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From: "Director, RAO Baguio"
Sent: Apr 14, 2006 8:34 PM To: flags@earthlink.net Subject: RAO Bulletin Update 15 April 2006 RAO Bulletin Update 15 April 2006 THIS BULLETIN UPDATE CONTAINS THE FOLLOWING ARTICLES:
TRICARE USER FEES UPDATE 11: Ignoring the intimidating props - boxes of angry letters from thousands of military retirees - senior Defense Department officials and military leaders appeared before a contentious House subcommittee to make their case for hiking Tricare fees sharply for under-65 retirees and their families. In the verbal sparring that ensued, Pentagon leaders gave as good as they got. But no lawmaker took the role of referee. All threw punches on behalf of retirees, and treated with kid gloves a second panel of witnesses representing dozens of pro-retiree military associations and veterans groups. The Pentagon's plan to boost out-of-pocket Tricare costs for 3 million beneficiaries, to include a tripling of managed care enrollment fees for retired officers and a doubling for senior enlisted retirees, seemed to shatter some traditional alliances and form new ones. Republicans and Democrats together questioned the realism of projected cost savings from raising Tricare fees and the wisdom of doing so in wartime. The active duty four-star officers in the room spoke in support of the increases. Retired officers led the opposition. David Chu, undersecretary of defense, and William Winkenwerder, the Pentagon's health affairs chief, reminded the armed services subcommittee on military personnel that, since 1995, Tricare benefits and the beneficiary population have grown, program costs have soared, yet Tricare fees have remained the same. Rep. Vic Snyder (D-AR) the ranking Democrat on the panel questioned DoD hand-wringing over the widening disparity between Tricare fees and private health insurance premiums. He noted there should be a disparity because that's part of what the government gives service personnel for turning their life's over to them 24 hours a day. He said, ".We're going to pay for health care for our men and women in uniform, and retirees. We're going to sustain the program. The question is how... and right now there's not a lot of enthusiasm for the method you all have proposed". Snyder asked if the firestorm over Tricare fees could have been avoided if officials pushed for a more modest change, perhaps to adjust retiree Tricare fees in the future by the percentage rise in military retired pay each year. Retired Navy Vice Admiral Norbert Ryan, Jr., testifying on behalf of the Military Coalition, a consortium of service associations, called the planned fees "disproportional and inappropriate. Chu countered by saying another way to look at the increased fees is that for 11 years, the beneficiary population has enjoyed a relief from indexing. Defense officials estimate the higher fees will help save $11 billion by 2011 but only about one-third of that would come from the fee increases. The bulk of the savings is based on the notion that many retirees and their families would drop Tricare if beneficiary costs rose. Rep. Walter Jones (R-NC) chastised Dr. David Chu, for statements that "Congress has gone too far in adding benefits." In effect, Jones said, the Pentagon is proposing to balance the budget on the backs of beneficiaries. "It's not really your responsibility," Jones added. "It's our responsibility in Congress to find the funds to pay for this care." Former DoD Comptroller Dov S. Zakheim, testified that the Administration is skirting FY2005 Defense Authorization Act (which shifted responsibility for all TFL trust fund deposits to the Treasury Department) by continuing to charge TFL fund deposits against the defense budget. Zakheim argued that these deposits should not be counted, as a matter of law or policy, against the defense budget. Zakheim also said he was struck by the difference in the positions being taken by today's military leaders and those of five years ago. Back then, he noted, the Joint Chiefs urged Congress to increase retiree health benefits because broken promises to retirees were hurting active duty retention. At this hearing, all four Service Vice Chiefs of Staff supported charging retirees higher fees. On a 22-15 party-line vote, the House Budget committee rejected an amendment by Rep. Chet Edwards (D-TX) which would have blocked Pentagon plans to double and triple Tricare premiums for working-age military retirees. The bill now moves to the floor of the House. The budget resolution is just a blueprint for spending in the fiscal year. The Appropriations Committees have the final say of how the money is actually spent. In the interim the Military Retirees' Health Care Protection Act H.R.4949 has gained 19 cosponsors for a total of 138. This bill would in effect prohibit the DoD from increasing the Tricare