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R.A.O. Bulletin Update

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The Retiree Assistance Office posts notices for Veterans that are not lnly retired, but also for Veterans in general.
This information is presented to allow Veterans an opportunity to look into what is being done fot the benefit of themselves and their brothers and sisters in arms.

>>>01-May-08<<<
R.A.O. Bulletin Update

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>>>15-Jun-08<<<
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>>>15-Jul-08<<<
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>>>15-Sep-08<<<
R.A.O. Bulletin Update



THIS BULLETIN CONTAINS THE FOLLOWING ARTICLES == Gasoline Savings [01] (Slow Down) == Americans at War (Online) == Dates to Remember (Mark Your Calendar) == Tricare User Fee [26] (Conditions for Support) == VA Claim Delay [02] (VDBCMA H.R.5892) == DeCA Dietician Service (Online) == VA Retro Pay Project [11] (End in Sight) == Filipino Vet Inequities [09] (S.1315 Passes Senate) == GI Bill [20] (Republicans Strike Back) == Tricare/CHAMPUS Fraud [07] ($100+ million in PI) == Tricare/CHAMPUS Fraud [08] (HV to Pay $100 million) == Tricare/CHAMPUS Fraud [09] (PI Scamming Continues) == Mobilized Reserve 23 APR 08 (4257 Increase) == VA Fraud [08] (Edmond OK) == VA Suicide Prevention [02] (Cover Up Revealed) == IRS Penalties & Interest (How Accessed) == Rental Car Age Restrictions (Cutoff Age at 70 or 75) == VA Lawsuit (Lack of Care) [05] (18 Suicides Daily) == VA Lawsuit (Lack of Care) [06] (Maris Testimony) == ACM/ICM [03] (Campaign Stars) == VA Flu Shots [02] (Only 44% Effective) == PTSD [19] (RAND Corp Study) == VA Home Loan [10] (2008 Legislative Package) == Military Stolen Valor [04] (How to Report) == SBP Paid Up Provision [05] (Account Review Begins) == VA Homeless Vets [09] (HUD-VASH Effort) == TFL Hospital Coverage] (New Patient Policy) == Asthma [01] (Dust Mites) == VET Hunting Permits (Special Provisions) == VA Blue Water Claims [02] (Manual M21-1 Change) == Windows Vista [04] (Save Windows XP Campaign) == REAP [02] (S.2871 Improvements) == Sole Survivor [02] (The Hubbard Act) == VA Regulations Change [01] (Plain Language Attempt) == VA Independent Living Program [01] (Cap Removal Bill) == Medicare Part D [21] (Premium Increase Bill) == VA Comp Payment Disparity [10] (H.R.5709) == VA Dental Treatment [02] (Eligibility Expansion Bill) == IRS Collection Policy [01] (Collection Agency Use) == Scholarship Application Deadline Season (Online Resource) == Tricare Autism Care (Demonstration Project) == Tricare Selection Considerations (Employer Policies) == Veteran Legislation Status 29 April 08 (Where we stand) GASOLINE SAVINGS UPDATE 01: Scientists and fuel efficiency experts say that for most cars, driving slower pays. Most cars get the best mileage between 45 and 55 mph. As speeds creep higher, fuel efficiency drops. For every mile per hour over 60 mph, fuel economy drops by an average of around 1%. How much you stand to save depends on a lot of factors. With gas at $4 a gallon, a driver with a long commute - 400 miles a week - and a gas-guzzling vehicle getting only 20 mpg would save $18.74 a week by slowing down dramatically from 75 to 55 mph, extrapolating from the government's most recent figures on the subject. Even a more moderate deceleration - from 70 to 60 mph - would save that driver $11.74 a week. In contrast, a commuter who started with a smaller carbon footprint - driving 100 miles a week in a car getting 30 mpg - would stand to save only a few dollars a week by slowing down. The estimates are rough at best. The U.S. Department of Transportation last studied the effect of speed on fuel efficiency in 1997, and its results were based on a fleet of nine vehicles manufactured between 1988 and 1997 - hardly what's on the road today. "Unfortunately this analysis has not been done over, to my knowledge, in the last 10 years," said the Union of Concerned Scientists, senior engineer Jim Kliesch. Still, the results are striking. Slowing from 70 to 60 mph improved average fuel efficiency by 17.2%t. A big slowdown - from 75 to 55 mph - improved fuel efficiency by a whopping 30.6%. The need to conserve gasoline is why, in 1974, in the wake of the Arab oil embargo and ensuing fuel shortage, President Richard Nixon ordered the speed limit nationally to be lowered to 55 mph. The limit was lifted to 65 mph in some areas in the late 1980s, and the 55 mph national speed limit was entirely discarded in 1995. Following is a collection of sites that offer tips for getting the best prices and for conserving gas: Х If youТre planning a trip, say to visit family for Easter, visit AAAТs Fuel Cost Calculator at http://www.fuelcostcalculator.com/. It will help you figure the total cost of your trip. Just enter your car make, model and year. Then select your starting city and destination. It also features a map that shows the average fuel prices by region. Х A comprehensive site on gas prices is http://www.fueleconomy.gov. It will help you find the cheapest local gas prices and lists the stations to avoid - the ones with the highest rates. You can also read tips for getting more miles per gallon or link to the AAAТs Daily Fuel Gauge Report which displays the average price by state and metro area. Х GasBuddy http://gasbuddy.com and GasPriceWatch www.gaspricewatch.com are two other sites that will help you locate good prices on gas. You can search by area, so you wonТt waste gas hunting cheap gas. Х If gas prices are too high, you can always share a ride! AlterNetRides http://alternetrides.com will hook you up with fellow commuters. Х Alternative fuel like propane or biodiesel locations can be found by entering your ZIP and the type of fuel you need at http://afdcmap2.nrel.gov/locator/FindPane.asp [Source: San Francisco Chronicle Michael Cabanatuan, article 28 Apr 08 ++] AMERICANS at WAR: Now instant access to powerful videos and stories from the award-winning PBS series УAmericans art WarФ can be accessed online at www.americans-at-war.com. The new website, launched by the U.S. Naval Institute (USNI) and sponsored by Lockheed Martin, features videos and stories which illuminate the actual combat experience from the perspective of the men and women who fought in America's wars from WWI to Iraq. [Source: Military.com 28 Apr 08 ++] DATES to REMEMBER: Upcoming dates to remember. DonТt forget to add your marriage anniversary and your spouseТs birthday: Х May 11 Mothers Day Х May 17 Armed Forces Day Х May 24 Ц 1 Senate Memorial Day recess (District work period) Х May 26 - 30 House Memorial Day recess(District work period) Х May 26 Memorial Day Х June 14 Flag Day Х June 15 Fathers Day Х June 21 First Day of Summer [Source: Various 28 Apr 08] TRICARE USER FEE UPDATE 26: At a 16 APR subcommittee hearing in which major military associations presented their annual wish lists of improvements in pay, allowances and other benefits, Sens. Ben Nelson (D-NE) and Lindsey Graham (R-SC) said they might be willing to support modest Tricare fee increases, but will not back a Pentagon proposal seeking Tricare fee increases of as much as 400% for some retirees. Nelson and Graham are the chairman and ranking Republican, respectively, on the Senate Armed Services personnel subcommittee. Representatives testifying on behalf of the military associations expressed a willingness to accept fee increases that are no more than the size of the annual military pay raise or the annual cost-of-living adjustment in military retired pay, which gives Nelson and Graham some maneuvering room. Both indicated they will work on providing better health coverage to service members who are discharged from active duty without medical retirement pay. Steve Strobridge of the Military Officers Association of America said capped fee increases were acceptable - as long as they are part of a broader policy that makes clear that co-payments, deductibles and enrollment fees for Tricare users should not be determined simply by health care budget shortfalls. "We realize it is unrealistic to have no increases, ever," said Strobridge, who co-chairs the Military Coalition, a group of more than 30 military-related associations. The Pentagon estimates Tricare fee hikes would save about $1.9 billion in the 2009 defense budget. If the committee adopts lower fee increases or rejects any increases, it would have to make up the funding gap somehow. [Source: Air Force Times Rick Maze article posted 28 Apr 08 ++] VA CLAIM DELAY UPDATE 02: Due to an influx of new claims and the antiquated rules by which the Department of Veterans Affairs must process claims the average processing time has risen from 174 in 2006 to 188 days in 2007. As of APR 08 the number of claims outstanding was 650,000. The Department of Veterans Affairs projects that the number of claims will surpass one million by the end of fiscal year 2008. In an effort to reduce the backlog Congressman John Hall (D-NY-19) on 23 APR introduced HR 5892, the ССVeterans Disability Benefits Claims Modernization Act of 2008ТТ. This bill is to amend title 38, United States Code, to direct the Secretary of Veterans Affairs to modernize the disability benefits claims processing system of the VA to ensure the accurate and timely delivery of compensation to veterans and their families and survivors, and for other purposes. The legislation specifically focuses on: Х Clarifying combat related disabilities; Х Readjusting the VA Schedule for Rating Disabilities; Х Changing the VBAТs work credit and management systems; Х Improving employee certification and training; Х Improving quality assurance measurements; Х Expediting fully-developed claims and improving VCAA notice requirements; Х Ensuring partial ratings for qualifying veterans Х Allowing substitution of qualifying survivors; Х Enhancing information technology; and Х Providing surer appellate justice adding matters related to the jurisdiction of the Court of Appeals for Veterans Claims to provide surer appellate justice [Source: VDBCMA H.R.5892 23 Apr 08 ++] DECA DIETICIAN SERVICE: The Defense Commissary Agency (DeCA) has its own dietitian who is available to help the retiree community lose weight, get in shape and maintain good health. Maj. Karen Fauber offers a weekly online column, УThe Dietitian's Voice,Ф and a discussion forum, УAsk the DeCA DietitianФ on the agencyТs Web site at www.commissaries.com. To find the link to the DeCA Dietitian page. click on the УHealthy LivingФ tab in the top navigation bar Visitors to the site will find suggestions for eating healthy, such as a variety of nutrition tips and meal choices. People can also submit questions to Major Fauber, and participate in an online forum to discuss healthy eating and shopping ideas. Major Fauber is a registered and licensed dietitian with more than 16 years of military service, including experience as a certified diabetes educator in Army medical facilities and public health clinics. [Source: AFRS Release No. 04-09-08 dtd 25 Apr 08 ++] VA RETRO PAY PROJECT UPDATE 11: In OCT 06, the Defense Finance and Accounting Service (DFAS) and the Department of Veteran's Affairs (VA) initiated the process of providing retroactive compensation for more than 133,000 disabled recipients of either Combat Related Special Compensation (CRSC) or Concurrent Retired Disability Payment (CRDP) and VA compensation. Since then, more than 85,000 additional retirees have been identified by the VA as potentially eligible for retroactive payment. As of April 20, DFAS reported that nearly 179,000 accounts have been processed, with approximately 39,000 remaining. Of those, more than 16,000 are new cases. But about 23,000 of the most complicated cases from the originally identified group are still being worked. The joint process gives priority to the original cases, but those remaining require multiple laborious computations. In many cases, these can only be done by hand, because the individuals have had several VA rating changes and have switched back and forth between CRDP and CRSC payments with annual changes in the relative value of the two programs - due to the rating changes or the ramp-up of CRDP payments, or both. DFAS has reported that by 31 MAY, it will complete its review of the initial 133,000 files of disabled retirees The number of contractors hired and trained to work the files has climbed to 233 from 51 since DEC 07. So far, DFAS and the Department of Veterans Affairs have paid a combined $308 million in back payments to disabled military retirees. Both continue to identify new retirees that may be eligible for retroactive compensation and are working to developing automated changes that will expedite that process. On a separate topic, medical retirees with less than 20 years of service will soon be able to have their CRSC applications adjudicated for disabilities incurred as a result of combat or combat related events. DoD expects to release guidance to the military services by the end of this month or in early May. MOAA will keep you informed as soon as the guidance is published. [Source: NAUS Weekly Update & MOAA Leg Up 25 Apr 08 ++] FILIPINO VET INEQUITIES UPDATE 09: On 24 APR, the Senate passed S .1315 the Veterans Benefits Enhancement Act (companion bill of H.R.760), which would authorize additional wounded warrior benefits including a new term life insurance program for disabled veterans. contains various measures to help veterans. One of the provisions would provide benefits to Filipino veterans who fought along side U.S. forces in World War II including non-citizens living outside the US in part by barring recent court-directed expansion of VA compensation to certain additional categories of disabled US veteran. Ranking member of the Senate Veterans' Affairs Committee Sen. Richard Burr (R-NC) offered an amendment, which was defeated, which would strip out benefits for those Filipino veterans that had not been injured in the line of duty. The House has not yet completed action on its bill, HR 760, which contains even more generous benefits for Filipino veterans of WWII. The Senate bill which contains the below provisions now goes back to the House where further attempts to change or eliminate this part of the bill are expected. For a complete listing of S. 1315 provisions, refer to the Thomas website at: http://thomas.loc.gov/cgi-bin/bdquery/z?d110:s.01315: Х Provide retroactive traumatic injury coverage under SGLI for qualifying injuries incurred between October 7, 2001 and December 1, 2005 Х Authorize SGLI coverage for members of the Individual Ready Reserve (IRR) Х Raise the VA home mortgage life insurance rates to $200,000 by 2012 Х Accelerate award of special adaptive housing benefits to certain currently serving servicemembers (including burn victims) likely to be released from active duty due to the extent of their disabilities. Х Increase supplemental burial benefits to $2100 in the case of a service-connected death and $900 for a non-service connected death. Х Allow troops called to active duty for not less than 90 days to cancel or suspend their cell phone contracts without incurring early termination or reactivation fees. Х Increase the maximum amount of supplemental Service-Disabled Veterans Insurance from $20,000 to $30,000. Х Expand eligibility for home improvement and structural alteration assistance to include permanently disabled servicemembers. Х Provide a specially-adapted housing grant to veterans and qualified servicemembers with severe burn injuries. Х Extend authority of the VA to assist individuals living temporarily in residences owned by family members. Х Provide automobile and adaptive equipment assistance to disabled veterans and servicemembers with severe burn injuries. Х Increase to $445 from the current $300 allowance for veteran burial plots. Х Provide a presumption of service-connection for osteoporosis for former POWs with post-traumatic stress disorder. Х Increase cost-of-living for additional dependency and indemnity compensation paid to certain surviving spouses with minor dependent children. Х Expand retroactive traumatic injury protection under SGLI (TSGLI) to include all servicemembers, not just those injured in Operation Enduring Freedom or Operation Iraqi Freedom. [Source: NAUS Weekly Update & MOAA Leg Up 25 Apr 08 ++] GI BILL UPDATE 20: A Republican GI Bill plan, the Enhancement of Recruitment, Retention and Readjustment through Education Act, with many features attractive to active-duty service members and their families was unveiled 22 APR. No bill number has been assigned to date. It is their effort to show that itТs not just Democrats who want to improve veteransТ education benefits through their Post-9/11 VeteransТ Educational Assistance Act S.22. The Republican plan includes increases in basic benefits, a new book allowance, broad rights to transfer unused benefits to family members, and the ability to use veteransТ benefits to pay off existing student loans. It also would extend GI Bill benefits to service academy and Reserve OfficersТ Training Corps scholarship graduates, who are currently ineligible for payments, and would allow about 5,000 people who entered active duty between 1977 and 1985 to sign up for the benefits plan from which they were excluded. The package is intended as an alternative to a GI Bill plan introduced last year by Sen. Jim Webb (D-VA) that has the support of most House and Senate members. It also helps Sen. John McCain, (R-AZ) Republican presidential candidate and ranking minority party member of the Senate Armed Services Committee, who has faced increasing pressure from veteransТ groups for not supporting WebbТs bill, S.22 which now has 57 cosponsors. Under the Republican bill active-duty members, monthly GI Bill benefits would rise 1 OCT to $1,500, up from the current $1,101, enough to cover the average cost of a four-year public college including room, board, tuition and fees, said Sen. Lindsey Graham (R-SC), ranking Republican on the Senate Armed Services personnel subcommittee. Another $500 annual payment would help cover the cost of books and supplies. Asked if he thought a living stipend was needed in addition to the basic benefit, Graham said room and board is factored into the cost. УWe donТt have beer money included,Ф he said. That is less than what Webb proposes in his bill S.22, which would provide GI Bill benefits plus a living stipend in amounts varying by state. Webb proposed basic benefits that matched college tuition and fees, up to a maximum payment set by the most expensive four-year public college in a state. The monthly living expense proposed by Webb would match the militaryТs basic allowance for housing for an E-5 with dependents in the area of the school being attended, estimated to be $1,000 a month or more. Sen. Richard Burr (R-NC), ranking Republican on the Senate VeteransТ Affairs Committee and another co-sponsors of the new bill, said WebbТs plan could take a year or more to implement because of the difficulty in setting a benefits cap for each state, and would create inequities between states. Burr said increases called for by the Republican bill would take effect this year, and veterans would get the same payment no matter where they went to school. Patrick Campbell of Iraq and Afghanistan War Veterans said the provisions noted by Burr are not necessarily advantages. Basing payments on average tuitions, Campbell said, Уmeans, by definition, that half of the people are not going to be paid enough to cover the cost of their college education. That is why I still prefer WebbТs bill.Ф The Pentagon has opposed WebbТs bill, arguing that it would encourage people to get out of the military to use the benefits. Defense officials do not want GI Bill benefits to be more than about $1,500 per month. In response to military concerns, the Republican bill promises to phase in additional increases for those who have served 12 or more years on active duty. Monthly benefits would increase by $150 in 2009, $150 in 2010 and $200 in 2011, capping at $2,000. Benefits for reservists also would increase to $1,200 a month for people who have been mobilized since 11 SEP 01, a jump from the current $880. Benefits for other Guard and reserve members would increase to $634 a month, double the current rate. Recognizing that veteransТ benefits are insufficient to pay for every school, the bill includes a provision encouraging colleges and universities to forgive loans accumulated by veterans. Schools can receive $1,000 for forgiving 25% of a veteransТ debt, $2,000 for forgiving 50% of debt and $3,000 for forgiving 100% of debt, Graham said. The proposal allowing transfer of GI Bill benefits to family members would be a retention boost for active, Guard and reserve forces, Graham said. It would allow those who have served six years to transfer 18 months of GI Bill benefits to a spouse or child, and allow 36 months of GI Bill benefits to be shared after 12 years of service. While the Republican bill is more generous than the plan envisioned by the Pentagon earlier this year, when President Bush endorsed the idea of sharing veteransТ educational benefits with family members, Graham said he did not expect administration opposition. Asked about the Pentagon view, Graham said he had spoken with defense officials who УagreedФ to the proposal but quickly amended that to say, УWell, I think they are going to agree.Ф The bill does meet the basic limitations on payments spelled out last week by defense officials in testimony before the House VeteransТ Affairs Committee. The Republican bill has three features not included in WebbТs proposal: Х Service academy graduates and Senior ROTC graduates who are excluded from the current GI Bill plan, unless they earned benefits through prior enlisted service, would get full benefits, including transfer rights, if they serve in uniform for five years beyond their initial obligation. Х About 5,000 active-duty members who entered service between 1977 and 1985, when the only education benefits plan available was the low-paying Veterans Education Assistance Program, or VEAP, would be allowed to enroll in the GI Bill. They would have to pay a $2,700 contribution, more than the $1,200 payment for other service members. They would also be limited to using the benefits only to pay for a bachelorТs degree and would not have the option of transferring benefits to family members. The enrollment option would be available to anyone still on active duty or to those who were on active duty on 11 SEP 01, who have since retired. Х GI Bill benefits could be used by enrolled active-duty members to pay off federal student loans, which is not currently allowed. State or private loans would not be covered. Up to $6,000 per year could be repaid. The payments would reduce a memberТs total GI bill benefits, under rules to be determined, to ensure no one is paid more than other GI Bill users. Republican aides said this feature would be another way to encourage people to remain on active duty. Webb spokeswoman Kimberly Hunter said the Republican bill seems to focus Уon educational benefits for career military officers while ignoring the 75% of service members that choose not to pursue a career in the military.Ф Hunter said. УS.22 is an affirmative readjustment benefit designed to transition post-9/11 veterans into civilian life, which is the same benefit given to the World War II vets. Sen. Webb has consistently said that the military does a fine job at managing its career force, but really fails to take care of their people once they leave the military. The Republican bill follows that same philosophy. As veteransТ unemployment continues to rise and recruitment continues to fall, we need affirmative programs that reward active-duty service, transition veterans into civilian life and target new pools of potential recruits.Ф [Source: NavyTimes Rick Maze article 23 Apr 08 ++] TRICARE/CHAMPUS FRAUD UPDATE 07: The U.S. military's health insurance program has been swindled out of more than $100 million over the past decade in the Philippines, where doctors, hospitals and clinics have conspired with American veterans to submit bogus claims, according to prosecutors and court records. Seventeen people have been convicted so far Ч including at least a dozen U.S. military retirees Ч in a little-noticed investigation that has been handled by federal prosecutors out of Wisconsin because Madison-based WPS Health Insurance holds the contract to process many of the claims. It has not been accused of any wrongdoing. At the center of the case is Tricare, a Pentagon-run program that insures 9.2 million current and former service members and dependents worldwide. The United States closed its military bases in the Philippines in 1992 and withdrew its active-duty forces, but thousands of retirees remained. Some saw an opportunity to pry easy cash from Tricare. Health care providers in the Philippines filed claims for medical services never delivered, inflated claims by as much as 2,000% and shared kickbacks with retirees who played along, court records reviewed by The Associated Press show. "There just seemed to be so many possibilities for abuse of the system, and there were so few controls in terms of monitoring," said former U.S. Attorney Peg Lautenschlager, who oversaw prosecutions in the late 1990s. Pentagon auditors say Tricare moved slowly to uncover and stop the fraud. And a FEB 08 audit warned that the program is still vulnerable to rip-offs because of lax controls and that similar fraud schemes are starting to emerge in Latin America. News of the scope of the fraud comes as the Pentagon seeks to raise fees for Tricare's beneficiaries Ч fourfold, in some cases. The proposed increases have outraged groups representing servicemen and have been blocked by Congress. Tricare paid $210.9 million in overseas claims in 2006, the latest year for which figures were available. At the height of the fraud in 2003, Pentagon officials say, two-thirds of the $61.8 million paid to Philippine providers Ч about $40 million Ч was fraudulent. The fraud in the Philippines was so extensive that the number of claims filed there skyrocketed nearly 2,000% between 1998 and 2003 even as beneficiaries there Ч about 9,000 mostly retired military members and dependents Ч remained constant. "I know this is illegal and wrong to submit fraudulent claims to get money, but I did it for fun," U.S. Navy retiree Romulo Estoesta told investigators. He died in 2002. Austin Camacho, a spokesman for the Pentagon's Tricare Management Activity, which runs the program, said the fraud has been hard to prove because of language barriers, a lack of cooperation from providers and limited law enforcement resources. But he said the agency added numerous controls and is making every effort to stop fraud. In one big case, prosecutors say Health Visions Corp. Ч which owns hospitals and clinics in the Philippines Ч bilked the program out of nearly $100 million from 1998 to 2004. Its former president, Thomas Lutz, has pleaded guilty to his role in a kickback scheme and could get five years in prison. He could be sentenced in Madison as early as 2 4APR. The company has also reached a plea agreement, but it is sealed. Prosecutors say Health Visions executives instructed billers to inflate every claim by at least 233% and falsify diagnoses. Lutz refused to comment when reached by telephone in Columbia, Mo., where he is living with relatives. The company's lawyer had no comment. Pentagon officials received fraud allegations against the company in 2000 but waited until late 2005 to move to cut off payments, according to an internal audit report. The company reaped tens of millions of dollars in payments in the meantime. In a 2005 memo, William Winkenwerder, then assistant secretary of defense for health affairs, complained that his requests to send additional investigators to the Philippines were ignored. The fraud went well beyond Health Visions. A Pentagon official warned in 2004 that the Philippine schemes were costing U.S. taxpayers $40 million a year. In all, those convicted have been ordered to pay back only about $1.8 million. Assistant U.S. Attorney Peter Jarosz said of the 37 people indicted, about 20 remain free, in part because requests to extradite suspects from the Philippines have rarely succeeded. Claro de Castro, chief of the Philippine National Bureau of Investigation's Interpol division, insisted Philippine authorities have cooperated with the U.S. Nevertheless, federal agents have resorted to trying to capture defendants when they step on U.S. soil. Dr. Diogenes Dionisio, who ran a clinic near Manila, was arrested earlier this year after he arrived in Guam for a vacation. He has pleaded not guilty to submitting $2 million in fraudulent claims. His lawyer, Charles Giesen, said his client was never notified he was facing indictment. "He was getting off the plane with his golf clubs and they put him in handcuffs," Giesen said. "It was a complete surprise and somewhat baffling." [Source: Associated Press Ryan J. Foley article 23 Apr 08 +] TRICARE/CHAMPUS FRAUD UPDATE 08: A federal judge ordered a Philippines company to pay back $100 million (euro63 million) it swindled from the US military's health insurance program. Health Visions (HV) Corp., which pleaded guilty to mail fraud, was ordered to liquidate all assets within 10 months and give the proceeds to the US government. Federal prosecutors say the company bilked the military's Tricare program out of $99.9 million (euro63.35 million) between 1998 and 2004. The company routinely inflated claims by more than 230%, operated a phony insurance program and billed for medical services never delivered, court records showed, and the Pentagon moved slowly to uncover the scheme. Assistant US Attorney Peter Jarosz described Health Visions as the biggest violator yet in a long-running investigation into Tricare fraud in the Philippines. "This is basically a death sentence for the company. It will no longer exist and that will protect the Tricare program since it was the biggest violator," he said after the hearing. "We got what we needed out of this prosecution." The US closed its military bases in the Philippines in 1992 and withdrew its active-duty forces, but thousands of retirees remained. Formed in 1997, Health Visions owned and operated hospitals and clinics in the Philippines and billed Tricare on behalf of other health care providers. On top of the $99.9 million (euro63.35 million) in restitution, US District Judge Barbara Crabb ordered the company to forfeit an additional $910,000 (euro577,000) and pay a $500,000 (euro317,000) fine. Health Visions will be required to sell off land, office buildings and hospitals in the Philippines and an airplane and houses in the US under Crabb's order. The company has run into problems selling hospitals because of ownership disputes, and Jarosz said it was uncertain whether the U.S. government would ever recover the full amount. The company's lawyer, Christopher Kelly, declined to comment. He told Crabb he had nothing to add beyond a plea agreement, which was unsealed on 24 APR. Health Visions and its former president, Thomas Lutz, were hit with a 75-count indictment in 2005. Lutz, a US citizen who turned 41 on 24 APR, has pleaded guilty to his role in a kickback scheme and could face up to five years in prison when he is sentenced. A date for that hearing will be scheduled shortly now that the company has been sentenced, Jarosz said. No word has been released yet on what action will be taken against the hundreds of military vets/dependents who knowingly aided and abetted this fraud. All were required to sign Tricare claim forms verifying treatment and all received EOBТs identifying what had been billed to Tricare by HV. The case has been an embarrassment to the Pentagon, where different branches have blamed one another for allowing the company's fraud to slip through the cracks. The fraud was so extensive that claims from the Philippines increased by 2,000% between 1998 and 2003 even as the number of Tricare beneficiaries remained the same. Payments to the country went up from less than $3 million (euro1.9 million) to more than $60 million (euro38.05 million) during that time. The Office of Inspector General has criticized Tricare's managers for waiting years to cut off payments to Health Visions after suspecting the company of fraud. William Winkenwerder, former assistant secretary of defense for health affairs, said that the inspector general's office was partly to blame because it refused his requests to send additional investigators to the country. He said he worked hard to stop the problems after they came to his attention in 2003. Asked how the company was able to defraud the program of $100 million (euro63.42 million), Winkenwerder said: "There were some very deceptive practices that were occurring. The fact that this was a faraway location did add to the challenge of uncovering problems. And they didn't get away with it ultimately, which is the good news." The investigation has been handled by prosecutors in Wisconsin because WPS Health Insurance, a Madison company, is the subcontractor that handles most overseas claims. About three dozen others have been indicted to date, mostly US military veterans and Philippine doctors. [Source: AP Ryan J. Foley article 24 Apr 08 ++] TRICARE/CHAMPUS FRAUD UPDATE 9: The clinic where Dr. Alberto Marzan allegedly played his role in a $100 million swindle of the U.S. military's health insurance program sits abandoned, along with the adjacent family home. But a legacy remains, with a U.S. Navy retiree saying scams are still rife even after a federal judge ordered a Philippines company to pay back the money it skimmed. Marzan, one of the longest-wanted fugitives in the probe, recruited dozens of military retirees to falsely claim they and their relatives were confined at his clinic and received expensive medical services, U.S. prosecutors say. He made fraudulent claims of $1.5 million to the program and was paid more than $1 million, prosecutors add. In return, he typically paid kickbacks to the retirees. A U.S. federal grand jury returned a 35-count indictment against Marzan in 1999, but he has apparently remained free in the Philippines after vanishing from Moncada RP. Neighbors, village leaders, police and former co-workers in the Moncada town hall, where he used to sit as councilor, say the doctor's family slipped out of town more than three years ago and remains underground. Claro de Castro, head of the National Bureau of Investigation's Interpol division, said his office has arrest warrants for a doctor and a beneficiary. But he refused to identify them or say if the wanted doctor was Marzan because agents are still working on the case. Jerry Minor, a Navy retiree and administrator of Lifeline Medical Center - a Tricare-accredited clinic in western Olongapo city near the former U.S.-run Subic Naval Base - said many accredited doctors and clinics in the city continue to overprice their services. Retirees are usually lured into the scheme because the clinics do not charge them the required 25% share of the cost, instead sending the whole bill to Tricare, Minor said. One clinic blacklisted by Tricare for fraudulent claims simply changed its name and is back in business, he told The Associated Press in an interview 25 APR. Minor said a retiree's wife who was convinced by a clinic four years ago to sign a stack of blank claim forms - one is filled out every time a beneficiary goes to a clinic - was shocked to find out last December that several women were collecting on claims using her details. "It was like signing a blank check," he added. He said he tried to find out for himself about the overpricing by going to a doctor, who told him he would be charged 850 pesos ($20) for a 15-minute consultation. The price was higher than the 500 peso ($12) fee per consultation under Tricare regulations. Minor said when he brought up his share of the cost, the doctor told him, "Don't worry about it, you pay nothing. Tricare does." He said he has reported the anomalies to Tricare officials but the scams continue. Vicky Gross, a retiree's widow who used to work for Health Visions, said many doctors and clinics don't charge beneficiaries their share of costs but she did not know what they were charging to Tricare. Austin Camacho, a spokesman for the Pentagon's Tricare Management Activity, said the program has implemented new controls to combat fraud in the Philippines in recent years. Among other things, the program looks for patterns of aberrant practices and reviews claims that appear excessive. In 2001-07, the program refused to pay $288 million in fraudulent or excessive claims from the country, he said. Still, he said it is hard to catch all fraud overseas and Tricare does not exclude providers "without sufficient evidence. This can be difficult in an environment where law enforcement resources are limited, providers are not always cooperative and are not subject to the U.S. government's subpoena power," he said. Rufino Bayao Jr., a Navy retiree who served a 1.5-year U.S. prison term and three years of probation for taking part in the scam with Marzan, advises retirees not to fall for the bait. "If they are caught, they will also suffer," he told AP in his home in northern Tayug town. "It's not worth it." Aside from the prison term, Buyao is having more than a third of his $800 monthly pension deducted to pay for $132,390 in restitution that a U.S. court ordered him to pay. He says he got only 200,000 pesos ($4,760) from Marzan for signing false claims, with much of the money going for drinking binges. [Source: Military.com AP article 28 apr 08 ++] MOBILIZED RESERVE 23 APR 08: The Army, Air Force and Marine Corps announced the current number of reservists on active duty as of 23APR 08 in support of the partial mobilization. The net collective result is 4,257 more reservists mobilized than last reported in the Bulletin for 26 MAR 08. 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. The total number currently on active duty in support of the partial mobilization of the Army National Guard and Army Reserve is 79,049; Navy Reserve, 5,211; Air National Guard and Air Force Reserve, 9,554; Marine Corps Reserve, 8,496; and the Coast Guard Reserve, 347. This brings the total National Guard and Reserve personnel who have been mobilized to 102,657, including both units and individual augmentees. A cumulative roster of all National Guard and Reserve personnel, who are currently mobilized, can be found at http://www.defenselink.mil/news/Apr2008/d20080423ngr.pdf . [Source: DoD News Release 196-08 12 Mar 08 ++] VA FRAUD UPDATE 08: A federal grand jury has indicted an Edmond OK man on making false claims about injuries and awards while serving in the Vietnam War. James Hull 66, faces three counts of using false documents and one count of falsely receiving a military medal. Charges arose from an investigation by the U.S. Department of Veterans Affairs Office of Inspector General Division. Hull is accused of signing and submitting fraudulent forms in MAR 05 and MAR 06 to the Veterans Administration to support his claims for disabilities that happened as a result of combat in Vietnam. According to court documents, Hull also submitted fraudulent citations for a Silver Star and Meritorious Service Medal he claimed he received as a result of his military service in Vietnam between 1964 and 1965. An investigation revealed that Hull was assigned to military units in the Republic of turkey, Fort Walters, Texas, and San Francisco during the times he claimed to be in Vietnam, according to court documents. [Source: NewsOK.com article 22 Apr 08 ++] VA SUICIDE PREVENTION UPDATE 02: On 22 APR Sens. Daniel Akaka, D-Hawaii and Patty Murray, D-Wash., said Dr. Ira Katz, the VAТs mental health director, withheld crucial information on the true suicide risk among veterans and called for his resignation saying he tried to cover up the rising number of veteran suicides. УDr. KatzТs irresponsible actions have been a disservice to our veterans, and it is time for him to go,Ф said Murray, a member of the Senate Veterans Affairs Committee. УThe No. 1 priority of the VA should be caring for our veterans, not covering up the truth.Ф Akaka, the committeeТs chairman, said in a letter to the VA that KatzТs Уpersonal conduct and professional judgmentФ had been called into question by his response to veteran suicides. A number of Democratic senators said they were appalled at e-mails showing Katz and other VA officials apparently trying to conceal the number of suicides by veterans. An e-mail message from Katz disclosed this week as part of a lawsuit that went to trial in San Francisco starts with УShh!Ф and claims 12,000 veterans a year attempt suicide while under department treatment. УIs this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?Ф the e-mail asks. Another e-mail said an average of 18 war veterans kill themselves each day Ч and five of them are under VA care when they commit suicide. A VA spokesman declined to comment. УIt is completely outrageous that the federal agency charged with helping veterans would instead cover up the hard truth Ч that more and more Americans coming home after bravely fighting for their country are suffering from mental illnesses and, in the most tragic circumstances, committing suicide,Ф said Sen. Tom Harkin, D-Iowa. УAnyone at the VA who is involved in this cover-up should be removed immediately.Ф Harkin, Murray and Sen. Russ Feingold, D-Wis., introduced legislation 22 APR calling on VA to track how many veterans commit suicide each year. Currently, VA facilities record the number of suicides and attempted suicides in VA facilities but do not record how many veterans overall take their own lives. The agency, however, is reluctant to disclose specific numbers, veterans advocates complain. The new bill would require VA to report to Congress within 180 days the number of veterans who have died by suicide since 1 JAN 97, and continue reports annually. HarkinТs office said statistics provided earlier this year by VA showed that 790 veterans under VA care attempted suicide in 2007. That figure is contradicted by the e-mail revealed this week. Two veterans groups last year filed the class-action lawsuit against a sprawling VA system that handled a record 838,000 claims last year. A government lawyer urged a judge Monday to dismiss the lawsuit, saying the agency runs a Уworld-classФ medical care system. [Source: Air Force Times AP Matthew Daly article posted 23 Apr 08 ++] IRS PENALTIES & INTEREST: For American expatriates used to the tax filing deadline in mid-June, the 15th of April tax paying deadline can easily be overlooked. So down the road when those 2007 taxes are finally paid with the tax return, Expats can be surprised to receive an IRS interest assessment for late payment. So if the 2007 tax return has not yet been prepared, the best strategy - after 15 April and before 15 June - is to estimate and pay any taxes owed. When IRS receives your tax return, they first check the return for mathematical accuracy. If taxes are owed, they bill the taxpayer and charge interest from 15 April on the federal short-term rate plus three percent. Interest is compounded daily. A penalty for late payment of one-half of one percent of the tax owed for each month may also be assessed until the full 25% maximum penalty is applied for non-payment. For reasonable cause, penalties can be abated, but not interest. Assessed taxpayers can send an explanation together with the bill to the IRS service center in Austin for consideration. However IRS will not act to abate until the taxes owed are first paid. To assure payment is properly made, a check or money order should be payable to UNITED STATES TREASURY. Also on the check, remember to enter the tax year, form number and your telephone number. Form 1040-V should accompany payment. The expatriate mailing address is: Internal Revenue Service Centre, PO Box 660335, Dallas, TX 75266-0335. [Source: The Tax Baron Report MAR/APR08 ++] RENTAL CAR AGE RESTRICTIONS: More seniors are traveling than ever before, and the travel industry has responded by offering a wide range of senior travel discounts and incentives (http://seniorliving.about.com/od/travelsmart/ss/traveldiscount.htm ), but there are still a few places in the travel world where age works against you. One example is the car rental counter in some European, African and South Pacific countries, where a little known regulation has stranded more than one unsuspecting senior traveler, leaving them without transportation because they are Уtoo oldФ to drive the rental car they have reserved. How can this happen? Easy. Insurance companies mandate the maximum age for car rental, and they usually set the cutoff age at 70 or 75. If an older customer has an accident, the company's insurance carrier will increase rates across the board, unless the company agrees to refuse service to any customer above a certain age. Different rental car companies have different insurance carriers, however, so the only way to know whether you will be allowed to drive away in the car you have reserved before leaving on your trip is to ask specifically about age restrictions for rental cars, and how they apply in the area where you will be traveling. The rules about renting cars after a certain age havenТt become more rigid, but with more seniors traveling the frequency of problems has increased. Most people know there is a minimum age for rental cars, but few people realize that there is also an upper age limit. Dealing exclusively with major rental car companies like Hertz or Avis wonТt necessarily help you avoid the problem. While some of the major companies donТt impose age maximums for rental cars at their corporate sites, many have franchise operations in various locations that restrict rental cars by age to meet insurance requirements. Despite the age limits some insurance companies impose on rental car companies and their customers, however, there are steps you can take to improve your chances of finding a rental car regardless of your age. Х Shop Around. If one company where youТre traveling has an upper age limit for rental cars, another company in the same city may not. Х Get Insurance. In some areas, older drivers are allowed to rent cars if they can provide their own insurance policy that will cover them and the rental car while they are traveling in that location. Х Drive Farther. Sometimes, it pays to get a rental car near your destination, because the regulations are more flexible, and drive it into the area where you really want to go. Х DonТt Count on the Web. Companies donТt always post rental car age restrictions on their Web sites in a place that is easy to find. If youТre 70 or older, call the rental car company directly and ask about their policy in the area where you want to travel. If you get a clerk who doesnТt know or seems uncertain about the policy, ask to speak to a supervisor and keep going up the ladder until you find someone who can verify that you can rent a car at your destination Some related driving issues seniors should be aware of are their stateТs DMV regulations regarding driver license revocation. In California: Х DMV cannot take your driving license away because of age. However, once you turn 70 you must renew your license in person rather than by mail. Х Medical doctors (for example, physicians, surgeons and psychiatrists) are required by law to report to a local health office patients who have been diagnosed with certain conditions which (in their opinion) will impact on your ability to drive. Doctors are protected against civil and criminal liability for these confidential reports. Х A spouse or family member (blood relatives within three degrees) can report you to the local DMV Driver Safety Office. If the reporting family member reasonably and in good faith believes that you cannot safely operate a motor vehicle, the reporter is protected from civil and criminal liability. [Source: About.com: Senior Living & www.help4srs.org Apr 08 ++] VA LAWSUIT (LACK OF CARE) UPDATE 05: THE lawsuit, filed in JUL 07 by two nonprofit groups representing military veterans, accuses the agency of inadequately addressing a Уrising tideФ of mental health problems, especially post-traumatic stress disorder.
