP meeting was open. Held in a small Pentagon conference room, it offered a rare public look at this hotly contested issue among the services. A consensus is building toward a unified command or a similar organization to merge service medical systems. Air Force surgeon Lt. Gen. James Roudebush said his service opposed a unified command and would take control only of the direct-care system. He noted that the Air force has seen only modest cost growth in recent years pointing out that it was the expansion of the Tricare benefit that has driven costs upwards at a very alarming rate. He argued that service missions and cultures are different, and those differences justify having separate medical staffs and resources. Also, that the services are responsible under Title X of the U.S. Code to provide a fit and healthy force. A unified command begins to move that away from the purview of the services.

The Navy’s top medical officer Vice Adm. Donald Arthur challenged the Air Force arguments. He was joined by members of the business board, as well as a two-star admiral on the Joint Staff and a two-star Army general who’s deputy director of Tricare. Arthur said the services separately recruited, trained and assigned medical staff, as well as operated three separate systems for logistics, purchasing of supplies and equipment, budgeting and quality assurance. As a result according to the Center for Naval Analyses (CNA), they waste up to $500 million annually. A board member, who led its medical task force, said the CNA figure was probably much too low. Arthur said at present the services were not interoperable, interchangeable or even interdependent. The problems this creates aren’t obvious when operating separate hospitals in peacetime. But they arise in war zones like Iraq and Afghanistan when the medical services learn that they can’t interchange people, equipment, supplies or doctrine. Army Maj. Gen. Elder Granger said he saw such difficulties firsthand while a senior medical commander and surgeon in Iraq. For lack of compatible gear Army medical staff couldn’t communicate with Air Force colleagues regarding the wounded arriving in medical evacuations. Also, because patient ventilators weren’t interoperable patients had to be taken off ventilators for brief periods during transport home. At the conclusion of the meeting the chairman indicated SECDEF Rumsfeld would be briefed on the board’s recommendations as soon as possible. [Source: Tom Philpott Military Update article 10 Sep 06 ++]


FAKE HEROES UPDATE 01: The Senate has passed a bipartisan bill S.1998 making it illegal to falsely claim to be a decorated veteran. Called the Stolen Valor Act, the bill expands on current criminal penalties for being a false military hero. Under current law, it is a crime to wear a Medal of Honor that a person did not receive but it is not a crime to claim to have a Medal of Honor. Similarly, it is a crime to wear a distinguished service medal from any of the services, such as the Navy Cross, Air Force Cross or Distinguished Service Cross but it is not a crime to claim to have received one of the awards. The Senate passed the bill on 7 SEP and it was referred to the House Judiciary Committee where a similar bill H.R.3352 has been sitting since JUL 05. Supporters hope Senate passage spurs the House committee to act.

The Senate bill amends the federal criminal code to prohibit wearing, manufacturing or selling military decorations or medals without legal authorization. It bans purchasing, soliciting, mailing, shipping, importing, exporting, producing blank certificates of receipt for, advertising or exchanging such decorations or medals without authorization. Fines and up to a year in prison are the possible penalties. One reason for passing the bill is that it has become very easy to make a fake certificate indicating the receipt of an award even if a person does not posses the actual medal. The Stolen Valor Act, sponsored by Sen. Kent Conrad (D-ND) in the Senate and by Rep. John Salazar (D-CO) in the House, covers fraudulent claims for receiving any medal or decoration, including medals for valor and the Purple Heart, awarded by either the armed forces or Congress. Salazar, an Army veteran and member of the House Veterans’ Affairs Committee said, “Senate passage of the bill is a huge success for our veterans and for those of us who are fighting to protect their honor. It is our job in Congress to protect the honor and integrity of our veterans, to make sure the memory of their heroism is not tarnished” Conrad said, “The medals earned by genuine American veterans recognize their courage, honor, and sacrifice. I will not let imposters diminish the honor of America’s veterans. It is disgraceful that there are imposters claiming to have received medals they did not earn.” [Source: NavyTimes Staff writer Rick Maze article 11 Sep 06]


AOL ADVISORY 07: Privacy watchdogs have slapped a health warning on the latest version of AOL's client software, AOL 9.0. StopBadware.org, an academic project supported by Sun and Google that aims to establish a neighborhood watch-style scheme to put pressure on purveyors of unsavory programs, has taken the unusual step of classifying AOL's software as potentially damaging “badware”. AOL's inclusion of bundled software apps and lack of transparency over additional installed components earned it the negative label. John Palfrey, co-director of StopBadware.org, in a posting on StopBadware.org's blog noted that AOL has a long and storied history of being a leader in the fight against badware. Although AOL plainly does not belong in the same category as the all-too-prevalent garden variety badware providers their free version of AOL 9.0 that they tested did not, in that organization’s view, live up to AOL’s rich legacy. StopBadware.org wants AOL to be more upfront about the software components its client installs. It also wants the internet giant to provide an easier way of declining to install these components or of removing them once they are installed. [Source: The Register /www.theregister.co.uk 29 Aug 06]
Editor’ Note: AOL’s Big Brother legacy of not granting their users choice in declining AOL’s attempts to regulate control of customer’s computers appears to continue. AOL presently will not allow the majority of their customers to receive the Bulletin which they have programmed their filters to block as spam. Nor have they responded to hundreds of requests to stop doing this or at least allow their user’s personal choice in declining or accepting receipt of this email newsletter. This has led to the deletion of over 12,000 AOL users from the Bulletin directory. AOL’s policies have also led to the loss of over 6 million users in the last 4 years.


MILITARY AWARDS REVIEW: The Department of Defense has begun a comprehensive review of military awards and decorations in order to ensure policies are consistent with the evolving nature of warfare. This comprehensive review will lead to an administrative revision of the Department of Defense Instruction 1348.33-M, the Manual of Military Decorations and Awards. A working group consisting of representatives from each Service, the Joint Staff and the Institute of Heraldry will form the core of the comprehensive review effort. This review is expected to continue over the next six to eight months and will involve but not be limited to the following:
• Honor and Valor awards with particular focus on clarity of criteria and processes.
• The “V” device and the Purple Heart medals in eliminating disparate qualification criteria among the military services.
• Expeditionary medals in regard to how the theatre of operations is defined.
• Iraqi and Afghanistan campaign medals with regard to subsequent awards of these campaign medals, with a goal of appropriately recognizing service over multiple tours in those theatres of operations.

David Chu, under secretary of defense for personnel and readiness comments on the review were, “The evolving nature of warfare demands that we review policies; for example, in the case of expeditionary medals, we must review how we define the operating box - whether it is the theater of direct action, or whether is might extend far beyond” said. “For example, we must consider whether air support originating at great distances or different continents indeed represents expeditionary service for purposes of those awards … When it comes to valor awards, we must clarify criteria, including a review of boundaries that increasingly extend far beyond a particular combat zone, yet involve direct threats to American lives. [Source: DoD News Release 8 Sep 06]


MOBILIZED RESERVE 13 SEP 06: THIS week, the Army, Navy, Air Force, Marine Corps and Coast Guard announced an increase in the number of reservists on active duty in support of the partial mobilization. The net collective result is 6,168 more reservists mobilized than last reported for 6 JUL 06. Total number currently on active duty in support of the partial mobilization for the Army National Guard and Army Reserve is 88,323; Navy Reserve, 6,981; Air National Guard and Air Force Reserve, 7,137; Marine Corps Reserve, 7,363; and the Coast Guard Reserve, 317. This brings the total National Guard and Reserve personnel, who have been mobilized, to 110,120, including both units and individual augmentees. At any given time, services may mobilize some units and individuals while demobilizing others, making it possible for these figures to either increase or decrease. A cumulative roster of all National Guard and Reserve personnel, who are currently mobilized, can be found at http://www.defenselink.mil/news/Sep2006 ... 913ngr.pdf . [Source: DoD News Release 6 Jul 06]


AIRLINE CARRY-ON RESTRICTIONS: Confused over what you can take in personal, carry-on, and checked baggage for your next flight. The Transportation Security Administration has provided the following guidance:

1. Allowed in carry-on baggage or personal items:
- Makeup & Personal Items: Cigar Cutter; Corkscrews; Cuticle Cutters; Nail Clippers; Nail Files; Tweezers; Plastic or metal Scissors with blunt tips; Metal scissors with pointed tips and blades shorter than four inches in length; Eyeglass Repair Tools; Screwdrivers, wrenches and pliers seven inches or less in length; Eyelash Curlers; Safety Razors including disposable razors; Toy Weapons if not realistic replicas and Toy Transformer Robots; Deodorants made of gel or aerosol; Hair styling gels and spray of all kinds including aerosol; Hair straightener or detangler; Knitting and Crochet Needles; Umbrellas and Walking Canes they have been inspected to ensure that prohibited items are not concealed; Gel-filled bras and similar prosthetics; and shoes constructed with gel heels.
- Less than 4 oz of: Eye drops; Essential non-prescription liquid medications; Non-prescription liquid or gel medicines like cough syrup and gel cap type pills; Personal lubricants; Saline solution.
- Baby formula and food, breast milk and other baby items. However, you must be traveling with a baby or toddler. All items including formula or breast milk will be inspected. Learn more on traveling with children at www.tsa.gov/travelers/airtravel/children/formula.shtm.
- Medication & Special Needs Devices: All medications must be properly labeled with a professionally printed label identifying the medication and manufacturer's name or pharmaceutical label. The prescription medicine must match the name on the passenger's ticket.): Braille Note-Taker, Slate and Stylus, Augmentation Devices; Up to 5 oz. (148ml) liquid or gel low blood sugar treatments, including juice for Diabetes; Insulin dispensing products; jet injectors; pens; infusers; and an unlimited number of unused syringes, when accompanied by insulin; lancets; blood glucose meters; blood glucose meter test strips; insulin pumps; and insulin pump supplies. These items must be inspected to ensure prohibited items are not concealed; Nitroglycerine pills if properly marked with a professionally printed label identifying the medication and manufacturer's name or pharmaceutical label; Nitroglycerine sprays less than 4 oz.; Ostomy Scissors with blades four inches or less; Prosthetic Device Tools and Appliances including drills and drill bits, Allen wrenches, pull sleeves used to put on or remove prosthetic devices, if carried by the individual with the prosthetic device or his or her companion; and wheelchairs with gel cushioned seats/pads. For more information on what to expect during security screening check visit www.tsa.gov/travelers/airtravel/specialneeds/index.shtm .
- Electronic Devices: Camcorders; Camera Equipment; Laptop Computers; Mobile Phones; Personal Data Assistants (PDA's); and Pagers. NOTE: Check with your airline or travel agent for restrictions on the use of these and other electronic items during your flight.

2. Not allowed in carry-on but allowed in checked baggage:
- Makeup & Personal Items - Aerosol spray bottles and cans; All creams and lotions including Neosporin or first-aid creams and ointments; topical or rash creams and ointments; Suntan lotions, moisturizers, etc.; Bubble bath balls, bath oils or moisturizers; Liquid bubble bath including gel or liquid filled; Bug and mosquito sprays and repellents; Knives - except for plastic or round bladed butter knives; Lip gels such as Carmex or Blistex; Liquid lip glosses or other liquids for lips; Liquid mascara; Liquid foundations; Liquid, gel or spray perfumes and colognes; Liquid sanitizers; Soaps, shampoos and conditioners;Toothpaste; Make up removers or facial cleansers; Nail polish and removers; and Mouthwash. NOTE: Some personal care items containing aerosol are regulated as hazardous materials. The FAA regulates hazardous materials. This information is summarized at www.faa.gov.
- Edibles: All Beverages; Canned or jarred goods such as soup, sauces, peanut butter, fruits, vegetables and jellies; Cheese in pressurized containers; Duty free alcohol and other items; Gel based sports supplements; Jell-O's; Pudding; Whipped cream; Yogurt or gel like food substances.
- Sharp Objects: Tools other than screwdrivers, wrenches and pliers seven inches or less in length; Razor-Type Blades such as box cutters, utility knives, razor blades not in a cartridge, but excluding safety razors; Sabers and Swords. NOTE: Any sharp objects in checked baggage should be sheathed or securely wrapped to prevent injury to baggage handlers and inspectors.
- Other: Martial Arts & Self Defense Items; Sporting equipment regardless of type; Guns regardless of type, associated equipment and ammunition; Gun Powder including black powder and percussion caps; Gel-type candles; Gel shoe inserts but shoes constructed with gel heels are allowed and must be removed and screened.
[Source: GOVEXEC.Com Daily Briefing 13 Sep 06]


AGENT ORANGE LAWSUITS UPDATE 05: The Veterans Benefits Administration held a meeting 7 SEP to brief VSO/MSO organizations on their ongoing information security upgrades and improvements. They also brought the attendees up to date on VBA’s reaction to the recent Agent Orange (Haas v. Nicholson) decision by the Court of Appeals for Veterans Affairs. This decision opens Agent Orange presumptive conditions to all personnel who were recipients of the Vietnam Service Medal and includes those personnel aboard ships and vessels who were off the coast and did not actually set foot “in-country.” VBA is currently working with the Department of Justice to perfect their appeal of this decision. They claim that if this decision is allowed to stand then VBA will have to hire an additional 230 full time employees to review approximately 500,000 cases. They also stated that they would expect approximately 86,000 new applications for the benefits and 14,000 DIC claims. It would also cost in excess of $3 billion, as many of the claims would be retroactive which would be very costly.

The VBA will accept and acknowledge any new claims based upon the “Haas” decision with letters stating that they have received the claim but any decision on that particular issue will be delayed pending further instructions from VA Headquarters. Current guidance requires each RO to control these claims with a discreet control number (end product) for tracking and control purposes. VA will continue working on any new claims made that are from other medical issues. The briefer also stated that the Haas decision, if allowed, will totally paralyze VA and nothing else would get done. The question arises that if this would have such a detrimental impact on VA’s ability to perform why can’t they go to Congress and request additional funding to comply with the court’s mandate. [Source: NAUS Weekly Update 8 Sep 06 ++]


GRANDPARENTS DAY: Grandparents Day is celebrated each year on the first Sunday after Labor Day. The specific date changes year-to-year. Because it is tied to Labor Day Grandparents Day is never earlier than September 7 or later than September 13. National Grandparents Day was created in 1978 by a federal proclamation, passed by Congress and signed by President Jimmy Carter. In honor of National Grandparent’s Day, the U.S. Census Bureau offers these interesting statistics about grandparents:

- About 56 million grandparents reside in the United States of which only 1.7 million are married.
- 5.7 million grandparents have grandchildren under age 18 living with them.
- 2.4 million or about 42% of grandparents are responsible for most of the basic needs (food, clothing, shelter) of one or more of the grandchildren who live with them. Of these caregiver grandparents, 1.5 million are grandmothers and 880,000 are grandfathers.
- 1.4 million grandparents are in the labor force and provide for most of the basic needs of their grandchildren.
- 920,000 grandparents are responsible for caring for their grandchildren for at least five years. Of those grandparent caregivers, 55% were over age 60.
- 460,000 grandparents whose income is below the poverty level are caring for their grandchildren.
- 700,000 grandparents with a disability are caring for their grandchildren.
- 320,000 foreign-born grandparents are responsible for caring for their grandchildren.
- 270,000grandparents who speak English less than “very well” are responsible for caring for their grandchildren.
- 28% of preschoolers with employed mothers are regularly cared for by their grandparent during the hours their mom spends employed outside the home.
- 6.1 million, or 8% of all children in the United States live with a grandparent in the home. Of these children, 4.1 million lived in a grandparent’s home and 1.9 million lived in a parent’s home.
- 2.2 million children reside with both a grandmother and a grandfather.
- About 80% of grandparents in the U.S. have either visited or spoken with their grandchildren by phone in the past month.
- About 3 million grandparents receive Grandparents Day cards, nationwide, each year. Did yours?
[Source: About Senior Living 12 Sep 06 ++]


VA HOMELESS VETS UPDATE 02: DVA officials hope to add more than 2,000 new beds for homeless veterans for its outreach efforts if Congress reauthorizes a transitional housing program later this year. A report released 11 SEP by the Government Accountability Office praised the VA for its homeless programs, but noted that the department is about 9,600 beds short of the 45,000 transitional beds it expects it will need next year. According to the VA an estimated 194,000 veterans were homeless in 2005. Pete Doherty, director of homeless programs for the VA, said the majority of those homeless are middle-aged and served during the Vietnam War. Of the more than 16,000 veterans served through the grant and per diem program last year, about 2,500 reported serving in the Middle East an only a few hundred of those are troops who served in the current conflicts in Iraq and Afghanistan.
The grant and per diem program, which allots funding to non-VA homeless assistance facilities with veterans, provides services such as temporary housing, job training and rehabilitation counseling. The number of beds under the grant program alone had grown from 2,000 six years ago to more than 8,000 this year, with a cost of about $67 million. Congress is scheduled to re-examine the program later this month and decide whether to approve funding for next year. Doherty said if the money is reauthorized, officials plan to make 2,200 more beds available through the program. That should assist nearly 5,000 more veterans in 2007 alone, because veterans typically spend only a few months at the facilities before moving on. GAO researchers said the VA needs to improve communication about the funding available and the limits on how long veterans can spend in transitional housing. That began earlier this year, with the department adding more liaison staff and holding more regional meetings with service providers to explain the grant programs rules and regulations. [Source: Stars and Stripes 13 Sep 06]


VA HOME LOAN UPDATE 06: The Department of Veterans Affairs home loan program came about in 1944 through the original Servicemen’s Readjustment Act, aka the GI Bill of Rights. The law, signed by President Franklin Roosevelt, offered veterans a federally guaranteed home loan with no down payment, making the dream of home ownership a reality for millions of veterans. From 1944, when VA began helping veterans purchase homes, through JAN 06 about 17.9 million VA home loan guarantees have been issued with a total value of $915 billion. VA began 2005 with 2.5 million active home loans reflecting an amortized $223.2 billion. In that year, VA guaranteed about 550,000 loans worth $78 billion. VA’s programs for specially adapted housing helped about 600 disabled veterans with grants totaling more than $32 million.

Until recently, the housing market was at an all-time high in some areas of the country. The Commerce Department reported that home prices nationally have risen 30% in the past four years, well above inflation. Buying a first home after years of moving and living in rented or government housing could be an economic challenge. But with dual incomes, longer assignments and mortgage-rate fluctuation, many service members have bought homes on active duty using the VA home loan. Today, more than 29 million veterans and service members are eligible for VA home loan financing at attractive rates. Vets are eligible if they have a discharge other than dishonorable after a minimum of 90 days of service during wartime or a minimum of 181 continuous days during peacetime. There is a two-year requirement if the veteran enlisted and began service after 7 SEP 80, or was an officer and began service after 16 OCT 81. Reserve and National Guard members have a six-year service requirement, and there are rules concerning the eligibility of surviving spouses.

VA guarantees a percentage of the home loan amount. This is generally, the reasonable value of the property or the purchase price, whichever is less, plus the funding fee of 2% (2.75% for reservists) of the loan amount that may be borrowed. VA-guaranteed loans are made to eligible veterans by private lenders such as banks, savings and loan associations or mortgage companies to buy a home for their own personal occupancy. The lender is protected against loss if you or a later owner fails to repay the loan. This makes a down payment unnecessary and allows vets to obtain favorable financing terms. Once you decide where you want to retire, your next call should be to VA. Service officers are trained professionals who can assist vets with the home loan program. They are not real estate agents or mortgage loan officers, but they understand the process, and their services helpful. If you are in the market to buy a home and are eligible to use the VA home loan program it would be beneficial to do so. VA’s online application system is at www.vabenefits.vba.va.gov or call (800) 827-1000. [Source: NavyTimes Alex Keenan article 18 Sep 06 ++]


TSP UPDATE 05: The Thrift Savings Plan can provide military members with a supplemental source of retirement income in addition to their uniformed services retired pay. Contributions and earnings can be kept even upon separation before retirement. If you leave the uniformed services and enter the Federal civilian service, you will be able to continue contributing to the TSP. You can also combine your uniformed services account with your civilian account. Contributions can be as little as 1% of your basic pay each pay period. Even small savings add up over time. If you put in only $40 from your pay each month and it earns 7%, after 20 years your TSP account could total almost $21,000. If you are thinking about cashing out your Thrift Savings Plan (TSP) when you leave the uniformed service, think twice. You might be about to forsake a financially secure retirement. When you switch jobs before retirement, you usually can choose among several things to do with your TSP nest egg:
- Leave the money in the plan.
- Roll over the money to your new employer’s plan, if the plan accepts transfers.
- Roll over the money into an Individual Retirement Account (IRA).
- Take the cash value of your account.

It may be tempting to choose the last option and use the money to buy a new television, take a cruise or even pay off a debt. And you would not be alone in thinking that way: A recent Hewitt Associates study of large-company retirement savings plans indicates that 45% of employees cash out their plans when they change jobs. But cashing out before you turn age 59 ½ can cost you dearly, both immediately and in the long run: If you do not transfer your money to an IRA or your new employer’s plan within 60 days of receiving it, your current employer is required to withhold 20 percent of your account balance to prepay federal taxes. If you keep the money, you must pay federal income tax on your entire withdrawal. In addition, you may also owe state tax on your distribution. Plus, the IRS will consider your payout an early distribution, meaning you could owe a 10% early withdrawal penal

[boardman]

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)
== Walter Reed Army Medical Center ------ (Closing in 2011)
== 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 Vietnam can now claim disability benefits for exposure to Agent
Orange under an appeals court ruling that opens the door for
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
Orange. Haas, represented by the National Veterans Legal Services
(NVLS) argued that clouds of the toxic defoliate, which the U.S.
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 Vietnam and come
ashore.

The three-judge panel said regulations governing the benefits
were unclear. The court said it made no sense for veterans who
patrolled Vietnam’s inland waterways and those simply passing through
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 Republic of Vietnam only briefly,” Judge William A. Moorman
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 Vietnam
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},
Thailand based Operations for USAF and other types of operations
which included loading the Agent Orange aircraft. Most Vietnam
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 Vietnam Veterans of America,
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 Washington DC to get current
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 Vietnam veterans
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 Vietnam, and who suffer from
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 & Arizona
Department of Veterans' Services msg 23 Aug 06 ++]


VA PRESUMPTIVE AO ILLNESSES [VETS]: The following health conditions
are presumptively recognized for service connection. Vietnam vets
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 Vietnam to qualify but this 30 year time
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 Washington, DC, and East Orange, NJ. Veterans who were
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. Vietnam veteran’s children with any of these conditions
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
Vietnam veterans. Covered birth defects” means any birth defect
identified by VA as a birth defect associated with the service of
women Vietnam veterans in Vietnam from 28 FEB 61 to 7 MAY 75, and
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,
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=la ... areer_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.as ... tion+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/for ... 2656-9.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 Pre

[boardman]

RAO Bulletin Update
15 December 2006


THIS BULLETIN UPDATE CONTAINS THE FOLLOWING ARTICLES:

== Tricare/CHAMPUS Fraud [04] ------------ (HVC Pleads Guilty)
== VA Budget 2007 [09] ----------------------- (Agreement Reached)
== Long-Term Care [01] ----------------------- (Something to consider)
== VA Compensation Rates (Disability) ----- (2007 Monthly Payments)
== Medicare Rates 2007 [04] -------- (Federal Subsidy Reduction)
== Overseas Troop Gift Giving ---------------- (How To)
== Call Home Act S.2653------------------------(Passed)
== North Central Federal Clinic San Antonio -- (Joint VA/DoD Venture)
== Pearl Harbor 65th Anniversary ------------- (Memorial Ceremony)
== VA Insurance Dividends 2007------------- ($369 million to be Paid)
== TSP 08] ----------------------------- (Contribution Limits Raised)
== Military Funeral Disorderly Conduct [07] -- (S.4202 Passed)
== VA Medical Center Waco ------------------ (Will Remain Open)
== DoD Mental Health Task Force [01] ------ (18 Dec Meeting)
== National Guard Birthday -------------------- (370 Years Old)
== Libel Protection Weakened ----------------- (Internet Newsletters)
== Money Recognition by Blind --------------- (Currency Change Ordered)
== VA My Health eVet [01---------------------- (Health Records Online)
== Vet Cemetery Xmas Wreaths --------------- (Annual Ceremony)
== Stolen Valor Act ------------------------------ (Fraudulent Claims)
== Medicare Part D [13] ------------- (Vet Enrollment Claims)
== Medicare Reimbursement Rates [04] ------ (Cuts Imminent)
== Medicare Reimbursement Rates [05] ------ (11th Hour Fix)
== Philippine Deers Registration --------------- (ID Cards Available)
== PTSD [09] ----------- (Propranolol Treatment Study)
== DFAS 1099-R for 2006---------------------- (Download from myPay)
== E-mail Petitions ------------------------------ (Ineffective)
== National Guard Memorial Museum -------- (Dedication 6 Dec)
== 110th Congress Schedule -------------------- (Senate 1st Session)
== WRAMC Donations ------------------------- (Returning Troops Needs)
== WRAMC Donations [01] ------------------- (Put on Hold)
== Air Force News Delivery ------------------- (Changing Methods)
== Vet Benefits Florida [02] -------------------- (Expansion Continues)
== GI Bill Inequities [01]: --------- (Total Force Proposal)
== VA Claim Doctor Letter -------------------- (Do it yourself)
== VA Claim Doctor Letter [01] -------------- (Sample Letter)
== Spinal Decompression Claims ------------- (Rarely Honored)
== SSA Benefits at Death ---------------------- (What & how to get)
== Military Legislation Status ----------------- (Where we stand)


TRICARE/CHAMPUS FRAUD UPDATE 04: Erik C. Peterson, United States Attorney for the Western District of Wisconsin, announced that Thomas Arthur Lutz, DOB 04/24/1967, of Olongapo City, Republic of the Philippines, pleaded guilty 11 DEC in U.S. District Court in Madison, Wisconsin to defrauding the federal TRICARE program. The charges were brought in the Western District of V because Wisconsin Physicians Service, the fiscal intermediary which processed and paid these alleged fraudulent claims, is located in Madison, WI which is in the Western District of Wisconsin. Lutz pleaded guilty to Count 33 of an Indictment that charged him with participating in a conspiracy with Health Visions Corporation (HVC) and a physician in the Philippines to double bill Tricare and kickback the inflated payments to HVC. As part of today plea hearing, Lutz stipulated, under oath, to a statement of facts that indicated, among other things, the following:

1. In August 1998, defendant THOMAS Lutz, in his capacity as the Administrator of HVC, met with representatives at a medical center in Olongapo City. During that meeting defendant Thomas Lutz offered to refer HVC patients to the medical center if HVC would receive a 50% discount. When the representatives balked at the size of the discount, defendant Thomas Lutz instructed the medical center representatives to inflate their bills by 100% and pay the inflated amount to HVC. Defendant Thomas Lutz wrote out on a piece of paper how two bills Should be prepared for every HVC patient; one bill should be the real bill, the second bill should be the inflated bill with every line item doubled in price. In exchange for this arrangement, defendant Thomas Lutz promised that the medical center would become a preferred provider for HVC patients and would receive immediate payment for services provided to HVC patients.

2. On or about October 1, 1998, defendant Thomas Lutz had another meeting with the same representatives at the medical center. At this meeting, defendant Thomas Lutz produced a letter on HVC letterhead dated October 1, 1998 to the medical center. The letter detailed an agreement between HVC and the medical center where HVC agreed to refer its patients to the medical center in exchange for “a rebate of 50% back to Health Visions Corp.... The rebate will be paid to Health Visions Corp. immediately after payment received by the[medical center.” The letter is signed by Thomas Lutz as the Administrator for HVC.

3. The arrangement between HVC and the medical center lasted from October 1, 1998 to June 20, 2000. During this time frame, HVC submitted to Wisconsin Physicians Service (WPS), a TRICARE subcontractor in Madison, Wisconsin, approximately 105 claims involving HVC patients who received medical care at the medical center;

4. HVC employed billers who prepared the claims submitted to Tricare. HVC instructed its billers to inflate the amounts listed on the hospital bills by at least 233% when entering the numbers on the TRICARE claim.

5. HVC also instructed its billers to hide denied medications on a hospital bill by moving those costs to “professional fees” on the Tricare claim.

6. HVC also instructed its billers to create false documentation to backup fake medical diagnoses that were not on the hospital bills, but would be added to the Tricare claims. This false documentation included fake letters with pasted on letterhead and doctor signatures.

7. HVC directed WPS to send the payments for all the Tricare claims to a lockbox account in the name of HVC at Bank of America in Columbia MO. When the account reached over $1,000,000, defendant Thomas Lutz’s brother directed Bank of America in Missouri to wire transfer funds from the HVC account at Bank of America to an HVC bank account at United Cocoa Planters Bank in Manila, in $1,000,000 increments.

8. During the years 1998 through 2004, WPS paid over $163,380,648 in total Tricare claims submitted by HVC. Of this amount, approximately $144,618,061 came from third-party billing by HVC, and $18,762,587 came from direct billing from HVC-owned hospitals.

Chief United States District Judge Barbara B. Crabb scheduled sentencing for 13 MAR 07. Lutz faces a statutory maximum penalty of five years in prison, a $250,000 fine, and three years of supervised release after serving his prison term. The charges against Lutz were the result of an investigation conducted by the
Defense Office of Inspector General Defense Criminal Investigation Service (DCIS), and the U.S. Postal Inspection Service. Also assisting were agents in the Philippines with the U.S. Naval Criminal Investigation Service, and Regional Security Officers with the U.S. State Department Diplomatic Security Service. Prosecution of the case has been handled by Assistant United States Attorneys Peter M. Jarosz and Daniel J. Graber. [Source: Office of the U.S. Attorney Western District of Wisconsin Press Release 11 Jan 06]


VA BUDGET 2007 UPDATE 09: Before its adjournment on 8 DEC, the 109th Congress reached agreement on critical veterans’ legislation. The $3.2 billion Veterans Benefits, Health Care and Information Technology Act of 2006 (S. 3421) is an collection of House and Senate initiatives that had been in limbo for months while lawmakers tried to reach a compromise. The bill includes an historic provision allowing veterans to hire an agent or attorney to represent them after a notice of disagreement has been filed. The attorney representation provision, opposed by some veterans’ groups and endorsed by others, allows—but does not require—veterans to be represented by an attorney or some other agent when filing claims. Under current law, an attorney cannot be paid for representation until a claim has made its way through the entire administrative process, but the provision’s primary sponsor, Senator Larry Craig (R-ID), the Senate Veterans’ Affairs Committee chairman, argued claims today are so complex today that veterans should not be precluded from getting additional help.

The bill also includes a provision to expand eligibility for Dependents Education Assistance to the spouse or child of a service member hospitalized or receiving outpatient care before the service member’s discharge for a total and permanent service-connected disability. The provision’s intent is to help enhance the spouse’s earning power as early as possible before discharge of the service member. Additionally, the bill:
• Provides increased support for service members returning from the war on terror through improved VA outreach and $65 million to increase the number of clinicians treating post traumatic stress disorder (PTSD) and improve their training. It authorizes the hiring of marriage and family therapists to expand counseling resources.
• Expands tele-health initiatives to improve health care to rural veterans, and expands the number of community-based outpatient clinics able to treat mental illnesses.
• Authorizes spending for collaboration in PTSD diagnosis and treatment between VA and the Department of Defense (DoD).
• Authorizes increased access to bereavement counseling for surviving family members at Vet Centers.
• Boosts VA health care construction by authorizing more than $600 million for repair or replacement of flood-damaged facilities in New Orleans and elsewhere on the Gulf Coast; $36.8 million for advance planning of a collaboration project between the Ralph H. Johnson VA Medical Center in Charleston SC and the adjacent Medical University of South Carolina (MUSC) [i.e. the primary issue that had held up the bill for weeks]; $98 million for the replacement of the VA medical center in Denver as well as 22 other major construction projects in 15 states. Several leases for outpatient clinics are also included.
• Authorizes $2 million for additional blind rehabilitation specialists and increases the number of facilities where these specialists will be located.
• Authorizes VA to designate six Parkinson’s Disease Research, Education, and Clinical Centers of Excellence, and at least two Multiple Sclerosis Centers of Excellence, and strengthens VA’s homeless grant and per diem programs.
• Creates a VA office of rural health and improves outreach for rural veterans.
• Provides for reimbursement by the VA to state veterans homes for the costs of care provided to veterans with a 70 percent or higher service-connected condition; further, veterans in these homes with service-connected conditions rated at least 50 percent would get their medications free of charge.
• Directs the VA to provide breach notification to individuals, reports to Congress, fraud alerts, data breach analysis, credit monitoring services and identity theft insurance.
• Provides for an Information Security Education Assistance program, an incentive to allow the VA the ability to recruit personnel with the information skills necessary to meet department requirements.
• Expands the veterans’ home loan guarantee program to include buying into cooperative housing units where a person owns membership or a share of a building instead of a unit.
• Directs the Labor Department to issue rules clarifying the priority of preference for veterans and dependents seeking help in federal job placement programs.
• Allows families to begin receiving educational assistance before the service member’s discharge for a total and permanent disability.
• Restores certain educational benefits for those who discontinued their education programs because of a National Guard call-up.
• Extends provision that allows family members to receive marker or headstones at marked graves in private cemeteries.
[Source: http://veterans.house.gov/news/109/12-8-06.html & NMFA E-News 12 Dec 06 ++]


LONG-TERM CARE UPDATE 01: During this time of year, many insurance plans offer open season for long-term care insurance. More than 70% of us who live to retirement age will need long term care at some time in our lives. While Tricare covers medically-necessary skilled nursing care, it does not cover beneficiaries' long-term care needs. Medicare pays limited amounts for skilled care following a hospital stay; Medicare does not cover most long term care services which assist people with the activities of daily living over a long period of time. Medicare will only cover the first 100 days of care in a nursing home per Benefit Period if you are receiving skilled care, and have a qualifying hospital stay of at least three days and enter the nursing home within 30 days of that hospital discharge. There are also some deductibles and co-pays .you have to pay. In addition, Medicare covers limited home visits for skilled care and incidental homemaker services.

Beneficiaries may want to consider other coverage options, such as: (1) Commercial Long-Term Care Insurance, which lets beneficiaries choose coverage; or (2) The Federal Long-Term Care Insurance Program (FLTCIP) available to active duty and National Guard activated for more than 30 days, retired uniformed servicemembers and Selected Reserve members. FLTCIP is designed specifically for members of the Federal Family. It is sponsored by the Federal Government and backed by two of the country's top insurance companies. FLTCIP is designed to help protect enrollees against the high costs of long term care. Personal access to registered nurse care coordinators, and home care provisions are just a few of the reasons why the Federal Program may be the smart choice for you.

Long term care is care that you need if you can no longer perform everyday tasks such as eating, dressing, bathing, using the bathroom, moving back and forth from a bed to a chair, and continence (i.e. the ability of the body to control urination or bowel movements or both) by yourself due to a chronic illness, injury, disability or the aging process. Long term care includes the supervision you might need due to a severe cognitive impairment (such as Alzheimer’s disease). It is not intended to cure you. It is chronic care that you might need for the rest of your life. This care can span years and can be expensive depending on the type of care you need and location where that care is received. The cost of long term care varies greatly, depending on the type of care, the place provided, and the region where you receive your care. For instance, the average hourly cost of home care ranges from $13 per hour in Montgomery AL to $20 per hour in Hartford CT. Nursing home care costs vary from $104 per day in Shreveport LA to $333 in New York City for a semi-private room. Home care — which most people prefer — is generally more affordable than nursing home care, but still can be expensive. When averaged nationally, the cost of a five-hour visit by a home health aide is $95.30. That’s well over $24,000 per year for a home health aide visiting five hours per day, five days a week. These costs rise significantly if around-the-clock care is needed.

FLTCIP calculates the initial cost of your plan, known as premium, based on your age on the date they receive your application and the benefit options you select. Your premiums do not change because you get older or your health changes after your coverage becomes effective. If interested, at www.ltcfeds.com/ltcWeb/do/assessing_your_needs/ratecalc you can determine how much the monthly premium for you would be based on the options you choose. For instance a 67 year old retiree born OCT 1939 electing a comprehensive 5 year coverage plan for $100 a day with an automatic compound inflation option would pay a monthly premium of $167.96 for a maximum lifetime benefit of $182,500. For more information, refer to the Federal Long-Term Care Insurance Program Website www.ltcfeds.com or call 1(800) 582-3337. [Source: Military.com 11 Dec 06 ++]


VA COMPENSATION RATES (DISABILITY): This benefit program evaluates disability resulting from all types of diseases and injuries encountered as a result of military service. The degree of disability as determined by VA represents (as far as can practicably be determined) the average loss in wages resulting from such diseases and injuries and their complications in civil occupations. Generally, the degrees of disability specified are also designed to compensate for considerable loss of working time from exacerbations or illnesses. By law, payment of VA compensation and military disability severance pay for the same medical condition or disability is prohibited. VA compensation will be withheld on a monthly basis until the total amount of military severance pay has been recovered. As required by the Veterans' Compensation Cost-of-Living Adjustment Act of 2007 the DVA has given notice of adjustments in certain benefit rates. These adjustments effective 1 DEC 06 affect the compensation program as indicated below:

10% - 20% Without Dependents: $115 $225
*****************************************************
30% - 100% Without Children
Veteran Alone: $348 $501 $712 $901 $1,135 $1,319 $1,483 $2,471
Veteran w/Spouse Only $389 $556 $781 $984 $1,232 $1,430 $1,608 $2,610
Veteran w/Spouse + One Parent $422 $600 $837 $1051 $1,310 $1,519 $1,708 $2,722
Veteran w/Spouse + Two Parents $455 $644 $893 $1118 $1,388 $1,608 $1,808 $2,834
Veteran w/One Parent $381 $545 $768 $968 $1,213 $1,408 $1,583 $2,583
Veteran w/Two Parents $414 $589 $824 $1035 $1,291 $1,497 $1,683 $2,695
Additional for A/A spouse (see footnote b) $38 $51 $63 $76$88 $101 $113 $126
****************************************************
30% - 100% With Children
Veteran w/Spouse + Child $420 $597 $832 $1045 $1,303 $1,511 $1,699 $2,711
Veteran w/Child Only $376 $538 $759 $957 $1,200 $1,394 $1,567 $2,565
Veteran w/Spouse + One Parent + Child $453 $641 $888 $1112 $1,381 $1,600 $1,799 $2,823
Veteran w/Spouse + Two Parents + Child $486 $685 $944 $1,179 $1,459 $1,689 $1,899 $2,935
Veteran w/One Parent + Child $409 $582 $815 $1024 $1,278 $1,483 $1,667 $2,677
Veteran w/Two Parents + Child $442 $626 $871 $1091 $1,356 $1,572 $1,767 $2,789
Add for Each Additional Child Under Age 18 $21 $28 $35 $42 $49 $56 $63 $70
Each Additional Schoolchild Over Age 18 (see footnote a) $66 $88 $111 $133 $155 $177 $199 $222
Additional for A/A spouse (see footnote b) $38 $51 $63 $76$88 $101 $113 $126
************

FOOTNOTES:
(a) Rates for each school child are shown separately. They are not included with any other compensation rates. All other entries on this chart reflecting a rate for children show the rate payable for children under 18 or helpless. To find the amount payable to a 70% disabled veteran with a spouse and four children, one of whom is over 18 and attending school, take the 70% rate for a veteran with a spouse and 3 children, $ 1,401, and add the rate for one school child, $155. The total amount payable is $1,556.
(b) Where the veteran has a spouse who is determined to require A/A, add the figure shown as "additional for A/A spouse" to the amount shown for the proper dependency code. For example, veteran has A/A spouse and 2 minor children and is 70% disabled. Add $88, additional for A/A spouse, to the rate for a 70% veteran with dependency code 12, $1,352. The total amount payable is $ 1,440.
[Source: www.vba.va.gov/bln/21/Rates/ Dec 06 ++]


MEDICARE RATES UPDATE 04: Medicare means-testing was enacted by Congress as part of the Medicare Modernization Act of 2003 (MMA). Its effects will be felt next month, as wealthier Americans begin to pay a greater percentage of the cost of their Medicare coverage than in the past. Retirees with Adjusted Gross Incomes (AGI) of at least $80,000 and couples with incomes of at least $160,000 are affected. AGI generally includes all wages, pensions, Social Security benefits, capital gains, and interest income before deductions are taken. Income levels are determined by a review of the past several years of tax returns filed with the Internal Revenue Service. Some seniors already have received written notification from the Social Security Administration stating how much they will pay, based on a review of those tax returns. If you receive Social Security benefits, new rates are sent each year with the December cost-of-living adjustment notice.

The MMA change reduces the government Part B subsidy from its current 7% for all beneficiaries to 65% or less for wealthier seniors. The federal subsidy reduction will be phased in over three years. By 2009, wealthier seniors will pay between 35% and 80% of the cost of their Medicare Part B coverage instead of the current 25%. Following is the percentage of Medicare Part B costs seniors will pay based upon their income by 2009along with their 2007 first installment premium:
- 25% of Medicare Part B costs for individuals with incomes of less than $80,000 w/ monthly premium of $93.50 in 2007;
- 35% of Medicare Part B costs for individuals with incomes of $80,000 or more ($160,000 or more for a married couple) w/ monthly premium of $105.80 in 2007;
- 50% for those with incomes of $100,000 or more ($200,000 for a couple) w/ monthly premium of $124.50 in 2007;
- 65% for those with incomes of $150,000 or more ($300,000 for a couple) w/ monthly premium of $142.90 in 2007; and
- 80% for those with incomes above of $200,000 or more ($400,000 for a couple) w/ monthly premium of $161.40 in 2007.

Future annual income thresholds will be indexed to inflation. Retirees affected by the reduction of government subsidy will see significant increases as the government share of costs is reduced and the costs of Medicare Part B rise. About 4% of the Medicare-eligible population is affected by the increases resulting from the federal subsidy reduction. [Source: MOAA News Exchange 6 Dec 07 ++]


OVERSEAS TROOP GIFT GIVING: If you would like to share a holiday greeting or send a goodie package to a loved one or “any soldier” overseas, here are a few of the many places that could help:
• Army and Air Force Exchange Service (AAFES): Friends and family of military overseas can sent a gift certificate from the one-shop shops for military personnel worldwide that stock all sort of goods, from licorice sticks to digital cameras to “bug-out” bags. A “bug out” bag is a backpack that service members pack in anticipation of having to change locations at a moment’s notice. Service members can buy anything they want with the gift certificate, but CDs and DVDs have been the most popular, say AAFES officials. Sold in denominations of $10 and $20, gift certificates can be redeemed at any AAFES PX (Postage Exchange) or BX (Base Exchange) throughout the world. AAFES currently operates 51 stores in the “SW Asian theater” or the countries involved in Operations Iraqi and Enduring Freedom (OEF/OIF), including 29 in Iraq, 10 in Kuwait, five in Afghanistan, four in Qatar/UAE/Djibouti, one in Pakistan, one in Kyrgyzstan and one in Uzbekistan. http://www.aafes.com/index.html
• United Service Organizations (USO): Every donation of $25 covers the cost of delivering a package to members of the U.S. Armed Forces deployed around the world. Each package contains a pre-paid worldwide phone card, sunscreen, travel size toiletries, a disposable camera and more. http://www.usocares.org/src/uso_home.htm
• Gifts From the Homefront: Anyone can send a gift certificate to a service member or an organization assisting families by making a donation to one of the organizations listed at the AAFES website: http://www.aafes.com/. Among the organizations currently on the list are the American Red Cross national headquarters, the Air Force Aid Society, The Fisher House and the USO. You can make a donation for a Gift of Groceries through some of the same organizations by going to: http://www.commissaries.com/certificheck/index.cfm.
• America Supports You: A nationwide program launched by the Department of Defense, recognizes citizens' support for military men and women and communicates that support to members of the Armed Forces at home and abroad. All events and information is highlighted on the America Supports You website www.americasupportsyou.mil/. This site allows participants to register and be recognized, share their stories of support with the nation and the troops, and download program materials for distribution and dissemination. Americans can find support efforts in their state in which they might participate by clicking on the U.S. map on the site. Military members can also access the web and learn about America's support for their service.
[NMFA E-News 12 Dec 06 ++]


CALL HOME ACT S.2653: In late action on December 9th, the House passed the Call Home Act of 2006. The measure had earlier passed the Senate and President Bush is expected to sign the measure into law within the next few days. The bill introduced by Senators Ted Stevens (R-AK) and Daniel Inouye (D-HI), directs the Federal Communication Commission (FCC), in coordination with the Department of Defense, to seek to reduce phone rates for Armed Forces personnel deployed overseas. The legislation authorizes the FCC to take actions necessary to reduce phone bills for troops deployed overseas, including waiver of government fees, assessments, or other charges. The legislation also directs that new technologies, such as Voice-over Internet Protocol (VoIP), be evaluated and means to reduce surcharges imposed by foreign governments be implemented. [Source: AFA Update 12 Dec 06 ++]


NORTH CENTRAL FEDERAL CLINIC SAN ANTONIO: The new North Central Federal Clinic (NCFC), the first Department of Veterans Affairs and Department of Defense venture using joint leadership and staffing, was scheduled to open 4 DEC 06 on the north side of San Antonio. The clinic will provide pharmacy, radiology, laboratory and optometry services for those enrolled. It is designed to improve access to medial care for VA and DOD beneficiaries living on the north side of San Antonio. Currently those Air Force beneficiaries must drive across town to Wilford Hall Medical Center on the south side of the city on Lackland Air Force Base. Approximately 5,600 Wilford Hall patients have been identified and notified as those who would benefit the most from being seen at the NCFC. Officials looked at active duty dependents, retirees and retiree family members, enrolled in Tricare Prime, who live in the north central San Antonio area. These individuals were then assessed by their medical needs and the level of services available at the NCFC.

The NCFC currently won't be open to active duty personnel. Active duty personnel will continue to be seen at their current care locations. NCFC enrollment has already been maximized. However, officials will be looking at demand in the area and considering options over the next six months, such as active duty sick call, to increase access if demand warrants. The congressionally approved facility was chosen after a federal competition, and is a test bed receiving national recognition. There are several other facilities in the U.S. that are working toward the same goal achieved in the San Antonio. Hospital officials, along with congressional and federal leaders, will be following the success of the clinic closely for consideration for other joint facilities to begin using joint leadership and staffing. [Source: Air Force Retiree News Service 8 Dec 06 ++]


PEARL HARBOR 65TH ANNIVERSARY: The National Park Service and the U.S. Navy hosted a joint memorial ceremony at Naval Station Pearl Harbor 7 DEC commemorating the 65th anniversary of the attack on Pearl Harbor. More than 1,500 Pearl Harbor survivors and their families and friends from around the nation joined 2,000 distinguished guests and the general public for the annual observance of the 1941 attack on Pearl Harbor on the Kilo Pier venue, which looks directly out to the USS Arizona Memorial approximately half a mile away. The theme of this year’s historic commemoration, “A Nation Remembers,” reflected on how the remembrance of Pearl Harbor has evolved throughout the years since World War II. At 7:55 a.m., the exact moment the Japanese attack began 65 years ago, a moment of silence was observed. Sailors aboard USS Russell (DDG 59) rendered honors to USS Arizona (BB 39), as the Hawaii Air National Guard F-15 Eagles performed a missing man formation fly-over above the memorial.

Highlights of the ceremony included the observance of morning colors, music by the U.S. Pacific Fleet Band, a Hawaiian blessing, a rifle salute by members of the U.S. Marine Corps, wreath presentations, echo taps and recognition of the men and women who survived Dec. 7, 1941, and those who gave the ultimate sacrifice for their country. Guest speakers included the governor of Hawaii, Linda Lingle; Secretary of the Department of the Interior, Dirk Kempthorne; Adm. Gary Roughead, commander, U.S. Pacific Fleet; and Ronald Sugar, chairman and chief executive officer, Northrop Grumman. Tom Brokaw, former NBC Nightly News anchor and managing editor, served as the keynote speaker for the commemoration. He spoke of the “greatest generation” and how during the war years, “Remember Pearl Harbor” became a battle cry for the nation, uniting the country to defend democracy and freedom. Today, according to Brokaw, “Remember Pearl Harbor” has taken on a different definition and provides an opportunity for reflection, a study of lessons learned, and gratitude toward the Pearl Harbor veterans who served and those of their comrades who paid the ultimate sacrifice. This anniversary was the last official reunion of Pearl Harbor survivors and many attended the commemoration events with their families. [Source: Navy News Service 8 Dec 07 ++]


VA INSURANCE DIVIDENDS IN 2007: More than a million veterans are in line to share $369 million in annual insurance dividends during 2007, according to the Department of Veterans Affairs (DVA). VA operates one of the nation’s largest life insurance programs, providing more than $1 trillion in coverage to 4.5 million service members, spouses and children. The dividend payments will be sent to an estimated 1.2 million holders of VA insurance policies on the anniversary date of their policies. Sent automatically through different payment plans, the amounts will vary based on the age of the veteran, the type of insurance, and the length of time the policy has been in force. The dividends come from the earnings of a trust fund into which veterans have paid insurance premiums over the years, and are linked to returns on investments in U.S. government securities. VA officials caution veterans about a long-running scam in which various groups charge fees to locate veterans who are eligible for the dividends.