rates and fees effective 31 DEC 05. Retirees are encouraged to write their Representatives and express their feelings about the proposed changes. At http://capwiz.com/usdr/issues/alert/?alertid=8591236&type=CO can be found a proposed letter, the current list of cosponsors, and the text of the bill. [Source: Military Update Tom Philpott article 1 Apr & USDR Action Alert 5 Apr 06 ++] TRICARE USER FEES UPDATE 12: Although the Defense Department has pledged to work with Congress on its plan for steep hikes in Tricare fees for military retirees, a top DoD health official says the department has full authority to jack up the enrollment fees for Tricare Prime and raise pharmacy copayments for all Tricare users except active-duty members. On the other hand, the Assistant Defense Secretary for Health Affairs said the plan to establish a first-time-ever enrollment fee for Tricare Standard would require a change in the law. On 14 MAR, the Military Officers Association of America proposed a list of 16 options to make Tricare more cost-effective. MOAA's president, retired Navy Vice Adm. Norb Ryan Jr., said that implementing only three or four of the cost-cutting items would fully eliminate the need to hit military retirees with a $11.2 billion fee increase over five years. On 7 APR the "Military Retirees' Health Care Protection Act." (S.2617) was introduced in the Senate. Senators Frank R. Lautenberg (D-NJ) and Chuck Hagel (R-NE) introduced the bipartisan legislation to protect military retirees and their families from DoD's proposed increase in health care fees. S. 2617 contains many of the provisions contained in H.R. 4949, which was introduced recently in the House by Representative Chet Edwards (D-TX). Both the House and Senate are in recess for the two week Easter break. Members of Congress will return to the Capitol on April 24. Perhaps, after getting an earful from their veteran constitutes, more in Congress will sign on as cosponsors to these two bills to defeat DoD's attempt to levy Tricare user fees and increase copays. [Source: Armed Forces News 7 Apr 06 ++] SBP DIC OFFSET UPDATE 09: The inclusion of amendment 3001 in the Senate FY 2007 Budget Resolution overcame one hurdle in the quest to eliminate the Dependency and Indemnity Compensation (DIC) offset to the Survivor Benefit Plan (SBP). The amendment provides for the budget authority needed to enable survivors to collect both the SBP and DIC in full. The amendment reads: "To provide funds ensuring Survivor Benefit Plan annuities are not reduced by the amount of dependency and indemnity compensation that military families receive, and to provide funds for "paid-up" SBP, offset by closing abusive corporate tax loopholes." The amount provided is $95 million for the first year. Senator Bill Nelson (D-FL) for sponsored this amendment, which reflects his bill S.185. Unless similar budget headroom is included in the House Budget Resolution, which has not yet passed, the status of the issue remains tenuous. Even if authority is included in the final budget resolution, the elimination of the offset must still be authorized in the FY 2007 National Defense Authorization Act (NDAA). [Source: NMFA eNews 11 Apr 06] VA MEDICARE SUBVENTION UPDATE 01: Under current law, Medicare-eligible veterans are not allowed to use Medicare coverage at local VA hospitals. Instead, they are forced to decide between receiving medical care at a VA hospital without being able to use Medicare to help them make their bill payments, or using Medicare at a non-VA hospital and losing the personalized veterans' care of a VA hospital. Rep. Sue Kelly (NY) 16 Mar 06 introduced HR 4992, the Veterans Medicare Assistance Act, that would provide Medicare eligible veterans with Medicare Subvention. This would give vets the right to use Medicare benefits to help pay their bills at local VA hospitals. Kelly pointed out that veterans pay into Medicare for most of their lives, yet the law prohibits them from using Medicare benefits at a VA hospital later in life. Since VA hospitals specialize in treating veterans' needs, veterans should not be forced to choose between cost and comfort. Veterans should be eligible for the same Medicare benefits at a VA hospital that they would have at any other hospital. [Source: USDR Action Alert 11 Apr 06 ++] GWOT MEDAL UPDATE 03: The Navy has added the following designated geographical locations for eligibility for the Global War on Terrorism Expeditionary Medal: Algeria, Bosnia-Herzegovina, Chad, Georgia, Hungary, Kosovo (only specified GWOT operations not associated with operations qualifying for the Kosovo Campaign Medal), Mali, Mauritania, Niger, Turkey, Uganda, the Mediterranean Sea (when conducting boarding and searching vessel operations), Colombia and Guantanamo Bay, Cuba. Initially eligibility only extended to: 1. LAND AREAS: Afghanistan, Bahrain, Bulgaria, Crete, Cyprus, Diego Garcia, Djibouti, Egypt, Eritrea, Ethiopia, Iran, Iraq, Israel, Jordan, Kazakhstan, Kenya, Kuwait, Kyrgyzstan, Lebanon, Oman, Pakistan, Philippines, Qatar, Romania, Saudi Arabia, Somalia, Syria, Tajikistan, Turkey (East of 35 degrees east longitude), Turkmenistan, United Arab Emirates, Uzbekistan, and Yemen. 