		THIS BULLETIN CONTAINS THE FOLLOWING ARTICLES == VA Burial Benefit [04] (Private Cemetery Headstone) == Dave & Buster Data Breach (Cash Register Terminals) == VA Gulf War Advisory Board (Established) == Tricare Reimbursement Rates [02] (Overseas) == Tricare/CHAMPUS Fraud [10] (Greenbelt MD $247K) == VA Suicide Prevention [03] (May Exceed Combat Deaths) == Medicare Reimbursement Rates [09] (Time Running Out) == New 2008 Postage Rates [01] (Retiree FPO Users) == Women Veterans' Scholarship (Apply to RNA) == Military Stolen Valor [06] (LA & Sacramento) == Merchant Marine WWII Compensation [02] (VA Opposed) == Agent Orange Lawsuits [12] (Haas vs. Peake Reversed) == VA Fraud [09] (Lubbock TX/Roanoke VA) == GI Bill [21] (S.22 Concerns) == Tricare Preventive Health Program (TFL Excluded) == Vet Support from States (Sample List) == PTSD Purple Heart (Needs to be Looked At) == Oklahoma Vet Homes (Locations & Eligibility) == Long Term Care w/Medicare (Coverage) == Economic Stimulus Package [06] (File after 15 APR) == Debit Card Data Breach (Bank Card Skimming) == VA Emergency Care [01] (Require vice Authorize) == Michigan Vet Cemetery (Ground Breaking OCT 08) == Credit Card Charges [02] (Reform Legislation) == NDAA 2009 [01] (S.2787 SASC Mark Up) == VA Lawsuit (Lack of Care) [07] (Judge Doubts Authority) == AAFES Community Malls (Six Planned) == VA Veteran Population Estimate (As of 30 SEP 07) == VA Home Loan [11] (H.R.4884) == Malware (PC Hazard) == NPRC Online Records Request [01] (DD-214) == Foreclosure Impact on Renters (Little Recourse) == Car Rental Tips (How to Save Money) == Caries (Tooth Decay) (Ramifications) == Veteran Legislation Status 13 May 08 (Where we Stand) VA BURIAL BENEFIT UPDATE 04: The VA has changed the regulation concerning the provision of a VA headstone or marker for a grave already marked in a private cemetery. As a result of passage of the Dr. James Allen Veteran Vision Equity Act of 2007, the VA can now provide a headstone or marker for those graves already marked in a private cemetery for those Veterans who died after 1 NOV 90. The claimant must pay the cost of the installation of the Government headstone or marker in a private cemetery. Details of the new regulation can be read at http://edocket.access.gpo.gov/2008/E8-10635.htm . [Source: VFW VSO Richard Springer 13 May 08 ++] DAVE & BUSTER DATA BREACH: Foreign hackers have compromised cash register terminals at 11 Dave & Buster's restaurants around the United States. The scheme resulted in losses of some $600,000. The hackers were arrested in various locations, including Turkey and Germany. They sold the stolen data to others who used it to make fraudulent purchases or resold it to make such purchases. In announcing the arrests, U.S. Attorney Benton J. Campbell said, УHackers who reach into our country from abroad will find no refuge from the reach of U.S. criminal justice.Ф According to the U.S. Department of Justice, the people arrested gained unauthorized access to cash register terminals, though details on how were not specified. They allegedly installed Уpacket sniffer" programs at each restaurant to capture communications on the Dave & Buster's link. The packet sniffer was configured to capture "track two" data as it moved from each restaurant's point-of-sale server to computer systems at the company's corporate headquarters. Track two data includes a customer's credit card account number and expiration date, but not cardholder names or other personally identifiable information. [Source: SC Magazine Chuck Miller article May 08 ++] VA GULF WAR ADVISORY BOARD: Veterans who served in the Southwest Asia theater of operations during 1990Ц1991 will have their own special advocates before Secretary of Veterans Affairs Dr. James B. Peake, thanks to a new advisory committee Peake established to respond to issues unique to them. The 14-member, independent panel will advise the Secretary and the Department of Veterans Affairs on the full range of health care and benefits needs of those who served in the conflict. УGulf War veterans made an invaluable contribution to national security and peace in a volatile region,Ф Peake said. УThis new panel will ensure that VA benefits and programs adapt to the needs of these veterans, just as our services have adapted for veterans of other conflicts.Ф Serving on the committee are Gulf War and other veterans, veterans service organizationsТ representatives, medical experts, and the survivors of Gulf War veterans. Members were selected to provide a variety of perspectives, experiences and expertise. The committee will be chaired by Charles Cragin, a retired Navy captain, who has had several senior level positions within the federal government, including Acting Under Secretary of Defense for Personnel and Readiness and Chairman of VAТs Board of Veterans Appeals. In January 2002, the Department created an advisory committee to assist VAТs secretary on research into the medical problems of Gulf War veterans. That older committee will retain responsibility for research involving veterans of the 1990-1991 conflict in the Middle East .This committeeТs first meeting will be held in mid-June in Washington, D.C. It is expected to complete its work within 18 months. Committee meetings will be open to the public. [Source: VA News Release 13 May 08 ++] TRICARE REIMBURSEMENT RATES UPDATE 02: Every year, the federal government tweaks the elaborate system that determines the amount doctors get paid for care and procedures, known as Уreimbursement ratesФ. Those changes, in turn, translate into changes in cost shares, or co-pays, for Tricare beneficiaries. Payment for inpatient hospital stays in specified locations outside the 50 United States and the District of Columbia, are made utilizing the lesser of (a) billed charges or (b) the prospectively determined per diems adjusted by a country specific index (CSI). The per diem rates are developed into reimbursement groupings by utilizing diagnosis codes as contained in the International Classification of Diseases, 9th Revision, and Clinical Modification (ICD-9-CM). The per diem rates are the maximum allowable amounts that Tricare shall reimburse and the amount on which patient cost-shares are calculated. The National U.S. per diem rate is multiplied by a unique CSI factor which adjusts the National U.S. per diems for the applicable country. The country specific hospital per diem, for those specified locations outside the 50 United States and the District of Columbia is the product of the National U.S. per diem and the CSI. This payment system applies to all hospitals providing hospital inpatient services and professional provider reimbursements in the Philippines, Panama, and other overseas areas as designated by the Government. The CSI is a factor obtained from the World BankТs International Comparison Program. The index factor is based on a large array of goods and services or market basket within the specific country which is then standardized and weighted to a U.S. standard and currency. The use of the CSI enables a conversion and therefore creates parity between the U.S. and the specific country in the purchasing of the same amount and type of medical services. Tricare is utilizing a two year phase in approach for the implementation of the World BankТs International Comparison Program CSI. Per change 77 dated 7 APR 08 to the Tricare Reimbursement Manuel for the Philippines and Panama, the first year of the CSI phase in has been set at 0.52 and 0.70 through 28 FEB 08. The second year of the CSI phase in has been set at 0.229 for the Philippines and 0.60 for Panama effective 1 MAR 09. However, their is a requirement that all providers that submit bills to Tricare and are effected by the changes must be given at least 100 days notice so it is likely that the changes will not take effect until AUG 08 and AUG 09 respectively. The change equates to a 27.1point index reduction (52%) for the Philippines and a 10 point index reduction (15%) for Panama assuming nothing is done to reverse these reductions. For additional info refer to http://manuals.tricare.osd.mil. [Source: Tricare Reimbursement Manual 6010.55-M w/Change 77 Chap 1 Sect 34 & 35dtd 7 Apr 08 ++] TRICARE/CHAMPUS FRAUD UPDATE 10: United States Attorney for the District of Maryland Rod J. Rosenstein announced 9 MAY that Melvin Shandler, age 61, of Chevy Chase MD, pleaded guilty today to committing health care fraud arising out of reimbursement he sought for medical services not rendered. According to the plea agreement, Shandler was a licensed clinical social worker with a private counseling practice in Chevy Chase. He was also formerly employed as a consultant at the Walter Reed Army Medical Center where he practiced social work. From JUN 03 to MAY 07, he submitted claims to Tricare for counseling services he provided to Tricare members. During a review of claims, Tricare auditors detected he billed 250% more services than the second highest billing provider in the Tricare North Region in 2006. At their peak, his billings averaged up to 24 counseling sessions per day, and he billed for services on Labor Day, Independence Day and Christmas Day. Further investigation revealed that ShandlerТs claims were disproportionately high, either because he requested compensation for services that were never performed, or inflated the amount of time he spent with patients. In the case of one family, he submitted claims for 202 services during a one year period from 2006 to 2007 that he never performed. As a result of his over billing he received $247,000 to which he was not entitled. Shandler faces a maximum sentence of 10 years in prison, followed by three years of supervised release and a $250,000 fine. U.S. District Judge Roger W. Titus has scheduled sentencing for 28 JUL 08. As part of his plea agreement, he has agreed to pay $247,000 in restitution at least five days before his sentencing. He has also signed a civil settlement agreement which obligates him to pay the government $444,600, less the deduction for the amount paid in criminal restitution. [Source: DOJ News Release 9 May 08 ++] VA SUICIDE PREVENTION UPDATE 03: Suicides by veterans of wars in Iraq and Afghanistan could well top the combat deaths in the two conflicts, according to the top official of National Institute of Mental Health. On 5 MAY, Dr. Thomas Insel, director of the National Institute of Mental Health, told reporters at an annual meeting of the American Psychiatric Association in Washington that it was possible that "suicides and psychiatric mortality...could trump combat deaths." Insel said he based this assessment in part on figures from a recent Rand Corp. study as well as suicide rates for patients who have substance abuse problems and other complications of post-traumatic stress disorder (PTSD) as a result of combat. Insel's comments were put in context on 6 MAY during a House Veterans Affairs Committee hearing, when Dr. James Peake, secretary of VA, said that the number of suicide attempts by all veterans under treatment by the department could exceed an earlier official estimate of 1,000 a month. The Defense Department estimates that slightly more than 4,500 troops have been killed in combat in Afghanistan and Iraq. The RAND study determined that up to 300,000 returning U.S. troops from those wars suffer from PTSD. The same study concluded that 320,000 troops returning from Afghanistan and Iraq have suffered traumatic brain injury (TBI), with only half of those veterans seeking treatment. During the hearing, Peake told lawmakers that the number of suicide attempts could be more than 1,000 a month because of "underreporting" within the VA. Dr. Ira Katz, deputy chief patient care services officer for mental health at the Veterans Health Administration, testified that his earlier estimate of 1,000 suicide attempts per was based on only three months of data from the department's mental health co-coordinators. Laurie Tranter, a VA spokeswoman, told Government Executive that the data Katz based his earlier estimate on was derived from a suicide tracking system and suicide prevention program. She said both are at various stages of deployment throughout the Veterans Health Administration. Rep. Bob Filner (D-CA), chairman of the House Veterans Affairs Committee accused Peake of "criminal negligence" in trying to cover up the number of suicide attempts by veterans. He said the VA's actions fit a pattern of trying to cover up or deny serious medical problems suffered by veterans from the Korean, Vietnam and Gulf Wars. Peake said that all veterans from Afghanistan and Iraq receive a mental health screening by a general practitioner. Filner said he wants VA and Defense to provide a mandatory, one-hour mental health check-up conducted by a psychiatrist for all combat veterans. Secretary Peake told the Committee that no single agency has accurate statistics on veteran suicides, but he is implementing ways to improve data collection and reduce suicide rates, including hiring suicide coordinators in VA facilities, establishing a suicide prevention call center, and pushing outreach and prevention efforts for veterans and their families. Peake assured the committee that his agency would be more forthcoming with information in the future and would work toward more transparency in the VA system. A Government Accountability Office offered additional recommendations, including: Х Ensuring timelier referral to care. Х Developing a comprehensive substance abuse program. Х Enhancing access to mental health care. Х Coordinating efforts between VA and non-VA health care providers. Х Fostering increased communication with veterans and their families [Source: GOV.EXEC.com BoB Brewin article 6 May 08 ++] MEDICARE REIMBURSEMENT RATES UPDATE 09: Everyone in Congress wants to stop a 10.6% cut in Medicare and TRICARE payments to doctors scheduled to take place on July 1. Medicare administrators don't want the cut to happen either, but they're worried about how to administer the program if Congress waits until the end of June -- or worse yet, until sometime in July or later -- to change the law. In early MAY Medicare officials told Congress that the law needs to be changed by 16 JUN in order to allow Medicare computers to be reprogrammed by 1 JUL. If they don't get updated guidance by that date, Medicare will have to implement the cut on 1 JUL and undo all the erroneous payments later if and when Congress changes the law. The same thing happened a couple of years ago, when Congress had to make a retroactive payment fix. But it's a nightmare for Medicare (and TRICARE) administrators, and even more so for the doctors who have to suffer the income and book-keeping consequences. Veteran organizations worry that such frustration may cause some doctors to stop seeing elderly and military beneficiaries. The American Medical Association released a survey of nearly 9,000 doctors showing that if the payment cut went into effect: Х 60% of doctors would limit the number of new Medicare patients they accept; Х More than two-thirds would defer the purchase of needed information technology in 2008; Х 50% would reduce their staff; and Х 14% would stop treating patients entirely. Congressional leaders would love nothing better than to meet the 16 JUN deadline, but they're struggling to find ways to pay for the $15-$18 billion cost of the fix that a majority of legislators are willing to accept. Like it or not, that's turned into a political football, with Republicans and Democrats preferring different options. And many on the Hill seem in no mood to compromise in this election year. MOAA said, it's unacceptable to hold TRICARE and Medicare-eligibles' access to care hostage to these kinds of political considerations. Congressional leaders need to work out a compromise -- and fast -- to stop that from happening. Veterans can help by visiting the MOAA or USDR websites http://capwiz.com/moaa/issues/alert/?alertid=10534466 & http://capwiz.com/usdr/issues/alert/?alertid=11354701&queueid=[capwiz:queue_id] to send a suggested message to urge their legislators to act fast. [Source: MOAA Legislative Update 11 May 08 ++] NEW 2008 POSTAGE RATES UPDATE 01: Effective 12 MAY the new postage rates go into effect. If in doubt on how much postage to use refer to the below or to the USPS Postage Calculator at http://postcalc.usps.gov/default.aspx: 1. First Class Mail: Not Over Oz Large envelopes 1 $0.42 $0.83 2 0.59 1.00 3 0.76 1.17 3.5 0.93 1.34 4 1.34 1.34 5 1.51 1.51 6 1.68 1.68 7 1.85 1.85 8 2.02 2.02 9 2.19 2.19 10 2.36 2.36 11 2.53 2.53 12 2.70 2.70 13 2.87 2.87 Over 13 oz use Priority mail rate of $4.60 up to 1 pound or $4.60 for a Priority flat rate envelop regardless of weight. FPO regulations limit outgoing/incoming mail to one pound for retiree mail . No packages other than checkbook, personal cassettes, personal VCR/DVDs, or medicine shipped by TMOP. 2. Post Card: $0.27 3. Certified Mail: In addition to regular postage add $2.70. If return receipt is desired add another $2.20 for mailed return or $1.00 for electronic. 4. Registered Mail: Not authorized for RAO services. [Source: Various May 08] WOMEN VETERANS' SCHOLARSHIP: Royal Neighbors of America (RNA) is announcing their Heroes at Home Women Veterans' Scholarship Program. Their goal is to help our female veterans give back to their communities by reaching their education goals, making them stronger women and stronger community leaders as a result. Awards will be presented at the Student VeteranТs Conference in Washington, DC on 13 JUN 08 for 2009 school year funding. The minimum award amount is $2,500. Multiple awards will be made. Eligibility Criteria is: Х Female Veteran Х Open to enlisted, officers and those who have completed their service Х Money can be used to pay for living expenses, as well as tuition, books and school fees Х You do NOT need to be a member of Royal Neighbors of America to be eligible Scholarship recipients are selected on the basis of demonstrated leadership, participation in community activities, goals and aspirations, and unusual personal or family circumstances. Financial need will also be considered. Applicants are responsible for gathering and submitting all necessary information. Applications are evaluated on the information supplied; therefore, it is important to answer all questions as completely as possible. All information that is submitted will be kept in strict confidence and will only be read by the Foundation Scholarship Review Committee and Executive Director of the Student Veterans Association. All personal records and tax information will be shredded and destroyed immediately after the judging is final. Interested students must submit the application by 1 JUN 08. Applications can be downloaded at http://www.royalneighbors.org/About-RNA/RNA-Foundation.aspx. RNA is accepting applications via mail to 230 16th St, Rock Island IL 61201 Tel: (800) 627-4762 or email contact@royalneighbors.org. [Source: www.royalneighbors.org/ May 08 ++] MILITARY STOLEN VALOR UPDATE 06: A man who lied during a public meeting about being awarded the nationТs highest military honor pleaded guilty 5 APR to violating the Stolen Valor Act of 2005. Xavier Alvarez, 50, of Pomona, said he served as a Marine and won the Medal of Honor when he was introduced as a newly elected member of a Claremont water board in JUL 07. УIТm a retired Marine of 25 years. I retired in the year 2001. Back in 1987, I was awarded the Congressional Medal of Honor. I got wounded many times by the same guy. IТm still around,Ф Alvarez said during the meeting, according to a recording of it. His attorney, Deputy Federal Public Defender Brianna Fuller, argued that his free speech was protected by the First Amendment. Government prosecutors argued that the First Amendment does not protect deliberate falsehoods. His plea with the U.S. AttorneyТs Office gives Alvarez the right to appeal the plea based on his right to free speech. Alvarez faces up to one year in federal prison and a $100,000 fine when he is sentenced 21 JUL. An Oroville CA man has pleaded guilty to falsely representing himself as a decorated military hero from the Vietnam War. Michael Allan Fraser, 62, claimed in an interview with the Oroville Mercury-Register last year that he was awarded two Purple Hearts and two Bronze Stars for combat in Vietnam. He also traveled to Vietnam with war veterans on a mission to Уbury the ghosts of the past.Ф But a Colorado man who helped write the Stolen Valor Act, which was signed into law by President Bush in 2006, noticed problems with FraserТs daring tale of valor. He looked up FraserТs record and found that he had served in the military as a veterinarianТs assistant in the Philippines. U.S. Magistrate Judge Edmund F. Brennan sentenced Fraser this week to 100 hours of community service helping veterans and issued a $500 fine. A Navy Reserve public affairs officer is facing a general court-martial next week for allegedly forging an award citation and pretending to be a lieutenant when he was one rank lower at the time, the Navy said. Lt. Paul J. Pelletier, 42, is charged with five counts of violating the Uniform Code of Military Justice, including failure to obey an order or regulation, making false official statements and going absent without leave. His court-martial is set to begin 13 MAY. According to the charge sheet, Pelletier put himself in for a Joint Service Achievement Medal at some point between 20 JUN and 20 JUL 06 while serving with Multi-National Force in Baghdad. He served at Camp Victory in Iraq for nine months in 2006. The award justification Уoutlined achievements he had not accomplished,Ф the sheet said. Around the same time, he wore the rank of lieutenant when he was actually a lieutenant junior grade, the sheet said. He continued to wear the unauthorized rank, the charge sheet stated, even though he had been ordered by a captain to stop. [Source: AP articles posted 6 & 9 May 08 ++] MERCHANT MARINE WWII COMPENSATION UPDATE 02: On 7 MAY, the Senate Veterans' Affairs Committee met to receive testimony on 28 separate veteransТ bills. One area of testimony of great interest to many veterans was enactment of the "Belated Thank You to the Merchant Mariners of World War II Act (S.961/H.R.23). The VA does not support S. 961 as they believe it would create a "service pension for a particular class of individual based on no eligibility requirement other than a valid certificate of qualifying service from the Secretary of Transportation or Secretary of Defense. Further, this bill would authorize the payment of a greater benefit to a Merchant Mariner...than a veteran currently receives for a service connected disability rated as 60% disabled. The second panel of veterans service organizations, for the most part did not object to S. 961, except for the costs involved and that it might take money from other programs. The final panel of former Merchant Mariners H. Gerald Starnes and Charles Dana Gibson was enlightening in expanding on some of the experiences and exploits of the men who transported all the necessary supplies to fight WW II on two fronts. The most surprising testimony was from Mr. Gibson, who as an historical writer had done extensive research on the Merchant Marine and Army Transport Service during the war. He dispelled one of the myths that the Merchant Marine had gone on strike during the war. In fact they had signed an agreement to not strike while hostilities continued and they didn't. To read the complete testimonies of all the participants refer to http://www.senate.gov/~veterans/public/index.cfm?pageid=12&release_id=11685 [Source: NAUS Weekly Update 9 May 08 ++] AGENT ORANGE LAWSUITS UPDATE 12: On 8 MAY the U.S. Court of Appeals for the Federal Circuit unfortunately reversed the decision of the U.S. Court of Appeals for Veterans Claims in Haas v. Peake. The U.S. Court of Appeals for Veterans Claims had previously found that Vietnam War blue water veterans who had served on ships off the coast of Vietnam but had never set foot within the land borders of Vietnam were entitled to a presumption of service connection disability if they suffer from one of the listed diseases associated with Agent Orange exposure. Also, they had ruled that the VAТs regulatory interpretation that the veteran needed to have Уset foot within the land borders of VietnamФ was unduly restrictive. The higher Court of Appeals for the Federal Circuit reversed and ruled: УWe hold that the agencyТs requirement that a claimant have been present within the land borders of Vietnam at some point in the course of his duty constitutes a permissible interpretation of the statute and its implementing regulation, and we therefore reverse the judgment of the Veterans Court.Ф This was a 2-1 decision with a thoughtful dissent by Judge Fogel so the Claimant may attempt to appeal to the U.S. Supreme Court which Commandeer Haas has said he will do. You can find the full 57 page decision in the list of decisions at http://www.cafc.uscourts.gov/dailylog.html Most likely VA will now move quickly to resolve (decide) claims that have been placed on hold awaiting this decision. These claims will almost certainly be denied unless they can show that their ship operated within the inland waterways of Vietnam or entered port in Vietnam. While ships logs do not routinely show crewmembers leaving their ship, they will show whether the ship entered an inland waterway (e.g. the Saigon River) or put into port. VA will generally concede the issue if service records show a veteran was attached to a ship during the period that the ship put into port in Vietnam. The negative decision in the Haas case does not relieve VA from the responsibility of making a legally correct decision that discusses all pertinent evidence and the reasons and bases for the decision. The VA in their written decision should specifically address the evidence of service in or visitation to Vietnam. They must discuss ships ' movements either shown by ships' history or logs. If the veteran has admitted never setting foot in Vietnam, VA must also discuss whether evidence shows that the ship operated in the inland waterways of Vietnam. The Haas decision does not apply if a claimant has alleged exposure to herbicides on a direct basis, such as loading drums of defoliant on board helicopters or decontaminating aircraft or helicopters, VA must discuss such allegations and resolve them. Claimants who are denied have several legal moves available to them. They can ask the Court of Appeals to review the case using all the judges on the Court. While the Court may decide to conduct an en banc review it doe not have to. Failing that, they could appeal to the Supreme Court. During any given year the Supreme Court takes up only about 1 in 20 cases to decide. Success at the Supreme Court is a long shot. [Source: TREA Washington Update & NVS Update 9 May 08 ++] VA FRAUD UPDATE 09: The U.S. Attorney's Office said 7 MAY that Lubbock TX man has been sentenced to five years in prison for cashing his dead mother's Veterans Administration checks for nearly two year after she died in 2004. Lyndell Simmons, 46, pleaded guilty in January to a charge of theft of government money or property. Besides prison time, Simmons must pay $21,529 in restitution to the Department of Veterans Affairs, prosecutors said in a release. Louise Simmons was a beneficiary of VA dependency and indemnity compensation benefits. An investigation started in MAR 07 after a complaint alleged that Louise Simmons had not returned a marital status questionnaire. Investigators discovered she had died on 10 NOV 04. The younger Simmons forged her signature on about 22 checks made out to his mother and cashed them from DEC 04 to MAR 07, prosecutors said. A jury in Virginia found Army veteran Randall Moneymaker "guilty of fabricating his service record and lying about his achievements and combat injuries to scam more than $18,000 in disability benefits from the Department of Veterans Affairs." Craig Jacobsen, the assistant U.S. attorney for the Western District of Virginia, said Moneymaker used 'different levels of deceit' against not only combat veterans but service members who are wounded in the line of duty. In the six-month period ending 31 MAR, the VA Inspector General's Office investigations resulted in nine indictments against people who tried to scam the system for medical and/or monetary benefits, said James O'Neill, assistant inspector general for investigations. The report at www.armytimes.com/news/2008/05/army_moneymaker_051008w details the case against Moneymaker, who faces up to 35 years in federal prison. [Source: Houston Chronicle AP & Army Times article 6 & 9 May 08 ++] GI BILL UPDATE 21: The Department of Veterans Affairs seemed to be standing in front of a fast-moving train 7 MAY when a top official said VA would need two years of preparation to come up with a payment system for a proposed overhaul of GI Bill education benefits. The warning flags were waved by Keith Pedigo, VAТs associate deputy undersecretary for policy and program management, who said meeting an 1 AUG 09, effective date for the benefits increases, under what lawmakers are calling the 21st Century GI Bill of Rights (S.22), would be extremely difficult. Because the proposal calls for the maximum benefit to be different in each state, payments would have to be manually, rather than automatically, processed, Pedigo said. УVA does not now have a payment system or the appropriate number of trained personnel to administer the program,Ф Pedigo said, predicting it would take two years to develop a payment system to provide the new benefits. Those benefits include paying the full cost of tuition and fees for the most expensive four-year public college or university in each state, plus a monthly living expense, an annual payment for books and other expenses, as well as up to $1,200 for tutorial assistance. Pedigo, testifying before the Senate VeteransТ Affairs Committee, also warned about the potential for large overpayments because the bill calls for lump-sum tuition payments directly to a school at the start of a quarter or semester, without specifying what would happen if a student drops out. Pedigo also warned of fundamental unfairness in a proposed housing allowance that would be based on where a school is located, rather than where a student lives, which could encourage veterans to enroll in online learning programs offered by schools in high-cost areas. His warnings come as the House and Senate are poised to attach S.22 to a wartime supplemental funding bill in an effort to overcome questions about how to pay for the benefits and the administrative costs. Attaching S.22 to the wartime funding bill also would put pressure on the Bush administration to sign onto a generous overhaul of veterans benefits in order to secure funding to continue military operations in Iraq and Afghanistan. Congressional leaders derive an additional benefit from attaching the GI Bill increases to the supplemental Ч it would attract more votes for the measure at a time when many lawmakers are reluctant to continue funding Iraq operations. The Pentagon, VA and the White HouseТs Office of Management and Budget oppose S.22, either as a separate bill or combined with the supplemental. But Bush administration opposition Ч and VAТs warning about implementation problems Ч do not seem to counter the growing push from veteransТ groups to pass what Sen. Jim Webb (D-VA), S.22Тs chief sponsor, calls a move to Уgive first-class futures to the people who serve.Ф The Congressional Budget Office (CBO), the nonpartisan analytical arm of Congress, said in a report 8 MAY that enactment of S.22 could lead to a 16% drop in re-enlistments. The Defense Department could counter that drop only by increasing re-enlistment bonuses. Fully offsetting the draw of a better veteransТ education program would require a $25,000 re-enlistment bonus for every first-term service member, something that would cost the Pentagon about $6.7 billion over five years. However, that cost would be offset by lower recruiting costs, the report predicts. It estimates there would be a 16 percent boost in recruits, which would allow a cut in enlistment bonuses and in other recruiting expenses that would result in $5.6 billion in savings over five years. The combination of better recruiting but weaker re-enlistments would leave the military with a $1.1 billion cost over five years to maintain the current force, the report said. Overall, CBOТs cost estimate is slightly lower than the estimated price tag issued by the Bush administration. Congressional budget analysts predict S.22 would have an overall cost of $680 million in the first full year and $51.8 billion over 10 years. VA officials told the Senate VeteransТ Affairs Committee on Wednesday that the proposal would cost $64.9 billion over 10 years. Currently, 75% of Army, 70% of Marine, 50% of Navy and 49% of Air Force enlistees who complete their first enlistment term get out of the military, The House of Representatives could pass a war supplemental soon that includes WebbТs GI Bill proposal, and the Senate plans to take up the bill when they do. In the Senate, Republicans are expected to offer their alternative bill, the Enhancement of Recruitment, Retention and Readjustment through Education Act (S.2983), that pays a little less to veterans and includes a Pentagon-requested provision that would allow career service members to transfer all or part of their benefits to family members, but they do not appear to have the votes to block S.22, which has 57 Senate co-sponsors, including 10 Republicans. VeteransТ groups, who have been pushing for years for an overhaul of the current Montgomery GI Bill, have picked WebbТs bill as their favorite. Carl Blake, national legislative director for Paralyzed Veterans of America, told the Senate committee that S.22 is better because it Уaccomplishes our goal of returning the GI Bill to the level established following World War II.Ф Blake also objected to Pentagon criticism that better GI Bill benefits, designed to encourage people to go to college, are bad for the nation. [Source: AirForceTimes Rick Maze articles posted 8 & 9 May 08 ++] TRICARE PREVENTIVE HEALTH PROGRAM: Budgetary rules forced a House subcommittee to take the unprecedented step of creating a new Tricare preventive health care program that does not apply to 1.5 million Medicare-eligible retirees and their families in the Tricare for Life (TFL) program. Rep. Susan Davis (D-CA), chairwoman of the House Armed Services military personnel panel, said the plan, approved 7 APR as part of the 2009 defense authorization bill, is aimed at cutting the militaryТs long-term health care costs by providing preventive care. The personnel portion of the defense policy bill, approved by voice vote and with no debate, includes: Х A 3.9 percent military pay raise. Х Increases in Army and Marine Corps active-duty personnel and in Army National Guard and Army Reserve support personnel on full-time active duty. Х A tuition assistance program for military spouses. Х Permission for a Pentagon-proposed experiment under which active-duty members could take a break of up to three years in their military career. Davis said her subcommittee rejected a Pentagon request for a $1.2 billion increase in Tricare health and pharmacy fees but wants to look for other ways to hold down costs, which is why expanding preventive care is attractive. She called the initiative УpreferableФ to the PentagonТs proposed increase in Tricare fees. The preventive care plan would waive co-payments for certain treatments such as vaccinations, smoking cessation help, and breast and colorectal cancer screening. It would apply to Tricare Standard, Tricare Select and Tricare Reserve beneficiaries Ч but, because of budgetary procedures, not TFL. Aides named two areas in which TFL beneficiaries would be treated differently than other Tricare users: shingle vaccinations and MRIs for mammograms. Younger retirees would receive these services for free, but TFL users would have to pay, either directly or by buying supplemental Medicare insurance, aides said. Rep. John McHugh of New York, the subcommitteeТ s ranking Republican, said this would be the first instance of differences in what is covered under Tricare, and also promised to work to try to find funding to offset that action. There are two kinds of spending in the defense budget: discretionary, which applies to personnel, operating and acquisitions costs and construction programs; and mandatory, also known as direct spending, for programs such as retired pay, GI Bill benefits for reservists, and some health care expenses, including TFL. Davis said only congressional leaders can resolve the funding problem because direct spending involves programs such as Social Security, Medicare, Medicaid and federal civilian retired pay that fall outside the jurisdiction of the armed services committee. Congressional leaders could agree to an offset by cutting other direct spending or could find another way to fund preventive care, subcommittee aides said. Steve Strobridge, government relations director for the Military Officers Association of America, said he understands the dilemma facing the subcommittee and agrees that what they did Уis certainly preferable to not doing anything.Ф УWe have been very supportive of preventive care programs,Ф he said. УIt only makes common sense that if you come up with programs like smoking cessation that it is going to save money in the long run.Ф [Source: NavyTimes Rick Maze article Posted 7 May 08 ++] VET SUPPORT FROM STATES: May is National Military Appreciation MonthЧa time to honor, appreciate, and remember military personnel and their families for their service to our country. It recognizes those on active duty, the National Guard and Reserves, retirees, veterans and all their families and survivors. Although the listing below is not all inclusive of state benefits available to veterans , it does indicate how many states show appreciation to the military in unique ways: Х Alabama. Operation Grateful Heart is a program to ensure all military personnel and their families receive appropriate recognition, tangible support, and neighborly care. It is focused on assisting those who are called upon to serve in the fight against terrorism and the defense of freedom, while they are serving on active duty and upon their return to communities in Alabama. http://www.governor.state.al.us/ogh/ Х Alaska. Spouses and dependent children of a military member who is deceased or a POW/MIA may qualify for free tuition for the pursuit of an undergraduate degree at any state-supported educational institution within the state. http://www.ak-prepared.com/vetaffairs/state_benefits.htm#Free%20Tuition Х Arizona. Military retirement payments and/or survivor benefits up to $2,500 per year are exempt from state taxes. http://myarmybenefits.us.army.mil/EN/Benefits/FactSheets/Regional/AZ/ Х Arkansas. Veterans may camp for half price in Arkansas State Parks. Х California. Education benefits are offered to dependents of qualified veterans by waiving mandatory system-wide tuition and fees at any State of California Community College, California State University, or University of California campus. www.military.com/benefits/veteran-benefits/california-state-veterans-benefits Х Colorado. Museum of Science and Nature gives free Museum admission to all active and retired military and their spouses, parents, siblings and children (18 and under). Х Connecticut. Tuition waivers for veterans cover 100% of tuition for General Fund courses at all public colleges and universities and 50% for Extension Fund and summer courses at Connecticut State Universities. http://myarmybenefits.us.army.mil/EN/Benefits/FactSheets/Regional/CT/ Х Delaware. Military members, while stationed in the state, may obtain fishing, hunting, or trapping licenses at the resident rate, regardless of residency status. http://myarmybenefits.us.army.mil/EN/Benefits/FactSheets/Regional/DE/ Х Florida. Several counties have established Active Military Combat Duty Grant Programs. The grant programs, which include property tax grants and direct grants, are designed to assist service members who are fighting in the Global War on Terrorism.