Veterans eligible for the dividends have had VA life insurance policies in effect since they left the military and have received annual notifications from VA about the policies. Dividends are paid each year to veterans holding certain government life insurance policies and who served between 1917 and 1956. World War II veterans holding National Service Life Insurance (“V”) policies comprise the largest group receiving 2007 insurance dividend payments. They are expected to receive total payments of $286.3 million. An additional group of World War II era veterans, those who have Veterans Reopened Insurance (“J”, “JR” and “JS”) policies, will in total receive dividends of $10.1 million. Korean War era veterans who have maintained Veterans Special Life Insurance (“RS” and “W”) policies can expect to receive dividends totaling $71.6 million. Dividends totaling $1million will be paid to veterans who served between World War I and 1940 and who hold U.S. Government Life Insurance (“K”) policies. Veterans who have questions about their policies may contact the VA insurance number at 1(800) 669-8477 or send an e-mail to VAinsurance@va.gov. For additional info refer to www.insurance.va.gov. [Source: VA News Release 8 Dec 06]


TSP UPDATE 08: The Federal Retirement Thrift Investment Board has announced a $500 increase in regular Thrift Savings Plan contributions to $15,500 for 2007 elective deferral maximum contributions. Catch-up contributions will remain at the $5,000 limit set in 2006. TSP offers investors the chance for lower taxes each year they contribute with taxes deferred until they withdraw the account after retirement. TSP is a long-term retirement savings plan, which is an ideal supplement to military and civilian retirement plans. Investment money is deposited directly from each paycheck which makes it easy to ‘pay yourself first' while only investing what you deem appropriate. [Source: Armed Forces News Issue 8 Dec 06 ++]


MILITARY FUNERAL DISORDERLY CONDUCT UPDATE 07: On 7 DEC the Senate passed, by voice vote, a bill that would bar protests at any funeral. Sen. Richard J. Durbin’s (D-IL) bill S.4042 extends the present prohibition of demonstrations at funerals held at federal cemeteries which became law on Memorial Day when President Bush signed H.R. 5037. That bill was only applicable to national cemeteries. Senate bill S.4202 would make would make it a criminal misdemeanor, punishable by a fine or up to one year in jail, to intentionally disrupt a funeral or protest within 150 feet of such a service. This is in response to the demonstrations that members of the Westboro Baptist Church in Topeka, KS, have been conducting at military funerals. They have been alleging that U.S. troops are being killed as retribution for America’s tolerance of homosexuality. [Source: TREA Washington Update 8 Dec 06 ++]


VA MEDICAL CENTER WACO: After a comprehensive review of the Waco Veterans Affairs (VA) Medical Center, its mission and veterans' needs, the Secretary of the Department of Veterans Affairs, Jim Nicholson, recently announced his decision to keep the Medical Center open. Waco's recent designation as a Center for Excellence in outpatient post-traumatic stress disorder services also builds upon the services to be provided by Waco. Nicholson noted that the facility's inpatient and outpatient services are important to residential care homes in the Waco area that care for veterans who do not need to be in an institution, but require outpatient services and periodically inpatient care. [Source: NAUS Weekly Update 8 Dec 06 ++]


DOD MENTAL HEALTH TASK FORCE UPDATE 01: The Department of Defense (DoD) Task Force on Mental Health (MHTF) will host open meetings 18-20 DEC, at the Hyatt Regency Crystal City Hotel, 2799 Jefferson Davis Highway, Arlington, Virginia. The public and media are invited to attend the open sessions. The open meetings provide an opportunity for attendees to hear briefings on mental health related topics. Additionally, time will be set aside one day for Task Force members to hear statements from veterans, DoD beneficiaries, their families, the public, and from veteran and military service organizations. Testimony to the Task Force during the open meeting should be in the form of a statement rather than a briefing or presentation, and should be no longer than 10 minutes. However, written statements of any length may be submitted to the Task Force at www.ha.osd.mil/DHB/mhtf/submission.cfm. Beneficiaries who may not wish to speak publicly or who are unable to attend the meeting may submit their statements at this link. For more info refer to www.ha.osd.mil/dhb/mhtf/meeting/2006-12.cfm. [Source: NAUS Weekly Update 8 Dec 06]


NATIONAL GUARD BIRTHDAY: Known originally as the militia, the National Guard on 13 DEC turns 370 years of age. It all started in 1636 when the General Court of the Massachusetts Bay Colony, which functioned as the colony's legislature, ordered existing militia companies from the towns surrounding Boston to form into three regiments: North, South and East. While other English colonies, such as Virginia and Spanish colonies like Florida and Puerto Rico, had individual towns with militia companies before 1636, Massachusetts was the first place in the New World where the population was large enough to justify organizing companies into regiments for command and control. Although their names have been changed and individual companies have come and gone, the three regiments still exist in the Massachusetts Guard. In retrospect, a string of 20-year career enlistments divides the Guard's life span into more than 18 generations. The differences between generation one and 18 are countless. Yet, even as the National Guard has transformed many times, it remains in line with its first role as the citizens' Army. In addition, the Air Guard has served as the citizens' Air Force for the last three generations. Now, a force of more than 450,000 men and women serve voluntarily and can be deployed anywhere in the world [Source: NGAUS Notes 8 Dec 06]


LIBEL PROTECTION WEAKENED: The California Supreme Court has ruled that Internet users who republish false and defamatory statements that were written by others are not liable for their content. The case arose after Ilena Rosenthal falsely stated to a newsgroup that a police report had said that a Canadian physician, had stalked several women. Rosenthal was informed that the statement was false and that the police had found no evidence of wrongdoing. She refused to retract the message and has continued to this day to falsely suggest that the doctor had actually stalked someone. The original libel was created by Tim Bolen, a professional character assassin who was hired to attack critics of Hulda Clark, an unlicensed naturopath who claims that herbs and a low-voltage electrical device can cure cancer and other serious ailments. When a libel suit was filed against Bolen and Clark, Rosenthal was included as a defendant. However, her attorney asserted that the Internet Decency Act protected her. This law was passed to protect operators of bulletin boards and other interactive sites from the impossible task of monitoring and regulating everything posted to their sites.

The trial judge dismissed Rosenthal from the case. The 1st District Court of Appeal put her back in, ruling that Internet discussion group operators who ignore notices that something is defamatory can be liable as a "distributor," in the same way a bookseller who knowingly sells a defamatory book would be. The Supreme Court acknowledged that "blanket immunity for those who intentionally redistribute defamatory statements on the Internet has disturbing implications," but it ruled that the "plain language" of the law exempted Internet intermediaries from defamation liability for republication. In other words, the court ruled that until Congress chooses to revise the law in this area, plaintiffs who contend they were defamed in an Internet posting may seek recovery only from the original source of the statement. Refer to www.casewatch.org/civil/rosenthal/supreme_court.pdf on this ruling. The suit against Clark and Bolen has been on hold but will resume when the Rosenthal appeal is final. Quackwatch has comprehensive information about the libel campaign at www.quackwatch.org/11Ind/bolen.html and Clark's activities at www.quackwatch.org/01QuackeryRelatedTop ... clark.html. [Source: Consumer Health Digest 4 Dec 04 ++]


MONEY RECOGNITION BY BLIND: A federal judge said 28 NOV in a ruling that could change the face of American currency that the government discriminates against blind people by printing money that all looks and feels the same. U.S. District Judge James Robertson ordered the Treasury Department to come up with ways for the blind to tell bills apart. He said he wouldn't tell officials how to fix the problem, but he ordered them to begin working on it. The American Council of the Blind has proposed several options; including printing bills of differing sizes, adding embossed dots or foil to the paper or using raised ink. "Of the more than 180 countries that issue paper currency, only the United States prints bills that are identical in size and color in all their denominations," Robertson wrote. "More than 100 of the other issuers vary their bills in size according to denomination, and every other issuer includes at least some features that help the visually impaired."

Government attorneys argued that forcing the Treasury Department to change the size of the bills or add texture would make it harder to prevent counterfeiting. Robertson was not swayed. "The fact that each of these features is currently used in other currencies suggests that, at least on the face of things, such accommodations are reasonable," he wrote. He said the government was violating the Rehabilitation Act, which prohibits discrimination on the basis of disability in government programs. The opinion came after a four-year legal fight. Electronic devices are available to help blind people differentiate between bills, but many complain that they are slow, expensive and unreliable. Visually impaired shoppers frequently rely on store clerks to help them. "It's just frankly unfair that blind people should have to rely on the good faith of people they have never met in knowing whether they've been given the correct change," said Jeffrey A. Lovitky, attorney for the plaintiffs in the lawsuit. Others have developed ways to cope with the similarly shaped bills. Melanie Brunson, a member of the American Council of the Blind, told the court that she folds her bills into different shapes: $1 bills stay straight, $5 bills are folded in half left to right, $10 bills in half top to bottom and $20 in quarters. The Treasury Department had no comment on the ruling. The government has 10 days to decide whether to appeal.

U.S. bills have not always been the same size. In 1929, the government standardized the size and shrank all bills by about 30% to lower manufacturing costs and help distinguish between genuine and counterfeit notes. Since then, the Treasury Department has worked to stay ahead of counterfeiters. Security threads and microprinting were introduced, the portraits were enlarged in 1996, and an infrared feature was added to encourage the development of electronic readers for the blind. The latest redesign is under way. New $10 bills, featuring splashes of orange, yellow and red, hit the market this year, following similar changes to the $20 bill in 2003 and the $50 bill in 2004. The $5 facelift is due in 2008.

In court documents, government attorneys said changing the way money feels would be expensive. Cost estimates ranged from $75 million in equipment upgrades and $9 million annual expenses for punching holes in bills to $178 million in one-time charges and $50 million annual expenses for printing bills of varying sizes. Any change to the dollar's design could ripple into the vending machine industry, which participated in discussions regarding previous redesigns. The American Council of the Blind is not seeking changes to the $1 bill, according to court documents. The Treasury Department spent $4.2 billion on printing over the past decade, Robertson said. Adding a raised number to the bills would have increased costs less than 5% over that period, he said. "If additional savings could be gained by incorporating the new feature into a larger redesign, such as those that took place in 1996 or 2004, the total burden of adding such a feature would be even smaller” Robertson wrote. [Source: AP Matt Apuzzo article 28 Nov 06]


VA MY HEALTH eVET UPDATE 01: The VA continues to improve their My Health eVet web site ww.myhealth.va.gov. My Health eVet gives veterans easy access to their health information while protecting their privacy. A feature on the site allows veterans to record their personal information and medical data - including emergency contacts, health care providers and insurance, prescriptions, tests and allergies - in a private, secure Internet environment. The web site’s new features significantly expand the information veterans can record and share with medical professionals, family members and others of their choice. Also included is a “Learn About” tab, which leads veterans to a variety of topics in health education. My Health eVet establishes a veteran-clinician partnership that should result in better-informed decision making and move veterans toward more proactive management of their health care. The idea is to make it as easy as possible for veterans to take good care of themselves.

Beginning 2007, the site will release features and functions for veterans to view online copies of their VA health records. More and more sections of the VA health record will be made available as electronic copies over the next year. These parts of your VA health information will be added to your the Personal Health Record, along with whatever information you enter yourself. The system is being prepared to gather your health information from all VA Medical Centers for inclusion in your electronic Personal Health Record for access whenever and wherever you have web access.

Presently veterans nationwide are able to complete a process called “In-Person Authentication” online, and then be able to view additional prescription information and order refills. For security and privacy of your health records veterans will only be able to access their Personal Health Record after they have completed In-Person Authentication in person. Veterans must go to the VA, present a valid form of identification, view an instructional video, and sign an agreement. Once an authorized VA employee has verified the identity of the veteran, My HealtheVet will allow this new access to their Personal Health Record. More parts of the Personal Health Record will become available over time. When My HealtheVet launches delegation functionality later in 2007 you will also be able to choose who else will be able to view or manage your Personal Health Record. [Source: e-Veterans News 8 Dec 06 ++]


VET CEMETERY XMAS WREATHS: On 14 DEC Christmas wreaths were placed on nearly 8,000 graves of veterans in ceremonies at cemeteries around the country. About 5,000 wreaths were placed at Arlington National Cemetery VA and another 1,500 at Togus National Cemetery in Maine, home state of the wreath company sponsoring the event. In its 15th year of operation, the Arlington Wreath Project has expanded to the 230 other state and national veterans’ cemeteries across the country, becoming Wreaths Across America. This year at Arlington, the wreaths were laid in Section 3 and Section 11. The superintendent of Arlington National Cemetery chooses a different area for the wreaths to be laid each year. The two sections chosen this year are in older areas, which receive fewer and fewer visitors each year. The idea is that eventually every grave will have had a wreath on it at some point. Some 60,000 wreaths have been laid since the project began in 1992. A list of the 208 cemeteries where arrangements were made for wreath-laying ceremonies is on the project’s Web site www.wreathsacrossamerica.com.

Culmination of wreath placement at all cemeteries occurred at noon Eastern Time on 14 DEC, the same time wreaths were being laid at the Tomb of the Unknown Soldier at Arlington. Wreaths are laid only on graves marked with the Christian cross, or those that are non-denominational. Worcester Wreath Company of Harrington ME donates the wreaths made with simple, lush evergreens featuring a large, red, hand-tied bow, a stark contrast against the bleached white headstones. The Maine wing of the Civil Air Patrol has participated in the event over the last several years, and Worcester Wreath enlisted the group’s help in expanding its reach to other veterans’ cemeteries around the country. Veterans’ groups also helped. The project began in 1992, when Morrill Worcester, president of the wreath company, had too many wreaths left as the holiday season was ending. Remembering his trip to Washington as a 12-year-old, when Arlington Cemetery left an indelible impression on him, he decided to do something special with the wreaths. With the help of Sen. Olympia Snow (R-ME) he made arrangements to have the wreaths placed in one of the older sections of Arlington. For the annual ceremony the organization encourages members of the local communities to attend the ceremonies. If that is not possible, they ask for a moment of silence at noon. [Source: NavyTimes Karen Jowers article 5 Dec 06 ++]


STOLEN VALOR ACT: The House of Representatives passed a Senate-approved bill 6 DEC that would make it a felony to claim unearned military decorations. The bill would close a loophole in current law that allows phony recipients to escape prosecution as long as they do not physically wear the awards they claim. If signed into law by the president, the Stolen Valor Act of 2005 would impose up to six months imprisonment and a maximum $5,000 fine for any false verbal, written or physical claim to an
award or decoration authorized for military members. Penalties would be doubled for fraudulent claims to decorations specifically awarded for combat valor, such as the Navy Cross, Silver Star and Medal of Honor. During floor debate on the Senate bill, which was passed unanimously on 7 SEP, House Judiciary Committee chairman Rep. James Sensenbrenner (R-WI) referenced recent cases in Illinois and Missouri of men who have never served a day in uniform each claiming to be Marine officers and recipients of the Navy Cross, the nation’s second highest award for valor.

Rep. John Salazar (D-CO) who introduced H.R. 3352, the House version of the legislation in the summer of 2005, said the bill re-introduces a precedent set by George Washington in 1782. When he established the Badge of Military Merit, the nation’s only military award at the time, Washington wrote, (… should anyone who is not entitled to these honors have the insolence to assume the badges of them, they shall be severely punished”. The House’s approval of the Senate bill, introduced by Sen. Kent Conrad (D-ND) on 10 NOV 05, was the result of a last-minute bi-partisan effort to put the legislation to a vote before the end of the current session. Salazar agreed on 3 DEC to set aside his own bill, which has been hung up in the judiciary committee since he introduced it, in order to support Conrad’s nearly identical legislation on the Senate side. Salazar spokesman Tate Rosenbusch said, “We don’t care if our name is on it. We don’t care if we are 30th on the list of co-sponsors. We just want something done”. [Source: NavyTimes John Hoellwarth article 6 Dec 06 ++]


MEDICARE PART D UPDATE 13: Medicare officials are touting the success of their new drug benefit by pointing to defections from the VA’s drug program. Health and Human Services Secretary Mike Leavitt told reporters recently that about a third of those who are on the Veterans Affairs Department (DVA) plan chose to enroll in a Part D plan. In a recent letter to the editor of the Chicago Sun-Times Ken Johnson, senior vice president of the Pharmaceutical Research and Manufacturers of America said as many as 40% of Medicare-eligible veterans enrolled in the VA drug plan have opted for a Medicare plan. However, the DVA says there have been no signs, large or small, of folks leaving. Mike Valentino, the VA’s pharmacy director said he has seen some of those comments about a million veterans leaving VA for Part D but his data does not support that. He said about 4.3 million got medicines through the VA this year, up from 4.1 million in 2005 and 3.8 million in 2006. It is possible both government departments are correct in their assessment, but that would mean that nearly 2 million veterans are enrolled in both programs. Jeff Nelligan, a spokesman for the Centers for Medicare and Medicaid Services, said the agency believes nearly 1.8 million veterans with prior VA coverage have enrolled in private plans offered through Medicare or get medicine from a plan administered by a former employer. Those employers get a tax break for providing drug coverage, and the workers are counted in the program’s overall enrollment. About half of the veterans in Medicare plans were automatically enrolled because their incomes made them eligible for both Medicare and Medicaid.

The VA serves veterans with service-connected disabilities, as well as those with low incomes.
For some veterans, medicine is free. For others, the only cost is an $8 co-pay per prescription. They pay no monthly premium or other costs. The government subsidizes health care for Medicare beneficiaries to a lesser degree. Under the standard Medicare plan, beneficiaries pay the first $250 in drug costs, then the government pays for 75% of a beneficiary’s medicine until total drug costs reach $2,250. At that point, beneficiaries pay for all of their medicine until out-of-pocket costs reach $3,600. After a beneficiary reaches $5,100 in covered expenses during the year, Medicare will pay for 95% of the remaining covered costs for the rest of that year. The poor get extra help. The very poor make only nominal co-payments of up to $2 for a generic medicine and $5 for a brand-name drug. The trade association representing drug manufacturers has adopted a similar strategy as the HHS Department when it comes to touting Medicare’s program.

With Democrats focusing on letting the government negotiate drug prices, people are taking note of
the advantages and disadvantages of the VA’s drug coverage. Under the VA’s program, drug makers negotiate with the government on the price of medicine. If they don’t, the manufacturers can’t participate in programs such as Medicaid. The Democrats’ fight for government negotiations on drug prices is focused on the lower prices the VA pays for its medicine when compared with what private insurers pay. But there are other important aspects of the VA’s health care program that often go unmentioned in the calls for government negotiations. For example, Veterans who get VA health care don’t see the family doctor when they get sick or undergo an exam. Nor do they drive down to the local drugstore when they need medicine. The veterans with VA coverage see the doctors who work at the VA’s clinics and hospitals. A treatment plan is developed for them. If that plan includes medication, those drugs must be picked up at a VA pharmacy or through home delivery.

There are also differences in the list of drugs the VA covers compared with the list of drugs a typical Medicare plan covers. The VA’s formulary is said to be among the most restrictive in the marketplace. In Medicare, slightly more than half of enrollees are in plans that cover 1,000 to 1,500 medications. Another 35% are in plans that cover more than 1,500 drugs. According to Valentino the VA plan covers about 1,300 drugs. However, he calls the number of drugs on a formulary almost irrelevant. He said if a plan covers the top 200 selling drugs, then it is basically covering everyone’s needs. When asked if the VA covers the top drugs used by seniors, Valentino said he was confident that it does. They are either on VA’s formulary or they have an equally safe and effective drug in that class on their formulary. [Source: NavyTimes.com AP article 5 Dec 06 ++]


MEDICARE REIMBURSEMENT RATES UPDATE 04: As things stand, unless Congress takes action before then end of the 109th session, users of Medicare and Tricare will found it much more difficult in 2007 to find a physician that will treat them. Effective 1 JAN 07 the Medicare sustainable growth rate (SGR) formula will cut payments to physicians and health care professionals by 5.1% which will cause many providers to drop their participation in the program. Following is an extract from Congressman Bart Stupa’s (D-MI-01) letter to one of his constituents on the subject that elaborates on Congress’ failure to enact a permanent fix to the problem:
December 4, 2006
Mrs Joann Muchow
xxx East Tawas, Michigan 48730

Dear Mrs Muchow:
Thank you for contacting me about physician reimbursement under Medicare. I appreciate hearing from you. Congress passed a budget reconciliation bill in February 2006 that canceled a scheduled reduction in the Medicare physician reimbursement rate. As you know, without this adjustment, physician payments would have been cut by 4.4% in 2006. Those cuts would have meant payment reductions of $109 million in Michigan alone. The formula was created as a way to control Medicare cost growth. However, the system is punishing physicians for providing quality medical care. Under the formula, as physician costs rise, payment rates drop. The challenge before Congress is to create a permanent fix to the formula. The cost estimates to permanently replace the current formula range from $90 billion to $126 billion over 10 years. While the cost is high, the cost of doing nothing is higher. The way the formula is written now, every yearly adjustment Congress enacts leads to larger cuts to reimbursement in the future.

I have consistently supported short-term updates and long-term efforts to reform the physician payment. I voted for an amendment in the House Energy and Commerce Committee offered by Congressman John Dingell in October 2005 to add a short-term fix to the reconciliation bill. The amendment would have provided a 2.7% update in 2006 and a similar update in 2007. The amendment would have also protected beneficiaries from having their premiums increase as a result of the payment increase. Unfortunately, the amendment failed on a near party-line vote. I voted against reporting the reconciliation bill out of committee because it failed to address the physician payment formula and because it also cut Medicaid by $10 billion and Michigan Medicaid by an average of $280 million per year. While the reconciliation bill that ultimately was signed into law included a short-term fix to the physician payment, it also included the $10 billion cuts to Medicaid. I cannot in good conscious vote to cut Medicaid for Michigan’s children, seniors, and persons with disabilities; and I therefore opposed final passage of the bill. Rest assured, I will continue to fight for short-term and long-term solutions to this problem to ensure you are able to continue to provide quality health care to Michigan’s 1.4 million Medicare beneficiaries.
Sincerely,
BAKRT STUPA
Member of Congress
[Source: Joann Muchow msg 4 Dec 04 ++]


MEDICARE REIMBURSEMENT RATES UPDATE 05: One of the last acts of the 109th Congress was an attempt to enact Rep. William Thomas’ [CA-22] Tax Relief and Health Care Act of 2006 (H.R. 6408) to stave off the 5.1% cut in Medicare and Tricare payments to doctors scheduled for January 2007. On 7 DEC House and Senate negotiators agreed on a package of actions that will freeze payments at the 2006 level - which is really the 2005 level, since Congress took a similar action at the end of last year. A vote was scheduled for 8 DEC. One new difference is that doctors who agree to report their compliance with a specific set of quality standards would receive a 1.5% payment increase in 2007. This is a big deal for Tricare beneficiaries as well as Medicare-eligibles, since Tricare payment rates are tied to Medicare's. Concern has been that cutting payments to doctors can only deter more of them from accepting Medicare and Tricare patients. Under the new agreement, they'll at least have some opportunity to see a modest increase. The new legislation also will extend for one more year a waiver of the $1,740 annual cap on Medicare payments for outpatient speech and physical therapy that was scheduled for implementation in January. Under the waiver, the cap won't apply to therapy that's considered medically necessary (as almost all therapy is).

A change in the law that sets such unrealistically low Medicare and Tricare payments is required for a long term fix. The current statutory formula will require cuts of more than 30% over the next seven years, which everyone in government acknowledges is inappropriate. The problem is that Congress so far hasn't been willing to put up the money required for a longer-term fix. For the last several years, they've found it easier simply to wait for each end-of-year funding crisis and then find a way at the very last minute to kick the can on the cuts for one more year. Not a very good way to run the Medicare and Tricare programs that 80 million people depend on to cover their health care needs. [Source: MOAA Update 12 Dec 06 ++]


PHILIPPINE DEERS REGISTRATION: Defense Manpower Data Center (DMDC) is now operational in the Philippines. ID cards and DEERS registration can now be obtained at the U.S. Embassy Manila. Their office is located between the VA office and SSA window 3. No walkins. They will only do appointments. To obtain one call 528-6300 Ext. 6327. The process of obtaining a new ID Card also registers the applicant in DEERS. This is necessary to receive medical care coverage under Tricare. New or replacement cards and updated DEERS registration is necessary to retain Tricare coverage whenever:
1. Retiree or dependent reaches age 65.
2. Child turns age 21
3. Applicant becomes a widow(er)
4. Every 4 years for spouse.
5. Marriage or divorce.
6. Birth or adoption of a child
7. Retirement
. [Source: Various ++]


PTSD UPDATE 09: The Army has agreed to fund research to see if a drug used to treat high blood pressure might be able to lessen the emotional impact of memories associated with post-traumatic stress disorder. CBS 60 Minutes first reported 26 NOV that the Army was looking at whether the drug Propranolol could be used to treat PTSD. Psychologist Dr. Scott P. Orr, who works at the Department of Veterans Affairs Medical Center in Manchester N.H. said, researchers hope to recruit several dozen veterans who served in Iraq and Afghanistan from the greater Boston area for the study who will help conduct the research. The study will look at whether Propranolol can reduce veterans’ emotional responses to certain memories by cutting down on the accompanying surge of adrenaline. In initial tests people given the drug were observed to have reduced physiological responses such as heart rates to certain memories said Orr who is also part of the department of psychiatry at Harvard Medical School and Massachusetts General Hospital. Orr stressed that the drug would not erase veterans’ memories. It isn’t that the memory’s being changed - the memory is still there. It’s that the emotional response that is attached to the memory is being reduced.

In an e-mail to Stars and Stripes Dr. Judith Broder, a Los Angeles-based psychiatrist who is the founder of a nonprofit organization that provides free mental health services to veterans said she has some reservations and is worried about several things:
- She believes our soldiers often feel dehumanized by their time in the service. To then treat them with a drug that potentially numbs them may further alienate them.
- She fears that the VA under funded and facing an increasing number of veterans returning with PTSD might resort to cost-effective solutions such as giving veterans with PTSD a pill rather than the therapy they need.
- She is concerned about the issue of concern of informed consent. Soldiers are used to following orders. These soldiers are now suffering from a disorder and of course want relief from their suffering. Is it really possible to give informed consent to an experimental procedure under these conditions?”

Orr said in response that, “The research is not intended to see if Propranolol can produce emotional numbing. If anything what it does is reduces the intensity of the emotion such that the emotional reaction may become more manageable for the person. It is not a replacement for psychotherapy. Rather it becomes an adjunct; it becomes a useful tool for psychotherapy. As for the issue of informed consent researchers generally bend over backwards to give people participating in research all the information they need on the potential risks and benefits they would face.” The upcoming research will be headed by one of his colleagues Dr. Roger Pittman at Harvard University. The Army and Pittman are still negotiating how much his grant will be and how the study will unfold said Chuck Dasey, a spokesman for Army Medical Research and Materiel Command at Fort Detrick MD. Pittman could be awarded up to $625,000 a

[boardman]

RAO Bulletin Update
1 January 2007


THIS BULLETIN UPDATE CONTAINS THE FOLLOWING ARTICLES:

== VA President Ford Observance ---------- (Health Centers Open)
== VA Budget 2007 Update 10 -------------- (Continuing Resolution)
== Agent Orange Lawsuits [08] -------------- (Blue/Brown Water Navy)
== Vet Bonus Massachusetts ----------------- ($500 & $1000)
== CRSC [35] ---------------------------------- (CRSC/CRDP Open Season)
== Breast Cancer [01] ------------------------- (Vaccination Results)
== VA Cancer Lawsuit ----------------------- (Family Awarded $500,000)
== Gulf War Presumptive Disease [01] ------(Expires 31 DEC 11)
== Personality Disorder Discharge ---------- (PD or PTSD?)
== Immigrant Recruitment -------------------- (Under Consideration)
== AF Retiree Council [01] ------------------- (Overseas Agenda Items)
== SSA COLA ---------------------------- (Net Elimination by 2012)
== Social Security Reform [01] -------------- (Indexing)
== COLA 2008---------------------------------- (1.2% Decline to Date)
== VA Data Breach [28] -------- (Comprehensive Legislation Needed)
== Federal Audit ------------------ (Government Exposure $50 Trillion)
== Armed Services Committee --------------- (New House Members)
== VA Prescription Policy [01] ---------- (Half-price Prescriptions)
== FTC Funeral Rule ------------------ (Funeral Home Investigation.)
== VA Compensation Rates (DIC): --------- (2007 Monthly Payments)
== Tricare Meeting w/Coalition ------- (Quarterly Meeting Planned)
== VA Facility Expansion -------------------- (Muskogee/Popular Bluff)
== Commissary Bag Selection --------------- (Paper Less Expensive)
== VA SSOC Deadline ----------------------- (Decrease Proposed)
== Mobilized Reserve 27 DEC 06----------- (Net Decrease 7,158)
== VA Incarcerated Person Benefits -------- (Reduction or Loss)
== Alzheimer’s [02] --------------------------- (A Step Forward)
== New VA Clinic ----------------------------- (Rural Colorado/Kansas)
== Aid & Attendance [01] -------------------- (Underutilized)
== Unified Medical Command --------------- (Rejected)
== Congressional Terminology -------------- (Military Funding Terms)
== DoD Mental Health Task Force [02] ---- (Combat Stress Concerns)
== Tricare T-Pharm Contract ----------------- (Solicitation Cancelled)
== VA Tinnitus Compensation [03] --------- (VFW Involvement)
== Mold & Mildew ---------------------------- (Impact on humans)
== Bladder Cancer ----------------------------- (Cause & treatment)


VA PRESIDENT FORD OBSERVANCE: Secretary of Veterans Affairs Jim Nicholson announced 29 DEC that as the nation mourns the passing of Navy veteran and President Gerald R. Ford on Tuesday, 2 JAN VA medical centers, outpatient clinics, Vet Centers and national cemeteries will remain open to serve President Ford’s fellow veterans. Veterans with scheduled clinic appointments, surgeries or other procedures at one of VA’s 155 hospitals or 876 outpatient clinics should report as scheduled, unless otherwise instructed. VA’s 207 Vet Centers will also be open to serve the needs of combat veterans in need of readjustment support. Also scheduled to be open are the 124 VA-operated national cemeteries. Burials, inurnments, visitations and other memorial events scheduled for Tuesday will be conducted, unless surviving families request otherwise. VA’s administrative offices, including the Department’s Washington headquarters and 57 regional benefits offices, will be closed Tuesday in observance of the National Day of Mourning. Secretary Nicholson invited World War II veterans and their families to show their respect to President Ford by attending a ceremony in the President’s honor that was held on 30 DEC at the World War II Memorial in Washington. [Source: VA News Release 29 Dec 06 ++]


VA BUDGET 2007 UPDATE 10: Before the 109th Congress recessed it attempted to pass a number of important items during its final hours in session. Unfortunately, those did not include the 11 overdue appropriations bills for FY2007, which began on 1 OCT. One of these was the Military Construction/VA spending measure, which funds the VA medical system. To keep the VA and other government agencies running into the new year, Congress passed a continuing resolution funding government agencies at House-passed, Senate-passed or 2006 funding levels, whichever is the lowest. That continuing resolution will expire on 15 FEB 07, which means next year's Congress will have to act before then to keep the government running. Rumors around Capitol Hill are that the new Congress will simply extend the continuing resolution for the rest of FY2007 so leaders can focus on crafting appropriations for FY2008.

This doesn't affect the Defense Department, since the FY2007 Defense Appropriations Act was one of the two appropriations bills the Congress actually finished. Although that can't be said about VA appropriations, the continuing resolution will let the VA reallocate up to $684 million to fund VA health care needs for the next couple of months. While this provides some interim relief, there is concern about the VA's ability to provide quality medical care at 2007 prices with a 2006 budget. Along with the continuing resolution, Congress also approved legislation to:
- Avoid the JAN 07 5.1% cut in Medicare and TRICARE payments to doctors by freezing 2007 rates at 2006 levels.
- Avoid imposing a $1,740 annual cap on Medicare payments for outpatient speech and physical therapy that had been scheduled to take effect in January.
- Ban protests at military funerals at any funeral site.
- Authorize the Federal Communications Commission to work with the Pentagon to reduce phone rates for deployed troops.
- Delay any action on a 2007 congressional pay raise at least until 16 FEB 07.
[Source: MOAA Leg Up 15 Dec 06]


AGENT ORANGE LAWSUITS UPDATE 08: 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. Specifically, the Court held the following:

- The reference to service in �Vietnam� as used in the statute was ambiguous because there are many definitions of the territory of a nation.
- VA’s regulation defining Vietnam service for purposes of granting the presumption of exposure to herbicides is ambiguous when viewed together with 38 CFR 3.313, which also defines service in Vietnam. The Court pointed to the use of different conjunctions as well as the differing placement of a comma in each regulation to prove the ambiguity and observed that VA had merely replaced legislative ambiguity with regulatory ambiguity.
- Because of its determination that ambiguity was present, the Court looked to a procedural manual (M21-1) provision from 1991 that stated that possession of a Vietnam Service Medal (VSM) would be conceded as proof of Vietnam service in the absence of contradictory evidence. The Court held this to be a substantive rule establishing entitlement to the presumption of exposure to herbicides. It held that VA’s attempted rescissions of that M21-1 provision were void because they failed to comply with the notice and comment requirements of the Administrative Procedures Act (APA). The Court also held that within the meaning of VA’s manual provisions: (1) proof that a veteran had blue water service without setting foot on mainland Vietnam would not necessarily be contradictory evidence, but (2) proof that a veteran served in a location that reasonably precluded exposure to Agent Orange could be considered contradictory evidence.

VA has appealed the Haas decision to the U.S. Court of Appeals for the Federal Circuit. The VA director subsequently issued a letter that provides interim procedures for controlling claims affected by the CAVC decision. Regional offices have been directed that claims with Haas issues will not be adjudicated until this litigation is resolved but will be acknowledged upon receipt with specific language approved by the Office of General Counsel and controlled as indicated in this letter. Among other things it provides general answers to typical questions VA employees may receive during interviews or when answering telephones. The primary one is, “We have received your claim for (insert the disability) based upon claimed herbicide exposure. Your claim may be affected by recent judicial action by the Court of Appeals for Veterans Claims in Haas v. Nicholson. VA has appealed that action to the Federal Circuit. We must await the outcome of that appeal and receive guidance from the Department of Veterans Affairs General Counsel prior to taking further action on your claim. We will advise you further when we receive guidance.”

The Secretary’s brief is due to be filed in the Haas appeal on 8 JAN 07. 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. The Secretary then may file a reply brief 14 days after that. Thus, the briefing will likely be completed by early March, but there is a small possibility that either party may ask for, and be granted, extensions for those filings. The Court will then likely schedule oral argument and, after it hears the argument, issue a decision. The decision will likely be issued several months after the oral argument and will be posted on the NVLSP website www.nvlsp.org. Questions should be submitted to Richard V. Spataro, Staff Attorney, National Veterans Legal Services Program, 1600 K Street, NW, Suite 500, Washington, DC 20006-2833 [Source: www.vawatchdog.org 14 Dec 06 ++]


VET BONUS MASSACHUSETTS: The Commonwealth of Massachusetts is offering cash bonuses to its service members. They are offering $500 for active duty members and $1,000 for veterans who served in Iraq or Afghanistan. There's no catch. It's called the Welcome Home Bonus and it honors Massachusetts's men and women who have deployed overseas to combat areas. It does take some legwork. Your town of legal residence has to verify your address and put a seal on the document before you can mail it into the Treasurers Office. This can be done via mail or if your relatives still live in the state they can do it at your town hall and mail it back to you. You don't have to be a current resident of Massachusetts to apply. You only have to have been a resident of MA anytime 6 months prior to 11 SEP 01 or later and served on active duty. [Source: NAUS Update 20 Dec 06 ++]


CRSC UPDATE 35: This annual open season election period will be from 1 JAN through 31 JAN 07 and allows the retiree to choose which payment is preferred. Federal law states that you can receive CRDP or CRSC; not both. Beginning in late December, eligible retirees were mailed a CRDP/CRSC Open Season Election Form. The retiree needs to return the form only if making a change from CRDP to CRSC or vice versa. If the retiree prefers to keep things the way they are, they should do nothing. The payments the retiree now receives will continue uninterrupted. To help the retiree make a more informed decision, the form will include a comparison of the CRSC and CRDP entitlement amounts as well as information about the collection actions and taxes to which each type of payment is subject. If the retiree wants to change from CRDP to CRSC, or vice versa, the form must be postmarked by 31 JAN 07. If the form is dated after this date, it will not be processed and the current payments will continue uninterrupted. The change in the payment will be effective with the first business day of FEB 07. Due to a 30-day processing timeframe, the retiree may not receive their first payment until the first business day of March 2007 including a retroactive adjustment for the payment that would have been paid on the first business day of February. The retiree’s election will remain in effect unless changed from CRDP to CRSC or vice versa in a subsequent annual open season. [Source: www.dod.mil/dfas/retiredpay/concurrentr ... dcrsc.html Jan 07]


BREAST CANCER UPDATE 01: Col. (Dr.) George Peoples, Brooke Army Medical Center surgeon and principal investigator for a six-year breast cancer vaccination study, released the results of the study 14 DEC at the San Antonio Breast Cancer Symposium. Out of the 186 patients in the study, the recurrence rate as of last month was 16% in the control group and 8% for the vaccinated group—a 50% reduction in recurrence. The vaccine targets HER2/neu, a protein that plays a role in cell growth. In larger amounts, the protein accelerates tumor growth, which can lead to a poorer prognosis for women with breast cancer. If the Food and Drug Administration agrees with Doctor Peoples, the next step will be Phase 3 testing, which will include multiple sites and a much larger pool of participants. That phase would be conducted by a commercial company called Apthera. [Source: Armed Forces News 29 Dec 06 ++]


VA CANCER LAWSUIT: The federal government agreed to pay $500,000 to settle the first of seven federal lawsuits brought by the widows of veterans who died in a corrupt cancer research program at Stratton VA Medical Center Hospital. The six other widows, who still have lawsuits pending against the U.S. Department of Veterans Affairs, are finding the government less willing to admit their husbands were used as guinea pigs in the tainted drug studies. The Justice Department has not agreed to settle the remaining cases, in part because it's never been determined or publicly disclosed that more than one veteran died as a result of the corruption. Attorneys in the case said the government's position has been that the men had advanced stages of cancer, so it is impossible to determine what killed them. But in at least one case it was clear, and Justice Department lawyers recently settled with the family of that victim, James J. DiGeorgio, a 71-year-old Air Force veteran from Brunswick who died at Stratton in JUN 01.

The settlement comes a little more than a year after a former hospital researcher, Paul H. Kornak, was sentenced to nearly six years in prison for his role in the scandal. VA officials and federal prosecutors have portrayed Kornak as an out-of-control researcher who forged medical records to push cancer-stricken patients into drug studies that allegedly paid the hospital thousands of dollars. But attorneys for the families and people familiar with the hospital's operation contend the corruption was widespread and Kornak was following orders from oncology doctors. At his sentencing, Kornak said he was a scapegoat. His conviction exposed deep problems at the hospital, where he masqueraded as a doctor despite flunking out of medical school, and was hired despite a felony criminal conviction in Pennsylvania in 1992 for forging a medical license application. The scandal triggered nationwide efforts by Congress to reform the Department of Veterans Affairs' hiring practices and embattled research programs.

Many widows have dismissed the government's assertions that Kornak acted alone. Attorneys for the widows recently obtained permission to depose Kornak at an Ohio prison, giving the public an opportunity to hear Kornak's story, contained in sealed files kept by the Justice Department, which has declined to prosecute anyone else. An assistant U.S. attorney in Massachusetts declined comment on the settlement last week, saying it has not been publicly filed. The criminal investigation was handled by the U.S. attorney's office in Albany. Many of the remaining widows have said the litigation is not about money. They contend it's about getting answers to why their husbands were used as experiments and in making sure it doesn't happen again. Their attorney said the quandary in their cases is convincing the government that it is indefensible to argue the men would have died anyway because they all had advanced cancer. Kornak admitted forging their medical backgrounds so they could be enrolled in the drug studies, where they were given drugs that may have worsened their conditions and hastened their deaths. Hospital officials have denied a widespread coverup and instead placed blame on Kornak, who pleaded guilty to federal charges of negligent homicide and falsifying medical records.

Kornak posed as a doctor at Stratton, including carrying the title "M.D." on his VA-issued business cards and being introduced to patients as "doctor" even though he never finished medical school. His supervisors knew about his lack of credentials. In all, Kornak is accused of undermining at least four major research studies involving dozens of veterans and hundreds of thousands of dollars. The hospital earned thousands of dollars for each patient enrolled in the programs, in which pharmaceutical companies tested new drugs on cancer patients to obtain approval for them from the Food and Drug Administration. Over the summer, attorneys for the plaintiffs obtained permission from a federal magistrate to depose Kornak at Elkton Federal Correctional Institution in Ohio. At his sentencing in NOV 05, Kornak apologized for his crimes but told a judge he was "used" by the hospital's former cancer research director, James A. Holland, who was fired along with Kornak shortly after the scandal broke about four years ago. No one else, including Holland, has been charged in the case. Holland now works in a cancer research program at a Georgia hospital. A federal review of his research credentials is pending. [Source: Albany Times Union Brendan Lyons article 5 Dec 06 ++]


GULF WAR PRESUMPTIVE DISEASE UPDATE 01: VA officials announced 18 DEC that Veterans of the 1991 Persian Gulf War who have disabilities from undiagnosed illnesses will continue to qualify for veterans' benefits and health care until 31 DEC 11. In an item published in the Federal Register, VA officials issued an interim policy expected to be final in 60 days that continues a policy started shortly after the Operation Desert Storm. The current policy of presuming that undiagnosed illnesses are connected to service began in 1994 in the wake of wide complaints about mysterious illnesses that acquired the collective name of Gulf War syndrome. Researchers have not been able to isolate a single illness or disease as a cause, but the VA, under pressure from Congress, has assumed that those who served in the combat theater who have chronic disabilities resulting from undiagnosed illnesses could receive disability benefits and be afforded other veterans’ rights. Initially, undiagnosed illnesses were covered for two years. But that time limit was extended several times, with the secretary of veterans’ affairs getting discretion to set the period for presumptive coverage. Prior to the VA’s 18 DEC announcement, the latest cutoff for undiagnosed illnesses among Gulf War veterans had been 31 DEC 06.

As is standard with government regulations, the VA will be accepting comment on the change until 16 FEB, when a final rule will be prepared. VA officials said in the notice that they are pushing for the extension “to provide consistency in VA adjudication policy and preserve certain rights afforded to Persian Gulf War veterans and ensure fairness for current and future Persian Gulf War veterans.” By future veterans, they are referring to people still on active duty who served in the Gulf War, who would be covered by VA benefits after separation. Research into Gulf War syndrome continues, VA officials said, with a project under way to see how deployment-related stress can affect long-term health. An ongoing study is not limited to veterans of the Persian Gulf War deployments of the early 1990s but also includes veterans of current conflicts, such as Operation Iraqi Freedom, occurring in part, within the Southwest Asia theater of operations. [Source: Military Times Rick Maze article 18 Dec 06 ++]


PERSONALITY DISORDER DISCHARGE: During Vietnam the use of the Personality Disorder (PD) discharge was common. Thousands of veterans still have the label "Personality Disorder, Unspecified" on their discharge papers. For those who received them the military claimed that the soldier brought the PD with them and that it had nothing to do with combat stress. Therefore, a PD was considered non-treatable and non-compensable by the VA since it was a pre-existing condition. Today, a personality disorder is still considered a pre-existing condition with non-compensable disability benefits but VA can provide treatment. A personality disorder assessment allows for quick honorable discharge but tags veterans with a label that is hard to remove. Also, those receiving it must repay part of their re-enlistment bonus based on the portion of time they did not serve. Though accurate for some, experts say, the personality disorder label has been used as a catch-all diagnosis to discharge personnel who may no longer meet military standards, are engaging in problematic behavior or suffer from more serious mental disorders. For returning veterans, the diagnosis can make it harder to obtain adequate mental health treatment if they must first show they have another problem, such as post-traumatic stress disorder (PTSD). VA disability benefits can cover as much as $2,000 a month for a veteran found to be disabled by PTSD.

Military records show that since 2003, 4,092 Army soldiers and another 11,296 men and women in other branches of the armed services have been discharged after being diagnosed with the disorder. A government worker at Fort Carson in Colorado who has access to personnel records and who spoke on condition on anonymity for fear of losing his job said Army psychologists there have diagnosed some soldiers with a personality disorder after a single evaluation lasting 10 minutes to 20 minutes. Several soldiers at Fort Carson interviewed by Cox Newspapers said they have been given or offered the diagnosis in a handful of meetings lasting less than an hour. The timing of many of the discharges, in some cases within months after soldiers have returned, appears to violate the military's rules, which say a personality disorder diagnosis should not be made if a soldier is experiencing combat exhaustion or other acute situational maladjustments. Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs, said he is unaware of any related discharges within three months of a deployment and has "full confidence in DoD’s medical personnel in their decision-making." Nonetheless, he has asked the Army surgeon general to review complaints of inadequate mental health care at Fort Carson. He said it was begun before Senators Barbara Boxer (D-CA), Barack Obama (D-IL) and Republican Sen. Kit Bond (R-MO) wrote a letter asking him to investigate such concerns after they were raised in a broadcast on National Public Radio.

A personality order is defined as a deeply ingrained, abnormal behavior pattern that appears during childhood or adolescence. Critics say that many returning soldiers are tagged with that label actually have PTSD stemming from their combat experiences. Some of the anti-social traits of PTSD, such as anger and occasionally strong emotions, could be mistaken for a personality disorder. Recommending a discharge on the basis of a personality disorder is a faster process than discharging someone for mental health problems of another nature. It requires only one military psychologist's finding, and the paperwork usually takes only a couple of days. A diagnosis of post-traumatic stress disorder, on the other hand, must be handled by a medical review board, which must confirm that the condition stems from combat, a process that usually takes several months. Dr. Joseph Bobrow, a former chief psychologist at Kaiser Hospital in San Francisco, said a personality disorder is one of the most difficult diagnoses to confirm, particularly when there is cumulative trauma. If a soldier complains of mental problems after returning from combat, a personality disorder is supposed to be ruled out for an unspecified amount of time because some of its characteristics, such as problems interacting with others and substance abuse, overlap with some of the hallmarks of post-traumatic stress disorder.

Determination of personality disorder in each services medical guidelines is as follows:
- Army: Requires a psychologist's findings.
- Navy: Vague language; not clear that determination must come from a mental health professional or command.
- Marines: Similar to Army rules but two forms of documents required. Same doctor must render findings on a Marine's impairment and on written nonmedical evidence to show examples of inability to function in the corps.
- Air Force: Alone in requiring oversight where commanders fail to act on appropriate findings. Commander must have decision reviewed by discharge authority.
[Source: WASHINGTON BUREAU Anne Usher article & http://vawatchdog.org 24 Dec 06 ++]


IMMIGRANT RECRUITMENT: According to Pentagon officials the armed forces, already struggling to meet recruiting goals, are considering:
- Expanding the number of non-citizens in the ranks.
- Disputed proposals to open recruiting stations overseas.
- Putting more immigrants on a faster track to US citizenship if they volunteer.

Foreign citizens serving in the US military is a highly charged issue, which could expose the Pentagon to criticism that it is essentially using mercenaries to defend the country. Other analysts voice concern that a large contingent of non-citizens under arms could jeopardize national security or reflect badly on Americans’ willingness to serve in uniform. The idea of signing up foreigners who are seeking US citizenship is gaining traction as a way to address a critical need for the Pentagon, while fully absorbing some of the roughly one million immigrants that enter the United States legally each year. The proposal to induct more non-citizens, which is still largely on the drawing board, has to clear a number of hurdles. So far, the Pentagon has been quiet about specifics—including who would be eligible to join, where the recruiting stations would be, and what the minimum standards might involve, including English proficiency.

In the meantime, the Pentagon and immigration authorities have expanded a program that accelerates citizenship for legal residents who volunteer for the military. According to a military affairs analyst, with severe manpower strains because of the wars in Iraq and Afghanistan and a mandate to expand the overall size of the military the Pentagon is under pressure to consider a variety of proposals involving foreign recruits. Already, the Army and the Immigration and Customs Enforcement division of the Department of Homeland Security have made it easier for green-card holders who do enlist to get their citizenship. According to military statistics, since 911 the number of immigrants in uniform who have become US citizens has increased from 750 in 2001 to almost 4,600 last year. Other Army officials, who asked not to be identified, said personnel officials are working with Congress and other parts of the government to test the feasibility of going beyond US borders to recruit soldiers and Marines. Present Pentagon policy stipulates that only immigrants legally residing in the United States are eligible to enlist. There are currently about 30,000 non-citizens who serve in the US armed forces, making up about 2% of the active-duty force, according to statistics from the military and the Council on Foreign Relations. A recent change in US law gives the Pentagon authority to bring immigrants to the United States if it determines it is vital to national security. So far, the Pentagon has not taken advantage of it, but the calls are growing to take use the new authority.