2. OFFSHORE: Arabian Sea (north of 10 degrees north latitude and west of 68 degrees east longitude), Bab el Mandeb Strait, Gulf of Aden, Gulf of Aqaba, Gulf of Oman, Gulf of Suez, Mediterranean Sea (east of 28 degrees east longitude), Persian Gulf, Red Sea, Strait of Hormuz, and Suez Canal. Vets must have served 30 consecutive days or 60 non-consecutive days in the above areas. Proof of service can consist of travel orders, letters of evaluation, or flight logs. Eligibility for the award meets the Veteran of Foreign Wars criteria for membership. [Source: Armed Forces News 7 Apr 06 ++] MOBILIZED RESERVE 5 APR 06: Army National Guard and Army Reserve on active duty in support of the present partial mobilization is now 90,034. In addition the other services have mobilized 5,589 Navy Reserve; 7,840 Air National Guard and Air Force Reserve; 6,725 Marine Corps Reserve; and 407 Coast Guard Reserve. As of 5 APR this brings the total National Guard and Reserve personnel, who have been mobilized to 110,595, including both units and individual augmentees. This is a decrease of 8,830 from last month's 8 MAR total mobilization announcement. 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 Reserve contingent personnel can be found at www.defenselink.mil/news/Apr2006/d20060405ngr.pdf for those now mobilized. [Source: DoD News Release No. 198-06 5 Apr 06] VA MEDICAL CENTER CUTS: VA's stock of hospitals and clinics was built up in the 1920s after World War I and again in the 1950s after World War II, but few changes to the system have been made since then, despite significant demographic changes among veterans. For example, dozens of VA facilities still operate in the Northeast, but there are fewer in the South and Southwest, even though those areas are now home to many veterans. Medical technology also has affected the way treatment is delivered to VA's patients. Now, more treatment is delivered on an outpatient basis than in the past. This year, VA expects to see 5.4 million people of which only 600,000 are expected to require inpatient services. That means VA doesn't necessarily need a medical center in a location where a clinic might suffice. Since replacing older obsolete facilities is expensive and replacement at the same locations will not deal with the changing demographics of veterans combined with a lack of government funding to build new medical facilities on these properties, they are turning 18 of their obsolete VAMC's into veteran and non-veteran independent, assisted living and geriatric care housing projects. Sometime back in the 1990s, the VA decided to start a process of determining which prime VA real estate locations could be leased out to housing developers, supposedly, so that the VA could attain more funding for VA medical use while making the transition. The first VA property to be leased out is the Ft. Howard, Maryland (Perry Point) VAMC. The other 17 are located at
The VA Capital Asset Realignment for Enhanced Services (CARES) web site www.va.gov/cares/ has information on and links to documented public meetings, proposals, community input, plans, etc. for each VAMC listed. It is the government's version of some things that are relevant to the issues surrounding these upcoming changes. Of concern to veterans is whether CARES income will provide funds to enhance existing veterans medical care capabilities or if it will be used as an excuse for Congress to cut future VA funding. [Source: Magic City Morning Star article 27 Mar 06++] PENNSYLVANIA SURVIVOR EDUCATION BILL: The children and spouses of Pennsylvania National Guard members who die on active military duty would receive free tuition at all state-owned colleges and universities under legislation approved 29 MAR 06 by the state Senate. The legislation, which passed 47-0, was sent to the House. The free tuition benefit would cover eight semesters or four years, whichever is greater. The slain Guardsman must have been a Pennsylvania resident and the family member applying for tuition must still live in the state to qualify. Current law extends a 50% tuition benefit to the children of a Guardsman who is slain during state duty, but not federal duty. The legislation would increase that benefit to 100%, extend it to spouses and include federal duty. The spouse would be eligible for the benefit for up to 10 years after the guardsman died, or until remarriage. [Source: The Philadelphia Inquirer 30 Mar 06] VA REGS CHANGE PROPOSAL: The Department of Veterans Affairs is proposing a complete overhaul of its compensation and pension