		THIS BULLETIN CONTAINS THE FOLLOWING ARTICLES == Medicare Reimbursement Rates 2008 [02] ------ (18 Days Left) == VA Report Card ------------------------------------- (High Marks) == Medicare Fraud [07] ------------------------------- ($205 million) == Mobilized Reserve 11 JUN 08 ---------------- (16,250 Increase) == Tricare Prior Authorization --------------------- (Requirements) == VA Home Loan [12] --------------------- (Mortgage Assistance) == Windows Vista [05] --------- (Performance Impacts Revenues) == NDAA 2009 [04] ---------------------------- (Steps to Complete) == Social Security Debit Card --------------- (Initiated Spring 08) == VA Blue Water Claims [03] ----------------------------- (Denied) == VA Ombudsman's Office ------------------------------ (H.R.2192) == Tricare Fees Overseas ------------------------------ (Action Alert) == TERA [01] -------------------------- (58,000 Retirees) == SSA Prisoner Rules [01] ---------------- (What is not Available) == Expatriate Income Tax [01] -------------------------- (Deadlines) == IRS Statute of Limitations ---------- (Expat False Assumptions) == Tax on Negotiated Balances ---------------------- (Credit Cards) == Shad [06] ------------------------------ (H.R.5954 Hearings) == VA Lawsuit (Lack of Care) [08] --------- (PerezТs PTSD email) == Tricare Gray Area Retiree Bill ------------------------ (H.R.6185) == Fisher House Expansion [03] ------------------- (Boost 38 to 62) == Veteran Rural Health Advisory Committee ------ (Appointees) == WI Vet Educational Benefits -------------------------- (Overview) == PTSD [21] -------------------------- (VA Denies Money a Factor) == CT Vet Educational Benefits -------------------------- (Overview) == Walter Reed Data Breach ---------- (GovТt Breaches Continue) == U of U Hospital Data Breach ------------- (2.2 million @ Risk) == Bank of NY Data Breach] ------------------ (4.5 million @ Risk) == AlzheimerТs [04] ------------------ (7 Stages) == VA PTSD Claim Support [01] ------------ (Stressor Symptoms) == Medicare Fraud [06] ------------------------ ($638 million in FL) == National Monuments --------------- (Pearl Harbor Considered) == Veteran Legislation Status 13 JUN 08 ------ (Where we Stand) MEDICARE REIMBURSEMENT RATES 2008 UPDATE 02: The cut in Medicare payments to physicians that are scheduled to take place on 1 JUL. Unless legislation is passed before then, there will be a cut of 10% in Medicare physician payments. This is very important for military retirees because Tricare payments to physicians are the same as the Medicare payments. There is great concern that if the payments cuts are not reversed doctors will not take any new Medicare patients, and likely no new Tricare patients. On 12 June, by a vote of 54 yea (58%, 60% required for passage), 39 nay 7 not voting, the Senate failed to pass S.3101, the Medicare Improvements for Patients and Providers Act of 2008, which would have cancelled the 10% cuts in physician reimbursements and provided a 1% increase to those reimbursements. Inexplicably, Sen. Harry Reid switched his vote from Yea to Nay. Also, very interesting is that the three contenders for the Presidency: Sen. John McCain, Sen. Hillary Clinton, and Sen. Barack Obama did not vote on this important issue. As always seems to be the case, the battle is over where to find the money to pay for the reversal of the cuts, since the Medicare (and military health care) budget for FY2008 was predicated on the cuts going into effect. Senate Finance Committee Chairman Max Baucus (D-MT) has come up with a bill that would stop the cuts by replacing them with a 0.5% increase in physician payments this year and an additional 1.1% increase in FY 2009. His bill would also improve Medicare benefits by expanding subsidies for low-income people, reducing co-payments for mental health treatment and increasing coverage for preventive health services. However, his bill is opposed by most Republicans because it would be paid for by cutting costs in privately run Medicare Advantage programs that have been championed by GOP lawmakers and President Bush. Senator Charles Grassley (R-IA), ranking member of the Senate Finance Committee, has drafted his own bill to fix the problem. The Grassley bill would give doctors the same increases as the Baucus bill, but would pay for them differently. GrassleyТs bill would eliminate bonus payments that some Medicare Advantage plans receive for operating in areas with teaching hospitals, a provision also contained in the Baucus bill. But Grassley would provide additional money by making cuts in some Medicaid provisions. Medicaid is the federal government health program for the poor. Both sides agree that fixing the pending cuts is the biggest health care priority they face this year, but they are running out of time to fix it. To see how your Senator voted on this legislation refer to http://tinyurl.com/3z2yee. After checking, you are encouraged to call and thank those who voted УYeaФ and to ask why those who voted УNayФ did so. Calling your congressional representative in Washington D.C. is easier than you think. Our government and the AMA have provided the following no charge numbers for constituents to talk to their elected officialТs offices located in the Capital Building: Х 1-866-272-6622 Capital Operator Direct Х 1-800-833-6354 AMA Grass Roots Hotline - follow prompts Х 1-800-828-0498 Capital Operator Direct Х 1-800-833-6354 AMA Grass Roots Hotline Ц follow prompts Х 1-866-340-9281 Capital Operator Direct Х 1-866-220-0044 Capital Operator Direct When the capitol operator answers: 1. Tell her which Senate or House office you want. 2. When the office answers, tell the staffer that you are a constituent and either thank the Senator for his Yea vote or ask why the Senator voted Nay. If Senator Reid's office, ask why he switched his vote from Yea to Nay. 3. Provide additional information requested by the staffer. Usually your zip code to confirm you are a constituent. 4. Be polite and courteous, remember the staffer is simply the "messenger". 5. For a listing of all other bills refer to http://thomas.loc.gov. [Source: TROA Washington Update & USDR Action alert 13 Jun 08 ++] VA REPORT CARD: A new Уhospital report cardФ by the Department of Veterans Affairs (VA) gives the DepartmentТs health care system high marks, with VA facilities often outscoring private-sector health plans in standards commonly accepted by the health care industry. Among the reportТs finding were: Х 98% of veterans were seen within 30 days at primary care facilities, 97% at specialty clinics. (Veterans requiring emergency care are seen immediately.) Х All of VAТs 153 medical centers are accredited by the independent Joint Commission which accredits all U.S. health care facilities. Х The quality scores for older veterans are similar to those for younger veterans. Although screening for breast and cervical cancer for women in VA facilities exceeds screening in private-sector facilities, women veterans lag behind their male counterparts in some quality measurements, the report noted. VA has already launched an aggressive program to ensure women veterans receive the highest quality of care, including placement of women advocates in every outpatient clinic and medical center. Health care will be a major topic at VAТs National Summit on Women Veterans Issues scheduled for 20-22 JUN in Washington. The report also found minority veterans are generally less satisfied with inpatient and outpatient care than white veterans. That disparity will be the focus of an in-depth study, based upon input from veterans, which will be completed this summer. The report card is available on the Internet at http://www.va.gov/health/docs/Hospital_Quality_Report.pdf. In FEB Congress directed VA to complete the report card, highlighting measurements of quality, safety, timeliness, efficiency and patient-centeredness. James Peake, the Secretary of Veterans Affairs noted that, УNo other health care organization provides this much information about its ability to care for its patients.Ф [Source: VA News Release 14 Jun 08 ++] MEDICARE FRAUD UPDATE 07: While Congress debates whether or not to reduce Medicare payments to practitioners, task force officials are uncovering increased amounts of fraud. Over nearly four years a high school dropout named Rita Campos electronically submitted more than 140,000 Medicare claims for unnecessary equipment and services. All it took to bilk the federal government out of $105 million was a laptop computer. After pleading guilty to filing false claims, she has helped authorities win indictments against more than half a dozen Florida doctors and patients who allegedly accepted kickbacks for pretending to receive costly HIV drug therapy. With her cooperation, FBI agents this week arrested three Miami-area men who, the government alleges, financed sham clinics that billed the government more than $100 million. Sentenced to 10 years, Campos Ramirez, 60, may yet reduce her prison term by helping authorities unwind "the large web of medical clinics, doctors, nurses, money laundering companies and HIV clinic financiers who participated in this massive fraud," prosecutors wrote earlier this year in court papers. Her lawyer did not return calls seeking comment. By many accounts, Campos Ramirez was unusually successful. Prosecutors say that corrupt medical clinic owners anticipate that Medicare will cover a quarter of their phony claims. But Campos Ramirez persuaded authorities to cover 60% of all the bills she submitted on behalf of 75 HIV clinics in South Florida, according to court filings. Health-care experts say the simplicity of Ramirez's scheme underscores the scope of the growing fraud problem and the need to devote more resources to theft prevention. Law enforcement authorities estimate that health-care fraud costs taxpayers more than $60 billion each year. A critical aspect of the problem is that Medicare, the health program for the elderly and the disabled, automatically pays the vast majority of the bills it receives from companies that possess federally issued supplier numbers. Computer and audit systems now in place to detect problems generally focus on overbilling and unorthodox medical treatment rather than fraud, scholars say. Daniel R. Levinson, the inspector general of the Department of Health an Human Services (HHS) has warned repeatedly that the Medicare program is "highly vulnerable" to fraud, particularly in South Florida, where schemes center on expensive, infusion-based HIV medications and on equipment such as wheelchairs, walkers, canes and hospital beds. Officials from the Centers for Medicare and Medicaid Services (CMS), which oversees federally funded health programs, say they have stepped up their efforts to combat fraud over the past year by working closely with investigators, removing the requisite billing numbers of nearly 900 companies and imposing new standards in high-fraud areas that would prevent people convicted of felonies from ever receiving a Medicare number. Investigators and prosecutors trained their focus on Miami after noticing two troubling patterns: Х HHS investigators discovered that nearly half of 1,581 medical equipment companies they visited in the Miami area did not comply with basic Medicare requirements to be open during scheduled hours and to have a telephone number. The inspector general and the Government Accountability Office have flagged weak oversight of these kinds of suppliers for a dozen years, according to congressional testimony. Х The South Florida region bills Medicare more than $2 billion each year for injectable HIV medications. That figure is 22 times as high as the amount of similar claims in the rest of the country, and is far out of line with demographic data in a population of 2 million people in Miami-Dade County. Justice Department officials moved to freeze money in suspicious bank accounts controlled by medical equipment company owners and they created a Washington-based strike force to handle the issue. The strike force, in concert with a small group of U.S. attorney's offices, has in the past year opened nearly 900 criminal investigations and convicted 560 defendants in health-care fraud offenses throughout the country. Authorities say the strategy is working. They point to a $1.75 billion drop in Medicare claims in Miami since the operation began a year ago. But even government officials hope for a more comprehensive solution. Christopher Dennis, the special agent in charge of the HHS inspector general's office in Miami, said fraudulent medical equipment companies appear to have shifted gears since the strike force arrived. After a crackdown in South Florida, at least some corporate owners moved to the north, he said. Investigators dubbed one initiative "Operation Whack-a-Mole," after the carnival game in which a creature pops up in different places after being hit with a hammer. The strike force recently established a base in Los Angeles, another area rife with fraud. Prosecutors announced criminal charges last month against two medical equipment company owners who are accused of falsely billing Medicare more than $2 million. Plans call for a similar rollout this fall in Houston, another potential fraud hot spot. Officials who oversee the Medicare program say they are vigilant despite time pressure and limited resources. Employees review fewer than 5% of the nearly 1 billion claims filed each year. The vast majority of claims shuttle through computer systems that are tweaked when authorities notice fraud patterns. This year, CMS is working to finalize a rule that would prevent convicted felons from obtaining Medicare billing numbers. At present, that regulation applies only in a few high-fraud regions. [Source: Washington Post Carrie Johnson article 13 Jun 08 ++] MOBILIZED RESERVE 11 JUN 08: The Army, Air Force and Marine Corps announced the current number of reservists on active duty as of 11 JUN 08 in support of the partial mobilization. The net collective result is 16250 more reservists mobilized than last reported in the Bulletin for 28 MAY 08. 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. The total number currently on active duty in support of the partial mobilization of the Army National Guard and Army Reserve is 87,542; Navy Reserve, 5,982; Air National Guard and Air Force Reserve, 12,452; Marine Corps Reserve, 9,150; and the Coast Guard Reserve, 784. This brings the total National Guard and Reserve personnel who have been mobilized to 115,950, including both units and individual augmentees. A cumulative roster of all National Guard and Reserve personnel, who are currently mobilized, can be found at http://www.defenselink.mil/news/Jun2008/d20080611ngr.pdf .. [Source: DoD News Release 456-08 11 Jun 08 ++] TRICARE PRIOR AUTHORIZATION: Tricare Standard puts the power to manage your health care in your hands by not requiring referrals. However, some services may require prior authorization. Under TRICARE Standard prior authorization is required for the following services: Х Adjunctive dental services Х Home health services Х Hospice care Х Non-emergency inpatient behavioral health care, including non-emergency inpatient admissions for substance use disorders Х Outpatient behavioral health care after the eighth visit in a fiscal year (Oct. 1ЦSept. 30) Х Transplants (solid organ and stem cell) Х Tricare Extended Care Health Option services Your network provider can coordinate the authorization with the regional Tricare contractor. Once an authorization is granted, the contractor will also issue service beginning and ending dates for medical or surgical services. For behavioral health authorizations, the contractor will specify a certain number of visits, in addition to the beginning and ending dates. All authorized care must be received before the authorization's end date. If not, your provider must acquire a new authorization. Additional authorization rules may apply, so it's best to call your regional Tricare contractor if you have questions. [Source: NAUS Weekly Update 13 Jun 08 ++] VA HOME LOAN UPDATE 12: Many home owners have found it difficult recently to pay their mortgages, VA guaranteed or otherwise, but intervention by loan counselors at the Department of Veterans Affairs (VA) has actually reduced the number of veterans defaulting on their home loans. Accounting for much of this success are VA counselors at nine regional loan centers who assist people with VA-guarantied loans avoid foreclosure through counseling and special financing arrangements. The counselors also can assist other veterans with financial problems. VA counselors have helped about 74,000 veterans, active-duty members and survivors keep their homes since 2000, a savings to the government of nearly $1.5 billion. Depending on a veteran's circumstances, VA can intercede with the borrower on the veteran's behalf to pursue options -- such as repayment plans, forbearance, and loan modifications -- that would allow a veteran to keep a home. To obtain help from a VA financial counselor, veterans can call VA at 1(877) 827-3702. Information about VA's home loan guaranty program can be obtained at www.homeloans.va.gov. Since 1944, when home-loan guaranties were offered with the original GI Bill, VA has guarantied more than 18 million home loans worth $911 billion. Last year about 135,000 veterans, active-duty service members and survivors received loans valued at nearly $24 billion. About 2.3 million home loans still in effect were purchased through VAТs home-loan guaranty program, which makes home loans more affordable for veterans, active-duty members and some surviving spouses by protecting lenders from loss if the borrower fails to repay the loan. More than 90% of VA-backed home loans were given without a downpayment. April 08 data shows that foreclosures are down more than 50% from the same months in 2003. VA attributes this to prudent credit underwriting standards, its robust supplemental loan servicing program and VA financial loan counselors. [Source: VA News Release 12 Jun 08 ++] WINDOWS VISTA UPDATE 05: The negative perception of Windows Vista may be catching up to Microsoft in the bank. On 11 JUN a financial analyst firm lowered its revenue estimate for Microsoft's 2008 and 2009 fiscal years, citing a negative perception about the operating system that is affecting its adoption by businesses. The research report by Sanford C. Bernstein analysts also hinted at the release date for the next version of Windows code-named Windows 7. In the report, analysts said they expect Windows 7 to be released in the second quarter of 2010. In the report, analysts Charles J. Di Bona, Maureen Murphy and Mariel A. Hardi lowered their revenue estimates for Microsoft by $49 million for fiscal 2008 and by $395 million for fiscal 2009. While the 2008 revision didn't affect the firm's earnings estimate of $1.91 per share for that year, it lowered its 2009 estimate to $2.17 from $2.20, according to the report. "Support for Vista has been battered across all enterprise sizes and corporate constituencies," the report stated. "As a consequence, the Vista cycle looks likely to be materially less robust than indicated in our prior survey." The key factor has been "overwhelmingly bad publicity" for Vista, particularly about the option for enterprise licensees to downgrade to XP from Vista, and the potential for companies to skip Vista in favor of Windows 7. The downgrade option has been especially troublesome for Microsoft, which in some cases has had to extend the time it will sell XP due to customer demand. The negative publicity has left businesses with a perception that there is no good reason for them to upgrade, according to the Bernstein report. "Almost no feature of the new OS is now seen as a meaningful positive driver for adoption," the analysts said. Independent analyst Brian Madden concurred. "From a company standpoint, there is not a single damn reason people should use Vista," he said. "Will you sell another widget because of Vista? No. And besides, Vista has so many hardware requirements th! at you i ncrease your costs." The Bernstein report also cites costs associated with Vista, which would require some companies to upgrade their desktop hardware because of the increased system requirements, a further impediment to adoption. Moreover, some features of Vista that Microsoft promoted as key reasons to upgrade, such as security, have been undermined by negative publicity around tools like User Account Control, a new security feature many customers have griped about, according to the report. [Source: IDG News Service Elizabeth Montalbano article 11 Jun 08 ++] NDAA 2009 UPDATE 04: The House and Senate have been working on their own versions of the 2009 NDAA, attempting to get a bill to the President's desk for signature into law by October 1, 2008. The House approved their version, H.R.5658, on 22 MAU by a vote of 384-23. The bill has $601.4 billion in regular funding (excludes war funding) for the Defense Department. Included in the bill is a 3.9% pay raise; increases in full time manning for the Army and Air Guard; allows for Tricare cost share increases; initiates a 3-year sabbatical program; initiates a tuition-assistance program for military spouses; buys more aircraft such as C-17s, F-22s, C-130s, and F-35s; includes $750 million for Guard & reserve equipment purchases; and authorizes $65.4 million for reintegration programs. The Senate version, S.3001, is still in committee and has not progressed to the floor for debate or vote yet. The best guess is that the Senate will not take up this legislation until after the 4 JUL recess is over. This bill has $612.5 billion in regular funding. It also increases full time manning for the Army and Air Guard; allows for no Tricare fee increases; includes the pay raise and sabbatical provisions; has $390 million for Guard homeland defense equipment but no equipment account; authorizes 21 days of paternity leave; and requires DOD and JCS and NGB to develop a strategic plan for the role of the Guard. Once the Senate votes their version of the bill, both bills go to conference committee to iron out any differences. Then the compromise conference bill goes back to both chambers for ratification vote, and following that affirmative vote, it goes to the President for signature (or veto). On May 22 MAY the White House issued a veto threat concerning HR 5658, citing 27 different provisions of concern in the bill. Among those provisions for which the President would veto the bill are: the pay raise (3.4% vs. 3.9%), purchase of additional C-17s, F-22s, and F-35s, and not increasing the Tricare cost share amounts t! o even h igher levels. [Source: EANGUS Minuteman Update 12 Jun 08 ++] SOCIAL SECURITY DEBIT CARD: For millions of Americans, accessing their Social Security benefits is now just a card swipe away. A new debit card being offered by the Treasury Department gives nearly 4 million recipients who have no bank accounts an alternative to paper checks that they must cash, usually at a price. The new debit card, issued by Comerica Bank, was quietly marketed to nearly 3.5 million recipients of Social Security and Supplemental Security Income (SSI) this spring. It's now available to any benefit recipient through enrollment at www.usdirectexpress.com. States already load child support payments and unemployment benefits onto debit cards. The federal government has used prepaid debit cards, too, for disaster relief aid. But the Social Security debit card is the largest push to date to switch from costly paper checks to electronic payments. "Our goal is to move to 100% electronic payments," says Judy Tillman, commissioner of Treasury's Financial Management Service. "It's safer and more reliable for delivery" of funds. The new debit card will eliminate the need for consumers without bank accounts to use costly check-cashing services, the Treasury Department says. It will also save the government money. The Treasury estimates that if all 4 million recipients without bank accounts signed up for the card, it would save $42 million a year. As with any other debit card, using it won't always be free. For instance, holders will get one free ATM withdrawal per month. After that, they'll be charged 90 cents for each withdrawal. A fee of 75 cents per month also applies if card holders want paper statements mailed to them. Still, the fees are among the lowest in the industry for such services, says Nora Arpin, director of government electronic solutions for Comerica. About 80% of the 57.3 million Social Security and SSI recipients have their benefits directly deposited into their bank accounts. The challenge will be to get the remaining consumers to switch from checks to electronic payments such as direct deposit or the new debit card. The card "might be confusing if they're not savvy about electronic payments and don't have (experience with) a bank account," says Chris Allen, a director for Hitachi Consulting. [Source: USA Today Cathy Chu article 10 Jun 08 ++] VA BLUE WATER CLAIMS UPDATE 03: The Montgomery Advertiser published the following article that is reflective of the frustrations of many of our veterans who served during the Viet Nam conflict: Joe Moody and Dave Sanderson volunteered to serve their country when that wasn't a popular thing to do. They joined the Navy. Both served on ships off the shore of Vietnam in the 1960s. Joe is 64, Dave is 60, and they're both sick. They feel abandoned by their country now; when they need her help the most. Joe was an engineer who served on the USS Oklahoma City, the flagship of the Seventh Fleet. Dave was a gunfire technician on the USS Lang. Both received comмbat pay, as did others of the 70,000 or so veterans who served as "blue water sailors" during that war. Both have developed diabetes mellitus, one of the diseases conмnected to Agent Orange, a highly toxic herbicide used to defoliate combat areas in Vietnam. Both have been denied service-connected compensation because Veterans Administration rules recently upheld by the courts say that only those who set foot in Vietnam are eligible. They don't care so much about the pension. But the medical benefits paid to other Vietnam veterans would be welcome. Joe has had medical costs taken out of his Social Secuмrity check. Dave has congestive heart failure and other medical problems related to the diabetes. They are among "500 to 1,000" members of a group called "Blueмwatersailors.org," who have mailed their Vietnam service medмals to Sen. Daniel Akaka of Hawaii and Rep. Bob Filner, chairmen reмspectively of the Senate and House Veterans Affairs committees. "We were going to have a march on Washington," Joe said Friday in a Prattville restaurant. "But most of us were too sick to march." Dave laughed. "It would have been a pretty short march," he said. "I was doing good to walk to the mailbox to mail my medals back." He had driven from Huntsville. He had on a Navy veteran's cap and a blue water sailor T-shirt that said, "Still Fighting." The reasoning goes that they were not exposed to the defoliant because they weren't in-country. But they both had photos of their ships firing on inland positions in Vietnam. You could see the mounмtains in the background. Joe said he had been as close as five miles. Dave's ship routinely operated within 3,000 to 6,000 yards from the shore. Their drinking water came from desalinized seawater, and they produced copies of studies that showed the pesticides could have drifted miles offshore, in the water and in the east-to-west winds. Given the way the water was produced, they feel they and their shipmates may have re-ceived a more concentrated dose of the poison. Their clothes were washed in the same water. Their mail came from Danang in canvas bags -- Agent Orange has been proven to cling to canvas. Joe said a guy came on their ship selling canvas hats from Vietnam. Almost everyмbody on board bought one. Ships carried Agent Orange to Vietnam in the first place. Both had helped load the 55-gallon drums that had the identifying orмange band around the top. They physically touched the containers. Dave recalled that his ship docked in Vietnam near the end of the war. He got off, walked on the dock for a few minutes, just to be able to say he'd set foot in Vietмnam. "If I had a picture of that, or if I could find enough eyewitnesses to say I had done that, I'd be eligible for benefits," he said. "That's just crazy." The blue water sailors from Australian and New Zealand ships that supported operations off the Vietnam shore have been granted aid from their countries. The men know the denials of their claims are about money. But they feel it's an insult to the Navy, and to their legacy. It sets a bad precedent for future veterans -- the thousands who are serving offмshore in support of troops in Iraq and Afghanistan today, right now. Other Vietnam veterans have a beef, Joe said. Air Force vets who flew over the country would not qualify. Navy pilots would not qualify, unless they were shot down. They both believe in the good will of their countrymen. People just don't know about it. "All we want is to be heard," Joe said. "Let the people know about this, and then let the public decide what's right." (Note: to obtain additional info on this subject refer to http://bluewaternavy.org/). [Source: Montgomery Advertiser article 8 Jun 08 ++] VA OMBUDSMAN'S OFFICE: Citing the confusion veterans face when trying to arrange benefits, the House Veterans' Affairs Health Subcommittee passed H.R.2192 on 5 JUN which would create an Ombudsman office within the Veterans Affairs Department (VA). The bill introduced on 7 MAY 07 and sponsored by Rep. Paul Hodes D-NH) was adopted by unanimous voice vote, along with the adoption by voice vote of a substitute amendment from Veterans' Affairs Health Subcommittee Chairman Michael Michaud (D-ME). The bill instructs the VA secretary to create an office of the ombudsman, and designate the head of the office. The office would act as a one-stop shop for information on benefits administered by the VA, including medical, housing and education. When testifying in support of his bill before the Health Subcommittee on 14 JUN 07, Hodes said the VA has separate hotlines for different benefits, and the process can be confusing to veterans returning from overseas. Michaud's substitute amendment expanded the duties of the new office. Under the amendment, the VA secretary will designate an ombudsman director in each of the departmentТs three administrations, health, benefits and cemeteries. The ombudsman director in each administration will report to the head ombudsman. The amendment also defines the official duties of the office of the ombudsman as providing patient advocacy and problem resolution, provide assistance in understanding benefits, provide information on claims submissions, and field complaints from veterans. The VA secretary will also designate six regional ombudsmen throughout the United States for both the health and benefits administrations. However, the VA does not support the bill. VA Undersecretary for Health Michael Kussman testified at the Health Subcommittee hearing on the bill that it would create an unnecessary level of bureaucracy within the VA. Kussman added the VA already has officers such as patient advocates and benefit counselors, and many state level veterans departments also have counselors. The bill currently has 43 cosponsors. [Source: Congress Daily Andy Leonatti article 9 Jun 08 ++] TRICARE FEES OVERSEAS: U.S. Military retirees and dependents of both active duty and retiree membersТ of the U.S. Militar residing outside of the United States will soon be experiencing increased out of pocket expense of up to double or more for using Tricare. This is happening in spite of CongressТ continued refusal in past years and their refusal in MAY 08 to allow DoDТs proposed Tricare fee increases requested in the 2009 NDAA. All active duty military, retirees and dependents are covered by Tricare for their health care. Tricare is a Department of Defense Health Insurance Program developed and authorized by Congress. Military memberТs dependents, retirees and their dependents living in foreign countries that are covered under the Tricare Standard Program will soon have a new Уcountry specific indexФ applied to all medical claims they submit to Tricare. This new index is a product of the World BankТs survey of the average cost of goods and services in a specific country and resulted in the development of a percentage factor that reflects what amount of goods and services $1.00 would buy in the foreign currency. Unfortunately, this survey was taken in 2005, prior to the decline of the U.S. dollar overseas and does not accurately reflect the cost of those goods and services in todayТs dollar. Worst yet, since this survey results are an average of the cost of goods and services, it mixes private health care cost with the foreign government health care cost, (which are normally provided free or at a nominal fee, much like Medicaid). The program is due to take effect in AUG 08 and will be phased in using a higher allowed percentage for the first year and then the World BankТs percentage starting on 1 MAR 09. The implementation of this program is being done under the DODТs rule making authority; however, it in effect skirts the U.S. CongressТ directions which established a 25% co-pay for Tricare Standard beneficiaries. DoD has apparently rationalized they can do this through the use of survey data from the World Bank. Data that even the World Bank states, in itТs handbook on this survey, must take into consideration the foreign exchange rate, (and presumably the inflation rate), for a specific country at the time of making use of their data. The DOD has ignored that part of the study handbook, and is going to ignore the vast difference in health care cost in rural vs. urban settings and private vs. government health care. The program is scheduled to start in the Philippines and Panama first with the intent to later make it the standard for all foreign countries where Tricare has beneficiaries residing. An example of how this program will affect the pocket books of the dependents and retirees in the Philippines is; Х A Beneficiary is admitted to a Hospital in Manila for a coronary bypass and is hospitalized for 10 days. Х The hospitalsТ legitimate charges, (the charges that the same procedure would cost a Philippine citizen), is $11,200. Х Tricare will only allow $6971 for this procedure based on the country specific index. Х Thus, the beneficiary must pay the hospital the additional $4,229 that Tricare will not pay. Х Tricare will only reimburse the beneficiary 75% of the allowed amount. The beneficiary is mandated by Federal statute to pay 25% of what ever Tricare pays. Thus, only $5,228.25 of the$11,200 will be at government expense. Х The beneficiary will pay the outstanding hospital bill of $4,229 plus the co-pay of $1,742.75 for a total of $5,971.75 (or 53.32% of the total hospital bill). Other examples for out-patient care have shown a beneficiary cost of 60-70-80% of the total amount of the bill. And then comes the kicker. In most third world countries, such as the Philippines, the patient must pay the hospital bill and doctors/laboratory bills in full prior to discharge from the hospital or prior to receiving medical care. Some hospitals require a deposit of 110% of the estimated hospital bill prior to admission. In the Philippines, unlike the U.S., a hospital is not required to admit a patient or treat a patient without getting paid for the medical care given. Using the above example there are very few Tricare users who could come up with $11,200 within a day in order to get treated for a life threatening medical condition. DOD has refused to use a prevailing rate system for the Philippines, even though this is the manner in which they determine allowable charges in the U.S., (and the U.S. rates are adjusted by zip codes and localities to account for the differences in health care cost in different parts of the U.S.). This and the use of a new country specific index will force overseas dependents and retirees to shoulder a higher percentage of their health care cost than is required of their counterparts in the U.S. Speculation as to why this is happening is: Х DOD does not think anyone will notice. They need to find funds to help with the Iraq war cost. They know, due to all the newspaper articles concerning poor treatment of active duty and retired military in U.S., that they could not extract the savings from U.S. military health system in the U.S. But the service members and retirees overseas donТt normally make the news, so why not get the dollars from them. Х Though intentional misuse of data from the World Bank they can ignore the exchange rate, inflation rate and take an average cost analysis to derive a reduction in benefits to the overseas retiree and dependent community. Х By reducing future overseas reimbursements DoD can recoup losses due to Tricare fraud intensified by inaction of their overseas regional contractor WPS. (i.e. $100 million over 6 years by Health Visions). Government should treat equally all active and retired military members who served their country honorably. If you feel to not do so is wrong you are encouraged to contact your Senate and House representatives and tell them to stop DOD from eroding our overseas military communityТs benefits. Attachment 3 to this Bulletin contains a suggested letter for mailing to one or more of your Congressional representatives. Attachment 4 contains extensive background on how we would up in this situation. Congressional contact information can be obtained from https://forms.house.gov/wyr/welcome.shtml . [Source: Various 9 Jun 08 ++] TERA UPDATE 01: Public Law 102-484 granted temporary authority for the military services to offer early retirements to members with more than 15 but less than 20 years of service. The retired pay was calculated in the usual way except that there was a reduction of 1% for every year below 20 years of service. Part or all of this reduction can be restored at age 62 if the retired member works in a qualified public service job during the period from the date of retirement to the date on which the retiree would have completed 20 years of service. Unlike members who leave military service before 20 years with voluntary separation incentives or special separation benefits, these early retirees are generally treated like regular military retirees for the purposes of other retirement benefits. This authority expired on 1 SEP 02. As of 30 SEP 06 & 07, there were approximately 58,000 TERA retirees receiving retired pay. In FY 2006, TERA retirees were paid approximately $769 million in 2006 and $841 million in 2007. [Source: DoD FY07 Military Retirement Fund Audited Financial Statement 30 Nov 08 ++] SSA PRISONER RULES UPDATE 01: Social Security disability benefits can be paid to people who have recently worked and paid Social Security taxes and are unable to work because of a serious medical condition that is expected to last at least a year or result in death. The fact that a person is a recent parolee or is unemployed does not qualify as a disability. Social Security retirement benefits can be paid to people who are 62 or older. Generally, you must have worked and paid Social Security taxes for 10 years to be eligible. Social Security benefits are not paid for the months you have been sentenced to a jail, prison or correctional facility or confined to certain public institutions for committing a crime. And, no benefits can be paid for any month in which you violate a condition of your probation or parole. Although you cannot receive monthly Social Security benefit payments while you are confined, your spouse or children can be paid benefits on your record if they are eligible. And if you have worked and paid Social Security taxes, survivors benefits also may be paid to certain family members if you die. SSI can be paid to people who are 65 or older, or who are blind or disabled and whose income and resources are below certain limits. No benefits are payable for any month in which you reside in a jail, prison or certain other public institutions. Also, you cannot receive an SSI payment for any month in which you violate a condition of your probation or parole. If your Social Security or SSI benefits were suspended because you were incarcerated, you can request that they be started again when you are released from prison. You will need to contact Social Security and provide a copy of your release documents before they can take action on your request. If you were not receiving benefits prior to your incarceration or your benefits were terminated, you will need to file a new application for benefits if you think you may be eligible. You should contact Social Security for more information about filing a claim for benefits. They will require proof of your release from prison, in addition to a new application and other documents. If your institution has a prerelease agreement with the local Social Security office, it will notify them if you are likely to meet the requirements for SSI or Social Security benefits. SSA can then process an application several months before your anticipated release so that benefits can start as soon as possible after your release. You should contact institutional or social service staff to find out if the institution has a prerelease agreement with Social Security. If there is no agreement, when you know your anticipated release date, contact Social Security to apply for benefits if you think you may be eligible so SSA can take prompt action on your application. For what you can do online refer to http://www.socialsecurity.gov/onlineservices/ [Source: http://www.socialsecurity.gov/pubs/10133.html Jun 08 ++] EXPATRIATE INCOME TAX UPDATE 01: For American expatriates, the tax filing deadline this year is 16 June. This means that the tax return must be at the IRS Service Centre in Austin, Texas by the due date. Postmarks do not count. For this reason, electronic filing is the better option over snail mailing. The due date can be extended by filing Form 4868 - Application for Automatic Extension Of Time to File U.S. Individual Income Tax Return. This form extends the due date to 15 OCT 08. However you will owe interest on any unpaid taxes that were due 14 APR for the 2007 calendar year. IRS may also assess a late payment penalty of 1/2 of 1% of any tax not paid by the regular due date up to 25%. A late filing penalty of 5% per month up to 25% can also be assessed if the return is filed late. Form 4868 can either be filed electronically or by post. Expatriates making a payment with the Form should send to the IRS Service Centre at: PO Box 660575, Dallas TX 75266-0575. Those not making a payment can send to: Austin, TX 73301-0215. [Source: The Tax Barron Jun/Jul 08 ++] IRS STATUTE OF LIMITATIONS: Often American expatriates do not file a US tax return under several mistaken assumptions. The three main ones are: Х They file and pay taxes to a foreign country of residence. Х They earn less than the foreign earned income exclusion. Х After many years of not filing to remain under the radar. Actually US tax laws require US citizens and resident aliens to report their worldwide income annually unless their income is below the combination of a Standard Deduction and Exemption amounts. In 2007 a Single filer's Standard Deduction was $5,350 and Exemption $3,400. So unless as a Single filer you were below this $8,750 ($5,350 + $3,400) threshold, filing an income tax return in a foreign country does not excuse you from filing stateside. The Foreign Earned Income Exclusion (FEIE), worth $85,700 in 2007, is intended to help US filers from being taxed twice on their foreign income. But FEIE cannot be applied against investment and other forms of income. Nor can it be taken if IRS challenges a nonfiler to report prior year foreign earnings and decides against allowing FEIE. So even if those foreign earnings are excluded from US taxation, they are still reportable. Staying under the radar is risky, especially as IRS is steadily increasing its reach via international tax treaties and auditors. The worst scenario is to be discovered and face possible criminal sanctions for tax avoidance. Under IRS Statute of Limitations, taxpayers have three years to claim a tax refund. IRS has three years to audit a tax return or assess additional taxes. And ten years to collect outstanding tax liabilities. Anyone who has not filed a US tax return for some years from overseas should take the offensive approach by filing rather than being put on the defensive by an aggressive and suspicious IRS auditor. The Service asks that three years returns be filed. [Source: The Tax Barron Jun/Jul 08 ++] TAX on NEGOTIATED BALANCES: Veterans should be aware of the tax ramifications of negotiating a credit card debt. If you or a member of your family that you claim as a dependent on your tax form become over-extended on their credit card balances it is possible to negotiate with many credit card companies for a reduced balance to clear the debt. However, once payment is made the credit card company will issue you a Form 1099-C reporting the amount not paid as a discharge of indebtedness income. This can later be taxed as income by the IRS. [Source: The Tax Barron Jun/Jul 08 ++] SHAD UPDATE 06: Veterans who believe they're suffering health problems from secret chemical and biological weapons testing conducted years ago will testify before Congress the week of 9 JUN on House bill H.R.5954 introduced on 1 MAY by Rep. Mike Thompson, Mike [CA-1]. Thompson and some of the bills 25 cosponsors have been trying for nearly seven years to get the U.S. Defense Department to acknowledge that the tests occurred and that affected veterans should be compensated and given treatment for their diseases. The bill is to amend title 38, United States Code, to provide veterans for presumptions of service connection for purposes of benefits under laws administered by Secretary of Veterans Affairs for diseases associated with service in the Armed Forces and exposure to biological, chemical, or other toxic agents as part of Project 112, and for other purposes. It also requires the secretary of Veterans Affairs to notify all veterans subject to the testing of the potential hazards. It is estimated there are about 500 veterans still surviving that were affected by the project. Rep. Denny Rehberg (R-MT) said in a prepared statement, "This is great news for all of the Project 112 veterans who have waited decades to receive proper health care. It's obvious we've gotten the committee's ear and they're interested in finally righting this wrong." The Defense Department now says 6,440 service members took part in 50 tests under Project 112 between 1962 and 1973, including open-air tests above a half-dozen U.S. states. In testimony prepared for the hearing, obtained in advance by The Associated Press, Bradley Mayes, the Veterans Affairs DepartmentТs director of compensation and pensions, calls the legislation unnecessary, Уdue to the lack of credible scientific and medical evidence that adequately demonstrates any statistically significant correlationФ between the tests and participantsТ diseases. Last year, the Institute of Medicine, which advises the government on medical and health matters, found no specific health effects as a result of Project SHAD Rep. Thompson and others argue that the report was shoddily done and left out key information. During the tests, conducted amid Cold War concerns about the Soviet UnionТs weapons capabilities, the military tested germs such as bacteria that could cause tularemia and Q fever, serious diseases more commonly found in animals. Also used were nonlethal simulated agents, including E. coli now known to pose health dangers. Some of those veterans now suffering from various maladies say test participants were given experimental vaccines but werenТt told of any risks, only that the shots were a protective measure. Dr. Michael Kilpatrick, the PentagonТs deputy director for force health protection and readiness, acknowledges that some participants werenТt fully informed about the project they were part of but says safety precautions taken then were appropriate for the time. Among the various Project 112 tests was SHAD, an acronym for Shipboard Hazard and Defense, which was conducted during the 1960s. SHAD encompassed tests designed to identify US warships' vulnerabilities to attacks with chemical or biological warfare agents and to develop procedures to respond to such attacks while maintaining a war-fighting capability. The Defense Department for years denied that the testing occurred. Although it now acknowledges the tests, it won't provide health benefits through Veterans Affairs for those exposed veterans who are now suffering various cancers and illnesses. During the SHAD tests crewmembers were inside shipТs sealed quarters when they were sprayed with biological and chemical agents in the Pacific Ocean. Participants claim that paper filters designed to prevent the agents from getting through the air ducts to the sealed spaces often deteriorated. They were required to wash down the boats after the spraying, but they wore the same gear every day and it was cleaned with cancer-causing agents. Their bunks, clothes and lockers also were exposed during the cleaning. The following are ships used in the SHAD operation along with the tests they were involved in: Х USS George Eastman (YAG-39): 63-1 Eager Belle I; 63-1 Eager Belle II; 64-2 Flower Drum I; 65-17 Fearless Johnny; ; 66-13 Half Note; 65-4 Magic Sword. Х USS Granville S. Hall (YAG-40): 63-1 Eager Belle II, 63-2 Autumn Gold; 64-2 Flower Drum I; 64-4 [Red Beva] Shady Grove; 65-6 Big Tom; 65-17 Fearless Johnny; 66-13 Half Note; 68-50 Speckled Start [68-11]; 69-32. Х USS Hoel (DDG-13): 63-2 Autumn Gold. Х USS Berkeley (DDG-15): 65-13 High Low. Х USS Navarro (APA-215): 63-1 Eager Belle II; 63-2 Autumn Gold. Х USS Okanogan (APA-220): 65-13 High Low. Х USS Fort Snelling (LSD-30): 69-10. Х USS Tioga County (LST-1158): 63-1 Eager Belle II; 63-2 Autumn Gold. Х USS Wexford County (LST-1168): 65-13 High Low. Х USS Carpenter (DD-825): 63-1 Eager Belle II; 63-2 Autumn Gold. Х USS Herbert J. Thomas (DD-833): 66-5 Purple Sage; 66-6 Scarlet Sage; 69-31. Х USS Power (DD-839): 65-1 Copper Head. Х USS Fechteler (DD-870): 65-13 High Low. Х USS Carbonero (SS-337): 65-6 Big Tom; 66-13 Half Note; 68-71 Folded Arrow. Х USNS Samuel Phillips Lee (T-AGS 31): 70-C. Х USNS Silas Bent (T-AGS 26): 70-C [Source: Billings Gazette Mike Dennison article 6 Jun 08 ++] VA LAWSUIT (LACK of CARE) UPDATE 08: A federal judge considering a lawsuit that alleges inadequate veteransТ medical care on 5 JUN ordered government lawyers to explain an e-mail by a Veterans Affairs psychologist suggesting that counselors diagnose fewer post-traumatic stress disorder cases in soldiers. The hearing ordered by U.S. District Court Judge Samuel Conti follows a two-week trial that ended last month. Veterans groups had sued VA, saying it inadequately addressed a Уrising tideФ of mental health problems, especially post-traumatic stress disorder and suicides. The plaintiffs asked Conti to reopen the case in light of the e-mail discovered after the trial ended. The judge agreed, saying Уthe e-mail raises potentially serious questions that may warrant further attention.Ф He ordered lawyers for both sides to appear in court 10 JUN to discuss whether the e-mail has any bearing on the case. The document in question is a 20 MAR memo written by Norma Perez, who helps coordinate a post-traumatic stress disorder clinical team in central Texas. УGiven that we are having more and more compensation-seeking veterans, IТd like to suggest that you refrain from giving a diagnosis of PTSD straight out,Ф Perez wrote to VA counselors. УWe really donТt or have time to do the extensive testing that should be done to determine PTSD.Ф The e-mail was forwarded to VoteVets.org, an Iraq and Afghanistan war veterans lobbying group opposed to the Bush administrationТs handling of the war and veterans issues. Lawyers for the veterans groups argue that PerezТs e-mail goes to the heart of their case, showing VAТs indifference to treating mental health. УThis is not Joe the janitor writing this,Ф said vetsТ lawyer Arturo Gonzalez. УThis is a supervisor and it shows how the VA thinks.