Just 15 years ago, during the Gulf War, the Army had a total of about 730,000 active-duty soldiers, amounting to about one American in 350 who were serving in the active-duty Army. Today, with 300 million Americans and about 500,000 active-duty soldiers, only about one American in 600 is an active-duty soldier. The country has relied before on sizable numbers of non-citizens to serve in the military. In the Revolutionary War, German and French soldiers served alongside the colonists, and locals were recruited into US ranks to fight insurgents in the Philippines. Other nations have recruited foreign citizens: In France, the famed Foreign Legion relies on about 8,000 non-citizens; Nepalese soldiers called Gurkhas have fought and died with British Army forces for two centuries; and the Swiss Guard, which protects the Vatican, consists of troops who hail from many nations. The number of non-citizens the armed forces have now is relatively small by historical standards. In the 19th century, when the foreign-born population of the United States was much higher, so was the percentage of foreigners serving in the military. During the Civil War, at least 20% of Union soldiers were immigrants, and many of them had just stepped off the boat before donning a blue uniform. There were even entire units, like the 15th Wisconsin Volunteer Infantry [the Scandinavian Regiment] and General Louis Blenker’s German Division, where English was hardly spoken. Officially, the military remains confident that it can meet recruiting goals—no matter how large the military is increased—without having to rely on foreigners. [Source: Boston Globe Bryan Bender article 26 Dec 06 ++]


AF RETIREE COUNCIL UPDATE 01: The Air Force Retiree Council meets once a year and can be reached at HQ AFPC/CCU, 550 C Street West, Suite 11, Randolph AFB TX 78150-4713 year round. After each meeting they recommend actions on retiree matters directly to the USAF/CC. Following are two agenda items under review for submission to the next Retiree Council Conference in 2007. Their approval would help alleviate the disparity in Tricare benefits between retiree residing overseas and those residing in the states:

1. TMOP - Tricare Mail Order Pharmacy (TMOP) prescriptions are authorized to be shipped via APO/FPO if the prescription is written by a U.S. certified physician (with a DEA license). However, the Philippines/other countries without certified physicians cannot receive this service. TMOP users are able to save 66% on co-payments through TMOP because prescriptions filled by mail order provide a 90 day supply versus 30 days in the retail network. The government saves on each prescription not filled in the retail network because of the discount they are able to negotiate with suppliers for bulk purchases. Thus, use of a Military Treatment Facility (MTF) or TMOP as a source of medications is more cost efficient for both patients and DoD. Japan has MTFs, while the Philippines/Thailand do not have MTF facilities. It is recommended that authorized Tricare providers overseas listed on the Tricare official web sites be allowed to write prescriptions for Tricare members. This would enable members with APO/FPO services to fully utilize the Tricare Pharmacy. In addition, all refill prescriptions could be filled via the TRICARE Pharmacy on a mandatory basis if the member has APO/FPO services available or lacks a MTF. If prescription refills via TMOP or MTF facilities were made mandatory it would eliminate the present fraudulent practice of Tricare members obtaining free pharmaceutical services from local Tricare providers who over bill Tricare for their services. The only exception should be for refrigerated drugs which must be obtained locally. Considering the convenience of mail order through Express-Scripts and the generic drug lower costs this would produce substantial savings.
2. Tricare for Life (TFL). Within the United States/Territories all TFL recipients pay $88.50 per month (next year $93.50) for Medicare Part B and Medicare becomes the first payer for medical services received and Tricare the second payer. The result is that all authorized medical services in the United States/Territories are basically free to TFL recipients if specifically covered. When a TFL recipient resides overseas, Tricare becomes the primary payer and their TFL status reverts back to Tricare Standard. Therefore they must pay the deductible plus 25% of all medical care until the cost exceeds the catastrophic cap. Thus, a military retiree living outside the U.S. could expend $3,000.00 more for medical care per year than his fellow retiree in the United States. This removes any benefit of Medicare to the overseas retiree. It has been recommend that when TFL military retirees file Tricare claims overseas their Tricare status revert to paid up catastrophic cap status. This would compensate the expense per family that is being paid for Medicare Part B, which cannot be applied to TFL while overseas. This would also balance the benefits received by TFL retirees in the U.S. to their overseas counterparts.
3. Tricare Fraud. Tricare fraud information should receive the widest dissemination to all retiree activity geographical areas with emphasis on what is to be observed and scrutinized. The Code of Federal Regulations (32 CFR, 199.9) provides examples of fraudulent/abusive practices that are prohibited and should be reported. Millions of dollars of tax payer monies have been lost due to these fraudulent practices and raises the question of whether TRICARE will have to raise rates for it’s services or discontinue contract services. Retiree Activity Offices throughout the world should report fraudulent/abusive activities whenever they are recognized overseas.

Retirees are encouraged to submit issues of concern along with corrective action recommendations to their Air Force Retiree Council representatives. These can be located via the Air Force Personnel Center web site http://ask.afpc.randolph.af.mil by clicking on the Retiree/Veteran logo and then “Air Force Retiree Council” in the Retiree Military Services box. There are 15 designated Council Areas. Area XIV covers the Pacific region where contact information can be obtained for the area Council representative and associated Retiree Activities Offices in that area. [Source: AF Retiree Council Issues msg 21 Dec 06 ++]


SSA COLA: The Social Security Cost of Living Adjustment (COLA), intended to help seniors keep up with rising inflation, will be completely eliminated for an estimated 9.9 million seniors due solely to disproportionately rising increases in Medicare Part B premiums by the year 2012, according to a new study released today by TREA Senior Citizens League (TSCL). As a result, the study finds that as many as 20% of those receiving Social Security today will receive monthly checks that fail to increase year-to-year to help keep pace with inflation, as it has for decades. The study also shows that the effects of Medicare Part B (which pays for doctors' visits, medical tests and outpatient hospital care) on the COLA will disproportionately impact lower income seniors. Women will be more negatively affected than men, since women often receive smaller Social Security checks.

Although lower-income seniors would be affected first, seniors with average benefits today would also be affected by 2016. As an example, the COLA has increased less than 14% over the past 5 years, but Medicare Part B premiums have skyrocketed by almost 60% during the same time span. These trends will continue to deteriorate with each passing year, leaving poorer seniors on their own to pay for all other inflationary expenses such as increases in the cost of energy, food, and transportation. Most seniors have Part B premiums deducted from their Social Security checks. If the Medicare premium increase to Part B is higher than the COLA increase, seniors are automatically protected by law from having their checks reduced. However, even though seniors will have their checks remain at the same dollar value year after year, their purchasing power will be significantly diminished by rising costs. A majority of the 48 million Americans aged 65 and over who receive a Social Security check depend on it for at least 50% of their total income, and one in three seniors – roughly 16 million Americans – rely on it for 90% or more of their income. As many as 12% of seniors are already living below the poverty line.

Currently, the government calculates the COLA for seniors based on a consumer price index (CPI) that tracks the spending habits of young, urban workers. This is a relatively slow-rising index. The problem with using the CPI is that younger workers have different spending habits than seniors, who must use a far greater percentage of their income on healthcare and prescription drugs, both of which rise many times faster than overall inflation. TSCL advocates for the use of the Consumer Price Index for Elderly Consumers (CPI-E) vice the CPI in determining the COLA. This index more accurately tracks the buying habits of seniors. Using the CPI-E, a senior who retired in 1984 with average benefits would today be receiving $70 more per month or $843 more this year. More than 100 members of Congress have signed on to H.R. 3601, a piece of legislation intended to use the CPI-E to calculate the COLA. Without legislation the Congressional Budget Office's projects that Medicare Part B premium increases will completely offset SSA COLA by 2012. [Source: The Social Security & Medicare Advisor DEC/JAN 07 issue]


SOCIAL SECURITY REFORM UPDATE 01: Although the public heard little about Social Security reform prior to the elections, some government experts nevertheless, were quietly hard at work. The GAO released a report that examined the implications of using different methods of indexing Social Security. Indexing is used in the calculation of initial retirement benefits, to annually adjust the maximum amount of wages subject to taxation, and in calculating the annual COLA. Many recent Social Security reform proposals have proposed modifications to the indexing currently used. The proposed modifications would generally cut initial retirement benefits for persons retiring in the future. But some proposals would result in COLAs that grow even more slowly than they do now, thus cutting the benefits of current retirees. Some economists, including retired Federal Reserve Chairman Alan Greenspan, argue that COLAs should be cut. He said the Consumer Price Index that the government uses to calculate COLAs overstates inflation and thus overpays seniors. The overwhelming majority of TREA’s Senior Citizen League (TSCL) 1.2 million members and supporters, however, believe the COLA is too low, and does not accurately reflect their health care costs.

Over the past five years for example, Medicare Part B premiums alone grew 60% while COLAs grew just 13.6%. Seniors would receive a more adequate COLA if the government were to calculate it using an index that more accurately reflects the portion of income that seniors spend on health care. The federal government has tracked such an index, the Consumer Price Index for the Elderly (CPI-E), for more than 23 years. In one case, a senior who retired with an average benefit of $460 in 1984 would have received $10,290 more over her retirement had COLAs been calculated using the CPI-E. The higher COLAs are like interest and grow bigger over time. Today, when that retiree is 85 and more likely to have costly health problems, she would be receiving a monthly benefit that's $70 more had the CPI-E been used over the course of her retirement. TSCL continues to lobby and build support for legislation that would provide a more fair and adequate COLA by using the CPI-E to calculate the annual increase. [Source: The Social Security & Medicare Advisor DEC/JAN 07 issue]


COLA 2008: On 15 DEC, the Bureau of Labor Statistics announced the NOV 06 monthly Consumer Price Index (CPI), which is the metric used to calculate the annual cost-of-living adjustment (COLA) for military retired pay, VA disability compensation, survivor annuities, and Social Security. The October downtrend in the Consumer Price Index continued in November, dropping another 0.1 % for a cumulative 1.2% decline for FY2007 - mainly due to lower energy prices. In the event the CPI was to have a net decline for the year the law protects retirees from having a negative COLA.

Most military retirees, SBP annuitants, and disabled veterans received a 3.3% COLA 2007 effective on 1 DEC 06. It will appear in the 2 JAN checks. Servicemembers who retired during calendar year 2006 will receive a somewhat smaller, partial COLA for the year of their retirement, because they already received a January military pay raise (which also raised their 2007 retired pay). If you retired in 2006, your COLA is calculated as follows:
- Members who entered service before 8 SEP 80, and who retired on or after 1 JAN 06, will receive a 2.8% COLA.
- Members who entered service on or after 8 SEP 80 (whose retired pay is calculated on their highest 36 months' basic pay rather than final basic pay), and retired between 1 JAN 06, and 30 DEP 06, will receive a partial COLA based on the calendar quarter in which they retired. Jan-Mar retirees will receive 2.8%; Apr-Jun retirees, 2.4%; and Jul-Sep retirees 0.6%. Those who retire after 1 OCT 06, (fourth quarter) will see no COLA this year.
- Members retired during 2006 will receive full-year COLAs in future years.
[Source: MOAA Legislative Action Center 15 Dec 06]


VA DATA BREACH UPDATE 28: Armed with a new number on data breaches, the Cyber Security Industry Alliance (CSIA) is calling on the 110th Congress to enact comprehensive legislation to secure sensitive personal information. The number of Americans whose personal data has been compromised has reached a new milestone --100 million, or more than one-third of the population, according to the Privacy Rights Clearinghouse. In testimony on Capitol Hill during hearings this year the CEO of Vontu, a data-protection company said he did not think the news is that it hit 100 million, but rather why we haven't passed legislation to do something about it. The executive director of CSIA Paul Kurtz said the time is now to establish a single standard for securing citizens' personal information, regardless of whether it is housed within federal, state or local government, private sector or educational institutions. Kurtz will be leaving CSIA at the end of the month for a private consulting company. Liz Gasster, will become executive director and will be the one to continue the lobbying effort next year for a comprehensive data-security bill with five key elements:

- It is critical to protect data wherever it sits -- whether that is a financial institution or a government agency.
- Security standards goals should prevent data loss in the first place, not just notifying victims after breaches.
- New rules should not result in double regulation for the financial or health industries.
- Any legislated federal law should pre-empt state regulations so places do not face two potentially different laws. And finally, she said,
- Businesses and government agencies should be freed from liability if they do take precautions like encryption.

Gasster commented she is even more disappointed by what she considers a bad data-protection measure that was hastily inserted into an omnibus bill for the Veterans Administration. She said the bill has two big problems -- the broad definitions of personal information and data breaches. "It includes any information about an individual, including just the name alone," Gasster said, noting that a telephone book would violate the new law, which just applies to the Veterans Administration. She said it should define personal data based on a combination of information that could be useful to thieves. [Source: GOVEXEC.com Daily Briefing 15 Dec 06 ++]


FEDERAL CONSOLIDATED AUDIT: As anticipated, the federal government flunked its Government Accountability Office (GAO) audit for fiscal 2006, with $797 billion, or 53%, of its reported assets and an additional $790 billion, or %, of net costs, on the balance sheets of five agencies that could not be fully audited. This marks the 10th year in a row in which the government's consolidated audit statement received a judgment of "no comment" from auditors. The Defense, State and Homeland Security departments, as well as NASA, received disclaimers on their 2006 audits. The Energy Department, which was only partially auditable due to a disclaimer in 2005, earned a qualified opinion -- a step up from no opinion but still short of a clean bill of health. Contributing to the problems at those agencies is the difficulty of valuing some of the complex, one-of-a-kind systems they own. After new accounting rules for property went into effect in 2003, about $325.1 billion in military equipment appeared on the books for the first time, according to a Treasury Department analysis. In fiscal 2006, the government's total reported assets increased $48.6 billion, to $1.5 trillion.

As it did last year, the GAO cited three major shortcomings: financial management problems at the Defense Department, an inability to account for and to reconcile balances that cross agency lines, and an ineffective process for preparing financial statements. The consolidated report also showed that the Transportation Department and Smithsonian earned qualified opinions on their audits, indicating significant problems. In a letter reporting the audit results, Comptroller General David M. Walker called for the adoption of another report in the annual arsenal -- a new statement that would provide "a long-term look at the sustainability of current social insurance and other federal programs." Walker has spent the past 15 months crisscrossing the country in what he has called a "fiscal wake-up tour" to speak about the problems the nation faces with its social insurance programs. Fiscal 2006 was the first year for which a statement of social insurance, which covers outlays for Social Security, Medicare, railroad retirement and black lung disease benefits, was considered a key financial statement. The statement showed projected outlays for those programs exceeding revenues by about $39 trillion over the next 75 years, Walker said. Combined with other long-term projected expenses, he said, the total government exposure was about $50 trillion at the end of fiscal 2006, up $4 trillion from the previous year and up $20 trillion since 2000. [Source: GOVEXEC.com Daily Briefing 15 Dec 06 ++]


ARMED SERVICES COMMITTEE: The Committee on Armed Services is a standing committee of both the House and Senate of the United States. The Senate empowered with legislative oversight of the nation's military, including the Department of Defense, military research and development, nuclear energy (as pertaining to national security), benefits for members of the military, the Selective Service System and other matters related to defense policy. The House Armed Services Committee is a standing committee of of the lower house of Congress which is responsible for funding and oversight of the Department of Defense (DOD) and the United States armed forces, as well as substantial portions of the Department of Energy. The Armed Services Committee was created as a result of the Legislative Reorganization Act of 1946 following US victory in the Second World War. It merged the responsibilities of the Senate Naval Affairs Committee (established in 1816) and the Senate Military Affairs Committee (also established in 1816.)

House Democrats have named eight new members to their armed services committee, including two high-profile veterans who won in the November elections. One is Rep.-elect Joe Sestak of Wallingford, Pa. Sestak who will become the junior Democrat on the armed services committee in January. Sestak will become the highest-ranking retired military officer ever to serve in the House. He is a retired Navy vice admiral whose military service ended in 2005 after he was relieved as deputy chief of naval operations for warfare requirements and programs by Adm. Mike Mullen shortly after Mullen became chief of naval operations. During the Clinton administration, Sestak was assigned as defense policy director on the National Security Council, and he also was the Navy director for the Quadrennial Defense Review. Sestak said he will use his armed services committee post to push for setting a “date certain” for withdrawing U.S. troops from Iraq. The Iraq war “does not have a military solution,” he said in a 14 DEC interview. He said he hopes that under Democratic control, the armed services committee will exercise rigorous oversight of President Bush’s Iraq policies. The congressional district Sestak represents has no major military bases but is home to two defense contractors. His experience could be a boon to the committee as its new chairman, Rep. Ike Skelton of Missouri, tightens oversight and investigations of current and past Pentagon plans.

Other new committee members are:

• Rep.-elect Patrick Murphy of Bristol Township, Pa., an Iraq war veteran who is still in the Army Reserve, defeated Republican Michael Fitzpatrick. Murphy, a former West Point professor and former military criminal prosecutor, comes from a military family. His father served in the Navy, two of his uncles served in the Army and his brother, J.J., is an Air Force Reserve officer. The incoming congressman deployed to Bosnia in 2002 and Iraq in 2003.

• Rep.-elect Nancy Boyda, a chemist from Roseville, Kan., defeated Republican incumbent Jim Ryun, a five-term lawmaker who has been on the armed services committee. Boyda’s congressional district includes Fort Riley and Fort Leavenworth.

• Rep.-elect Brad Ellsworth of Evansville, Ind., a former county sheriff, defeated Republican John Hostettler, a six-term incumbent. Ellsworth’s district includes the Crane Naval Surface Weapons Center, which has few military personnel but almost 4,000 federal civilians.

• Rep.-elect Gabrielle Giffords is a businesswoman and former member of the Arizona state legislature from Tucson. She won an open seat caused by the retirement of Republican Rep. Jim Kolbe, who was not on the armed services committee. Her congressional district includes Fort Huachuca and Davis-Monthan Air Force Base.

• Rep.-elect Kirsten Gillibrand of Greenport, N.Y., a former Department of Housing and Urban Development attorney, defeated Republican Rep. John Sweeney to represent a congressional district with no major military bases. Sweeney has been a member of the powerful House Appropriations Committee, his only assignment, but positions on that committee rarely go to freshmen.

• Rep.-elect Hank Johnson of Lithonia, Ga. defeated incumbent Democrat Cynthia McKinney, an armed services committee member, in the primary and went on to win the seat in the November general election. Johnson is a former county judge whose district in the Atlanta suburbs has no major bases or defense contractors.

• Rep.-elect Joe Courtney of Vernon, Conn., defeated three-term Republican incumbent Rob Simmons. Simmons is a retired Army officer, while Courtney, a former lawyer and state legislator, never served. His congressional district includes New London Naval Submarine Base. The Courtney-Simmons race was one of the closest in Congress, with Courtney winning by fewer than 100 votes in a final recount.
[Source: NavyTimes.com Rick Maze article 15 Dec 06 ++]


VA PRESCRIPTION POLICY UPDATE 01: The Department of Veterans Affairs is helping some veterans get generic prescriptions for half the VA price. Veterans in health care priority categories 4 through 8 normally must make an $8 co-pay for drugs from the VA that might be available at the $4 rate being offered by Wal-Mart Stores Inc., and Target Corp. VA deputy undersecretary William Feeley has told VA providers they can write prescriptions that can be filled at any private-sector pharmacy. They cannot transfer the veterans’ prescriptions directly to a private-sector pharmacy, but they can write new prescriptions if they meet state requirements and cancel existing VA prescriptions. For the $4 drugs available at Wal-Mart, visit http://i.walmart.com/i/if/hmp/fusion/ge ... uglist.pdf, and for the Target drugs go to http://sites.target.com/images/pharmacy ... m_list.pdf. [Source: Armed Forces News 15 Dec 06]


FTC FUNERAL RULE: The Federal Trade Commission has announced the results of enforcement sweeps of more than 100 funeral homes in seven states to assess their compliance with the FTC's Funeral Rule. During the past year, undercover visits in California, Georgia, New York, Ohio, Oklahoma, Oregon and Texas found violations at 12 funeral homes. Faced with the prospect of FTC lawsuits that could lead to a court order and civil penalties, facilities in violation elected to participate in the Funeral Rule Offenders Program (FROP) which is a 5-year monitoring program. The FTC also warned 32 other funeral homes to correct technical violations. In its enforcement sweeps, the FTC has benefited from assistance from AARP and several state Attorneys General. The rule, which was established to counter widespread fraud and deception, took effect in 1984 and was revised in 1994. Its aim is to help people select what they want and to pay for only what they select. Regulation is needed because survivors of the deceased are emotionally vulnerable and typically have little time to do comparison shopping. Under the rule:

**You have the right to choose the funeral goods and services you want (with some exceptions).
**The funeral provider must provide a General Price List (GPL) that states your right to choose what you want in writing.
**If state or local law requires you to buy any particular good or service, the funeral provider must disclose it on the price list with a reference to the specific law.
**The funeral provider cannot charge a fee or refuse to handle a casket or urn purchased elsewhere.
**Funeral providers who offer cremation must make alternative containers available.
**You can't be charged for embalming that your family didn't authorize, unless it's required by state law.

Since the FROP was established in 1996, the FTC has investigated than 1,850 funeral homes in 33 states and referred about 240 to the FROP. Their new brochure, “Paying Final Respects: Your Rights When Buying Funeral Goods & Services,” includes information about the Funeral Rule, consumers’ rights, cost considerations, resources to help consumers plan funerals for themselves and others, and suggestions for resolving any problems they may have with funeral services they obtain. The brochure is available at http://www.ftc.gov/bcp/edu/pubs/consume ... /pro26.htm. The FTC also has produced a more comprehensive pamphlet, “Funerals: A Consumer Guide,” which is available at http://www.ftc.gov/bcp/conline/pubs/ser ... uneral.pdf. The FTC works for consumers to prevent fraudulent, deceptive, and unfair business practices in the marketplace and to provide information to help consumers spot, stop, and avoid them. To file a complaint in English or Spanish (bilingual counselors are available to take complaints), or to get free information on any of 150 consumer topics, 1(877) 382-4357, or use the complaint form at www.ftc.gov. The FTC enters Internet, telemarketing, identity theft, and other fraud-related complaints into Consumer Sentinel, a secure, online database available to thousands of civil and criminal law enforcement agencies in the U.S. and abroad. [Source: Consumer Health Digest 12 Dec 06 ++]


VA COMPENSATION RATES (DIC): As required by the Veterans' Compensation Cost-of-Living Adjustment Act of 2007 the DVA has given notice of adjustments in certain benefit rates. These adjustments effective 1 DEC 06 affect the dependency and indemnity compensation (DIC) programs as indicated below:

Veteran's Death Was On or After January 1, 1993: $1067 per month.
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Veteran's Death Was Before January 1, 1993
E-1 through E-6 $1067 (Footnote f. for E1 thru E-6 + Footnote a. for E-3)
E-7 $1,104 : E-8 $1,056 : E-9 $1,165 : E-9 $1,215 (Footnote d. for E-7 thru E-9)
E-9 $1312 (Footnote b.)
W-1 $1,128 : W-2 $1,172 : W-3 $1,207 : W-4 $1,276 (Footnote d. for W-7 thru W-4)
0-1 $1,128 : 0-2 $1,165 : 0-3 $1,246 (Footnote d. for O-1 thru O-3)
0-4 $1,319 : 0-5 $1,452 : 0-6 $1,637 : 0-7 $1,768 : 0-8 $1,941 : 0-9 $2,076 : 0-10 $2276
0-10 $2,443 (Footnote c.)

Footnotes:
a. Surviving spouse of Aviation Cadet or other service not covered by this table is paid the DIC rate for enlisted E-3 under 34.
b. Veteran who served as Sgt Major of the Army or Marine Corps, Senior Enlisted Advisor of the Navy, Chief Master Sgt of the Air Force, or Master Chief Petty Officer of the Coast Guard.
c. Veteran who served as Chairman, Joint Chiefs of Staff, service Chief of Staff, Chief of Naval Operations or Commandant of the US Marine Corps)
d. Base rate is $1,295 if vet rated totally disabled 8 continuous years prior to death and surviving spouse was married to vet those same 8 years.

******************************************
DIC payments regardless of when the death occurred:
Add the following additional allowances as applicable:
* $265 when the surviving spouse is entitled to Aid and Attendance
* $126 when the surviving spouse is House Bound
* $265 for each child under age 18 (DIC apportionment rates approved by the Under Secretary for Benefits will be the additional allowance received for each child.)
* $228 if the veteran was rated as totally disabled 8 continuous years prior to death and the surviving spouse was married to the veteran those same 8 years.

******************************************
Children’s Rates:
1.) If the Surviving Spouse is also entitled the additional separate award for each child over 18 is $225 for school child and $452 for helpless child.
2.) If No Surviving Spouse is entitled the total payment for the number of children indicated is: $453 for one, $649 for two, $846 for three and for each additional child add $162
3.) For each helpless child over 18 add $265

******************************************
Parent(s) DIC Rates:
Payments for parents are based on parent’s income, marital status, and with whom they are living. The greater their income the smaller their entitlement. Separate tables based on these factors are available on the VA website www.vba.va.gov.
[Source: www.vba.va.gov/bln/21/Rates/ Dec 06 ++]


TRICARE MEETING w/COALITION LEADERS: On 7 DEC, leaders from military associations met with Tricare's Deputy Director and Program Executive Officer Major General Elder Granger, USA,. General Granger expressed his intent to establish a quarterly meeting with association representatives to ensure direct feedback for leadership, as well as an opportunity to inform associations of Tricare’s efforts to support beneficiaries. Updates from the discussion included:

- Planned expansion of the TRICARE Retiree Dental Program to overseas locations, starting in 2008.
- Implementation of updated coverage for TRICARE For Life beneficiaries whose doctors have opted out of Medicare. (In general, TFL will pay the second-payer amount, as if the doctor accepted Medicare. In certain cases in rural or remote areas where access to medical care is limited, TFL will act as first payer.)
- An expression of appreciation to the associations for helping to publicize the advantages of the TRICARE mail-order pharmacy.
- Plans and progress for special disease management programs to assist beneficiaries with asthma or congestive heart failure.
- Plans for a special task force to examine needs for patients with autism.
- Ongoing outreach efforts to encourage more providers to accept new TRICARE Standard patients.
[Source: MOAA Update 12 Dec 06 ++]


VA FACILITY EXPANSION: It was recently announced that the Department of Veterans Affairs has reaffirmed support for inpatient surgery beds at the Muskogee, Oklahoma VA Medical Center and will proceed with expansion of psychiatric services. The announcement ends a more than year-long review of the facility and follows the recommendations of a local advisory panel. The study considered the cost and quality of services available in the local community and at other VA facilities and rejected the idea of transferring patients to other facilities. The study concluded that the Muskogee Medical Center is in good condition and that moving services from Muskogee would result in inefficient use of resources with no improvement in access for veterans. In addition, local options for services from non-VA health care providers did not demonstrate any potential gain in quality. The expansion of psychiatric beds will be undertaken under normal planning processes. Additionally the VA has reaffirmed their commitment to providing inpatient care at its medical center in Poplar Bluff, Missouri. They have also added cardiology services at the facility -- which will mean fewer patient referrals to other VA facilities. The decision concludes a more than year-long review of the facility and follows the recommendation of a local advisory panel. The study considered the cost and quality of services available in the local community and rejected the idea of contracting services to local providers. [Source: NAUS Update 20 Dec 06 ++]


COMMISSARY BAG SELECTION: Commissaries are hoping shoppers in the United States will say yes to paper bags for bagging their groceries as part of the Defense Commissary Agency’s measures to offset recent major cost differentials between plastic and paper bags. The cost difference amounts to big bucks. DeCA spent about $20 million on bags last year to handle its nearly 100 million customer transactions. The cost of paper bags has increased 34% in the past three years, while plastic bag costs have risen 84 percent. Shipping costs offset the difference for overseas commissaries, so the paper bag emphasis isn’t applied there, although double bagging is discouraged DeCA-wide. Commissaries in the United States have targeted usage goals of 70% paper and 30& plastic, and customers will be hearing more, “Is paper okay?” [Source: Armed Forces News 29 Dec 06 ++]


VA SSOC DEADLINE: The Department of Veterans Affairs (VA) is proposing to amend its regulations to change the response period from 60 days to 30 days as the time limit for filing a response to a Supplemental Statement of the Case (SSOC). Their rationale is to improve efficiency in the appeals process and reduce the time it takes to resolve an appeal, while still providing an appellant with a reasonable period of time to respond to a SSOC. The difficulty for a veteran receiving an SSOC is that he/she may not know whether the various issues of the SSOC are being adjudicated for the first time or not. Many may believe their previously filed Form VA9 (Appeal to the Board of veterans Appeals - BVA) is sufficient to appeal all issues to the BVA. That belief may not be true and their appeal for the issue in question will be denied by the BVA if it is not. For example:

- Veteran fractured a lumbar vertebra on active duty leading to a VA service connected award of 30% following military service. The vet filed a Notice of Disagreement (NOD) that the 30% award was not high enough. The Regional Office (RO) denied the increase and issued a Statement of the Case (SOC). The veteran responded by filing a Form VA9 to appeal all issues to the BVA. The veteran faithfully sent in his continuing medical records about his back to the Regional Office after the SOC was issued. One of these records diagnosed that the veteran’s back pain radiated down the right leg to his foot. The RO issued a Supplemental Statement of the Case (SSOC) with two issues: (1) “Entitlement to increased rating for fracture of the lumbar spine” and (2) “Entitlement to service connection for increased rating for fracture of lumbar spine causing adiculopathy”.
- Issue number (2) is a new issue for which the veteran never gave an NOD. Unless the veteran files an NOD within one year of the SSOC date, he has failed to appeal issue number (2). The BVA need not issue a decision on issue number (2).

The better practice when receiving an SSOC is for the veteran to file a new

[boardman]

RAO Bulletin Update
15 January 2007


THIS BULLETIN UPDATE CONTAINS THE FOLLOWING ARTICLES:

== CRDP [40] -------------------------------- (New Legislation)
== Military End Strength ------------------- (Increase Proposed)
== Vet Educational Assistance ------------- (Post 911 Program)
== VA COLA 2007 [04] -------------------- (Summary of Increases)
== DoD Mental Health TF [03] ------------ (22 Jan Meeting)
== COLA 2008 [02] ------------------------- (TMC Asks 3/5%)
== Echo Taps Worldwide ------------------- (Armed Forces Day Plan)
== VA Panel Hearing Change [02] -------- (Joint Hearings Reinstated)
== Medicare Part D [14] -------------------- (Lower Premiums)
== Diet Pills [01] ---------------------------- (False Claims)
== SSA Prisoner Rules --------------------- (Inmate Benefits)
== SSA Wage Credits [01] ----------------- (Military Service)
== Navy Lodge New Facility -------------- (Accepting Reservations)
== IRS New Collection Policy ------------- (Collection Firms Profit)
== NDAA 2007 [18] ------------------------ (UCMJ & Contractors)
== South Dakota Vet Bonus [01] ---------- (Still Available)
== Disabled Vet Tax Termination Act ---- (New CRDP Legislation)
== Tricare Uniform Formulary [16] ------- (More Tier Changes)
== Legislative Agenda for 2007------------ (Legislation Needed.)
== VDBC [10] ------------------------------- (JAN Washington DC Mtg)
== VA Budget 2007 [11] ------------------- (Funding Shift)
== Surgery to Replace Eyeglasses --------- (No Waiting List)
== BRAC [21] -------------------------------- (More Funding Needed)
== U.S. Passport Policy [01] --------------- (New Travel Requirement)
== House Armed Services Committee ---- (Background)
== HASC [01] -------------------------------- (Democrat’s Restructure)
== PTSD Update 10-------------------------- (Heart Attack Risk)
== SSA Fund Depletion [04] --------------- (Mexico Agreement Released)
== NDAA 2007 [17] ------------------ (Retirement/SBP Improvements)
== VA Retro Pay Project [06] -------------- (Overview)
== CRSC [36] --------------------------------- (CR Open Season)
== VA Compensation Rates (SMC) ------- (2007 Monthly Payments)
== SSA Benefits at Death ------------------- (What & how to get)
== Military Legislation Status 13 JAN 07-- (Where we stand)


CRDP UPDATE 40: Following in his father's footsteps, Rep. Gus Bilirakis (R-FL) has reintroduced concurrent receipt legislation in the new 110th congress which is well-known to the disabled military community. H.R. 303 called the Retired Pay Restoration Act would eliminate the 10-year phase-in period for retirees with a disability rating of 50% - 90% and extends concurrent retirement and disability payments' (CRDP) eligibility to retirees rated less than 50%. H.R. 89 would extend eligibility for combat-related special compensation (CRSC) to chapter 61 (disability) retirees with fewer than 20 years of service. His father Michael Bilirakis retired after 24 years in Congress, having succeeded in breaking the federal government’s long-standing opposition to paying full military retired pay and veterans’ disability compensation for the same period of service

Meanwhile, Rep. Jim Marshall has introduced H.R. 333, a proposal called the "Disabled Veterans Tax Termination Act," which is the most comprehensive concurrent receipt legislation ever introduced. Marshall's all-encompassing bill includes the elements of H.R. 303 and H.R. 89, and would also open CRDP to chapter 61 retirees with less than 20 years of service. In essence, H.R. 333 would vest service-earned retired pay at 2.5% times years of service times base pay - exempting that amount of retired pay from any offset by VA disability compensation. This formula is the same formula that is now used for chapter 61 retirees with over 20 years of service. [Source: MOAA Leg Up 12 Jan 07 ++]


MILITARY END STRENGTH: Defense Secretary Robert Gates and General Peter Pace testified at the House Armed Services Committee’s hearing on the situation in Iraq. Secretary Gates announced that he is recommending to the President a permanent increase of 92,000 soldiers and Marines over the next five years. The increase includes 65,000 soldiers and 27,000 Marines with an emphasis on increasing combat capability. Each year, as part of the Military Authorization Act, Congress sets the Active Duty End Strength, which is the maximum number of people that each of the services can have on active duty. For FY 2007 the present limits are: Army - 512,400, Air Force - 334,200, Navy - 340,700, and Marine Corps - 180,000.

Gates also discussed policies on managing and deploying members of the Guard and Reserves. Guard units will be recalled on an accelerated basis until the current OEF/OIF conflict has been stabilized. Changes in policy will include mobilization of ground reserve forces on a unit basis rather than an individual basis in an effort to increase unit cohesion. Members of the Guard and Reserves will also be involuntarily mobilized for a maximum of one year at a time, as opposed to the current practice of sixteen to twenty-four months. These shortened periods of mobilization are to be made possible by significantly reducing post-mobilization training times. Training responsibilities and certifications are to be delegated to Adjutants General and unit commanders. [Source: NAUS Update 12 Jan 07 ++]


VETERANS EDUCATIONAL ASSISTANCE: Freshman Senator Jim Webb (D-VA) introduced "The Post-9/11 Veterans Educational Assistance Act of 2007" (S.22) on 4 JAN to amend title 38, United States Code, to establish a program of educational assistance for members of the Armed Forces who serve in the Armed Forces after September 11, 2001, and for other purposes. The bill provides:

- A new benefits package to cover costs of tuition, room and board, and a monthly stipend of $1,000 for service members who have served on active duty since September 11, 2001. For veterans to qualify they must have served at least two years of active duty, with at least some period of active duty time served beginning on or after September 11, 2001;
- Educational benefits for a period of time that is linked to time served in the military. Generally, veterans will not receive assistance for more than a total of 36 months, which equals four academic years;
- Additional payments for tutorial assistance, up to $100 a month, as well as licensure and certification tests;
- Veterans up to fifteen years (currently 10 years for active duty only) to use their educational assistance. But veterans would be barred from receiving concurrent assistance from this program and the Montgomery G.I. bill program;
- Reservists would have the option of participating in the Reserve MGIB or electing to participate in the new program; and
- The Secretary of Veterans Affairs (VA) would administer the program.
[Source: FRA NewsBytes 12 Jan 07]


VA COLA 2007 UPDATE 04: By now millions of veterans and eligible family members will have received their VA disability compensation, pension, and survivors’ benefits COLA increases in their January pay. A recent law signed by President Bush provides the 3.3% increase in disability compensation and survivors’ benefits. Under the veterans disability compensation program, tax-free payments will generally range from $115 to $2,471 per month depending on the degree of disability. Special payments up to $7,070 per month apply to the most severely injured veterans. Pension disability benefits will also be increased by the same percentage and effective on the same date. The maximum annual rate for permanently and totally disabled veterans can range from $10,929 to $18,234. Payments under this program are based on household income. This increase also applies to survivors of veterans who died in service or from a service-connected disability. Dependency and Indemnity Compensation (DIC) survivors’ benefit payments can range from $1,067 to $2,443 per month. Survivors of wartime veterans receiving death pension are also entitled to an increase. The maximum annual payment rate for a surviving spouse can range from $7,329 to $11,715. Benefits under this program are intended to bring an eligible spouse’s income to a level established by law. Under each benefit program, additional allowances may be payable for helpless, minor or school age children. [Source: NAUS Update 12 Jan 07]


BLOOD DONOR MONTH: About 20% of servicemembers donate blood, compared to less than 5% of the civilian population. This year, the Armed Services Blood Program (ASBP) will collect about 160,000 units or pints of blood products. The ASBP collects blood only from servicemembers, government civilians, retirees and their family members. The program manages 18 stateside blood donor centers and four overseas centers. Specific information can be found on the program’s website www.militaryblood.dod.mil. Blood is always needed because blood products normally must be replenished about 42 days after being collected. [Source: NAUS Update 12 Jan 07]


DOD MENTAL HEALTH TF UPDATE 03: The next meeting of the DoD Task Force on Mental Health will be held in Tacoma, Washington, on January 22 & 23. The Task Force will obtain, review and evaluate information related to the effectiveness of mental health services provided to members of the Armed Forces by the DoD. They will also hold a “Town Hall Meeting” to hear concerns from the Active Duty, Guard and Reserve, Retired and veterans communities in the Ft. Lewis, Tacoma and Seattle metropolitan areas. [Source: NAUS Update 12 Jan 07]


COLA 2008 UPDATE 02: The Military Coalition (TMC), a grouping of more than 30 associations that support quality-of-life issues for troops, veterans, retirees, and their families, has set a goal for 2007 of adjusting active-duty and reserve military pay upwards with an ultimate intent of matching private-sector wages. They plan to ask for a 3.5% raise effective 1 JAN 08 which would be a half percentage point higher than equivalent pay raises in the private sector. This would narrow the 4% gap that remains in the wake of the 2.2% across-the-board raise and certain targeted raises in January, according to TMC. The gap would continue to close if Congress should re-establish a previous formula that kept military pay increases a half percentage point above the private sector. The Defense Department currently is planning for only a 3% hike in 2008. [Source: Armed Forces News 12 Jan 07]


ECHO TAPS WORLDWIDE: Hundreds of volunteer brass players are being recruited to perform the 24 notes of “Taps” on 19 May 07, in recognition of Armed Forces Day at National Cemeteries, State Veterans Cemeteries and American Battle Monuments Cemeteries overseas. The event, called “Echo Taps Worldwide,” is being organized by the VA National Cemetery Administration and Bugles Across America to honor and remember American veterans through a worldwide performance of Taps. Organizers also hope the event will interest brass players in volunteering to perform Taps at the military funerals of veterans throughout the year. Each day, America loses about 1,800 of its veterans, primarily those who fought in World War II and Korea. In honor of them and the service they provided, it is important that our Nation preserves the tradition of a live bugler to play final military honors. During the event, players will form a line through the cemetery and perform a cascading version of Taps. Brass players of all ages are encouraged to perform at the cemetery of their choice. Schools and other organizations are also invited to participate in the tribute as performers or support volunteers. More information and a sign-up sheet are available at www.echotaps.org.

The first large “Echo Taps” event occurred In May 05, when 674 brass players from 30 states lined 42-miles of road between Woodlawn National Cemetery in Elmira, NY, and Bath National Cemetery in Bath, NY. Playing “Taps” in cascade, it took nearly three hours from the first note played at Woodlawn to the final note of Taps sounded at the National Cemetery at Bath. In 2006, players performed “Echo Taps” at 52 National Cemeteries and State Veterans Cemeteries across the Nation on Veterans Day in preparation for the upcoming effort. The Armed Forces Day event in 2007 will involve buglers around the world to include participants at American Battle Monument Cemeteries overseas. Thomas Day, a Marine veteran who founded Bugles Across America in 2000 said, “A live bugler performing Taps is an expression of the Nation’s appreciation for the service of each veteran. With more than 600,000 veterans dying each year, we are always looking for new volunteers to perform this valuable service. Echo Taps Worldwide will honor America’s 40 million veterans who have served over the course of our history and draw attention to the need for more buglers to perform “Taps” as part of final military honors. [Source: TREA Update 12 Jan 07 ++]


VA PANEL HEARING CHANGE UPDATE 02: On 11 JAN congressional leadership from both the House of Representatives and Senate made good on one of their commitments to America's veterans. In a joint statement issued, House Speaker Nancy Pelosi, Senate Majority Leader Harry Reid, House Veterans' Affairs Committee Chairman Bob Filner, and Senate Veterans' Affairs Committee Chairman Daniel Akaka announced the reinstatement of the traditional joint hearings process in which veterans and military service organizations appear before the Veterans' Affairs Committees. Chairman Filner said, "I look forward to working with the veterans' community, the administration and my colleagues in the House and Senate to provide our troops, veterans, and military families the benefits and health care they have earned and deserve." The announcement reverses a policy created by Rep. Steve Buyer (R-IN) who used his position as House Veterans' Affairs Committee chairman to end the annual joint appearances by veterans' groups to give legislative presentations before a joint meeting of the House and Senate veterans committees.

Buyer believed the appearances were not helpful to lawmakers because their timing jumped around from year to year, timed to coincide with annual meetings of the organizations rather the congressional schedule or budget process. As such, Buyer decided over objections from some major veterans' groups to stop participating. House aides who asked not to be identified said Buyer's decision may have made sense in terms of getting meaningful testimony from veterans' groups that was more integrated with the annual budget process, but picking a fight with the organizations over the largely ceremonial appearances of veteran leaders who testified before an audience of their membership rubbed many the wrong way. Buyer invited the leaders of veterans' groups to testify early in the 2007 budget process last year, both before and after the Bush administration submitted its funding request to Congress, but those appearances did not mollify the organizations, which appealed to then-House Speaker Dennis Hastert (R-IL) to order Buyer to schedule the joint hearings. Buyer never budged, although appearances continued before the Senate Veterans' Affairs Committee because its chairman, Sen. Larry Craig (R-ID) didn't share Buyer's view. [Source: NavyTimes Rick Maze article 11 Jan 07 ++]


MEDICARE PART D UPDATE 14: HHS Secretary Mike Leavitt announced 8 JAN that independent estimates for the Medicare Part D prescription drug benefit for the FY 2008 budget cycle show that net Medicare costs are 30% less ($189 billion lower) than were originally predicted when the benefit was created in 2003. In addition, based on strong, competitive bids by health care plans for 2007, average monthly premiums will be approximately $22 for beneficiaries, down from $23 in 2006, if enrollees remain in their current plans. The initial estimate for 2006 premiums was $37. According to actuaries with the Centers for Medicare & Medicaid Services (CMS), the updated Medicare Part D baseline of payments to Part D plans for the FY 2008 budget cycle has decreased from last summer’s mid-session review numbers by $113 billion over the next ten years (2007 - 2016). Importantly, of the $113 billion reduction, $96 billion is a direct result of competition and significantly lower Part D bids. The bottom line from the news is that beneficiaries are paying less in premiums and taxpayers are seeing billions of dollars in savings.

In addition to the $96 billion reduction resulting from the substantially reduced bids in 2007 in an effort to compete with rival plans, two other factors have lowered the estimated cost of Part D payments. Lower growth in drug costs in general and lower enrollment than originally expected. Lower actual growth in drug costs in 2005, compared to last summer’s mid-session review estimates, resulted in an approximate $13 billion reduction in the new baseline. The reduced Part D cost estimates reflect lower actual growth in drug costs than had been expected, with a single-digit percentage increase (5% in 2005) observed for only the second time in more than a decade. Relatively slow growth in actual drug prices and costs, compared to past trends, is expected to persist over the next few years, as more generic drugs become available and aggressive steps to keep down drug costs continue. Lower-than-anticipated enrollment in Part D reduced the new Medicare Part D payments to Part D plans by $20 billion when compared to last summer’s mid- session review figures. As the CMS actuaries discovered, many Medicare beneficiaries had creditable prescription drug coverage from other sources (such as FEHB, Tricare, and the VA), and did not need to sign up for what would have been duplicative coverage under Part D.
The new baseline numbers also reflect an increase of $16 billion due to updated figures from the 2002 to the 2003 Medicare Current Beneficiary Survey.

In addition to savings as a result of drug plan competition, beneficiaries are saving more as well by overwhelmingly selecting less-costly drug plans for themselves. The average monthly Part D premium in 2006 for the standard benefit package would have been about $32 if beneficiaries had enrolled in plans randomly, without a preference for the lower-cost, lower-premium plans. Instead, enrollees actually paid premiums that averaged about $23 in 2006, reflecting their choice of more efficient plans with lower premiums. The actuaries note that this pattern is expected to occur again in 2007, as beneficiaries opt for the best bargains among competing plans, and should further lower the average monthly premium. [Source: HHS Press Release 8 Jan 07 www.hhs.gov ++]


DIET PILLS UPDATE 01: The FTC has filed complaints in four separate cases alleging that weight-loss and weight-control claims were not supported by competent and reliable scientific evidence. Marketers of the four products – Xenadrine EFX, CortiSlim & CortiStress, TrimSpa, and One-A-Day WeightSmart – have settled with the FTC, surrendered cash and other assets worth at least $25 million, and agreed to limit their future advertising claims. In separate cases, the marketers of these products admitted that they engaged in deceptive marketing as follows:

- Two marketers will pay between $8 million and $12 million to settle FTC allegations that Xenadrine EFX’s weight-loss claims were false and unsubstantiated. The funds will be used for consumer redress. Xenadrine EFX contains green tea extract, caffeine, and bitter orange (Citrus aurantium). Among other things, the FTC charged that people appearing in the ads had achieved their reported weight loss by engaging in rigorous diet and/or exercise programs and were paid from $1,000 to $20,000 in connection with their testimonials. In a bankruptcy case not involving the Commission, the defendants have agreed to pay at least an additional $22.75 million to settle claims brought by creditors and consumers, including personal injury claims for an earlier ephedra-based product.
- Seven marketers will surrender assets totaling at least $12 million to settle FTC charges that they made false and unsubstantiated claims that CortiSlim would cause rapid, substantial, and permanent weight loss in all users and that CortiStress would reduce the risk of osteoporosis, obesity, diabetes, Alzheimer’s disease, cancer, and cardiovascular disease.
- The marketers of TrimSpa will pay $1.5 million to settle FTC allegations they made unsubstantiated claims that it causes rapid and substantial weight loss and that one of its ingredients, Hoodia gordonii, enables this by suppressing appetite.
- The Bayer Corporation will pay a $3.2 million to settle FTC allegations that advertisements for One-A-Day WeightSmart multivitamins violated an earlier Commission order requiring all health claims for One-A-Day brand vitamins to be supported by competent and reliable scientific evidence. The FTC objected to claims that One-A-Day WeightSmart, which contains EGCG (epigallocatechin gallate), would prevent weight gain and facilitate weight loss by increasing metabolism.
[Source: FTC News Release 4 Jan 07 ++]


SSA PRISONER RULES: The Social Security Administration pays benefits under both the Social Security and Supplemental Security Income (SSI) programs. Both of these programs prohibit payments to most prisoners. Social Security benefits are suspended if an otherwise eligible person is confined in a jail, prison, or other penal institution for more than 30 continuous days due to conviction of a crime. Nor can SSA pay benefits to someone who, by court order, is confined in an institution at public expense in connection with a criminal case if the court finds that the person is: guilty, but insane; not guilty of such an offense by reason of insanity or similar factors (such as a mental disease); or incompetent to stand trial for such an alleged offense. Also, SSA cannot pay benefits to someone who, immediately upon completion of a prison sentence for conviction of a criminal offense (an element of which is sexual activity), is confined by court order in an institution at public expense. The confinement must be based on a court finding that the individual is a sexually dangerous person or sexual predator (or a similar finding.) However, if a person is not confined in prison or other similar place, benefits may be paid to an eligible individual.

There is no provision in the Social Security Act to provide benefits for a spouse or dependent child while the sponsor is incarcerated and is not currently receiving or eligible to receive social security benefits. However, you may want to contact your Social Services/Welfare department to find out if there are any locally sponsored programs that may be able to provide you with assistance. They may also be able to provide you with the names of organizations that may be of some help. If the sponsor was eligible and receiving Social Security benefits prior to incarceration, payments to eligible dependents would not be affected. The Social Security Administration does not provide any benefits just for ex-prisoners. Once you are released, you can get Supplemental Security Income (SSI) payments if you are 65 or older, or are blind or have a disability have little or no income and resources.

It is important that you tell SSA of your confinement as soon as possible to avoid receiving money that you are not due and subsequently have to pay back. Once released, even if on an ankle bracelet monitoring program, you notify SSA to have your benefits reinstated. You can contact SSA at anytime at www.socialsecurity.gov/reach.htm to report any changes that may affect your Social Security payments. If you were getting Medicare and cash benefits before you went to jail, your cash benefits will stop but your hospital insurance (Part A) coverage will continue. To keep your Supplemental Insurance (Part B) coverage or medial insurance that you are paying for, you must pay the premiums or your coverage will end. If your coverage ends while you are in jail because you did not pay your Medicare premiums, you will be able to enroll again during the next General Enrollment Period (JAN thru MAR of each year). Your insurance coverage will start again the following year. If you reenroll, you will be responsible for any unpaid past-due premiums and your ongoing premium will be higher. [Source: www.socialsecurity.gov Jan 07]


SSA WAGE CREDITS UPDATE 01: The earnings of people who serve in the military services on active duty or active duty for training have been covered by Social Security since 1957. Inactive duty service in the armed forces reserves [such as weekend drills] has been covered since 1988. However, people who served in the military before 1957 did not pay into SS directly. Veteran’s records are credited with special earnings [wage credits], depending on when they served which for SS purposes count toward any benefits that might be payable. Those in the military service from 1957 on paid SS taxes the same way as civilian employees do. Those taxes are deducted from you pay and an equal amount is paid by the U.S. government as your employer. You must have credit for a certain amount of work covered by SS before any benefits can be paid on your record. The number of credits you need to qualify for benefits depends on your age and the type of benefit you might be eligible for. Nobody needs more than 40 credits. In some cases you can qualify with less than 40 credits. The amount you get from SS depends on earnings averaged over much of your working lifetime. Generally, the higher the earnings, the higher your benefits.