regulations, hoping the rewrite will make it easier for people filing claims to understand the process. The proposed new regulations would regroup provisions to make it easier to find information about specific problems. For example, one leadoff section would describe general provisions, a second section would cover eligibility rules governing military service and a third would explain the claims process, including what kind of evidence is needed and how to appeal decisions. Additional sections would cover service-connected disability pay, pensions for low-income veterans, survivor benefits and burial benefits. One goal of the rewrite is to redefine words and phrases used in benefits claims so they have the same meaning under every part of the regulations. For example, "active military service" would be used in place of the longer "active military, naval and air service" that is now a definition in permanent law. Similarly, the word "benefit" would replace the awkward phrase "payment, service, commodity, function or status entitlement" in current regulations. Public comment on the rewrite, which appeared in the 31 MAR Federal Register, will be accepted until 30May, with plans to put the revised regulations into effect 30 to 60 days later. [Source: Times staff writer Rick Maze 4 Apr 06] VA COMPENSATION & PENSIONS UPDATE 01: Rep. Jeff Miller (R-FL) recently introduced legislation (H.R. 4843) that would increase the rates of disability compensation for vets with service-connected disabilities and also raise dependency and indemnity compensation (DIC) payments for survivors of certain veterans with service-related disabilities. The measure, which presently has 17 cosponsors, would increase both forms of payment effective 1 DEC 06. Reps. Steve Buyer (R-IN) and Lane Evans (D-IL) chair and ranking member of the House Veterans Affairs Committee, endorsed the bill. [Source: FRA NewsBytes 7 Apr 06] TRICARE UNIFORM FORMULARY UPDATE 10: On 30 MAR the DoD Beneficiary Advisory Panel (BAP) met to review proposals to move certain medications for overactive bladder, hypertension, and neuropathic pain from the $9 copayment category to the list of $22 "third tier" drugs. The BAP concurred with the pharmacy panel's recommendation to move Detrol, Oxytrol, and Sanctura, used for treatment of overactive bladders, to the third tier. Several other equally effective but less costly drugs would remain available for the $9 copay. The beneficiary panel recommended a 120-day implementation delay, rather than the recommended 60 days by the pharmacy panel, to ensure notification of beneficiaries taking those drugs. In a separate family of drugs the BAP concurred with moving Lexxel and Tarka to the third tier over the objections of some panel members. These are combination drugs used to treat high blood pressure. That change would leave Lotrel as the only $9 combination drug for high blood pressure. When a combination of drugs is needed for this purpose, doctors usually prescribe the two pills separately until a patient's dose is properly regulated and then switch them to the combination drug, so they only have to take one pill. Unfortunately, one of the component drugs in Lotrel is not in the DoD formulary, so physicians will be discouraged from prescribing it. The practical effect of the approved plan would be to remove all three combination drugs from the formulary. The panel also recommended moving Lyrica (for neuropathic pain) to the third tier. Two similar drugs (Gabapentin and Gabitril) will remain on the formulary. The panel's recommendations will be submitted to Dr. Winkenwerder, Director of the TRICARE Management Activity, for a final decision. The changes are expected to be approved. [Source: MOAA Update 8 Apr 06 VA HEALTH BENEFITS FUND: Rep. Jo Ann Davis (D-VA) introduced the Veterans Health Benefits Voluntary Option Act of 2006 (HR 5044) on 20 MAR 06. Enactment of the bill would allow the Treasury of the United States to establish an account to be known as the "Department of Veterans Affairs Health Benefits Fund". Once established it would allow taxpayers to designate income tax overpayments to be transferred to pay for VA healthcare benefits. Amounts of one dollar or more could be entered on their income tax form to be transferred to the fund by the IRS vice being forwarded to the taxpayer as a refund. [Source: TREA Leg Up 7 Apr 06] BUGLES ACROSS AMERICA: At www.buglesacrossamerica.org can be found the Bugles Across America organization. It is a non-profit network of 5,000 musician, drill team and color guard member volunteers who support about 1,000 funerals a month throughout the United States. In addition to playing "Taps" at veterans' funerals they also play at other military events, including Veterans Day and Memorial Day observances. Participation in the organization is free and open to anyone able to play "Taps" with