Ф Gonzalez wants the judge to add the e-mail to the evidence given to him at the nonjury trial in support of the lawsuit. On 4 JUN, DOJ lawyer James Schwartz wrote the judge a letter arguing that the e-mail was a mistake, that Perez had been УcounseledФ and that it has nothing to do with the lawsuit. УIt was the action of a single individual that in no way represented the policies of VA, that, once discovered, was dealt with quickly and appropriately,Ф Schwartz told the judge. [Source: Air Force Times AP Paul Elias article Posted 6 JUN 08 ++] TRICARE GRAY AREA RETIREE BILL: Rep. Bob Latta (R-OH) has sponsored legislation (H.R.6185) that would let reservists who are enrolled in Tricare Reserve Select (TRS) to continue that coverage after they retire until they reach age 60, when they become eligible for free Tricare coverage under current law. Reservists and MOAA who worked closely with Rep. Latta's staff in crafting the legislation believe strongly that it's unfair to extend Tricare coverage to drilling reservists, and then drop them from coverage between the time they stop drilling and the time they attain age 60. Their career of service demands some option for continuity of coverage. Under the new bill, these "gray area" retirees would pay full-cost premiums to participate in Tricare, contrasted with those currently drilling, who pay 28% of the premium, with the remaining 72% subsidized by the military. How much the gray area retirees would have to pay is not quite clear yet. Under current TRS rules, it would be $289 a month for a single person and $975 a month for a family. But a recent GAO report concluded that current TRICARE premiums are 45-75% too high based on actual program costs. As the excessive premiums charged by DoD do not accurately reflect the actual cost of coverage, GAO recommended an Executive Order to correct the overcharging, which has not yet occurred. In the interim both the House and Senate versions of the FY2009 Defense Authorization Bill direct the Pentagon to recompute the premiums based on actual costs. Reservists and veterans who would like to see this inequity corrected are encouraged to go to http://capwiz.com/moaa/issues/bills/?bill=11460441 where they can find a preformatted message urging their U.S. representative to cosponsor H.R. 6185 and the means to send it to their legislators. [Source: MOAA Legislative Update 6 Jun 08 ++] FISHER HOUSE EXPANSION UPDATE 03: Bracing for a generation of war veterans needing long-term medical care, the Fisher House Foundation plans to build two dozen homes near military and Veterans Affairs hospitals in the U.S. By 2011, the non-profit foundation plans to boost its network of 38 homes to 62, said James Weiskopf, executive vice president of communications for the Rockville MD based Fisher House Foundation, Inc. He said the foundation is expecting an influx of veterans from the wars in Iraq and Afghanistan with such ailments as traumatic brain injury and post-traumatic stress disorder. The foundation, created in 1990, builds homes near military or VA medical facilities for families of patients needing a place to stay while their loved ones receive care. Donations allow families to stay at the homes for free. "WeТve largely taken care of the needs of the Army, Navy and the Air Force, but the needs of the [Veterans Affairs] is absolutely huge," Weiskopf said 4 JUN while on a visit to Landstuhl Germany. "They really need these houses. These young men and women have got to have their families with them when theyТre going through their rehabilitation, and the house is the means that allows them to do that." The foundation plans to finish building five homes by the end of this year. Four of those homes are near VA hospitals and clinics. "Our future is really with the [Veterans Affairs clinics]," Weiskopf said. "The long-term signature wound of this war is the traumatic brain injury and that has a long-term period of rehabilitation, and that will be done by the VA." Landstuhl Regional Medical Center, the largest military hospital outside the U.S., has two Fisher Houses that offer 19 rooms. The hospital serves war wounded and patients stationed at bases across Europe. Weiskopf said there are no plans to build any additional houses at Landstuhl because they currently have enough space to accommodate the need. [Source: Stars and Stripes Scott Schonauer article 6 Jun 08 ++] VETERAN RURAL HEALTH ADVISORY COMMITTEE: Secretary of Veterans Affairs Dr. James B. Peake has appointed 13 people to a new Veterans Rural Health Advisory Committee, which will advise him on health care issues affecting veterans in rural areas. The 13-member group will examine ways to enhance Department of Veterans Affairs (VA) health care services for veterans in rural areas by evaluating current programs and identifying barriers to health care. The committee, chaired by James F. Ahrens, former head of the Montana Hospital Association, includes affected veterans, rural health experts in academia, state and federal professionals who focus on rural health, state-level veteransТ affairs officials, and leaders of veterans service organizations. Members appointed are: Х James F. Ahrens of Cascade MT - Former member of Montana governor's task force on health care. Х Dr. Robert Moser of Tribune KS - Physician who practices in rural Kansas and Colorado. Х Cynthia Barrigan of Centreville VA - Veteran, now acting executive director of Virginia Telehealth Network. Х Charles Abramson of Missoula MT - Air Force veteran who served on the medical staff ethics committee of St. Patrick Hospital. Х Maj. Gen. John W. Libby of Sidney ME - Adjutant general of the Maine National Guard. Х Hilda Heady of Morgantown WV - Social worker and associate vice president for West Virginia Rural Health Association. Х Dr. Ronald Franks of Theodore AL - Psychiatrist and vice president of the College of Medicine at the University of South Alabama. Х Bruce Behringer of Johnson City TN - Assistant vice president at East Tennessee State University for Rural and Community Health. Х Rachel Gonzales Hanson of Uvalde TX - Member of National Association of Community Health Centers. Х Tom Ricketts, Ph.D., of Chapel Hill NC - Director of North Carolina Rural Health Research Program. Х Michael Dobmeier of South Grand Forks ND - National Judge Advocate of the DAV and president of the North Dakota Veterans Home Foundation. Х Terry Schow of Ogden UT - Veteran and executive director of the Utah Division of VA. Х James Floyd of Salt Lake City UT - Native American and director of the Salt Lake City VA Medical Center. [Source: VA News Release 5 Jun 08 ++] WI VET EDUCATIONAL BENEFITS: The Wisconsin G.I. Bill is a state program that is entirely separate from the federal VA's Montgomery G.I. Bill. It provides a full waiver (remission) of tuition and fees for eligible veterans and their dependents for up to 8 full-time semesters or 128 credits at any University of Wisconsin System (UWS) or Wisconsin Technical College System (WTCS) institution for continuing education, or for study at the undergraduate or graduate level. In accordance with 2005 Wisconsin Act 468 effective with the 2007-08 academic year, the tuition remission is a full 100% of tuition and fees for eligible veterans. There is no post-service time limitation (such as the federal Montgomery G.I. Bill 10-year delimiting date) on the use of the benefit. The veteran may attend full-time or part-time. The benefit may be used for continuing education, or for study at the undergraduate or graduate level. Eligibility prerequisites are Wisconsin resident at the time of entry onto active duty (Character of service and active duty service requirements apply) and recipient must reside in Wisconsin. A 100% remission is also provided to the qualifying dependents of an eligible veteran (i.e. Spouse; or Unremarried Surviving Spouse; or child between the ages of 18 and 25) where the qualifying Wisconsin veteran: Х Is currently rated by the federal VA with a combined service-connected disability rating of 30% or greater; or Х Died in the line of duty while on active, Reserve, or Guard duty; or Х Died as the direct result of a service-connected disability, as determined by the federal VA. For qualifying spouses and unremarried surviving spouses, the benefit must be used within 10 years of the date of death or the initial disability rating of 30% or greater. The spouse or unremarried surviving spouse may attend full-time or part-time. For qualifying children, the benefit is available only if they attend full-time. The Veterans Education (VetEd) grant program provides a reimbursement grant following successful course completion at an eligible UW, technical college, or approved private institution of higher learning. The grant is based on a credit-bank system that is based on length of active duty military service to eligible veterans who have not yet been awarded a bachelor's degree for the reimbursement of tuition and fees. The veteran and spouse's combined annual income may not exceed $47,500 plus $500 for each dependent in excess of two dependents. Veterans may concurrently receive Chapter 30 Montgomery G.I. Bill (VA) benefits and VetEd for the same semester. However, individuals eligible for Wisconsin G.I. Bill benefits must apply for, and use those benefits in order to be eligible for VetEd reimbursement. VetEd reimbursement will be reduced to the extent that tuition and fees have already been paid by other grants, scholarships, and remissions provided for the payment of tuition and fees. Service members, reservists, and veterans pursuing a college education may be able to obtain academic credit for military courses they have completed through the military. Prior to enrollment individuals should discuss possible credit with the VeteransТ Coordinator at the college or university they plan to attend; credit received may reduce attendance time and cost. They may obtain information regarding transcripts and potential credit for military experience from the links below. Х The American Council on Education's (ACE): Their College Credit Recommendation Service (CREDIT) provides access to academic credit for formal courses and examinations taken outside traditional degree programs. The ACE Guide to the Evaluation of Educational Experiences in the Armed Services contains recommended credit awards for formal military courses and occupations. http://www.acenet.edu. Х The Department of Defense Activity for Non-Traditional Education Support (DANTES): Coordinates several programs that advance the acceptance of military education and experience at civilian colleges and universities. Additionally, DANTES maintains the educational records of service members who have completed DSSTs, CLEP examinations, USAFI (United States Armed Forces Institute) and GED tests .http://www.dantes.doded.mil/dantes_web/danteshome.asp?Flag=True . Х Military Transcript Services: Each branch of service provides transcripts for current and former service members that include individual military education, training, and experience, which are evaluated according to ACE standards for recommended college credit. Refer to Army http://aarts.army.mil. ; USN & USMC https://www.navycollege.navy.mil/transcript.html; and USAF http://www.maxwell.af.mil/au/ccaf/transcripts.asp; Х The DANTES Subject Standardized Tests (DSSTs): Approved by ACE and accepted or administered at over 1,900 colleges and universities nationwide. DSSTs enable people to use the knowledge acquired outside the classroom to accomplish educational and professional goals. The website includes downloadable forms, practice tests, and other information. http://www.getcollegecredit.com. Х Servicemembers Opportunity Colleges (SOC): A consortium of over 1800 colleges and universities pledged to support the higher education needs of military personnel. SOC works with civilian and military educators to overcome obstacles associated with gaining a college education when pursued through traditional means. Among its key goals is the award of credit for military training and experience. The SOC Consortium Guide provides specific information for awarding credit for national testing programs, military experience, and other non-traditional learning. http://www.soc.aascu.org/socgen/SOCGuide.html. [Source: http://dva.state.wi.us/Ben_education.asp Jun 08 ++] PTSD UPDATE 21: A Veterans Affairs Department psychologist denies that she was trying to save money when she suggested that counselors make fewer diagnoses of post-traumatic stress disorder in injured soldiers. Norma Perez, who helps coordinate a post-traumatic stress disorder clinical team in central Texas, indicated she might have been out of line to cite growing disability claims in her 20 MAR e-mail titled УSuggestion.Ф She said her intent was simply to remind staffers that stress symptoms could also be adjustment disorder. The less severe diagnosis could save VA millions of dollars in disability payouts. УIn retrospect, I realize I did not adequately convey my message appropriately, but my intent was unequivocally to improve the quality of care our veterans received,Ф Perez said in testimony prepared for delivery4 JUN before a Senate panel. The Senate VeteransТ Affairs Committee and the VA inspector general are investigating whether there were broader VA policy motives behind the e-mail, which was obtained and disclosed last month by two watchdog groups. VA has strenuously denied that cost-cutting is a factor in its treatment decisions. УOne question that was raised repeatedly about this latest e-mail was, СWhy would a clinician be so concerned about the compensation rolls?ФТ said Sen. Daniel Akaka (D0HI) who chairs the Senate panel. УAs an oversight body, we must know whether the actions of these VA employees point to a systemic indifference to invisible wounds.Ф VA Secretary James Peake has called PerezТs e-mail suggestion Уinappropriate.Ф VA officials this week said her e-mail was taken out of context. УThe e-mail, as characterized by others, does not reflect the policies or conduct of our health care system,Ф said Michael Kussman, VAТs undersecretary for health, in testimony prepared for the Senate hearing. УWe certainly agree that it could have been more artfully drafted.Ф In her e-mail to staffers at the VA medical center in Temple, Texas, Perez wrote, УGiven that we are having more and more compensation-seeking veterans, IТd like to suggest that you refrain from giving a diagnosis of PTSD straight out. ... We really donТt or have time to do the extensive testing that should be done to determine PTSD.Ф Many veterans and injured troops have long charged that the government might seek to reduce disability costs by assigning a lower benefits rating. Last year, retired Lt. Gen. James Terry Scott, chairman of the VeteransТ Disability Benefits Commission, said he believed the Army might at least subconsciously consider cost. A lawsuit filed in San Francisco accuses VA of misclassifying PTSD claims. In her testimony, Perez said symptoms for PTSD and adjustment disorder are often similar, as are the treatments for them. She said by making an initial diagnosis of a lesser disorder, VA staff can begin treatment right away without going through the arduous process of diagnosing PTSD. Perez also noted that awarding disability benefits is not part of her staffТs work, but she did not say why she chose to cite that as a factor in urging fewer PTSD diagnoses. Veterans diagnosed with PTSD are eligible to receive up to $2,527 a month in government benefits. A recent Rand Corp. study found about 300,000 U.S. military personnel who served in Iraq or Afghanistan are suffering from PTSD or major depression, potentially saving the government millions of dollars if lesser diagnoses are used in disability benefits decisions. УAlthough our clinic is a treatment clinic, we all fully support the compensation process and the departmentТs policy of erring in the best interest of the veteran whenever there is any doubt,Ф Perez wrote. PerezТs testimony comes after Peake was called to Capitol Hill last month to answer questions about internal e-mails suggesting that VA officials were hiding the number of veterans trying to kill themselves. One of the e-mails, disclosed during a San Francisco trial, started with УShh!Ф Some lawmakers have said the VAТs top mental health official who wrote it, Dr. Ira Katz, should be fired, but Peake has said he has no plans to do so. [Source: Air Force Times AP article Posted 4 Jun 4 08 ++] CT VET EDUCATIONAL BENEFITS: Veterans may attend Connecticut Public Colleges and Universities tuition free. Connecticut statutes provide that tuition may be waived for qualified veterans attending the University of Connecticut, Connecticut State Universities and the 12 Community-Technical Colleges. Waivers cover only the cost of tuition for credit-bearing undergraduate and graduate programs. Other charges, such as for books, student activity and course fees, parking, and room and board, are not waived. To qualify for a waiver at the University of Connecticut and Connecticut State Universities, veterans generally must be matriculated, that is, admitted to a degree program. The Community-Technical Colleges are more flexible. Remember to take a copy of your separation papers with you when applying for admission and registering for courses. Tuition waivers for veterans cover 100% of tuition for General Fund courses at all public colleges and universities and 50% for Extension Fund and summer courses at Connecticut State Universities. Waivers cover only the cost of tuition for credit-bearing undergraduate and graduate programs. Other charges, such as for books, student activity and course fees, parking, and room and board, are not waived. To be eligible for veteransТ tuition benefits at any college or university, a veteran must be honorably discharged from the U.S. Armed Forces with 90 days or more active Military duty during war, and must have resided in Connecticut for at least one year upon enrolling in college, and have been accepted to an approved institution. A veteranТs dependents can also qualify for tuition waiver if the veteran is declared missing in action while serving in the armed forces after 1 JAN 06. On 23 May 08 Connecticut Governor M. Jodi Rell signed SB 48 into law. The new law requires state institutions of higher learning to waive tuition for any state resident who is a dependent or surviving spouse of an active duty military member who was a Connecticut resident and killed in action after September 11, 2001. Also, Local Boards of Education may award high school diplomas to those World War II veterans who did not receive them when they left high school before graduation for military service. [Source: NMFA eNews & www.ct.gov/ctva/site/default.asp 3 Jun 08 ++] WALTER REED DATA BREACH: Sensitive information on about 1,000 patients at Walter Reed Army Medical Center and other military hospitals was exposed in a security breach, sparking identity theft concerns and an investigation by the Army. The chairman of the House Armed Services Committee, Rep. Ike Skelton (D-MO), said he wants to hear from the Army about its investigation. Names, Social Security numbers, birth dates and other information were released, hospital officials said 2 JUN. The computer file that was breached did not include information such as medical records, or the diagnosis or prognosis for patients, they said. Walter Reed officials declined to explain exactly how the information was compromised, pending an ongoing investigation by the hospital and the Army. They would only say that the computer file was found on a "non-government, non-secure computer network." The medical center learned of the breach on 21 MAY from an outside data mining company, which officials did not identify. They said the company was working for another client, found the file and contacted Walter Reed. The hospital said it is working to notify all of the people named in the data file. Letters or e-mails were being sent out, beginning Monday. Officials declined to say how many patients were from Walter Reed and how many were from other military hospitals. Walter Reed plans to offer free credit protective services to patients whose information was revealed. The hospital also has set up a hot line for people to call to see if their information was disclosed (1-877-854-8542, ext. 9). The disclosure marked the latest in a series of breaches of government computer records. The federal government has been stung by a rash of data breaches in recent years. Х At the Agriculture Department, a hacker broke into the computer system in June 2006 and may have obtained names, Social Security numbers and photos of 26,000 Washington-area employees and contractors. Х The Veterans Affairs Department acknowledged a massive breach in May 2006, in which personal data on up to 26.5 million veterans was lost. Х At the Health and Human Services Department, personal information for nearly 17,000 Medicare beneficiaries may have been compromised in early 2006 when an insurance company employee called up the data through a hotel computer but didn't delete the file. Х At the Energy Department, Social Security numbers and other data for about 1,500 people working for the National Nuclear Security Administration may have been compromised when a hacker gained entry to its computer system in 2005. [Source: Washington Post Jennifer C. Kerr article 2 Jun 08 ++] U of U HOSPITAL DATA BREACH: University of Utah Hospital and Clinics patients are bracing for the unknown as police and prosecutors investigate the theft of 2.2 million billing records filled with personal information. Authorities say the records, stolen out of a courier's personal vehicle earlier this month, put the private data of patients from the past 16 years at risk. Measures taken so far include offering free credit monitoring services for at least 1.3 million patients whose Social Security numbers were compromised, and a $1,000 reward for the return of the tapes - no questions asked. Salt Lake County Sheriff Jim Winder and Lorris Betz, a senior vice president for health sciences for University Health Care, say the stolen records were on backup tapes designed to safeguard the records in case materials housed in the hospitals and clinics were destroyed. The tapes were taken from the vehicle of an employee of Sandy-based Perpetual Storage Inc. near the employee's Kearns home on 2 JUN. The employee had been assigned to pick up the tapes in a secure company van and transport them to an off-site vault, said James Nowa, a vice president for sales and marketing for Perpetual Storage. He violated company policy by taking them home and leaving them in his car. A thief then broke into the employee's vehicle stealing a metal box holding the tapes, Winder said. Nowa said the 18-year veteran employee has been fired, and the incident is the first of its kind he knows of in the company's 40-year history. An investigation is ongoing, but the theft appears to be the work of inexperienced criminals, who likely believed the metal box containing the tapes was filled with cash, said Winder. After collaborating with the FBI, Winder said it's unlikely the tapes were stolen to commit identity theft. There's no evidence any of the information on the tapes has been accessed; besides, anyone trying to use the tapes would need specialized equipment to view the contents, Winder said. But there are also no guarantees. Melodie Rydalch, spokeswoman for the U.S. Attorney's Office, said the FBI and the Utah Identity Task Force, which includes local and county law enforcement agencies, is investigating the thefts. She warned of federal penalties for anyone who uses stolen identities. Betz said the university delayed releasing news of the security breach to the public until the sheriff's office had completed an initial investigation. The university had worked with Perpetual Storage for 12 years before the theft but suspended deliveries after the incident. An assessment of university data security policies and procedures is under way, Betz said. [Source: Salt Lake Tribune Melinda Rogers article 11 Jun 08 ++] BANK of NY DATA BREACH: The Connecticut attorney general announced that a Bank of New York Mellon contractor lost a laptop containing the personal information of some 4.5 million bank customers. An unencrypted backup tape holding the personal information disappeared on 27 FEB while in possession of a third-party vendor. Potential victims did not learn of this until 27 MAY giving them little chance of protecting themselves. Andy Kicklighter, director of product marketing for GuardianEdge, provider of mobile data protection solutions, said businesses must prioritize the need for laptop encryption and search for solutions that allow for simple implementation and manageability. "IT organizations are afraid that it will be a big project," he said, adding that companies who have never experienced a data-loss incident also have difficulty understanding the ramifications of a breach. "It just hasn't reached their priority level," Kicklighter told SCMagazineUS.com. (EditorТs Note: From the preceding it is once again evident that the government it not the only entity having limited control over data breaches resulting from human error. Veterans need to protect themselves against personal losses through some form of identity theft insurance). An undisclosed number of management-level workers at AT&T have been notified that their personal information was stored unencrypted on a stolen laptop. The laptop was stolen 15 MAY from the car of an employee. The data on the computer was not encrypted -- a violation of company policy -- and included names, Social Security numbers and in some cases, salary and bonus information. Walt Sharp, a spokesman for AT&T said the company would not disclose the number of affected individuals, but indicated there is no reason to believe any of the data was being targeted when the machine was stolen. "Usually these are property crimes in which the drive is wiped clean and resold for profit," he said. The employee who was in possession of the laptop when it was stolen has been disciplined. "There are a number of rules governing the handling of encrypted material and the mobile devices handling that material that employees must follow," Sharp said. "It is up to the employee to ensure that any sensitive material is encrypted." AT&T began notifying victims on 23 May through email and standard mail and is offering them free credit monitoring. AT&T used the breach as a reminder that employees must follow policies. [Source: SC Magazine Dan Kaplan article 4 Jun 08 ++] ALZHEIMERТS UPDATE 04: More than a third of U.S. adults have a family member or friend who has AlzheimerТs. Half of those who live past age 85 will succumb to Alzheimer's disease. It is a progressive neurological disorder that leads to personality changes, memory loss, intellectual slowing and difficulty with regular activities. Although each person with Alzheimer's is different, most individuals affected by the disease progress through a series of stages. Each stage is characterized by more serious symptoms. Although the stages provide a blueprint for the progression of Alzheimer's disease, not everyone advances through the stages similarly. Caregivers report that their loved ones sometimes seem to be in two or more stages at once, and the rate at which people advance through the stages is highly individual. Still, being aware of the stages will help you understand the disease and prepare for potential symptoms and their accompanying challenges. The following seven stages were developed by researchers and physicians to describe how your or your loved one's functioning will change over time. Your doctor might consolidate the seven stages into early/middle/late or mild/moderate/severe, so these classifications are provided as well: Stage 1 (Absence of Impairment): There are no problems with memory, orientation, judgment, communication, or daily activities. You or your loved one is a normally functioning adult. Stage 2 (Minimal Impairment): You or your loved one might be experiencing some lapses in memory or other cognitive problems (i.e.faculty for processing of information, applying knowledge and changing preferences) , but neither family nor friends are able to detect any changes. A medical exam would not reveal any problems either. Stage 3 (Noticeable Cognitive Decline): Family members and friends recognize mild changes in memory, communication patterns, or behavior. A visit to the doctor might result in a diagnosis of early-stage or mild Alzheimer's disease, but not always. Common symptoms in this stage include: Х Problems producing people's names or the right words for objects. Х Noticeable difficulty functioning in employment or social settings. Х Forgetting material that has just been read. Х Misplacing important objects with increasing frequency. Х Decrease in planning or organizational skills Stage 4 (Early-Stage/Mild Alzheimer's): Cognitive decline is more evident. You or your loved one may become more forgetful of recent events or personal details. Other problems include impaired mathematical ability (for instance, counting backwards from 100 by 9s), a diminished ability to carry out complex tasks (for example, throwing a party or managing finances), moodiness, and social withdrawal. Stage 5 (Middle-Stage/Moderate Alzheimer's): Some assistance with daily tasks is required. Problems with memory and thinking are quite noticeable, including symptoms such as: Х An inability to recall one's own contact information or key details about one's history. Х Disorientation to time and/or place. Х Decreased judgment and skills in regard to personal care (Note: Even though symptoms are worsening, people in this stage usually still know their own name and the names of key family members and can eat and use the bathroom without assistance.) Stage 6 (Middle-Stage/Moderate to Late-Stage/Severe Alzheimer's): This is often the most difficult stage for caregivers because it's characterized by personality and behavior changes. In addition, memory continues to decline, and assistance is required for most daily activities. The most common symptoms associated with this stage include: Х Reduced awareness of one's surroundings and of recent events. Х Problems recognizing one's spouse and other close family members, although faces are still distinguished between familiar and unfamiliar. Х Sundowning, which is increased restlessness and agitation in the late afternoon and evening. Х Difficulty using the bathroom independently. Х Bowel and bladder incontinence (i.e. strong, sudden urges to go to the bathroom , frequent trips to the bathroom, and leakage). Х Suspicion. Х Repetitive behavior (verbal and/or nonverbal). Х Wandering Stage 7 (Late-Stage/Severe Alzheimer's): In the final stage, it is no longer possible to respond to the surrounding environment. You or your loved one may be able to speak words or short phrases, but communication is extremely limited. Basic functions begin to shut down, such as motor coordination and the ability to swallow. Total care is required around the clock. [Source: http://alzheimers.about.com/od/symptomsofalzheimers/a/symptoms.htm Jun 08 ++] VA PTSD CLAIM SUPPORT UPDATE 01: Post traumatic stress disorder (PTSD) happens after a person faces some traumatic incident that affects the mind and soul of the person deeply. It involves intense fear, helplessness and horror that happens because of previously experienced events. A person is not able to forget the incident and the memories and the picture of the incident keep coming back which ultimately becomes a big stressor which affects their behavior and/or health. The person gets overly worried about the incident and becomes depressed. PTSD stress disorder shows many symptoms that work as stressors. Symptoms are: Х Poor concentration and short term memory. Х Depression and Apathy. Х Difficulty in communicating. Х Physical problems. Х Emotional numbing. Х Difficulty in trusting others. Х Stress. Х Anger & Rage. Х Frustration. Х Irritability. Х Isolation. Х Poor self esteem. Х Negative self image. Х Lack of feelings. Х Hypervigilant. Х Easily startled. Х Sleep disturbance or insomnia. Х Flashbacks. Х Anxiety. Х Loss of interest and motivation. Х Poor judgment. Х Guilt and Survivor guilt. Х Intrusive memories. If you received a diagnosis of PTSD while on active duty and are suffering from any of the above symptoms you have the basis for a VA claim for PTSD. If your medical records do not show you were previously diagnosed or treated for PTSD and you are suffering from any of the above which you feel is related to your service you can submit a claim but must provide proof of involvement in a combat scenario if your claim is based on a combat stressor. The VA concedes that receipt of any of a Decoration denoting Combat Service (Combat Action Ribbon, Combat Infantry Badge, etc.), a Decoration for Valor in Combat (Service Achievement or Commendation Medal, Bronze Star, etc.), with УVФ for Valor, or a Purple Heart Medal, are grounds to file a claim with the VA for service-connection of PTSD. To initiate the claim the Veteran just needs to make a simple written statement of the symptoms he (or she) is experiencing at present. When veterans are in denial and won't admit the severity of their disability it is helpful if a relative or close friend also makes a separate written statement of the symptoms they've observed in the Veteran. Call the VA at 1(800) 829-1000 and ask for the location of the nearest VA Veterans Center or Healthcare Facility that can assist you. [Source: VFW VSO Scott H. Langhoff article 2 Jun 08 ++] MEDICARE FRAUD UPDATE 06: Fraud and abuse costs Medicare an estimated 16 billion dollars every year and leads to higher costs for everyone with Medicare in the form of higher premiums, deductible and other costs. Doctors and other health care providers who commit Medicare fraud may be dishonest about other things as well. Reporting fraud can help Medicare ensure that people with Medicare receive health care only from health care professionals who provide quality services. If you report fraud that cost Medicare more than $100, Medicare may pay you up to 10% of the money you helped recover, up to $1,000. To report Medicare fraud, call the Medicare fraud hotline at (800) 447-8477 or send Fax to (800) 223-8164 or email HHSTips@oig.hhs.gov, or mail to Office of Inspector General , Department of Health and Human Services, Attn: HOTLINE, PO Box 23489, Washington, DC 2002 and provide the following: Х Personal Data - Your Name, full mailing address and email addee. If you would like your referral to be submitted anonymously indicate in your correspondence or phone call. Х Subject/Person/Business/Department that allegation is against and the accused full mailing address. Х A brief summary relating to your allegation. Last year 20% of all Medicare Fraud cases in the U.S. were prosecuted in South Florida. This a much greater amount than other larger metropolitan areas around the country. In 2007, U.S. Attorney R. Alexander Acosta and the Justice Department established a South Florida strike force of federal agents and prosecutors to target fraudulent providers. The South Florida strike force prosecuted 120 criminal and civil cases against 200 defendants who were charged with more than $638 million in fraudulent Medicare claims. It is considered Medicare fraud is when doctors or other providers deceive Medicare into paying when it should not or paying more than it should. This is against the law and should be reported. Some types of fraud include Х Billing Medicare for services you never received; Х Billing Medicare for services that are different than the ones you received (usually more expensive); Х Continuing to bill Medicare for rented medical equipment after you have returned it; Х Offering or performing services that you do not need in order to charge Medicare for more services; Х Telling you that Medicare will pay for something when it wonТt; Х Using another personТs Medicare number or card [Source: Medicare Rights Center 2 Jun 08 ++] NATIONAL MONUMENTS: President Bush has asked his defense and interior secretaries to look into designating Pearl Harbor and other historic World War II sites in the Pacific a national monument. A 29 MAY presidential memo to Defense Secretary Robert Gates and Interior Secretary Dirk Kempthorne said such status could offer the sites additional protection. УThese objects of historical and scientific interest may tell the broader story of the war, the sacrifices made by America and its allies, and the heroism and determination that laid the groundwork for victory in the Pacific and triumph in World War II,Ф Bush said. The letter, posted on the White House Web site, doesnТt say what specific places Bush has in mind aside from Pearl Harbor. Parts of the naval base which are already under some form of protection or have historic designation. The USS Arizona, an underwater grave for over 1,100 sailors and Marines unable to escape the ship before it sank during the Dec. 7, 1941, Japanese attack, is currently part of the USS Arizona Memorial run by the National Park Service. Ford Island, where several of the NavyТs battleships were moored during the attack, is a National Historic Landmark. The island, located at the center of Pearl Harbor, is home to historic airplane hangers that survived the aerial assault. A red and white striped airplane control tower on Ford Island delivered the first radio broadcast of the attack. Next door to Pearl Harbor, the top Air Force commander in the Pacific today has his headquarters in a building that served as barracks for Army airmen in 1941. Bullet holes left by Japanese machine guns are still visible on the outside of the structureТs concrete walls. Outside Hawaii, crucial battles were fought at Midway, Wake and Guam islands. All are still U.S. territory. Today, Midway is mainly a wildlife bird refuge and key node in the island chain making up the Papahanaumokuakea Marine National Monument that Bush established in 2006. The former naval base, where the U.S. defeated Japan in June 1942 to turn the tide of World War II in the Pacific, was named a National Historic Landmark in 1986. Many areas Ч particularly Pearl Harbor, Hickam Air Force Base, and Guam Ч that would likely be eligible for inclusion in the monument are still actively used today by the U.S. military. Making them part of a monument could complicate daily operations for the services. But BushТs memo told Gates and Kempthorne that national monument classification shouldnТt interfere with the militaryТs business. The Antiquities Act of 1906 gives the president the authority to make national monuments of Уhistoric landmarks, historic and prehistoric structures, and other objects of historic or scientific interest.Ф The president doesnТt need Congressional approval to do designate monuments. Other national monuments include the Statue of Liberty, designated by Calvin Coolidge in 1924, and the Grand Canyon, made a national monument by Herbert Hoover in 1932. [Source: Navy Times AP Audrey McAvoy article posted 1 Jun 08 ++] HAVE YOU HEARD: A guy is driving around the back woods of Tennessee and he sees a sign in front of a broken down shanty-style house: "Talking Dog for Sale" He rings the bell and the owner appears and tells him the dog is in the backyard. The guy goes into the back yard and sees a nice looking Labrador retriever sitting there. "You talk?" he asks. "Yep," the lab replies. After the guy recovers from the shock of hearing a dog talk, he says "So, what's your story?" The Lab looks up and says, "Well, I discovered that I could talk when I was pretty young. I wanted to help the government, so I told the CIA and they had me sworn into the toughest branch of the armed services...the United States Marines. You know one of their nicknames is "The Devil Dogs." In no time at all they had me jetting from country to country, sitting in rooms with spies and world leaders; because no one figured a dog would be eavesdropping. I was one of their most valuable spies for eight years running, but the jetting around really tired me out, and I knew I wasn't getting any younger. So, I decided to settle down. I retired from the Corps (8 dog years is 56 Corps years) and signed up for a job at the airport to do some undercover security, wandering near suspicious characters and listening in. I uncovered some incredible dealings and was awarded a batch of medals. I got married, had a mess of puppies, and now I'm just retired." The guy is amazed. He goes back in and asks the owner what he wants for the dog. "Ten dollars," the guy says. "Ten dollars? This dog is amazing! Why on earth are you selling him so cheap?" "Because he's such a liar. He never did any of that stuff. He was in the Navy!" VETERAN LEGISLATION STATUS 13 JUN 08: Refer to the BulletinТs House & Senate attachments for a listing of Congressional bills of interest to the veteran community that have been introduced in the 110th Congress. Support of these bills through cosponsorship by other legislators is critical if they are ever going to move through the legislative process for a floor vote to become law. A good indication on that likelihood is the number of cosponsors who have signed onto the bill. A cosponsor is a member of Congress who has joined one or more other members in his/her chamber (i.e. House or Senate) to sponsor a bill or amendment. The member who introduces the bill is considered the sponsor. Members subsequently signing on are called cosponsors. Any number of members may cosponsor a bill in the House or Senate. At http://thomas.loc.gov you can review a copy of each billТs content, determine its current status, the committee it has been assigned to, and if your legislator is a sponsor or cosponsor of it. To determine what bills, amendments your representative has sponsored, cosponsored, or dropped sponsorship on refer to http://thomas.loc.gov/bss/d110/sponlst.html. The key to increasing cosponsorship on veteran related bills and subsequent passage into law is letting our representatives know of veteranТs feelings on issues. At the end of some listed bills is a web link that can be used to do that. You can also reach his/her Washington office via the Capital Operator direct at (866) 272-6622, (800) 828-0498, or (866) 340-9281 to express your views. You can locate on http://thomas.loc.gov who your representative is and the phone number, mailing address, or email/website to communicate with a message or letter of your own making. Refer to http://www.thecapitol.net/FAQ/cong_schedule.html for future times that you can access your representatives on their home turf. [Source: RAO Bulletin Attachment 29 May 08 ++] Lt. James УEMOФ Tichacek, USN (Ret) Director, Retiree Assistance Office, U.S. Embassy Warden & IRS VITA Baguio City RP PSC 517 Box RCB, FPO AP 96517 Tel: (951) 238-1246 in U.S. or Cell: 0915-361-3503 in the Philippines. Email: raoemo@sbcglobal.net Web: http://post_119_gulfport_ms.tripod.com/rao1.html AL/AMVETS/DAV/FRA/NAUS/NCOA/MOAA/USDR/VFW/VVA/CG33/DD890/AD37 member
THIS BULLETIN CONTAINS THE FOLLOWING ARTICLES == Veterans Benefits Expirations ------------------ (Did you Know?) == MN Disabled Property Tax Exclusion -------- (Up to $300,000) == Veteran's Pensions -------------------------------- (Did you know?) == Long Term Care w/Medicaid --------------------------- (Coverage) == CRSC [38] ------------------------------------------ (Phishing Scam) == Army Combat Action Badge [01] ----- (Retroactive Award Bill) == Mobilized Reserve 28 MAY 08 ----------------- (2927 Decrease) == VA Claim Backlog [15] -------------- (GAO Faults VA Training) == SSA Trust Fund ------------------------------- (In Trouble) == Medicare Trust Fund ----------------------------------- (In Trouble) == Award Modifications ----------------------------- (TIOH Changes) == CRSC under Disability Retirement ---------- (How to Compute) == Legislation of Interest [10] -------- (Houses Passes 10 Vet Bills) == Veterans Tax Relief ----------------------------- (H.R.6081Passes) == GI Bill [23] ------------------------ (Passes Senate 75-22) == VA Commercial Ins Coverage ------------ (National Agreement) == Medicare Drug Use Safety Program -------- (Sentinel Initiative) == VA Emergency Care [02] ------------- (S.2142/H.R.3819 Status) == VA Benefit Rolls ---------------------------------------- (Sep 2007) == SBP SSDI --------------------------------- (Additional $50 Oct 08) == VA Clinic Openings [09] ------------------------------ (H.R 5856) == Iowa Veteran Grant Program --------------- ($500 per Semester) == Tricare Medicaid Coverage ------------- (Tricare Primary Payer) == SSA COLA 2009 ------------------------------- (CPI-W vs. CPI-E) == Economic Stimulus Package [06] --------------- (Filing w/ITINs) == VA Suicide Prevention [04] --------------- (Oversight Authority) == COLA 2009 --------------------------------------------- (3.5% YTD) == Eagle Hammock RV Park ----------------- (MWR Vacation Site) == NDAA 2009 [02] ----------------------- (House passes H.R.5658) == NDAA 2009 [03] ------------- (Anticipated Senate Amendments) == GI Bill [22] ------------------------------ (H.R.2642 Passes House) == VA PTSD Evaluation Criteria ------- (General Rating Formula) == VA PTSD Claim Support ------------------------- (Valor awards) == PTSD Purple Heart [01] ------------------------ (MOPH Opposes) == PTSD [20] ----------------------------------- (VA Diagnosis Policy) == Pennsylvania Vet Bonus [01] ---------- (Applications Available) == Veteran Legislation Status 29 May 08 ------- (Where we Stand) VETERANS BENEFITS EXPIRATIONS: Many of your earned benefits have an expiration date. Below are several of the more important ones to remember. Make sure you know take advantage of your benefits before they expire. - Tuition Assistance: $4,500 a year that expires as soon as you transition from Active Duty. - Montgomery GI Bill for Active-Duty (MGIB): 10 years from date of last discharge or release from active duty. - Veterans Education Assistance Program (VEAP): 10 years from date of last discharge or release from active duty. - Montgomery GI Bill for Selected Reserve (MGIB-SR): 14 years from the date of eligibility for the program, or until released from the Selected Reserve or National Guard. Some extensions are available if activated. - Vocational Rehabilitation and Employment (VocRehab): Generally, 12 years after separation from service or within 12 years of being awarded service-connected VA disability compensation. - Servicemembers' Group Life Insurance (SGLI): Coverage ends 120 days after separation or can be extended up to 1 year for totally disabled veterans. - Combat Vet VA Health Care: 5 years after discharge for non-service connected care. - Combat Vet VA Dental Care: 180 days after discharge for non-service connected care. [Source: NAUS Weekly Update 30 May 08 ++] MN DISABLED PROPERTY TAX EXCLUSION: A new program enacted in 2008 will provide honorably discharged disabled Minnesota veterans with some, if not all, of their property taxes forgiven beginning in 2009. Qualifying veterans must have the proper paperwork filed with their county assessor's office. Veterans should start the process early in order to file the necessary official military discharge papers and documents verifying disability status before the 1 JUL 08 deadline. Veterans with 70% disability or higher will have $150,000 excluded from the annual market value of their homestead property. Those with a 100% disability rating will receive$300,000 exclusion. A property must be the homestead of a qualified veteran in order to receive this value exclusion. To qualify, a veteran must have been honorably discharged from the United States armed forces as indicated by United States Government Form DD214 or other official military discharge papers, and must be certified by the United States Veterans Administration as having a service-connected disability. In the case of agricultural homesteads, only the house, garage, and immediately surrounding one acre of land will qualify for the exclusion. If a property qualifies for this market value exclusion, the property does not receive the residential homestead market value credit provided under Minnesota Statute 273.1384, subdivision 1. Applications are available in your county assessorТs office or online at. Х CR-DVHE70 http://www.taxes.state.mn.us/taxes/property/forms/cr_dvhe70.pdf Х CR-DVHE100 http://www.taxes.state.mn.us/taxes/property/forms/pe12.pdf. Applications must be made by July 1 to qualify for the exclusion on the current yearТs market value for taxes. Mail or take completed application and required attachments to your county assessor. For more information, visit the Minnesota Department of Veterans Affairs website www.mdva.state.mn.us or telephone Minnesota's Veterans Linkage Line at 1(888)546-5838. [Source: NAUS Weekly Update 30 May 08 ++] VETERAN'S PENSIONS: If you are a wartime veteran with a limited income and you are no longer able to work, you may qualify for a Veterans Disability Pension or the Veterans Pension for Veterans 65 or older. Many veterans of wartime service are completely unaware of the fact that if they are 65 or older and on a limited income they may qualify for a VA Pension without being disabled. An estimated 2 million impoverished veterans and their widows are not receiving the VA pension they deserve because they do not know about it. The VA has had limited success in getting the information to them. You may be eligible if you were discharged from service under other than dishonorable conditions, AND you served 90 days or more of active duty with at least 1 day during a period of war time. With the advent of the Gulf War on 2 AUG 90 (and still not ended by Congress to this day), veterans can now serve after 2 AUG 90 during a period of war time. When they do, they generally now must serve 24 months to be eligible for pension or any other benefit provided they meet the exclusions of 38 CFR 3.12(d). which require you are permanently and totally disabled, or are age 65 or older, AND your countable family income is below a yearly limit set by law. Family Annual Income Limits effective 1 DEC 07 cannot exceed the following: * Veteran with no dependents $11,181 * Veteran with a spouse or a child $14,643 * Veteran married to a veteran $14,643 * Veterans with additional children: add $1,909 to the limit for EACH child * Housebound veteran with no dependents $13,664 * Housebound veteran with one dependent $17,126 * Veteran who needs aid and attendance and you have no dependents $18,654 * Veteran who needs aid and attendance and you have one dependent $22,113 Some income is not counted toward the yearly limit (for example, welfare benefits, some wages earned by dependent children, and Supplemental Security Income). It's also important to note that your medical related expenses are considered when determining your yearly family income. VA pays you the difference between your countable family income and the yearly income limit which describes your situation. This difference is generally paid in 12 equal monthly payments rounded down to the nearest dollar. You can apply by filling out VA Form 21-526, Veteran's Application for Compensation Or Pension. If available, attach copies of dependency records (marriage & children's birth certificates) and current medical evidence (doctor & hospital reports). You can also apply on line through the VONAPP website http://vabenefits.vba.va.gov/vonapp/main.asp. For More Information Call 1(800) 827-1000. [Source: http://www.vba.va.gov/bln/21/pension/vetpen.htmMay 08++] LONG TERM CARE w/MEDICAID: If you qualify for Medicaid, a federal and state program that covers medical care for people with low incomes and very little assets, it will pay for nursing home care and other long-term care (LTC) costs that Medicare does not cover. Medicaid may also pay for some LTC services provided at home. Medicaid is the countryТs largest public payer of long-term care services. Most people with long-term care needs spend down their assets until they are eligible for Medicaid coverage. The Medicaid program varies a great deal from state to state, as well as within each state. This is because within broad national guidelines set by the federal government through the Centers for Medicare and Medicaid Services (CMS), each state can: Х Establish its own eligibility standards; Х Determine the type, amount, duration and scope of services; Х Set the rate of payment for services; and Х Administer its own program. Each state has its own method of determining eligibility depending on your age, family size, medical condition and financial situation. Generally, to be eligible for Medicaid, your monthly income must be less than $867 in 2008* ($1,020 for couples). You also must have little or no assets (savings and investments). If you have high medical expenses, you may still qualify for Medicaid if your income is more than $867 in 2008* ($1,020 for couples). Income levels are based on the Federal Poverty Level (FPL), which goes up every year in February or March. For a list by state of Medicaid descriptions and plans refer to http://64.82.65.67/medicaid/states.html For a list of Medicaid benefits by state refer to http://www.kff.org/medicaid/benefits/state_main.jsp. [Source: Medicare Rights Center www.medicareinteractive.org May 08 ++] CRSC UPDATE 38: A phishing scam has been sent to families of fallen Soldiers. As part of the scam, the proponents request personal information, such as SSN, DOB, addresses, etc., and are instructed to come to either visit the Army Human Resources Command Offices in Alexandria, VA, or email the information to an overseas Yahoo account. Like most scams, the grammar is poor, it is not on official letterhead, nor does it come from a valid Army e-mail account. CRSC will never ask for personally identifiable information to be sent over e-mail due to security concerns. CRSC will never promise payment or award of any kind. CRSC is not eligible for SBP. An example of phishing letter follows: Classification: UNCLASSIFIED Caveats: NONE Supplemental Guidance for Benefit Pay off Section 644, P.L.108-375, Administration Letter (BAL) #98-109, US Army Survivor Benefit Plan). 