The wage credits for military personnel can help you qualify for SS or increase the amount of your benefit. Credits are granted for periods of active or active duty training only. Social Security cannot add extra wage credits to your earnings record until you file for SS benefits. Wage credits are granted for

• Service in 1978 to 2001. For every $300 in active duty basic pay, you are credited with an additional $100 in earnings up to a maximum of $1200 per year. If you enlisted after 7 SEP 80, and didn't complete at least 24 months of active duty or your full tour, you may not be able to receive the additional earnings.
• Service in 1957 thru 1977. You are credited with $300 in additional earnings for each calendar quarter in which you received active duty basic pay.
• Service in 1940 theu 1956. For military service inclusive of time spent in a military academy your record may be credited with $160 a month in earnings from 16 SEP 1940 thru 1956 under the following circumstances
(1) You were honorably discharged after 90 or more days of service, or you were released because of a disability or injury received in the line of duty; or
(2) You are still on active duty; or
(3) You are applying for survivor’s benefits and the veteran died while on active duty.

You cannot receive credits if you're already receiving a federal benefit based on the same years of service unless you were on active duty after 1956. In this situation you are eligible to receive the credit for 1951 thru 1956 even if you are drawing a military retirement based on these years. Congress ended wage credits JAN 02 under Public Law 107-117 NDAA after deciding that service members are better paid today and that wage credits were losing their importance and value.

Every applicant for SS benefits is asked to note their or their sponsor’s military service on the application and to show proof, either a DD 214 or W-2. If a person has difficulty in producing those documents SSA will assist them by contacting the armed services and requesting some kind of verification of military wages. Every veteran or military widow drawing Social Security today might want to check with SSA to verify if the wage credits were used in setting benefits, not just noted on an application. You are entitled to reimbursement from the time you started drawing SS and to an increase in your monthly SS check if the wage credits were not used in computing your entitlement. You can get both SS and military retirement. Generally there is no offset for SS benefits because of your military retirement with the exception of SBP. You'll get your full SS benefit based on your earnings. However, your benefit may be reduced if you also receive a government pension you didn't pay SS taxes. This is covered in SS Pub No. 05-10045. Use www.socialsecurity.gov to access SS information on the Internet. [Source: Various Jan 07 ++]


NAVY LODGE OPENS NEW FACILITY: Navy Lodge Norfolk VA has opened the doors of its new four-story 100-room facility. The new Navy Lodge features all types of rooms – family, business class, standard as well as handicapped rooms. Each of the new guest rooms has the latest amenities including Internet hook up, free local phone calls, air conditioning, cable TV, a DVD, direct-dial telephone service and a kitchenette complete with microwave and utensils. Navy Lodges are on average 40% less expensive than comparable civilian accommodations but still have all of the same amenities. You'll also have housekeeping service, vending machines, video rental service and guest laundry facilities as well as handicapped accessible and non-smoking rooms. There are 41 Navy Lodges located around the world. Guests may reach the Navy Lodge Reservation Center by calling toll-free 1-800-NAVY-INN (628-9466) in the continental United States. The Reservation Center never closes. Reservations can also be made online at www.navy-lodge.com.
Once you make a reservation you cannot be bumped from your room. Reservation and room assignments are accepted on an as-received basis without regard to rank, rate or time of reservation. Reservations are to be made by and guaranteed by the sponsor. You can reserve as many rooms as required. Group reservations can be made by calling the Navy Lodge of your choice directly. Your room reservation can be guaranteed with your credit card. Family members staying at Navy Lodges without the military member are required to show their identification at check-in. You as the sponsor will be required to be present to check in your sponsored guests. Pets are not allowed in the Navy Lodge. Kennel information is available by calling the Navy Lodge where you will be staying. Retirees can make advance reservations based on their classification as follows:
- Medical (both inpatient and outpatient) 60 Days
- Leisure 30 Days
- Surviving spouses and their family members (18 years of age or older with ID card) 30 Days
[Source: Military.com Benefits 8 Jan 07 ++]


IRS NEW COLLECTION POLICY: The IRS’s national taxpayer advocate Tuesday issued a stinging rebuke of the agency's program to use private agencies to collect delinquent tax debts, saying the initiative is fatally flawed and urging Congress to terminate it once and for all. The recommendation came in Taxpayer Advocate Nina Olson's 2006 annual report to Congress, in which she listed the private debt collection initiative among the most serious problems facing the agency. Under authority granted by Congress in 2004, the IRS began assigning certain taxpayer accounts to three private collection firms in SEP 06. The agency planned to turn over 40,000 cases, although fewer than that ultimately were assigned due to various complications in administering the program. The IRS plans to turn over 446,000 cases over two and a half years.

The problem, Olson reported, is that under the program, the government (aka taxpayers) has the 'privilege' of paying up to 25% of any taxes collected to private collection agencies, even while estimates show that IRS employees could perform the work far more efficiently, with a return on investment of approximately 13:1. The law establishing the debt collection program does not allow for true cost-benefit comparisons between the use of private collectors and the IRS's own workers, Olson said. In October, the Government Accountability Office reported that IRS projections showed that debt collection program might not pay off in its initial phase. Rep. Steve Rothman, D-N.J., who sponsored legislation last year to end the initiative, applauded Olson's recommendation to kill it. "This outsourcing program is estimated to cost tens of millions of dollars a year," he said, "and has already allowed the most complained-about industry in America to get hold of tax returns, which include taxpayers' Social Security numbers." Colleen M. Kelley, president of the National Treasury Employees Union, which represents IRS workers, said Congress should move "immediately" to implement Olson's recommendation.

In a response to Olson's report, the IRS said the private collection program has started off well. During the first 10 weeks, the agency reported, the IRS referred nearly $90 million in outstanding accounts to the firms and collected $8.43 million. That, officials said, exceeds the conservative target of 6% set for this initial year and is on target for achieving the business-case assumption of 10 to 15% annually, depending on case type. The Tax Fairness Coalition, which represents the private collection companies, issued a statement saying that Olson's report fails to recognize the value of the program, the success it has seen so far, and the complementary way in which private collection agencies are working with the IRS to help recover billions of dollars in unpaid taxes, thereby helping to close the ever-widening tax gap. The group noted that the IRS has yet to find any instances of fraud or misuse of taxpayer information in the initiative. [Source: GOVEXEC.com Daily Briefing Tom Snoop article 9 Jan 07 ++]


NDAA 2007 UPDATE 18: U.S. Military Contractors operating in combat zones are now subject to the Uniform Code of Military Justice (UCMJ). Congress quietly made this change as part of the FY 2007 Military Authorization Act. The provision makes a very small, but important change to Article 2 of the UCMJ. Under previous law, the UCMJ only applied to civilians in combat areas during periods of war declared by Congress. Paragraph a (10) of Article 2 originally read, "(10) In time of war, persons serving with or accompanying an armed force in the field." In a Vietnam-era case, the Court of Military Appeals set aside the conviction of a civilian contractor in Saigon because it construed the old Art. 2(a)(10) to apply only in cases of declared war [United States v. Averette, 19 C.M.A. 363, 41 C.M.R. 363 (1970)].
The new provision changes this paragraph to read: "In time of declared war or a contingency operation, persons serving with or accompanying an armed force in the field." The law also defines “contingency operation” to mean a military operation that:
(A) is designated by the Secretary of Defense as an operation in which members of the armed forces are or may become involved in military actions, operations, or hostilities against an enemy of the United States or against an opposing military force; or
(B) results in the call or order to, or retention on, active duty of members of the uniformed services under section 688, 12301(a), 12302, 12304, 12305, or 12406of this title, chapter 15 of this title, or any other provision of law during a war or during a national emergency declared by the President or Congress.

This means that civilian contractors in locations such as Iraq or Afghanistan can now be court-martialed or punished under the provisions of Article 15 if they violate any of the punitive articles of the UCMJ. For example, a civilian contractor who mouths off to a commissioned officer in Iraq could conceivably be court-martialed and sentenced to prison for up to one year for violating Article 89, Disrespect toward a superior commissioned officer. The legal change is the work of Sen. Lindsey Graham, R-S.C., who said it would give military commanders a more fair and efficient means of discipline on the battlefield by placing civilian contractors accompanying the Armed Forces in the field under court-martial jurisdiction during contingency operations as well as in times of declared war. The change was intended to close a legal loophole that has enabled contract personnel to escape punishment for violating the law. [Source: About U.S. Military 9 Jan 07 ++]


SOUTH DAKOTA VETERANS BONUS UPDATE 01: The state of South Dakota is paying a veterans' bonus of up to $500 to certain servicemembers. Bonuses are available for servicemembers who:
-- were legal residents of the state for at least six months immediately preceding entry into the armed forces.
-- are currently on active duty or were honorably discharged from the armed forces.
-- served on active duty during one of the following periods.

For service between Jan. 1, 1993, and Sept. 10, 2001, payment will be made to those who served overseas and were awarded the Armed Forces Expeditionary Medal, Southwest Asia Service Medal, Kosovo Campaign Medal or any other United States campaign or service medal awarded for participation in combat operations against hostile forces. All active duty service between the dates of Sept. 11, 2001, and a date to be determined qualifies for a bonus payment. This program also allows payment for active duty during the Desert Storm dates of 2 AUG 90 to 31 DEC 92 for people who did not already receive payment for service during this period. Application forms may be obtained by writing to: SD Veterans Bonus, 500 E. Capitol, Pierre, SD 57501, or by calling (605) 773-7251. Forms can also be requested by e-mail to john.fette@state.sd.us. Writers should include their name, street or post office box number, city, state and zip code. [Source: About U.S. Military 9 Jan 07]

DISABLED VETERANS TAX TERMINATION ACT: Representative Jim Marshall on 9 JAN introduced HR 333, the Disabled Veterans Tax Termination Act which would correct the following inequities that now exist in title 10 US Code 1414 (Concurrent Retirement Disability Pay):

- Extend the benefits of CRDP to some 375,000 retired career veterans who are rated less than 50% disabled by the VA.
- 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.
- 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.
- 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 Iraq and Afghanistan are denied the benefits of CRDP.

Veterans are urged to contact their Congressional representative and request their cosponsorship of this bill. [Source: USDR Action Alert 9 Jan 06]


TRICARE UNIFORM FORMULARY UPDATE 16: On 20 DEC, beneficiary representatives got to review the latest Defense recommendations to move some Attention Deficit Hyperactivity Disorder (ADHD) and narcolepsy medications to the third tier ($22 copay), along with some newer contraceptive and topical antifungal agents. The beneficiary panel concurred with moving Focalin, Focalin XR, and Daytrana to the third tier with a 90-day implementation time. That will still leave a choice of four ADHD drugs at the lower copay level: Straterra, Concerta, Ritalin, and Adderall. Two new contraceptives (Seasonique and Loestrin 24 Fe) and one new antifungal drug (Vusion) will be moved to the third tier. Over 30 contraceptives will remain in the formulary for a $3 or $9 copay.

MOAA Deputy Director CDR John Class, USN (Ret) once again urged timely notification to beneficiaries affected by the change. Currently, DoD depends on the military associations to spread the word. But relatively short lead times for implementation leave no time for advance publication in associations' magazines. Thus, for beneficiaries who don't receive e-mail updates from members of the Military Coalition (TMC), Retiree Activities Offices (RAO/RSO), and others the first notification is usually when they show up for their refills and get charged $22 instead of the $9. The recommendations will be submitted to Assistant Secretary of Defense (Health Affairs) Dr. William Winkenwerder for final decision.

Third tier drugs may not be stocked in Military Treatment Facility (MTF) pharmacies, but may be special-ordered if prescribed by an MTF physician after a medical necessity determination is granted and may be special-ordered if prescribed by a non-MTF physician to whom the patient was referred after medical necessity is determined to be warranted. For information, you may contact the TRICARE retail pharmacy (TRRx) customer service line at (866) 363-8779, or visit them online. For the TRICARE mail order pharmacy (TMOP) go to their Web site or call (866) 363-8667. For additional information, go to the Formulary Search Tool for additional information about medications, their availability and cost at the TRICARE Web site. A chart of drugs already approved for the third tier can be found at www.moaa.org. [Source: MOAA Update 5 Jan 06 ++]


LEGISLATIVE AGENDA FOR 2007: In 2007 the military community can expect to see numerous bills introduced in the 110th Congress that will impact on their well being. Some will be the reintroduction of legislation under new bill numbers that expired when the 109th Congress recessed and some will be new or revised approaches to enhance veteran’s benefits. All will require cosponsors to sign on and support them. Without sufficient cosponsors the bills will never get out of committee to give them a chance at approval on the floor of the House and Senate. Legislators listen to their constituents and if enough constituents support an issue they will sign on as cosponsors in support of veteran issues. Thus, input to them by veterans is essential. Elsewhere in this Bulletin Update is information on how to contact your legislator. Knowledge of the issues affecting our community will enhance your communications. It is never too early to express your views and it is not necessary to wait for a bill to be introduced to contact your representative. The Retired Enlisted Association (TREA) has published their 2007 Legislative Agenda which is fairly comprehensive on the issues that need to be addressed by Congress. More will be forthcoming in the Bulletin on these below issues as the year progresses:

- Expansion of CRSC to those with less than 20 years of service
- Expansion of Concurrent Receipt (CR) to those with VA disability compensation ratings of 40% and below (to include those with 0% disabled with Special Awards from VA).
- Expansion of CR to those with 15 years or more service (last enlistment should benefit).
- Elimination of the 10 year phase-in for CR for those less than 100% to include those rated as unemployable.
- Effective date of CRSC and CR to be retroactive to VA disability compensation rating effective date (VA claims can be backlogged for a year or more before claim is adjudicated).
- Specific legislative language indicating that guard/reserve eligible retirees at age 60 who become disabled on active duty with less than 20 years of active service are eligible for CRSC or CR at age 60.
- Include those as unemployable for higher CRSC rating.
- Refundable tax credit for Medicare Part B premiums.
- Pre-tax deduction of TRICARE premiums, deductibles and co-payments.
- Increase reimbursement rate for TRICARE Standard.
- Equality in TRICARE Prime – same benefits for retirees as active duty (for example eyeglasses are not covered for retirees).
- FEHBP eligibility for military retirees.
- Reserve/Guard retirement lowered to age 55 (includes full TRICARE benefits).
- Reform the Uniformed Services Former Spouse Protection Act.
- Monitoring of the Base Realignment and Closure (BRAC) process for beneficiary impact (active, guard/reserve, retired and survivors).
- Eliminate the SBP/DIC offset.
- Paid-up Premiums at age 70 with 30 years in SBP.
- Correct the SBP government subsidy to the 40% as originally intended.
- Authorize DoD and VA to become Medicare providers.
- Guaranteed funding of the VA Appropriations (Currently enrolled and those eligible to enroll).
- Zero percent service connected – category 3 for VA healthcare.
- Non-service connected military retirees – category 3 for VA healthcare.
- Flag Protection Constitutional Amendment.
[Source: www.trea.org/LegislativeAgenda.htm Jan 07 ++]


VDBC UPDATE 10: The Veterans Disability Benefits Commission will be holding their first meeting of 2007 Thursday, 18 JAN 08-1515 and Friday, 19 JAN 08-1500 in the Hotel Washington, 515 15th Street, NW, Washington, DC. The (draft) agenda for the meeting includes updates on the progress of the studies being conducted by the Center for Naval Analyses (CNA) and the Institute of Medicine (IOM). CNA will include an overview and discussion with Commissioners regarding its research and analyses of Individual Unemployability (IU) and Program Operations. VA will provide a public response to IOM’s request for documents and information related to IOM’s research on behalf of the Commission. In addition to providing a summary of the overall status of Issue Papers addressing specific research questions, Commission staff will also facilitate the presentation and discussion of new or revised Issue Papers at various stages of development. (Research Questions approved by the Commission on 14 OCT 05.)

On Friday morning there will be time set aside for the Commission to receive comments from veteran and military service organizations and interested members of the public on three topics related to specific Research Questions:
• Line of Duty (Research Question 13);
• Character of Discharge (Research Question 23); and
• Concurrent Receipt (Research Question 21 - addressing concurrent receipt policies for military retirees only.)

The SBP-DIC Offset Paper (also referred to as the Survivors Concurrent Receipt Issue) will be posted for review following the anticipated approval by the Commission with public comments to be received at the next month’s meeting of the Commission. Retirees who live near or are visiting the Washington DC area are encouraged to attend. [Source NAUS Weekly Update 5 Jan 07 ++]


VA BUDGET 2007 UPDATE 11: Secretary of Veterans Affairs R. James Nicholson notified Congress 19 DEC that he was transferring $250 million from construction and maintenance in order to pay for medical care costs for veterans. His letter suggested that, if Congress doesn’t provide more money, Nicholson might have to shift additional funds. In the short term, the initial shift will be reflected in delays in facility maintenance, but if VA funding remains flat-lined beyond mid-February, the department might have to place a freeze on hiring. This would prevent scheduled hiring of additional claims workers to reduce the buildup of pending claims. The administration had requested a $2.8 billion increase for health care in 2007, to be used for mental health and long-term care programs as well as medical care for veterans of the Iraq and Afghanistan wars. [Source: Armed Forces News 5 Jan 06 ++]


SURGERY TO REPLACE EYEGLASSES: The Wilford Hall Refractive Surgery Center at Lackland Air Force Base, Texas, is offering eye surgery as a possible replacement for eyeglasses. The Director, Lt. Col. Charles Reilly said the center has no waiting list because it has increased its capacity due to advanced technology and systems as well as improved efficiency. Surgical options available include Laser-In-Situ Keratomileusis, or LASIK; Photorefractive Keratectomy, known as PRK; and newer procedures such as Epi-LASIK, which is a combination of the two. Military members requesting the surgery must submit an application, have their commander’s authorization and an eyeglass prescription that is at least one to two years old. Only 10 to 15% of patients who apply for the surgery will not qualify. Colonel Reilly says that patients have a 96 to 98% chance of achieving better than 20/20 vision after surgery. [Source: Armed Forces News 5 Jan 06 ++]


COMMISSARY USER SAVINGS: Commissary customers closed 2006 with record-breaking savings. According to Patrick Nixon, Defense Commissary Agency director and chief executive officer the average customer savings for a family of four have risen to nearly $3,000 annually. Savings have actually been holding steady at about 32% for several years. DeCA has not revised its savings messages for more than a year, but using current U.S. Department of Agriculture figures for retail grocery food purchases consumed at home, a family of four shopping at the commissary on a regular basis can save $2,957 annually on groceries. The figure formerly used was $2,700. Under the latest calculations, couples can save $1,885, and individuals can save $1,029 by shopping regularly at their commissary. [Source: Armed Forces News 5 Jan 06 ++]


BRAC UPDATE 21: Senior military officials are pressuring lawmakers to add billions of dollars to a long-term continuing resolution (CR) to cover necessary base-closure costs and pay for military construction and quality of life projects in fiscal 2007, warning that failure to do so would have dire consequences for the services. In particular, officials said a CR without added funds would create a $4 billion funding shortfall for a spate of base closures and realignments approved by the White House in 2005. The military must complete all personnel and equipment moves mandated during that base-closure round by September 2011, a tight deadline even without these budget constraints. Army, Navy and Marine Corps leaders sent two strongly worded letters to House and Senate leaders and key members of the Armed Services and Appropriations committees late last month, after it became apparent that Congress would not pass most of the fiscal 2007 spending bills and instead hold funding for military construction at fiscal 2006 levels for the rest of the current fiscal year under a CR.

Army Chief of Staff Peter Schoomaker and Secretary Francis Harvey warned that efforts to shut down and realign bases are "quickly coming apart at the seams," with the Army limited to spending less than one-quarter of the amount needed to keep base realignment and closure moves on schedule. Navy Secretary Donald Winter, Chief Naval Officer Michael Mullen and Marine Corps Commandant James Conway warned of similar consequences in a letter delivered to Capitol Hill 22 DEC 06. They wrote that the CR could stymie their efforts to construct facilities and move equipment and people to receiver locations, and impede their ability to harvest savings and organizational efficiencies already accounted for in the budget. Lawmakers have not yet determined whether to add money or otherwise alter the continuing resolution to pay for base closures, although Democratic leaders have indicated they would consider limited spending increases in certain areas. But several House and Senate members -- including those who would gain personnel and military missions at their local bases -- would support fully funding BRAC at the $5.8 billion level requested by President Bush and authorized in the fiscal 2007 defense authorization bill, which Bush signed into law.

Many communities affected favorably by base closures are already writing their lawmakers to press the issue. But the losers in the 2005 BRAC round, who comprise a formidable force of their own, could just as likely back decreased funding in the hopes of buying their communities time and the economic benefits from prolonged military spending. The Defense Department does not have to rely solely on Congress for adequate funding of base closures this year. Defense officials could opt to reprogram money, or add money to base-closure accounts in the fiscal 2007 supplemental spending bill due to Capitol Hill in the next several weeks. [Source: GOVEXEC.com Daily Briefing 4 Jan 07 ++]


U.S. PASSPORT POLICY UPDATE 01: Beginning in 2007, all passengers traveling by air to or from the United States will be required to hold a valid passport. The U.S. Department of State estimates this new requirement will go into effect on 23 JAN 07, and applies to all passengers - including U.S. citizens - traveling to and from Canada, Mexico, Bermuda, and the Caribbean. [Source: MOAA News Exchange 4 Jan 07]


HOUSE ARMED SERVICES COMMITTEE: The U.S. House Committee on Armed Services, commonly known as the House Armed Services Committee (HASC), is a standing committee of the United States House of Representatives, the lower house of Congress. It is responsible for funding and oversight of the Department of Defense (DOD) and the United States armed forces, as well as substantial portions of the Department of Energy. The committee's work is handled through six subcommittees. According to the committee rules their responsibilities are:

- Subcommittee on Projection Forces: Navy and Marine Corps programs, except strategic weapons, space, special operations and information technology programs, deep strike bombers and related systems, and strategic lift programs.
- Subcommittee on Readiness: Military readiness, training, logistics and maintenance issues and programs. In addition, the subcommittee will be responsible for all military construction, installations and family housing issues, including the Base Realignment and Closure process.
- Subcommittee on Strategic Forces: Strategic Forces except deep strike systems, space programs, ballistic missile defense and Department of Energy national security programs, except non-proliferation programs.
- Subcommittee on Tactical Air and Land Forces: All United States Army and Air Force acquisition programs, except strategic weapons and lift programs, special operations and information technology accounts. In addition, the subcommittee will be responsible for all United States Navy and Marine Corps aviation programs, National Guard and Army and Air Force reserve modernization, and ammunition programs.
- Subcommittee on Terrorism, Unconventional Threats and Capabilities: Department of Defense counter proliferation and counter terrorism programs and initiatives. In addition, the subcommittee will be responsible for Special Operations Forces, the Defense Advanced Research Projects Agency, information technology and programs, force protection policy and oversight, and related intelligence support.
- Subcommittee on Total Force: Military personnel policy, reserve component integration and employment issues, military health care, military education and prisoner of war and missing in action issues. In addition, the subcommittee will be responsible for Morale, Welfare and Recreation issues and programs

The Chairman may designate a panel of the Committee consisting of members of the Committee to inquire into and take testimony on a matter or matters that fall within the jurisdiction of more than one subcommittee and to report to the Committee. Panels cannot continue in existence for more than six months. However, a panel so appointed may, upon the expiration of six months, be reappointed by the Chairman. No panel so appointed shall have legislative jurisdiction. The Chairman of the Committee or of any subcommittee or panel is required to make public announcement of the date, place, and subject matter of any committee or subcommittee hearing at least one week before the commencement of the hearing. However, if the Chairman of the Committee or of any subcommittee or panel, with the concurrence of the respective ranking minority member of the Committee, subcommittee or panel, determines that there is good cause to begin the hearing sooner, or if the Committee, subcommittee or panel so determines by majority vote, a quorum being present for the transaction of business, such chairman shall make the announcement at the earliest possible date. Any announcement made under this rule shall be promptly published in the Daily Digest, promptly entered into the committee scheduling service of the House Information Resources, and promptly posted to the internet web page maintained by the Committee.

In accordance with House rules the full Committee is required to meet every Wednesday at 10:00 a.m., and at such other times as may be fixed by the chairman of the Committee or by written request of members of the Committee. A Wednesday meeting of the Committee may be dispensed with by the Chairman, but such action may be reversed by a written request of a majority of the members of the Committee. Each subcommittee is authorized to meet, hold hearings, receive evidence, and report to the Committee on all matters referred to it. Insofar as possible, meetings of the Committee and its subcommittees shall not conflict. A subcommittee chairman sets meeting dates after consultation with the Chairman and the other subcommittee chairmen, and the ranking minority member of the subcommittee with a view toward avoiding simultaneous scheduling of committee and subcommittee meetings or hearings wherever possible.

Meetings and hearings are open to the public unless it is determined by record vote that all or part of the remainder of that hearing or meeting on that day shall be in executive session because disclosure of testimony, evidence, or other matters to be considered would endanger the national security, would compromise sensitive law enforcement information, or would violate any law or rule of the House of Representatives. For the purpose of carrying out any of its functions and duties under rules X and XI of the Rules of the House of Representatives, the Committee and any subcommittee is authorized:
(1) To sit and act at such times and places within the United States, whether the House is in session, has recessed, or has adjourned, and to hold hearings, and
(2) To require by subpoena, or otherwise, the attendance and testimony of such witnesses and the production of such books, records, correspondence, memorandums, papers and documents, including, but not limited to, those in electronic form, as it considers necessary.

The HASC maintains a web site for public review and in accordance with its obligation to keep the public informed at www.house.gov/hasc. This site provides information to veterans about the HASC, the latest news, schedules and transcripts, press releases, bills/reports/publications, and Democratic views. [Source: Various ++ Jan 07]


HASC UPDATE 01: Democrats in charge of the House Armed Services Committee are reshuffling its subcommittees to align each panel's jurisdiction closer to the individual military services' budgets and programs. As one of his first orders of business, incoming Chairman Ike Skelton (D-MO) plans to undo many of the structural changes that his Republican predecessor Duncan Hunter of California imposed in 2003 when subcommittees were organized to focus on different military missions. Skelton plans, for example, to change the names of the existing Projection Forces Subcommittee to the Seapower and Expeditionary Forces Subcommittee, and of the Tactical Air and Land Forces Subcommittee to the Air and Land Forces Subcommittee. The Seapower panel, which likely will be chaired by Rep. Gene Taylor (D-MS) will oversee nearly all Navy and Marine Corps systems, including Navy and Marine Corps aviation programs that once fell under the purview of the Tactical Air and Land panel. Meanwhile, deep strike and strategic airlift programs, including the B-1 and B-52 bombers and the C-17 Globemaster III cargo plane, all previously overseen by the Projection Forces panel, will now move to the renamed Air and Land Forces Subcommittee. Rep. Neil Abercrombie (D-HI) is expected to be chairman of that panel, though a House aide cautioned that decisions on subcommittee leadership for the 110th Congress are not yet final.

The changes will give the subcommittees less of a mission focus, more of a service focus. The decisions had a lot to do with the desires of the incoming subcommittee chairs and how they felt the organization of the committee would be most effective. Meanwhile, the House Armed Services Committee is in the planning and hiring stages for its new Subcommittee on Oversight and Investigations, which is expected to be chaired by Rep. Martin Meehan (D-MA). Meehan, a senior member of the committee, wrote Skelton the day after the 7 NOV elections to lay claim to the subcommittee chairmanship and detail his plans for it. In a three-page letter, Meehan proposed focusing on force protection, military readiness, Pentagon funding priorities and contracting abuses. The House Armed Services Committee had an oversight and investigations panel from 1993-1994, and an investigations subcommittee from 1981-1992. Skelton has said that oversight of the Iraq war and other Pentagon activities will be the hallmark of his chairmanship. [Source: GOVECEC.com Daily Briefing 3 Jan 06 ++]


PTSD UPDATE 10: A groundbreaking study of 1,946 male veterans of World War II and Korea suggests that vets with symptoms of post-traumatic stress disorder are at greater risk of heart attacks as they age. The new study is the first to document a link between PTSD symptoms and future heart disease, and joins existing evidence that vets with PTSD also have more autoimmune diseases such as arthritis and psoriasis. A second study, funded by the Army, found that soldiers returning from combat in Iraq with post-traumatic stress disorder reported worse physical health, more doctor visits and more missed workdays. The Army study is based on a survey of 2,863 soldiers one year after combat. Their study was funded by the National Institutes of Health and the Department of Veterans Affairs. The Army study appears in the American Journal of Psychiatry. Medical authorities first accepted post-traumatic stress disorder as a psychiatric condition in 1980 at the urging of Vietnam veterans. In PTSD, the body's normal hormonal response to stress becomes trigger-happy, scientists believe. Long after traumatic events, people remain edgy, fearful and prone to nightmares and flashbacks. The continual release of adrenaline may wear down the cardiovascular system. The Harvard and Boston University researchers analyzed data from the Veterans Administration Normative Aging Study, a long-term research project tracking Boston-area vets. [Source: Associated Press National News article 2 Jan 07 ++]


SOCIAL SECURITY FUND DEPLETION UPDATE 04: After numerous refusals over three and a half years, the Social Security Administration (SSA) has released the first known public copy of the U.S.-Mexico Social Security Totalization Agreement. The government was forced to make the disclosure in response to lawsuits filed under the Freedom of Information Act by TREA Senior Citizens League, a 1.2 million-member nonpartisan seniors advocacy group. The Totalization Agreement could allow millions of illegal Mexican workers to draw billions of dollars from the U.S. Social Security Trust Fund. The agreement between the U.S. and Mexico was signed in JUN 04, and is awaiting President Bush’s signature. Once President Bush approves the agreement, which would be done without Congressional vote, either House of Congress would have 60 days to disapprove the agreement by voting to reject it.

The Social Security Administration itself warns that Social Security is within decades of bankruptcy. According to the SSA, the Social Security Trust Fund will begin paying out more than it is taking in by 2017, and will be exhausted by the year 2040. Yet, they seem to have no problem making agreements that hasten its demise. The U.S. currently has 21 similar agreements in effect with other nations, which are intended to eliminate dual taxation for persons who work outside their country of origin. All of the agreements are with developed nations with economies similar to that of the U.S. For example, a worker who turns 62 after 1990 generally needs 40 calendar quarters of coverage to receive retirement benefits. Under totalization agreements, workers are allowed to combine earnings from both countries in order to qualify for benefits. The Agreement with Mexico, like other totalization agreements, would allow workers to qualify with just six quarters, or 18 months, of U.S. coverage. Mexico’s

[boardman]

RAO Bulletin Update
1 February 2007


THIS BULLETIN UPDATE CONTAINS THE FOLLOWING ARTICLES:

== Navy IRR --------------------------- (Remaining Service Obligation)
== Navy Casualty Assistance Division ------ (Organization & Duties)
== Renters Insurance [01] -------------- (Recommended if Applicable)
== DoD/VA Seamless Transition -------- (Hearings Highlight Efforts)
== Disabled Retiree Back Tax [01] ---------- (Refund Beyond 3 years)
== VA Vision Care ------------------------------------ (To be Enhanced)
== TJX Data Breach ----------------- (Legislation Still Needed)
== Mobilized Reserve 24 JAN 07 ----------------- (Net Increase 2,038)
== DoD VA Record Transition [02] ------------ (Agreement Reached)
== VDBC [11] ------------------------------- (Issues Discussed)
== VDBC [12] ------------------------------- (7/24 Disability Coverage)
== Tricare Alaska Provider Pmts ---------- (Higher Authorized Rates)
== VA Obesity Initiative [01] -------------- (41,000 Participants)
== Tricare Prime Allotment [02] -------------------- (Pay by Allotment)
== Tricare Uniform Formulary [17] -- (Beneficiary Input Procedure)
== Military Health Care TF ---------------------- (Holds First Meeting)
== Anheuser-Busch Hero Salute ----------- (Extended Through 2007)
== Iowa Vet Benefits ---------------------- (What’s Available)
== Fisher House Expansion ------------------------------- (New Homes.)
== Gulf War Presumptive Disease [02] --------- (Signs or Symptoms)
== CRSC [36] --------------------------- (You May Qualify)
== Medicare Part D [15] ----------- (Tricare Beneficiary Enrollment)
== Tricare User Fees [15] ----------------------- (DoD Increase Press)
== Tricare User Fees [16] --------------------- (H.R. 4949 Introduced)
== COLA 2008 [03] ----------------------------------- (1% below 2007)
== Korean War Armistice Day -------------------------- (27 July 2007)
== Federal Excise Tax Refund Credit -------------- (2006 Tax Return)
== Congressional Budget Schedule -------------------------- (FY 2007)
== Expatriate Income Tax ------------------------------ (Who Must File)
== 2006 Tax Law Changes ----------------------------------- (Summary)
== TSP [08] ---------------------------- (Hackers Steal $35,000)
== SSA Name Change [01] ------------------------------ (2007 How To)
== Philippine DEERS Registration [01] ---- (Walk-ins Discouraged)
== Blood Donor Month ------------------- (Retiree Donations Needed)
== Commissary User Savings -------------------------- (32% Annually)
== VA Compensation Rates (Other) ------ (2007 Monthly Payments)
== Hospital Cleanliness ------------------- (5% Infection Rate)
== Health Care Provider Performance --------------- (Where to Look)
== Military Legislation Status 31 JAN 07 --------- (Where we stand)


NAVY IRR: Service obligations normally last for either six or eight years after the sailor’s initial enlistment date, depending upon the terms of his contract. Under a new Navy policy, sailors leaving active duty who decline to transfer to the selected reserve will be counseled about their remaining military service obligation under the Individual Ready Reserve (IRR) program. Those leaving active duty before their obligation is up will be told that they have to keep their uniforms ready; muster once a year for at least two hours, either in person or online; and tell the Navy whenever they change jobs, become unemployed or start school. During counseling, sailors will be warned that if they fail to comply with muster requirements they will be classified as unsatisfactory participants and can be ordered to active duty for 45 days, transferred to inactive status or processed for separation. Commissioned officers who are deemed unsatisfactory participants can be discharged only if a board of officers recommends it.

The total time a sailor spends during the annual muster, including travel to and from the muster site for in-person musters, must not exceed eight hours. Any sailor who lives more than four hours from the nearest muster point will not be asked to muster in person. Sailors mustering in person will be paid 125% of the average per diem rate for travel in the continental U.S. The muster pay rate is normally about $165 per person, which would mean the Navy would spend about $1 million paying for musters if rates from the past two years hold up. During those two years, between 5,000 and 7,000 IRR sailors were ordered to muster in person. There are now about 70,000 sailors in the IRR. Sailors who muster online will not be paid, although that policy could be changed at a later date. All IRR sailors are required to muster online. Many in high-demand specialties, such as physicians, nurses and Seabees, will then be asked to do the follow-on in-person muster, where they can be encouraged to take individual augmentee assignments, funeral details and other military work. [Source: NavyTimes Chris Amos article 26 Jan 07 ++]


NAVY CASUALTY ASSISTANCE DIVISION: The mission of the Navy Casualty Assistance Division in Millington TN is to provide timely, compassionate and caring assistance for Navy families in times of need. The Navy Casualty Assistance Division consists of a Primary Response Branch, Survivors Benefit and Entitlements Policy Branch, Casualty Case Settlement Branch, and a Prisoner of War/Missing in Action Branch. Navy Casualty Assistance Division personnel are available via 1(800) 368-3202. Their mailing address is: Bureau of Naval Personnel, Casualty Assistance Division (N1352), 5720 Integrity Dr., Millington TN 38055-6210. Components of the Navy Casualty Assistance Division include:
1. Casualty Assistance Calls Program (CACP) managed regionally by Casualty Assistance Calls/Funeral Honors Support (CAC/FHS) Program Coordinators. Among other duties they coordinate the funeral honors program.
2. Emergency Coordination Center (ECC) Operations staffed by duty personnel in the event of a mass casualty situation. The ECC provides assistance by answering telephone inquiries, providing family members with information and referral, and acting as a clearinghouse for information in mass casualty scenarios.
3. Retired Casualty Assistance Program (RCAP) assists surviving family members by providing survivors with the "Retiree Survivors Guide”, conducting telephone counseling, informing survivors of various benefits, and providing personal counseling through Retired Activities Offices (RAO).

Quick reference links available for survivor’s review are:
- Military Homefront - DoD Survivors Guide http://www.militaryhomefront.dod.mil/po ... .0.0.0.0.0 gives the survivor a clear idea of how the Department of Defense will assist them from their first meeting with their Casualty Assistance Officer.
- Casualty Assistance Guide for family members of deceased servicemen www.npc.navy.mil/NR/rdonlyres/51D2C9C1- ... Family.pdf. The guide provides survivors with the basic information needed to ensure their benefit are promptly identified and distributed.
- SGLI Letter to Spouse (sample) www.npc.navy.mil/NR/rdonlyres/63294BC6- ... Spouse.doc
- Navy Casualty Assistance Calls Office (CACO) Guide http://www.npc.navy.mil/NR/rdonlyres/3B ... vyCACO.pdf.
[Source: Military.com 29 Jan 07 ++]


RENTERS INSURANCE UPDATE 01: If a renter or their family starts a fire that destroys their apartment building, not only will they suffer the loss of their own personal belongings, they could also be responsible for damage to the entire structure. Usually, the landlord would collect from his or her insurance company. The insurance company would in turn sue the individual for the amount paid to the landlord. Alternatively, the landlord could sue them directly. This is where renter's insurance can save the day. Renter's insurance covers individuals' personal property such as televisions, stereos, clothing, furniture, jewelry, carpets and appliances. Typically, renter's insurance provides coverage when their belongings are stolen or damaged by one of several causes specifically stated in the policy, such as fire, lightning, falling objects, hail or faulty appliances. It usually covers unintentional or non-negligent damage the renter and their family members may do to the property of others. For example, if a fire in their apartment gets out of control and destroys their apartment building, their policy would pay for damages to the entire structure. It will also provide coverage for:
- A guest suing for something as unreasonable as tripping and falling over your doorstep.
- Your dog biting a child selling candy or a visiting neighbor tripping over your rug.
- Anyone hurt as a result of a party guest you served drinks to that has a wreck on the way home. In 31 states, court precedents have found that hosts who serve alcohol are liable as third parties to crimes caused by drunk drivers.
- Expense of living elsewhere while damage to your residence is being repaired.

Renters often think insurance costs too much. However, nominal monthly premiums, often less than $20, will typically buy $12,000 or $15,000 of replacement cost coverage for their personal belongings and $100,000 of liability insurance to protect the individual from lawsuits. Companies whose clientele are predominantly from the military community (such as USAA) usually offer higher coverage for the same premium. Also, for those who maintain a rental residence at more than one geographic location one policy will cover both residences year round with no increase in premium. [Source: Los Angeles AFB RAO News Jan-Apr 07 ++]


DOD/VA SEAMLESS TRANSITION: Two Senate Veterans Affairs Committee hearings on 23/24 JAN shed some additional light on progress made by the Departments of Defense (DoD) and Veterans Affairs (VA) in improving the transition between military and VA health care systems for wounded and disabled veterans. On 23 JAN, Deputy VA Secretary Gordon Mansfield and DoD Under Secretary for Personnel and Readiness Dr. David Chu testified about the joint DoD/VA plan in this area, which Mansfield said fosters an unprecedented level of cooperation between VA and DoD in an effort to remove institutional barriers and address operational challenges. They said several first steps are under way.
- A "Benefits at Discharge Program" is in place, enabling active duty members to register for benefits before leaving active service.
- Each VA office now has a point of contact assigned to work with veterans returning from Iraq and Afghanistan. Thus far, the VA has coordinated the transfer of 6,700 injured or ill active duty service members from DoD to VA, and both agencies have agreements with state National Guard leaders to provide briefings and information to ease transition for returning Guard and Reserve personnel.

In addition, the joint DoD/VA plan would establish standard guidelines in areas such as mental health (specifically PTSD), joint facility use, information management, contingency planning, patient safety, and research. Committee Chairman Sen. Daniel Akaka (D-HI) liked what he heard, but believes these efforts need more funding. He said this is “a cost of war" and will push for additional funds immediately. On 24 JAN, DoD and VA witnesses outlined plans to acquire a new, common electronic health record system that can be used jointly by health care facilities in both agencies. This has been a major sore spot for years, as military and VA facilities currently use entirely different electronic medical record systems that don't interact. While VA facilities have some limited capacity to view certain information in military health records, there is nothing like a jointly usable system at present. Sen. Larry Craig (R-ID), the Committee's senior Republican, said the new agreement to develop a joint system is "a major step... [that] is long overdue." [Source: MOAA Update 26 Jan 07 ++]


DISABLED RETIREE BACK TAX UPDATE 01: Most VA disability claims filed by military retirees are resolved in less than a year. But lost paperwork, administrative errors, and appeals of rejected claims delay thousands of disability awards for years on end. The VA disability award is retroactive to the date of the application -- making some portion of past military retired pay tax-free. But to get a refund of back taxes paid, disabled retirees must file an amended tax return for each applicable year. That's when retirees run into a major problem: the IRS Code bars filing amended returns beyond the last three tax years. As a result, VA administrative glitches and insensitive tax laws cost these disabled retirees thousands of dollars through no fault of their own.

The "Disabled Veterans Tax Fairness Act of 2007" (S. 326) would allow disabled veterans whose disability claims have been pending for more than 3 years to receive refunds on previous taxes paid for up to five years - the length of time the IRS keeps these records. Sen. Lincoln (D-AR) received bipartisan support on her bill, with 11 senators joining as original cosponsors. House champion Rep. Sam Farr (D-CA) is expected to re-introduce a similar measure soon, according to his staff. The Farr bill would authorize a 15-year look-back exception to IRS rules for amended returns from disabled military retirees. Those who would like communicate their support of this bill to their legislators can go to http://capwiz.com/moaa/issues/bills/?bill=9294921 and see/send a recommended letter by typing in their
zip code. [Source: MOAA Update 26 Jan 07 ++]


VA VISION CARE: The VA announced in JAN 07 that more than a million visually impaired veterans will receive enhanced health care services from the Department of Veterans Affairs (VA) under a reorganization of VA’s vision rehabilitation services. VA will make approximately $40 million available during the next three years to establish a comprehensive nationwide rehabilitation system for veterans and active duty personnel with visual impairments. The system will enhance inpatient services and expand outpatient services throughout the 1,400 locations where VA provides health care. Under the reorganization plan, each of VA’s 21 regional networks—called Veterans Integrated Service Networks, or VISNs—will implement a plan to provide eye care to veterans with visual impairments ranging from 20/70 to total blindness. Basic low-vision services will be available at all VA eye clinics, and every network will offer intermediate and advanced low-vision services, including a full spectrum of optical devices and electronic visual aids. VA’s 10 existing inpatient blind rehabilitation centers will continue to provide the Department’s most intensive eye care programs, but each VISN now will also provide outpatient-based blind rehabilitation care. VA estimates there are more than 1 million visually impaired veterans over the age of 45 in the United States. Within this group, approximately 157,000 are legally blind, and 1,026,000 have low vision. About 80% of all visually impaired veterans have a progressive disability caused by age-related macular degeneration, glaucoma, or diabetic retinopathy. [Source: NAUS Weekly Update for 26 Jan 07 ++]


TJX DATA BREACH: The Cyber Security Industry Alliance (CSIA) is calling on the new Congress to pass comprehensive data-security legislation after another massive data breach reported in mid-JAN 07. TJX, the parent company of stores including Marshalls and TJ Maxx, announced that hackers broke into a system that handles credit and debit card transactions. The company has refused to say how many customers were affected. Liz Gasster, president and CEO of CSIA said the episode “has the potential to be a very large breach,” and the fact that the company is based in Massachusetts, one of 15 states without breach laws, highlights the need for national legislation. Several data-security bills were introduced in the last session of the 109th Congress, some addressing protections for data housed by commercial companies and others addressing sensitive data stored by various government agencies. The legislation outlined requirements for notifying affected consumers in the event of a security breach and sometimes mandated preventive measures like encryption. Various committees, including the House Government Reform and Financial Services panels, held hearings, but none of the legislation became law.

So far this session, Sen. Dianne Feinstein (D-CA) has introduced a bill, S.239, that would require federal agencies to disclose data breaches, and Rep. Jo Ann Davis (R-VA)., has introduced a measure, H.R.516, that also just addresses the security of government data. It would require encryption for all sensitive data housed by government agencies and also outline security requirements for government workers and contractors with access to the data. Gasster said, “The biggest priority is to pass a comprehensive data-security law that applies to all entities. A lot of proposals focus on the private sector. I think it’s important for the law to apply equally to the government and the private sector. It does not make sense for security standards and procedures to change depending on where the data rests because it certainly does not matter to an identity-theft victim. It is especially unfair to consumers when a government agency fails to secure sensitive data. We can choose to do business with a company, but when we do business with the government, we don’t have a choice.” [Source: GOVEXEC.com Heather Greenfield article 22 Jan 07 ++]


MOBILIZED RESERVE 24 JAN 07: The Army, Navy, Air Force, Marine Corps and Coast Guard announced the current number of reservists on active duty as of 24 JAN 07 in support of the partial mobilization. The net collective result is 2,038 more reservists mobilized than last reported for 27 DEC 06. Total number currently on active duty in support of the partial mobilization for the Army National Guard and Army Reserve is 74,688; Navy Reserve 5,269; Air National Guard and Air Force Reserve 5,307; Marine Corps Reserve 5,573; and the Coast Guard Reserve 309. This brings the total National Guard and Reserve personnel, who have been mobilized, to 91,344, including both units and individual augmentees. At any given time, services may mobilize some units and individuals while demobilizing others, making it possible for these figures to either increase or decrease. A cumulative roster of all National Guard and Reserve personnel, who are currently mobilized, can be found at http://www.defenselink.mil/news/Jan2007 ... 124ngr.pdf. [Source: DoD News Release 24 Jan 07 ++]


DOD VA RECORD TRANSITION UPDATE 02: After nearly a decade of attempting to exchange information stored in separate systems, the Veterans Affairs Department and the Pentagon have agreed to join together to establish an updated electronic health records system. While details remain sparse, the Defense Department announced 24 JAN that the two agencies would jointly acquire and use a new in-patient electronic health system. The VA developed its current system, known as VistA, in 2001. Work began on the Pentagon’s Armed Forces Health Longitudinal Technology Application, or AHLTA, in 1997. Both systems are in need of an upgrade. The agencies have agreed to study their clinical processes and requirements and assess the benefits and the potential effects on their timelines and costs, before making a final decision on a joint acquisition strategy for the upgraded system. Until now, the VA and Defense have been working independently on enhancing and improving their existing systems. They have made various attempts to share health information. According to Defense, millions of records and data messages are regularly moved electronically between the agencies.

VA Secretary James Nicholson, who announced plans for the joint venture 23 JAN at a meeting of the American Health Information Community, called the agreement “groundbreaking” and said that “it has the potential to further transform the way we care for our nation’s veterans and active duty service members.” A joint system for documenting in-patient health information will smooth the process of transferring active duty service members to veteran status, according to the Pentagon. The system will also make the inpatient health care data on shared beneficiaries immediately accessible to both Defense and VA health care providers. The joint acquisition and development of the system could result in significant cost savings, the Pentagon said in a statement. The two existing systems have diverse missions. Defense needs its system to support patients in its combat theaters, and pediatric and obstetrical patients. The VA’s system supports domiciliary care. But both agencies “believe that the similarities in clinical and business processes may make the adoption” of a joint system a viable option, according to the Pentagon. Robert McFarland, former VA chief information officer, said it made no sense for the two organizations to have separate systems. The two agencies have more similarities than differences, he said, and should have combined their efforts a long time ago. He predicted that hundreds of millions of dollars could be saved as a result of the joint effort. [Source: GOVEXEC.com Daniel Pulliam article 25 Jan 07 ++]


VDBC UPDATE 11: The Veterans' Disability Benefits Commission met 18 & 19 JAN in Washington, D.C. and continued their review of veterans' benefits. The two-day hearing included testimony from a panel of military and veteran organization representatives, including the TMC, MOAA, FRA, AL, and VFW representatives in attendance. They opened with an oral statements that drove home recommendations for three severe inequities that exist in concurrent receipt law:
- Changing current legislation to include "Chapter 61" disability retirees with less than 20 years of service,
- Extending eligibility to disabled retirees with 10-40% disability ratings, and
- Accelerating/eliminating the 10-year phase-in schedule.

Their written statement can be found on www.moaa.org. Several Commissioners, but not all, were receptive to including Chapter 61s with less than 20 years as an option in their concurrent receipt deliberations. The Commission's position on that issue is expected during the 21-23 FEB public hearing. [Source: MOAA Leg Up 19 Jan 07 ++]


VDBC UPDATE 12: Testifying 19 JAN before the Veterans Disability Benefits Committee, which is considering limits on veterans disability and health care, the American Legion argues it is “fundamentally unfair” to change standards. The commission, appointed by Congress, is looking at updating military and veterans’ benefits. One of the proposed changes involves restricting benefits to cover health problems among veterans only if those problems have a direct connection to military duties. The commission is expected to make a recommendation by fall. Steve Smithson, the American Legion’s deputy director for claims services says, “We find such a proposal detrimental to the national interest and patently absurd. If a service members is subject to the Uniform Code of Military Justice 24 hours a day, seven days a week, whether on or off a military base and whether performing official duties or taking personal time, then health care and disability coverage should be the same.”

Two related issues that would limit veterans’ health and disability benefits are being discussed:
- One would try to separate on-duty and off-duty health problems, leaving the government fully responsible for any injury or illness related to military service, while providing limited or no coverage for off-duty health problems, such as a drunken service member having a motorcycle accident while on leave.
- The second issue involves trying to separate age-related health problems from service-connected health problems.