dignity and willing to volunteer their time. Families or organizations in need of such services should complete an online request form at www.buglesacrossamerica.org/volunteer.php to locate a volunteer to play taps. You will be required to indicate on what date a bugler is needed, the state, city, and funeral home location where needed at plus your contact information. At present about 1800 veterans die daily. [Source: Military 14 Nov 05 ++] MILITARY RECORDS/DD-214 UPDATE 01: All retirees and veterans need copies of their Report of Separation (DD Form 214 or equivalent) available and stored in a secure place known by their next of kin. The retained documents should be either the original or government certified true copies. If you do not have these they can be obtained from the National Personnel Records Center (NPRC) using a Request Pertaining to Military Records Standard Form 180 (Rev-2/02) which can be downloaded at www.archives.gov/veterans/military-service-records/standard-form-180.html. The mailing address is listed on the form. Your family will need at least three copies in the event of your demise to pursue their requests for benefits. To expedite the process NPRC has made it easier for military veterans and the next of kin of deceased former military members with computers and Internet access to obtain copies of documents through their website vetrecs.archives.gov. The next of kin can be a surviving spouse that has not remarried, father, mother, son, daughter, sister, or brother. Because the requester will be asked to supply all information essential for NPRC to process the request, delays that normally occur when NPRC has to ask veterans for additional information will be minimized. The new web-based application was designed to provide better service on these requests by eliminating the records center's mailroom processing time. Users will be guided through a four step process and then will be required to print, sign and date the signature verification area of their customized form. This is necessary because the Privacy Act of 1974 (5 U.S.C. 552a) requires that all requests for records and information be submitted in writing and each request must be signed and dated by the veteran or next of kin. If you don't have a printer, have a pen and paper handy and NPRC will guide you through the process. Upon completion the signature verification form must be mailed or faxed to NPRC for processing within the first 20 days of entering the data, or the request will be removed from their system. [Source: e-Florida News 0 Apr 06 ++] VA COLA 2007: On 6 APR Senators Craig (R-ID) and Akaka (D-HI) introduced the Veterans' Compensation Cost-of-Living Adjustment Act of 2006 (S.2562). The bill would increase the rates of compensation for veterans with service-connected disabilities and the rates of dependency and indemnity compensation for the survivors of certain disabled veterans. The percentage of increase would match the COLA payable under title II of the Social Security Act (42 U.S.C. 401 et seq.) increase scheduled for 1 DEC 06. The bill was referred to the Committee on Veterans' Affairs. Those estimated to receive the increase to their compensation are 5 World War I veterans; 335,180 World War II veterans; 160,889 Korean conflict veterans; 992,360 Vietnam era veterans; and 762,230 veterans of the Persian Gulf war era. The COLA legislation will also benefit an estimated 348,479 survivors. [Source: New Mexico e-Veterans News 12 Apr 06 ++] SBP SSA OFFSET UPDATE 07: SBP annuitants who are not already receiving 45% of their deceased spouse's SBP base amount will see their annuity increase soon. The increase, which went into effect 1 APR, will appear in annuitants' May 06 deposit. The increase is the result of the 2005 NDAA provisions that phase out the SBP "widows tax" over 3 1/2 years. As written it will continue to raise the minimum SBP annuity for survivors age 62 and older to 50% on 1 APR 07 and to 55% on 1 APR 08. [Source: MOAA News Exchange 13 Apr 06 ++] FOREIGN MEDICAL PROGRAM UPDATE 01: The Foreign Medical Program (FMP) is a healthcare benefits program for US veterans with VA-rated service-connected conditions who are residing or traveling abroad (Philippines excluded). Under FMP, VA assumes payment responsibility for certain necessary medical services associated with the treatment of those service-connected conditions. In a VA memorandum dated 18 MAY 04 it appeared the VA's Foreign Medial Program had been changed regarding dental care guidance for Class 3 & 4 veterans residing overseas who are enrolled FMP. Class 3 are veterans having a dental condition determined to be currently aggravating a service connected medical condition. They are eligible for dental care to resolve dental conditions having a direct and material detrimental effect upon associated basic condition or disability. Class 4 are those veterans