21 May 2008 Attn: Dear Mr. Mark, We believe you are the next of kin of a deceased officer who died in service in that you bear the same name and last known geographical area of same person. We wish to duly compensate the family by paying the deceased officers benefits and financial entitlements to them. So many deceased officers have the same problem of difficulty in locating their kin but we are doing the best we can. We have gone as far as Asia, Central and southern Africa, Europe, Australia and the Americas in search for next of kin of deceased officers. So the benefits entitled to you amounts to $12,859,555.23 and you can receive it in one week. Our search attorney Mr. Louis Manches undertaking Group B16 search (AMERICA ,EUROPE & AFRICA SEARCH GROUP) found & located you. We need you to come to our office at: U.S. Army Human Resources Command, Army Physical Disability Agency (CRSC), 200 Stovall Street Alexandria , VA 22332-0470 With photocopies of the following documents. (As the originals will not be returnable.) 1. Letter of Introduction or ID of next of kin (In which case you) 2. Sworn affidavit of next of kin. 3. You are also required to complete the forms below. A. FORM DD 2860, CLAIM FOR COMBAT-RELATED SPECIAL COMPENSATION (CRSC) B. FORM DD 2656-7, VERIFICATION FOR SURVIVOR ANNUITY You can download these forms from our US Army Human Resources Command website using the URL (FOR DD FORM 2860) (web links deleted) Or Defense Technical Information website using this URL (FOR DD FORM 2656-7) (web links deleted) To make it simpler for you, if you cant come to our offices yourself to submit these documents due to ill health or whatever you can appeal to your search attorney to file these documents on your behalf. The search attornies are legal practitioners contracted by the United States Army to help locate next of kins who are in various countries of the world. Your name fell among Group 16 Search which complises of beneficiaries from EUROPE,AMERICA & ASIA. The search attorney responsible for this areas is Barrister Louis Manches. It is the search attorney who shortlisted your name for payment. You are therefore advised to contact him if you have difficulty in completing the forms as well as providing the necessary documents. We understand the problems you could face in getting these documents owing to the fact that it has taken a long time when the officer died. You can write your search attorney for clarifications through the following email (e-mail address deleted by S1NET) If you also have problems filling all these forms , just fill out and return by email the short version attached below. Your search attorney will fill the rest of the forms on your behalf but of course you will contact him and negotiate this service with your search attorney. We expect to hear from you soon. H.S. Park Defense Finance and Accounting Service, US Army Human Resources. [Source: USDR Action Alert 29 May 08 ++] ARMY COMBAT ACTION BADGE UPDATE 01: In 2005, the Department of the Army authorized the creation of the Combat Action Badge to recognize U.S. soldiers who engage the enemy in battle. This badge applies to men and women in our armed forces who might not qualify for awards such as the Combat Infantry or Combat Medical Badge, which are limited to those individuals serving with infantry or medical units. There is no doubt that the Combat Action Badge is a great idea; in Iraq and Afghanistan we are seeing soldiers from every military occupational specialty distinguish themselves in battle. However, the Army's current policy limits eligibility to only those individuals who meet its criteria after 18 SEP 01. While the Combat Action Badge recognizes those who have served their country bravely in the 21st century, it overlooks the thousands of veterans who made similar sacrifices in previous wars. To rectify this injustice Rep. Ginny Brown-Waite (R-FL-05) introduced H.R.2267 on 10 MAY 07 to retroactively award the Army Combat Action Badge to those members of the U.S. Army who were engaged by the enemy from 7 DEC 41 to the present day. The bill was then referred to the Subcommittee on Military Personnel. This bill currently has only 27 cosponsors and will die in committee unless veterans take action to move it to the house floor. Those who would like to see the award of this badge to those who meet its criteria prior to 18 SEP 01 are encouraged to contact their legislators and request they support this bill. [Source: The American Legion Online Update 29 May 08 ++] MOBILIZED RESERVE 28 MAY 08: The Army, Air Force and Marine Corps announced the current number of reservists on active duty as of 23APR 08 in support of the partial mobilization. The net collective result is 2,927 fewer reservists mobilized than last reported in the Bulletin for 23 APR 08. 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. The total number currently on active duty in support of the partial mobilization of the Army National Guard and Army Reserve is 77,007; Navy Reserve, 4,543; Air National Guard and Air Force Reserve, 8,135; Marine Corps Reserve, 9,704; and the Coast Guard Reserve, 341. This brings the total National Guard and Reserve personnel who have been mobilized to 99,730, including both units and individual augmentees. A cumulative roster of all National Guard and Reserve personnel, who are currently mobilized, can be found at http://preview.defenselink.mil/news/May2008/d20080528ngr.pdf. [Source: DoD News Release 456-08 28 May 08 ++] VA CLAIM BACKLOG UPDATE 15: In fiscal 2007, VA employed 4,900 staff to handle disability compensation claims, a 40% increase between fiscal 2000 and 2006. Still, in 2007, VA had a backlog of 392,000 claims with an average waiting time of more than four months. This year, VA plans to add 3,100 new claims-processing employees. Although the Veterans Affairs Department has added thousands of staff to help process disability claims, a new study finds those new employees face no consequences if they donТt attend mandatory training. And because the caseload is so heavy, instructors arenТt always available to provide on-the-job training for new employees. The Government Accountability Office (GAO) said in a report released 26 MAY that the VBA Уis taking steps to strategically plan its training, but does not adequately evaluate its training and may be falling short in some areas of training design and implementationФ. Rep. Bob Filner (D-CA), chairman of the House Committee on VeteransТ Affairs, asked GAO to find out what training is provided and whether it is uniform; how well it is implemented and evaluated; and how it compares with performance management practices in the private sector. The questions came after veterans testified that the disability compensation system is Byzantine in complexity, and that it takes months Ч sometimes years Ч to make it through the process. From SEP 07 to MAY 08, GAO looked at four VBA regional offices, in Atlanta; Baltimore; Milwaukee; and Portland OR. VA officials said it takes at least two years to properly train disability claims employees, and they must complete 80 hours of training a year. New employees have three weeks of intense classroom training before they begin several months of on-the-job training at their home offices. But Уbecause the agency has no policy outlining consequences for individual staff who do not complete their 80 hours of training per year, individual staff are not held accountable for meeting their annual training requirement,Ф the GAO found. УAnd, at present, VBA central office lacks the ability to track training completed by individual staff members.Ф In 2007, VBA conducted 67 centralized training sessions for 1,458 new claims processors, compared with 27 sessions for 678 new employees in 2006.nVBAТs online training tool, the Training and Performance Support System, was found to be out of date, too theoretical, and lacking in real-life examples. Employees at one office did not know what the system was. GAO also found that more experienced staff members felt training was not helpful because it was redundant or was not specific to the work they do, and some said the training is adapted directly from training for new employees. They also said they did not have time to spend 80 hours a year in training because their caseloads are too heavy. УA number of staff from one regional office noted that instructors were unable to spend time teaching because of their heavy workloads and because instructorsТ training preparation hours do not count toward the 80-hour training requirement,Ф the GAO said. УStaff at another regional office told us that, due to workload pressures, staff may rush through training and may not get as much out of it as they should.Ф GAO found VBAТs performance management conforms to accepted practices in the private sector, except that almost all employees fell into two standards: УoutstandingФ or Уfully successful.Ф GAO auditors said that does not provide constructive feedback to employees, and is not a good way for managers to evaluate staffs. GAO recommended that VBA collect feedback on training from regional offices to see if 80 hours is the right amount for all staff, to see if training is relevant and to see if the online training tool needs to be improved. The report also recommended that VBA hold individual staff members accountable if they do not receive their annual training, and that the performance rating system be adjusted. VA said such changes are already in the works. Officials also are working on an automated system to track which employees have attended training and how much they received. VA Secretary James Peake wrote in response to the report. УVA will closely monitor and evaluate the success of our efforts to enhance claims processor performance.Ф Peake said that VA has an Уactive program for training evaluation driven by the administrationТs prioritiesФ; that the 80-hour requirement is evaluated annually; that VA officials will evaluate the training through its regional offices; that supervisors will evaluate training at the individual level; and that they have already evaluated the on-line learning tool and have made recommendations for improvement. VA also plans to establish training specific to certain jobs, and to provide standardized training progress reports. [Source: Air Force Times Kelly Kennedy article Posted 28 MAY 0-8 ++] SSA TRUST FUND: There actually is a Social Security Trust Fund Ч of sorts. It lays nestled in the bottom drawer of an unremarkable filing cabinet in a government office building in West Virginia. ItТs kept in a pair of loose-leaf notebooks holding plastic page covers, and each page resents a bond worth billions, according to a 2005 story from The Associated Press (AP). Today, the total УassetsФ in the Social Security Trust Fund are worth more than $2.2 trillion. The paper is Уsymbolic,Ф a spokesman for the U.S. Bureau of Public Debt says. According to AP, in 1994 Congress anticipated the current debate about Social SecurityТs solvency and whether the Trust Funds held anything more than I.O.U.s. Congress passed legislation requiring the Treasury to create a physical document Уrather than an accounting entry.Ф Andy Jacobs, the former Indiana Congressman responsible for the law, said he wanted to rebut the Уdisingenuous assertionsФ that there was no trust fund, even though there was, in fact, no vault stuffed with cash to pay benefits. In 2008 it was projected that the Social Security Trust Fund cash surplus excluding interest will be $79 billion reflecting a growing downward trend as baby boomers enter the programs. This does not take into consideration cost associated with CongressТs recent attempts to add illegal immigrants to the program. According to the Congressional Budget Office (CBO) neither the Medicare Trust Fund nor the Social Security Retirement and Disability Trust Funds operate like a УTrust FundФ as the average person would understand it. Instead of setting the money aside and protecting it in a special account, both the Medicare and Social Security Trust Funds exist only on paper as an accounting mechanism. Government accounting is hiding serious financing problems, making the trust funds appear to have more cash coming in than they actually do. The majority of Medicare Hospital Insurance (Part A) and Social Security costs are presently financed by the payroll taxes that workers pay and taxes that seniors pay on a portion of their Social Security benefits. When one of the trust funds receives more from these sources than it needs to pay benefits, the U.S. Treasury issues a government bond to the Trust fund and borrows the cash from the surplus to pay for other government expenses. The bonds earn interest, but are very different from the bonds sold to the public that can be redeemed for cash. The bonds placed in the trust funds are non-marketable, representing only an УI.O.U.Ф from the Treasury. A big problem is that in recent years the so-called УinterestФ earned by the bonds in the government trust funds has become a growing source of funding for both programs, at least on the governmentТs books. But the interest funding, like the trust funds, exists only on paper and does not represent any real cash resources to pay benefits. GAO says for the trust funds to be paid, the Treasury will need to provide cash from general revenues in exchange for those trust fund securities and interest I.O.U. bonds. Such use of general revenue for Social Security would represent a major policy shift in how the government pays for expenditures. In the past Congress for the most part has rejected general revenue financing for Social Security. The GAO says payments to the trust funds in the future, should only come through Уincreased revenue, increased borrowing, and reduced spending (benefit cuts) or some combination.Ф The current state of denial is leading to a day of reckoning that could have serious long-term financial repercussions for both todayТs and tomorrowТs retirees. The Social Security Trustees further estimate that the program costs will begin to exceed cash revenues in 2017, or about nine years from now. According to the former U.S. Comptroller General, David Walker, the new president and Congress will have about 5 years to make changes, before we run out of cash revenues to pay full Social Security benefits. The Medicare Part A Hospital Insurance Trust Fund is in trouble today. The Social Security and Medicare Lock-Box ActФ (H.R. 4338) that was recently introduced in the House by Representative Timothy Walberg (MI) and (S. 302) in the Senate by Senator David Vitter (LA) would establish new procedures to safeguard extra Social Security and Medicare taxes. Congress would be prevented from dipping into the Trust Fund surpluses to pay for other wasteful or pet projects. Instead the extra Social Security taxes would be Уlocked awayФ to pay future Social Security benefits [Source: TSCL, The Budget And Economic Outlook, CBO, Jan 08,. Social Security & Medicare Trustees Reports 23 Apr 07, and Social Security Reform GAO-07-213 Mar 07 ++] MEDICARE TRUST FUND: When a government trust fund no longer has enough cash revenues to pay benefits in full, the Treasury must provide cash from general revenues to pay the interest and redeem the bonds held by the trust fund. But, first, lawmakers must agree on where the money will come from to do that. They can increase taxes, increase borrowing, curt benefits, or cut spending such as COLAs. Historically, seniors have paid their share in higher out-of-pocket costs. The Medicare Hospital Insurance (Part A) Trust Fund last ran low on cash in the late 1990Тs. By 1997 Congress passed the most massive cuts to Medicare in the history of the program Ч $116 billion ($153 billion in todayТs dollars) over five years. In addition to cutting payments to hospitals, a provision of the 1997 law moved certain costs that were originally paid under Part A to Part B. While most seniors do not pay a premium for Part A, they do pay a hefty one for Part B. Thus the transfer of costs was one of several factors contributing to the astronomical growth in Medicare Part B premiums, which grew from $43.80 in 1998, to $96.40 in 2008 (120%). Now the Medicare Part A Trust Fund is in trouble all over again. Earlier this year, the Congressional Budget Office projected that the Medicare Part A Hospital Insurance Trust Fund ended 2007 with a $17 billion surplus, and would end 2008 with a $16 billion surplus. But if the government only counts the real cash revenues (excluding government bonds on interest earned), according to the 2008 Medicare and Social Security Trustees reports the Part A Trust Fund ended 2007 about $500 million in the red, and is projected to end 2008 with a $10 billion deficit. President Bush has proposed $178 billion in cuts over the next five years, which, if passed, would exceed the cuts in the 1997 Balanced Budget Act. The Senior CitizenТs League (TSCL) is highly concerned and recently submitted a statement to a hearing on The PresidentТs Fiscal Year 2009 Budget to the House Ways and Means Committee supporting the passage of УThe Social Security and Medicare Lock-Box Act,Ф in addition to recommending that the government do a better job of reducing waste, fraud, and abuse. Because the new President and Congress will surely be tasked with fixing MedicareТs financing, TSCL also urges seniors to carefully examine the records of candidates, and make sure your voter registration is up-to-date to be ready for the upcoming elections. [Source: Social Security and Medicare Advisor, Vol. 13, No. 5 dtd 27 May 08 ++] AWARD MODIFICATIONS: The Department of Defense announced today that The Institute of Heraldry (TIOH) will remove the word "medal" from four campaign and service medals in order to align their designs with heraldic protocols. The word "medal" will be removed from the Global War on Terrorism Expeditionary Medal, Global War on Terrorism Service Medal, Korea Defense Service Medal and Armed Forces Service Medal. In addition, TIOH will resize eight campaign and service medals that were initially designed one-eighth of an inch larger in diameter than required by specification. The larger medals will be gradually replaced over the next several years as current stock levels are depleted. These medals will not be made obsolete and will remain authorized decorations. In addition, the applicable miniature medals will also be re-sized from eleven-sixteenths of an inch diameter to five-eighths of an inch. The medals being resized are the: Kosovo Campaign Medal, Afghanistan Campaign Medal, Iraq Campaign Medal, Global War on Terrorism Expeditionary Medal, Global War on Terrorism Service Medal, Korea Defense Service Medal, Armed Forces Service Medal and the Military Outstanding Volunteer Service Medal. Historically, campaign and service medal pendants are 1 1/4 inches in diameter; the only exceptions are the two victory medals commemorating the end of World War I and World War II; these medals were designed at 1 13/32 inches in diameter in order to enhance their heraldic stature given the magnitude of the two world wars. Questions may be directed to Army Public Affairs at (703) 692-2000. [Source: DoD News Release 444-08 dtd 23 May 08 ++] CRSC UNDER DISABILITY RETIREMENT: For disabled Chapter 61 retirees who retired under a disability retirement law who are eligible for CRSC entitlement, an offset is calculated before CRSC entitlement is calculated. To determine the amount of offset subtract your DoD monthly retirement pay calculated based on years of service prior to retirement from the VA disability retirement monthly payment for the CSRS percentage assigned. Retirement computations vary according to each individual's retirement date, retirement age, and years in service. The figures in the following example are only to explain the calculation method. Х Disability Retirement Monthly Payment = $2000.00 Х Monthly Retirement Pay calculated based on years of service = $1500 Х Difference between two retirement methods (i.e. Offset) = $500 Example CRSC entitlement amounts for approved Combat Related combined disability percentages less the $500.00 example offset amount using CRSC entitlements at the Vet only rates would be: 10% $ 117.00- $500.00 = $0.00 CRSC entitlement due 20% $ 230.00- $500.00 = $0.00 CRSC entitlement due 30% $ 356.00- $500.00 = $0.00 CRSC entitlement due 40% $ 512.00- $500.00 = $12.00 CRSC entitlement due 50% $ 721.00- $500.00 = $228.00 CRSC entitlement due 60% $ 117.00- $500.00 = $421.00 CRSC entitlement due 70% $1161.00- $500.00 = $661.00 CRSC entitlement due 80% $1349.00- $500.00 = $849.00 CRSC entitlement due 90% $1517.00- $500.00 = $1017.00 CRSC entitlement due 100% $2527.00- $500.00 = $1500.00 CRSC entitlement due * * (Note: Any entitlement due cannot exceed the retired pay amount computed based on years of service) [Source: NAUS Weekly Update 23 May 08 ++] LEGISLATION of INTEREST UPDATE 10: As Memorial Day approached, the U.S. House of Representatives approved the following 10 bipartisan measures on 21 MAY to improve benefits and services for veterans. Х H.R.2790, as amended, which passed by voice vote, will establish the position of Director of Physician Assistant Services within the Department of Veterans Affairs (VA). Х H.R.3681, as amended, the Veterans' Benefits Awareness Act of 2007, which passed by voice vote, will authorize VA to purchase advertising in national media to promote awareness of veterans' benefits. Х H.R.3889, as amended, which passed by voice vote, will require a longitudinal study of VA vocational rehabilitation programs. Х H.R. 5554, as amended, the Justin Bailey Veterans' Substance Use Disorders Prevention and Treatment Act of 2008, which passed by a voice vote, will expand and improve VA health care services for substance use disorders. Х H.R. 5664, as amended, which passed by voice vote, will direct VA to update, at least once every six years, plans and specifications for its specially adapted housing program. Х H.R. 5729, as amended, the Spina Bifida Health Care Program Expansion Act, which passed by voice vote, will direct VA to provide comprehensive health care to certain Vietnam veterans' children born with spina bifida. Х H.R. 6048, which passed by a voice vote, will amend the Servicemembers Civil Relief Act to provide for the protection of child custody arrangements for parents deployed in support of a contingency operation. Additionally the House unanimously approved the following three bipartisan measures to improve benefits and services for veterans. Х H.R. 3819, the Veterans' Emergency Care Fairness Act of 2007, which passed the House by a vote of 412-0, will require the Department of Veterans Affairs (VA) to reimburse veterans receiving emergency treatment in non-VA facilities for such treatment until transfer to a VA facility is possible. Х H.R. 5826, The Veterans' Compensation Cost-of-Living Adjustment Act of 2008, which passed the House by a vote of 417-0, will increase effective December 1, 2008, 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. Х H.R. 5856, the VA Medical Facility Authorization and Lease Act of 2008, which passed the House by a vote of 416-0, will authorize major medical facility projects and major medical facility leases for VA in fiscal year 2009, and will authorize approximately $2.2 billion over the next five years to improve access to healthcare for our nation's veterans. [Source: NAUS Weekly Update 23 May 08 ++] VETERANS TAX RELIEF: The House and Senate passed H.R.6081, the Heroes Earnings Assistance and Relief Tax (HEART) Act of 2008 which will provide more than $1.2 billion dollars in tax relief to benefit AmericaТs veterans and soldiers. The Senate Finance leaders worked closely with House colleagues, especially Ways and Means Committee Chairman Charlie Rangel, to combine their own military tax relief bill Ц the Defenders of Freedom Tax Relief Act of 2007 Ц with an earlier version of the HouseТs HEART Act. HEART was approved by the House of Representatives on 20 MAY. The legislation includes tax cuts for members of the military who are receiving combat pay, saving for retirement, or purchasing their own homes. It also helps civilian employers of military men and women keep jobs available for soldiers who are called to active duty. Final HEART Act provisions, including many originally introduced by Baucus and Grassley in the Defenders of Freedom Act, include: Х Allow disabled veterans to file up to 5 years of amended tax returns to recoup taxes when VA processing delays result in retroactive benefits. Х Allow members of the armed forces who have non-citizen spouses to qualify for the economic stimulus rebate. Х Make permanent the ability to include combat pay as earned income for purposes of the Earned Income Tax Credit. Х Make permanent the provision that permits active duty reservists to make penalty-free withdrawals from retirement plans. Х Allow survivors to roll over military death gratuity payments into tax-advantaged savings accounts. Х Permit reserve component members to withdraw money from flexible spending accounts without penalty . Х A tax cut for small businesses when they continue paying some salary to members of the National Guard and Reserve who are called to active duty. Х A permanent allowance for soldiers to count their non-taxable combat pay when figuring their eligibility for the earned income tax credit, a refundable federal income tax credit that puts cash in the hands of low-income working individuals and families. Х The ability for active duty troops to withdraw money from retirement plans, and an allowance of two years to replace the funds without tax penalty. Х A 180-day period for Reservists called to active duty to use unspent funds in a health flexible spending account or cafeteria plan. Х The ability for military families to count most military cash allowances beyond basic pay to be treated as earned income for purposes of determining Supplemental Security Income (SSI) eligibility and benefit amounts, and treat certain housing payments as in-kind support and maintenance. Х A one year extension of parity between mental and physical health benefits. Х A permanent allowance for all veterans to use qualified mortgage bonds to purchase their homes. Х Authority for the IRS to treat gifts of thanks from states to veteransЧsuch as payments of excess state revenueЧas nontaxable gifts. Х The ability for blind, disabled, and aged veterans to disregard state annuity payments when determining Supplemental Security Income eligibility and benefits. Х The ability for families of Reservists killed in the line of duty to collect life insurance and other benefits provided by the civilian employer. Х An end to cumbersome rules for reporting of income when companies continue paying some salary to members of the National Guard and Reserve who are called to duty. This makes it easier for reservists to file their taxes and simpler for employers to keep contributing to those employeesТ retirement plans. Х Increases the penalty for people who fail to file their tax returns and allows the Social Security Administration and the VeteransТ Administration to work together to verify low-income status when distributing veteranТs benefits. Baucus said that he would continue to work for additional provisions aiding AmericaТs military men and women in the coming days. Both the House and Senate passed multiple versions of this legislation last year, but got hung up negotiating minor differences. Congress finally got past the haggling and acted on this measure to end tax inequities now imposed on the military community. [Source: MOAA Leg Up 23 May 08 ++] GI BILL UPDATE 23: The Senate overwhelmingly backed a landmark increase in educational aid to the nationТs veterans on 22 MAY, defying the White House and challenging President Bush to make good on a threatened veto. Senators voted 75-22 to attach the revamped GI Bill to a $165 billion appropriations measure for continued military operations in Iraq and Afghanistan. The total is $57 billion more than Bush requested and includes billions of dollars in additional aid to victims of Hurricane Katrina and heating subsidies for the poor, among other domestic programs. With an estimated 10-year cost of $51 billion, the Webb proposal would be the largest increase in decades in a veteranТs aid program. Modeled after the GI bill provided to World War II veterans, the measure would give veterans tuition aid equal to the cost of the most expensive public college in their home states once theyТve served for at least three years since the 911 attacks. Veterans choosing private schools, which typically are more expensive, could get additional aid if their colleges agreed to reduce tuitions. And all participants would be eligible for a monthly cost-of-living stipend while attending college. In a concession to the administration engineered by Warner, Webb agreed to amend the legislation later this year to permit career service members to transfer at least part of their college aid to a spouse or children. The White House has argued that such transferability is critical to efforts to encourage experienced troops to remain in uniform. Bush has promised to veto any bill spending more than the $108 billion he sought for the war effort. The 75 votes WebbТs plan received is eight more than supporters would need to override a veto. The previous week the House passed the 21st century GI Bill by a vote of 256-166. However, the administration position apparently has more strength in the House. The Senate package now goes to the House to reconcile differences. White House spokeswoman Dana Perino said, УThereТs a long way to go in this process, and fortunately, it takes two houses of Congress to send a bill to the president. Our position hasnТt changed: This is the wrong way to consider domestic spending, and Congress should not go down this path.Ф The House is expected to consider the package after the Memorial Day recess. The Senate vote for WebbТs plan represented a greater-than-expected show of strength for the enhanced benefit and underscored an election-year gap between the president and his fellow Republicans. Twenty-five of the SenateТs 47 Republicans backed the Webb plan, despite the fact that the president and Arizona Sen. John McCain, their partyТs presumptive presidential nominee, support a less generous alternative. McCain was on the campaign trail and did not take part in the vote. But South Carolina Sen. Lindsey Graham, perhaps McCainТs closest ally in the Senate and the chief sponsor of the administrationТs preferred GI Bill plan, renewed arguments that the Webb plan will encourage needed troops to leave the military. Graham cited a Congressional Budget Office study indicating that the Webb bill could cut the militaryТs annual re-enlistments by 16%. The same report, however, suggested that the prospect of a fully financed college education would stimulate a 16% jump in initial enlistments. Democrats Hillary Rodham Clinton and Barack Obama fighting for their partyТs presidential nomination, showed up to support WebbТs proposal. Webb insisted again that the legislation should not be a partisan issue. He recruited 11 Republicans as co-sponsors in the Senate, he reminded reporters, adding that Уif I were able to sit down with John McCain for 10 or 15 minutes, I honestly think that he would support this bill.Ф Both Webb and Warner paid tribute on 22 MAY to a broad coalition of veterans groups that supported the bill, with Webb suggesting that their backing might have helped persuade Republicans in particular to differ with the administration. Patrick Campbell, legislative director for the Iraq and Afghanistan Veterans of America, said members of the organization watched with excitement as senators switched their votes on the floor. The group began working on the bill four months ago with Webb, Warner, and representatives from the American Legion, Veterans of Foreign Wars, and Military Officers Association of America, Campbell said. УHow can you tell a veteran thatТs been to war three or four times that itТs too rich of a benefit?Ф he asked. [Source: The Virginian Pilot Dale Eisman article 23 May 08 ++] VA COMMERCIAL INSURANCE COVERAGE: UnitedHealthcare has bridged a wall between private and public insurance with a national agreement that gives eligible veterans in their commercial health plans in-network coverage at facilities in the Department of Veterans Affairs. Those enrollees meeting VA eligibility requirements can use all VA hospitals and outpatient clinics the same way they would use any hospital or doctor's office in United's network. Also included are transplants and services for mental health and substance abuse services, administered by United Behavioral Health. Adding the VA to United's network enables veterans to more easily coordinate their medical care and finances when they use both private and VA facilities, CEO Ken Burdick said. The agreement provides more convenient access to the "VA's vital and relevant health care services on which so many veterans rely," Burdick said. Along with the network agreement, UnitedHealth Group has created UnitedHealth Military & Veterans Services with a focus on providing health care benefits and services to veterans, active-duty military, retirees and their families by augmenting the existing military health systems. [Source: Dayton Daily news article 21 May 08 ++] MEDICARE DRUG USE SAFETY PROGRAM: Federal health officials will begin monitoring prescription drug usage by millions of Medicare participants in an effort to identify potential safety problems. The Food and Drug Administration has been under increasing pressure to develop a comprehensive drug surveillance system since the painkiller Vioxx was pulled from the market in 2004 after it was linked to increased risk of stroke and heart attack. New regulations announced 22 MAY by the Health and Human Services Department will enable the FDA, states and academic researchers to screen the Medicare claims data. Under the regulation, the Medicare data can be made available in 30 days. Medicare beneficiaries use an average of 28 prescriptions a year, and those who consider themselves in poor health have an average of 45 prescriptions annually, giving investigators a huge database of health records to tap into. Officials said they no longer would have to wait years to see how a drug or medical device affects millions of people. "The era of wait and see is going to become the era of tell me right now," the FDA commissioner, Dr. Andrew von Eschenbach, said. The Institute of Medicine recommended creation of such a surveillance system in 2006. Personally identifying information will stay inside the Medicare agency and will not be part of the information that the FDA and others look at, officials said. The FDA primarily relies on physicians and patients to report suspected adverse events. Often, it takes a number of cases before someone at the agency detects a pattern that's worth investigating. Then it conducts an investigation to determine whether the side effects were caused by the drug. At the first hint of trouble, the FDA now will be able to query databases involving tens of millions of patients. It will not only be able to see the medications used, but also whether a patient had lab work done or whether they had to be hospitalized. The first batch of records the agency will have at its disposal will be from 25 million Medicare beneficiaries. Later, private companies will contribute medical data, Health and Human Services Secretary Mike Leavitt said. "We're moving from a reactive dependence on voluntary reporting of product safety concerns to a proactive surveillance of medical products currently on the market," Leavitt said. Officials provided only general details about the cost of enacting what the FDA has labeled the Sentinel Initiative. The agency is hiring more staff, but it won't need a large new computer system. That's because agencies such as the Centers for Medicare and Medicaid Services will use their own computer systems to do the data-mining. The FDA will simply provide the questions while Medicare's computers supply the answer. Medicare officials said the program could end up reducing the government's health costs if it can cut down on adverse drug events. The cost of treating preventable adverse events in Medicare comes to about $900 million a year. Also, officials said they will be able to determine when a drug is being inappropriately dispensed to treat certain conditions. By promoting best practices in therapy management, agency officials said they hope to cut down on unnecessary prescription bills. Dr. Mark McClellan, a senior fellow at the Brookings Institution and a former Medicare administrator, said the new data mining system was actually a good model for maintaining patient privacy. The personal data stays where it was, with an insurer or within a medical practice, or within Medicare. The FDA doesn't need personally identifying information to help it monitor medical practices. "You don't have to share with the FDA a whole lot of detailed personal information about each case," McClellan said. "What FDA mainly needs to know is what's going on in the population being treated by all these different components of our health care system." Rep. Rosa DeLauro, (D-CT) said she was glad the FDA was laying the groundwork for the surveillance system. But she said the effort has taken too long and that it's still just in the planning stages. Von Eschenbach said a pilot project allowing the FDA to look at Medicare data could begin after 30 days. [Source: AP Kevin Freking article 22 May 08 ++] VA EMERGENCY CARE UPDATE 02: On 21 MAY, the House passed the Veterans Emergency Care Fairness Act of 2007 (H.R.3819) by a vote of 412-0. The ball now has been passed to the Senate under a companion bill S.2142 introduced by Senator Sherrod Brown. Currently, when a veteran needs emergency medical treatment, the VA allows that veteran to go to the nearest private or community hospital. Once the veteran is stabilized, the veteran must then be transferred to a VA hospital for any necessary continued care. A problem arises when there is a wait for a bed in a VA hospital. The law does not require the VA to reimburse the hospital for the care given after the point of stabilization. S.2142/HR 3819 simply closes that loophole and requires the VA to reimburse the private hospital for care. In rural areas, the problem with the current law is particularly pronounced. Often, a patient may be deemed stable but is not necessarily stable enough to make ambulance trips traveling long distances. More specifically, the Veterans Emergency Care Fairness Act: Х Requires (under current law, authorizes) the Secretary of Veterans Affairs to reimburse certain veterans without a service-connected disability enrolled as active participants of the Department of Veterans Affairs (VA) health care plan for the cost of emergency treatment received in a non-VA facility until such time as such veterans are transferred to a VA facility. Х Requires (under current law, authorizes) the Secretary to reimburse certain veterans with a service-connected disability or a non-service- connected disability associated with or aggravating a service-connected disability for the value of emergency treatment for which such veterans have made payment from sources other than the VA. Veterans are encouraged to contact their Senators and impress upon them the necessity of voting favorably on this legislation. This can be easily done by referring to http://capwiz.com/usdr/issues/alert/?alertid=11407326&queueid=[capwiz:queue_id], entering a zip code, reviewing a preformatted message, and completing constituency data to forward the message to their Senators. [Source: USDR action alert 22 May 08 ++] VA BENEFIT ROLLS: Following are the numbers of veterans, children, parents, and surviving spouses on the U.S. Veterans and Dependents Benefits Rolls as of SEP 07: CONFLICT ЕЕЕЕЕ. VETS Ц Kids Ц PARENTS - SPOUSES Civil War ЕЕЕЕЕЕ.. 0 Ц 3 Ц 0 Ц 0 Indian Wars ЕЕЕЕЕ.. 0 Ц 0 Ц 0 Ц 0 Spanish-American War ... 0 Ц 108 Ц 0 Ц 108 Mexican Border ................ 0 Ц 15 Ц 0 Ц 62 World War I ЕЕЕЕЕ. 0 Ц 3,500 Ц 0 Ц 6,059 World War II (Note 1)Е.. 396,944 Ц 15,006 Ц 167 Ц 225,908 Korean Conflict ЕЕЕЕ 223,499 Ц 3,278 Ц 335 Ц 60,885 Vietnam Era ЕЕЕЕЕ.. 1,141,946 Ц 9,227 Ц 3,252 Ц 158,127 Gulf War (Note 2) ЕЕЕ 802,381 Ц 13,189 Ц 859 Ц 14,471 Nonservice-connected 322,875 Ц 19,176 Ц 0 Ц 180,664 Service-connected 2,844,354 Ц 28,176 Ц 6,133 Ц 317,385 (Note 1) Based on new population projections VA estimates the number of living World War II U.S. vets over the next 15 years will be: Х SEP 08 - 2,457,000; SEP 09 - 2,143,000; SEP 10 - 1,850,000; SEP 11 -1,581,000; Х SEP 12 - 1,336,000; SEP 13 - 1,117,000; SEP 14 - 921,000; SEP 15 - 750,000; Х SEP 16 - 602,000; SEP 17 - 477,000; SEP 18 -371,000; SEP 19 - 285,000; Х SEP 20 - 214,000; SEP 21 - 158,000; and SEP 22 Ц 115,000. (Note 2) For compensation and pension purposes, the Persian Gulf War period has not yet been terminated and includes veterans of Operations Iraqi and Enduring Freedom.) [Source: VA AmericaТs Wars Fact Sheet Nov 07 ++] SBP SSDI: Section 644 of the 2008 National Defense Authorization Act (NDAA) authorizes a Special Survivor Indemnity Allowance (SSDI) for person affected by required SBP annuity offset for Dependency and Indemnity Compensation (DIC). This includes Guard/Reserve retirees who died before age 60. The service secretary concerned shall pay SSDI to the surviving spouse/former spouse if the surviving spouse/former spouse is entitled to DIC and is eligible to receive an annuity by reason of an election of SBP who, except for the DIC offset, would be eligible to receive the annuity, shall be paid the monthly amount equal to: Х For months during fiscal year 2009, $50.00; Х For months during fiscal year 2010, $60.00; Х For months during fiscal year 2011, $70.00; Х For months during fiscal year 2012, $80.00; Х For months during fiscal year 2013, $90.00; Х For months after fiscal year 2013, $100.00. The amount of the allowance paid for any month may not exceed the amount of the annuity for that month that is subject to DIC offset. The survivor indemnity allowance is not subject to adjustment under any other provision of law. The funds shall be paid from the retirement trust fund, and shall only apply with respect to months beginning on 1 OCT 08, through 28 FEB 16. The indemnity allowance might be perceived as a first step toward easing the ban on concurrent receipt for military widows. [Source: DFAS Retired Pay Newsletter Apr 08 ++] VA CLINIC OPENINGS UPDATE 09: The House with a vote of 416-0 passed a bill 21 MAY that would authorize the Veterans Affairs Department to pay for major medical facility construction projects and leases in fiscal 2009." The legislation, H.R.5856: Department of Veterans Affairs Medical Facility Authorization and Lease Act of 2008 sponsored by US Rep. Michael H. Michaud (D-ME), chairman of the Veterans Affairs Health Subcommittee, would authorize approximately $2.1 billion to build new and previously authorized medical facilities, while approximately $60.1 million would be authorized for the VA to lease 12 medical facilities. The VA secretary, meanwhile, would be required to submit an annual report on community-based outpatient clinics to the House and Senate Veterans Affairs committees. The report would include lists of outpatient clinics opened by the department during the preceding fiscal year, those opened during the current fiscal year and proposals for clinics to be opened in the following fiscal year. [Source: Congressional Quarterly Johnson article 21 May 08 ++] IOWA VETERAN GRANT PROGRAM: The University of Iowa has created a Veterans Grant Program to help fill the financial gap that many veterans face with existing GI Bill benefits. The UI will provide grants of up to $500 per semester to offset educational expenses for veterans who entered service from the state of Iowa and who were on active duty to serve in support of the Global War on Terror, or other periods of hostility. The UI has allocated $100,000 for the Veterans Grant Program, according to UI President Sally Mason. John Mikelson, advisor for the UI Veterans Center, explained that while the current GI Bill covers some tuition and fees for veterans, it does not cover all costs, depending on individual situations. "In a best-case scenario, approximately 60% of these educational costs are currently covered for veterans, and the UI grant will be a big help to current students," he said, adding that the UI is among the first universities in the country to offer this kind of grant to veterans. The new UI Veteran's Grant is based on need as determined by completion of the Application for Federal Student Aid (FAFSA) form. Students who are eligible for benefits as a dependent of a veteran who became 100% disabled or died as a result of military duty may also be awarded this grant. The Veterans Grant is renewable, but cannot exceed eight semesters. To reapply, the veteran must complete the FAFSA each year and must submit an application. To apply, students are required to complete the FAFSA, and present military discharge papers to the UI Veterans Affairs office, Office of the Registrar, Room 1 of Jessup Hall, Iowa city IA 52242 Tel: (319-335-0219). Proof of eligibility for benefits can be submitted by dependents of veterans. The Veterans Affairs Office will provide a brief grant application upon request. [Source: UI News Service Office 21 May 08 ++] TRICARE MEDICAID COVERAGE: Most Tricare users are aware that Tricare by law is always the last payer over any other type of medial care insurance (including Medicare) that a user has. However, this does not apply to Medicaid. Medicaid is essentially a welfare program, providing medical benefits for people under various state welfare programs (such as Aid to Families with Dependent Children) or who qualify by reason of being determined to be "medically indigent" based on a means test. Congress enacted P.L. 97-377 with the intent that no class of Tricare beneficiary should have to resort to welfare programs; therefore, Medicaid was exempted from these double coverage provisions. Whenever a Tricare beneficiary is also eligible for Medicaid, Tricare is always the primary payer. Medicaid can supplement Tricare. [Source: Washington Times Sgt Shaft article 19 May 08 ++] SSA COLA 2009: For years seniors have been getting by on Social Security benefits with a very small Cost-of-Living-Adjustment (COLA). The Senior Citizens League (TSCL) recently released a study that puts real numbers of the loss of buying power they are facing. This study shows that, from 2000 through 2008 alone, Medicare Part B premiums have increased 112%, and that prescription drugs have increased 49%. Concurrently seniors are facing cost increases in basic groceries like milk and eggs. Meanwhile, their Social Security benefits have increased only 24%. The study shows they have lost 51% of their buying power just since 2000. Clearly, the Social Security COLA is not keeping up with inflation, which is what it was intended to do. One primary reason is that the current COLA is based on a market basket of goods typically purchased by younger wage earners, called the Consumer Price Index for Wage Earners (CPI-W). As a result, Social Security beneficiaries received a 2.3% increase in benefits for 2008. The government does track a Consumer Price Index for Elderly Consumers (CPI-E), which takes into account the spending habits of senior citizens. That index would have increased seniors benefits by 2.6% vice 2/3% this year. While that difference sounds tiny, it means thousands of dollars in extra benefits over your retirement. The effect of a larger COLA is cumulative like compound interest. A person retiring with an average benefit of $1,055 in 2007 would receive $2,000 more in the first ten years of retirement using the CPI-E vice the CPI-W and $18,227 more over a 25-year retirement. A senior who retired with a benefit of $460 in 1984 would have received almost $11,200 more over the past 24 years if the COLA was based on the CPI-E. Legislation has been introduced by Rep. Charles Gonzalez (TX-20) that would base the Social Security COLA on the CPI-E. If signed into law the Consumer Price Index for Elderly Consumers Act (H.R.1953) would base the Social Security COLA on the CPI-E. To see if your Member of Congress is one of the 16 who so far have supported the CPI-E or request he/she do refer to http://capwiz.com/usdr/issues/alert/?alertid=11399626&queueid=[capwiz:queue_id]. Enter your zip code and complete your constitute data. If he/she is already sponsoring the bill you can send an automatic УThank YouФ message. If he/she has not signed on to support the bill you can send an automatic message requesting to so. [Source: TSCL Action alert 20 May 08 ++] ECONOMIC STIMULUS PACKAGE UPDATE 06: Clarification for tax filers who are using Taxpayer Identification Numbers (ITIN) vice Social Security numbers on their 1040 & 1040A tax forms for their spouse or children is provided in the below taken from the IRS website. Bottom line if your spouse does not have a SSN and you file jointly using his/her ITIN neither of you will receive a ECS payment. If you both have SSNs and your child does not you will receive your ECS payment but nothing for the child: Q. I file using an individual taxpayer identification number (ITIN). Can I still get a stimulus payment? A. No. The law does not allow stimulus payments to people who file a return using an ITIN. A taxpayer must have a valid Social Security number to qualify for the stimulus payment. If married filing jointly, both taxpayers must have a valid Social Security number. And children must have valid Social Security numbers to be eligible as qualifying children. Q. If I currently have an ITIN and file my return but later this year get an SSN, can I amend my return to get the payment or will I need to wait until I file my 2008 return to claim it? A. You will need to wait until you file your 2008 income tax return to claim the economic stimulus payment. [New 4/14/08] Q. I have an ITIN, but my spouse has a valid Social Security number. Can we get a payment? A. If you and your spouse file a joint return, you will not get a stimulus payment. If your spouse files a separate return, your spouse may qualify for a payment, based on his or her income deductions and credits. Q. If I have a spouse with an ITIN and therefore choose "married filing separately" status to qualify for the economic stimulus payment and later on amend my original return to "married filing jointly" status, will I need to return the stimulus payment? A. No. [New 4/14/08] Q. If I have a valid Social Security number and my child has an ITIN, do I get extra money for the child? A. No. To qualify for the extra credit for