Under the most restrictive proposal, death, disease or injury would have to be incurred during military operations or training to be covered by veterans’ disability, health and death benefits, and could not be due to willful misconduct or the abuse of alcohol or illegal drugs. Not providing around-the-clock disability coverage would create a major hole in military and veterans’ benefits, Smithson said. “The federal government does not provide service members with health insurance, long-term disability insurance, or workers’ compensation benefits,” Smithson said. “If VA disability compensation was unavailable for medical conditions that occur during or result from the period of military service, but not from performance of military duties, members would be forced to purchase private insurance to protect against financial hardship after they are discharged. Buying insurance, however, could be difficult. Private insurers would likely charge high premiums for coverage against disabilities for service members and health insurance purchased after leaving the military might exclude coverage for pre-existing conditions. Deciding what is and is not a disability resulting from military duties also is a question ripe for problems because it is not always clear. For example, would it be considered to be in the line of duty if a service member is paralyzed by a drunk driver while returning to her off-base home at 2:30 in the morning after reporting for an emergency recall drill?. Would it be considered to be in the line of duty in a case where an individual is injured running or playing basketball, while on leave, in order to keep in shape to comply with military fitness standards?” [Source: ArmyTimes Rick Maze article 23 Jan 07 ++]



TRICARE ALASKA PROVIDER PAYMENTS: To improve access to care for its beneficiaries in Alaska, Tricare Management Activity will conduct a three-year demonstration project there. Beginning 1 FEB 07 physicians and other non-institutional individual professional providers in Alaska will receive payment at a rate higher than the Medicare rate. Access to health care services in Alaska is often severely limited by the overall scarcity of providers, their reluctance to accept Tricare payment rates, transportation issues, and other factors. Tricare is raising reimbursement rates in response to these challenges. During the three-year demonstration project, Alaska doctors will receive payment at a rate 1.35 times the current Tricare allowable rate. The project will test how this increase affects provider participation in Tricare, beneficiary access to care, and the cost of health care services, all of which could impact military medical readiness, morale and welfare. When local providers are unavailable, patients must be transported to Seattle or another location for treatment, which is expensive and involves considerable lost duty time. This demonstration will test to what extent savings in travel costs, lost duty time, and other factors might offset the increased costs of provider payments. Tricare provider payments are generally the same as under Medicare, unless the Defense Department takes specific action to increase payment rates in response to a severe access problem in a location. Alaska's Military Treatment Facilities meet a large percentage of the state's beneficiary health care needs. Those remaining must be referred to local civilian providers or to the lower 48 states. [Source: TMA News Release 23 Jan 0 ++]


VA OBESITY INITIATIVE UPDATE 01: By the start of Healthy Weight Week (21-27 JAN), more than 41,000 veterans were participating in a weight management program designed by the Department of Veterans Affairs (VA) to reduce the high rates of illness among VA’s patients caused by obesity. According to Secretary of Veterans Affairs Jim Nicholson there is a growing epidemic of obesity and diabetes in the nation, especially among veterans. Of the veterans VA cares for 70% are overweight and one in five has diabetes, both of which increase the risk of many diseases. VA’s Managing Overweight Veterans Everywhere (MOVE!) program not only encourages veterans enrolled in VA care to get in shape but also offers information to family members and anyone trying to lose weight through an Internet link. VA started MOVE! to encourage veterans to increase their physical activity and improve their nutrition.

Through individual and group counseling, physicians, nurses, dieticians and recreational therapists help enrollees change their eating behavior and increase their exercise. Primary care teams at all VA medical centers stay in touch with participants to track their progress. Increasing numbers of VA community-based clinics also are enrolling veterans. Among activities they promote are competitions in fitness challenges, joining community exercise programs that partner with VA medical facilities, and leading families and friends into movement and nutrition routines. Anyone can log onto www.move.va.gov where a questionnaire helps identify personal barriers to weight control. The questions link to about 100 informational materials on the site. People not enrolled in VA health care can take the information about themselves to their personal health care providers. [Source: VA News Release 23 Jan 07 ++]


TRICARE PRIME ALLOTMENT UPDATE 02: Military retirees in TRICARE Prime are reminded they may pay their Prime enrollment fees by establishing a monthly allotment from their Service retirement pay. The Defense Financial Accounting System (DFAS), the U.S. Coast Guard or the U.S. Public Health Service deducts the retirement pay allotment. Retirees enrolled in TRICARE Prime currently receive a quarterly or annual bill, which they can pay by check or credit card. Choosing to pay by allotment saves on paperwork and time. Retirees may begin to take advantage of this convenient process by downloading and completing an enrollment fee allotment authorization form, based on the region in which they live: TRICARE North, TRICARE South, TRICARE West. This form is used to stop, start, or change monthly allotment payments from retiree pay accounts. Allotment forms can be found at these links:
 West Region: https://www.triwest.com/triwest/default ... nrollment/
 North Region: https://www.hnfs.net/bene/enrollment/en ... iaries.htm
 South Region: http://www.humanamilitary.com/south/ben ... orms.htm#2.

Retirees should send the completed form with an initial quarterly payment to their regional contractor. The regional contractor will forward a payment request to the designated pay agency and the agency will set up a monthly payment to the regional contractor on the retiree’s behalf. Retirees should contact their regional contractor or go online to a contractor’s secure website to make sure it received the enrollment fee allotment authorization form and initial quarterly payment. DFAS will put allotment orders in the pay system for processing once Tricare sends the request. Retirees may view their allotment details through myPay at: https://mypay.dfas.mil/mypay.aspx, or on their pay statements (leave and earnings statement or retired or annuitant account statement), when DFAS activates the allotment.

Beneficiaries who receive survivor benefits from either retired or active duty sponsors are paid through a separate pay account and are not eligible for an enrollment fee allotment. For more information on enrollment fee allotments, retirees may contact their regional contractor at:
 West Region: TriWest, 1(888) 874-9378, www.tricare.osd.mil/west
 North Region: HealthNet, 1(877) TRICARE, www.tricare.osd.mil/north
 South Region: Humana Military, 1(800) 444-5445, www.tricare.osd.mil/south
For more information on monthly allotments, visit the DFAS website at: http://www.dfas.mil/. [Source: NMFA Government and You E-News 23 Jan 07 ++]


TRICARE UNIFORM FORMULARY UPDATE 17: .When it directed DoD to institute the 3-tier formulary, Congress established the Uniform Formulary Beneficiary Advisory Panel (BAP) to review and comment on the recommendations of the DoD Pharmacy and Therapeutic (P&T) Committee. Members of the BAP include active duty family members, retirees and retiree family members, two clinical experts outside of DoD, a pharmacist from the Uniformed Services Family Health Plan and physicians or pharmacists from the Tricare regional contractors and the pharmacy contractor. NMFA Government Relations Volunteer Deb Fryar serves as an active duty family member representative on the panel. The P&T Committee forwards recommendations, along with the comments from the BAP, to the director, TRICARE Management Activity for consideration prior to a final decision. The military health system encourages Tricare beneficiaries to be part of the process by communicating their concerns to the BAP. The Federal Register announcement of the public BAP meeting and its agenda is posted on the BAP website at www.tricare.osd.mil/pharmacy/BAP/ two to six weeks in advance of the meeting. The site provides information on how beneficiaries should submit comments or concerns. [Source: NMFA Government and You E-News 23 Jan 07 ++]


MILITARY HEALTH CARE TASK FORCE: The Task Force on the Future of Military Health Care held its first open meeting 16 JAN, in Alexandria, Virginia. The commissioners received an overview of the Military Health System (MHS), the Defense Health Program (DHP), and the DoD “sustaining the military health benefit” efforts. Dr. William Winkerwerder, Assistant Secretary of Defense for Health Affairs, and Dr. David Chu, Under Secretary of Defense for Personnel and Readiness, added their commentary on their health care programs and initiatives. The MHS and DHP briefing included information about the MHS mission, beneficiaries and benefits, financial resources, operation and maintenance structure, medical military construction, the Medicare eligible retiree health care fund and current issues. The MHS mission is to:
- Provide health care to the military in order to deploy healthy service members;
- Provide patient care to beneficiaries;
- Maintain professional proficiencies: and
- Deploy medical staff in support of deployed service members.

Currently, the approximately 9.1 million beneficiaries include 2.3 million active duty family members and 2.2 million eligible retiree family members. Funding for the DHP covers operation and maintenance (O&M), research, development, test and evaluation (RDT & E) and procurement (purchases for equipment and systems). Total DHP funding included in the President’s FY 2007 budget is approximately $21 million. Additional FY 2007 budgeted items are medical military personnel, medical military construction and unified medical program, totaling approximately $28 million. The Medicare eligible retiree health care fund covers beneficiaries eligible for Tricare for Life (TFL). The total FY 2007 estimated TFL cost is $7.7 billion. and has a total budget authority of approximately $36 million. The MHS infrastructure consists of 259 veterinary, 417 dental, and 409 medical clinics, as well as 70 inpatient facilities. Patient care makes up 81% of the DHP O&M budget. Patient care received within the military medical facilities is valued at approximately $5.6 million, with $11 million paid for private sector care. Current financial issues are the added cost of the Global War on Terrorism and the failure of the 110th Congress to pass the FY 2007 appropriations bill that funds military construction and Defense health care. Instead, it decided to fund all programs without a completed appropriations bill through at a Continuing Resolution at FY 2006 levels. This decision will create a $2 billion budget shortfall for Defense health care this year.

The DoD briefers presenting the “sustaining the military health benefit” discussed the rising cost of Tricare, in terms familiar to beneficiaries who have followed this issue since DoD’s attempt last year to increase certain Tricare fees. Currently, health care makes up 8% of DoD’s total budget, but is projected to rise to $62 billion and 12% in 2015. Officials noted that the under age 65 retiree eligible population is approximately 3 million. They indicated that the changes proposed last year, and still supported by the Department, are estimated to create $11.2 billion savings over five years. The initial report of the task force is due to Congress in MAY 07. The next meeting is scheduled for 6 FEB 07 in the Washington, DC, area. The task force website is: http://www.ha.osd.mil/dhb/fmhc/. [Source: NMFA Government and You E-News 23 Jan 07 ++]


ANHEUSER-BUSCH HERO SALUTE UPDATE 02: Anheuser-Busch has extended its “Here's to the Heroes” program through 2007. The program provides a single day's free admission to any one SeaWorld or Busch Gardens park, Sesame Place, Adventure Island or Water Country USA for the servicemember and as many as three of his or her direct dependents. Any active duty, active reserve, ready reserve servicemember or National Guardsman is entitled to free admission under the program. He or she need only register, either online at www.herosalute.com or in the entrance plaza of a participating park, and show a Department of Defense photo ID. Also included in the offer are members of foreign military forces serving in the coalitions in Iraq or Afghanistan or in the United States attached to American units for training. Inactive, standby and retired reserve members, military retirees, U. S. Merchant Marine and civilian DoD employees are ineligible for the program. Dependents may take advantage of the offer without their service member, though an adult must accompany minor dependents. Busch Gardens Williamsburg and SeaWorld San Antonio are seasonal operations that will remain closed until spring 2007. The remaining parks, SeaWorld Orlando, Busch Gardens Tampa Bay and SeaWorld San Diego are open year round. Personnel interested in visiting those parks can check operating schedules at www.herosalute.com. Here's to the Heroes is the fourth tribute to military personnel offered by Anheuser-Busch since Yellow Ribbon Summer welcomed servicemembers home from the Gulf War in 1991. [Source: Milirary.com article 22 Jan 07 ++]


IOWA VET BENEFITS: In addition to benefits available from the federal government the State of Iowa has expanded its Vet Benefit programs to include:
- The Iowa Veteran's Housing Grant Program, which gives a $5,000 matching grant to any veteran for the purchase of a home, tax free. To qualify, the service member must have served on active duty under title 10, 90 days or more after 911. Active duty for training does not count. For more information, log onto www.ifahome.com Veterans also receive an annual property tax
exemption on their homes.
- The Injured Veteran Grant Program, which provides grants to any Iowa veteran injured in a combat zone while in the line of duty. The injury does not have to be combat action related. To qualify, the injured veteran must be medically evacuated from a combat zone. Within one week of evacuation, the veteran or his/her designated family member receives a check in the amount of $2,500. The veteran will continue to receive $2,500 every 30 days while he or she is receiving medical treatment, up to a maximum of $10,000. This grant is provided by the state to help off set the additional financial burdens veterans and their families incur during convalescence.
- If you join the Iowa National Guard, the state will pay 100% of your college tuition for four years, up to a maximum of about $6,000 a year. This amount can be applied to attend any private or independent college as well. Guardsmen can then use their GI bill to pay for other expenses.

These are in addition to:
- Annual Tax exemption for veterans of the:
(1) Mexican War or War of the Rebellion: The property not to exceed $11,111 in taxable value.
(2) War with Spain, Tyler Rangers, Colorado Volunteers in the War of the Rebellion (1861-1865), Indian Wars, Chinese Relief Expedition or Philippine Insurrection: The property not to exceed $56,667 in taxable value.
(3) World War I: (April 6, 1917 to November 11, 1918): The property not to exceed $2,768 in taxable value.
(4) World War II: (December 7, 1941 to December 31, 1946): The property not to exceed $1,852 in taxable value.
(5) Korean Conflict: (June 25, 1950 to January 31, 1955): The property not to exceed $1,852 in taxable value.
(6) Vietnam Conflict: (December 22, 1961 to May 7, 1975): The property not to exceed $1,852 in taxable value.
- Use of the Iowa Veterans Home located in Marshalltown, Iowa 50158. Presently, the home provides personalized medical, nursing, rehabilitative care, mental health, pharmacy and dietary services, along with many other services.
- War Orphans Educational Aid from the Iowa Department of Veterans Affairs which may be used to defray the expenses of tuition, matriculation, laboratory and similar fees, books and supplies, board, lodging, and any other reasonably necessary expense for the War Orphan to attend the educational institution of higher learning. Aid is limited to $600.
- Use of The State of Iowa Veterans Cemetery when constructed.

Note: At http://www.military.com/benefits/veteran-benefits/ can be found benefits provided by all states. [Source: Military.com article 22 Jan 07 ++]


FISHER HOUSE EXPANSION: The Fisher House Foundation plans to expand its efforts by building five new homes per year until 2010. This year, VA medical centers in Los Angeles, Dallas, and Seattle are scheduled to break ground on new homes, and the San Diego Naval Medical Center is scheduled to get its second Fisher House as well. On 29 JAN Fisher Houses III and IV at the Brooke Army Medical Center, at Ft. Sam Houston, Texas will be dedicated. The foundation builds homes on and near active military and Veterans Affairs medical facilities. The houses provide free lodging for servicemembers who must stay near a hospital for continuing treatment, as well as families visiting wounded loved ones. Today, there are 36 Fisher House facilities in 16 states and one in Germany. After the houses are built, they are gifted to U.S. government, which then maintains them. The foundation works closely with the military to determine where a new house should be built. For more information, visit the Fisher House Foundation Website www.fisherhouse.org. [Source: Milirary.com article 22 Jan 07 ++]


GULF WAR PRESUMPTIVE DISEASE UPDATE 02: Other than Amyotrophic lateral sclerosis (ALS or Lou Gehrig's Disease) researchers have not been able to isolate any other illness or disease that could be attributed to to active service in the Southwest Asia theater of operations during the Persian Gulf War. However, the VA assumes that those who served in the combat theater who have chronic disabilities resulting from undiagnosed illnesses could receive disability benefits and be afforded other veterans’ rights. Signs or symptoms that may be a manifestation of an undiagnosed illness or a chronic multisymptom illness include the following:
1. Fatigue
2. Unexplained rashes or other dermatological signs or symptoms
3. Headache
4. Muscle pain
5. Joint pain
6. Neurological signs and symptoms
7. Neuropsychological signs or symptoms
8. Signs or symptoms involving the upper or lower respiratory system
9. Sleep disturbances
10. Gastrointestinal signs or symptoms
11. Cardiovascular signs or symptoms
12. Abnormal weight loss
13. Menstrual disorders
Source: www.gulfwarvetlawsuit.com/040902.html ++]


CRSC UPDATE 36: Ann Lacey of the CRSC office at the Air Force Personnel Center says many vets may be missing out on special compensation. Just because a veteran was not injured storming the beaches at Normandy does not mean he or she may not be entitled to receive Combat-Related Special Compensation (CRSC). Veterans may be missing out on hundreds, if not thousands, of dollars every month because they have not applied for the compensation. “Don’t let the term ‘combat’ throw you; there are many circumstances which are combat related that could justify approval of extra tax-free money for you” she said. CRSC is designed to restore military retirement pay that has been offset by Department of Veterans Affairs compensation when evidence exists to confirm the associated disabilities are combat related. For example, if a veteran is currently rated for a disability of 10% with the VA, he or she receives a check from the VA for $115 each month, but his or her retired pay is reduced by that same amount. If that disability is found to be combat-related by the CRSC review board, he or she would continue to receive the monthly check from the VA for $115 along with the remainder of the retired pay, but begin to receive an additional monthly check from CRSC for $115.

Many disabilities that resulted from conditions during peacetime may meet the criteria for CRSC. For example an aircraft mechanic who works on the flight line and begins to lose his hearing while in-service; a personnel technician who dives for cover during a simulated air raid and injures a shoulder; a pararescue journeyman who makes a peacetime parachute jump and breaks his ankle upon landing. If you’re not sure the circumstances surrounding your disability meet the combat-related criteria, it would be beneficial for you to apply for CRSC and let the board make a determination for you. There are a few prerequisites to consider before submitting a CRSC application. To meet the basic eligibility criteria to be considered for CRSC, veterans must inequities that exist in concurrent receipt law:
 Be retired with 20 (or more) years of active-duty military service, or retired at age 60 from the Guard or Reserve.
 Be receiving military retired pay. Veterans who waived military retirement pay for Civil Service credit are not eligible to apply for CRSC.
 Have a compensable VA disability rating of 10 percent or higher.
 Receive military retired pay that is reduced by VA disability payments.

Copies of the Application for Combat-Related Special Compensation, DD Form 2860, and more information on the program can be downloaded from the AFPC Web site at http://ask.afpc.randolph.af.mil/. People can call the Air Force CRSC office at 1(800) 616-3775 for assistance, or e-mail them at afpc.dppdc.afcrsc@randolph.af.mil. It will take a little time to complete the application and make copies of your documentation but it is may qualify you for monthly tax-free compensation for the rest of your life. [Source: Air Force Retiree News 12 Jan 07 ++]


MEDICARE PART D UPDATE 15: In 2006, the Centers for Medicare and Medicaid Services (CMS) started automatically enrolling some Tricare beneficiaries in a Medicare Part D prescription drug plan. According to federal law, the Tricare pharmacy benefit is considered a secondary payer to a Medicare Part D prescription drug plan. Tricare in accordance with federal law established payment rules with their claims processor to ensure their secondary payer role was complied with. Some Tricare beneficiaries who have tried to use their Tricare prescription plan have been surprised to learn that they are enrolled in a Medicare Part D prescription drug plan without their consent. Now, the Department of Defense has established a place for beneficiaries in this position to go with their problem. The Tricare Management Activity (TMA), the Defense Manpower Data Center (DMDC), and CMS have jointly developed a customer-focused process for beneficiaries to resolve Medicare Part D and Tricare coverage issues, and obtain their prescriptions quickly.

If a Tricare beneficiary is denied prescription coverage due to Medicare Part D enrollment, and believes that he or she is not enrolled in Medicare Part D, or have disenrolled from Medicare Part D, the beneficiary should contact Express Scripts at 1(866)363-8779. The Express Scripts customer service representative will ask for the beneficiary’s permission to access Medicare Part D coverage information from CMS and determine whether the beneficiary is currently in a Part D plan. If CMS records show no Part D coverage, DMDC will update the beneficiary’s Defense Enrollment Eligibility Reporting System (DEERS) information in one business day. Additionally, a representative from DMDC will contact the beneficiary to confirm the record correction.

If Express Scripts discovers that CMS shows the beneficiary having Medicare Part D coverage, they will advise the beneficiary how to obtain confirmation of disenrollment or cancellation from Medicare Part D, and how to forward the disenrollment or cancellation information to DMDC to update the beneficiary’s DEERS record. Once DMDC receives this documentation, a customer service representative will update the DEERS records and telephone the beneficiary to confirm the correction. To view current Medicare Part D enrollment status on the Medicare Web site, beneficiaries may go to www.medicare.gov, select the Medicare Prescription Drug Plan Finder option, "Check Current Enrollment" option, then select “View Your Current Plan” and follow the instructions. [Source: TMA Press Release 06-06 dtd 18 Jan 07 ++]


TRICARE USER FEES UPDATE 15: Senior Defense officials have renewed their call to raise TRICARE enrollment fees and co-payments for under-65 military retirees and their dependents. Official’s are warning anew that unless the cost of military health care is more-balanced, so the beneficiary pays more and the government less, the present lifetime benefit, arguably the best in the country, cannot be sustained over time. Defense officials said they briefed key lawmakers on the planned fee increases back in 2005 and most seemed to agree they were needed. But in early 2006, an election year, lawmakers bolted after the Pentagon’s “Sustain the Benefit” plan officially was unveiled. This year, Defense officials hope that, at a minimum, their call for higher Tricare fees will win the endorsement of a new study group, the Task Force on the Future of Military Healthcare.

The 14-member panel was created by Congress, but its members were appointed by the same officials pressing for fee increases. Half of the task force already works for the DoD, being senior military officers or civilian executives. Congress gave them a broad range of issues to examine. But at their first public hearing 16 JAN Dr. David Chu, under secretary of defense for personnel and readiness, told the task force that it needs to address the structure of benefits. Ideally, DoD wants the task force to endorse higher Tricare fees for 3.1 million beneficiaries in an interim report to Congress due in May, presumably early enough for legislative action this year when no lawmaker stands for reelection. Odd numbered years are probably better than even numbered (election) years, quipped Chu when a task force member asked for timing guidance on getting recommendations to Capitol Hill. Defense officials briefed the task force on the military health system’s skyrocketing costs. They say the total this year will be $38 billion, up 131% since 2000. Healthcare spending now is 8% of the defense budget but will climb to $64 billion, or 12% by 2015, unless fees are increased. Most of the growth is tied to new benefits enacted since 2001, including Tricare for Life for 1.9 million Medicare-eligible beneficiaries.

Two other key factors are medical inflation and a shift by retirees into Tricare and away from more expensive health plans earned in second careers or by working spouses. Last year’s Tricare fee plan is expected to be endorsed again in the president’s 2008 budget request to Congress in early February. It would raise enrollment fees and deductibles for under-65 retirees using a triple-tiered fee schedule tied to rank. After two years of stepped increases, fees would rise annually by the percentage change in premiums for federal civilian health care. Defense officials conceded to the task force that their plan’s projected cost savings of $11.2 billion over five years did not survive a review by the Congressional Budget Office. CBO said $6.5 to $7 billion savings is more likely. The Tricare increases planned just are not big enough to spark the behavior DoD projects: that 150,000 beneficiaries will leave Tricare and another 350,000 will decide to stay under employer-provided plans rather than switch to Tricare. Retiree advocates had challenged the savings estimate as too high and evidence of a rush by the department to make changes. The GAO also is auditing projected savings. Its report is due in JUN 07.

Dr. William Winkenwerder, assistant secretary of defense for health affairs said, “Unfair criticism has been leveled at the plan including a charge that higher fees will be a great financial burden. Not so. An E-6 retiree in TRICARE Prime has been paying roughly $38 a month since 1996. That would increase to $50 over two years. That $12 increase is like five cups of coffee. Over the same period, E-6 retired pay has climbed an average of $300 a month to keep pace with inflation.” Defense officials overall are striking a harder tone than was heard last year. Winkenwerder, advised the task force that if it wants to consider more sweeping cost-control measures, to include higher fees for retirees 65 and older too, it should do so. He also said he learned too late that, by law, the department has authority to raise the $22 co-payment for non-formulary Tier-3 prescription drugs to $30. He suggested that should have been part of the plan. Several task force members, including retired Air Force Gen. Richard Myers, former chairman of the Joint Chief, are on record as supporting the fee increases and newer faces on the task force also seem to consider higher fees as reasonable.

Dr. Robert Galvin, director of global healthcare for General Electric, said the DoD plan sounded like it was well researched, rigorously thought through. But why, Galvin asked, did Congress not enact it? Part of the problem, Chu said, is that Congress only votes one budget year at a time and in the immediate year it’s not a crisis. So it is easier to listen to the concerns of various constituencies and to think about the fact that you would have to stand for reelection in the face of this unpopular and difficult decision. The lone task force member appointed to represent the views of military associations and veterans’ service organizations even seemed to side with raising fees. Retired Army Reserve Major Gen. Robert W. Smith III, former president of the Reserve Officers Association, urged defense officials to work harder to explain that military healthcare is not an “entitlement” as some retiree groups contend, but a “benefit” which, he implied, an employer can adjust from time to time. Smith said, “When perceived as an entitlement health care is a more emotional issue. Service associations have been making that kind of argument. Veteran groups and The Military Coalition went to the congressmen and the senators and created a lot of this.” Winkenwerder said he agreed with that premise. [Source: Military.com Tom Philpott article 18 Jan 07 ++]


TRICARE USER FEES UPDATE 16: Taking up the cudgel where they left off last year, Tricare champions Rep. Chet Edwards (D-TX) and Walter Jones (R-NC) on 19 JAN reintroduced their "Military Retirees Health Care Protection Act" (H.R. 579) just days after Pentagon officials renewed their calls for increasing Tricare premiums, deductibles and co-payments for some beneficiaries to deal with the military's rising health care costs. Last year, the Bush administration proposed to double and triple Tricare premiums for working-age retirees, those under age 65, but Congress blocked the move, ordering more study. That has not stopped the Pentagon from pursing higher fees, which is why Edwards and Jones made a point of introducing their bill before the administration sends its fiscal 2008 budget to Congress. The new bill is virtually identical to the one (H.R. 4949) they introduced last year, which gathered 164 cosponsors and helped prevent imposition of Pentagon-proposed fee increases of up to $1,000 a year for retired members, family members and survivors under age 65. The Edwards-Jones bill would remove the Pentagon's authority to increase Tricare fees, specifying that that authority should reside only with Congress. It would also establish certain principles in law, including:
- Acknowledgement that military members pay very large premiums for their future care "up front" through decades of arduous service and sacrifice;
- Acknowledgement that the primary offset for enduring the extraordinary sacrifices inherent in a military career is a package of retirement and health benefits that must be considerably better than that afforded civilian workers; and
- The principle that the percentage increase in health fees in any year should not exceed the percentage increase in beneficiaries' military compensation.
[Source: MOAA Leg Up 19 Jan 07 ++]


COLA 2008 UPDATE 03: This week, the Bureau of Labor Statistics announced the DEC 06 monthly Consumer Price Index (CPI), which is the metric used to calculate the annual cost-of-living adjustment (COLA) for military retired pay, VA disability compensation, survivor annuities, and Social Security. The Consumer Price Index had its first increase of the first quarter of the fiscal year by jumping 0.6 percent above November’s CPI. However, the CPI still stands 1.0 percent below the FY2007 CPI base - which may indicate a relatively low COLA for 2008. For more information visit MOAA’s Web site at http://moaaonline.org/ct/Lpzmics1hXjm/. [Source: MOAA Leg Up 19 Jan 07]


KOREAN WAR ARMISTICE DAY: The Korean War Armistice Day Committee has announced that ceremonies marking the 54th anniversary of the armistice ending the Korean War will be held on 27 JUL 07 at 10am at the Korean War memorial on the Mall in Washington, DC. For detailed information contact J. Norbert Reiner, 6632 Kirkley Ave., McLean VA 22101 or call (703) 893-6313. Info on accommodations and tours is available from Jack Cloman, 2702 Franklinville Road, Joppa, MD 21085 or call (410) 676-1388. [Source: NAUS Weekly Update 19 Jan 07 ++]


FEDERAL EXCISE TAX REFUND CREDIT: When you file your 2006 tax return, make sure you do not overlook the “federal excise tax refund credit.” This credit is a refundable credit. That means you get this money, no matter how your tax return works out. If you would end up owing the IRS a balance, the refund will reduce that balance you owe. If you end up getting a refund, the credit will be added and you get a bigger refund by that $30 to $60, depending on how many dependents are on your return. The credit is claimed on line 71 of form 1040. A similar line will be available if you file the short form 1040A. Also, if you know anyone who no longer files a tax return and they have their own land phone in their home and have been paying a phone bill for years, make sure they know about the form 1040EZ-T, which they can use to claim this refund. The one time credit is available because the federal excise tax has been charged to you on your phone bill for years. It is an old tax (Spanish American War era) that was assessed on your toll calls based on how far the call was being made and how much time you talked on that call. When phone companies began to offer flat fee phone service, challenges to the excise tax ended up in federal courts in several districts of the country. The challenges pointed out that flat fee/rate phone service had nothing to do with the distance and the length of the phone call. Therefore, the excise tax should/could not be assessed and restitution should be made to those concerned.

The IRS has now conceded this argument. Phone companies were given notice to stop assessing the federal excise tax as of 30 AUG 06. You most likely will have seen the tax on your September cutoff statement, but it should NOT have been on your October bill. But the challengers of the old law also demanded restitution. The IRS has announced that a one time credit will be available when you file 2006 tax return. However, the IRS also established limits on how large a credit you can get. Here’s how it works.
- If you file your return as a single person with just you as a dependent, you get to claim a $30 credit on line 71 of your 1040.
- If you file with a child or a parent as your dependent, you claim $40.
- If you file your return as a married couple with no children, you claim $40.
- If you file as married with children, you claim $50 if one child, $60 if two children

In all cases, the most you get to claim is $60 - unless you have all your phone bills starting after 28 FEB 03 through 31 JUL 06. If so, then you can add up the actual tax as it appears on your bills and claim that for a credit. If you do this you cannot use line 71 on your tax return. You have to complete a special form number 8913 and attach it to your tax return. Individuals using the special from 1040EZ-T will have to attach this form 8913 also. [Source: NAUS Weekly Update 19 Jan 07 ++]


CONGRESSIONAL BUDGET SCHEDULE: Most, but not all, law changes affecting military personnel and compensation policy are incorporated in the annual Defense Authorization Bill and funded via the Defense Appropriations Bill. Last year Congress failed to enact 9 of the 11 annual spending bills for FY2007 which started on 1 OCT 06. Instead, Congress passed a continuing resolution, which funds non-DoD government agencies for 2007 at 2006 levels. Congressional rules outlining the budget schedule are supposed to avoid this type of slippage. Here’s this year’s schedule if they live by the rules:

• February 5: Deadline for submission of President’s budget.
• Six weeks after budget submission: Deadlines for committees to submit cost estimates for their proposed initiatives to the Budget Committees, as applicable.
• March-April: House/Senate pass separate budget resolutions (self-imposed, annual spending ceilings).
• April: House/Senate agree on a single budget resolution. Last year, the House and Senate could not agree on a single resolution.
• Mid-May: Begin to consider annual appropriations bills.
• June: Appropriations Committees report the last of the appropriations bills and each chamber completes action on the spending bills.
• July 1.
• October 1: New fiscal year begins. Only two annual appropriations bills were completed by Oct 1 last year - defense and military construction.
[Source: MOAA Update 19 Jun 07 ++]


EXPATRIATE INCOME TAX: U.S. citizens and resident aliens who live in a foreign country must file a tax return if their global income exceeds their standard deduction and exemption amount(s). For Married Couples, the Standard Deduction is $10,300; for Singles, $5,150; Heads of Household, $7,550; Married Couples Filing Separately, $5,150; Qualifying Widow(er), $10,300. The Standard Deduction is increased by $1,250 for an unmarried individual age 65 or blind, and $2,500 for a combination of the two. It is increased $1,000 for any married person 65 years or older, or blind, or $2,000 for both conditions. The Exemption amount is $3,300 per dependent. A married couple with two children would therefore not be required to file a tax return if their global income in 2006 was under $23,500 ($10,300 + ($3,300 x 4)), unless either spouse had foreign earned income. A couple marrying the last day of the calendar year may file as though married for the entire year. But a couple who divorces on 31 DEC is considered unmarried for the entire year. Regardless of whether foreign earned income (salaries, wages, earnings from self-employment) can be excluded from U.S. taxation by the $82,400 Foreign Earned Income Exclusion resulting in an American expatriate filer falling below the Standard Deduction + Exemption threshold, a tax return must be filed. Otherwise, in a future audit, IRS can deny a non-filer the FEIE and tax him or her on the foreign earnings.

A resident alien living outside the United States can be a resident in the U.S. for 183 days in the past three years plus 31 days during the recent calendar year, or a green card holder. A nonresident alien may have to file a tax return based on income from U.S. sources. Income effectively connected with a U.S. business and capital gains from the sale of U.S. real estate are subject to regular income tax rates. Otherwise income is taxed at 30% or lower treaty rate. A U.S. citizen living abroad can file a tax return as Married Separate but might well consider the possibility of a better tax break by filing jointly with his or her alien spouse. Under certain circumstances a person arriving in or

[boardman]

RAO Bulletin Update
15 February 2007


THIS BULLETIN UPDATE CONTAINS THE FOLLOWING ARTICLES:

== United Nations Memorial Wall ----- (Contains 40,895 Names)
== Fair Tax Act [01] ------------------- (Reintroduced as H.R.0025)
== Military Health Care TF [01] -------------------- (TMOP Copay)
== Tricare User Fees [17] ------------------------- (Hikes Inevitable)
== Tricare User Fees [18] ----------------------- (DoD Ups the Ante)
== VA Data Breach [29] ---------------------- (Hard Drive Missing)
== VA Claim Processing Goals ------------ (OIF/OEF Vet Priority)
== VA Facility Expansion [02] --------------- (23 New Vet Centers)
== VA Hiring Freeze Fallout ------------------------- (Waiting Lists)
== Small Business Administration ---------- (Extension to 31 JUL)
== GI Bill Inequities [02] --------------------- (Means Test)
== Telemarketing Call Elimination [05] -- (139 Million Registered)
== VA Prescription Policy [02] --------------- (Split Pills)
== Thunderbirds 2007 Show Schedule ------- (Dates & Locations)
== Vet Cemetery Arizona ----------------------- (Prescott Reopened)
== Air Force Week Schedule --------------- (2007 Locations/Dates)
== VA Budget 2008 -------------------------- ($87 Billion Proposed)
== Budget 2008 [01] ------------------------------- (SVAC Comments)
== VA Budget 2008 [02] ---------------------------- (VFW Comments)
== VA Budget 2008 [03] ---------------------------- (DAV Comments)
== Government Overpayments --------------- (Who’s Responsible?)
== VDBC [13] -------------------------------------- (Next Mtg 21 FEB)
== NGB DOD Representation [02] ------------- (NG Empowerment)
== CRDP [41] ------------------------------ (Majority Leader Support)
== Military Payday Lenders [03] ---------- (Reconsideration Asked)
== VA Health Care Funding [07] ----------------------- (H.J. Res. 20)
== Medicare Part B Tax Credit [01] ----------------------- (H.R.0343)
== Income Tax (State) [01] ------------------------- (Who Taxes What)
== Reserve GI Bill [05] ----------------- (Veterans Misled)
== VA Medical Education Support ----------------------- (Increasing)
== AFSA Benefits Monitoring ------------ (Reduced Fringe Benefits)
== VA Headstones & Markers [01] ------ (Eligibility & Availability)
== Vet Gravesite Locator ------------------ (Where to go)
== Retiree Survivor Comfort Act ------------ (Last Check Retention)
== Claims and Appeals ---------------------- (Responsibility is Yours!)
== VA Homeless Vets [03] -------------- (Substance Abuse Services)
== AF Combat Action Award [01] ----------- (Awards Begin Apr 07)
== Army Leisure Travel Services----------------- (Discounts Offered)
== Retiree Medal Wearing Policy-------------------- (When & Where)
== SBP SSA Offset [08 -------------------------------- (5% Reduction)
== Referral Bonus Pilot Program [01] ------------- (Raised to $2000)
== Army Retired Soldiers Pin -------------------------------- (New Pin)
== Cold Hands ------------------------------------- (Cause & treatment)
== Military Legislation Status 14 FEB 07 --------- (Where we stand)


UNITED NATIONS MEMORIAL WALL: The United Nations Memorial Wall can be found in the UN Memorial Cemetery, Daeyon-4dong, Nam-gu, Busan Metropolitan City, Korea. It is a little known memorial and work of art measuring two meters high by approximately 150 meters in length (one and one-half football fields) that contains the names of 40,895 allied servicemen who lost their lives on United Nations service during the Korean War. It is so little known that a search of the U.S. internet to gather data to assist in writing this article revealed no information on it. In length it is larger in size than the Vietnam Veterans Memorial in Washington DC which contains the names of 58,253 personnel who fell in service during the Vietnam War. The Memorial Wall was dedicated with virtually no fanfare or publicity on 24 OCT 06, marking the 61st anniversary of the 1945 founding of the United Nations.

The UN Memorial Cemetery Commission overseas the cemetery and is comprised of the Ambassadors (or their representatives) of the countries of the interred servicemen. The cemetery occupies 14.7 hectare of land donated by the Korean government. It became a burial ground in APR 51 following relocation of the graves by the UN Forces Command in Korea, which began in January of the same year, from six temporary graveyards scattered around the nation. These were mainly in the areas of Kaeseong, Incheon, Daejeon, Daegu, Milyang, and Masan. Although there had been about 11,000 of the UN’s fallen braves interred at the cemetery in the years from 1951 to 1954, there now rest only 2,300 since Belgium, Colombia, Ethiopia, Greece, Philippines, and Thailand brought their fallen warriors back home. The US also took back most of theirs and France and Norway transferred some of theirs back home. Currently interred are 281 Australians, 378 Canadians, 44 French, 117 Dutch, 34 New Zealanders, 1 Norwegian, 36 Koreans, 11 South Africans, 462 Turkish, 885 British, 36 Americans, 4 unknown, and 11 non-combatants. [Source: Korea Vet News (Canada) 11 Feb 07 ++]


FAIR TAX ACT UPDATE 01: On 4 JAN Rep. John Linder (R-GA-07) introduced the Fair Tax Act of 2007 H.R. 0025 as a bipartisan bill for the first time since 2003. It immediately drew 24 cosponsors from 11 states. Today, just over one month into this Congress, the FairTax and its supporters have amassed 53 cosponsors from 24 states. To put this accomplishment in perspective, in the 107th Congress, they never came anywhere close to this number; in the 108th Congress, they only barely achieved it after two full years; and in the 109th Congress, the FairTax reached 52 cosponsors only after 15 months of hard work by volunteers across the country. Everyone knows that the income tax code is complicated and oppressive, but not everyone knows that the FairTax will free them from this intrusive burden.

The Act’s stated purpose is, "To promote freedom, fairness and economic opportunity by repealing the income tax and other taxes, abolishing the Internal Revenue Service, and enacting a national sales tax to be administered primarily by the states. If The Fair Tax Act were to become law, the following would happen.
- The law establishing the federal income tax would be repealed, both for individuals and for businesses.
- A constitutional amendment repealing the 16th Amendment would be sent to the states for ratification.
- All laws providing for payroll taxes for the funding of Social Security and Medicare would be repealed.
- A sales tax would be instituted on the sale of all goods and services at the retail level. This retail sales tax would replace all payroll and federal income taxes.
- Government funding would remain at present levels, and no changes would be made to Social Security and Medicare other than the method of funding those programs.

With the passage of H.R.0025 people would receive 100% of their paycheck. They would only pay tax on the money they spend at the retail level. All savings and investments would be tax free. Any money spent at the retail level would carry a 23% sales tax. A 23% sales tax may sound high until you consider there are the embedded taxes on every single product or service you purchase at the retail level. Harvard economists have estimated this embedded tax to be around 22% of the cost of those goods. That 22% represents the payroll taxes and corporate business and income taxes paid by every manufacturer, shipper, wholesaler, merchandiser and retailer having any connection whatsoever with the product you have purchased. These taxes are all added to the cost of consumer goods. As soon as these taxes vanish, economists agree that competitive market pressures will immediately cause prices at the retail level to fall. If prices decrease by over 20% and you start paying a 23% sales tax the overall costs of things would be the same. However, since people would not be taxed on their income they would retain all of their paycheck and every dollar they do not spend at the retail level remains untaxed.

The Fair Tax Act provides that no family, rich or poor, will pay sales taxes on the basic necessities of life. The cost of these basic necessities is set at the federally determined poverty level for various sized families. At the beginning of every month the head of every household in America will receive a check, or an electronic credit to their bank account, in an amount equal to the sales tax they would pay on the basic necessities for their sized family. This provision is completely neutral as to income, so class warfare political rhetoric becomes useless. Most people are not aware of this legislation which was initially introduced as H.R.2525 in the 107th Congress. To become law people need to let their elected officials know that they want some action. If you have interest in reducing your tax burden check out www.fairtax.org which explains in detail how the law would work. [Source: Rep. John Linder msg. 9 Feb 07 ++]

MILITARY HEALTH CARE TF UPDATE 01: The Task Force on the Future of Military Health Care held its second public hearing in Washington DC 6 FEB and was provided a number of informational briefings. RADM Tom McGinnis (USPHS), chief pharmacist for the Tricare Management Activity, warned that the non-formulary, or third-tier, copayments – which are set at $22 - are having minimal impact on beneficiaries in both the mail order (TMOP) and retail pharmacy venues. Despite efforts to shift beneficiaries away from those high cost drugs, both pharmacy venues have seen increased use in those drugs. As reported before, the retail system is the most costly for both the beneficiary and the government. In order to move patients away from the use of non-formulary ($22) drugs he made several proposals to the task force which include:
- Making non-formulary drugs available only through TMOP
- Barring beneficiaries from obtaining maintenance drugs from the retail system
- Raising copayments in the retail network for a 30-day supply to from $3 and $9 to $5 and $15 for generics and brand name drugs, respectively
- Revising copayments in TMOP for a 90-day supply from $3 and $9 to $0 and $15 for generics and brand name drugs, respectively. Third tier drug copayments would change from a flat $22 to 20% or 25% of the total cost of the drug.

At this meeting it was announced that they intend to hold public hearings around the country in the next few months. A schedule will be provided as soon as they decide were and when. Their recommendations may have enormous effects on all members of the military community. It is very important that they hear from the grass root retirees. [Source: MOAA Leg Up 9 Feb 07 ++]


TRICARE USER FEES UPDATE 17: The Pentagon’s top health official reiterated 30 JAN the need to increase Tricare fees because across-the-board cuts have not been enough to decrease the Defense Department’s health care costs. Dr. William Winkenwerder Jr., assistant defense secretary for health affairs, said there is no way to cut operating enough to prevent higher fees. “That is a false hope,” he said. “It is not possible.” During a roundtable at the annual Military Health System Conference in Washington, Winkenwerder said the health care budget was at $18 billion in 2000. In 2007, he expects it to grow to about $40 billion. “We don’t see an end to that, in the absence of some appropriate adjustments and changes. We haven’t made any change in the benefits structure in 13 years. The rate of growth, especially with new benefits and the expansion of Tricare for older military retirees and reservists, is twice the rate of inflation and higher than private-sector growth.” He reiterated a list of all the things the Defense Department has done to cut costs: changes to the prescription-drug formulary that saved $5 million in two years, changes in the payment process for care that saved $1 billion, and the conversion of military positions to civilian positions to save several hundreds of thousands of dollars. In spite of this he noted doing all of these things still does not get DoD anywhere near the amount of savings needed to have a lower-cost growth. Congress rejected last fall a 2006 proposal to save $11 billion through increased fees for retirees younger than 65 or increasing what they spend out-of-pocket for doctor visits met with strong opposition. The Defense Department had planned to save $735 million this year by increasing Tricare fees. The House defense appropriations subcommittee demanded that Winkenwerder solve the problem by asking the White House to present a request for more money. [Source: NavyTimes Kelly Kennedy article 30 Jan 07 ++]


TRICARE USER FEES UPDATE 18: The defense budget the Administration submitted to Congress on 5 FEB significantly upped the ante in the Pentagon's campaign to raise Tricare fees. It assumes even bigger fee hikes for FY2008 than last year's budget submission assumed for FY2007. Last year's budget proposed tripling Tricare Prime and Tricare Standard fees for retired officers and their family members and survivors over a two-year period, and more than doubling them for most enlisted retirees. It also would have increased retail pharmacy fees for all Tricare beneficiaries of all ages by almost 70%. The Administration projected that those fee hikes would save the Pentagon $735 million in FY2007 and $1.86 billion in FY2008, and cut last year's defense health budget by $735 million on the assumption that Congress would accept them. Fortunately, Congress did not and barred the Pentagon from increasing fees in FY2007, pending review of alternative options.

This year, the Pentagon hasn't published any specific fee increase plan, indicating they are awaiting the results of a DoD-appointed Task Force on the Future of Military Health Care, which is supposed to provide interim recommendations on cost-sharing and pharmacy copays in May. But that's disingenuous, because the budget submitted to Congress this week assumes $1.8 billion in savings from Tricare fee increases. That's almost three times the savings assumed in the FY2007 budget -- and happens to be precisely the amount of savings associated with the second year of last year's fee hike plan. So the budget puts enormous pressure on the Task Force (all of whose members were appointed by the Secretary of Defense and half of whom work for the Secretary) to propose at least the same fee hikes the Pentagon pushed last year - and assumes that Congress will implement them all immediately, without any two-year phase-in. In essence, the Administration has underfunded the defense health budget by presuming the task force's outcome, and has challenged Congress to either change the law to implement fee increases high enough to save $1.8 billion or to find another $1.8 billion from another source to make up for the underfunding.

The Military Officers Association of America thinks it's wrong to play this kind of budget "chicken" with the defense health program - especially in time of war. They believe strongly that Congress should establish clear guidelines in law about the unique role of military retirement benefits, including health care, as the primary offset for the extraordinary demands and sacrifices inherent in a military career. They must recognize that military members and families who serve two or three decades under those conditions are making a substantial, in-kind pre-payment for those benefits. The cash deductibles, enrollment fees and copays that they pay in retirement are only a small portion of their very large personal contributions toward their benefits. To help make this case, MOAA is asking their members and all others in the military community member to do the following as applicable:

- Sign, stamp and mail the four tear-out letters in their February issue of Military Officer magazine (two at page 32 addressed to the House and Senate Armed Services Committee Chairmen and two at page 52 addressed to the Committees' senior Republican). Similar tear-out letters last year helped turn the tide in Congress when Committee leaders stacked them on a witness table at a TRICARE hearing. Even more participation is needed this year, now that Congress is facing a far greater budget challenge.
- Use MOAA's Web site to urge your U.S. representative to cosponsor Rep. Chet Edwards' (D-TX) and Rep. Walter Jones' (R-NC) Military Retirees Health Care Protection Act (H.R. 579).
- Pass the word about the proposed increases to all of your TRICARE-eligible friends and urge them to send the message available at http://capwiz.com/moaa/issues/bills/?bill=9275676
[Source: MOAA Leg Up 9 Feb 07 ++]


VA DATA BREACH UPDATE 29: The Department of Veterans Affairs (VA) announced 2 FEB that an employee reported a government-owned, portable hard drive used by the employee at a Department facility in Birmingham AL and potentially containing personal information on about 48,000 veterans is missing and may have been stolen. The hard drive also contained highly sensitive information on nearly all U.S. physicians and medical data for about 535,000 VA patients. The data for the 1.3 million physicians who have billed Medicaid and Medicare, both living and deceased, could result in widespread fraud, such as the creation of fake Medicare and Medicaid invoices. According to congressional sources, the personal information on patients and the medical data were kept in separate files, but there is enough information that files could be linked. A VA research assistant was using the physician data to analyze VA health care providers and compare them to non-VA providers, according to a statement from the department. The research assistant used the hard drive to back up information contained on an office computer, and the data is not believed to have been encrypted. The employee has been placed on administrative leave pending the outcome of a criminal investigation, which is being conducted by the VA’s inspector general and the FBI. A spokesman for the Centers for Medicare and Medicaid Services said the agency is aware of the situation and is working with the VA to get more information.

The VA announcement said there is no information that the data has been misused. VA spokesman Matt Burns said initial reports show encryption policies were not strictly followed. The incident marks the third major breach at the VA in less than a year. In MAY 06, the theft of computer equipment containing sensitive information from an employee's home put 26.5 million people at risk for identity theft. Four months later, another breach put at risk the personal data of up to 38,000 people. In both instances, the data was recovered and officials determined it was probably not touched. Following are actions taken to date or contemplated on this incident:

- On January 22, the employee at the Birmingham VA Medical Center reported that an external hard drive was missing. The hard drive was used to back up information contained on the employee’s office computer, and may have contained data from research projects the employee was involved in. The employee also indicated the hard drive may have contained personal identifying information on some veterans, but asserts that portions of the data were protected. Investigators are still working to determine the scope of the information potentially involved.
- On January 23, VA’s IG was notified the external hard drive was missing. The OIG opened a criminal investigation, sent special agents to the medical center, and notified the FBI. VA’s Office of Information & Technology in Washington, D.C. also dispatched an incident response team to investigate.
- The OIG has seized the employee’s work computer and is in the process of analyzing its contents. VA IT staff is providing technical support in this effort. Analyzing the work computer may help investigators determine the nature of the information the hard drive potentially contained.
- Pending results of the investigation, VA is prepared to send individual notifications and provide one year of free credit monitoring to those whose information proves compromised.
- In addition to the ongoing criminal investigation, the OIG has initiated an administrative investigation to determine how such an incident could occur. VA will provide further updates as the investigation produces additional information.