whose service connected disabilities have been rated at 100% or, who are receiving 100% rate by reason of individual unemployability. The memorandum directed a number of modifications to the FMA policy manual one of which included a change that modified or removed limitations on dental care for these veterans and extended eligibility for any needed dental care including repeat care. This was in error. Accordingly, Class 4 veterans remain ineligible for dental care and future claim submissions will be denied. Normally veterans who feel they are not receiving proper service from the VA can refer to the Patient's Advocacy Program provided at VA medical facilities for assistance. The Foreign Medical Program currently does not have a veteran's advocate. In lieu of this the FMP program itself takes on this responsibility. Veterans who want to contact an advocate regarding anything related to the FMP program should email hac.fmp@med.va.gov , call (303) 331-7590 or FAX (303) 331-7803. Vets planning to work for an extended time or permanently reside overseas should enroll in the FMP as soon as they have a permanent foreign address. To enroll send your full name, SSN, VA claim number, permanent mailing address and/or overseas residence address, and a copy of the VA rating decision letter(s) to HAC, PO Box 65021, Denver CO 80206-9021. If you do not have a copy of the VA rating decision letter(s) you may authorize FMP to obtain copies from your servicing VARO. After eligibility is verified you should get a benefits authorization letter and an FMP Handbook. The Handbook has detailed explanations of covered benefits, advice on selecting overseas health-care providers, and where and how to submit claims. Further info on FMP can be found at www.va.gov/hac/aboutus/programs/fmp.asp or by sending an email to hac.fmp@med.va.gov . With the exception of medical services received in Philippines, all foreign provided services are under the jurisdiction our Foreign Medical Program (FMP) Office in Denver, Colorado. In the Philippines, write to or visit the VA Outpatient Clinic (358/00), 2201 Roxas Blvd., Pasay City 1300, Republic of Philippines or FAX 011-632-838-4566 or send an email to manlvaro.inqry@vba.va.gov. [Source: VA FMP Director ltr dtd 24 Mar 04 ++] SPACE A TRAVEL REDUCTION UPDATE 01: Patriot Express is the AMC-managed, military-chartered commercial air service for transporting DoD customers to and from overseas locations. Members of the retiree community also use the service for space available travel. According to the Air Mobility Command's Air Transportation Division the reengineering process to significantly scale down Patriot Express is on track. Since the 1960s, Patriot Express or a similar program has provided regular passenger service from the United States to 27 locations in the European Command, Central Command and Pacific Command areas of operation. At one time, the system handled more than 340,000 passengers a year with more than two-thirds of the seats on the contracted aircraft filled by passengers on permanent change-of-station orders. In DEC 01 AMC saw the need to recapture declining passenger movement to avert substantial financial losses. Numerous improvements were made in an effort to attract DOD passengers back to its use. These included price reductions, free headphones, meal upgrades and reconfigured aircraft that offer passengers more leg room. In spite of these, DOD customers continued to book commercial flights, leaving empty seats on Patriot Express flights. With commercial flights the preferred mode of travel, AMC directed reengineering of Patriot Express. As part of that process, all routes-except for those into locations with no commercial airline service or those with force protection considerations-would be phased out over a three-year period. By fiscal 2008, the command will eliminate all but a handful of Patriot Express missions. As part of the reengineering process, the Defense Department approved the closure of AMC passenger gateways at Los Angeles International Airport, Seattle-Tacoma International Airport, Hartsfield-Jackson Atlanta International Airport and all overseas passenger reservation centers. Although the Seattle-Tacoma gateway closed on 30 SEP 05, AMC is maintaining a limited Patriot Express route supporting weekly missions to Japan, including Misawa and Yokota air bases and Iwakuni Marine Corps Air Station. Additionally, following the Los Angeles and Seattle closures, a Pacific Command request was approved to extend Patriot Express service from Seattle to Kadena AB, Japan. AMC is continuing to monitor usage but initial duty passenger numbers are not encouraging. Unless these increase significantly in the next few months, operations cannot continue simply to support Space A travel. Accordingly, Patriot Express reengineering will continue as planned with the elimination o |