qualifying children, not only do the taxpayer and spouse, if filing jointly, need valid Social Security numbers, but the qualifying child must also have a valid Social Security number. Q. I adopted a child this year and my child has an ATIN (Adoption Taxpayer Identification Number). Will I receive the $300 additional child payment? A. An ATIN is issued by the IRS as a temporary taxpayer identification number for the child. Adoptive parents who do not yet have a Social Security number for their child will not get the advance payment. However, if they receive a Social Security number for the child before the end of 2008, they can claim the additional child payment on their 2008 tax return. [Source: IRS Website http://www.irs.gov/newsroom/article/0,,id=181995,00.html 20 May 08 ++] VA SUICIDE PREVENTION UPDATE 04: On 15 MAY Senator Daniel K. Akaka (D-HI) invoked his oversight authority as Chairman of the Veterans' Affairs Committee to formally request data from VA on veterans' suicides that is not otherwise available to the Congress. In a letter to Veterans Affairs Secretary James Peake, Akaka stressed the need for full and accurate data on the issue. In his letter, Akaka specifically requested the following from Secretary Peake: Х The total number of veterans who have committed suicide or attempted to commit suicide Х The number of veterans who have committed suicide or attempted to commit suicide while receiving care from VA Х Information on VA's efforts to improve outreach and assistance for veterans between the ages of 30 and 64 Х All of VA's health care quality assurance reviews related to suicides and suicide attempts over the past three years As Chairman of the Senate Veterans' Affairs Committee, Akaka is empowered by federal law to review medical quality assurance records that are otherwise not provided outside of the Department. Akaka's request follows heightened concerns from Congress and others regarding veteran suicides. Last week, Secretary Peake testified that both male and female veterans are more likely than non-veterans to commit suicide. In recent weeks Akaka has sought action on veteran mental health issues, meeting with Secretary Peake, and working with the Senate Majority Leader to bring up S.2162, the bipartisan VeteransТ Mental Health and Other Improvements Act of 2008. According to a recent Rand study nearly one in five Iraq and Afghanistan veterans - roughly 300,000 so far - report symptoms of PTSD or major depression, and fewer than half receive mental health care. [Source: Akaka Press Release 15 May 08 ++] COLA 2009: On 14 MAY, the Bureau of Labor Statistics at www.bls.gov/cpi announced the APR 08 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 CPI jumped 0.7% over March's value. The CPI-W for April is 210.698. That puts cumulative inflation at 3.5% above the 2007 third quarter average base index of 203.6. The COLA will be even higher if inflation goes up between now and 30 SEP. About one in every six Americans - millions of former feds, ex-military and people on Social Security - will get the JAN 09 COLA. It's automatic. Congress and the White House don't have to do anything to implement it. And, because Social Security is the dangerous third rail of American politics, Congress and the White House know better than to touch it. The majority of federal retirees are under the old Civil Service Retirement System. They will get the full COLA regardless of their age. Retirees who are under the FERS retirement system get one percentage point less than the full COLA and they don't qualify for it until they are age 62 or older. MAYТs consumer price indices will be released on 13 JUN 08. [Source: NARFE Legislative Update 629 dtd 16 May 08 ++] EAGLE HAMMOCK RV PARK: The NavyТs MWR Eagle Hammock RV Park is located on the Naval Submarine Base Kings Bay GA 6 miles from the Florida state line, Georgia Exit 1, Interstate 95. It contains 50 RV sites equipped with paved pads, water, sewage, and electrical hookups, picnic tables, and fire rings. Five sites and one restroom are American Disability compliant. Sites run $18 to $32 daily dependent on season, site location and hookups. A community center structure offers no cost laundry room and bathhouse plus WiFi connectivity. Limit of 2 pets allowed per campsite with usual leash and clean-up rules. Cell phone use while driving on base is prohibited. BioDiesel is available at on-base gas station. Recreational activities available include Х Fishing in a 220 acre lake and various ponds stocked with bass, bream and catfish Х Miles of paved paves for joggers and cyclist. Х On base 18 hole golf course and bowling center. Х Fitness complex with cardio theatre, racquetball basketball and tennis courts, weight room, and Olympic size swimming pool with a 150 foot double water slide. Kings Bay is situated on GeorgiaТs coastal region in the town of St. MaryТs in the SE corner of the state. Cumberland Island National Seashore and Okefenokee Swamp National Wildlife Refuge are just minutes away. Jacksonville FL is about 35 miles away. Facilities are available year round to all Active Duty, Retirees, Reserves, National Guard, and DOD Civilians. For additional info and reservations email eaglehammock@tds.net or call either (800) 818-1815 or (912) 673-1161 or mail to: Outdoor Recreation, 1063 USS Tennessee Avenue, Kings Bay, GA 31547. [Source: U.S. Military Campgrounds and RV Parks 29 May 08 ++] NDAA 2009 UPDATE 02: On 14 MAY the House Armed Services Committee (HASC) completed action on H.R.5658, the FY 2009 National Defense Authorization Act, and reported the bill to the full House for further consideration. Subsequently, on 22 MAY by a vote of 384-23, the House approved H.R. 5658 the FY 2009 National Defense Authorization Act (NDAA). It may appears, on first look that the bill sent to the House floor by the HASC rejected the Pentagon and Task Force plan to steeply raise Tricare fees and prescription costs. However, unlike the Senate's rejection of higher fees, there's a serious wrinkle in the HASC version. Instead of outright rejecting the Pentagon plan, Personnel Subcommittee Chairwoman Susan Davis (D-CA) decided that retirees could help cover the costs of Tricare by absorbing a one month, one percent reduction in their COLAs. In other words, Chairwomen Davis would have retirees pay for their Tricare benefits from their retirement pocket instead of their healthcare pocket. Subcommittee Ranking Member John McHugh (R-NY) objected to the plan and said he would find a more palatable alternative. According Tom Philpott's Military Update column, Subcommittee Chairwomen Davis "shrugged off McHugh's criticism, saying difficult choices had to be made." NAUS Memo to House Members: Here's a "less difficult" choice for our U.S. Congress: how 'bout getting your priorities straight. End "free health care for illegal immigrants" and keep the promise made to Americans who gave a lifetime to military service defending our country and our way of life. The Committee good news is that it also approved a 3.9% pay raise for active duty forces, which is a half percent higher than the Administration requested. Rep. Thelma Drake (R-VA) successfully added an amendment to see that military pay raises are at least a half-percentage point higher than the Employment Cost Index (ECI) through 2013. Other provisions would: Х Lower premiums paid by drilling reservists who enroll in the Tricare Reserve Select (TRS) program; Х Bar any TRICARE or pharmacy fee increases for FY2009. Х Establish a new preventive health program, which now includes Tricare for Life beneficiaries. Х Bar studies of commissary privatization through 2013. Х Require DoD recommendation on selling beer and wine in commissaries. Х Direct DoD recommendation on opening commissaries to disabled veterans with VA ratings of 30% or greater. Х Direct DoD plan to simplify Guard/Reserve duty status categories. Х Authorize Reservists who retired with 20 years of active duty to switch to Reserve retirement if that provides greater retired pay, as of JAN 09 (no retroactive payment). Х Authorize recomputation of Guard/Reserve retired pay following at least two years of recalled active duty . Х Extend Guard/Reserve income replacement authority through 2009. Х Authorize a pilot program to exempt certain preventive care (e.g., mammograms, colonoscopies, vaccinations) from TRICARE copays and deductibles (Note: original reports indicated that Medicare-eligibles would be excluded, but Committee leaders resolved that problem). Х Authorize chiropractic care for all active duty members (but not family members, retirees or survivors). Х Restore SBP to survivors of members who died on active duty, but whose SBP was switched to children (when children attain majority or if remarriage ends). Х Include the Mail Voucher program (H.R.1439) as an amendment to provide free mailing privileges for family members to send mail and packages to their loved ones serving in combat areas. Unfortunately, three key initiatives were offered but rejected or withdrawn during the mark-up. The Committee majority rejected: Х Rejected an amendment offered by Rep. Thelma Drake (R-VA) to repeal the SBP/DIC offset. This was blocked on a procedural ruling that it was not allowed under the budget resolution guidelines; Х Rejected an amendment from Rep. Joe Wilson (R-SC) to lower Guard and Reserve retirement age retroactive to Sept. 11, 2001; and Х In the face of these rejections, Rep. Joe Kline (R-MN) withdrew his amendment for full concurrent receipt to all disabled retirees. The House defense authorization bill also includes language that would halt construction of replacement hospitals for Walter Reed Army Medical Center until the Defense Department demonstrates that it can deliver world-class health services. Language inserted in the bill would prohibit construction from going beyond the foundation stage until lawmakers are satisfied with the design of a new hospital at Fort Belvoir in Fairfax County and expansion of the National Naval Medical Center in Bethesda. Hopefully there will be a sense of urgency, which will spur the Senate to complete action and approve their version of the NDAA and allow a conference to be completed before Congress recesses in October for elections. [Source: NAUS Weekly Update 16 & 23 May 08++] NDAA 2009 UPDATE 03: Sometime in June, the full Senate will be considering Defense Authorization Bill (S.2787) amendments on a variety of issues close to the hearts of the military community. These include: Х Tricare Fees: Senators Frank Lautenberg (D-NJ) and Chuck Hagel (R-NE) will be offering their amendment that would establish principles in law that military people pay large in-kind premiums of sacrifice for their lifetime health care in addition to cash fees in retirement, and that their fees shouldn't rise in any year by a percentage that exceeds the percentage increase in their military compensation. Х Concurrent Receipt: Majority Leader Harry Reid (D-NV) will offer one or more amendments to eliminate the VA disability offset to earned military retired pay. Х Survivor Benefit Plan (SBP): Sen. Bill Nelson's (D-FL) amendment would end the deduction of VA survivor benefits from SBP for all survivors of servicemembers who died of service-connected causes. Х GI Bill Transferability: Sen. John Warner (R-VA) will offer an amendment to allow servicemembers who complete their initial obligations and commit to extended service the opportunity to transfer part (or in some cases all) of their GI Bill benefits to a spouse or child(ren). Х Reserve Retirement Age: Sen. Saxby Chambliss's (R-GA) amendment would allow three months' reduction in the reserve retirement age for every 90 days activated since Sept. 11, 2001. When these amendments are finalized, veterans will be asked to e-mail and call their senators to support them. The House completed action on their Defense Authorization Bill (H.R.5658) in MAY. After the Senate approves its version (hopefully by the end of June), House and Senate leaders will have to negotiate resolutions to the differences in the two versions. This could be accomplished before Congress recesses for the election. However, recent history indicates we may not get a final defense bill until late NOV or DEC, via a post-election "lame duck" session of Congress. [Source: MOAA Leg Up 30 May 08 ++] GI BILL UPDATE 22: On 15 MAY, the House approved a war-funding bill H.R.2642 without any funding for the war after the Democratic leadership had stated that they would allow only 3 Amendments to be considered splitting the bill into 3 parts: War funding, policy provisions and domestic spending. The bill included provisions, which Bush announced he would veto, that would require withdrawal of troops to begin 30 days after it was signed into law and a non-binding goal of total removal in 18 months. So without the ability to propose Amendments, the funding issue failed on a 141-to-149 vote with 132 Republicans voting "present," holding back their support to protest against domestic-spending items Democrats added to the must-pass legislation. While there's no war funding, the legislation does contain a domestic spending package including: Х Money to grant 13 more weeks of unemployment insurance for workers whose insurance has run out and 13 weeks more in high unemployment states. Х A Уmillionaire tax surchargeФ to pay for it and other programs. The surcharge would be a 1/2% tax on incomes above $1 million but, it would apply to an individual making $500,000, or a couple making $1 million). Х Utilization of the tax proceeds to cover the estimated $51 billion costs over 10 years of a 4-year Public UniversityТs tuition plus a monthly stipend and book costs. Х A withdrawal of U.S. troops from Iraq to begin within 30 days with a "goal" of withdrawal within18 months. The billТs passage hardly settles all the issues in the Supplemental, but it would mean that the bill would start to move through the process. As is it includes $96.6 billion to fund the Wars in Iraq and Afghanistan through September. (President requested $100 billion.) The remaining $3.4 billion is assigned to pay for military base and hospital construction, food aid and money for the Federal Bureau of the Census and the Federal Bureau of Prisons. There is an additional $66 billion for DoD to pay for the Wars from 1 OCT until a new Administration is sworn in next year. President Bush has said that he would veto the bill if it included tax increases. It is expected that the Senate will remove the War withdrawal provisions and the tax increase from the bill. Smart money on the Hill is the President will not veto the Supplemental if it includes the improved Veterans Benefits or the unemployment provisions. Only time will tell. Leaders in the House and Senate now say final action is unlikely to be completed before the Memorial Day recess. Without the extra money, Pentagon officials warn that by June the services will run out of money and be forced to cut elsewhere to cover war costs. Though once assured that Congress would finish the bill by early May, Senate Majority Leader Harry Reid now believes the bill may not be completed until mid-June. Debate, however, may begin before the recess. [Source: TREA/NAUS 16 May 08 ++] VA PTSD EVALUATION CRITERIA: Per 38 CFR DC 9440 the evaluation criteria for chronic adjustment disorder and General Rating Formula for mental disorders is: Х 100%: Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. Х 70%: Occupational and social impairment, with Deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work like setting); inability to establish and maintain effective relationships. Х 50%: Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. Х 30%: Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events. Х 10%: Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication. Х 0%: A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication. [Source: VFW VSO Scott H. Langhoff article 15 May 08 ++] VA PTSD CLAIM SUPPORT: There has been some confusion concerning what is a decoration for Valor in combat to support PTSD claims filed due to combat. The decorations on the below list are the only decorations recognized for Valor in combat. If the Veteran has one of these decorations, he (or she) does not need a diagnosis of PTSD, as exposure to combat is conceded by the VA. They only need to complete VA form 21-0781 detailing stressful incidences to the best of their ability, and provide a "Stressor Statement" detailing the symptoms they're experiencing (see attached list). There can be other acceptable evidence in the form of official Unit Records, Diaries and Ship's Deck Logs on occasion. Х Air Force Cross Х Air Medal with "V" Device Х Army Commendation Medal with "V" Device Х Bronze Star Medal with "V" Device Х Combat Action Badge Х Combat Action Ribbon (Note: Prior to FEB 69, the Navy Achievement Medal with "V" Device was awarded.) Х Combat Aircrew Insignia Х Combat Infantry/Infantryman Badge Х Combat Medical Badge Х Distinguished Flying Cross Х Distinguished Service Cross Х Joint Service Commendation Medal with "V" Device Х Medal of Honor Х Navy Commendation Medal with "V" Device Х Navy Cross Х Purple Heart, and/or Х Silver Star. [Source: VFW VSO Scott H. Langhoff article 15 May 08 ++] PTSD PURPLE HEART UPDATE 01: Recently, a military psychologist John E. Fortunato at Fort Bliss TX told reporters during a roundtable that making troops with PTSD eligible for the Purple Heart could help destigmatize the disorder. "These guys have paid at least a high as high a price, some of them as anybody with a traumatic brain injury, as anybody with shrapnel wound, and what it does is it says this is the wound that isnТt worthy, and I say it is.Ф When asked about FortunatoТs suggestion later, Defense Secretary Robert Gates called it an interesting idea, adding the matter is clearly something that needs to be looked into. On 16 MAY, Pentagon Press Secretary Geoff Morrell said the issue was referred to the Defense Department Awards Advisory Group after Gates' remarks. "I should point out they've looked at this before, and they determined that it was not appropriate to make PTSD a qualification for the Purple Heart," Morrell said at a news conference. Right now, the regulation that outlines the criteria for the Purple Heart lists PTSD as an injury that does not merit the award, along with trench foot, heat stroke and self-inflicted wounds. The group does not have a timetable to produce a recommendation on the issue, Morrell said. The awards group is made up of awards experts from the services and the Defense Department, said Lt. Col. Jonathan Withington, a Defense Department Spokesman. The Military Order of the Purple Heart (MOPH) veterans group for combat wounded troops whose mission is to preserve the integrity of the Purple Heart has come out against giving the award to troops suffering from post-traumatic stress disorder. They claim that PTSD does not merit the Purple Heart, according to an Army regulation that lays out the criteria for the award. MOPH representatives said, the Purple Heart was set up for combat wounds, for those who have shed blood, and although PTSD is a physical disease and is an injury it does not qualify for the merit of Purple Heart based on that. Injuries that merit the Purple Heart must happen in a combat theater and must be a direct result of enemy action. The groupТs concern about PTSD is that it can be caused by other factors, not necessarily the enemy. "Did it occur in boot camp? Did it occur because of the rough air flight into theater? Or did it occur because an individual saw the results of the Taliban massacre of a village? Stars and Stripes called the medical center where Fortunato works for a response, but a spokesman there referred questions to Army Human Resources Command, adding that Fortunato should not have commented on the Purple Heart in the first place because the issue is Уout of our medical lane." [Source: Stars and Stripes Jeff Schogol article 14 & 17 May 08 ++] PTSD UPDATE 20: Two veteransТ advocacy groups have asked for copies of all documents relating to the Veterans Affairs DepartmentТs post-traumatic stress disorder policies after an e-mail surfaced asking VA doctors to keep costs down by giving diagnoses of adjustment disorder instead. Veterans diagnosed with PTSD are eligible for health benefits and, in some cases, disability retirement pay. Adjustment disorder, on the other hand, is considered a short-term diagnosis, and does not qualify veterans for benefits, said Brandon Friedman, vice chair of VoteVets.org, one of the advocacy groups. УThey can say, СAh, youТve got something temporary, itТll go away, so we donТt need to pay you for the rest of your life,Т Ф Friedman said. He said several veterans have told him they were diagnosed with adjustment disorder rather than PTSD, and that they felt they had received the wrong diagnosis. УWe hear anecdotal evidence all the time that VA is trying to cut costs by not diagnosing PTSD,Ф said Friedman, a former infantry officer who served in Iraq and Afghanistan. УBut weТve never actually seen proof that it was being done in an organized way.Ф The e-mail, which Friedman said came from a VA hospitalТs PTSD program coordinator, was apparently sent to several VA employees at that hospital. A psychologist from the hospital in turn sent it to VoteVets.org, Friedman said. УGiven that we are having more and more compensation-seeking veterans, IТd like to suggest you refrain from giving a diagnosis of PTSD straight out,Ф the e-mail states. УConsider a diagnosis of adjustment disorder, r/o [rule out] PTSD. Additionally, we really donТt ... have time to do the extensive testing that should be done to determine PTSD.Ф The e-mail also states veterans are appealing their compensation and pension ratings based on diagnosis from his staff. VA Secretary James Peake acknowledged in a statement that the e-mail did come from a VA facility, but said itТs not official policy. УA single staff member, out of VAТs 230,000 employees, in a single medical facility sent a single e-mail with suggestions that are inappropriate and have been repudiated at the highest level of our health-care organization,Ф he said. УThe employee has been counseled and is extremely apologetic.Ф VoteVets.org and Citizens for Responsibility and Ethics in Washington (CREW) filed a Freedom of Information Act request 14 MAY asking VA for all documents relating to PTSD. On 28 MAY they requested that the Inspector General for the DVA open an investigation into the process and manner by which the VA makes a diagnosis of post traumatic stress disorder (PTSD) in veterans. Their basis for making this request was additional information they became aware of indicating: Х The VA has adopted incentive programs that, by rewarding those employees and hospitals that distribute lower levels of compensation to veterans, encourage adjustment disorder diagnoses rather than the most appropriate but also more costly diagnosis of PTSD. Х VA's internal computer system permits medical files to be changed by health professionals who did not conduct the initial examinations, a practice that appears to have resulted in changed diagnoses from PTSD to adjustment disorder, even where there is no additional medical evidence to support the downgraded diagnoses. Х Assertions from VA employees that they suffered retaliation for their failure to support these practices. УWeТre not head-hunting,Ф Friedman said. УThere are a lot of great people who work at VA who have helped me and my friends. We had to file the FOIA to get to the bottom of this. Is it from the head of the VA? The presidential administration? Or individual hospitals? I would like to know where this directive is coming from.Ф Peake said his staffs Уworks hardФ to make sure mental health issues are accurately diagnosed. УVAТs leadership will strongly remind all medical staff that trust, accuracy and transparency is paramount to maintaining our relationships with our veteran patients,Ф he said. УWe are committed to absolute accuracy in a diagnosis and unwavering in providing any and all earned benefits. PTSD and the mental health arena is no exception.Ф [Source: Air Force Times Kelly Kennedy article posted 16 May & CREW press release 28 May 08 ++] PENNSYLVANIA VET BONUS UPDATE 01: Eligible veterans are those who: Х Served with the United States Armed Forces, a reserve component of the United States Armed Forces or the Pennsylvania National Guard. Х Served on active duty in the Persian Gulf Theater of Operations during the period from August 2, 1990 to August 31, 1991 and received the Southwest Asia Service Medal. Х Been a legal resident of Pennsylvania at the time of active service (Aug 2, 1990 - Aug 31, 1991) and served under honorable conditions. Eligible beneficiaries of deceased veterans include, in the following order of precedence: Х Surviving spouse. Х Surviving children. Х Surviving parents. Vets will receive $75 per month for each month (or major fraction) of active service, up to a maximum of $525. The sum of $5,000 will be paid on behalf of veterans who died in active service or as a result of service-connected wounds, and $5,000 to prisoners of war in the conflict. Service members, veterans or their surviving beneficiaries are not eligible for the program if a bonus, gratuity, or compensation similar to that provided by this Act has been received from any other state, or if the service member or veteran has renounced his or her US citizenship. To request a copy of an application or ask questions call (866) 458-9182 between 9AM and 5PM, M-F or anytime to utilize the automated voice system. Forms can be downloaded. The short form (PG-1 Short) at http://www.milvet.state.pa.us/DMVA/Docs_BVA/PGVB/Application_Short_FILL.pdf for veterans or service persons filing on their own behalf. The long form (PG-1 Long) at http://www.milvet.state.pa.us/DMVA/Docs_BVA/PGVB/Application_Long_FILL.pdf should be used if you are a surviving family member of a veteran, or if you are applying on behalf of a veteran deemed incompetent. It can be obtained at Completed applications with attachments should be mailed to: Persian Gulf Conflict VeteransТ Benefit Program, PO Box 1109, Harrisburg, PA 17108-1109. For more info ion the program, refer to www.persiangulfbonus.state.pa.us . [Source: EANGUS Minuteman Update 15 May 08 ++] VETERAN LEGISLATION STATUS 29 MAY 08: Congress recessed on 22 MAY for the Memorial Day weekend and will return to Washington 2 JUN. For a listing of Congressional bills of interest to the veteran community that have been introduced in the 110th Congress refer to the BulletinТs House & Senate attachments. By clicking on the bill number indicated you can access the actual legislative language of the bill and see if your representative has signed on as a cosponsor. Support of these bills through cosponsorship by other legislators is critical if they are ever going to move through the legislative process for a floor vote to become law. A good indication on that likelihood is the number of cosponsors who have signed onto the bill. A cosponsor is a member of Congress who has joined one or more other members in his/her chamber (i.e. House or Senate) to sponsor a bill or amendment. The member who introduces the bill is considered the sponsor. Members subsequently signing on are called cosponsors. Any number of members may cosponsor a bill in the House or Senate. At http://thomas.loc.gov you can also review a copy of each billТs content, determine its current status, the committee it has been assigned to, and if your legislator is a sponsor or cosponsor of it. To determine what bills, amendments your representative has sponsored, cosponsored, or dropped sponsorship on refer to http://thomas.loc.gov/bss/d110/sponlst.html. The key to increasing cosponsorship on veteran related bills and subsequent passage into law is letting our representatives know of veteranТs feelings on issues. At the end of some listed bills is a web link that can be used to do that. Otherwise, you can locate on http://thomas.loc.gov who your representative is and his/her phone number, mailing address, or email/website to communicate with a message or letter of your own making. Refer to http://www.thecapitol.net/FAQ/cong_schedule.html for future times that you can access your representatives on their home turf. [Source: RAO Bulletin ! Attachme nt 29 May 08 ++] HAVE YOU HEARD: A famous Viking explorer returned home from a voyage and found his name missing from the town register. His wife insisted on complaining to the local civic official who apologized profusely saying, 'I must have taken Leif off my census.' Lt. James УEMOФ Tichacek, USN (Ret) Director, Retiree Assistance Office, U.S. Embassy Warden & IRS VITA Baguio City RP PSC 517 Box RCB, FPO AP 96517 Tel: (951) 238-1246 in U.S. or Cell: 0915-361-3503 in the Philippines. Email: raoemo@sbcglobal.net Web: http://post_119_gulfport_ms.tripod.com/rao1.html AL/AMVETS/DAV/FRA/NAUS/NCOA/MOAA/USDR/VFW/VVA/CG33/DD890/AD37 member


THIS BULLETIN CONTAINS THE FOLLOWING ARTICLES == Medicare Reimbursement Rates 2008 [10] ------ (No Compromise) == VA Clinic Openings [10] --------------------------- (44 New Clinics) == Tricare/CHAMPUS Fraud [11] ---------------- (5 years for $100M) == Tricare/CHAMPUS Fraud [12] ------------------------- (Retribution) == Shad [07] ----------------------- (Low Claim Approval Rate) == VA Lawsuit (Lack of Care) [09] -------- (Outside Court Authority) == Mobilized Reserve 25 JUN 08] -------------------- (1,884 Decrease) == VA Dental Treatment [03] ---------------------------- (VA Insurance) == Economic Stimulus Package [06] --------- ($2 billion Confiscated) == Veterans Disarmament Bill [01] ------ (Gun Ownership Protected) == VA Pay to Performance ---------------------- (Pilot Project) == Reserve Component Mental Health Act ----------------- (H.R.6075) == SBP Lawsuit [02] --------------------------- (Judge Orders Payment) == GI Bill [24] -------------------- (Webb Bill Passes Congress) == VeteransТ Benefit Expirations [01] ------------------------ (Updated) == Saluting the Flag [02 ---------------------- (Civilian Attire) == Veterans Tax Relief [01] ----------------- (Signed Into Law) == Bequest Basics ---------------------------------- (Types) == VA Appeals [04] --------------------------- (Vet Lawyer Disbarment) == VA Mileage Reimbursement [04] --------- ($0.505/mile Proposed) == Telemarketing Call Elimination [06] ------------- (Rules Amended) == Chap 61 CRSC Claims ------------------------- (Guidance Released) == DoD Disability Severance Law --------------------- (Violated?) == Senate Rules ---------------------------------- (Clarification) == Tricare Hospital Selection in PI ------------- (Verify First) == VA Gulf War Advisory Committee [01] -------------- (1st Meeting) == VA Health Care Funding [13] ---------- (Advance Appropriations) == VA Health Care Funding [14] ---- (Dysfunctional Budget System) == VA Drug Testing on Vets -------------------- (Hearings to be Held) == VA Drug Testing on Vets [01] ------------- (300 Studies Ongoing) == PTSD [22] ----------------------------------- (H.R. 6268) == Gulf War Vet Fatigue Study ----------------------- (CoEnzyme Q10) == VA Budget 2009 [03] -------------------- (Subcommittee Approved) == Veteran Grave Vandals [01] ----------- (Senate Committee Action) == Long Term Care Expense ------------------ (Insurance or Self Pay) == Army Sea Duty Ribbon --------------- (Guard & Reserve Eligible) == VA Fraud [10] -------------------------------- (Tampa FL) == Credit Card Scam [01] ------------------------- (EPPI Card system) == Medicare Preventive Care Services --- (Guidelines & Frequency) == Medicare Summary Notice (MSN) ---------------------- (What it is) == Veteran Legislation Status 29 JUN 08 ---------- (Where we Stand) MEDICARE REIMBURSEMENT RATES 2008 UPDATE 10: On 24 JUN, the House overwhelmingly passed H.R.6331, Medicare Improvements for Patients and Providers Act, which would have stopped the payment cuts, substituted a small increase for doctors seeing Medicare and TRICARE patients, and prevented the therapy cutoff. The vote was a solid veto-proof 355-59 with 20 not voting. This bill was almost identical to one rejected by the Senate two weeks ago. But Senate Republicans and President Bush didn't approve of the funding source for that fix (cutbacks in some Medicare Advantage programs that pay doctors up to 17% more than regular Medicare does), and pushed an alternative bill. Medicare Advantage is but a small portion of those dependent upon Medicare. After the overwhelming House vote, Senate leaders tried to bring the bill up for a vote anyway. But when Republicans objected, they needed 60 votes to overcome the objection. On 26 JUN at 8:20PM, they got 58 with 40 nays and two not voting. Not enough to even get a vote, let alone override a threatened presidential veto. Republicans then proposed extending the current rates for 30 days to allow more time for a fix. But that was a non-starter, since the House had already left town for recess, and the Senate can't approve a new fix by itself. Congress took a week's vacation over Independence Day and promised to fix things when they return. Now Medicare payments to doctors will be cut 10.6% starting 1 JUL. Also as of July 1, speech, physical or occupational therapy patients for whom Medicare has already paid at least $1,810 for therapy in 2008 will have further Medicare payments for that care stopped. (NOTE: Tricare doesn't have a therapy payment cap like Medicare does, so Tricare therapy patients should be okay. For Tricare For Life patients, Tricare will pick up payments when Medicare stops, BUT only after the $150 annual Tricare deductible has been satisfied, along with applicable copays.) Tricare patients have a little more breathing room. Although Tricare doctor payments are tied to Medicare's, there's usually about a month's delay in updating Tricare payment files when Medicare makes a change. This isn't the first time Congress has failed to stop a Medicare payment cut. In 2006, Congress missed the deadline, but approved a fix within a few weeks and made it retroactive. That caused doctors and Medicare administrators lots of headaches in the interim, but in the end, the lost payments were made up. And Tricare patients were never affected, because Congress fixed the rates before TRICARE got around to implementing the cuts. That's the best-case scenario now - if Congress can act quickly after 4 JUL to approve a fix the president will sign. But the risk remains that some number of fed-up doctors will decide not to accept any more Medicare or Tricare patients and some may even turn away current Medicare/Tricare patients. Whatever Congress does after 4 JUL, they could have done before 1 JUL and prevented this mess. Actually, they have had since 2002 to fix the problem but have only applied a band-aid fix each year. If the President, the House, the Senate, Republicans, and Democrats had been willing to compromise -- just a little -- health care access for our seniors and military beneficiaries need not have been put at risk in this irresponsible way. All active duty and retire personnel with Tricare are encouraged to go to http://capwiz.com/usdr/issues/alert/?alertid=11554371&queueid=[capwiz:queue_id] , enter your zip code, and send a message to both of your Senators to work out their differences on this issue. Note: The Bush Administration announced 27 JUN 08, that it will hold all Medicare claims from doctors for the first 10 business days of July and that it will make no payments at the 10% reduced reimbursement rate until 15 JUL at the earliest. This positive step by the administration gives Congress a window of time to come together on a reasonable, bipartisan Medicare bill to eliminate the 10% cut in Medicare payments to doctors. [Source: USDR Action Alert 27 Jun 08 ++] VA CLINIC OPENINGS UPDATE 10: Secretary of Veterans Affairs Dr. James B. Peake announced 26 JUN plans to create 44 new community-based outpatient clinics to bring the health care of the Department of Veterans Affairs (VA) closer to home for veterans in 21 states. The new clinics, scheduled to be activated over the next 15 months, will increase VA's network of independent and community-based clinics to 782, an increase of more than 100 in five years. This growth in community clinics has helped VA meet veterans' expectations for prompt, quality service, with 98% of veterans seen within 30 days in all types of VA primary care facilities throughout the country. VAТs Planned Sites for New Outpatient Clinics are: Х Alabama (2) -- Marshall County , Wiregrass Х Alaska -- Matanuska-Susitna Borough area Х Arkansas (2) -- Ozark, White County Х California -- East Bay-Alameda County area Х Florida Ц Summerfield Х Georgia (4) -- Baldwin County , Coweta County , Glynn County , Liberty County Х Indiana (2) -- Miami County , Morgan County Х Iowa -- Wapello County Х Louisiana (5) -- Lake Charles , Leesville, Natchitoches , St. Mary Parish, Washington Parish Х Maine -- Lewiston-Auburn area Х Minnesota (2) -- Douglas County , Northwest Metro Х Missouri -- Franklin County Х New Mexico -- Rio Rancho Х North Carolina (2) -- Robeson County , Rutherford County Х North Dakota -- Grand Forks County Х Ohio -- Gallia County Х Oklahoma (4) -- ltus, Craig County , Enid, Jay Х Tennessee (3) -- Giles County , Maury County , McMinn County Х Texas (5) -- Katy, Lake Jackson , Richmond , Tomball, El Paso County Х Virginia (3) -- Augusta County , Emporia , Wytheville Х West Virginia -- Greenbrier County [Source: VA Press Release 26 Jun 08 ++] TRICARE/CHAMPUS FRAUD UPDATE 11: A former health care executive was sentenced 17 JUN to five years in prison for helping his Philippines-based company swindle nearly $100 million from the U.S. military health insurance program. Thomas Lutz, age 41, said in federal court he took responsibility for the six-year scheme in which Health Visions Corp. bilked $99.9 million from the militaryТs Tricare program through inflated and fraudulent claims. U.S. District Judge Barbara Crabb said the five-year sentence was modest given the extent of the fraud, but it was the longest she could impose under LutzТs plea deal. Health Visions and Lutz were initially charged in a 75-count indictment in 2005. He pleaded guilty in 2006 to a single count of conspiracy to pay kickbacks and agreed to cooperate with prosecutors, a deal Crabb called Уa huge breakФ for Lutz. УItТs just horrifying that you were able to take as much money as you did,Ф Crabb told Lutz. Prosecutors said the company routinely inflated claims by more than 230%, operated a phony insurance program and billed for medical services never delivered. In April, Crabb ordered Health Visions to pay $99.9 million in restitution. Under her order, the company must sell all of its assets, including land, hospitals and office buildings, within 10 months. She said Lutz would be responsible for paying the remainder, including at least 25% of his income once he is released from prison. Crabb gave Lutz until 18 MAR to report to prison. Prosecutors asked for the nine-month delay so Lutz could help the government recover as much money as possible from the company. Formed in 1997, Health Visions owned and operated hospitals and clinics in the Philippines and billed Tricare on behalf of other health care providers. The company served thousands of U.S. military retirees living in the Philippines, where bases were located until the early 1990s. The company was reimbursed $163 million by Tricare between 1998 and 2004, and prosecutors believe at least $99.9 million of that was fraudulent. Lutz, an American citizen, read a brief statement in which he took full responsibility for his companyТs actions. УI would like to apologize to the Department of Defense,Ф he said. УI am truly sorry for all those who have been affected. [Source: Air Force Times Ryan J. Foley AP article 18 Jun 08 ++] Editors Note: The magnitude of this fraud was allowed in part because of the failure of the U.S. government to provide sufficient transportation funds to DCIS over six years to follow through on repeated reports by Tricare users of what was going on since 1997. After 3 to 4 years many retirees in the Philippines just gave up on their attempts to report this fraud in the belief that Tricare officials and WPS for whatever reasons did not want to pursue stopping it. Now, in part as a result of these losses, TMA has initiated actions that will result in all Philippine Tricare users having to effectively pay higher Tricare fees than those in CONUS. This they are allowed to do by lowering the allowed amounts that can be reimbursed to Philippine providers. The net result of this is that in addition to the 25% copay, retirees will also have to pay their providers the difference between what Tricare allows and what is charged to Philippine citizens. TRICARE/CHAMPUS FRAUD UPDATE 12: The former health care executive responsibility for the six-year scheme in which Health Visions Corp (HVC) bilked $99.9 million from the militaryТs Tricare program through inflated and fraudulent claims, was sentenced 17 JUN to five years in prison. However, it is likely he (Thomas Lutz) will never have to spend a day in jail for this fraud. How can this be? Consider the following Х Lutz was convicted on only one count of mail fraud out of 75 charges. This was in exchange for a deal to work with the prosecution to recover assets and evidence to build cases for additional prosecutions. Х The time between his conviction and sentencing was 18 months during which he was out of custody on personal recognizance with no BAIL. Х At the request of the prosecution team, the judge is allowing him to stay a "free man" another 9 months until 18 MAR 09 to help in the recovery of money owed the government. Х Because the state prosecutors ask for his freedom to help the government the time (a total 2 years 3 months) will count towards jail time served. Х Under the law he can earn one day for every day served for good behavior or another 2 years 3 months. Х That leaves only six months of the 5 year sentence to serve. However, because of the overcrowding of penal facilities they could extend their early release program by another 3-6 months. Adding up these times results in the potential of him serving no real jail time. Even if he were to serve a few months in custody, since this was a "white collar" crime and he has shown by his extended time out of custody with no bail (he was allowed to remain in Missouri the entire time) not to be a flight risk he would go to a minimum security facility and avoid exposure to the hardships of a regular penal institution. Thus, the only real retribution he will have to make for his $100 million theft will be from the judgeТs order that he has to give 25% of his earning for the rest of his life to the government to help pay off the $100 million fine. Assuming upon release he could earn $10,000 a month he would have to work for another 3,300 years to pay off the fine. Even then, to ensure he is paying the correct amount the government will have to prove his earnings and the court can always take in consideration the needs of his family to reduce the amount of that order. The judge ordered that all corporation assets be liquidated to help pay the balance of the fine. However the majority of those assets are in a foreign country (Philippines) under the legal control of foreigners who are not subject to U.S. law. Lutz and his partner Thieke Sr. had hospitals in Olongapo (2 facilities), Metro Manila, Angeles City, and Iloilo. Thieke's wife, a Filipino citizen, was on the Board of Directors of HVC and the end owner of the hospitals. The U.S. Government has acknowledged s in a newspaper article that they "may not be able to get those facilitiesФ. Local sources say that the Manila hospital was either in the name of Thieke Jr's natural mother or sold. Local sources also say in Olongapo, one hospital is closed down with all the equipment being seen to be moved to the hospital in the Subic Bay Freeport Zone. Allegedly the closed hospitalТs lease is still under the name of Thieke Jr. who has joined with a local official and opened a new medical school. They had an open house last month to introduce the reopening of the Hospital under a new name. They still operate the nursing school. Bottom line it is unlikely the U.S. government will recoup much from the assets of the HVC Corporation. Perhaps, if he writes a book on УHow to Defraud the U.S. Government and Avoid ProsecutionФ the royalties will help pay off some of the fine. Source: Various Jun 08 ++] SHAD UPDATE 07: Within the last few days the Associated Press reported that only 6% of health claims filed by veterans of secret Cold War chemical and germ warfare tests conducted by the Pentagon have been granted by the Department of Veterans Affairs. However, by way of comparison, the VA has granted approximately 88%of claims from Gulf War veterans. And more than 90% of the claims from veterans of the Iraq and Afghanistan wars have been granted. The VA claims it is not correct to make those sorts of comparisons because each group of veterans has its unique circumstances. It also noted that most of these veterans ended their service more than 30 years ago and that a study by the Institute of Medicine found no clear connection between the warfare tests and the cancer, respiratory illnesses and other problems now being experienced by those veterans. However, that study has been dismissed by some veterans groups as having been conducted in a shoddy manner. According to the DoD, 6,440 veterans took part in the tests. Of the 641 claims that had been processed by the VA as of May, 56 were pending, only 39 were granted, and 546 were denied. House Veterans Affairs Committee Chairman Bob Filner reacted to the information by saying, УThis is ridiculous. These guys were there. They all have cancer. Take care of them.Ф Two weeks ago the House VA Committee held hearings on bipartisan legislation that would grant coverage to the veterans who were involved without them having to prove a link between their diseases and the experiments they participated in. Filner said he hopes to have the bill passed out of his committee by the 4 JUL recess. However, that will only be the start of the battle. Both the VA and DoD oppose the bill. According to the AP story, УThe Pentagon only began to disclose details of the tests publicly in 2001, after pressure from veterans and lawmakers. Two years later Defense officials stopped looking for additional participants, despite criticism from the Government Accountability Office, which said untold numbers of veterans and civilians could remain unaware of their potential exposure.Ф Far too often, the leadership in both the VA and DoD are more concerned with the impact on their budgets than on the need to take care of veterans. [Source: TREA Washington Update 27 Jun 08 ++] VA LAWSUIT (LACK OF CARE) UPDATE 09: A judge determined 25 JUN that he does not have the jurisdiction to change the way the Veterans Affairs Department cares for returning service members in a lawsuit Veterans for Common Sense filed against VA Secretary James Peake. УThe grievances are misdirected,Ф Judge Samuel Conti wrote in his decision for the U.S. District Court, Northern District of California. УThe remedies to the problems, deficiencies, delays and inadequacies complained of are not within the jurisdiction of this court.Ф But though he found for the defendants, the judge laid out in an 82-page decision many problems he identified within VA from three weeks of testimony. Veterans for Common Sense complained that VA needs better oversight to ensure programs are in place and well-run, and that delays and gaps in mental-health care have led to problems for Iraq and Afghanistan veterans, including lost jobs, ruined relationships, homelessness, accidental overdoses in VA facilities and suicide while under VA care. Conti said the plaintiffs Уhave demonstrated that their members have suffered injuries in factФ. He wrote, УGiven the dire consequences many of these veterans face without timely receipt of benefits or prompt treatment for medical conditions, especially depression and [post-traumatic stress disorder], these injuries are anything but conjectural or hypothetical. As VA concedes, delays in health care, especially for mental health issues, and delays in receipt of disability benefits, which are often the primary or sole source of income for a veteran, can lead to exactly the type of injuries complained ofФ by Veterans for Common Sense.Ф In fact, he said, the actions sought by Veterans for Common Sense, including a time limit on how long an appeal can take, would likely improve the situation. УThis issue ... is whether this and other relief sought by [Veterans for Common Sense] are within the power of the court to grant,Ф Conti wrote. УThe Court finds that [Veterans for Common SenseТs] individual members would have standing to sue.Ф The trial brought to light an e-mail showing 1,000 veterans a month attempt suicide while under VA care Ч written by VAТs top mental health doctor with the subject line, УShh!Ф It caused a VA employee to forward an e-mail sent to mental health staff at a Temple, Texas, VA facility requesting that mental health workers diagnose adjustment disorder before PTSD because they didnТt have the resources to deal with PTSD. And it showed that delays in medical appointments, which VA claimed were 30 days, were actually much longer. But Veterans for Common Sense had to prove the problems were systemic Ч that they affected every veteran. Instead, they showed that many of the problems affected a lot of veterans, but not all of them. Though Veterans for Common Sense intends to appeal the decision, Paul Sullivan, executive director of the organization, said they Уstand willing to work with Congress and VA to resolve the many serious problems the court confirmed.Ф [Source: Marine Corps Times Kelly Kennedy article Posted 27 Jun 08 ++] MOBILIZED RESERVE 25 JUN 08: The Army, Air Force and Marine Corps announced the current number of reservists on active duty as of 25 JUN 08 in support of the partial mobilization. The net collective result is 1884 fewer reservists mobilized than last reported in the Bulletin for 11 JUN 08. 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. The total number currently on active duty in support of the partial mobilization of the Army National Guard and Army Reserve is 87,791; Navy Reserve, 5,601; Air National Guard and Air Force Reserve, 11,431; Marine Corps Reserve, 8456; and the Coast Guard Reserve, 787. This brings the total National Guard and Reserve personnel who have been mobilized to 114,066, including both units and individual augmentees. A cumulative roster of all National Guard and Reserve personnel, who are currently mobilized, can be found at http://www.defenselink.mil/news/Jun2008/d20080625ngr.pdf. [Source: DoD News Release 532-08 25 Jun 08 ++] VA DENTAL TREATMENT UPDATE 03: Legislation has been introduced in Congress that would provide veterans and their dependents with access to dental insurance. The bills would allow the Department of Veterans' Affairs (VA) to establish a dental program for the 7.9 million veterans, surviving spouses, and certain dependent children enrolled in VA health care system. The program, which is completely voluntary, would give them the benefit of VA's buying power in order to get lower premiums on dental insurance coverage. Sen. Richard Burr (R-NC) said, "Healthy teeth are an important part of overall health, and our veterans should have access to affordable dental care. This legislation would provide veterans with access to group insurance rates they may not otherwise be able to get on their own.