Secretary of Veterans Affairs Jim Nicholson, said, “I am concerned about this report. VA’s Office of Inspector General and the FBI are conducting a thorough investigation into this incident. VA’s Office of Information and Technology is conducting a separate review. We intend to get to the bottom of this, and we will take aggressive steps to protect and assist anyone whose information may have been involved. VA is unwavering in our resolve to be the leader in protecting personal information, and training and educating our employees in best practices in cyber and information security. We have made considerable progress, but establishing a culture that always puts the safekeeping of veterans’ personal information first is no easy task. I have committed VA to achieving such reform – and we will. This unfortunate incident will not deter our efforts, but it underscores the complexity of the task we have undertaken.” Veterans who have lost faith in our government’s ability to protect their personal data are advised to seek personal protection against identity theft through companies like LifeLock www.lifelock.com which will reimburse any losses incurred. [Source: VA News Release 2 Feb & GOVEXEC.com 12 Feb 07 ++]


VA CLAIM PROCESSING GOALS: Admiral Daniel Cooper, VA Undersecretary for Benefits and head of the Veterans Benefits Administration (VBA), has directed that all claims for benefits from veterans who have served in Operation Iraqi Freedom or Operation Enduring Freedom (OIF/OEF) will be given a higher processing priority. In a memo sent to all VA Regional Offices Cooper said, “Effective immediately, the processing of claims received from all OEF/OIF veterans will be a priority for VBA. This effort will supplement our previous initiative of providing case management for all seriously injured OIF/OEF veterans. While not every OIF/OEF claim will be case managed, these claims will be given first priority by VBA employees. These young men and women have recently returned from the combat zone and it is vital that we enter them into the VA system as soon as possible.” Secretary Cooper’s efforts to ensure our returning troops are given this priority are commendable. Now if only he can find enough employees to help shrink the ever growing claims backlog of the remaining vets. [Source: NAUS Weekly Update 9 Feb 07 ++]


VA FACILITY EXPANSION UPDATE 02: The Department of Veterans Affairs’ vet center program, which provides readjustment counseling and outreach services to combat veterans, is expanding into 23 new communities across the nation in the next two years, the Department announced. These facilities are an important resource for veterans returning from the Global War on Terror and their families. New vet centers will be located in Montgomery, AL; Fayetteville, AR; Modesto, CA; Grand Junction, CO; Orlando, Fort Myers, and Gainesville FL; Macon, GA; Manhattan, Kan.; Baton Rouge, LA; Cape Cod MA; Saginaw and Iron Mountain MI; Berlin NH; Las Cruces NM; Binghamton, Middletown, Nassau County and Watertown NY; Toledo OH; Du Bois PA.; Killeen TX; and Everett WA. During 2007, VA plans to open the new facilities in Grand Junction, Orlando, Cape Cod, Iron Mountain, Berlin and Watertown. The other new vet centers are scheduled to open in 2008.

All vet centers are community-based. They provide counseling on mental health and employment, plus services on family issues, education, bereavement and outreach, to combat veterans and their families. They are staffed by small teams of counselors, outreach specialists and other specialists, many of these individuals are combat veterans themselves. Congress established the vet center program in 1979 in recognition that a significant number of Vietnam veterans were still experiencing readjustment problems. Today, all veterans who served in combat are eligible for care at a VA vet center at no cost, as are their families for military-related issues. Also eligible are veterans who were sexually assaulted while on active duty and the families of service members who die on active duty. Currently, VA maintains 209 vet centers in all 50 states, the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands. [Source: NAUS Weekly Update 9 Feb 07 ++]


VA HIRING FREEZE FALLOUT: In JAN 07 a former Marine Lance Corporal suffering from a severe case of post traumatic stress disorder, committed suicide at a friend’s home in New Prague, Minn. The combat-wounded warrior received two Purple Hearts for his service and shrapnel injuries he sustained to his neck and hip while stationed in Fallujah and Ramadi. While he was there, 35 Marines in his unit were killed, including 17 of them in just 48 hours of intense combat. He looked forward to returning home to Minnesota to renew his life with loved ones and friends, but the horrific images and sounds of war followed him home. Unable to deal with his stress and wishing to salvage his relationship with his family, he went to the VA Hospital in St. Cloud, Minn. He told a staff member he was thinking of killing himself and asked to be admitted to the mental health unit. He was told that he could not be admitted that day. When he spoke to a counselor on the following day, he was told that he was No. 26 on the waiting list. Four days later, he committed suicide. While there is a full-scale investigation going on into the VA’s handling of the case, it very sad that there had to be 26 other veterans on that list ahead of him waiting to be seen.

Waiting lists are a chronic VA problem that that cannot be alleviated with the limited number of staff at most VA hospitals that is the result of them having to make financial cutbacks . Congress’ inability to pass funding bills in time to meet VA’s financial needs is a major factor in the cause of these cutbacks which has and is impacting adversely on many veterans. The problem continues to grow. On 6 FEB, the Veteran Affairs Health Revenue Center in Topeka announced a hiring freeze that will delay efforts to fill 90 new jobs. About 350 people work at the four-year-old center, which answers phone calls from veterans nationwide with questions about their health care bills. VA officials there say the hiring freeze is in place because Congress hasn't passed a permanent budget for the current fiscal year. The agency is operating under a continuing resolution that extends the old budget until a new one is passed. VA officials are hopeful the new budget will be approved by the time the continuing resolution expires February 15th. However, it takes time to hire and train new staff so even with increased funding there is no short term solution and many veterans will continue to have to wait for treatment to relieve their suffering. [Source: AL Weekly Update 9 Feb 07 ++]


SMALL BUSINESS ADMINISTRATION: On 7 FEB, the House cleared a measure that would extend the authorization of the Small Business Administration (SBA) through 31 JUL. This action gives Congress time to consider a longer-term reauthorization. The bill (HR 434), cleared by voice vote, would authorize all SBA programs and provisions (including pilot programs) implemented before 30 SEP 06. Recently, the Senate Committee on Small Business and Entrepreneurship held a hearing on Assessing Federal Small Business Assistance Programs for Veterans and Reservists during which they accepted testimony from representatives of service-connected small business owners. They have been pressuring GSA and their contracting officers to honor the presidential Executive Order 13360 (26 OCT 04) that requires all federal agencies to award at least 3% of all of their contracts to service disabled veteran owned businesses (SDVOB’s). It was emphasized at this hearing that there are 3 million small businesses owned by veterans. In addition, 22% of veterans in the United States are either purchasing or starting a new business or considering purchasing or starting one. Congress has not made major changes to the SBA’s authorization in six years. A previous House version of the measure would have extended the reauthorization through 31 DEC 07, but the Senate cut that back to midyear. On 7 FEB Rep. Nydia M. Velázquez (D-NY), chairwoman of the House Small Business Committee, urged lawmakers to clear the amended measure to ensure that all agency programs continue to operate. [Source: AL Weekly Update 9 Feb 07 ++]


GI BILL INEQUITIES UPDATE 02: The American Legion Economic Division has uncovered am injustice with Financial Aid packages available to recently discharged veterans. The “Means Test’, or simply a test to assess the income and other education financial aid packages is unfair to veterans. Veterans education benefits are not used in EFC (Expected Family Contribution) calculation, however the prior years income is used to determine other eligibilities. This means that members who choose to enroll in school the year following their discharge must count their last year of active duty as their income. Reservists and National Guard members who are called up on average of 16 months must use this formula even if they were enrolled in college prior to their mobilizations. The average total tuition, fee, room, and board charges for in-state students at public institutions are $12,796, $3121 more than the $9675 granted annually for the full time MGIB-AD. The dollar amount of the MGIB-AD entitlement should be indexed to the average cost of college education including tuition, fees, textbooks and other supplies for a commuter student at an accredited university, college or trade school for which they qualify and that the educational cost index should be reviewed and adjusted annually. [Source: AL Weekly Update 9 Feb 07 ++]


TELEMARKETING CALL ELIMINATION UPDATE 05: As the number of phone numbers on the National Do Not Call (DNC) Registry surpassed 139 million, the Federal Trade Commission on 6 FEB reiterated that despite the claims made in e-mails circulating on the Internet, consumers should not be concerned that their cell phone numbers will be released to telemarketers at any time in the near future. In addition, according to the agency, it is not necessary to register cell phone numbers on the DNC Registry to be protected from most telemarketing calls to cell phones. The truth about cell phones and the DNC Registry is:

- Contrary to the e-mail, cell phone numbers are NOT being released to telemarketers, and you will NOT soon be getting telemarketing calls on your cell phone.
- There is NO deadline by which you must register your cell phone number on the Registry.
- Federal Communications Commission (FCC) regulations prohibit telemarketers from using automated dialers to call cell phone numbers. Automated dialers are standard in the industry, so most telemarketers are barred from calling consumers on their cell phones without their consent.
- The national associations representing telemarketers have stated that their clients do not intend to start calling consumers’ cell phones.
- There is only ONE DNC Registry. There is no separate registry for cell phones. You can register your phone number(s) in the National Do-Not-Call Registry at http://donotcall.gov or by calling 1(888) 382-1222.
- The DNC Registry accepts registrations from both cell phones and land lines. You must call from the phone number that you want to register. If you register online, you must respond to a confirmation e-mail.
- While the telecommunications industry has been discussing the possibility of creating a wireless 411 directory, according to the FCC, even if a wireless 411 directory is established, most telemarketing calls to cell phones would still be illegal, regardless of whether the number is listed on the federal government’s National Do Not Call Registry.
- To learn more about the National DNC Registry and the rules that enforce it, visit the FTC at www.ftc.gov or the FCC at www.fcc.gov. For more information about a planned “wireless 411” directory, visit http://www.qsent.com/wireless411.

The FTC works for the consumer to prevent fraudulent, deceptive, and unfair business practices in the marketplace and to provide information to help consumers spot, stop, and avoid them. To file a complaint in English or Spanish (bilingual counselors are available to take complaints), or to get free information on any of 150 consumer topics, call 1(877) 382-4357), or use the complaint form at http://www.ftc.gov. The FTC enters Internet, telemarketing, identity theft, and other fraud-related complaints into Consumer Sentinel, a secure, online database available to hundreds of civil and criminal law enforcement agencies in the U.S. and abroad. [Source: FTC News Release 6 Feb 06 ++]


VA PRESCRIPTION POLICY UPDATE 02: Ever wonder why so many VA prescribed medications call for splitting pills to meet dosage requirements. One reason could be that United States Code; 38 USC 1722a. Paragraph (a)(1) subject to paragraph (2), states the Secretary shall require a veteran to pay the United States $8.00 for each 30 day supply of medicine. If the amount supplied is less than a 30 day supply the amount of the charge may not be reduced. Paragraph (2) states The Secretary may not require a veteran to pay an amount in excess of the cost to the Secretary for medication as described in paragraph (1). VA’s interpretation of this law allows the splitting of pills into smaller dosages and charging the $8.00 copay for 15 vice 30 pills which can be split to provide a 30 day supply. Thus, by purchasing pills in larger dosages at a lower cost and splitting those to fill prescriptions VA can further reduce their overall cost of purchasing medications by doubling the return on each pill purchased. In other words if VA purchases 900 pills at $1 each and dispenses them as whole pills in 30 day dosage increments VA will collect $240 in copays making their net cost for the pills $660. However, if they dispense the same pills in half pill dosages in 30 day increments they will collect $480 in copays making their net cost for the pills $420.

If the Bush budget proposal to raise VA copay from $8 to $15 is approved, VA’s net cost for the aforementioned medication would be $450 for whole pills and zero for split pills. However, since the Secretary may not require a veteran to pay an amount in excess of the cost to the Secretary for medication VA should then be required to reduce the $15 copay to equal their purchase cost if the purchase cost does not exceed $15 to comply with the law as it is now written. This same logic applies to dispensing pills in daily vice monthly increments. Since 50% of months have 31 days the charge for a monthly supply during those months would be$16.00 vice $8.00. Retirees using the TRICARE Mail-Order Pharmacy (TMOP) managed presently by Express Scripps should ensure their physicians use 30 day increments vice monthly increments in their prescriptions. If they do not, their Tricare copay will double to $6, $18, or $44 for 31 day months. [Source: Various Feb 07 ++]


THUNDERBIRDS 2007 SHOW SCHEDULE: The U.S. Air Force Air Demonstration Squadron, "Thunderbirds," has announced its 2007 air show schedule featuring 68 shows in 21 states and nine European countries. The 2007 schedule is as follows:

- MAR: 24 & 25 -- Luke Air Force Base AZ; 31 -- Point Mugu Naval Base Ventura County CA
- APR: 1 -- Point Mugu Naval Base Ventura County CA; 14 & 15 -- Eglin AFB FL. ; 21 & 22 -- Barksdale AFB LA; 28 and 29 -- Langley AFB VA
- MAY: 5 & 6 -- Fort Lauderdale , FL; 12 & 13 -- McGuire AFB, NJ; 19 & 20 -- Andrews AFB, MD; 26 & 27 -- Wantagh ( Jones Beach ), NY
- JUN: 2 & 3 -- Davenport IA; 9 & 10 -- Sacramento CA; 16 & 17 – Pittsburgh; 23 & 24 -- Galway , Ireland; 26 -- Krzesiny Air Base , Poland; 28 -- Mihail Kogalniceanu , Romania; 30 -- Ankara , Turkey
- JUL: 1 -- Graf Ignatievo , Bulgaria; 4 -- Aviano AB , Italy; 7 & 8 -- Evreux Field , France; 14 & 15 – Royal Air Force Fairford , Eng; 25 -- Cheyenne WY; 28 & 29 -- Dayton OH
- AUG: 11 & 12 -- Niagara Falls , NY; 15 -- Atlantic City , NJ; 18 & 19 – Chicago; 25 & 26 -- Otis Air National Guard Base, MA
- SEP: 1 to 3 – Cleveland; 8 -- Minot AFB ND; 15 -- Hickam AFB HI; 22 & 23 -- El Paso TX; 29 & 30 -- Columbus OH
- OCT: 6 & 7 -- Pope AFB NC; 13 & 14 -- Miramar Marine Corps Air Station CA; 20 & 21 -- Moody AFB Ga.; 27 & 28 -- New Orleans
- NOV: 3 & 4 -- Cape Canaveral FL; 10 & 11 -- Nellis AFB NV

The Thunderbirds will also commemorate the 60th anniversary of the Air Force throughout their 2007 season. "We are representing six decades of air dominance this year," Colonel Robbins said. "The Air Force and Thunderbirds of today uphold the pride and professionalism that millions of Airmen have displayed for 60 years." [Source: Air Force Print News Feb 07]


VET CEMETERY ARIZONA: The Department of Veterans (VA) has announced veterans in central Arizona can now be buried at Prescott National Cemetery with the opening o f a columbarium for cremation inurnments. The new, expanded facility for cremated remains officially opened 5 FEB. The 15.4 acre cemetery closed in 1974 when the facility ran out of space for casket burials, although eligible family members of veterans already buried there could be interred. The new columbarium provides a burial option to nearly 27,000 veterans and their dependents who were not served by an open VA national or state veterans cemetery. The $2.4 million columbarium wall on the western side of the cemetery provides 3,000 niches for cremated remains and was built by Hal Hays Construction, a California-based small business contractor. Infrastructure improvements, including a road, sidewalks, irrigation and landscaping, were also made at the cemetery. Prescott National Cemetery is located at 500 Highway 89 North Prescott, AZ 86313
Tel: (480) 513-3600/1412 Fax. It was placed on the National Register of Historic Places in 1999.

Also available to vets is the Southern Arizona Veterans' Memorial Cemetery (SAVMC) located at 1300 Buffalo Soldier Trail, Sierra Vista, AZ 85635 Tel: (520) 458-7144/7147 Fax or 1(888)952-4700. The Arizona Department of Veterans’ Services has established the cemetery on approximately 145 acres of land which was previously part of Ft. Huachuca Military Reservation. The cemetery entrance is south of Fry Boulevard on Buffalo Solder Trail. The state veterans’ cemetery was made possible by a grant from the VA State Cemetery Grant Service in the amount of $7.7 million for construction and equipment. Ground breaking was held 1 OCT 01with internments began in DEC 01. Any veteran who has an other than dishonorable discharge is eligible for burial in the SAVMC. Spouses and certain dependents are also eligible for burial. There is no charge for interment, for either veterans or their family members. Veterans may choose either a columbaria niche (which includes an inscribed granite niche marker) or a full-casket, in-ground burial (which includes an inscribed upright grave marker and a single or double concrete crypt liner). Applications for burial are available at the cemetery; most funeral homes in Arizona also have copies of the application.

Veterans with a discharge other than dishonorable, their spouses and dependent children can be buried in a national cemetery. Other burial benefits available for eligible veterans, regardless of whether they are buried in a national or a private cemetery, include a burial flag, a Presidential Memorial Certificate, and a government headstone or marker. In the midst of the largest cemetery expansion since the Civil War, VA operates 124 national cemeteries in 39 states and Puerto Rico and 33 soldiers’ lots and monument sites. More than three million Americans, including veterans of every war and conflict, are buried in VA's national cemeteries. Information on VA burial benefits can be obtained from national cemetery offices, from the Internet at http://www.cem.va.gov, or by calling VA regional offices at 1(800) 827-1000. [Source: VA News Release 6 Feb 07 ++]


AIR FORCE WEEK SCHEDULE: Pentagon officials have announced the Air Force Week locations and dates for 2007. They are:
• Phoenix , 19 to 25 MAR (Luke Air Force Base Open House, 24 & 25 MAR);
• Sacramento , 4 to 10 JUN ( California Capital Air Show, 9 & 10 JUN);
• St. Louis , 2 to 8 JUL (Scott AFB Open House, 7 & 8 JUL);
• New England with activities focused around Boston , 18 to 26 AUG (New Hampshire Air National Guard Air Show, 18 &19 AUG, and Otis ANG Air Show, 25 & 26 AUG);
• Honolulu , 12 to 15 SEP (Air Force Ball, 15 SEP); and
• Atlanta , 8 to 14 OCT (Great Georgia Air Show, 13 & 14 OCT).

The inaugural Air Force Week took place in St. Louis in AUG 06, and the success prompted Air Force officials to partner with other communities this year. The Air Force Week program is part of the proactive approach in communicating to the public, said officials. This year the Air Force will celebrate its 60th anniversary. Brig. Gen. Erwin Lessel, Air Force director of communication said these weeklong events offer people an opportunity to meet Airmen who are defending America, and to thank the public for its support. Each Air Force Week includes community visits and talks by senior Air Force officials, flight demonstration team performances, and displays providing a close look at Air Force men and women serving on the front lines. [Source: Air Force Retiree News Service 7 Feb 07 ++]


VA BUDGET 2008: Secretary of Veterans Affairs Jim Nicholson announced 5 FEB that President Bush will seek a landmark budget of nearly $87 billion in fiscal year 2008 for the Department of Veterans Affairs (VA), with health care and disability compensation for veterans receiving the majority of the spending. The FY ‘08 proposal represents an increase of $37.8 billion, or 77%, from the budget in effect when the President took office. Under the new budget, VA will begin a new initiative to provide priority in processing claims for disability compensation from veterans of the Global War on Terror. Secretary Nicholson also announced plans to create a special Advisory Committee on OIF/OEF Veterans and Families, which will advise him on the full spectrum of issues affecting VA and the veterans and families of Operation Iraqi Freedom and Operation Enduring Freedom. The FY ’08 budget proposal calls for $42 billion in discretionary funding (mostly for health care) which is the largest amount ever requested by a President. It also would provide $45 billion in mandatory funding, mostly for compensation, pension, educational assistance, home loan guaranties and other benefit programs.

In addition to the budget providing for the continuation of existing programs other highlights are:

• Inclusion of $750 million for capital improvements to its health care facilities, bringing the total to $3.7 billion during the last five years. Funding is included for major construction projects in Denver; Las Vegas; Lee County, Fla.; Orlando, Fla.; Pittsburgh; and Syracuse, N.Y.
• Nearly $3 billion in mental health services to continue improvements in access to a full continuum of care for veterans with mental health problems, including comprehensive treatment for post-traumatic stress disorder (PTSD).
• Funding for extended care services will reach $4.6 billion in FY ‘08, of which 90% will be for institutional long-term care and 10% for non-institutional care.
• Nearly $192 million in construction funding to support VA’s burial program. Resources are included to establish six new national cemeteries in Bakersfield, Calif.; Birmingham, Ala.; Columbia-Greenville, S.C.; Jacksonville, Fla.; Sarasota, Fla.; and southeastern Pennsylvania. This budget also includes funds for a gravesite development project at Fort Sam Houston National Cemetery in San Antonio and $32 million in grants for the construction of state veterans cemeteries.
[Source” VA News Release 5 Feb 07 ++]


VA BUDGET 2008 UPDATE 01: In a major change of strategy, the 2008 Department of Veterans Affairs budget submitted to Congress 5 FEB separates the fate of proposed fee increases from the VA health care budget. Under the plan, any money generated from a proposed increase in prescription drug co-payments and a new enrollment fees of up to $750 for priority category 7 and 8 veterans would go into the U.S. Treasury, not directly into the VA’s budget. The plan is explained in the fine print of the 2008 budget documents. This arrangement, a departure from previous years, does not make it any more likely that Congress would approve the fee increases and may even make it easier for lawmakers to reject them. VA budget proposals for each of the past three years had the fee increases built into the health care budget. As a result, when Congress rejected the increases, lawmakers had to find other funding sources to replace the money that would have flowed into the VA budget from the fee increases.

Sen. Daniel K. Akaka, D-Hawaii, the Senate Veterans’ Affairs Committee chairman, said he is not likely to approve fee increases under the new arrangement. He comments were:
- The doubling of drug co-payments for veterans’ who make as little as $28,000 a year seems particularly cruel. Take the example of a veteran living on Oahu, where the cost of living is so high, who takes seven different prescriptions each month: his out-of-pocket cost goes up by $600 a year.
- The fact that the fees would go to the U.S. Treasury rather than the VA budget did not persuade him, either. Why are we asking veterans to suffer in order to finance a war? he asked. This administration consistently fails to consider the cost of caring for veterans as part of the cost of war.
- Under the administration’s plan, priority category 7 and 8 veterans would have a higher co-payment for prescription drugs and would have an enrollment fee based on their family income. The drug co-payment, now $8, would increase to $15 for a 30-day supply. The new enrollment fee would be $250 for veterans with family incomes of $50,000 to $74,999; $500 for those with family incomes of $75,000 to $99,999; and $750 for those with family incomes of $100,000 or more. The plan would generate $331 million for the Treasury from the co-pay increase and $138 million from the tiered enrollment fees, according to budget documents.
[Source: NavyTimes Rick Maze article 6 Feb 07 ++]


VA BUDGET 2008 UPDATE 02: The national commander of the largest organization of combat veterans in the nation called President Bush’s fiscal 2008 budget request for the Department of Veterans Affairs a significant step forward for America’s military veterans. “The administration is again demonstrating that funding a nation at war includes caring for her warriors when they return home,” said Gary Kurpius, a Vietnam veteran from Anchorage, Alaska, who leads the 2.4 million-member Veterans of Foreign Wars of the U.S. and its Auxiliaries. Released on 5 FEB was a $87 billion proposal for the VA that includes an increase in discretionary medical care funding to $34.2 billion, or almost $3 billion more than last year’s request, with significant increases in mental health care, and additional funding to help reduce a VA backlog that currently exceeds more than 870,000 claims. The administration’s request does fall short of what the VFW and three other veterans’ service organizations are recommending in their co-written Independent Budget, but Kurpius still called today’s request a significant step forward, and an excellent starting point for the new Congress.

“The challenge for Congress now is to ensure that those areas that need additional funding are taken care of, and for both the House and Senate to ensure that a VA budget is approved before the government’s new fiscal year begins on 1 OCT,” he said. The VFW also calls upon Congress to reject the administration proposal to increase prescription co-payments and create annual enrollment fees for almost two million Category 7 and 8 veterans who do not have service-connected disabilities. The co-payment would jump 88% from $8 to $15 per monthly prescription. The enrollment fees would impact these veterans on a graduated scale of $250 to $750 per year and be based on family incomes. “We are very pleased with the overall direction of this budget and commend the president for not forgetting about America’s veterans,” said Kurpius, “but we remain adamantly opposed to the prescription co-payment increase and enrollment fees. Veterans should not have to pay for health care they earned.” [Source: VFW Press Release 6 Feb 07]


VA BUDGET 2008 UPDATE 03: While President Bush’s fiscal year 2008 budget request would come close to providing adequate funding for veterans health care and other programs, the Disabled American Veterans (DAV) sees a number of flaws and shortcomings in the proposal that could adversely affect sick and disabled veterans. The President’s budget proposes $34.2 billion for the Department of Veterans Affairs (VA) health care system and relies on $2.3 billion in collections. The budget plan also would increase prescription co-payments from $8 to $15 and impose a three-tiered annual enrollment fee of $250, $500 or $750 for some veterans, depending on family income. But instead of going directly to the VA, those fees would be paid to the U.S. Treasury, where they conceivably could be siphoned off for other purposes. The DAV and other veterans service organizations that co-author The Independent Budget each year have recommended nearly $44.3 billion in discretionary spending for the VA, with $36.8 billion of that for veterans health care. They urge Congress to reject proposed higher pharmacy co-payments and the burdensome enrollment fees and fully fund veterans health care through direct appropriations. DAV National Commander Bradley S. Barton said:.

- The President’s co-payment and enrollment fee proposals are deliberately designed to force thousands of veterans out of the VA health care system.
- Because of chronic funding shortfalls, many veterans wait longer for medical appointments, VA hospitals are prevented from hiring additional nurses and other health care professionals to meet the growing demand for services and are forced to ration care.
- No matter how generously the administration believes it is funding veterans programs, it cannot guarantee the VA receives its new budget by the beginning of the new fiscal year on Oct. 1,” he added.

Another major area of concern is that while the President’s budget contains a commitment to improving the timeliness of veterans’ benefits claims, it does not address the adverse impact of recently passed legislation that expands attorney involvement in the process. The VA has said it will have to create a whole new bureaucracy to perform the additional accreditation and attorney fee oversight responsibilities. With a backlog of more than 600,000 pending benefits claims and processing times averaging six months for initial claims and more than two years for appeals, the attorney fees law would likely add to the VA’s woes, causing further delays and complicating an already overburdened system. 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. It is dedicated to a single purpose: building better lives for our nation’s disabled veterans and their families. For more information, refer to organization’s Web site www.dav.org. [Source: DAV News Release 6 Feb 06]


GOVERNMENT OVERPAYMENTS: IT doesn’t matter whose fault the error is, you’re responsible for reporting it and can be held liable for any money overpaid for pay, allotment, compensation, pension, etc. Members of the military community who suspect they are drawing too much in pay or allowances because of a clerical error or computer glitch should alert pay officials rather than ignore the situation. When the government finds the error as it almost certainly will it will want that extra money back. Waivers of overpayments are granted on occasion. However, more often, recipients are found responsible for reporting pay errors and thus liable for any money overpaid. If you want to review repayment policies refer to the Defense Office of Hearings and Appeals (DOHA) web site www.dod.mil/dodgc/doha/ and read decisions on claims brought by fellow servicemembers or retirees to the DOHA’s Claims Appeals Board. Cases are interesting because they often involve thousands of dollars. They are instructive too because recipients routinely are advised that they should have caught the overpayments even though the error originated elsewhere. The claims division of the DOHA handles disputes regarding pay allowances, travel, transportation, unused accrued leave, retired pay, and survivor benefits. It also settles disputes between transportation carriers and uniformed servicemembers concerning transit loss or damage on military moves. Claims actions usually uphold long-standing military pay principles applied to individual circumstance. Claims board decisions published on the DOHA Web site withhold the names of claimants to protect their privacy. [Source: Online Tom Philpott article 7 Jan 07 ++]


VDBC UPDATE 13: The next meeting of the Veterans Disability Benefits Commission is 21-22 FEB at the Hotel Washington, 15th & Pennsylvania Avenue, NW, Washington, DC. The agenda for the Commission’s February meeting will feature:
- Updates on progress of studies underway at the Center for Naval Analyses (CNA) and the Institute of Medicine (IOM).
- A summary report on VDBC Member site visits and other related Issue Papers at various stages of development.
- Comments from interested parties on two topics related to specific Research Questions approved by the Commission on October 14, 2005. The two topics will be: Survivors’ Concurrent Receipt (Research Question 21 addressing the SBP/DIC Offset); and Time Limit to File (Research Question 18).

Interested persons may attend and present oral statements to the Commission on 22 FEB. Oral presentations will be limited to five minutes or less, depending on the number of participants. Interested parties may also provide written comments for review by the Commission prior to the meeting by e-mail to veterans@vetscommission.com or by mail to Mr. Ray Wilburn, Executive Director, Veterans Disability Benefits Commission, 1101 Pennsylvania Avenue, NW, 5th Floor, Washington, DC 20004. Written comments were requested to arrive by 1700 on Friday, February 9th, to be included in the Commissioners pre-meeting documentation. [Source: NAUS Weekly Update for 2 FEB 07]


NGB DOD REPRESENTATION UPDATE 02: The House and Senate on 1 FEB introduced the National Guard Empowerment Act of 2007, to the 110th Congress which would make the National Guard Bureau (NGB) chief a four-star general with statutory authority to speak for the Guard at the highest levels of the Defense Department. Sens. Patrick Leahy (D-VT) and Christopher Bond (R-M0), co-chairs of the Senate National Guard Caucus, reintroduced their bill, S.430, to help make the National Guard a stronger and more responsible defense agency, which will improve the nation’s defense and improve the military’s ability to support civilian authorities during domestic emergencies. Reps. Tom Davis (R-VA) and Gene Taylor (D-MS) introduced an identical bill in the House, H.R.718. The Senate passed a modified version of the bill last year, while the House took no action. But the 2007 National Defense Authorization Act (NDAA) directed the Commission on National Guard and Reserves to review and present an opinion on the legislation, which is due 1 MAR. Guard leaders and a growing number of lawmakers, however, think the matter requires no further assessment. They believe their lack of input into final Pentagon decisions is responsible for the Guard’s chronic funding shortfalls and recent Army and Air Force proposals to cut Guard personnel and equipment. Concerned citizens are encouraged to contact their elected officials and voice their opinions concerning this legislation that will impact our National Guard at the highest levels. [Source: Minute Man Update 2 Feb 07 ++]


CRDP UPDATE 41: The Senate majority leader on 31 JAN said that he would continue his seven-year push to eradicate the government’s policy of reducing military retired pay for retirees who also receive veterans’ disability compensation. Sen. Harry Reid of Nevada, who became majority leader in January when Democrats took control of the Senate, said that while he may be busy working on hundreds of other issues in his new role, concurrent receipt of disability and retired pay “remains one of my highest priorities. I am committed to a goal so that 100% of disabled veterans get what they deserve. I’ll continue fighting until we succeed. We need to continue to chip away at this policy.”

In reintroducing his bill, the Retired Pay Restoration Act (S.439), Reid said it would end once and for all the dollar-for-dollar offset in retired pay required for veterans also receiving disability compensation.
Reid’s sponsorship of legislation to end the ban on so-called concurrent receipt of full retirement and disability pay has kept the issue alive, as year after year the Senate has adopted Reid-sponsored amendments to the annual defense authorization bill. What had once been a complete prohibition on receiving both payments in full has slowly eroded to the point that the offset has been reduced or eliminated for thousands of veterans, including those who served 20 years in the military who have combat-related disabilities, and those with 20 years of service whose disabilities are rated at 50% or more.
Reid specifically mentioned that he will fight this year to provide full concurrent receipt for veterans whose inability to work is a factor in their disability rating. By law, disabled veterans who are unemployable can be considered fully disabled even though their actual disability ratings may be as low as 70%. Although these “individual unemployability” veterans receive VA disability pay at the 100-percent-disabled rate, the extra pay does not count for the purposes of concurrent receipt and is still offset from their retirement pay.
Reid said some progress has been made, calling the past seven years “good but not really good” for disabled retirees. The offset in retired pay, a legacy of a law passed in the late 19th century, is still mostly in effect.

Reid said that when he first learned about the law on military retirement and veterans’ disability pay from an aide, he thought the aide did not know what he was taking about. But he did. In many cases, this ban takes away a veteran’s full retirement pay, wiping away benefits he or she earned in 20 or more years of service, and it’s wrong. Few disabled retirees “can afford to live on their retirement pay alone. They are often denied any post-service working life. They receive disability compensation to pay for the pain and lost future earnings caused by a service-connected injury.” He called the offset in retirement pay a “special tax on the very men and women who keep us safe.” [Source: NavyTimes Rick Maze article 31 Jan 07 ++]


MILITARY PAYDAY LENDERS UPDATE 03: Reps. Kendrick Meek (D-FL-17) and Mike Ross (D-AR-04) are trying to persuade other House members to backtrack on legislative fixes won last year by the military coalition and others to protect the troops against unscrupulous payday lenders. Payday lenders often target military personnel to lure them into short-term loans of a few hundred dollars at 400% interest, holding the borrower's signed personal check as collateral. When borrowers can't pay off the high-interest loans immediately, they're trapped into renewing them repeatedly. The Military Coalition, the Defense Department, and a long list of consumer-protection organizations joined forces last year to win a law change capping interest rates on loans to servicemembers at a 36-percent annual rate. That still sounds high, but it limited their potential profits enough that payday lenders have indicated they'll stop targeting military families unless the law is changed. Reps. Meek and Ross are trying to get Congress to reconsider the 36% rate cap. Military, civil rights, veteran, and consumer organizations have sent letters to Congress strongly objecting to the Meek/Ross proposal and urging Congress not to sell out the troops to serve this unsavory industry. [Source: MOAA Leg Action Center 2 Feb 07 ++]


VA HEALTH CARE FUNDING UPDATE 07: Faced with a 15 FEB federal shutdown absent additional legislation to fund the government for the remainder of the fiscal year, the House passed a $463.5 billion spending bill H.J. Res. 20 with bipartisan support by a vote of 286 to 140. The bill now moves to the Senate where is must be approved before the additional funding is available to VA. The resolution included some very good news for the VA - boosting up that agency’s funding by $3.6 billion, which should be enough to meet projected needs for VA health care and other programs. However, the additional funding will not bring instant relief to the VA or to the millions of veterans who rely on its services, primarily because the current fiscal year could be almost half over by the time the money is appropriated, and because it takes time to properly plan new construction and infrastructure upgrades, and to hire new employees. The resolution also included $6.2 billion for military construction, but it fell short of providing what’s needed in some other important areas:

 Military health care: Provides an additional $1.2 billion over 2006 funding levels - but that’s still almost a billion dollars short of the $2.1 billion the Pentagon says it needs to continue current programs.
 Base realignment and closure (BRAC): Provides an extra $2.5 billion - $1 billion more than the FY2006 amount - but that’s a shocking $3.3 billion short of what’s needed to keep needed base facility changes on track. That makes a bad situation much worse, because the services are already four months into the fiscal year and still don’t have their appropriations. And now they’re going to get even less money than they thought. These cuts impact a wide-ranging list of military construction and quality-of-life projects: barracks, family housing, child care centers, training, and other facility issues that directly affect readiness. It raises the risk that families in units moving to new installations will arrive there only to find that there isn’t enough housing, child care, schools, and other support facilities to accommodate their needs. You don’t need a crystal ball to forecast how that would affect the pocketbooks and quality of life for military families - especially for the Army, which has been allocated over 60% of the BRAC budget.

As usual, the issues that so directly affect the troops have become a political football. Several senators, mostly Republicans, are lining up to try to add money in the Senate, saying current leaders have fallen short of meeting their obligations. Leaders on the Democratic side blame last year’s Republican-led Congress for the problem, saying they wouldn’t be faced with this mess if last year’s Congress had finished the FY2007 funding as it was supposed to. Both points have some validity. The government has an absolute obligation to fully fund the well-documented needs of the military families who already are bearing the entire burden of sacrifice for the country in the current war along with the needs of those veterans who came before them. Health care needs must be funded. And if there is going to be a continuance of reshuffling units around the country, Congress must do whatever it takes to ensure needed support facilities are in place before they arrive without closing down support services at a closing or losing base. Troops and families need the support at both locations. Veterans concerned over these issues need to contact their legislators and let them now how they feel about these shortfalls. A suggested message to send is available at http://capwiz.com/moaa/issues/alert/?al ... 46&type=CO. [Source: MOAA Leg Action Center 2 Feb 07 ++]


MEDICARE PART B TAX CREDIT UPDATE 01: On 9 Jan 07 Rep. JoAnn Emerson (R-MO-08) reintroduced

[boardman]

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 Tours)
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 Miami Center)
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 San Diego)
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 Philippines to San Diego 1 MAR so it may take a few days to respond to your inquiries.


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 Georgia. Great Value peanut butter with a product code beginning with 2111 is made in the same facility as Peter Pan peanut butter; Great Value peanut butter made by other manufacturers is not affected.

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 Tennessee and DNA fingerprinting has shown that the pattern is the outbreak strain.

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/sal ... 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 Seoul area tours. The cost, including air fare, ranges from $1,400 to $1,600. Departures are from gateway cities all over the US as well as Honolulu. The USO coordinator will arrange ticketing. The tour does not include a visit to the UN Memorial Cemetery in Busan where the Memorial Wall is located but participants can extend their stay at the hotel for up to four nights at a substantially discounted rate and travel to Busan and back by high-speed train at reasonable cost. There are three tours available in 2007: May 21-24 (apply by March 14), September 10-13 (apply by July 21) and October 20-25 (apply by August 30). Apply by e-Mail to: usoreunion@yahoo.com or Young.Frie@korea.army.mil. If there are special requests, the USO coordinator, Lee Im-kyung can be contacted at Young.Frie@korea.army.mil or usoreunion@yahoo.com. The mailing address is USO Seoul, Attn: Reunion, PSC 303 Box 53, APO AP 96204-0053. For a description of the 2007 program refer to www.uso.org/Korea/files/REUNION_PROGRAM_for_2007.doc. [Source: Korea Vet News msg. 21 Feb 07 ++]


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 Iraq and Afghanistan are denied the benefits of CRDP. (HR 303 would extend CRDP to Chapter 61 based on 2.5%/year of service thereby limiting Ch 61 retirement pay to that amount.) (HR 89 would extend CRSC {but not CRDP} to Chapter 61 based on 2.5%/year of service thereby limiting Ch 61 retirement pay to that amount.)
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/?al ... 26&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, Conway said. "We do not want to sacrifice the quality of recruits simply to make the numbers." The Marine recruit standard is higher than that set by the Defense Department. The DOD standard states that 90% of all recruits must be high school graduates. The Marine standard is 95%, and the service is recruiting 96%. DOD officials said that only about one-third of 18 to 24-year-olds qualify to join the military. The 27,000-Marine increase will be put against those units experiencing the heaviest "deployment-to-dwell" ratios. The Marine Corps would like to get to the point of seven months deployed, 14 months at home station. The general said aviation units, military police and civil affairs are among the most heavily stressed units. The commandant is adamant that the corps must do something about deployment-to-dwell time. [Source: American Forces Press Service 16 Feb 07 ++]


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," Davis said as he again introduced a bill H.R.1110 to extend the tax break. The bill would result in average savings of $820 a year for federal retirees, he estimated. Under the bill, federal civil service and military retirees would pay their monthly health-care premiums through a pretax deduction from their annuities. The bill also would permit active-duty military personnel to deduct from their taxable income certain supplemental premiums or enrollment fees for Tricare, their military health insurance.

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 Davis bill would address. In recent years, Davis has gotten such legislation through the House Oversight and Government Reform Committee, which he chaired until this Congress. But the measure has always faltered because the House Ways and Means Committee, which has jurisdiction over tax policy, has balked at taking up the issue. The likely cost of the bill appears to be the sticking point. According to a Congressional Budget Office estimate, extending the tax break to federal retirees would cost about $600 million over 10 years. Davis hopes to build bipartisan support for this year's measure. Reps. Steny H. Hoyer [D-MD] the House majority leader; Chris Van Hollen [D-MD] who has a seat on Ways and Means; and Jon Porter [R-NV] have signed on as chief co-sponsors. The Washington area congressional delegation and about half of the Ways and Means Committee also have agreed to be listed as co-sponsors of the bill, Davis said. The National Active and Retired Federal Employees Association and the Military Coalition, a group of 35 military and veterans organizations, are supporting the Davis effort. [Source: Washington Post Stephen Barr article 22 Feb 07 ++]


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 Vietnam or in the Gulf War, as well as special benefits for veterans with severe disabilities. In addition to describing benefits provided by VA, the 2007 edition of the 160-page booklet provides an overview of programs and services for veterans provided by other federal agencies. It also includes resources to help veterans access their benefits, with a listing of toll-free phone numbers, Internet addresses and a directory of VA facilities throughout the country. The handbook can be downloaded free from VA's Web site at www1.va.gov/opa/vadocs/fedben.pdf or purchased with credit card or check from the U.S. Government Printing Office (GPO). GPO accepts credit card orders for the publication at (866)512-1800 for a cost of $5 each to U.S. addresses, or $67 for bulk orders of 25 copies. It order is by mail make check out to Superintendent of Documents and mail to the GPO at Superintendent of Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954. [Source: www.va.gov Feb 07 ++]


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 U.S. are taxed at a flat rate of 30%. These same spouses cannot collect social security benefits on their deceased spouse’s account if they have not spent an aggregate of five years in the United States. For those who can receive SS benefits the benefits re also taxed at 30%. A consideration for retirees with non-U.S. citizen spouses residing overseas who do not meet the 5 year US. residency criteria to collect social security is to weigh the SBP benefit against the VA Death Pension non-taxable benefit paid to a veteran’s survivors. For 2007 this amounted to $610 monthly. To get the equivalent net payment from SBP the retiree would have to have a base retirement pay of $1583 assuming the survivor would have no other income. The retiree should also consider that under the VA Death Pension benefit any income (i.e. interest, dividends, social security, wages of any type, tax refunds, etc.) will reduce the amount of monthly pension payment from VA dollar for dollar. In the case of social security the reduction will be the gross amount earned before taxes are automatically deducted vice the net amount received by the survivor. [Source: NavyTimes Alex Keenan article 19 Feb 07 ++]


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 Iraq has intensified and the total number of soldiers wounded or injured there has soared above 15,000.

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 Washington Update & MOAA Leg Up 23 Feb 07 ++]


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 America's seniors are falling further and further behind, but we've never seen anything quite like these projections," said Ralph McCutchen, chairman of TREA Senior Citizens League. "If our annual Social Security increases get eaten up by just one part of Medicare, how are we supposed to keep up with the rising costs of everything from prescription drugs to home heating to groceries?" The TREA Senior Citizens League is pushing for a change in the way the COLAs are calculated in order to more accurately reflect the inflation rate experienced by older people on goods and services such as medicine and health care. At www.tscl.org/NewContent/102589.asp can be found estimated Part B Premiums for 2008 & 2009. [Source: Palm Beach Post Washington Bureau Larry Lipma article 13 Feb 07 ++]


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 Iraq and Afghanistan. Nicholson said the budget will help his department cut the average processing time for veterans’ benefits claims by 18%. According to budget documents, the average time to process a disability claim in 2006 was about 185 days and is expected to be 182 days in 2007. VA’s goal is 125 days.

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 America’s Military Retirees Act were introduced in the 109th Congress after the Supreme Court said it was a congressional vice legal matter. Despite alleged support by lawmakers these bills died in committee when that Congress recessed. To date they have not been reintroduced in the 110th Congress and retirees continue to have to pay out of pocket the Medicare Part B premium if they want to continue their Tricare coverage past age 64.. There have been two related legislative actions:
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/?al ... 1&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 United States, and approximately 3,700 women died from the disease. Nearly all cervical cancer cases are associated with an HPV infection. “It is important for us to protect our beneficiaries from preventable disease whenever we can,” said Army Maj. Gen. Elder Granger, deputy director, TRICARE Management Activity. “So we cover all immunizations the CDC's Advisory Committee on Immunization Practices recommends and adopts.” The CDC recommends a three-dose schedule for the HPV vaccine with the second and third doses administered two and six months after the first dose. They recommend routine vaccination with HPV for girls 11 to 12 years old. Doctors may start the vaccination series in girls as young as nine years old, and can give a catch-up vaccination to 13 to 26 years olds who have not been vaccinated previously or who have not completed the full vaccine series. Because the vaccine is new, it may not be available everywhere. Interested beneficiaries or their parents should contact their doctors to find out if they administer the HPV vaccine. Also, the new vaccine does not protect against every type of HPV infection and can’t prevent all cervical cancers. So getting vaccinated does not eliminate the need for screening pap smears, or reduce the importance of regular gynecological exams. For more on vaccination schedules refer to www.cdc.gov/mmwr/pdf/wk/mm5551-Immunization.pdf. [Source: TMA News Release 20 Feb 07 ++]


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, Michael D. Palm Center, through a Freedom of Information Act request. “The fact that the military has allowed more than 100,000 people with such troubled pasts to join its ranks over the past three years illustrates the problem we’re having meeting our military needs in this time of war,” said Aaron Belkin, director of the center

Lawmakers are concerned that continuing war in Iraq and Afghanistan is causing the Army to lower their standards in order to meet their recruiting goals. In the past two years, for example, the Army has increased their non-prior service recruiting age limit from 35 to 42. Additionally, the Army has been approving more waivers for applicants who score in Category IVA of the Armed Forces Vocational Aptitude Battery (ASVAB). “Our armed forces are under incredible strain, and the only way that they can fill their recruiting quotas is by lowering their standards,” said Rep. Marty Meehan, a Massachusetts Democrat who has requested additional information from the Department of Defense. “By lowering standards, we are endangering the rest of our armed forces and sending the wrong message to potential recruits across the country.”

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

[boardman]

RAO Bulletin Update - 15 March 2007


THIS BULLETIN UPDATE CONTAINS THE FOLLOWING ARTICLES:

Mobilized Reserve 14 MAR 07 ----------------- (Net Decrease 9,937)
Credit Score --------------------------------------- (How to Raise)
Guard and Reserve Personnel ------------------ (2007 Fact Sheets)
Veteran Federal Employment [03] ------ (Vets Entitled to Hearings)
Census Bureau Data Breach --------------------- (672 Missing Laptops)
TFL Prior to Age 65 ---------------------- (SSA Disability Impact)
Vitamin Supplements --------------------- (May be of no Benefit)
SSA-1099 [01] ------------------------------------- (Order Online)
Military Health Care TF [03] ------------------ (TMC Position)
Military Health Care TF [04] ------------------- (ROA Position)
VA Comp Payment Disparity [07] ------------- (Disparities continue)
VA Claim Processing Goals [03] ------- (Caseload Warnings Ignored)
VA Claim Processing Goals [04] --------------- (House Panel Hearing)
VA Handbook 2007 ------------------------------- (Now Available)
Veterans Home Scam ----------------------------- (Veterans Salute Scam)
Vet Cemetery Florida [04] ----------------------- (Opens 16 April)
Veterans Healthcare Empowerment Act ------- (Vets to Select Caregivers)
Vet Cemetery Illinois ----------------------------- (What’s Available)
Vet Cemetery Minnesota ------------------------- (What’s Available)
TF on Combat Benefits -------------------------- (Inter-Agency)
WRAMC [05] ------------------------------------- (Tip of the Iceberg)
Medicare Rates 2008 ----------------------------- (Could be $109.40)
VA Data Breach [31] --------------------- (Expect Future Incidents)
Armed Services Committee [01] --------------- (Special Hearing)
VA Budget 2008 [05] -------------------- (Fee Increases Rejected)
DoD Disability Evaluation System -------------(Undergoing Overhaul)
Reserve Reemployment Rights [03] ----------- (ESGR a Bureaucratic Mess)
CPR -------------------------------------------------(Old and new)
Traumatic Brain Injury [02] -------------------- (VA Program)
PTSD [11] ---------------------------- (Related Health Problems)
TRICARE Help While Traveling -------------- (Where to Go)
VA Facility Expansion [04] --------------------- (Lanai New OPC)
VA Facility Expansion [03] -------------------- (Orlando New Hospital)
CRDP [41] --------------------------------------- (2007 Increase)
CNGR Commission [02] ------------------------ (CNGR Blasts Pentagon)
Dignity for Wounded Warriors Act ----------- (S.713 Introduced)
AFRH [01] ------------------------ (Admission Criteria)
Marine Det Memorial USS Arizona ----------- (To be Demolished)
Illinois Vet Hiring Tax Credit -------(Vet Hiring Incentive)
How To Make Sure You Get Your Email ---- (Bypassing Spam Filters)
Cell Phone Tips [01] ----------------------------- (Correction)
Military Retirement Pay Restrictions ---------- (What they are)
Military Legislation Status 13 MAR 07 ------- (Where we stand)


MOBILIZED RESERVE 14 MAR 07: The Army, Navy, Air Force, Marine Corps and Coast Guard announced the current number of reservists on active duty as of 24 JAN 07 in support of the partial mobilization. The net collective result is 9,937 fewer reservists mobilized than last reported for 24 JAN 07. Total number currently on active duty in support of the partial mobilization for the Army National Guard and Army Reserve is 64,375; Navy Reserve 6,022; Air National Guard and Air Force Reserve 5,307; Marine Corps Reserve 5,149; and the Coast Guard Reserve 301. This brings the total National Guard and Reserve personnel, who have been mobilized, to 81,407, including both units and individual augmentees. At any given time, services may mobilize some units and individuals while demobilizing others, making it possible for these figures to either increase or decrease. A cumulative roster of all National Guard and Reserve personnel, who are currently mobilized, can be found at http://www.defenselink.mil/news/Mar2007 ... 314ngr.pdf. [Source: DoD News Release 14 Mar 07 ++]


CREDIT SCORE: Your credit score is a three digit number ranging from 350 to 850. Half of all Americans have a score above 720. The higher your credit score the lower will be your assessed interest and fees on purchases and loans. Your credit report generally reflects how you have handled your credit in the last 24 months. There is no shelf life for a score. It is recalculated every time a lender requests it. If your 30 days late with a payment and your creditor reports it, a score in the mid 700s can plummet more than 50 points into the checkered 600 category. Typically a low score in the 600 range can be pulled up over time by doing the right things but it is a slow process. Your score might move up just 30 points in a year even if you are doing the right things. Factors that will hold you back are personal bankruptcy or more than one payment that exceeds the due date by three months or more. You can still build up your score; it will just take a little more time. Five ways to raise your score are:

1. Pay your bills on time. Payment history affects about 35% of your score. To ensure timely payments set up automatic payments online, keep stamps on hand, and maintain your budget.
2. Keep credit balances at 30% of your credit limit or lower. Around 30% of you credit score is based on how much credit you have access to and how much you are using.
3. Do not cancel credit cards to up your score. About 10% of your score is based on how long you have held you credit cards.
4. Do not apply for too many credit cards. About 10% of your credit score is determined by the number of times lenders request your credit reports. Lots of requests might indicate you are desperate for credit and might be headed for trouble, or are already there.
5. Watch the kinds of credit you use. About 10%of your score is based on the types of credit you are using. Secured loans such as car loans and mortgages, or unsecured loans such as student loans and credit cards. Unsecured loans are considered riskier in your credit report.

According to the Public Interest Research Group one out of four credit reports contain a serious error that could lower your score and/or could stop you from getting a loan, or one with the best terms. You should check your report for outdated data, paid-off loans listed as due, or money owed by someone with a similar name to yours. It can easily take up to six months to get an error fixed. Never using credit can actually hurt you because you have no record to rate. [Source: USAA Magazine Kerry Hanon article Winter 06 ++]


GUARD AND RESERVE PERSONNEL: The Air Reserve Personnel Center released the 2007 Guard and Reserve Personnel Fact Sheets at http://arpc.afrc.af.mil/pa/fact/factsheet.asp. The fact sheets offer information on a variety of subjects as indicated below. ARPC Contact Center counselors are available, 06-1800 MST, M-F and 0730-1600 MST the first weekend of each month. Call (800) 525-0102, or e-mail arpc.contactcenter@arpc.denver.af.mil.

• Drill Pay Chart
• Personnel Services Delivery transformation
• Reserve Force Development
• Officer promotions
• Officer performance reports
• Enlisted promotions
• Enlisted performance reports
• Reserve assignments
• Reserve categories
• Finding new assignments
• Activation of individual reservists
• Retired Reserve
• Retirement point valuation
• Retired pay formula
• Age 60 retirement benefits
• Space-A travel
• Veterans benefits
• Reserve Component Survivor Benefit Plan
• Survivor benefits
• Servicemembers' Group Life Insurance
• SGLI coverage for families
• Veterans' Group Life Insurance
• Thrift Savings Plan
• DEERS
• Tricare
• Entitlements
• Survivor benefits tables
• VSI/SSB
• Ready Reference AFIs/manu
[Source: Military Report 12 Mar 07 ++]


VETERAN FEDERAL EMPLOYMENT UPDATE 03: A recent federal appeals court ruling held that veterans who allege discrimination in government employment because of their military service are legally entitled to a hearing. In Kirkendall v. Department of the Army, the Federal Circuit Court of Appeals ruled that these veterans have a statutory right to a hearing from the Merit Systems Protection Board. That right comes from the Uniformed Services Employment and Reemployment Rights Act (USERRA), a law that protects veterans from discrimination resulting from their military service. In its decision, the court criticized the manner in which MSPB has denied hearings with no explanation. "Until now, it has been the board's practice to grant hearings as a matter of administrative grace, or deny one at its convenience," wrote Haldane Robert Mayer, a judge for the appeals court. "But it must administer the law as Congress wrote it. The board's consistent misapplication of the law can neither be used to defend its practice; nor to justify what Congress did not intend."

The case dates back to 1999 when Kirkendall, a disabled veteran with organic brain syndrome, a general disease in which a physical disorder causes decreased mental function, applied for a position as a supervisory equipment specialist with the Army at Fort Bragg, N.C. Kirkendall's service and resulting disability entitled him to a 10-point preference for the position. But in early 2000, the Army found that Kirkendall's application lacked sufficient detail on his experience and rated him ineligible for the position, offering it to another 10-point preference eligible veteran. Kirkendall filed several complaints with the Army contesting his ineligibility, but all of them were denied. He then filed a complaint with the Labor Department, which also rejected his claim because it was not filed within 60 days of the Army's alleged violation as required by law. In 2002, Kirkendall appealed to the MSPB. The MSPB administrative judge dismissed Kirkendall's claim on the grounds that it was untimely and that the Army selected another qualified and 10-point eligible veteran for the position. Kirkendall then appealed the board's decision to the federal circuit court.

According to a judge advocate in the Naval Reserve, who spoke under the condition of anonymity, many of the cases brought before the MSPB are pro se, meaning the claimants represent themselves without a lawyer. The source said MSPB often views these cases as less serious, and as a result, not worthy of a hearing. Matthew Tully, the founding partner of the New York law firm Tully, Rinckey & Associates.
Tully has represented hundreds of current and former federal employees in similar cases, though he did not represent John Kirkendall. Tully said the appeals court decision offers a "huge advantage" to veterans who cannot afford legal representation, especially because it allows veterans the ability to cross-examine their supervisors. He said the newly established right to cross-examine will make it much easier for veterans to win discrimination cases. Tully also said he hopes the ruling will encourage more training for federal managers on USERRA law. He said many federal managers are trained solely on Equal Employment Opportunity law and very little on USERRA, though the penalties for denying rights under both laws are almost equally harsh. "There doesn't seem to be any system in place in the federal government about USERRA," Tully said. "The publicity [from] this case will help educate people about its importance." [Source: GOVEXEC.com Daily Briefing Brittany R. Ballenstedt article 12 Mar 07 ++]


CENSUS BUREAU DATA BREACH: The Census Bureau this week announced that it accidentally posted personal information concerning 302 American households on a Web site where it was publicly accessible intermittently for about five months. Bureau Director Charles Louis Kincannon said in a statement that as soon as agency officials learned of the improper posting, they shut the site down and started an investigation. The information did not include Social Security numbers, and bureau officials have no evidence that it was misused. Officials discovered the file on 15 FEB. It had been uploaded onto one of the Census Bureau’s externally accessible servers, and contained names, addresses, phone numbers, birthdates, family income ranges and other demographic data for the 302 households. This information was mixed in with 250 fictitious test records. The information was posted multiple times between October and February to test new software applications. This site is typically used to make large public-use files available. The bureau said the public nature of the information and the mingling of actual data and test records make it unlikely it would have been useful to the casual user or someone with malicious intent. The bureau is in the process of notifying those affected and offering assistance with credit monitoring.

Census law prohibits the disclosure of sensitive data, and the bureau has strict policies protecting it. These prohibit the uploading of data to a nonsecure Web site, bureau officials said. The employees who posted the information also failed to follow a required review process to avoid placing confidential information on the agency’s Web site, the bureau stated. Census officials said,” Appropriate administrative action” has been taken against those employees, pending the results of the investigation. The matter has also been referred to the inspector general for the Commerce Department, of which the Census Bureau is a part. Over the past 10 months, federal agencies have reported dozens of incidents of exposing sensitive personal information—such as Social Security numbers and dates of birth—on millions of people. In SEP 06, Commerce released date [www.govexec.com/dailyfed/0906/092206p1.htm] showing the Census Bureau reported 672 missing laptops over the last five years, of which 246 contained some degree of personal data. The agency employs a large number of temporary workers to conduct field work. Census employees will receive additional training on the proper handling of survey responses and telework policies. Despite Census’ recent problems, the Ponemon Institute, a group that advocates responsible information and privacy management practices in business and government, named the bureau as one of the top agencies in terms of protecting privacy in a report released last month. [Source: GOVEXEC.com Daily Briefing Dainiel Pulliam article 9 Mar 07 ++]


TFL PRIOR TO AGE 65: The Tricare program is essentially a modernized and upgraded version of the program called CHAMPUS from 1966 until 1995. To a great extent, they are the same program. Tricare is governed by the same law (now amended) as CHAMPUS was in 1966. Before 1 OCT 01, all Tricare beneficiaries lost their Tricare eligibility automatically if they became entitled to Medicare Part A at age 65, even if they were enrolled in Part B. That was a result of the 1966 law that created CHAMPUS as an interim program. Congress never intended CHAMPUS to provide lifetime coverage. It was intended to provide health care coverage between the young age when most uniformed service members retire and when they become entitled to Medicare at age 65. That changed when Tricare for Life began on 1 OCT 01. For the first time, Tricare beneficiaries could retain their Tricare eligibility after gaining Medicare coverage at age 65. They were required to enroll in Part B of Medicare in order to do that.

Active-duty family members, as well as retirees and their families, were treated differently by the 1966 CHAMPUS law. Their benefits were described in two separate sections of the law. The 1966 law provides that a CHAMPUS beneficiary who becomes entitled to Part A of Medicare at any age or for any reason may not retain CHAMPUS eligibility. There was no mention of a Part B enrollment requirement in the original legislation. It was not until 1991 that Congress amended that provision of the 1966 law to allow a beneficiary of Medicare Part A to retain CHAMPUS eligibility, provided he was enrolled also in Part B of Medicare. With that amendment, a CHAMPUS beneficiary who became disabled, as defined by Medicare law and regulations, could have Medicare parts A and B, plus CHAMPUS. Such people were initially referred to as dual eligibles. There was no “CHAMPUS for Life”. With the subsequent advent of the Tricare for Life (TFL) program it was decided to refer to them as TFL members even though it is possible they could recover from their disability and revert back to ordinary Tricare status. As it stands now, a Tricare beneficiary who qualifies for Medicare disability benefits has exactly the same coverage as the person entitled to Medicare because he has reached age 65. However, the legal requirement for Medicare Part B enrollment still stands for all but active-duty family members. Thus:
- A retiree or a retiree family member who becomes entitled to Medicare because of disability is eligible for Tricare for Life, provided he is enrolled in Medicare Part B.
- A disabled active-duty family member becomes eligible for Tricare for Life in the same way, but without the requirement for enrolling in Part B.

Under Social Security rules an individual who becomes disabled and is unable to work can draw social security benefits upon approval of their application. At that point they would retain their previous Tricare status and be subject to any associated deductibles and copays for their medical care. If after two years they are still unable to work they can apply for Medicare Part B and upon approval become eligible for TFL provided they have updated their DEERS status. At that point Medicare will cover 80% of most medical expenses and TFL would pick up the balance. 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) should be billed directly to Wisconsin Physicians Services (WPS) and Tricare will pay as primary insurer with beneficiaries responsible for any cost shares. Payments for services that are not covered by either program remain individuals sole responsibility. TFL beneficiaries may continue to use any of the Tricare pharmacy programs. Prescriptions can be filled at any military treatment facility pharmacy, through the Tricare Mail Order Pharmacy (TMOP) or through any Tricare network or non-network pharmacy. As is the case with those who become eligible for Tricare for Life because of age, only the beneficiary will be affected by transition from ordinary Tricare to TFL. Their family’s Tricare eligibility will not be affected in any way. [Source: Tricare Help, Times News Service James Hamby article 12 Mar 07 ++]


VITAMIN SUPPLEMENTS: People seeking to improve their health with vitamin supplements may want to think twice before popping pills containing vitamin A, vitamin E, and beta-carotene. New research suggests that these antioxidants may actually increase the risk of death by 5% according to a report in the Journal of the American Medical Association. Antioxidant supplements are popular among consumers based on studies claiming that antioxidants improve health and prevent disease. But other reviews and guidelines suggest that antioxidant supplements may be of no benefit. Researchers searched the medical literature through 2005 to identify trials involving adult subjects comparing beta-carotene, vitamin A, vitamin C, vitamin E, and selenium, singly or combined, versus inactive "placebo" or versus no treatment. Their search turned up 68 trials with 232,606 participants. When all trials were considered:

- There was no convincing evidence that antioxidant supplements have beneficial effects on overall death rate.
- In 47 trials with 180,938 participants, the antioxidant supplements significantly increased the death rate.
- Beta carotene, vitamin A, and vitamin E given singly or combined with other antioxidant supplements significantly increase mortality.
- The potential roles of vitamin C and selenium on mortality need further study.
- Considering that 10% to 20% of the adult population in North America and Europe may consume the assessed supplements, the public health consequences may be substantial.
- Because the study examined only the influence of synthetic antioxidants, its findings should not be applied to the potential effects of eating fruits and vegetables.
[Source: Journal of the American Medical Association, 28 Feb 07 ++]


SSA-1099 UPDATE 01: An SSA-1099 Benefit Statement is mailed to you in January showing the total amount of benefits you received in the previous year. If you are a nonresident alien who received or repaid Social Security benefits last year, you will receive an SSA-1042S instead. People who receive Supplemental Security Income (SSI) do not receive Benefit Statements, since SSI is based on need and is not considered taxable income. You can request online a copy of your most recent SSA-1099/1042S for yourself or on behalf of a deceased beneficiary if you are receiving benefits on the same record as the deceased at www.socialsecurity.gov/onlineservices. A copy of your SSA-1099/1042S will arrive in the mail in about 10 days (30 days if you live outside the United States) at the address on file at Social Security. If you have moved, you must first make an address change before you request your SSA-1099/1042S. This can be done on the same website. If you need a replacement SSA-1099 or SSA-1042S for an earlier tax year, refer to www.socialsecurity.gov/reach.htm for contact info. [Source: W-2 News Mar 07 ++]


MILITARY HEALTH CARE TF UPDATE 03: On 7 MAR Military Coalition (TMC) representing more than 30 service organizations presented the Coalition's health care views and objectives to the Task Force on the Future of Military Health Care. Representatives from the Military Officers Association of America, Fleet Reserve Association, National Military Family Association, the Retired Enlisted Association, National Association for Uniformed Services, and Reserve Officers Association were present for testimony. The majority of the Coalition members could not accept DoD arguments that fees had to be increased to restore government/beneficiary cost relationships from the 1990s. MOAA's director of government relations Col Steve Strobridge (USAF-Ret), noted that much of DoD's cost growth has been driven by the government's own decisions that beneficiaries had no control over. As for Pentagon arguments that fees need to be doubled and tripled now because there have been no increases since 1995, he said that ignores the flip side of the coin. He pointed out that there are plenty of military compensation elements that are set at flat rates and adjusted only occasionally. He also told the Task Force that the same population being targeted for higher Tricare fees has already suffered an average loss of 10% of retired pay because military pay raises were capped below the average American's throughout the 1980s and '90s.

The other Coalition witnesses agreed, and added their own objections to the DoD plan. The Fleet Reserve Association's Joe Barnes highlighted five principles endorsed by The Military Coalition that:
Members on active duty and their families should pay no fees other than retail and mail-order pharmacy copays except to the extent they choose to use Tricare Standard.
- Tricare fees should not rise in any year by a percentage that exceeds the percentage growth in their military compensation.
- The Tricare Standard inpatient copay ($535 per day) should not be increased in the foreseeable future, as it already exceeds the amount charged by most other plans.
- There should be no enrollment fee for Tricare Standard, since Standard does not provide assured access to a TRICARE-participating provider.
- There should be one fee schedule for all Tricare beneficiaries, just as all legislators, defense leaders, and federal civilians have a single fee structure, and it should be significantly lower than the lowest schedule envisioned in the DoD proposal.
Although a member of the TMC, the Reserve Officers Association did not concur with the Coalition and presented independent testimony as noted in Update 04. [Source: MOAA Leg Up 9 Mar 07 ++]


MILITARY HEALTH CARE TF UPDATE 04: On 7 MAR Military Coalition (TMC) representatives from the Military Officers Association of America (MOAA), Fleet Reserve Association (FRA), National Military Family Association (NMFA), the Retired Enlisted Association (TREA), National Association for Uniformed Services (NAUS), and Reserve Officers Association (ROA) presented their health care views and objectives to the Task Force on the Future of Military Health Care. The ROA provided the Task force with a slightly different viewpoint than the rest of the TMC. As indicated on their website their position is as follows:

- A moratorium on fee increases be continued to allow the Task Force for the Future of Military Health Care and Congress time to review this action.
- Any changes to the beneficiary cost share should be phased in. The 2-year period proposed by DOD is too abrupt.
- Tricare Prime enrollment fee adjustments are acceptable if tied to true health care costs. It is important to review an independently evaluation of the current total cost of DoD health care benefits. Such an audit will permit Congress to validate proposals made by all parties. Any cost-sharing adjustments should be spread over at least five years to permit household budgets to adjust. Annual increases should not be tied to the market-driven Federal Employee Health Benefits Plan (FEHBP).
- ROA is not in favor of Tricare Standard annual enrollment fee for either DoD or VA beneficiaries. If Tricare Standard requires beneficiary enrollment, it should be only a one-time minimal administrative fee. Adjustments to Tricare Standard should be made to the deductible. Because of larger co-payments of 25% after the deductible, the costs of TRICARE standard must be analyzed from a total cost rather than initial cost perspective. Presently, Tricare Standard’s cost deductible automatically adjusts with escalating health care costs.
- Tricare Standard overseas retires over 65 pay for both Tricare Standard and Medicare Part “B”. This form of double charge needs to be examined along with other fee discussions.
- TRS should not be included in any TRICARE Standard Fee increase. Family Premiums and deductible for a Tier I TRS operational Reservist are $3,336 per year for CY2007 compared to a proposed combined cost of $1,120 for TRICARE Standard in FY2008. This is inequitable. .
- Tricare standard deductible increases should not be rolled over into TRS as Reservists pay more upfront.

ROA position regarding Tricare Reserve Select (TRS) was:
- Request a study as to why there is such a high drop during application to TRS.
- Allow a seamless transition between TRS, TRICARE and back.
- Improve the process and education for application to TRS.
- Continue to improve health care continuity to all drilling Reservists and their families by allowing demobilized Reservists involuntarily returning to IRR tier I TRS coverage, allowing demobilized Retirees to qualify for tier I TRS coverage, and allowing demobilized FEHBP eligible to qualify for tier I TRS coverage.
- Extend military coverage for restorative dental care following deployment as a means to insure dental readiness for future mobilization.
- Advocate that physicians who accept Medicare must accept TRICARE.
- Allow Gray area retiree buy-in to TRS.
- Include an Employer health care option as an additional option to TRS subsidized by DoD.

On Pharmacy ROA believes higher retail pharmacy co-payments should not apply on initial prescriptions, but on maintenance refills only. ROA supports DoD efforts to enhance the mail-order prescription benefit and identified an overseas Tricare Mail Order Pharmacy catch-22. While the Tricare system approves overseas licensed doctors to provide service and insure quality in foreign country it doesn’t recognize these same doctors to write prescriptions that are accepted by TMOP. As no one can use the TMOP outside of the US, DoD incurs increased cost for pharmacy because of higher administrative and retail drug cost when beneficiaries file individual claims. Apparently, all it would take to fix the problem is a change in an administrative regulation. [Source: www.roa.org/site/PageServer?pagename=testimony 7 Mar 07 ++]


VA COMP PAYMENT DISPARITY UPDATE 07: An analysis by The New York Times has found that veterans face serious inequities in compensation for disabilities depending on where they live and whether they were on active duty or were members of the National Guard or the Reserve. Those factors determine whether some soldiers wait nearly twice as long to get benefits from the DVA as others, and collect less money, according to VA figures. The agency said it was trying to ease the backlog and address disparities by hiring more claims workers, authorizing more overtime and adding claims development centers. The problems partly stem from the their inability to prepare for predictable surges in demand from certain states or certain categories of service members, say advocates and former department officials. Numerous government reports have highlighted the backlog of disability claims and called for improvements in shifting resources. Veterans’ advocates say the types of bureaucratic obstacles recently disclosed at Walter Reed Army Medical Center are eclipsed by those at the Veterans Affairs division that is supposed to pay soldiers for service-related ills.

The influx of veterans from the Iraq war has nearly overwhelmed an agency already struggling to meet the health care, disability payment and pension needs of more than three million veterans. Stephen Meskin, who retired last year as the VA’s chief actuary, said he had repeatedly urged agency managers to track data so they could better meet the needs of former soldiers. VA officials say they have begun an aggressive oversight effort to determine if all disability claims are being properly processed and contracted for a study that will examine state-by-state differences in average disability compensation payments. Many new veterans say they are often left waiting for months or years, wondering if they will be taken care of. The backlogs are worst in some states sending the most troops, and discrepancies exist in pay levels. The agency’s inspector general in 2005 examined geographic variations in how much veterans are paid for disabilities, finding that demographic factors, like the average age of each state’s veteran population, played roles. But the report also pointed to the subjective way that claims processors in each state determined level of disability. Staffing levels at the VA vary widely and have not kept pace with the increased demand. The current inventory of disability claims rose to 378,296 by the end of the 2006 fiscal year. The claims from returning war veterans plus those from previous periods increased by 39% from 2000 to 2006. During the same period, the staff for handling claims has remained relatively flat, a problem the department highlighted in its 2008 proposed budget.

The department expects to receive about 800,000 new claims in 2007 and 2008 each. The growing strains on the veterans agency have affected some soldiers more than others. While the Reserve and National Guard have sent a disproportionate number of soldiers to the war, the average annual disability payment for those troops is $3,603, based on 2006 VA data for unmarried veterans with no dependents. Active-duty soldiers on average receive $4,962. Though the VA acknowledged that there were discrepancies, officials also said they believed that a significant factor might be length of service. Active-duty soldiers generally serve longer, and therefore more suffer from chronic diseases or disabilities that develop over time. Many who served in the Guard think they are losing the battle against the bureaucracy. It is alleged that while active-duty soldiers often receive medical disability evaluations in about 30 days, many reservists wait two years or more to get an initial appointment. Active-duty personnel also routinely received legal advice about appeals and other issues from military lawyers, while reservists have to request those hearings.

For years, the VA’s inspector general, the GAO, members of Congress and veterans’ advocates have pointed out the need to improve how the VA tracks data on soldiers as they are deployed and when they are injured. That would help prepare for their future needs and ease delays in processing health and benefit claims. In 2004, a system was designed to track soldiers better, prepare for surges in demand and avoid backlogs. But the system was shelved by program officials under Secretary Jim Nicholson for financial and logistical reasons according to VA officials. The VA, which has said it has an alternate tracking system nearly operational, depends on paper files and lacks the ability to download Department of Defense records into its computers. President Bush has appointed a commission to investigate problems at military and veterans hospitals.

Dr. David S. C. Chu, the defense undersecretary for personnel and readiness, recently said he is not surprised that servicemembers get different disability ratings from each of the services, the Department of Veterans Affairs and the Social Security Administration. Each system has fundamentally different approaches to the basis on which you should rate the individual. They are three different systems governed by their own sets of laws and rate disabilities using scales unique to each department. Appearing before the House Armed Services Committee on March 8, Dr. Chu expressed confidence that, with legislative support, the system could be fixed. DOD currently is revising its disability evaluation system. Each service manages its own evaluation process within the framework of the DOD system. In fiscal 2006, service eligibility board caseloads were 13,162 for the Army; 5,684 for the naval services; and 4,139 for the Air Force. In 2001, the numbers were 7,218 for the Army; 4,999 for the naval services; and 2,816 in the Air Force. [Source: New York Times Ian Urbina/Ron Nixon article 9 Mar 07 ++]


VA CLAIM PROCESSING GOALS UPDATE 03: A former Veterans Affairs official testifying before a House Veterans Affairs subcommittee panel 8 MAR said he the department as early as AUG 05 of backlogs in the VA health care system but officials instead shelved a program aimed at alleviating delays. Paul Sullivan, a former project manager for the VA, told the panel investigating veterans care that he helped develop a program to consolidate medical records with DoD but that the program suddenly ended once Secretary Jim Nicholson took office in late 2005. Sullivan also said he sent e-mails on several occasions warning of a surge in claims from veterans returning from Iraq and Afghanistan and that more staffing and funding was needed but never received a response. Testimony from Sullivan and the Government Accountability Office (GAO) painted a picture of neglect, bureaucratic delays and poor coordination in the nation’s vast network of 1,400 VA hospitals and clinics.

Lawmakers from both parties expressed outrage. Rep. Harry Mitchell (D-AZ) who chairs the subcommittee said, “That’s unacceptable and embarrassing, and the American people deserve answers. I am not convinced the Veterans Affairs Department is doing its part.” Rep. Steve Buyer (R-IN) agreed, citing years of warnings. “I can’t even begin to count the number of GAO reports over the years outlining the problems,” he said. “It’s been 20 years in the making trying to get the VA and DoD to cooperate.” Responding, Michael Kussman, acting under secretary for health at the VA, told the House Veterans Affairs subcommittee that it was wrong to suggest that Nicholson had shelved the program. The decision to abandon Sullivan’s plan was made by program officials who determined it was logistically unsound. Since then, department officials have been working on a system to improve tracking of medical records, he said. Under questioning, Kussman also acknowledged that the department was a bit “surprised” by the extent of reported cases of post-traumatic stress syndrome (PTSD) and traumatic brain injury (TBI) but were making adjustments to cope. “We are ideally poised to take care of” the growing caseload, he said. That drew an angry response from Rep. Bob Filner (D-CA) who said, “I find that kind of misplaced optimism, that defense of the system, a cause of where we are today,” noting that VA officials in individual clinics themselves had reported an overstressed system.

Thursday’s hearing was the latest to examine the quality of care for wounded veterans in the wake of disclosures of shoddy outpatient health care at Walter Reed, one of the nation’s premier facilities for treating veterans wounded in Iraq and Afghanistan. The VA facilities provide supplemental health care and rehabilitation to 5.8 million veterans after they are treated at military hospitals such as Walter Reed. Earlier in the week, Nicholson made clear that he would not tolerate substandard conditions. Also, he explained in a separate setting to Sen. Jon Tester (D-MT)and Sen. Bernie Sanders (I-VT) steps being taken to reduce the backlog of 400,000 disability claims. The VA has recently expanded the network of centers designed to provide care to those with TBI and will be screening all patients who served in combat for PTSD, he said. During the hearing Thursday, Cynthia Bascetta, director of health care at GAO, testified that while some improvements have been made by the VA, GAO investigators could not offer assurances that problems of veterans falling through the cracks wouldn’t happen again.

In testimony 6 MAR before a joint hearing of the House and Senate Veterans Affairs Committees, the national commander Gary Kurpius of the Veterans of Foreign Wars of the U.S. said the claims processing system at the Department of Veterans Affairs was broken. He said it was broken because VA has an unmanageable backlog of claims and that it takes a half year for a claims rating, and that more than 100,000 claims are decided wrongly every year, or one in every eight. “It is unacceptable, because each delay and every wrong decision have real human costs,” he said. “Fixing the Veterans Benefits Administration is important because the VBA is the gateway to all of VA. No disabled veteran should have to wait for benefits many of them need to care for themselves and their families.” [Source: AP Hope Yen/ Pauline Jelinek article 8 Mar 07 ++]


VA CLAIM PROCESSING GOALS UPDATE 04: Investigators said 13 MAR that the Veterans Affairs’ system for handling disability claims is strained to its limit, and the Bush administration’s current efforts to relieve backlogs won’t be enough to serve veterans returning from Iraq and Afghanistan,.
In testimony to a House panel, the Government Accountability Office (GAO) and Harvard professor Linda Bilmes detailed their study into the VA’s claims system in light of growing demands created by wars. They found a system on the verge of crisis due to backlogs, cumbersome paperwork and ballooning costs. Daniel Bertoni, an acting director at the GAO, Congress’ investigative arm, said the VA system has been riddled with problems for years. “After more than a decade of research, we have determined that federal disability programs are in urgent need of attention and transformation.” According to GAO’s findings, the VA:

• Took between 127 to 177 days to process an initial claim and an average of 657 days to process an appeal, resulting in significant hardship to veterans. In contrast, the private sector industry takes about 89.5 days to process a claim.
• Had a claims backlog of roughly 600,000.
• Will see 638,000 new first-time claims in the next five years due to the Iraq war (400,000 by the end of 2009 alone) creating added costs of between $70 billion and $150 billion.
• Maintained a system for determining a veteran’s disability that was complex and applied inconsistently across regional centers. Results varied; for example, Salt Lake City took 99 days to process a claim, while Honolulu spent 237 days.
• Had antiquated technology for processing claims, such as unreliable old fax machines.

Bilmes, a professor at Harvard’s Kennedy School of Government who co-authored a paper on the war’s economic costs with Nobel laureate Joseph Stiglitz, described a failed system that could have been prevented after years of warnings. She urged simplifying the disability ratings system, reducing time VA staffers spend documenting disabilities, and conducting random audits instead. “The veterans returning from Iraq are suffering from the same problem that has plagued many other aspects of the war, namely a failure to plan ahead,” she said.

Responding, Ronald Aument, deputy under secretary for benefits at the VA, told the House panel that the department was working to shorten delays. The VA also was consolidating some processing operations, and planned to add 400 new employees by the end of June. The findings drew fire from House members. Rep. John Hall, chairman of the House Veterans Affairs subcommittee on disability assistance, floated the possibility that the Veterans Affairs Department should be merged into the Defense Department. Colorado Rep. Doug Lamborn (R-CO) , said the overstressed claims system was courting a “financial and potentially emotional disaster.” The hearing follows disclosures of roach-infested conditions and shoddy outpatient care at Walter Reed Medical Center, one of the nation’s premier military hospitals. Since the disclosures by the Washington Post, three high-level Pentagon officials have been forced to step down. President Bush has also appointed a commission led by former Sen. Bob Dole, R-Kan., and former HHS Secretary Donna Shalala, a Democrat, to conduct a broad review on veteran and troop care. The House hearing is the latest to review the quality of care for wounded troops returning from Iraq; from emergency medical care at military hospitals, to long-term rehabilitation at VA clinics and eventual transition to civilian life with VA disability payments. [Source: Associated Press Hope Yen article 14 2007]


VA HANDBOOK 2007: 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 Vietnam or in the Gulf War, as well as special benefits for veterans with severe disabilities. In addition to describing benefits provided by VA, the 2007 edition of the 160-page booklet provides an overview of programs and services for veterans provided by other federal agencies. It also includes resources to help veterans access their benefits, with a listing of toll-free phone numbers, Internet addresses and a directory of VA facilities throughout the country. The handbook can be downloaded free from VA's Web site at http://www1.va.gov/opa/vadocs/fedben.pdf or http://www1.va.gov/OPA/vadocs/current_benefits.asp or http://www1.va.gov/opa/feature/index.asp or purchased with credit card or check from the U.S. Government Printing Office (GPO). GPO accepts credit card orders for the publication at (866)512-1800 for a cost of $5 each to U.S. addresses, or $67 for bulk orders of 25 copies. It order is by mail make check out to Superintendent of Documents and mail to the GPO at Superintendent of Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954. [Source: www.va.gov Feb 07 ++]


VETERANS HOME SCAM: The U.S. Department of Veterans’ Affairs Regional Office in Portland, the Benton County Board of Commissioners and the Benton County Veterans Service Office urge veterans, their spouses, or their families to beware of unauthorized franchises or individuals offering representation for benefits from the Department of Veterans Affairs. The current scam targeting Veterans’ is being run by Veterans Salute based in Florida. The company has been contacting nursing homes, assisted living facilities, and adult day-cares looking for veterans who maybe eligible for VA pension benefits. They try to get the home or facility to pay $800 for their service, which is free at all VA county service offices, or at the ODVA office in Salem for Marion and Polk county veterans. So far in Oregon, there have been a couple of near misses, but nobody has yet to report falling victim to the scam. The Portland VA Regional Office recommends anyone who has been contacted by an unauthorized franchise or individual to contact them at (800) 827-1000. [Source: Salem-News.com Kevin Hays article 8 Mar 07 ++]


VET CEMETERY FLORIDA UPDATE 04: What began as a dream a decade ago will become reality when the first veteran is laid to rest at the South Florida National Cemetery. The new cemetery is located in Palms Beach county in Lake Worth on U.S. 441 just south of Lantana Road and north of Boynton Beach Blvd. The burial ground opens 16 APR, two years after the original projected date that was rolled back several times. As many as a dozen interments are expected on the first day, said South Florida Cemetery Director Kurt Rotar. There would be more, but only one of the six shelters for services will be ready. The
Rotar expects to keep up that pace for months, with as many as a dozen burials six days a week. veteran community can contact the cemetery staff at (561) 649-6489 for information about burial and eligibility. More than 700 families are holding cremated remains or planning to move their loved ones from other cemeteries to South Florida National. So many that the VA will not add new names to the waiting list until after 9 APR. Service and burial scheduling for new national cemeteries will be handled by a centralized VA system in St. Louis, with requests being taken in the order they were received and juggled with the burials of the newly deceased. Living veterans cannot make reservations, and their interments, or those of their spouses, who are entitled to national cemetery gravesites, even if they die before the veterans, are handled by funeral homes at the time of death.

The first burials in the 50-acre “fast track” section near the cemetery entrance off U.S. 441, which has room for about 10,000 in-ground and cremated remains, were pushed back last year from this spring to late summer because of wet weather stalling site preparation. But Rotar said that when he came on board in January, VA officials told him to scramble and make an April deadline. “The feeling was the veterans were asking for it to open and had been waiting a long time,” said Rotar, who previously was director of Massachusetts National Cemetery, on Cape Cod, for nine years. Bulldozers and graders growled over the barren grounds this week as workers plumbed an irrigation system in advance of laying sod and planting trees. The South Florida site will have more water features than most national cemeteries. Three of its five lakes, required to offset environmental impacts, already circle the trailers serving as temporary administration and construction offices. A columbarium, for above-ground remains, probably won’t be completed for up to another five years. When finished, the cemetery will cover 313 acres and have room for 115,000 veterans, enough to meet South Florida’s needs for the next 50 years.

The 130 families seeking to move already buried remains to South Florida National will have to pay for the relocation, which can cost as much as several thousand dollars. The 570 others on the waiting list, with cremated remains, can bring their urns or boxes to the cemetery themselves. The VA does the burial and provides a gravesite, a marker, a grave liner and a military honor guard at no charge. South Florida National is the fifth VA cemetery in Florida, home to one of the nation’s largest populations of World War II veterans. The VA is purchasing land near Jacksonville and Sarasota for two additional burial grounds. VA presently maintains other Florida National Cemeteries at:
- Barrancas National Cemetery, Naval Air Station, Pensacola, FL 32508-1099 Tel: (850) 452-3357 or 4196.
- Bay Pines National Cemetery, P.O. Box 477, Bay Pines, FL 33504-0477 Tel: (352) 793-7740.
- Florida National Cemetery, 6502 SW 102nd Ave, Bushnell, FL 33513 Tel: (352) 793-7740 or 1074.
- St. Augustine National Cemetery, 104 Marine Street, St. Augustine, FL 32084 Tel: (352) 793-7740.
[Source: South Florida Sun-Sentinel Diane C. Lade article 8 Mar 07 ++]


VETERANS HEALTHCARE EMPOWERMENT ACT: Expressing strong confidence in the current healthcare system run by the U.S. Department of Veterans Affairs, the Ranking Member of the Committee on Veterans' Affairs (SCVA) U.S. Senator Larry Craig (R-ID) said 8 MAR that he is willing to see how the system might fare in competition with the free market. Under legislation he is introducing - The Veterans Healthcare Empowerment Act - veterans with service connected disabilities will be able to go to any hospital or medical clinic of their choice. “Many of my colleagues have spent the past week or so accusing VA of ‘failing’ our injured service-members. Most of their evidence is based on reports from the news media who have highlighted recently a number of veterans who were treated badly by VA or who do not have faith in VA’s care. I take these concerns very seriously. But, I am also a little frustrated by it,” said Craig. “That’s why I will introduce legislation that says: If you have a service- connected disability, go wherever you want. No strings. No ifs, ands, or buts. Let’s find out where veterans chose to go.”

Approximately 2.5 million veterans have service connected disabilities and approximately 1.7 million currently use the VA healthcare system. VA operates 154 hospitals and 881 outpatient clinics. Craig’s healthcare bill would operate somewhat like the G.I. Bill, which allows veterans to choose the college or university of their choice. “It’s very simple, if service-connected veterans leave in droves, we’ve learned something. But, if veterans overwhelmingly stay, and I think they will, we’ve also learned something,” Craig said. “This bill is about my confidence in VA.” The senior senator from Idaho noted that VA’s health care system has consistently been ranked as among the best in the nation. For the seventh year in a row, a study conducted by the VA’s health care system outscored the private sector in the University of Michigan’s Consumer Satisfaction Survey
- VA outscored the private sector by 11 percent in inpatient care (84 to 73%)
- VA outscored them in outpatient care by 11% (82 to 71%)
- 91% of VA patients were satisfied with the overall customer service at VA
- VA also scored 94% in “veterans loyalty” category

Other national publications have also touted VA’s healthcare system. Last year Time Magazine had a front page article titled “How VA Hospitals Became the best Health Care?” and Business Week called VA healthcare The Best Medical Care In The U.S.” more recently Harvard University’s Kennedy School of Government awarded VA it’s “Innovations in American Government award” for the electronic health record and performance system.” The SCVA regularly releases News Release of interest to veterans via their website http://veterans.senate.gov/. [Source: SCVA Press Release 8 Mar 07 ++]

VET CEMETERY ILLINOIS:: The Department of Veterans Affairs (VA) has awarded a construction contract for more than $10 million to a Chicago contractor to expand the Rock Island IL, National Cemetery. The expansion project encompasses approximately 25 acres and will provide more than 7,000 gravesites, including casket gravesites, pre-placed crypts and a columbarium for cremation remains. It will also provide a new committal service shelter, an assembly area, public restrooms, an information building, a maintenance area, and additions and renovations to the administration building. New and renovated infrastructure features for water distribution, roads and utilities are included. VA expects to begin construction within approximately one month and to be completed by late 2008. The expansion will permit burials for veterans and eligible family members to continue at Rock Island National Cemetery for at least the next decade. Contact info on the Rock Island National Cemetery is Bldg 118, Rock Island Arsenal, Rock Island, IL 61299 Tel: (309) 782-2094/2097F www.cem.va.gov/CEM/cems/nchp/rockisland.asp.

Illinois’ other six national cemeteries are:
- Abraham Lincoln National Cemetery (near Chicago) 27034 South Diagonal Road, Elwood, IL 60421 Tel: (815) 423-9958/5824F www.cem.va.gov/CEM/cems/nchp/abrahamlincoln.asp
- Danville National Cemetery, 721 Lee Street, Danville, VA 24541 Tel: (704) 636-2661/1115F www.cem.va.gov/CEM/cems/nchp/danvilleva.asp.
- Camp Butler National Cemetery, 5063 Camp Butler Road, Springfield, IL 62707 Tel: (217) 492 – 4070/4072F www.cem.va.gov/CEM/cems/nchp/campbutler.asp.
- Mound City National Cemetery, HWY Junction 37 & 51, Mound City, IL 62963 Tel: (314) 260-8691 or (800) 535-1117 or (314) 260-8723F www.cem.va.gov/CEM/cems/nchp/moundcity.asp.
- Quincy National Cemetery, 36th and Maine Street, Quincy, IL 62301 Tel: (309) 782-2094/2097F www.cem.va.gov/CEM/cems/nchp/quincy.asp.
- Alton National Cemetery, 600 Pearl Street, Alton, IL 62003 Tel: (314) 260-8691 or (800) 535-1117 or (314) 260-8723F www.cem.va.gov/CEM/cems/nchp/alton.asp.

Abraham Lincoln, Danville, Camp Butler and Mound City national cemeteries have space available for casketed and cremated remains. Alton has space available for cremated remains and can accommodate casketed remains in the gravesites of previously interred family members. Quincy is closed to new interments, but can bury family members in existing gravesites.

In the midst of the largest cemetery expansion since the Civil War to care for the aging veterans population, VA operates 124 national cemeteries in 39 states and Puerto Rico and 33 soldiers' lots and monument sites. More than three million Americans, including veterans of every war and conflict, are buried in VA national cemeteries. Veterans with a discharge other than dishonorable, their spouses and eligible dependent children can be buried in a national cemetery. Other burial benefits available for all eligible veterans, regardless of whether they are buried in a national or private cemetery, include a burial flag, a Presidential Memorial Certificate, and a government headstone or marker. Information on VA burial benefits can be obtained from national cemetery offices, from the Internet at http://www.cem.va.gov, or by calling VA regional offices toll-free at 1(800) 827-1000. [Source: VA News Release 23 Feb 07 ++]


VET CEMETERY MINNESOTA:: The Department of Veterans Affairs (VA) has awarded a construction contract for more than $19 million to a Minnesota contractor to expand the Fort Snelling National Cemetery located at 7601 34th Avenue, South, Minneapolis, MN 55450-1199 Tel: (612) 726-1127/725-2059F. Sheehy Construction Company of St. Paul wil be developing approximately 25,000 gravesites, including graves with pre-placed crypts, and a columbarium for cremation remains. The expansion project encompasses nearly 60 acres. Besides burial space, it will include renovations and additions to the administration building, public information building and maintenance facility. New committal service shelters, signage, site furnishings, fencing and landscaping will also be included. VA expects construction to be completed by late 2009. The expansion will permit burials for veterans and eligible family members to continue at Fort Snelling National Cemetery for at least the next decade. For additional info regarding this cemetery refer to www.cem.va.gov/CEM/cems/nchp/ftsnelling.asp.

Eligible veterans or their dependents can also elect to be buried in the Minnesota State Veterans Cemetery located at 15550 Hwy 115, Little Falls, MN 56345 Tel: (320) 616-2527/2529F. Eligibility for burial is the same as the guidelines followed at Ft. Snelling National Cemetery. Members of the National Guard or Reserve forces are not eligible unless they meet current regulations, which are:
- Death while on active duty for training.
- Death under honorable conditions while hospitalized or undergoing treatment at the expense of the United States for injury or disease incurred while performing active duty for training.
- Any individual who, at the time of death, was entitled to retired pay as a result of non-regular service or would have been entitled to retired pay for credible non-regular service (20 years), but for the fact the person was not at least 60 years of age, is eligible for burial.
For questions or additional information on this facility refer to dswantek@uslink.net or www.mdva.state.mn.us/cemetery.htm

In the midst of the largest cemetery expansion since the Civil War to serve for the aging veterans’ population, VA operates 124 national cemeteries in 39 states and Puerto Rico and 33 soldiers' lots and monument sites. More than three million Americans, including veterans of every war and conflict, are buried in VA’s national cemeteries. Veterans with a discharge other than dishonorable, their spouses and eligible dependent children can be buried in a national cemetery. Other burial benefits available for all eligible veterans, regardless of whether they are buried in a national or a private cemetery, include a burial flag, a Presidential Memorial Certificate and a government headstone or marker. Information on VA burial benefits can be obtained from national cemetery offices, from the Internet at http://www.cem.va.gov, or by calling VA regional offices toll-free at 1(800) 827-1000. For information on the Fort Snelling National Cemetery, call the cemetery office at (612) 726-1127. [Source: VA News Release 28 Feb 07 ++]


TF ON COMBAT BENEFITS: President Bush has created a special, inter-agency task force under the leadership of Secretary of Veterans Affairs Jim Nicholson to thoroughly examine and cut through red tape affecting the latest generation of combat veterans seeking services and benefits from the Department of Veterans Affairs (VA) or any other federal agency. Called the “Task Force on Returning Global War on Terror Heroes,” the panel held its first meeting 7 MAR. The task force consists of the secretaries of Defense, Labor, Health and Human Services, Housing and Urban Development, and Education, plus the administrator of the Small Business Administration and the director of the Office of Management and Budget. Nicholson said. “This task force will identify ways to cut red tape and ease the transition back home for our combat troops, especially our wounded heroes. They deserve less hassle and more action from their government, and that will continue to be our focus.” Under the terms of the executive order creating the task force, the group has 45 days to:
• Identify and examine existing federal services that currently are provided to returning Global War on Terror service members;
• Identify existing gaps in such services;
• Seek recommendations from appropriate federal agencies on ways to fill those gaps; and
• Ensure that appropriate federal agencies are communicating and cooperating effectively.”

Executive secretary of the task force is retired Rear Adm. Patrick W. Dunne, VA’s assistant secretary for policy and planning. Matt Smith, special assistant to Secretary Nicholson, will serve as the task force’s senior advisor. [Source: VA News Release 7 Mar 07 ++]


WRAMC UPDATE 05: Before recent exposés, the Pentagon called Walter Reed Army Medical Center the shining example of how the nation should treat its wounded soldiers. If this was the model, veterans are in deep trouble. The deplorable conditions uncovered at Walter Reed have brought complaints from veterans and their families across the country. Washington Post reporter Dana Priest, who broke the story, says the newspaper has received thousands of reports of similar problems at hospitals and medical facilities throughout the Veterans Affairs system. Only the naive and the Pentagon brass would believe that Walter Reed was an isolated case. Incredibly, despite the rising numbers of those who will need care, the White House is proposing a VA budget that is essentially flat from last year. The administration wants to cut money for prosthetic research and provide inadequate financing for the backlog of cases that only will grow. Yet on 27 FEB, Mr. Bush called on Congress to “fund our war fighters.”

Department of Veterans Affairs Secretary Jim Nicholson has compounded the administration’s indifference with insulting rhetoric. Asked about the 200,000-plus who have tried to get care, Mr. Nicholson says, “A lot of them come in for dental problems.” Mr. Nicholson isn’t the only one who first underestimated reaction to the disclosures. On 1 MAR, Defense Secretary Robert Gates fired Maj. Gen. George Weightman as commander of Walter Reed. But Mr. Gates replaced him with Army Surgeon General Lt. Gen. Kevin Kiley. According to the Post, Gen. Kiley was warned about outpatient problems at Building 18 three years ago but never walked across the street to look. On 2 MAR, Gen. Kiley was out, and so was Frances Harvey, secretary of the Army. The House Committee on Oversight and Government Reform is investigating the role privatization may have played in the breakdown. The management staff at Walter Reed was cut from 300 to fewer than 60 this year. Chairman Henry Waxman [D-CA] wants to know why the Pentagon awarded a five-year, $120 million contract for support services at the center to IAP Worldwide Services, a Florida firm run by two former Halliburton executives, one of them a retired Army general. To hire IAP, the Army reversed its own findings that federal employees could do the work for less

Sen. Bill Nelson (D-FL, has raised questions about care at a Tampa veterans hospital, where active-duty trauma patients are treated, during a Senate Armed Services Committee grilling of top defense officials about problems at Walter Reed Army Medical Center. The James A. Haley Veterans Hospital in Tampa is one of four VA hospitals in the country that specialize in traumatic brain injury (TBI) who handle veterans and active-duty military. Nelson said there have been delays in getting rehabilitation for troops with brain injuries -- sometimes postponing care until the patient is moved from active duty to veteran status. Nelson cited a report showing that at model hospitals the delay in starting rehabilitation was slightly more than two weeks, but for the VA it was six weeks. Carolyn Clark, spokeswoman for the James A. Haley facility, disagreed with Nelson's conclusions, saying the hospital provides state-of-the-art care for traumatic brain-injury patients.

The Senate committee's hearing was Congress' second in two days on Walter Reed. Reports of wounded troops battling excessive red tape and dilapidated living conditions have enraged Republicans and Democrats. They are worried that problems there point to a broader pattern of neglect at military hospitals During the House Oversight and Government Reform subcommittee hearing 5 MAR, two soldiers wounded in combat and a spouse of a wounded soldier recounted nightmarish stories of frustration as they tried to get medical attention and disability compensation. "I'm afraid this is just the tip of the iceberg, that, when we [get] out into the field, we may find more of this," said Rep. Tom Davis [R-VA] a member of the committee. On 6 MAR, President Bush named former Sen. Bob Dole and former Health and Human Services Secretary Donna Shalala, the University of Miami president, to lead the administration’s investigation into the Walter Reed scandal. They have a long year ahead. The government’s failure of veterans goes far beyond the Washington hospital. [So

[boardman]

RAO Bulletin Update - 1 April 2007


THIS BULLETIN UPDATE CONTAINS THE FOLLOWING ARTICLES:

== Tricare Uniform Formulary (18) -------------- (More Tier Changes)
== FL Disabled Vet Tax Exemption (01) -------- (Property Tax Discounts)
== Vet Healthcare Mandatory Funding----------- (Impact on Care)
== Tricare Pharmacy Policy (02) ---------- (Medicare Part “D” Impact)
== Wounded Warrior Assistance------------------ (WRAMC Fallout)
== Small Business Administration (01) ---------- (H.R.0109)
== FL Dept of Revenue Data Breach ------- (Identity Theft Protection)
== Mobilized Reserve 28 MAR 07 --------------- (Net Decrease 1,511)
== SBP SSA Offset (09) --------------------------- (1 April Decrease)
== National Uniform Claim Committee --------- (VHA Membership)
== Angioplasty vs. Drugs ------------------------- (Equally Effective)
== Traumatic Brain Injury (03) ------------------ (Vets Helping Vets)
== Diabetes (03) ------------------------------------ (Take the Test)
== Tricare Emergency Facility Use ------------- (Claim Submission)
== Marines' Memorial Assn -------------- (San Francisco Military Club)
== Medicare Fraud -------------------- (Federal False Claims Act)
== Vet Home Patient Neglect -------------------- (AZ/AL Vet Homes)
== Tricare EOBs ----------------------------------- (Policy Change)
== Base Decals--------------------------- (AF No Longer Requires)
== Referral Bonus (02) ------------ (Expanded to Army Civilians)
== SBP Legislation-------------------------------- (Inequities)
== AFRH (02) -------------------------- (Poor Conditions Alleged)
== STROKE (02) -------------------------- (Transient Ischemic Attacks)
== VDBC (15) ------------------------------------- (CR Recommendations)
== Military Pay Tax Bill ------------------------- (Active Duty Only)
== Medal of Honor Day -------------------------- (March 25th)
== Tricare/CHAMPUS Fraud (05) ---------- (PI Claim Pmt Suspensions)
== Filipino Vet Inequities ------------------------ (Wartime Promises)
== VA Facility Maintenance --------------------- (1,100 Problems Cited)
== Veterans Benefit Protection Act ------------- (Hiring Attorneys)
== Echo Taps Worldwide ------------------------ (Armed Forces Day Plan)
== Recruiter Misconduct (02) ------- (Video Surveillance Contemplated)
== WRAMC (07) ------------------------ (Alternate Closing Proposal)
== Bug Safety (Children) ------------------------ (Summer Safety tips)
== WRAMC (06) ---------------------------- (May Not close)
== Millennium Cohort Study --------------- (Military Health Survey)
== NDAA 2008 ----------------------------------- (TMC Priorities)
== Tax on Home Sale ---------------------------- (Exclusion rules)
== COLA 2008 (04) ------------------------------ (-0.3% thru FEB 07)
== VBDR---------------------------------- (DR Program Abolishment)
== Supplemental Appropriations Act ---------- (Impact on VA)
== Will Rogers Memorial Museum ------------- (Words of Wisdom)
== Future for Vets Commission ----------------- (Tampa Meeting)
== DFAS Death Notification (01) --------------- (Where to Notify)
== Returning GWT Heroes TF ------------------- (Inviting Feedback)
== Hepatitis & Liver Cancer --------------------- (Five Known Viruses)
== VA Hepatitis “C” Web Site ------------------ (Where to Look)
== Military Retirement Taxation ---------------- (What is/is not)
== Awards Replacement (01) ------------------- (What to Expect)
== Awards Replacement (02) ------------------- (Letter Request Format)
== Veteran Legislation Status 31 MAR 07 ------- (Where we stand)

Editor’s Note: Attached is a listing of veteran legislation with current cosponsor status that has been introduced in the 110th Congress. To see any of these bills passed into law representatives need input from their veteran constituents to guide them on how to vote. For the Easter holiday the House will recess 2-13 April and the Senate 2 to 9 April.