Ф The legislation calls for an annual enrollment period with the ability to cancel insurance once a year or if a person is prevented by a serious medical condition from receiving any dental benefits or moves to a place where dental insurance cannot be used, such as overseas. Rep. Steve Buyer introduced his bill on 17 JUN. Sen. Richard Burr (R-NC) introduced his version on 23 JUN. The only significant difference between BuyerТs House bill, HR 6277, Richard Burr (R-NC) bill, S 3178, is that Buyer would authorize, but not require, VA to create the insurance program, while Burr would mandate its creation. In a statement, Buyer described the idea as similar to the Tricare Retiree Dental Program (TRDP) for retirees created in 1997 that now covers about 800,000 people, including military retirees, National Guard and reserve members and families. VA provides such care to veterans with service-connected dental disabilities, those who are 100% disabled for any condition, and those who were prisoners of war for 90 days or longer. Additionally, veterans newly separated from active duty can receive one-time dental treatment from VA if their discharge records show they were receiving dental treatment that was not completed before they were discharged. The bills would not replace any dental services provided by VA. While Buyer talked about the militaryТs Tricare Reserve Dental Program as a success, military retirees have complained about that programТs cost and the fact that the government does not subsidize the insurance. As a result, dental premiums are higher for some military retirees than their premiums for health care. Premiums for military retirees vary by region, with family coverage costing $90.57 a month in Arkansas, $121.39 in the District of Columbia and $138.66 in California. In addition to the monthly premiums, an annual deductible must be met before any dental expenses are covered. The insurance plan also does not fully cover all costs. For example, it covers only 60% of the cost of a tooth extraction and only 80% of the cost of a filling. New enrollees also sometimes must wait for a year before they are eligible for some coverage, such as dentures and orthodontics. [Source: Marine Corps Times Rick Maze article 26 Jun 08 ++] ECONOMIC STIMULUS PACKAGE UPDATE 06: About $2 billion in economic stimulus rebate checks are being confiscated to pay overdue bills for child support, student loans and back taxes, the government says. So far, 1.8 million rebate checks have been intercepted by Treasury Department computers showing that individuals owe money to federal or state governments. The biggest beneficiaries: parents who are owed child support. The Internal Revenue Service has mailed 77 million checks worth $64 billion Ч a little more than half the expected total. "It's a nice bonus for the children and families in need," says Mike Adams, head of child support at the Tennessee Department of Human Services. His state has received $8.5 million of $20 million expected for unpaid child support. The large take for unpaid debts is the result of an increasingly sophisticated debt-collection program that was started in 2001. Today, most states and federal agencies send weekly lists of delinquent Americans to the Treasury Department. Before a rebate is mailed, it's run through a list that contains the names and Social Security numbers of people who owe money. "We've had a few complaints but not many," says Dean Balamaci, director of debt collections at the Treasury Department. "We're proud that we're sending money back to families who need it." So far, nearly $1 billion has been collected. Where it has gone: 55% for child support, 39% for federal debts such as student loans or farm loans, and 6% for unpaid state taxes. Taxpayers denied their rebate get letters explaining why they got a reduced payment or none at all. The diverted money is sent directly to the family or government agency to which it was owed. A few states, however, are losing out on millions of dollars available through the program. Michigan doesn't get its delinquent state taxes collected, Balamaci says. The reason: It hires private contractors to collect back taxes. Also, Mississippi hasn't joined yet, and California doesn't submit the names of income tax debtors! . So, w hile Maryland has collected $6 million from rebate checks for unpaid state income taxes, California has received nothing. [Source: USA TODAY Dennis Cauchon article 25 Jun 08 ++] VETERANS DISARMAMENT BILL UPDATE 01: Lists of veterans who have been assigned fiduciaries to handle financial matters on their behalf could not be used to prevent gun ownership under an amendment approved by the Senate VeteransТ Affairs Committee on 26 JUN. By voice vote, the committee attached to a veteransТ health care bill an amendment prohibiting the Department of Veterans Affairs from sharing lists of so-called УincompetentФ veterans with the FBI. Only if there has been specific ruling that a veteran poses a risk to himself or others could the VA pass a name on to the FBI for inclusion in records used to make instant background checks before gun purchases, under the amendment to S.2969, the VeteransТ Health Care Authorization Act of 2008. Sen. Richard Burr of North Carolina, ranking Republican on the veteransТ committee and the chief sponsor of the amendment, said the VA makes a determination of incompetence based, primarily, on whether a veteran is capable of handling his own finances. If he cannot, a fiduciary is appointed to handle their benefits. Currently, the Brady Handgun Violence Prevention Act (P.L. 103-159) prohibits certain individuals from purchasing a firearm, including those who have been deemed a "mental defective." The VAТs sharing of records, done under a memorandum of understanding with the FBI, has resulted in about 116,000 veteranТs names being turned over, Burr said. Under current law, veterans have the right to request the removal of their name from the FBI list once it has been turned over, something Burr said presents an unfair burden, especially because other federal agencies, including the Social Security Administration, do not share its records of beneficiaries with fiduciaries with the FBI. The FBI uses the information in its National Instant Criminal Background Check System. Being listed on that site prevents the purchase of some firearms. The decision to appoint a fiduciary is an administrative process, decided by a claims adjudicator, who might be an expert in benefits but Уare not the ones to be calling the shots on constitutional mattersФ such as gun ownership, Burr said. Sen. Daniel Akaka, D-Hawaii, the veteransТ committee chairman, tried to discourage Burr, arguing that jurisdiction over the FBIТs criminal records system is not a veteransТ issue and that more time was needed to study the bill, particularly to get the VAТs views. After Akaka tried but failed to get enough votes to table the amendment, Akaka was among those voting for it. On the voice vote, only Sen. Patty Murray, D-Wash., opposed the amendment. Murray said she supported Уcommon senseФ gun laws but warned that turning over records of incompetent veterans was something that needed careful study. УWe want to tread carefully,Ф she said. [Source: Army Times Rick maze article 27 Jun 08 ++] VA PAY TO PERFORMANCE: The Veterans Affairs Department is launching a pilot project that will replace the decades-old General Schedule pay system with one that more closely ties pay to performance. On 18 JUN, VA announced that it would place 150 employees at the Veterans Health Administration under a pilot pay-for-performance system for at least the next five years. The plan will cover employees in the health systems administrator job series at the GS-14 and 15 grade levels, with the first performance-based pay adjustments awarded in January 2010. The Office of Personnel Management (OPM) said in the Federal Register that the General Schedule has limited options for recognizing superior performance, and that VA would like to use the human capital accountability and assessment framework to tie annual increases directly to job performance. The process would eliminate the fixed steps (up to 3 years) that give automatic pay raises to employees and instead make annual pay adjustments performance-sensitive, according to the OPM notice. Like other alternative pay experiments across government, pay pool adjustments would be funded from a kitty with money that would otherwise be used to fund the annual GS pay adjustment, quality step boosts and within-grade increases. "By regularly rewarding better performance with better pay, the participating organization will strengthen the results-oriented performance culture," wrote OPM. "Among other things, they will be better able to retain their good performers and recruit new ones." Lawrence Bifareti, director of workforce planning and organization development at VHA, said in DEC 07 that the agency already had implemented a five-tiered performance management system instead of the pass-fail systems many agencies use. At the time he said tying such ratings to pay was the agency's next step. According to OPM, federal agencies have the authority to place up to 5,000 employees in pay-for-performance demonstration projects. OPM must approve the projects and cannot manage more than 10 at any one time. Currently, pay-for-performance pilots are active in three federal agencies -- the acquisition component at the Defense Department, and the Commerce and Energy departments. The Agriculture Department announced in MAY that it planned to test pay for performance for 2,900 employees at the Food Safety and Inspection Service. Written comments on the proposal must be submitted by 18 JUL, and can be sent by e-mail to demoprojects@opm.gov. A public hearing on the plan is scheduled for 5 AUG at VA headquarters in Washington. [Source: GovExec.com Today 24 Jun 08 ++] RESERVE COMPONENT MENTAL HEALTH ACT: H.R.6075, the National Guard and Reserve Mental Health Access Act of 2008, was introduced on 17 JUN by Rep. Patrick Kennedy (D-RI). The bill focus is to educate soldiers on the mental health care available upon their return from deployment. УWith the levels of Post Traumatic Stress Disorder (PTSD) rising to epidemic proportions among our returning troops, it is imperative that we educate our Guard and Reserve Components about the mental health services they are eligible for so that no veteran or their family slips through the cracks,Ф said Kennedy. The billТs main provisions will: Х Support the recently enacted Yellow Ribbon Reintegration Program. Х Create a Joint Psychological Health Program to coordinate mental health services within the DoD. Х Test the feasibility of tele-mental health services available. Х Create a process to combat the stemmas department to combat the stigmas that exist concerning mental health problems. Х Assign Community Outreach Coordinators to educate local business, schools and others about the difficulties faced in reintegration [Source: NGAUS Leg Up 20 Jun 08 ++] SBP LAWSUIT UPDATE 02: When Congress changed the law several years ago to restore VA Dependency and Indemnity Compensation (DIC) payments to previously eligible widows who remarried after age 57, several of them who also were eligible for Survivor Benefit Plan (SBP) annuities sued to claim that the law required continuation of their SBP in addition to the DIC, without the normal dollar-for-dollar offset. The judge in the case seemed sympathetic and ordered the Defense Department to show why he shouldn't rule in their favor. But the Pentagon lawyers didn't reply. On 12 JUN, the judge made a summary judgment directing DoD to restore the widows' SBP annuities. But DoD isn't done, and is expected to appeal the decision, hoping for a more sympathetic appeals court judge. DoD won't have to restore the SBP annuities until the appeal is heard by a higher court first. [Source: MOAA Leg Up 20 Jun 08 ++] GI BILL UPDATE 24: A sweeping new veteransТ education package has been approved as part of the 2008 war budget. The package is designed to fully cover the cost of completing four years of college Ч including tuition and fees, books and living expenses Ч and to let career troops share those benefits with dependents. The new УGI Bill for the 21st CenturyФ will offer a benefit worth an average of $80,000, double the GI BillТs current value. The new benefit would pay up to the in-state rate for tuition and fees for the most expensive four-year public college or university in the state where a veteran attends school. The package also includes a monthly living stipend, a $1000 annual book allowance, and money for tutorial assistance, along with many other features. The House of Representatives passed the war funding bill 19 JUN and the Senate passed it 26 JUN. Benefits increases take effect as soon as the war funding bill is signed into law by President Bush who has already said he will sign it the next few weeks. But veterans now in school will not get the higher amounts right away because lawmakers are giving the Veterans Affairs Department until 1 AUG 09, to calculate and pay amounts that will vary by state and by school. Retroactive payments will have to be made. Also, anyone who had not previously enrolled in the GI Bill will have to wait until ` AUG 09, to collect any payments. Under the packageТs new family transfer option will give active-duty, National Guard and reserve members the right to transfer benefits to spouses or children after meeting certain time-in-service milestones. No transfer rights would be available until regulations are issued by the Pentagon. [Source: Marine Corps Time Rick Maze article 20 Jun 08 ++] VETERANSТ BENEFIT EXPIRATIONS UPDATE 01: Many of your benefits have an expiration date. Below are a few important federal ones to remember so you donТt lose out. Most veterans are not aware, that their benefits can expire: For more detailed information of these programs go to http://www.military.com/benefits/veteran-benefits/veterans-benefit-expiration-dates or: www.va.gov: Education, Training, and Employment Programs: 10 years from date of last discharge or release from active duty. Veterans Education Assistance Program (VEAP): 10 years from last discharge or release from active duty. Montgomery GI Bill for Selected Reserve (MGIB-SR): 14 years from the date of eligibility for the program, or until released from the Selected Reserve or National Guard. (Some extensions available if activated.) Reserve Educational Assistance Program (REAP): No time limit, while remaining in the same level of the Ready Reserve. Vocational Rehabilitation and Employment (VocRehab): Generally, 12 years of separation from service or within 12 years of being awarded service-connected VA disability compensation. VA Life Insurance Programs: Х ServicemembersТ Group Life Insurance (SGLI): Coverage ends 120 days after separation or Can be extended up to 1 year for totally disabled veterans. Х Family Group Life Insurance (FGLI): Coverage ends 120 days after separation or Can be extended up to 1 year for totally disabled veterans after separation. Х Veterans Group Life Insurance (VGLI): Within 120 days of separation. Х Service Disables Veterans Insurance (SDVI): Within 2 years from the date of being notified of service-connected status. Х Veterans Mortgage Life Insurance (VMLI): Must apply before age 70 Veterans Health Care Administration (VHA) PROGRAMS: Х Veterans Health care: No Time Limit Х Combat Veterans Health Care: 5 years from release from active duty. Х Dental Treatment: Within 90 days of separation. VA Pension And Compensation Programs: Х Disability Compensation: No Time Limit. Х Disability Pension: No Time Limit. Х VA Home Loan Guaranty Program: No Time Limit. [Source: CFVI Newsletter Jun 08 ++] SALUTING THE FLAG UPDATE 02: President Bush signed on 28 JAN 08 a law amending federal code to allow a veteran to salute the U.S. flag while not in uniform in certain, but not all, situations. The amended federal code addresses actions for a viewer of the U.S. flag during its hoisting, lowering or passing. In these instances, the law allows a veteran in civilian attire to salute the flag. All other persons present should face the flag, or if applicable, remove their headdress with their right hand and hold it at the left shoulder, the hand being over the heart. Citizens of other countries present should stand at attention. All such conduct toward the flag in a moving column should be rendered at the moment the flag passes. However, another section of federal code that specifically relates to actions of those reciting the Pledge of Allegiance was not amended. In this case, a veteran in civilian attire is not specifically authorized to render a hand salute during the Pledge. In any case, a veteran in civilian clothes is authorized to place their right hand over their heart as has been tradition. [Source: eFlorida News 20 Jun 08 ++] Veterans Tax Relief Update 01: A military tax bill containing a combination of new tax benefits and the extension of existing benefits was signed into law 17 JUN by President Bush. The Heroes Earnings Assistance and Relief Tax Act of 2008, or HEART Act, includes a provision allowing military families to receive the $600-per-person economic stimulus rebate even if a spouse does not have a Social Security number. Also, through the law: * Survivors of people who die on active-duty are now allowed to put all or part of death gratuity payments into a tax-deferred savings or retirement plan, even if this puts them over the annual limit for contributions. * Mobilized National Guard and reserve members may make penalty-free withdrawals from their personal retirement plans. This especially helps those with financial troubles caused by military service. * Guard and reserve members who contribute to an employer-provided flexible spending account can get refunds of contributions at the end of a calendar year, rather than lose the money, if they have been mobilized, since mobilizations could interfere with their ability to spend money as expected. * Small businesses employing Guard and reserve members may receive a $4,000 tax credit to make up salary differences for employees who are mobilized for military duty. * When calculating aid for military families, the Social Security Administration will not use combat-related pays to disqualify a family for disability or health benefits. * California, Texas and other states with their own home loan programs would be able to provide loans to newly discharged service members, something that was not previously allowed because of bond-related issues. [Source: Navy Times Rick Maze article 19 Jun 08 ++] BEQUEST BASICS: A bequest is the means by which you transfer property to beneficiaries through your will or living trust. When it comes to planning a bequest, nothing can replace the experience and knowledge of a skilled professional. Consult an estate planning attorney for this purpose. Following are eight generally accepted ways to make a bequest in your will or revocable living trust. The first four generally define the amount of the bequest. And apply in the case of bequests to individual heirs or bequests to charitable organizations, such as Military Officers Association of America Scholarship Fund. Numbers 5 thru 8 are optional considerations added to any of the first four when the bequest is made to charity: 1. Specific bequest. This is a gift of a specific item to a specific beneficiary. For example, "I give my golf clubs to my nephew, John." If that specific property has been disposed of before death, the bequest fails and no claim can be made to any other property. 2. General bequest. This is usually a gift of a stated sum of money. It will not fail, even if there is not sufficient cash to meet the bequestЧeven if other estate assets need to be sold. For example, "I give $50,000 to my daughter, Mary." 3. Contingent bequest. This is a bequest made on condition that a certain event must occur before distribution to the beneficiary. For example, "I give $50,000 to my son, Joe, provided he enrolls in college before age 21." 4. Residuary bequest. This is a gift of all the "rest, residue and remainder" of your estate after all other bequests, debts and taxes have been paid. For example, say your estate is worth $500,000, and you intend to give a child $50,000 by specific bequest and the residuary estate to your spouse. If the debts, taxes and expenses are $100,000, there would only be $350,000 left for the surviving spouse. Most people prefer to divide their estates according to percentages of the residue (rather than specifying dollar amounts), to ensure that your beneficiaries receive the proportions you desire. 5. Unrestricted bequest. This is a gift for our general purposes, to be used at the discretion of some organizationТs governing board. A gift like thisЧwithout conditions attachedЧis frequently the most useful; as it allows the recipient to determine the wisest and most pressing need for the funds at the time of receipt. 6. Restricted bequest. This type of gift allows you to specify how the funds are to be used. It's best, however, to consult recipient organization when you make your will to be certain your intent can be fulfilled. 7. Honorary or memorial bequest. This is a gift given "in honor of" or "in memory of" someone. 8. Endowed bequest. This bequest allows you to restrict the principal of your gift, requiring the recipient to hold the funds permanently and use only a small percentage or the income they generate. Creating an endowment in this manner means that your gift can continue giving indefinitely. If you intend to make a charitable bequest you should heed some simple guidelines that will help ensure that your gift will qualify as an estate tax deduction. Although the estate tax is repealed for one year in 2010 , it is reinstated at less favorable levels in 2011. In many ways, federal estate tax rules parallel income tax rules, but with this favorable difference: There are no maximums on the dollar amount of the charitable deduction from your estate. If you are so inclined, you can leave your entire estate to a qualified charitable organization and your estate won't pay a penny of tax. A qualified charitable organization (like Military Officers Association of America Scholarship Fund) is any religious, charitable, scientific, educational or other organization described in section 501(c)(3) of the Internal Revenue Code. You should be aware that there are some circumstances that might affect the deductibility of your bequest. Х Conditional bequest. No deduction is allowed for a charitable bequest that is conditional if there is a real possibility that the condition will not be met. Х Challenged bequest. If you are concerned that a relative might challenge your charitable bequest, consider providing in your will, in states where allowed, that any beneficiary who does so will not receive a share of your estate. Х Discrimination. A bequest to an institution that practices some form of discrimination can trigger disallowance. [Source: MOAA News Exchange 18 Jun 08 ++] VA APPEALS UPDATE 04: An attorney who chose to spend his career helping injured veterans secure disability benefits could lose his law license for his efforts. Edward Bates stands accused of violating a decades-old rule that prevented veterans from directly paying an attorney to help them appeal a ruling on benefits. That rule has since been lifted, but state legal officials are pushing for disbarment after complaints were made by the Department of Veterans Administration about the years of work Bates did. At issue are VA rules allowing a "disinterested third party" to pay an attorney on the vet's behalf, but prohibiting the attorney from taking payment directly from the vet or sharing in the benefits secured on the vet's behalf. The VA accused Bates of violating that rule, and a hearing officer recommended a five-month suspension of his law license. But the Illinois Attorney Registration Disciplinary Commission (ARDC) is now appealing, pushing for disbarment. "I thought someday my daughter would be able to look back and say how much I did for people," the 65-year-old said. "Now, they'll only remember these proceedings. I'm not going to be able to undo any of this." Attorney Thomas McGarry is fighting to help Bates keep his license, calling the VA rules archaic and insulting to veterans. "They tell vets, 'You don't need a lawyer, we'll look out for your best interests,'" he said. "[Bates] represented them, did stellar work for them and is now accused of committing a crime that reflects adversely on the legal profession." Bates suspects he made himself a target because of the national reputation he earned by winning so many benefits for injured veterans. But VA and ARDC officials contend Bates reaped in those earnings, as well. While VA officials declined to address his case, they said the rules were clear and that Bates violated them. And while the ARDC acknowledges in court filings "it may well be that the veterans' benefits system is flawed," the answer can't be to allow attorneys to skirt rules while they're in effect. Bates, they say, "built a personally lucrative practice on the backs of those he professed to serve ... his misconduct was dishonest and illegal, and it was undertaken to enrich himself." A decision by a legal panel is expected this summer. [Source: Chicago Sun-Times Steve Patterson Article 16 Jun 08 ++] VA MILEAGE REIMBURSEMENT UPDATE 04: Rep. Mark Souder (R-IN-03) working with Rep. Brad Ellsworth (D-IN-08) intend to sponsor the Veterans Travel Equity Act, which will increase the reimbursement rate for veterans traveling to Veterans Affairs medical facilities and make the benefit available to more veterans. The congressman spoke about the bill 16 JUN in Fort Wayne IN. Secretary of Veterans Affairs James Peake increased the mileage reimbursement for veterans in February from 11 cents a mile to 28.5 cents a mile. Veterans traveling 54 miles or more for medical care receive that benefit to compensate for fuel costs and vehicle wear. This bill would increase the rate to 50.5 cents a mile Ц the same rate federal employees receive for driving their personal vehicles for work. It would also reduce the minimum round trip distance to 30 miles. He said the change is necessary because some veterans are skipping appointments to keep from having to pay for the trip. УI believe especially with gas prices where they are, never should their mileage be an impediment to getting health care,Ф he said. Souder said his bill would also eliminate disability requirements to receive the benefit, as veterans currently must have service-connected disabilities at 30% or higher for mileage reimbursement. The bill would likely bring significant costs, but Souder said he didnТt have any estimates. He said there were several similar proposals being floated, so he was confident something would get done to help veterans this year. He expected any plan to get enough votes to override a presidential veto and said the overwhelming support could force the administration to change it without legislation. [Source: Journal Gazette Benjamin Lanka article 17 Jun 08 ++] TELEMARKETING CALL ELIMINATION UPDATE 06: Federal Communications Commission on 11 JUN 08 has amended its rules to require telemarketers to honor registrations with the National Do-Not-Call Registry indefinitely. The previous rules provided that registrations would expire after five years. This action is consistent with CongressТs mandate in the Do-Not-Call Improvement Act of 2007, which prohibits the removal of numbers from the Registry unless the consumer cancels the registration or the number has been disconnected and reassigned or is otherwise invalid. The Federal Trade Commission has already committed to retain numbers on the Registry indefinitely. This rule change serves to minimize the inconvenience to consumers of having to re-register their phone numbers every five years and furthers the underlying goal of the Registry to protect consumer privacy rights. To enhance the accuracy of the Registry, the Commission encourages telephone companies to convey information on disconnected and reassigned numbers to the FTC, the administrator of the Registry, in a timely and accurate manner. The Commission also said it will continue to coordinate with the FTC on additional ways to improve the RegistryТs accuracy. 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. [Source: FCC News Release CG Docket No. 02-278 dtd 17 Jun 08 ++] CHAP 61 CRSC CLAIMS: About 20,000 veterans forced out of the military early by a combat-related injury could be eligible for hundreds in special compensation pay under new rules outlined by the services this month. Congressional researchers estimated the new program will cost the Defense Department about $680 million over the next 10 years. The change, mandated by Congress last year, makes veterans who served less than 20 years (i.e. Chap 61, TERA, and TERA) eligible for Combat-Related Special Compensation payments from the Defense Department. Those funds are designed to restore money deducted from troopsТ military retirement accounts because they also receive veteransТ disability payouts. The offset can trim a significant portion of the military retirement pay, and veterans groups have lobbied for years to end the deductions. Since 2002, servicemembers with 20 years of military service and a combat-related injury have been receiving monthly Combat-Related Special Compensation, but those with fewer years were not eligible. Now, the new change is effective back to 1 JAN 08 making all combat veterans eligible to apply for six months of retroactive payments and future monthly compensation. Medical and TERA retirees must still provide documentation that shows a causal link between a current VA disability and a combat-related event. Department of Defense guidance defines a combat-related disability in one of the three following ways: 1. A Purple Heart disability, which is a disability with an assigned medical diagnosis code from the Veterans Affairs Schedule for Rating Disabilities, or VASRD, that was attributed to injuries for which the member was awarded a Purple Heart. 2. One with an assigned medical diagnosis code from the VASRD that was: -- incurred as a direct result of armed conflict; -- as a result of hazardous service; -- in the performance of duty under conditions simulating war; or -- through an instrumentality of war. 3. One with an assigned medical diagnosis code from the VASRD that was deemed presumptive or "presumed" by the VA to be incurred as a result of combat operations. More To receive the special compensation, veterans must be currently receiving military retired pay and veterans disability payments, and must have a 10% or greater rated disability recognized by the military as combat related. The amount of the monthly CRSC pay will be based on troopsТ rank, years of service and severity of their injury. In some cases the formula for Combat-Related Special Compensation could actually reduce a veteranТs total monthly payments however, Defense Finance and Accounting service (DFAS) will calculate all of the disability pay impact to make sure veterans are receiving the highest payouts possible and begin CRSC payments within 60 to 90 working days of receiving the approval letter. All veterans, including recently separated servicemembers, will have to apply to receive the new compensation by completing a DD Form 2860 with the required documentation attached. . Required documentation includes a signed claim form and: a). Copy of Chapter 61 Board results (Chapter 61 claimants only). b). Copies of ALL VA rating decisions which include the letter and the narrative summaries c). Copies of ALL DD214's d). Medical records that support "HOW" the injury occurred for each claimed disability that meets the criteria for combat-related. Refer to CRSC website to learn what combat-related is. PDF Claim forms can be downloaded at www.dtic.mil/whs/directives/infomgt/forms/eforms/dd2860.pdf. For additional info and where to send applications refer to Х USA: www.crsc.army.mil Х USN/USMC: www.hq.navv.mil/corb /CRSCB/ combatrelated.htm Х USCG: http://www.uscg.mil/adm1/crsc.asp. Х USAF: http://www.afpc.randolph.af.mil/library/combat.asp. [Source: Stars & Stripes Leo Shane article 18 Jun 08 ++] DOD DISABILITY SEVERANCE LAW: At the end of a boisterous House Veterans Affairs Committee hearing in which lawmakers lambasted Veterans Affairs Department and Pentagon officials for not meeting various deadlines for improving care for wounded combat troops, Disabled American Veterans (DAV) dropped a quiet bombshell. The Pentagon Уknowingly violated the law and ignored the intent of CongressФ in implementing a provision of the 2008 Defense Authorization Act that lawmakers designed to enhance disability severance pay for wounded and injured service members, wrote Kerry Baker, associate national legislative director for DAV. Baker argued that Congress created Section 1646 of the 2008 Defense Authorization Act with the intent that service members injured in combat, in a combat zone, or performing tasks related to combat Ч such as training Ч would not have to pay back any disability retirement severance pay they receive from the Defense Department before becoming eligible for VA disability compensation, as has been the case under long-standing policy. But Baker said David S.C. Chu, undersecretary of defense for personnel and readiness, sent out a Уdirective-type memorandumФ March 13 instructing that only those injured in a combat zone in the line of duty or as a direct result of armed conflict do not have to pay back their severance money. Baker said he believes ChuТs decision was purely monetary. УThis action has intentionally read Сhazardous service,Т Сconditions simulating war,Т and Сinstrumentality of warТ completely out of the lawЕ forces one to question his true resolve to care for those he sends into battle, or orders to train for battle. We can think of no other conceivable reason Е to circumvent the law as he has done here. To answer the question of Сwhy,Т Congress need only determine in whose budget the disability compensation is deposited once offset by VA. We believe the answer to that question is the [Defense Department] budget.Ф Baker wrote. Defense Department spokeswoman Eileen Lainez said that was not ChuТs intent. УRest assured that saving money was not the driver in the implementation,Ф she said in an e-mail. УThe statutory intent of [the law] clearly and appropriately focuses the Сenhanced disability severanceТ to those service members where the unfitting condition is a result of direct participation and performance of duty in the war effort.Ф But Baker said the memo intentionally leaves out people clearly included in both the lawТs definition of Уcombat-related disabilityФ and the Defense DepartmentТs own definition of Уcombat-related,Ф and that Congress had made clear its intent that anyone with a combat-related disability should be included. The memo is important because a service member who breaks his back in a helicopter accident at Fort Bragg, N.C., while training to deploy to Iraq still must pay back his severance before qualifying for VA disability compensation. УIt can take 20 yearsФ to pay back the severance, Baker said. УWe do not view this as an oversight. We view this as an intentional effort to conserve monetary resources at the expense of disabled veterans.Ф The 2008 Defense Authorization Act states: УNo deduction may be made under paragraph (1) in the case of disability severance pay received by a member for a disability incurred in line of duty in a combat zone or incurred during performance of duty in combat-related operations as designated by the secretary of defense.Ф Baker said it is the second part of that sentence Ч Уincurred during performance of duty in combat-related operationsФ Ч that has been misconstrued. According to the 2008 Defense Authorization Act, a Уcombat-related disabilityФ occurs Уas a direct result of armed conflict, while engaged in hazardous service, in the performance of duty under conditions simulating war, or through an instrumentality of war.Ф The Defense Department has defined Уcombat-relatedФ as being Уattributable to the special dangers associated with armed conflict or the preparation or training for armed conflict.Ф That includes hazardous service, such as flight duty, parachute duty, demolition duty, experimental stress duty and diving duty. An instrumentality of war is a weapon, a combat vehicle, or a sickness caused by fumes, gases or explosion of military ordnance. But ChuТs memo states that Уincurred during performance of duty in combat-related operationsФ will be defined by paragraph E3.P5.1.2 of Defense Department Instruction 1332.28 Ч Уarmed conflict.Ф ChuТs narrower definition includes injuries Уas a direct result of armed conflict,Ф Baker wrote, or Уin the line of duty in a combat zone,Ф leading to questions of whether someone playing basketball in the Green Zone would qualify. The Defense Department had not answered that question. Baker, who submitted written testimony but did not appear before the committee for questioning, said the memo has not affected many veterans yet, but it has the potential to affect Уtens of thousands.Ф It applies only to service members medically retired after 28 JAB 08, with disability ratings of less than 30% from the Defense Department. Baker said the net result is that troops injured during training for combat Ч situations that Congress meant to cover with the recent change in law Ч will not be covered, and troops injured in those situations will still have to repay their severance money before they can get VA disability payments. Lainez said Congress left it up to Pentagon officials to decide the definition of Уcombat-related operations. УClearly the statutory intent is to provide wounded warriors enhanced disability compensation,Ф she wrote. УSaving money was not a policy development factor Е rather, [it was] ensuring proper compensation for those service members who are wounded, ill or injured as a result of armed conflict in the combat zone.Ф Baker disagreed, urging Congress to revisit the issue to prevent defense officials Уfrom continuing such blatant disregard for the law and for the livelihood and welfare of those who stand up to defend the country.Ф[Source: Marine Corps Times Kelly Kennedy article 18 Jun 08 ++] SENATE RULES: In a recent Bulletin article on Medicare Reimbursement Rates a question was raised as to why Sen. Reid (D-NV), who favored stopping a reduction in rates to providers, changed his vote at the last minute to oppose it. Under Senate rules a resolution that was voted down cannot be raised again by someone who voted for it. By changing his vote from Yea to Nay when he saw there were insufficient votes for the resolution to pass , Senator Reid kept open the possibility of raising the issue again (since he was now in the minority). Apparently, Senator Trent Lott (R-MS) used the same technique when he was Majority Leader. In the interim unless a similar resolution is introduced by 1 JUL Medicare reimbursement rates to providers will be reduced impacting on the number of Tricare providers available to retirees. [Source: Gratiot MI County Veterans Rodolfo Diaz-Pons input 15 Jun 08 ++] TRICARE HOSPITAL SELECTION IN PI: Tricare users requiring hospitalization need to be aware that in order for a claim for their stay in the hospital to be approved by WPS the facility must be listed on the certified Philippine providers list at http://tpaoweb.oki.med.navy.mil. However, just because the facility is listed as a certified provider the services offered through it (i.e. physician fees) may not be. It really depends on the arrangement between the institution and the providers it allows to utilize their facility as a base for offering services. If the institution has been certified, the cost of care-including the professional fees can be filed using the institution's certified credentials. The institution can then pay the provider for his/her professional fees once reimbursement is received from you or Tricare. If a provider wants to file directly to Tricare for his/her professional fee and not through the institution, then he/she should request to be certified separately from the institution to obtain his/her own provider number. Certification verifies that the physician has valid credentialing and a physical facility location. Once certification has been granted, TRICARE issues a provider number that facilitates the processing of claims for care rendered by that provider. Certification does not mean that these claims will automatically be paid. Claims are paid only if the services or supplies were determined to be medically necessary and a covered benefit. Editor's Note: Realistically, it is very difficult to find any hospital/clinic/physician willing to wait for reimbursement from Tricare because of length of time required to receive payment. Most will require payment up front by the patient who in turn will need to file the claim directly to WPS along with copies of the billing indicating payment was made by you. A prudent step to take to maximize the likelihood that a claim to WPS will be honored is to discuss in advance with your family members where you should be taken in the event of an emergency. (Facts reviewed by TAO-P 18 June 08) VA GULF WAR ADVISORY COMMITTEE UPDATE 01: Veterans of the 1990-91 Gulf War will gained additional access to the leadership of the Department of Veterans Affairs (VA) when the department's Advisory Committee on Gulf War Veterans held its first meeting 17-19 JUN. The 14-member, independent panel was formed to advise the Secretary and the department on the full range of health care and benefits needs of those who served in the conflict. Serving on the committee are Gulf War and other veterans, veterans service organizations' representatives, medical experts, and the surviving spouse of a Gulf War veteran. Members were selected to provide a variety of perspectives, experiences, and expertise. Open to the public the first meeting was designed to give committee members an overview of VA as well as the benefits and services provided to Gulf War veterans. Members received briefings on education, home loan guaranty, disability compensation and other benefits. Additional briefings planned include health care and veterans' legal and appeal rights. Public comments were heard on the afternoons of 18-19 JUN. Secretary of Veteran Affairs Dr. James B. Peake welcomed the members and thanked them for their service both on the committee and in their lives as citizens, veterans or veteran advocates. He also discussed the importance the VA places on the unique issues and challenges faced by Gulf War veterans. [Source: VA News Release 17 Jun 08 ++] VA HEALTH CARE FUNDING UPDATE 13: Veterans benefits are one of the most popular causes in Congress. But Veterans Affairs hospitals and clinics are routinely buffeted by the annual uncertainties of the increasingly dysfunctional budget process on Capitol Hill. Now veterans advocates have proposed a controversial fix. For years, veterans groups have argued, in vain, for making veterans health care funding automatic, as it is for Social Security, Medicaid, and Medicare. In recent months, however, a coalition led by the 1.4 million-member Disabled American Veterans (DAV) has switched tactics. Instead of seeking politically unpalatable mandatory funding, the group is proposing that VA health care be funded through an obscure legislative mechanism called "advance appropriations." In contrast to mandatory or entitlement funding, the advance-appropriations process does let Congress vote on funding levels--but it does so a year in advance of the regular budget cycle. So while Congress debates most programs' appropriations for fiscal 2009, it is setting aside almost $30 billion worth of advance appropriations for 2010. This money funds an eclectic mix of programs ranging from Section 8 housing subsidies to education grants to the Corporation for Public Broadcasting. No matter how delayed or disrupted funding may be for the rest of the federal government, these advance-appropriations programs are guaranteed to get their money on time, at the start of each fiscal year. "The VA has had a hideous problem for a decade" with tardy funding bills, said John M. Bradley, a longtime Hill staffer who is now with the Disabled American Veterans. "Advance appropriations are a very attractive potential vehicle." Advance appropriations began in 1967 as a way to insulate the Corporation for Public Broadcasting from congressional criticism of its programming. Congress slowly added other appropriations in ensuing years; as late as 1996, however, the total sum was less than $3 billion. Then appropriators seized on the mechanism as a way to bypass budget caps. Over the next five years, advances increased 800%. For fiscal 2001, budgeteers stepped in to limit advances being slipped into the budget to $23.5 billion. That figure is expected to hit $28.9 billion in fiscal 2009. If the veterans groups manage to move most VA health care accounts into the advance-appropriations process, the total would more than double, to approximately $70 billion a year. Such a large sum speaks to the central irony of the whole debate. Activists are generally happy with the amounts that Congress is voting for VA health care. The problem is with how long it takes Congress to vote. Congress last managed to enact veterans funding on time in 1996, when it passed the 1997 appropriation just four days before the beginning of the fiscal year, which begins on 1 OCT. It has been late every year since, never by less than 19 days and, on average, by more than two months. The appropriation for fiscal 2008 was passed the day after Christmas, 86 days late. To keep federal agencies operating in the no-man's months after one year's funding has expired and before the next year's is appropriated--and to avoid a politically costly government shutdown such as 1995's--Congress passes "continuing resolutions" that keep programs at last year's spending levels. (In an unprecedented departure, a fall 2007 continuing resolution did give the VA an increase.) This stopgap is awkward for any department or agency. It is especially problematic for the VA, which has to keep 153 hospitals and 732 clinics running day in, day out, for a patient population that continues to grow rapidly--from 4.2 million in 2001 to 5.7 million today. The VA has come up with a host of stopgaps to keep the lights on and the patients cared for. To keep paychecks coming for nurses and doctors, VA administrators routinely put off buying equipment, doing maintenance, restocking inventories, and even hiring staff until later in the year. When appropriations finally do arrive, they often trigger a scramble to cover backed-up needs and to spend money that, thanks to congressional generosity, is well in excess of what the VA had planned for. Such a cycle of famine and feast encourages inefficiency, hampers planning, and can make hiring in certain medical specialties almost impossible. [Source: National Journal Magazine Sydney J. Freedberg article 14 Jun 08 ++] VA HEALTH CARE FUNDING UPDATE 14: Advocates have long argued that making veterans health care funding automatic--as veterans disability payments already are--would guarantee the VA the funds it needs, when it needs them. Veterans groups are still backing mandatory-funding bills by Tim Johnson (D-SD) in the Senate and Phil Hare (D-IL) in the House. "We have to suck it up and keep the promise that we made," Hare told National Journal. "I put it up on par with Social Security and Medicare." Most legislators, however, are loath to move any more programs from the discretionary side of the budget, where they can vote funding levels every year, to the entitlement side, where spending is set by statutory formulas and increasingly runs out of control. And veterans groups are giving up hope that Democratic control of Congress might soften this resistance. Speaker Nancy Pelosi (D-CA) has said positively that she wants mandatory spending for VA health care, but we can't get any traction," said Hill staffer John M. Bradley of the Disabled American Veterans. "So our thinking for the past year has been directed to looking at an alternative approach, and we stumbled upon this advance-appropriations technique." The idea originated with a June 2007 memo from a consultant to the Disabled American Veterans, Marsha Simon, who was a clerk on the Senate Appropriations subcommittee covering the departments of Labor and Health and Human Services when they dramatically expanded advance appropriations back in the 1990s. It took some effort to explain the arcana of advance appropriations to the veterans advocates, but as the prospects for mandatory funding grew increasingly dim, veterans groups seized on Simon's proposal. The Disabled American Veterans are now working with sympathetic lawmakers with an eye toward introducing legislation sometime this summer. "We will [still] take mandatory spending in a heartbeat if they enact it," Bradley said, "but we're trying to spread the word that this is the new direction." The House and Senate Budget committees are likely to be the first line of resistance. "We appropriate annually for a reason," a staffer said. "We set priorities, and we make programs compete against each other annually. They would like not to have to compete." Appropriators are skeptical as well. "There's 100% agreement with the veteransТ organizations that we must pass VA appropriations on a more timely basis," said Rep. Chet Edwards (D-TX), chairman of the House Appropriations Committee panel that covers the Veterans Affairs Department. "There may be honest differences on the means of getting there. The easiest, simplest, cleanest way to solve the problem is for us to start passing VA appropriations bills on time. If that proves to be an impossible task, we'll just have to look at the other options." Democrats like to blame tardy appropriations on President Bush's intransigence--but the delays began during the Clinton years. It is hard to ask veterans, or any constituency for that matter, to sit tight and have faith that Congress will get its act together soon. "What this highlights is how dysfunctional the budget system has become," said Robert Bixby, executive director of the Concord Coalition, "and I don't blame them for looking for alternative ways." But the more that programs sidestep the annual logjam by getting mandatory or advance funding, the worse the problem becomes overall--which only increases the pressure on Congress to create more special cases for special interests. "Because there's a lot of attention on veterans these days, if anybody can do it, they might have the strongest case," Bixby said. "But I think you'd find a lot of other folks coming out of the woodwork saying, 'Hey, what about us?