TRICARE UNIFORM FORMULARY UPDATE 18: On March 22, a DoD panel proposed moving several pain narcotic, glaucoma, and anti-depressant medications to the third tier ($22 copay vs $3 or $9 for drugs on first and second tiers), along with some newer sedatives.
- Ultram ER (extended release) will be moved to the third tier with a 90-day implementation time. There are 38 other medications in this class that remain available at the lower copays, including the immediate-release form of Ultram.
- Glaucoma drugs Travatan, Istalol, Betimol, and Azopt to the third tier, while 18 medications in this class will still be available at the lower copay.
- Among anti-depressants, the Emsam patch will move to the third tier, leaving Marplan, Nardil and Parnate available at lower copays.
- Some newer sedatives -- Rozerem, Sonata, and Ambien CR (controlled release) - also will move to the third tier. Ambien and Lunesta will remain on the lower-copay list, along with eight other older drugs. However, a "prior-authorization" requirement is being proposed for first-time use of all drugs in this class other than Ambien, which is the most commonly prescribed and cost-effective drug in this class. The prior-authorization requirement would not apply to patients who previously had another first- or second-tier sleep agent prescribed in the last six months. The panel indicated that Ambien is scheduled to be available in generic form in April. When that happens, use of that generic will be made mandatory. Other drugs in the class will be available only if the doctor demonstrates that there is a medical necessity to prescribe one of the other drugs in the class for the particular patient (e.g., to avoid adverse side effects).
[Source: MOAA Leg Up 30 Mar 07 ++]


TAX EXEMPTION FOR FL DISABLED VETS UPDATE 01: An amendment to the Florida Constitution voters approved in 2006 to give property tax discounts to a small group of disabled veterans could be implemented under a bill that cleared the state’s Senate. Only those veterans with combat-related disabilities who were Florida residents when they joined the military would be eligible for the tax discounts on their primary homes, known as homesteads. The percentage of a veteran’s discount would correspond to the percentage he is disabled as determined by the U.S. Department of Veterans Affairs. The Senate passed the bill 39-0. It now goes to the House, where no similar bill has yet been filed. [Source: Southwest Florida Herald Tribune 29 Mar 07 ++]


VETERANS' HEALTHCARE MANDATORY FUNDING: On 8 MAR 07 Senator Charles Schumer (D-NY) told a Washington, DC newspaper; “Nationwide, veterans are facing a healthcare funding shortfall of more than $2.8 billion in the midst of a growing nationwide scandal over inadequate treatment of wounded soldiers returning from Iraq and Afghanistan”. He pledged to promote, support, and vote for full mandatory funding of veteran’s healthcare and services. Full funding for Veterans Healthcare is something all veterans would like to see achieved. A group of veterans has initiated “Operation Firing for Effect” (OFFE) to help achieve that goal. On 19 MAR, while visiting the VA Medical Center in Canandaigua New York, Sen. Schumer took time to meet with Operation Firing For Effect representatives and to sign their Resolution calling for full mandatory funding of veteran’s healthcare and services. This Resolution posted at http://offe2008.org/public_html/resolution.htm has been adopted and passed by several U.S. northeast cities and townships, including the Mayor of Chicago, Illinois, Richard Daley, the Governor of Oregon, Ted Kulongoski, plus over 500,000 labor union members in New York State.

healthcare system is essential to provide vets with adequate healthcare. The links shown provide documentation on the conditions noted:

- On 22 AUG 86, the VAMC in Atlanta Georgia released a Memorandum changing their procedures for self injections for diabetic insulin users. The change in policy was as follows; “Effective for new prescriptions written after 2 SEP 86, you should use each disposable insulin syringe two times before throwing it away”. The only possible reason for this new policy was budgetary. This change in procedure was an attempt to cut the year’s insulin syringe budget in half. Apparently, the VA needed funds elsewhere, and decided this very questionable and risky injection procedure was a good idea. Well known Georgia veterans rights advocate Jere Beery led a successful public campaign to have this unsafe practice stopped immediately. This one small example illustrates how budget restraints affect the quality of healthcare our veterans receive. Mandatory full funding would guarantee that our veterans would never be asked to use a dirty syringe again. Documentation; http://jerebeery.com/va-syringe-useage.htm
- Although the telephone has been around for well over a century, it wasn’t until 1996 that all VA hospitals nationwide were equipped with bedside telephones. Up until that time, unless you could make it to the pay phone down the hall, patients made no calls, much less receive any. In 1995, Mr. Francis Dosio of PT Phone Home and the Communication Workers of America Union took up the concept veterans activist Jere Beery had started several years earlier and launched a nationwide project to install bedside phones in every VA hospital in the country. All of the labor and equipment was donated but the story was not publicized. The VA didn’t have to pay anything for the bedside phone project as all of the funds were donated from the private sector. Mandatory full funding would insure that our veterans do not have to depend on public donations for basic amenitie and services. Documentation; http://jerebeery.com/bedside_telephones ... ospita.htm.
- In 1998, the VAMC in Atlanta attempted to implement parking fees for all veterans visiting the facility. Vietnam combat veteran Jere Beery openly challenged the parking plan and stimulated public outrage which halted the idea before it was enforced. Mandatory full funding would guarantee that our veterans are never again ask to pay to access the healthcare services they have earned. Documentation; http://jerebeery.com/va%20parking%201.htm.
- In 2006, two veterans died after they were refused entrance and lifesaving treatment at the VA hospital in Spokane Washington. The reason; they arrived after the emergency room had closed. Mandatory full funding would insure that all VA hospitals with a pre-existing emergency room could maintain 24/7 emergency services for critically ill veterans. Documentation; http://jerebeery.com/offe_extremely_con ... bout_d.htm .
- In 1978, travel reimbursement for veterans traveling to a VA hospital for a scheduled appointment was 11 cents per mile, which was when gas was 49 cents a gallon. This reimbursement amount has remained unchanged for 29 years. In this case, Mandatory full funding would provide the funds to increase this allowance and allow for the payment of travel pay to fluctuate with the rising cost of fuel.
- Currently, the VA has a backlog of over 90,000 claims waiting processing. Many veterans are required to wait well over a year for their VA rating decision. Under-staffing is the primary reason for these delays. Mandatory funding would make it possible for the VA to hire additional staff to process and expedite claims.
- Low wages offered by the VA make it difficult to entice and retain high quality medical professionals. Doctors, nurses, dentist, psychiatrist, counselors, and nutritionist all make significantly more money in the private sector. Mandatory funding would allow for increases in salaries which would attract more medical professionals into the VA healthcare system.
- Mandatory funding would also insure that future medical research done by the VA would not be restricted by budget constraints.
For additional info on OFFE refer to Refer to http://offe2008.org/public_html/index.htm. [Source: OFFE Gene Sims msg. 29 Mar 07 ++]


TRICARE PHARMACY POLICY UPDATE 02: The Tricare Management Activity (TMA) announced that, in collaboration with the Defense Manpower Data Center (DMDC) and the Centers for Medicare and Medicaid Services (CMS), it has developed a customer-focused process for beneficiaries to resolve Medicare Part D and Tricare coverage issues, and obtain their prescriptions more quickly. Since the initiation of the Medicare Part “D” program some Tricare beneficiaries who try to use their Tricare prescription drug benefit have found their Tricare coverage denied due to the inadvertent Medicare Part D enrollment. Should this situation happen to you, TMA recommends the beneficiary contact Express Scripts at 1(866) 363-8779. The Express Scripts customer service representative will ask for the beneficiary’s permission to access Medicare Part D coverage information from CMS and determine whether the beneficiary is currently in a Medicare Part D plan. If CMS records show no Medicare Part D coverage, DMDC will update the beneficiary’s Defense Enrollment Eligibility Reporting System (DEERS) information, in one business day. Additionally, if Express Scripts discovers that CMS shows the beneficiary as having Medicare Part D coverage, they will advise the beneficiary how to obtain confirmation of disenrollment or cancellation from Medicare Part D, and how to forward the disenrollment or cancellation information to DMDC to update the beneficiary’s DEERS record. Once DMDC receives this documentation, a customer service representative will update the DEERS records and telephone the beneficiary to confirm the correction. [Source: TMA News Release 22 Mar 07 www.tricare.mil/pressroom/news.aspx?fid=271 ++]


WOUNDED WARRIOR ASSISTANCE: On 28 MAR the House unanimously passed H.R. 1538, the Wounded Warrior Assistance Act of 2007. This bipartisan bill responds to the problems brought to light at the Walter Reed Army Medical Center and other military health care facilities by including provisions to:
1) Improve the access to quality medical care for wounded service members who are outpatients at military health care facilities;
2) Begin the process of restoring the integrity and efficiency of the disability evaluation system and taking other steps to cut bureaucratic red-tape; and
3) Improve the transition of wounded service members from the Armed Forces to the VA system.

More specifically an overview of some of the key provisions of the bill discloses it:
- Improves the training and reduces the caseloads of medical care case managers for outpatient wounded service members, so that service members and their families can get the help they need when they need it. For example, the bill requires that case managers for outpatients handle no more than 17 cases and review each case at least once a week to better understand patient needs.
- Creates a system of patient advocates for outpatient wounded service members. These advocates are there to fight, when necessary, to ensure that outpatients get the right treatment. The bill limits patient advocates to a caseload of no more than 30 outpatients.
- Requires DOD to establish a toll-free hot line for reporting deficiencies in facilities supporting medical patients and family members, requiring rapid responses to remediate substantiated complaints.
- Establishes an independent medical advocate to serve as a counselor and advisor for service members being considered by medical evaluation boards.
- Requires DOD to recommend annually improvements in the training of health care professionals, medical care case managers, and patient advocates to increase their effectiveness in assisting recovering wounded warriors. The bill, at a minimum, requires DOD to make recommendations about improving training in the identification of post-traumatic stress disorder, suicidal tendencies, and other mental conditions among recovering service members.
- Requires the Army to establish an Army Wounded Warrior Battalion pilot program at an installation with a major medical facility modeled after the Wounded Warrior Regiment program in the Marines. The unit is intended to track active-duty soldiers in outpatient status who still require medical care.
- Begins the process of reforming administrative processes in order to restore the integrity and efficiency of the disability evaluation system. For example, the bill requires DOD to establish a standardized training program and curriculum for those involved in the disability evaluation system.
- Takes some substantive steps in reducing the turmoil of being transferred from military to veterans’ medical care for service members who are discharged. The bill creates a formal transition process from the Armed Forces to the VA for service members who are being retired or separated for health reasons. The transition is to include an official handoff between the two systems with the electronic transfer of all medical and personnel records before the member leaves active-duty.

The Dignity for Wounded Warriors Act H.R.1268 & S.713 are similar bills that have been introduced in the 110th Congress on this issue. [Source: House Speaker Pelosi msg. 29 Mar 07 ++]


SMALL BUSINESS ADMINISTRATION UPDATE 01: Legislation moving through the House aims to reduce fees on U.S. Small Business Administration loans and boost lending in rural areas and low-income urban neighborhoods. On 15 MAR the House Small Business Committee approved H.R.0109. This bill would eliminate fees on loans made to veterans through the SBA’s 7(a) program and cut fees in half on loans made to doctors and dentists in areas where there is a shortage of medical professionals. Small businesses that need large loans would benefit from a provision that allows borrowers to combine a 7(a) loan, which can be used for a variety of business purposes, with a 504 loan, which must be used for real estate or other fixed assets. The bill would allow the SBA to use money appropriated by Congress to reduce fees on 7(a) loans. The government-guaranteed loans are popular because they offer longer terms and lower monthly payments than conventional small-business loans. Congress lowered 7(a) loan fees to stimulate the economy after the 911 terrorist attacks. Fees on borrowers and lenders went back up in OCT 04, when Congress - at the SBA’s request - stopped subsidizing the loans. Fees now cover loan defaults and other program costs. Eliminating the subsidy saves taxpayers about $80 million a year. But critics say the higher fees make the loans too expensive for some small businesses, adding $1,500 to $3,000 to the cost of small 7(a) loans and as much as $50,000 for large loans. [Source: South Florida Business Journal 27 Mar 07 ++]


FL DEPT OF REVENUE DATA BREACH: A Cape Coral veteran is afraid he could become the victim of identity theft again after learning 26 MAR his personal information had been stolen for the fourth time in a year - this time from a state agency. Bill Trowler received a letter from the Florida Department of Revenue saying his information had been stolen from a database. Exposure to identity theft as a result of data breaches has happened to Trowler four times in the last year. It started when he got caught up in the largest identity theft case in U.S. history when 26.5 million veterans were compromised by a stolen laptop. His personal information was again compromised when he applied for a line of credit from department store and again when he applied for a standard credit card. In both of those cases his information was used to get new credit lines and one crook even set up a business in Trowler’s name. He immediately started trying to protect his identity. “We froze all our accounts with the credit bureau. We also changed all our account numbers on all credit cards. We have destroyed or shredded anything that contains financial information. We got extra locks on the door now,” said Trowler.

He has contacted the Florida Department of Revenue to deal with this latest incident, but so far he hasn’t heard back from them to find out exactly what happened. The state did admit that there is a criminal investigation going on and that about 5,000 people’s information was compromised. Officials aren’t saying how the data was stolen or when. Last year Florida State warned their employees via a 16 MAY email message that their personal information may have been compromised after work on the state's People First payroll and human resources system was improperly subcontracted to a company in India. Employees who worked for the state during the 18-month period between 1 JAN 03 and 30 JUN 04, were potentially exposed. The state's Department of Management Services (DMS), which oversees the People First system, estimated that 108,000 then current and former state employees may have been affected by the data breach, although that estimate could change as a result of their investigation into the matter.

The military community continues to be at risk for identity theft because the government and many large companies cannot get their act together on this issue. As a result veterans are continually being exposed to the potential of identity theft from hackers and criminals. Although those who have been exposed are reassured by these agencies that appropriate actions are being taken to protect them from personal loss, these actions and notifications are always taken after data breaches have occurred giving criminals ample time to act on the data they have obtained. One sure way to protect yourself is to purchase insurance against losses and let the insurer fight the battles with creditors seeking reimbursement from you for alleged purchases/loans. Companies offering these services can be located on the web by entering “Identity Theft Insurance” into your search engine. Premiums and coverage vary. One such company is Lifelock www.lifelock.com which offers a 25% discount to veterans for $1,000,000 coverage at a $7.50 monthly premium. Those seeking protection are encouraged to shop for the best deal to meet their personal needs. [Source: WBBH NBC2 News Fort Myers FL 27 Mar 07 ++]


MOBILIZED RESERVE 28 MAR 07: The Army, Navy, Air Force, Marine Corps and Coast Guard announced the current number of reservists on active duty as of 28 MAR 07 in support of the partial mobilization. The net collective result is 1,511 fewer reservists mobilized than last reported for 14 MAR 07. Total number currently on active duty in support of the partial mobilization for the Army National Guard and Army Reserve is 62,879; Navy Reserve 6,174; Air National Guard and Air Force Reserve 4,983; Marine Corps Reserve 5,559; and the Coast Guard Reserve 301. This brings the total National Guard and Reserve personnel, who have been mobilized, to 79,896, including both units and individual augmentees. At any given time, services may mobilize some units and individuals while demobilizing others, making it possible for these figures to either increase or decrease. A cumulative roster of all National Guard and Reserve personnel, who are currently mobilized, can be found at http://www.defenselink.mil/news/Mar2007 ... 328ngr.pdf. [Source: DoD News Release 28 Mar 07 ++]


SBP SSA OFFSET UPDATE 09: Survivor Benefit Plan (SBP) annuitants who currently do not receive 50% of their deceased spouse's SBP annuity base amount will soon see their annuity increase. The increase, which goes into effect 1 APR will appear in annuitants' May 2007 deposit. Survivors who already receive 50% or more of their late spouse's annuity base amount will not see an increase this April, but they may see one next April. By April 2008, all survivors will receive the full 55% of their late military retiree's pay covered by SBP. Public Law 108-375, which was implemented on 1 OCT 05 established the phased elimination of the Social Security offset and the two-tier annuity computation for surviving spouses under the Survivor Benefit Plan/Reserve Component Survivor Benefit Plan (SBP/RCSBP). [Source: MOAA News Exchange 28 Mar 07 ++]


NATIONAL UNIFORM CLAIM COMMITTEE: The Veterans Health Administration (VHA) has been named to the National Uniform Claim Committee (NUCC), a key organization in the health care industry. The NUCC develops the paper claim form for professional billing to insurers (currently, the CMS 1500). Comprising both payers and providers, the NUCC selected VHA as a Provider member. VHA has a vital interest in policies affecting professional health care claims. During fiscal year 2006 VHA submitted 4.8 million claims to third-party payers for reimbursement of professional nonservice-connected care of veterans. The VA Health Administration Center (HAC), which processes approximately two million professional claims per year as a payer for VHA programs, most recently worked with the NUCC to update the Revised 08/05 Version of the CMS 1500 Health Insurance Claim Form currently under national implementation. Officially, NUCC is “a voluntary organization created to develop a standardized data set for use by the non-institutional health care community to transmit claim and encounter information to and from all third-party payers.” The NUCC is chaired by the American Medical Association, with the Centers for Medicare and Medicaid Services as a critical partner. The NUCC is formally named in the HIPAA (Health Insurance Portability and Accountability Act) legislation as one of the organizations to be consulted on national standards for health care transactions. For additional info on the NUCC refer to www.nucc.org. [Source: Office of the Secretary of Veterans Affairs News Release 27 Mar 07 ++]


ANGIOPLASTY VS. DRUGS: For patients with clogged arteries who have not yet had a heart attack, the widely used surgical treatment of balloon angioplasty with the insertion of a stent is no better than conventional drug treatment. Researchers from the Department of Veterans Affairs told a meeting of the American College of Cardiology on 26 MAR that in a study of more than 2,000 patients, those receiving only drug therapy had the same number of heart attacks, strokes and deaths as those who received the drugs and underwent artery-opening angioplasty. The only difference was a slight improvement in quality of life for those receiving angioplasty because of fewer chest pains, known as angina. The findings deal a blow to the stent industry, which sells an estimated $3.2 billion worth of stents each year in the United States. As many as 65% of the estimated 1 million stenting procedures performed each year occur in such patients at a cost of about $40,000 per surgery.

Experts cautioned that the results do not apply to patients who have suffered a heart attack because of a blockage in the coronary artery. Numerous studies have shown that angioplasty is the gold standard for such patients, and physicians urge that it be implemented as soon as possible to re-open the artery and restore blood flow to the heart. But in nonemergency situations, the drugs act fast enough to forestall the need for angioplasty. Stent makers said the study provided little new information, did not include the newest generation of drug-eluting stents and did not address the key issue of whether stents prevent the need for further angioplasties. They also argued that the device’s greatest benefit is improving quality of life. The study published online 26 MAR by the New England Journal of Medicine is the first large analysis examining its value for those with what is known as stable disease.

The study, called the Courage Trial, enrolled 2,287 patients at 15 VA medical centers and another 35 hospitals in the U.S. and Canada. It was sponsored primarily by the VA and the Canadian Institutes of Health Research. Many of the researchers involved have received consulting and lecture fees from major drug companies. All the patients had at least a 70% blockage of their coronary artery and chest pains several times per week. Most also had high cholesterol and high blood pressure, and many had diabetes. All of the patients were placed on multiple medications, including beta-blockers, ACE inhibitors and diuretics to lower blood pressure, statins to decrease cholesterol and blood thinners to prevent clots. The patients also were counseled about lifestyle programs for smoking cessation, increased exercise and a better diet. The drug treatments typically costs about $1,500 a year. Half the patients underwent angioplasty, and many of them received a stent—a wire-mesh tube inserted into the artery to hold it open after the balloon is withdrawn. The balloon and the stent are threaded into the coronary artery through a small incision in the groin.

After an average of 4.6 years of monitoring, there were 211 deaths, heart attacks or strokes in the group receiving angioplasty and 202 in the group receiving only drug therapy. The only difference between the two groups was that angioplasty patients had fewer symptoms of angina. After three years, 67% of those in the angioplasty group were free of angina, compared with 62% in the medication-only group, according to the study. Stent makers tended to scoff at the study. Dr. Donald Baim of Boston Scientific Corp. argued that the results “don’t really tell us much that we didn’t already know.” Some cardiologists who specialize in the procedures also argued that the study did not focus on the sickest patients who are most likely to benefit and that the main purpose of angioplasty in many is to alleviate chest pain, not to prevent heart attacks. Some Wall Street analysts agreed about the study’s limited impact, but only because they don’t anticipate it will depress sales any more than they’ve fallen already. Sales of stents have been declining since last year over concerns that deadly clots might form around a small percentage of the most popular devices after they are implanted and that bypass surgery might have a significant survival advantage over stents in some patients. Analysts say cardiologists are more reticent about recommending the procedure. [Source: Los Angeles Times article 27 Mar 07 ++]


TRAUMATIC BRAIN INJURY UPDATE 03: Veteran Construction 1 (VETCON 1), a joint venture between a Serviced-Disabled Veteran-Owned Small Business (SDVOSB) and an Alaskan Native corporation, marks the first time a SDVOSB has been selected to build a VA facility as a prime contractor. VA’s Center for Veterans Enterprise (CVE) played a vital role in turning the venture into reality. After receiving an email from Alaskan Native Corporation CCI Inc., looking to team with another small business, CVE found a suitable SDVOSB to fit the bill. They contacted the president of Metropolitan Enterprise, Inc., and in just three weeks were able to bring the two businesses together to win a $31 million contract. The facility in Menlo Park CA , is one of four that will be built at VA poly-trauma centers to house separate education and diagnosis screening programs for Traumatic Brain Injury (TBI) and Post-Traumatic Stress Disorder (PTSD) in support of the VA Medical Centers throughout the country. Ground breaking was 27 MAR 07. For more information about CVE and its services to veterans in business refer to www.VetBiz.gov. [Source: Office of the Secretary of Veterans Affairs News Release 27 Mar 07 ++]


DIABETES UPDATE 03: The 19th annual American Diabetes Alert Day was 27 MAR 07. The American Diabetes Association has asked everyone to help spread the word by informing their family, friends, and co-workers about the seriousness of diabetes, particularly when diabetes is left undiagnosed or untreated. Sixty million Americans are unaware they have diabetes or are at risk for developing type 2 diabetes. Your risk for type 2 diabetes increases as your get older, gain too much weight, or if you do not stay active. Diabetes is more common in African Americans, Latinos, Native Americans, Asian Americans and Pacific Islanders. Risk factors for type 2 diabetes include:
- Having high blood pressure (at or above 130/80)
- Having a family history of diabetes.
- Having diabetes during pregnancy or having a baby weighing more than nine pounds at birth.

What can you do? Encourage those at risk for developing type 2 diabetes to take the American Diabetes Risk Test and, if they score high, to schedule an appointment to see their doctor. The test is available in English or Spanish at http://main.diabetes.org/site/R?i=8wJAw ... w1q8n750xQ. Here they can also review information on the link between Diabetes and heart disease and stroke. [Source: American Diabetes Alert 27 Mar 07 ++]


TRICARE EMERGENCY FACILITY USE: Tricare beneficiaries are normally required to use only authorized providers if they expect their claims to be paid. However, in geographic areas other than the Philippines or Puerto Rico there are established guidelines for emergency conditions under which a regional contractor can honor claims submitted by beneficiaries on the use of unauthorized facilities. These are outlined in the Tricare Reimbursement Manual 6010.55-M, August 1, 2002 General Chap. 1 Section 29. Claims must be for medically necessary services and supplies rendered in the emergency situation. Medically necessary inpatient emergency services are those that are necessary to prevent the death or serious impairment of the health of the patient, and that because of the threat to the life or health of the patient, necessitate the use of the most accessible hospital available that is equipped to furnish the services. In the case of inpatient psychiatric emergencies, payment will be extended when the patient is determined to be at immediate risk or serious harm to self or others as a result of a mental disorder and requires immediate continuous skilled observation at the acute level of care. When a case qualifies as an emergency at the time of admission to an unauthorized institutional provider and the provider notifies the managed care support contractor of the admission, payment can be extended for medically necessary and appropriate care until a transfer is medically feasible (i.e., coverage will be extended up to the point of discharge or until a medically appropriate and legally authorized transfer can be initiated). The timing of the transfer will be based on the availability of authorized facility beds.

Requisites for reimbursement of emergency inpatient admissions to unauthorized facilities are:

a.) At the time of admission to an unauthorized institutional provider, the beneficiary’s condition must meet the definition of medical or psychiatric emergency as prescribed in 32 CFR 199.2.
b.) The contractor must be notified as soon as possible after the emergency admission (preferably within 24 hours) so that arrangements can be made to transfer the beneficiary once the emergency no longer exists, or until such time as a medically appropriate and/or legally authorized transfer can be initiated.
c.) The provider must submit the necessary medical records and other documentation required in the processing and payment of emergency inpatient admissions. These are essential in substantiating that an emergency condition did exist at the time of the admission and that care provided to the beneficiary after the emergency no longer existed, but before a medically appropriate transfer could be initiated, was medically necessary. Refusal to submit the appropriate medical documentation will result in the denial of payment for the entire stay in the facility, including the emergency portion of the patient’s care.
d.) A determination must also be made that treatment was received at the most accessible (closest) hospital available that was equipped to furnish the medically necessary care.
[Source: TRICARE Area Office-Pacific Feb 7 ++]


MARINES' MEMORIAL ASSOCIATION: The Marines' Memorial Association (MMA) was established in 1946 as a living memorial to the Marines who lost their lives in the Pacific during World War II. Its mission is to maintain a living memorial honoring Marines and other veterans of the United States Armed Forces, including Regular and Reserve Components, the U.S. Coast Guard, the U.S. Merchant Marine, and their reserves; to educate and perpetuate the achievements and the sacrifices of these veterans, and to aid and assist these veterans. The non-profit organization offers membership to former and retired members of all branches of the U.S. Armed Forces. It presently is composed of over 21,000 worldwide members. Yearly membership rates are free for active duty and their spouses. Veterans and family members pay $20 annually. Spouse membership is free and sponsoring parents may also include their children. The Association sponsors annual scholarships to recognize qualifying students who have demonstrated scholastic aptitude, community involvement and civic spirit. The MMA maintains the Marines' Memorial Club located in the heart of downtown San Francisco which boasts some of the best rates and most spectacular views in the bay area. The 12-story Beaux-Arts structure’s history dates back to 1926 and the décor retains the character and elegance of old San Francisco. It is two blocks from cable cars, Union Square and the theatre district and offers rooftop dining, a library/museum, ballroom accommodations, 138 rooms/suites, business center, locale and health club (with pool), and pet accommodations. http://www.marineclub.com/leatherneckst ... .htmAccess to the club and its Leatherneck Steakhouse is limited to sponsored guests and members of the Marines' Memorial Association. Membership includes reciprocal club privileges at over 150 private clubs throughout the world. For more information on the association and its club refer to www.marineclub.com or call (415) 673-6672. [Source: Military.com 26 Mar 07 ++]


MEDICARE FRAUD: Attorney General Bill McCollum announced 22 MAR the arrest of a Miami-Dade psychiatrist on charges that she defrauded the Florida Medicaid program and several other benefits services out of more than $1 million. Investigators with the Attorney General’s Medicaid Fraud Control Unit believe Moraima Trujillo was involved in a scheme that defrauded the Florida Medicaid program, the Medicare program, the Veteran’s Administration and several private employers during a year-long period. Investigators acted upon information received from the State of Florida Agency for Health Care Administration. A review of documents from Trujillo’s facility revealed that between JAN & DEC 04, Trujillo billed the Medicaid and Medicare programs for the treatment of Medicaid and Medicare recipients at the same time she was supposedly performing similar functions for the Veteran’s Administration and several other employers. Throughout the year 2004, there were 207 days on which Trujillo submitted time reports to several employers and billings to the Medicaid and Medicare programs claiming to have worked between 20 and 40 hours on each day. Trujillo is currently being held at the Miami-Dade County jail. She is charged with one count each of grand theft and organized scheme to defraud, both first-degree felonies. If convicted of both charges, she faces up to 60 years in prison and a $20,000 fine. The Medicaid Fraud Control Unit also seized funds from several bank accounts controlled by Trujillo pursuant to the Florida Contraband Forfeiture Act.

To assist citizens in reporting Medicare Fraud the Office of the Inspector General maintains a hotline, which offers a confidential means for reporting vital information. The Hotline can be contacted at: 1(800) 447-8477)/ 1(800) 223-2164 Fax, HHSTips@oig.hhs.gov , or Office of the Inspector General. HHS TIPS Hotline, P.O. Box 234, Washington, DC 20026. If you are attempting to report specific information proving Medicare fraud, please provide as much identifying information as possible regarding your concern. Such information should include subject's name, address and phone number etc. Details regarding the allegation should include the basics of who, what, when, where, why, and how. It is current Hotline policy not to respond directly to written communications.

The Federal False Claims Act Act (31 U.S.C. Sections 3729-33) is 20 years old this year, and remains the most important tool the Government has to fight fraud against U.S. taxpayers. The False Claims allows a private individual or "whistleblower", with knowledge of past or present Medicaid fraud to sue on behalf of the state government to recover stiff civil penalties and triple damages. The person bringing the suit is formally known as the "Relator." If the suit is successful, it not only stops the dishonest conduct, but also deters similar conduct by others and may result in the Relator’s receipt of a substantial share of the state government’s ultimate recovery as much as 30% percent of the total. Examples of Medicaid provider fraud include:
- Billing for services not rendered: A provider bills Medicaid for treatments or procedures which were not actually performed, such as for X-rays and blood tests; for care allegedly given to patients who have died or who are no longer eligible; or for care allegedly given to patients who have transferred to another facility.
- Billing for unnecessary services: A provider misrepresents or falsifies a patient’s diagnosis and symptoms on recipient records and billing invoices to obtain payment for unnecessary services, including transporting Medicaid patients by ambulance when it is not medically necessary.
- Substitution of generic drugs: A pharmacist fills a recipient’s prescription with a generic drug or an over-the-counter drug but bills Medicaid for a higher cost name-brand drug.
- Kickbacks: A Medicaid provider (such as a hospital, a transportation company or a laboratory) offers or pays kickbacks to another Medicaid provider's employees for referring a Medicaid recipient to the provider as a patient or client. A provider (such as a doctor or a hospital) requests and receives kickback payments from Medicaid providers (physical therapists, pharmacies or laboratories) in exchange for referring Medicaid business to the providers. Payments may be in the form of cash, vacation trips, or merchandise.
- Double billing: A provider bills both Medicaid and the recipient (or private insurance) for the same service, or two providers bill for the same service.
- Other unauthorized billings: A provider charges a Medicaid recipient for a service which is covered by and should be billed to Medicaid, or charges a recipient the difference between the provider’s usual fee and what Medicaid pays.
[Source: Florida Attorney General’s Office News Release 22 Mar 07 ++]


VET HOME PATIENT NEGLECT: The Arizona State Veteran Home on Phoenix provides long-term care to as many as 200 veterans. Most are ages 70 to 94 and fought in World War II and the Korean War. It is one of the few places for veterans to get skilled nursing and long-term care. Patients can get that type of care from Veterans Affairs facilities, but those VA patients have more serious disabilities. The facility has recently been fined $10,000 after state investigators found cases of "substantial" patient neglect, according to documents obtained Friday by local newspaper reporters. Gov. Janet Napolitano, who was informed of the situation late Friday afternoon, said that the problems are unacceptable and has ordered a full review. "Our veterans deserve the very best care," she said. "All necessary action will be taken to ensure that." The Arizona Department of Veterans' Services, which runs the Phoenix nursing home, has already fired five people, including the head of the facility, and vowed to fix what it deemed a culture of incompetence. During what was supposed to be an unannounced routine inspection 5 FEB, Arizona Department of Health Services inspectors found

• A patient's colostomy bag not being emptied and the patient left in soiled bedclothes for 50 minutes after activating a call button. Nurses are supposed to answer call buttons within five minutes but ignored calls for help.
• A patient was dragging herself down the hallway in a urine-soaked nightgown because no one would answer her call button.
• Patients were left unsupervised while smoking to the point that they were burning their clothes.
• One patient's penis was damaged so much by a catheter that it faced "erosion," according to the state inspectors report.

The inspectors classified the facility on 9 FEB as being in "immediate jeopardy," which is a situation that can be a danger to residents' health or safety. Inspectors would not leave the facility until employees came up with a plan for smoking patients, some of whom were wandering the hallways and had their clothes burned by cigarettes. Former Gov. Jane Hull hired Pat Chorpenning in 1999 to fill the position of Director of Veterans' Services in Arizona in part to fix problems at the home. At that time, state inspectors found that 43 veterans, nearly a fourth of the 196 residents, had been physically restrained in wheelchairs or beds with straps and vests unnecessarily or against doctors' orders. A 72-year-old man was restrained for seven weeks.

Chorpenning, in response to the recent inspection results said, “This is probably the worst survey that we have had as far as the veterans’ home is concerned. I think to a large degree there was a lot of complacency on the part of leadership, and I think there's been some complacency on the part of individuals within specific areas of the home. I think, above everything else, I haven't stayed on top of it as much as I should have. The agency has moved swiftly to fix the situation and that, at this point and time, virtually every issue that has been raised has been addressed, and we have put systems in place to correct every single thing that has been raised.” According to Chorpenning they are updating care plans and training for nurses. A new leadership team meets every morning and evening to ensure that duties are being completed, and that as part of a new effort to monitor the situation, he and other officials are continually stopping by the facility to ensure changes are being instituted. Mary Wiley, director of licensing services for the state health department said that addition to the federal fine, the facility could also face fines from the state. The home passed its last state inspection in FEB 06. There were no complaints about care at that time, Wiley said.

While Patrick F. Chorpenning remains department director, he is being separated from any action that has to do with operation of the home according to a spokesman for Governor Napolitano. State House Speaker Jim Weiers said legislators will investigate but it was apparent that Chorpenning should be fired or at least suspended. In another state Alabama’s Veterans Affairs commissioner W. Clyde Marsh is closely monitoring that state's three centers. He has personally visited the homes in Alexander City, Huntsville and Bay Minette and routinely checks with agency workers charged with inspecting the homes. At a Veterans Affairs board meeting, Marsh declared the homes to be in good condition, but added state officials want to make them better. "We will be looking at skilled nursing care, an Alzheimer's unit and assisted-living type care," Marsh said. "The need is there." For additional info on these two Veterans homes refer to www.azvets.com/ASVH.HTM & http://members.tripod.com/~warveterans. [Source: The Arizona Republic Jodie Snyder article 24 Mar 07 ++]


TRICARE EOBs: As of 1 JUN 04 all Tricare claims started being processed by either Palmetto Government Benefits Administrators or by Wisconsin’s Physicians Service. The Explanation of Benefits, or EOB, is the statement you receive after you file a claim with Tricare or a claim has been filed on your behalf by the doctor. This statement is a summary of the action taken on your claim—how much of the bill was paid by Tricare and how much is your responsibility to pay which you may have already paid at the time of service. In the TRICARE Handbook, Chapter 14, “How to File a Claim,” is available a state-by-state listing of claims administrators (including small-region exceptions), with addresses and toll-free phone numbers. No matter which processor handles your claim, the EOB will always include:
- In boldface, the statement, “THIS IS NOT A BILL.”
- A “Claim Number,” which is a handy piece of information to have available if you ever must call about or discuss your claim.
- The report of your “Beneficiary Liability,” which is the dollar-amount that you owe: You can expect to be billed that amount by your doctor, or you might already have paid your portion of the bill at the time of treatment.
- On the back, instructions for disputing a decision and filing an appeal, if you believe that your claim has been incorrectly processed or denied.
- Contact information for your regional contractor.

Beginning 1 APR 07, claimants will no longer be mailed a paper copy of their Tricare for Life (TFL) EOB if their Medicare patient liability has been paid and there is no further out-of-pocket payment due from them. In cases where they still have a liability they will receive an EOB. TFL providers will continue to receive paper copies of the TFL EOB for all their patients. Though TFL beneficiaries will no longer get a copy of their EOB in the mail when their Medicare patient liability has been paid, they can print a copy if they sign up to receive an email when any of their claims process. This email service begins 1 APR 07 for those who sign up for this feature. When you receive a notification you will be able to access the TRICARE4u.com website and view and/or print a copy of your EOB. This is the same EOB you would have received through the mail. In addition, you may contact Customer Service toll free at 1(866) 773-0404 to request a hardcopy Explanation of Benefits be mailed to you. To receive this electronic notification, register on TRICARE4u.com. Registering is easy and only takes a few minutes. Simply log onto www.TRICARE4u.com and click on “Register as a Beneficiary/Sponsor”. If you have questions about the registration process, call 1-866-773-0404. For those requiring a Telecommunications Device for the Deaf (TDD) use 1(866) 773-0405.

On the up side elimination of mailing paper EOB’s will be a cost savings to the government. On the down side:
- The change places the burden of tracking EOBs on the beneficiary.
- The limited advance notice of the policy change will leave many beneficiaries wondering why they are not receiving an EOB. Especially for those residing overseas where it is not uncommon to experience excessive delays in receiving EOBs.
- Many elder TFL beneficiaries will no longer be able to track their EOB’s because they do not have a computer, are not computer literate, or are just too old/ill /feeble to follow the new guidelines.
- Many older generation beneficiaries who are uncomfortable with dealing with or receiving medical services on line will no longer review their EOBs
- The change in policy could potentially lead to additional expense to the Tricare program through increased provider fraud. Many of those who are most familiar with the services provided will no longer be able to discover and report double-billing or other irregularities through their EOBs. Provider’s who are familiar with their patient’s limitations could be tempted to improperly bill for services with reduced potential of it being reported.
- The extremely small type used on the www.TRICARE4u.com website will be difficult to follow for elderly beneficiaries who are visually challenged.

WPS is advising beneficiaries who call expressing their dissatisfaction with the new short notice policy change to contact their Congressional representatives on the subject. [Source: USDR Action Alerts 24 MAR & MOAA News Release 28 Mar 07 ++]


BASE DECALS: Vehicle decals will no longer be required to enter Air Force bases in the United States, according to Air Force officials. A February memo issued by Air Combat Command (ACC) instructed installation commanders to discontinue registering privately owned vehicles and issuing decals. The suggested effective policy date is March 15, though the dates are left to the discretion of commanders. The change has already taken effect at Cannon AFB, Hill AFB UT, and ACC. Maj. Thomas Crosson, a public affairs officer for ACC at Langley Air Force Base, VA., said that in the pre-9/11 era, vehicle decals were the key to base admittance, security guards often simply waving cars through upon seeing the stickers. However 9/11 brought about heightened security, including 100% identification checks at the gates of military bases. Since 9/11, every base has someone at the gate checking IDs. Whether you've got a sticker or not, you have to show your ID. So why have the decals? There are 1.66 million vehicles registered with the Air Force. In 2005, $727,000 was spent just printing decals. Each installation has to provide personnel to register those vehicles. "Essentially it's a cost-saving measure," Crosson said. "It's also a manpower measure." Most people will notice no change

The Air Force is taking the lead in this initiative. The other Services are interested in the Air Force proposal, but are further behind in the staffing process. After checking the ID card, military gate sentries will render salutes as appropriate when force protection and traffic conditions permit. Visitors will continue to follow the entry procedures established at each Air Force installation. Air Force Security Forces will check for compliance randomly at the gates and during traffic enforcement for all requirements for insurance, state registration, safety inspections, etc? .Motorcycle operators will still need to comply with base safety standards and have required training before being allowed to ride on AF installations. Commanders at all levels will also enforce compliance. Air Force drivers will have to comply with the entry requirements of other Service installations. This might require getting a visitor's pass. Drivers who frequently visit other Service installations may want to consider registering their vehicle at that installation, if allowed to do so. [Source: Clovis News Journal 4 Mar 07 ++]


REFERRAL BONUS UPDATE 02: Effective 15 MAR the Referral Bonus Program is expanded to include Department of the Army Civilians. This recruiting incentive currently pays Soldiers and Army retirees $2,000 for referring applicants who enlist in the Regular Component of the Army, Army Reserve, or Army National Guard; complete basic training; and graduate advanced individual training. Prior to the new recruit's first meeting with a recruiter, the referral must be made by the Army Civilian at https://www.usarec.army.mil/smart/ or, for Army National Guard recruits, at www.1800goguard.com/esar The Secretary of the Army may pay a bonus to any Soldier, Army retiree, or Army Civilian who refers to an Army recruiter a person who has not previously served in the Armed Forces and enlists in either the Active Army, Army National Guard or the Army Reserves. The referrer may not be an immediate family member and the Soldier, retiree or Army Civilian referring may not be serving in a recruiting or retention assignment. Lt. Gen. Michael Rochelle, Army Deputy Chief of Staff G-1 said, "There are 240,000 Army Civilians, and as the Army Civilian Creed notes, they are dedicated members of the Army Team, they support the mission, and they provide stability and continuity during war and peace and I know they are directing deserving youth to recruiters now. This will not only encourage them but also reward them for their service." For more information about this incentive program, visit https://www.usarec.army.mil/smart/ or call toll free (800) 223-3735, ext. 6-0473. For the Army National Guard, the referrer must either submit the referral through a process via the ESAR (every Soldier is a recruiter) on-line portal www.1800goguard.com/esar or via the toll-free number (866) 566-2472. [Source: ENGUS Minute Man Update 23 Mar 07 ++]


SBP LEGISLATION: On 20 MAR Sen. Bill Nelson (D-FL) and Rep. Henry Brown (R-SC), re-introduced their bills, S. 935 and H.R. 1589, respectively, to end two major survivor benefit inequities. Both bills would end the unfair deduction of VA-paid dependency and indemnity compensation (DIC) from SBP. Nelson's bill would also accelerate the effective date of paid-up status for retirees who have paid SBP premiums for 30 years and attained the age of 70. Rep. Jim Saxton's (R-NJ) H.R. 784 addresses this in the House. Both bills would make paid-up coverage effective 1 OCT 07 (vs. 1 OCT 08 under current law). Survivors of active duty and retired members who die of service-connected causes now have DIC ($1,067 per month) deducted from SBP.

In a joint statement to the President of the Senate upon introducing S.935 Sen. Nelson said, “… Back in 1972, Congress established the military survivors’ benefits plan--or SBP--to provide retirees’ survivors an annuity to protect their income. This benefit plan is a voluntary program purchased by the retiree or issued automatically in the case of service members who die while on active duty. Retired service members pay for this benefit from their retired pay. Upon their death, their spouse or dependent children can receive up to 55% of their retired pay as an annuity. For over five years, I’ve been talking about the unfair and painful offset between SBP and the Department of Veterans Affairs’ Dependency and Indemnity Compensation, or DIC, which is received by the surviving spouse of an active duty or retired military member who dies from a service-connected cause. Under current law, even if the surviving spouse of such a service member is eligible for SBP, that purchased annuity is reduced by the amount of DIC received. Another inequity in the current system is the delayed effective date for ‘paid-up status’ under SBP. We should act to correct these injustices this year.

We have made progress, but even with the important changes made over the last few years, the offset still fails to take care of our military widows and surviving children the way it should. We have considered and adopted increased death gratuity benefits for the survivors of our troops lost in this war, and we have changed the law to enable these survivors to automatically enroll in SBP. However, now we see the pain caused when at the same moment a widow is enrolled in SBP she is hit with the DIC offset. The SBP offset is no less painful for the survivors of our 100% disabled military retirees. SBP is a purchased annuity plan. Before coming to the U.S. Senate, I served as Insurance Commissioner for the State of Florida, and I know of no other purchased annuity program that can then turn around and refuse to pay you the benefits you purchased on the grounds that you are getting a different benefit from somewhere else.

Our Federal civil servants receive both their purchased survivor income protection annuity and any disability compensation for which they may be entitled--without offset. Why on earth would we treat our 100% disabled military retirees any differently, especially after they have given the best years of their lives and their health in service to the Nation? Let me be clear about this: survivors of servicemembers are entitled in law to automatic enrollment in SBP; 100 percent disabled military retirees purchase SBP. Survivors stand to lose most or even all of the benefits under SBP only because they are also entitled to DIC.”

The retired community and The Military Coalition which represents them believe strongly that, if military service caused a retired member's death, DIC should be added to the SBP benefit the retiree paid for, not substituted for it. There are about 61,000 survivors affected by the DIC offset. The paid-up SBP initiative would affect 172,000 Greatest Generation retirees. Retirees can help end these SBP inequities by going to the MOAA website http://capwiz.com/moaa/issues/bills/, scrolling down to "Survivor Issues" and clicking on H.R. 1589, S. 935, and H.R. 784 to send your legislators a suggested- message urging them to cosponsor these important bills. [Source: MOAA Leg Up & TREA News Flash 23 Mar 07 ++]


AFRH UPDATE 02: The Government Accountability Office (GAO) requested that the Defense Department investigate allegations against the historic Armed Forces Retirement Home (AFRH) in the heart of the nation’s capital that has housed four U.S. presidents, including Abraham Lincoln. The GAO said patients may be at risk because of health-care problems. Tim Cox, the facility’s chief operating officer Cox acknowledged that the home has experienced incidents consistent with a nursing home environment. In a statement released 21 MAR he said, “Resident care is the paramount concern at the Armed Forces Retirement Home here, and allegations of poor conditions are without merit. Half its residents are older than 80, and many are frail and suffer from chronic health conditions.” Mr. Cox noted a particularly troublesome incident involving maggots in the leg wound of an 87-year-old resident that occurred in August. “Our medical staff discovered it and immediately took remedial action,” Mr. Cox said. The fact that the resident had refused medical treatment was no excuse for the incident, and that eight health-care workers were fired after an investigation showed they had failed to meet the home’s standards of care.

The home is getting a close evaluation. Assistant Secretary of Defense for Health Affairs Dr. William Winkenwerder sent a team of doctors on an unscheduled visit to the campus 21 MAR to assess conditions for themselves, Mr. Cox explained. In addition, legislative staffers are expected to visit the facility to see firsthand the care and security its staff provides. “We welcome these visits,” Mr. Cox said. More than 1,100 enlisted military veterans live at the home. Mr. Cox said the home offers the amenities of a retirement community plus an extensive health-care system, ranging from a wellness clinic for those who live independently to assisted living to long-term and hospice care. Congress consolidated the U.S. Soldiers’ and Airmen’s Home here with the U.S. Naval Home in Gulfport, Miss., in 1991, creating the Armed Forces Retirement Home as an independent establishment in the executive branch of the federal government. Ravaged by Hurricane Katrina, the Gulfport campus closed in 2005. Nearly 400 residents of the Gulfport facility were relocated to the Washington campus. For info on the AFRH refer to www.afrh.gov. [Source: American Forces Press Service Donna Miles article 22 Mar 07 ++]


STROKE UPDATE 02: New studies confirm that transient ischemic attacks (TIA) sometimes called a “ministroke” are an important warning of more serious things to come. Almost 10% of people who have a TIA will have a major stroke within a week, and another 20% within three months. When certain risk factors like advanced age or high blood pressure are present, that figure goes up. The symptoms of ministroke are identical to those of full-blown stroke, which kills 200,000 Americans a year. Stroke is the third-leading cause of death after heart disease and cancer, and the number one cause of adult disability. About 85% of major strokes and all TIAs are ischemic meaning they’re caused by a clot or plaque that blocks the blood flow to the brain. They are treated with clot-busting medications. The other 15% of strokes are “hemorrhagic,” caused by a flood of blood into the brain. Imaging tests can detect brain changes in up to half of those who have had a TIA, but these ministrokes appear to leave no permanent damage. Chances of damage are greater in the case of a major stroke, when the brain has been deprived of blood for a longer period and brain cells have died.

Unlike major stroke, which can cause paralysis, impaired memory, speech or vision loss, or death, TIAs are not fatal. Nor do they leave any permanent disability. The body resolves a TIA without any intervention, sometimes in just a few minutes. People either brush off their symptoms or are so relieved when they disappear that they don’t do what doctors say is crucial: get to an emergency room as fast as possible. Immediate diagnosis and treatment are crucial to prevent a devastating subsequent stroke. New guidelines developed by doctors in the clinical neurology department at Britain’s Oxford University can help determine which TIA patients are most likely to have a major stroke. Called the “ABCD” test, the scoring system takes into account (A) age, (B) blood pressure, (C) clinical symptoms, such as weakness or headache, and (D) duration of the TIA. The Oxford scientists have urged that the test become standard practice in evaluating TIA patients. The