Ф [Source: National Journal Magazine Sydney J. Freedberg article 14 Jun 08 ++] VA DRUG TESTING ON VETS: A Washington Times/ABC News investigation has revealed the government is testing drugs with severe side effects like psychosis and suicidal behavior on hundreds of military veterans, using small cash payments to attract patients into medical experiments that often target distressed soldiers returning from Iraq and Afghanistan. In one such experiment involving the controversial anti-smoking drug Chantix [Varenicline], the VA took three months after they learned from the FDA that the drug was linked to a large number of hallucinations, suicide attempts and psychotic behavior to alert its patients about severe mental side effects. The VAТs warning did not arrive until after one of the veterans taking the drug had suffered a psychotic episode that ended in a near lethal confrontation with police. One of the nation's premier medical ethicists said the VA's behavior in the anti-smoking study violated basic protections for humans in medical experiments. In all, nearly 1,000 veterans with PTSD were enrolled in the study to test different methods of ending smoking, with 143 using Chantix. VA initially acknowledged there were 21 serious adverse events (SAE) from the drug, including one in which a vet suffered suicidal thoughts but subsequently raised their figures to 26 with 10 of them being of a psychiatric nature and two cases of suicidal thoughts. According to the FDA, nearly 40 suicides and more than 400 incidents of suicidal behavior have been linked to Chantix. The drug testing began in JAN 07, and the FDA issued its first alert about dangerous side effects to Chantix in November. House Veterans Affairs Committee Chairman Bob Filner, along with committee members Rep. Ed Markey (D-MA), and Rep. Paul Hodes (D-NH), sent a letter 18 JUN to VA Secretary James B. Peake requesting immediate response to dozens of questions about his agency's treatment of service members in its medical studies." Earlier that day, Filner "demanded that the VA immediately terminate experiments in which" Chantix "is being administered to soldiers suffering from PTSD." Veterans groups are also expressing their anger over the study and are also calling for the studies to be ceased and for an investigation. Filner announced that he will hold hearings in early July to figure out why it took so long to notify patients of the side effects of the drug that was used in this study. The White House on Tuesday said that the VA is doing everything it can to be mindful of the safety of these veterans in all its programs and try to help them. In a VA news release on their Smoking Cessation Program they said the reports are inaccurate and misleading. More than six million prescriptions were written for Varenicline in the United States in 2007; it is an FDA-approved, widely used medication for smoking cessation. In NOV 07, FDA issued an Уearly communicationФ to health care providers indicating concerns had arisen about the medication having a possible side effect involving mental health; VA immediately passed along that concern to practitioners at all of their medical centers. On 1 FEB, FDA issued a УPublic Health AdvisoryФ to providers, providing more information on potential side effects of which clinicians and patients should be aware. VA distributed this alert to pharmacists in its system on that same day, and to researchers on 5 FEB. Throughout, VA's use of Varenicline has been consistent with guidelines on smoking cessation the U.S. Surgeon General's office has established. They note that FDA has never asked that Varenicline be removed from the market, and it continues to be FDA approved as a safe and efficacious medication. Also, neither FDA nor the manufacturer has ever recalled Varenicline, and VA has never been asked to do so. [Source: Washington Times Audrey Hudson article 17 & 18 Jun 08 ++] VA DRUG TESTING ON VETS UPDATE 01: At the request of The Times and ABC News, the director of the Center for Bioethics at the University of Pennsylvania Arthur Caplan reviewed the consent and notification forms used in VAТs controversial anti-smoking drug Chantix study. He concluded the VA deserved an "F" and that it has an obligation to end the study, given the vulnerability of veterans with PTSD and the known side effects of Chantix. The VA continues to test Chantix on veterans, even as reported problems with the drug increase and have prompted at least one other federal agency to take action. On 21 MAY the Federal Aviation Administration banned airline pilots and air traffic control personnel from taking Chantix, citing the adverse side effects. VA officials defend their use of veterans in medical studies, saying that helping PTSD sufferers to stop smoking would prolong their lives. As for the three-month delay in notifying its patients about the Chantix problems, the VA said bureaucracy slowed down their warning because the alert letters had to be issued through an Institutional Review Board (IRB) that oversees the experiment at each VA location. Miles McFall, director of the VA's programs for PTSD sufferers commented he believed the VA response was incredibly quick response for a governmental institution. Asked about adverse reactions now linked to the drug, Mr. McFall said: "We are certainly aware of FDA warnings and we took all precautions ... so it can be used safely. All drugs have side effects or potential side effects." The government has a controversial history of using military personnel as human research subjects. Mustard gas was tested on the military during World War II, radiation during the early Cold War period, LSD in the 1960s, herbicide in Vietnam and Panama, and chemical and biological warfare drugs during the Gulf War, according to Senate testimony given by the Vietnam Veterans of America (VVA) on 10 JUL 02. In most of those cases, few if any military test subjects were informed of the potential health consequences of the exposure. "We have a phrase to describe this phenomenon - the disposable soldier syndrome," said Richard Weidman, former VVA director of government relations. The most infamous government experiment is the Tuskegee Syphilis Study conducted by the U.S. Public Health Service from 1932 through 1972, which used 400 poor and uneducated black male sharecroppers who carried the sexually transmitted disease. The men were purposely undiagnosed and untreated for a disease that already had progressed to late stages, and were studied through autopsy. The VA has extensive screening of veterans who enroll in medical experiments and requires detailed consent forms to ensure patients know about the potential complications and benefits. Currently, the VA and other federal agencies are conducting nearly 300 clinical studies involving veterans with PTSD. Most studies are behavioral, including one that tests the effects of yoga on PTSD sufferers. Twenty-five, however, are testing drugs on 4,796 veterans, more than half (2,488) of whom are just returning from the wars in Iraq and Afghanistan, according to clinical trials filed with the National Institutes of Health (NIH) and reviewed by The Times. Mr. Caplan, the bioethicist, said that using veterans with PTSD in clinical trials carries a "high risk" that must be addressed by the VA. He recommended several steps the government should adopt before allowing future testing on vulnerable veterans, including more participation by families and veterans on committees that review and approve research proposals. Future studies that involve veterans with PTSD also should receive special approval from the VA secretary. And a clear policy should be established that prohibits drugs reported to have serious side effects be tested on populations at risk of those side effects, including veterans with PTSD, he said. Veterans Affairs Secretary James B. Peake on 19JUN sought to quell a growing controversy over his agency's failure to quickly notify veterans about psychotic and suicidal side effects from the anti-smoking drug Chantix, vowing that his department will improve its communication process to ensure patients are alerted more quickly when dangerous side effects emerge. Mr. Peake also said the letter the Department of Veteran Affairs (VA) sent to veterans in February - three months after learning about new complications from Chantix - should have identified suicidal behavior as one of the risks. To make the point, the former Army surgeon turned VA chief said he was personally sending a letter to more than 32,000 veterans taking Chantix to ensure they understand all of the issues, including the risks of suicidal behavior as a side effect. [Source: Washington Times Audrey Hudson article 17, 18, & 19 Jun 08 ++] PTSD UPDATE 22: Fort Carson CO and Fort Leonard Wood MO would become test beds for predeployment counseling programs aimed at reducing the risk of combat stress under legislation sponsored by two Colorado lawmakers. Reps. Mark Udall (D-CO) and John Salazar (D-CO) are urging the creation of pilot programs at the two Army bases to try to prevent post-traumatic stress disorder in combat troops, and to provide early detection and treatment for PTSD when it happens. The bill H.R.6268they introduced 12 JUN also gives active-duty service members access to readjustment and mental health counseling from veterans centers, provide grants for nonprofit groups who provide counseling services for the survivors of service members or veterans, extends military survivor benefits to families of service members who commit suicide after a history of combat-related health problems, and creates a new scholarship program to train behavioral health specialists about mental health treatment for service members and veterans. The wide swath of initiatives complicates passage. The bill was referred to the House VeteransТ Affairs Committee, but its provisions fall under the jurisdiction of two other panels Ч the Armed Services Committee that is responsible for military benefits, and the Ways and Means Committee that oversees grants for nonprofit groups. The bill is similar to S 3008, a measure introduced 12 MAY by Sens. Barbara Boxer (D-CA) and Christopher Bond (R-MO). Boxer and Bond might offer their package as an amendment to the 2008 defense authorization bill when the Senate takes up that measure in JUL. Senate passage of the legislation would provide a legislative shortcut that would avoid giving three House panels the chance to consider Ч and possibly change Ч the bill. Udall said Congress needs to do more. About 40,000 Iraq and Afghanistan veterans have been diagnosed with PTSD, with more than 600,000 reporting symptoms of PTSD or severe depression. Udall, who serves on the House Armed Services Committee, said the Defense Department and Veterans Affairs Department are not doing enough. [Source: Marine Times Rick Maze article 17 Jun 08 ++] GULF WAR VET FATIGUE STUDY: Principal Investigator Beatrice A. Golomb, MD, Ph.D is seeking veterans who served in the Persian Gulf Theater of Operations during Operation Desert Shield/Desert Storm between AUG 90 and JUL 91 with Gulf War Illness to participate in a 12-month research study. Gulf War Illness includes symptoms that started during or after Gulf War participation and are present for at least six months. Symptoms may include fatigue, muscle or joint pain, sleep problems, memory problems and/or others. The research is to see if CoEnzyme Q10 can improve symptoms and benefits quality of life for affected veterans. Participants will receive CoEnzyme Q10, a nutritional supplement, and a placebo, an inactive pill, during alternate periods of their participation in the study. Monetary compensation, lab work, diet profiles, and study drugs, will be provided. Those desiring to participate should contact Study Coordinator Janis Ritchie, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0995 Tel: (858) 558-4950 ext 203 or email jbritchie@ucsd.edu. [Source: "CA VFW VSO Scott Langhoff email 16 Jun 0 ++] VA BUDGET 2009 UPDATE 03: The House Military Construction-Veterans Affairs Appropriations Subcommittee on 12 JUN unanimously approved a $72.7 billion fiscal 2009 funding bill that would provide a large increase in spending for veterans programs for the second year in a row. The bill was referred to the full committee with strong bipartisan support and a plea from the ranking member that it would not get caught up in the political battles that have stalled most substantial legislation this year. The measure would provide a total of $3.4 billion more than President Bush requested, including a $2.9 billion increase in VA funding. House Military Construction-Veterans Affairs Appropriations Subcommittee Chairman Chet Edwards (D-TX) noted that if approved by Congress that increase would make a total of $16.4 billion added to VA funding in two years. Appropriations Chairman David Obey said the bill "demonstrates that the number one priority of this Congress is veterans." The bill adds $400 million to Bush's request for military construction and Base Realignment and Closure, with an emphasis on improving family housing. Edwards said the legislation "sends a clear message to America's service men and women, their families and our veterans that we appreciate and we respect their service and sacrifice." House Military Construction-Veterans Affairs Appropriations Subcommittee ranking member Zach Wamp (R-TN) praised the bipartisanship that produced a very good bill. Wamp sees room for work. "We need to complete the process. I would challenge both sides" to get this bill and the defense appropriations signed into law. "If we can't get together on these, we can't get together on anything," Wamp said. Only one of the 12 fiscal 2008 funding bills -- defense -- became law. The rest of the government was funded by an omnibus appropriations bill. The bill would: Х Provide $47.7 billion for VA, a $4.6 billion increase over 2008. Х Add $1.6 billion to VA's health administration to increase access to services, ensure safer facilities, and improve treatment. Х Require VA to spend "no less than $3.8 billion" on mental health services and $584 million for substance abuse programs, reflecting the increase in problems resulting from repeated combat tours. Х Pay for 1,400 more claims processers, above the 703 additional personnel Bush requested to cut the backlog in requests for benefits. Х Add $1.1 billion to VA's construction budget to cover six additional major building projects and 145 minor construction efforts. The $24.8 billion approved for military construction, family housing and BRAC includes additional money for facilities to house and train the 92,000 extra soldiers and Marines being recruited to reduce the strain on the ground forces. It also adds $136 million for military health care facilities, a result of hearings that revealed inadequate and badly aged facilities. The bill will now be scheduled for markup in the full House Committee on VeteransТ Affairs. [Source: Congress Daily Otto Kreisher article 13 Jun 08 ++] VETERAN GRAVE VANDALS UPDATE 01: The Senate Judiciary Committee voted 12 JUN to impose severe federal penalties for vandals who desecrate graves or steal grave plaques of deceased military veterans. Without discussion, the committee approved the House-passed bill (H.R. 3480) on a voice vote for Senate consideration. The House approved the bill on 21 MAY. Metal grave markers are being stolen from the grave sites of veterans either as an act of vandalism or to get the metal to sell to scrap yards. Incidents have occurred in Texas, Washington state and Michigan. The measure would make such acts that occur to a veteran's grave in a federal or private cemetery a federal crime. It would require the U.S. Sentencing Commission to review its guidelines and increase penalties for those convicted of crimes associated with "desecration, theft, or trafficking in, a grave marker, headstone, monument, or other object, intended to permanently mark a veteran's grave." It also states penalties should be "appropriately severe." [Source: Congress Daily Michael Posner article 13 Jun 08 ++] LONG TERM CARE EXPENSE: Approximately 20 million people are eligible to apply for the governments FLTCIP insurance, including Federal and Postal employees and annuitants, active and retired members of the uniformed services, their qualified relatives and a few other eligible groups. For more infpo on this program refer to http://opm.gov/insure/ltc/. For those that are not eligible Long-term care insurance from private insurance companies covers some of the costs of long-term care and can help you preserve your assets. It generally covers nursing home and home care, but only if your needs are substantial enough. Each policy sets a minimum set of health care needs that УtriggerФ coverage to begin. While long-term care insurance can limit health care costs for some people, it is not a good option for most. It is expensive and premiums can increase substantially as you age. You should not consider a long-term care policy if paying the premiums would require that you make any lifestyle changes. And if you have AlzheimerТs or other serious health problems, you may not be able to buy a policy at any price. To obtain a quote for LTC refer to http://www.longtermcarequote.com or call 1(800) 587-3279 You will have to pay for long-term care yourself if you: Х Do not qualify for Medicaid; Х Do not have long-term care insurance; Х Have used up your Medicare 100-day skilled nursing benefit or do not qualify for it; Х Do not qualify for MedicareТs home health benefit. Many people go without coverage and pay for care themselves. You need to think about how much care may cost over an extended period of time and as you become increasingly frail. Find out about nursing home care costs in your area. Then calculate how much money you would need for a four-year stay. If you can set aside enough to cover four years of residential care, you should consider simply paying for it yourself. Keep in mind that actual costs can't be predicted. If you suffer from AlzheimerТs or other forms of dementia, you may need care for many more years. Home care often costs much less than residential care. Since people often wish to continue living in their own homes, you may want to research the cost of home and community-based services in your area. Along with home adaptations (like ramps for wheelchair access), such services, may help you stay in your own home. [Source: Medicare Rights Center www.medicareinteractive.org May 08 ++] ARMY SEA DUTY RIBBON: A retroactive award for soldiers who log sea duty now includes Army National Guard and Army reserve troops. The Army Sea Duty Ribbon was approved in 2006 to include soldiers who have served aboard Army vessels since 1 AUG 52. The Army Transportation Corps recently updated the awardТs qualifications to include the Guard and Reserve. To be eligible, active duty soldiers must complete two years of cumulative sea duty on a class A (such as tugs, LSVs and large landing crafts) or Class B (smaller landing craft and all amphibians) vessels. Guardsmen and reservists must have two creditable years in a U.S. Army watercraft unit, which must include at least 25 days underway each year and two annual training exercises underway on a class A or B vessel or a 90-day deployment aboard an Army vessel underway. The Army Sea Duty ribbon is the first non-campaign ribbon approved by the Army in more than 20 years. The retroactive date corresponds to the standing-up of the 1st Heavy Boat Company in the Army. Requests should be sent to: Chief, Marine Qualification Division, Attn: Career Pay Office, HRC, Bldg. 705, Rm. 231, 705 Read St., Ft. Eustis, VA 23604-5407 email: armyseapay@conus.army.mil. [Source: VFW Magazine Jun/Jul 08 ++] VA FRAUD UPDATE 10: Federal judges this week sentenced two people to prison for either stealing from or defrauding the Department of Veterans Affairs. The cases of Frank M. Persicano, of St. Petersburg, and Catherine Rodriguez, of Tampa, are unrelated, the U.S. Attorney's Office said. Persicano, 63, was sentenced today to serve 41 months in prison after he pleaded guilty 31 JAN to theft of government funds, mail fraud and making a false statement to the VA. He concealed his income and employment status from the Department of Veterans Affairs and fraudulently received more than $70,000 in disability benefits, prosecutors said. Rodriguez, 37, was sentenced 9 JUN to six months in prison after investigators said she stole more than $30,000 from the James A. Haley Veterans Hospital canteen. Rodriguez, who was manager of the store, also falsified cash register records and other receipts, prosecutors said. Along with the prison terms, U.S. District Judge Elizabeth A. Kovachevich ordered Persicano to pay $72,225 in restitution to the VA and U.S. District Judge James D. Whittemore ordered Rodriguez to pay back $30,000. [Source: Tampa Tribune article 12 Jun 08 ++] CREDIT CARD SCAM UPDATE 01: The U.S. Federal Bureau of Investigation warned 13 JUN that online scammers are now targeting single parents who use the EPPICard system to receive child-support payments. The criminals are running a typical phishing scam, but one that is targeted at a new group of victims. "Individuals have reported receiving e-mail or text messages indicating a problem with their account. They are directed to follow the link provided in the message to update their account or correct the problem," said the FBI's Internet Crime Complain Center (IC3) in an advisory. "The link actually directs the individuals to a fraudulent Web site where their personal information, such as account number and PIN, is compromised." In another scam, victims are asked to fill out an online survey and are then told that once they enter their account information, they will receive an EPPICard deposit as a token of thanks for their answers. Instead, their accounts are emptied by criminals. EPPICards are issued by government agencies in 15 U.S. states. They work like debit cards, and are promoted as an easy-to-use alternative to child support payment checks. The EPPICard association also warns about the scam on its Web site. "We will never request your personal information such as social security number, card number or PIN through any of these methods," the warning reads. "Please do not respond to requests like these." Scammers have also been trying to get this information via the telephone, the association warns. [Source: IDG News Service Robert McMillan article 14 Jun 08 ++] MEDICARE PREVENTIVE CARE SERVICES: Even though it is commonly said that an ounce of prevention is worth a pound of cure, Medicare has not traditionally covered preventive care. However, coverage for many preventive care services has been added in the past few years. Doctors may not realize that Medicare now covers these services, so it is important to ask your doctor about them. As long as you meet basic eligibility standards, you have the right to receive these services no matter which Medicare health plan you are enrolled in. Your costs for these services may be different if you are in a Medicare private health plan (HMO or PPO). However, private plans cannot charge you anything for the flu or pneumonia vaccine. In addition, private plans cannot require that you get a referral in order to get a screening mammogram or a flu shot. Be sure to follow the Medicare guidelines for receiving preventive care services in order to ensure that Medicare will cover them since some are covered only once every few years and others are only covered if you meet specific criteria. The following coverage guidelines are only for preventive screenings. Medicare may cover these tests more frequently if they are needed to diagnose or treat an illness or condition. Х Diabetes screening: 100% of the Medicare-approved amount (no Part B deductible). Every 12 months if you meet the profile for getting diabetes. Х Diabetes services and supplies: 80% of the Medicare-approved amount (after Part B deductible). Up to 10 hours of self-management training for your first year, and two hours every year if you have diabetes and your doctor says that you need diabetes self-management training and education and specified diabetic supplies. Х Medical Nutritional Therapy: 80% of the Medicare-approved amount (after Part B deductible). Three hours for the first year and two hours every year thereafter, although it will cover more hours if your doctor says you need them. Х Glaucoma screening:80% of the Medicare-approved amount (after Part B deductible). Annual (every 12 months) if you are at high-risk for glaucoma. Х Blood testing for cardiovascular diseases: 100% of the Medicare-approved amount (no Part B deductible). Once every five years. Х Bone mass measurement: 80% of the Medicare-approved amount (after Part B deductible). Every two years (24 months), If your doctor believes you are at risk for osteoporosis and orders the test. Х Screening mammograms: 80% of the Medicare-approved amount (no Part B deductible). One Baseline mammogram for women 35 to 39 years of age and every 12 months for women 40 years and older. Х Pap smears, pelvic exams and clinical breast exams: 100% for Pap lab test (no Part B deductible). Every two years (24 months) Х 80% of the Medicare-approved amount for Pap test collection, pelvic exam and clinical breast exam (no Part B deductible). Х Colon cancer screening: 100% for fecal occult blood test; 80% of the Medicare-approved amount for flexible sigmoidoscopy, colonoscopy and barium enema. Once a year for Fecal occult, once every four years for flexible sigmoidoscopy, once every 24 months if you are at high-risk (once every 10 years if not) for colorectal cancer Х Prostate cancer screening: 100% for PSA test; 80% of the Medicare-approved amount for digital rectal exam (after Part B deductible). Prostate screening once a year for men age 50 and older Х Flu shot: 100% of the Medicare-approved amount (no Part B deductible). Once every flu season if you are less able to fight infections; 50 or over; have chronic disorder; 6 or more months pregnant; or reside in a long term care facility. Х Pneumonia vaccine: 100% of the Medicare-approved amount (no Part B deductible). Once in your lifetime. Х Hepatitis B vaccine: 80% of the Medicare-approved amount (after Part B deductible). As needed. Х One routine physical exam : 80% of the Medicare-approved amount (after Part B deductible). One-time during the first six months after you enroll in Medicare Part B regardless of your age. [Source: Medicare Rights Center Jun 08 ++] MEDICARE SUMMARY NOTICE (MSN): When Medicare processes a claim for health care services you received, the claim is detailed in a Medicare Summary Notice (MSN). It is a summary of claims for health care services Medicare processed for you during the previous three months. They are mailed four times a year and contain information about submitted charges, the amount that Medicare paid, and the amount you are responsible for. The most important fields on your MSN explain: Х You May Be Billed: This field indicates the total amount that the provider is allowed to bill you (balance billing). It deducts the amount you already paid. In many instances, Medicare forwards your MSN to your supplemental insurer, which may pay this amount in full or in part. Sometimes, you may be responsible for a portion of the balance which neither Medicare nor your supplemental insurance has paid. Note: You should ignore the "Amount Charged" field. Х Non-covered charges, if any: This field shows the portion of charges for services that are denied or excluded (never covered) by Medicare. A $0.00 in this field means that there were no denied or excluded services. If you disagree with a non-covered charge, you can appeal. You are encouraged to save your MSNs for about seven years. You might need them in the future to prove that payment was made if a provider sends you a bill or that services were received if you claimed a medical deduction on your taxes. If you have lost your MSN or you need a duplicate copy, call 800-MEDICARE. You will be redirected to the Medicare carrier who originally issued the MSN and can send you a copy. When you receive your (MSN) or your Explanation of Medicare Benefits (EOMB) if you are in a private health plan, look at it carefully to make sure that you actually received all the services listed. Sometimes this can be hard to do if you received services from several doctors at the same time. The MSN is not a bill but is a useful tool to help identify Medicare fraud. Some other ways to help identify fraud are: 1. In selecting providers or receiving care you should be suspicious of people who tell you they represent Medicare and want to offer you a service for free; call you or visit your house to offer services or equipment; offer Уfree consultationsФ only to people with Medicare and ask for your Medicare number. 2. At your doctorТs office your doctor should not charge a coinsurance for most preventive services, such as pap smears or flu shots, offer tests or other services that you donТt need, especially if the doctor says that the more tests you receive, the cheaper they are, are fail to charge a coinsurance all the time. Doctors can sometimes forgive a coinsurance if a patient is in great financial need, but they should not do this routinely. 3. If you have returned your Durable Medical Equipment, your supplier should not continue to charge Medicare for rental fees or maintenance. These charges would appear on your MSN or EOMB. [Source: Medicare Rights Center Jun 08 ++] HAVE YOU HEARD: A college professor, an avowed Atheist, was teaching his class. He shocked several of his students when he flatly stated he was going to prove there was no God. Addressing the ceiling he shouted: "God, if you are real, then I want you to knock me off this platform. I'll give you 15 minutes!" The lecture room fell silent. You could have heard a pin fall. Ten minutes went by. Again he taunted God, saying, "Here I am, God. I'm still waiting." His count-down got down to the last couple of minutes when a Marine - just released from active duty and newly registered in the class - walked up to the professor, hit him full force in the face, and sent him tumbling from his lofty platform. The professor was out cold! At first, the students were shocked and babbled in confusion. The young Marine took a seat in the front row and sat silent. The class fell silent...waiting. Eventually, the professor came to, shaken he looked at the young Marine in the front row. When the professor regained his senses and could speak he asked: "What's the matter with you? Why did you do that?" "The marine replied, УGod was busy. He sent the Marines." VETERAN LEGISLATION STATUS 29 JUN 08: Congress is on vacation and is not expected back in Washington until 7 JUL. Refer to the BulletinТs House & Senate attachments for or a listing of Congressional bills of interest to the veteran community that have been introduced in the 110th Congress. Support of these bills through cosponsorship by other legislators is critical if they are ever going to move through the legislative process for a floor vote to become law. A good indication on that likelihood is the number of cosponsors who have signed onto the bill. A cosponsor is a member of Congress who has joined one or more other members in his/her chamber (i.e. House or Senate) to sponsor a bill or amendment. The member who introduces the bill is considered the sponsor. Members subsequently signing on are called cosponsors. Any number of members may cosponsor a bill in the House or Senate. At http://thomas.loc.gov you can also review a copy of each billТs content, determine its current status, the committee it has been assigned to, and if your legislator is a sponsor or cosponsor of it. To determine what bills, amendments your representative has sponsored, cosponsored, or dropped sponsorship on refer to http://thomas.loc.gov/bss/d110/sponlst.html. The key to increasing cosponsorship on veteran related bills and subsequent passage into law is letting our representatives know of veteranТs feelings on issues. At the end of some listed bills is a web link that can be used to do that. You can also reach his/her Washington via the Capital Operator direct at (866) 272-6622, (800) 828-0498, or (866) 340-9281 to express your views. Otherwise, you can locate on http://thomas.loc.gov who your representative is and his/her phone number, mailing address, or email/website to communicate with a message or letter of your own making. Refer to http://www.thecapitol.net/FAQ/cong_schedule.html for future times that you can access your representatives on their home turf. [Source: RAO Bulletin Attachment 29 Jun 08 ++] Lt. James УEMOФ Tichacek, USN (Ret) Director, Retiree Assistance Office, U.S. Embassy Warden & IRS VITA Baguio City RP PSC 517 Box RCB, FPO AP 96517 Tel: (951) 238-1246 in U.S. or Cell: 0915-361-3503 in the Philippines. Email: raoemo@sbcglobal.net Web: http://post_119_gulfport_ms.tripod.com/rao1.html AL/AMVETS/DAV/FRA/NAUS/NCOA/MOAA/USDR/VFW/VVA/CG33/DD890/AD37 member		THIS BULLETIN CONTAINS THE FOLLOWING ARTICLES == VA Voter Registration Ban ------------------------- (Criticism) == VA Drug Testing on Vets [02] --------------------- (Hearings Held) == GI Bill [25] ------------------------------------- (20% Increase) == VA Claim Backlog [16] ---------------------- (Status) == VA Claim Backlog [17] ------------------------ (Law Slows Claims) == Family Film Festival -------------------------- (No Cost Movies) == Medicare Reimbursement Rates 2008 [11] ---- (Sent to President) == VA Third-Party Insurers ------------------------- (Billing Problems) == Adventure Excursions for OEF/OIF Vets --------- (Fully Funded) == Vet Job [02] ----------------------------- (Trucking Business) == Mobilized Reserve 9 JUL 08 --------------------- (2,267 Decrease) == VA Vet Centers [05] ----------------------------- (39 More by 2009) == Ohio Vet Tuition ------------------------------ (New Policy) == Medicare Fraud [08] ------------------------------ ($92 million) == Medicare Part B Premiums [03] --------- (Medically Retired Vets) == Tricare Back Surgery ------------------------------- (Policy Change) == Vet Cemetery Arkansas [01] ------------------------ (Cross County) == Rhode Island State DVA ------------------- (Proposal Fails Again) == Tricare Overseas Programs [01] -------------- (PI Satellite Office) == Enlistment Waivers [01] ------------------ (Process Standardized) == VA Brachytherapy Treatments --------- (Some Improperly Done) == DoD PDBR ----------------------------------------------- (New Board) == DoD PDBR [01] ---------------------------- (Anticipated Problems) == VA Fraud [11] -------------------------- (Hines IL CMOP Director) == VeteransТ Benefit Expiration [01] ------------------------- (Update) == Atrial Fibrillation ------------------------- (What it Is) == Forgotten Military Orphans -------------- (Adverse Impact of Law) == Legal Residency ----------------------------- (Guidelines) == SSA International Agreements --------- (Totalization Agreement) == Veteran Legislation Status 13 JUL 08] -------- (Where we Stand) VA VOTER REGISTRATION BAN: The U.S. Department of Veterans Affairs is facing mounting criticism over its national ban on voter registration drives on its property with Florida Secretary of State and chief election's officer Kurt Browning being the latest to join the chorus of criticism. Two states -- Connecticut and Washington -- have joined California in asking the VA to do away with its policy. And Browning, while saying he is legally powerless to force the VA's hand, nonetheless thinks their stand is wrong. Browning, Florida's, said in an interview that he is yet to receive a complaint from either a veteran or a group complaining that the VA is preventing the registration of voters in Florida. The agency has previously said it allows its official volunteers to assist residents of VA nursing homes, hospitals and shelters in registering when they ask for help. Tom Bowman, VA chief of staff, told the St. Petersburg Times in May that the VA needed to control access to its property so patient care would not be affected. On 10 JUL U.S. Sen. Daniel Akaka, chairman of the Senate's Veterans Affairs Committee, joined senators John Kerry and Dianne Feinstein in writing a letter to VA Secretary James Peake asking him to allow voter registration on VA property. The trio also said the VA's insistence that the Hatch Act prevents voter registration drives on federal property is simply a misreading of the law, saying it simply prevents federal employees from engaging in political activity on VA time. They said the act doesn't prevent employees from assisting veterans in registering and said the act doesn't prevent any third party from a voter registration drive. Washington attorney Scott Rafferty has sued the VA over its policy. [Source: St. Petersburg Times William R. Levesque article 10 JUL 08 ++] VA DRUG TESTING on VETS UPDATE 02: In a congressional hearing this week, Secretary of Veterans Affairs James B. Peake, M.D., discussed the actions taken in the wake of published reports in the Washington Times about a VA research program on smoking cessation involving veterans with post-traumatic stress disorder (PTSD). Secretary Peake emphasized the research project was not a drug study, but an examination of the most effective way to treat heavy smokers who have PTSD, using medications approved by the Food and Drug Administration (FDA). None of the medications used in this study are investigational or experimental, all are FDA approved, and the drug that made headlines, Chantix, is in fact considered to be the most effective medication available for smoking cessation with six million prescriptions written. Peake noted any veterans receiving Chantix in the study or anywhere in the VA had been put on the drug by their doctors as an individual doctor-patient decision, with continued monitoring the health status. As information within the VA and by the FDA suggested potential psychological side effects were being seen in some patients taking Chantix, clinical providers were notified promptly. Not only were letters sent by researchers to members of the study, but, additionally, a letter has been sent to every veteran prescribed Chantix by the VA discussing possible side-effects, encouraging them to contact their provider immediately if they experience side effects and assuring them that the VA will help them find another way to quit smoking if they are concerned about Chantix or are having side effects. Secretary Peake has directed four internal investigations: Х A comprehensive review of the smoking cessation study within 30 days. Х A review of all PTSD drug protocols in the VA system within 45 days. Х A full review of our adverse event reporting system for pharmaceuticals within 20 days. Х A review of VA's medication notification system to ensure the system's policies support timely communications to our patients and providers within 20 days. Chantix has been linked to at least 40 suicides and 400 suicide attempts in the population at large according to the FDA, which published its first alert about the potential dangers of the drug on 20 NOV 07. A second warning was issued by the FDA and one from the drug's maker, Pfizer, before the VA finally began to warn veterans in the study on 29 FEB 08. Even then the word "suicide" was not mentioned in the letter sent to veterans. House Veterans' Affairs Committee Chairman Rep. Bob Filner asked Secretary Peake "Why don't you just stop if you know the drug induces suicidal thoughts?" No response was reported by this source. [Source: NAUS Weekly Update 11 Jul 08 ++]. GI BILL UPDATE 25: The Department of Veterans Affairs recently announced that the Montgomery GI Bill will soon be increased by 20% -- a total increase of nearly $220 a month increase over last year's rate. The increased full-time student payment rate of $1,321 multiplied by the 36-month brings the GI Bill total payout to over $47,500. If you are GI Bill eligible and have benefits remaining, you get this increase no matter when you became eligible or begin using it. This is increase that will help pay college costs until the new GI Bill goes into effect in AUG 09. [Source: NAUS Weekly Update 11 Jul 08 ++] VA CLAIM BACKLOG UPDATE 16: As of two years ago, the Department of Veterans Affairs had a backlog of about 400,000 disability claims according to Iraq and Afghanistan Veterans of America, an advocacy group. Despite efforts to speed up the claims process, the backlog remains at about the same number now, VA officials said. In the week ending 5 JUL 08 there were a total of 637,000 rating and non-rating cases pending of which 23% were over 6 months old, in addition the VA has over 172,000 cases on appeal. To make matters worse, the Department of Defense and the VA have lagged at making the transition to civilian life easy for soldiers. According to a report issued in April by the GAO, the departments still haven't developed a "one-stop shopping process" for soldiers that would provide standard discharge examinations, help with filing discharge claims, and assurances that vets don't get lost in a sea of paperwork. The departments also don't have a joint system to make it easier to keep track of soldiers' medical histories. The system, the report said, was supposed to have been in place three years ago. "They've treated our veterans like stepchildren," said U.S. Rep. Patrick Murphy, who in 2006 became the first Iraq veteran elected to Congress. A number of legislative and bureaucratic steps have been taken to improve the transition process: The VA announced an effort this year to track down 550,000 veterans and remind them of the benefits to which they are entitled, and Murphy helped pass legislation that allowed the VA to add 1,800 disability-claims processors. But more needs to be done, he said. "We had to change the philosophy first and start making our vets a real priority," Murphy said. The Department may have reached a turning point in its long battle to process a huge backlog of benefits claims Ч for the first time in years, the VA is processing more claims than it is receiving. Sen. Daniel Akaka (D-HI) called this Уgratifying news,Ф but expressed concern that faster processing may cause more errors on claims. УTimelines cannot take precedence over accuracy,Ф Akaka said at a 9 JUL senate hearing. While pleased with the VAТs progress, Akaka said, УIt is far too soon to declare victory in the claims battle. Processing an initial disability claim takes an average of 185 days, about two months longer than the VAТs goal. Getting a handle on incoming claims is important because the workload will only increase because of a combination of new Iraq and Afghanistan combat veterans with service-connected disabilities and an aging population of veterans whose health and disabilities worsen with age.Ф Retired Rear Adm. Patrick Dunne, acting VA undersecretary for benefits, acknowledged that the workload is growing. The VA expected to get 855,000 claims this year but now projects it will receive 883,000, a 5% increase over 2007, Dunne said. But even with the increased volume, Уwe are now completing more claims than we receive,Ф Dunne said. УAs a result, the pending inventory at the end of May was reduced to 390,000.Ф [Peninsula Daily News David Gambacorta & Army Times Rick Maze articles 30 Jun & 8 Jul 08 ++] VA CLAIM BACKLOG UPDATE 17: In the last decade, the Department of Veterans Affairs has doubled the number of disability claim processors on staff, and yet the average time to process a claim has climbed during that period from four months to six. From JAN 07 through JUN 08, as VA added 2,700 claim processors to its inventory of 8,000, the average time to process a claim still fell unimpressively, from 183 days to 181. "SomethingТs going on here that isnТt right, that needs to be fixed. I donТt know what the hell it is," said a frustrated Sen. Jon Tester (D-MT) during a hearing 9 JUL of the Senate Veterans Affairs Committee. "In the 1990s you were at 120 days" to process a claim. "Was there something in the process that changed," Tester asked Michael Walcoff, deputy undersecretary for benefits for the VeteransТ Benefits Administration. Yes, Walcoff said. Congress in 2000 passed the Veterans Claims Assistance Act. Since then, two-thirds of the time required to process a claim is committed to blocks of time set up to develop evidence to support the claim. A recent study of VA claims processing, conducted by IBM, confirmed that compliance with the VCAA has created bottlenecks for processors. "ItТs good law Е set up to guarantee that veterans have certain rights and they are protected. ItТs something we all agree with," Walcoff said. But courts have interpreted that law "in various ways that have made it very difficult to administer and have added time to the process." Passage of the VCAA, in effect, overturned a 1999 decision by the Court of Appeals for Veterans Claims that veterans had to submit a "well grounded" claim for VA officials to be required to help them obtain further evidence Ч such as doctor files or witness statements Ч to prove their claim. While the VCAA lowered evidentiary standards for veterans, it also spelled out in great detail what actions VA had to take, and what deadlines it had to set, to help veterans develop evidence to support claims. When a claim is filed, the VCAA mandates that claim processors carefully analyze it and send a letter to the veteran explaining evidence on file and evidence still needed. The letter also must explain that VA will help obtain evidence if names and addresses of doctors or witnesses are provided and that VA will obtain government records pertinent to the claim. But the VCAA letter also tells a veteran that he or she has 60 days to submit the required evidence. And if the claim is to be based on the medical findings of a private physician, the doctor too is given a 60-day deadline to submit medical records. The process can be delayed further if their original claim fails to include a signed privacy form required for VA to request medical records from private physicians. "We then have to go back to the veteran to get the privacy form," Walcoff said. All of this, he said, is required by VCAA. Some veteransТ service organizations and lawmakers have criticized VA for implementing the VCAA, and follow on court rulings, like a lumbering bureaucracy rather than like a dynamic agency bent on speeding up the claims process. VA officials told senators they soon will implement some of the IBM report recommendations to speed the claims process. The study said, for instance, that the VA should reduce the 60-day period given veterans to provide evidence supporting their claim. "We are shortening that to 30 days so we can act faster," said retired Navy Rear Adm. Patrick W. Dunne, acting undersecretary for benefits for the Veterans Benefits Administration. VA also will make the VCAA letter more understandable for veterans and make it available electronically in November after a software update. VA disability claims have climbed by 5% from last year, to 883,000, the result of Iraq, Afghanistan and an aging veteran population. The claims backlog is still a hefty 390,000. Though decision timeliness remains a concern, said Sen. Daniel Akaka (D-HI) committee chairman, decisions finally are being handed down faster than claims are being filed. But North Carolina Sen. Richard Burr, ranking Republican on the committee, said claim timeliness remains very frustrating for veterans and their families. "Simply drawing more money and more personnel to the problem clearly Ч clearly Ч has not been the solution," Burr said. ItТs time "to seriously explore other options" including conversion to paperless claims and overhauling VAТs overly complex disability rating system. Howard Pierce, chief executive officer of PKC Corp., testified that his company in 2001 was tasked to set up a computerized decision model that could be used by VA disability raters and claim adjudicators. PKC analysts were stunned by the complexity of the decisions. "What a rater is asked to do on a day-to-day basis is extraordinarily complicated. We live in a world of complexity in my company. We work with very challenging science. We have never seen anything more complex" than the VA claims system, Pierce said. But Kerry Baker, with Disabled American Veterans, suggested other ways for VA to speed claim decisions and be fairer too. He said most claims still hinge on medical opinions, and VA should be more willing, as is the Social Security system, to accept well documented private medical opinions. VA also should be required, "as a matter of fairness," to inform claimants on basic elements that render a private medical opinion adequate for rating disabilities. "VA relays this exact information to its own doctors when it seeks medical opinion," Baker said. Source: Stars & Stripes Tom Philpott article 12 Jul 08 ++] FAMILY FILM FESTIVAL: While school's out, kids and their parents can visit selected Regal theatres around the country for their no charge Family Film Festival for nine weeks of movies. Regal has provided this service to the community since 1991. Selected G & PG movies start at 10AM each TUE and WED during the festival. First-come, first-served seating is limited to theatre capacity. The Family Film Festival is safe, lots of fun and a great way for kids to spend a weekday morning in the summer. To see if the no charge movies are playing in your city go to http://www.regmovies.com/nowshowing/familyfilmfestivalschedule.aspx and use the drop down box to find your state. It will then display the local theaters, movies, show times, etc. [Source: EANGUS Minuteman Update 10 Jul 08 ++] MEDICARE REIMBURSEMENT RATES 2008 UPDATE 11: The Senate sent President Bush a controversial Medicare bill H.R.6331 passed by an unexpectedly wide margin 9 JUL. However, the President has threatened to veto it. The Senate cleared it by voice vote after voting 69-30 to overcome a final procedural hurdle. That tally is more than the two-thirds majority needed to override a presidential veto. Similarly, the House passed the bill by a vote of 355-59 on 24 JUN. The legislation would stop a 10.6% cut to doctors' Medicare payment rates, replacing them with steady payments for the next 18 months. After that, more cuts would go into effect. The cuts technically went into effect on 1 JUL, but the administration has put a freeze on payments until 15 JUL, extending the deadline for work to be completed. Tricare provider payments are tied to Medicare payment rates. If the Senate had not passed the bill, Tricare payment rates would have been cut, which may have meant that doctors and dentists would no longer take Tricare patients, existing or new, having a significant effect on the military community. By passing the bill, the rate cuts are averted (if the President signs the bill) and rates will actually rise a bit. The bill also would make cuts in privately administered Medicare Advantage plans to pay for the decreases in provider payments, and it was those cuts that the White House and Senate Republicans had objected to most vigorously. Republicans who initially had voted against the bill joined Democrats at the last minute, after Senator Ted Kennedy made his surprise appearance on the Senate floor. A senior Senate aide said Kennedy had been following the issue closely from Massachusetts and that he personally called Majority Leader Harry Reid on 7 JUL to say he would likely come back for the vote. The aide said Kennedy would return to work in the Senate in September. Kennedy is recovering from a brain tumor. The bill does a lot more than roll back a drastic Medicare pay cut to doctors. Following is a list of reforms a number of which the Medicare Rights Center has advocated for years: Х New preventive services of proven benefit will be covered by Medicare. Х Patient coinsurance for mental health services will be lowered from 50% to 20, the same rate that now applies to other doctor visits. Х A life insurance policy or in-kind help from friends and family (e.g. with groceries, heating bills) will no longer disqualify people from help with their drug costs. Х Bureaucratic obstacles that prevent low-income people from receiving help with their drug and medical costs will be eliminated. Х The Centers for Medicare & Medicaid Services will be required to rein in the exorbitant broker commissions that have fueled aggressive and fraudulent marketing of Medicare private health plans. Х Medicare private health plans will be required to provide care coordination and other services that meet the special needs of the enrollees they are designed to serve. Х All Medicare private health plans will be required to implement programs to improve the quality of care they provide. Х Fewer Medicare private health plans will be exempt from requirements that they have networks that guarantee access to specialists and other local providers. Х The Part D drug benefit will cover benzodiazepines, a class of drugs used to treat seizure disorders and anxiety disorders, which are now excluded from coverage. Х Part D coverage for anticancer drugs will be expanded to encompass more treatments that have been shown in respected medical journals to be effective. [Source: EANGUS Minuteman & Asclepios Updates 10 Jul 08 ++] VA THIRD-PARTY INSURERS: According to a report released on 10 JUL by the Government Accountability Office (GAO) a sample of medical centers managed by the Veterans Affairs Department failed to follow proper billing procedures on about $1.7 billion in uncollected payments to check if private insurance companies owed money to the department, In a study of 18 VA medical centers, GAO found that delays, billing mistakes or a lack of oversight led to the centers failing to check if $1.7 billion in fiscal 2007 should have been billed to third-party insurance companies. The medical centers have valid reasons for not billing for certain medical procedures, such as treatment received during military service, services covered by Medicare and a patient not having private health insurance. But "medical center management did not always validate the reasons for these unbilled amounts," said the report which can be viewed at http://www.gao.gov/new.items/d08675.pdf. "VA still has significant weaknesses in their controls in billing, follow-up and collection," said Kay Daly, GAO's acting director for financial management and assurance and the one of the report's authors. "They could be obtaining hundreds of millions in revenue from third-party insurers if they addressed these weaknesses." GAO performed the case study as a follow-up to a 2004 report that also identified failures in VA's ability to bill third-party insurers for care given at medical centers. The department often did not bill private insurance companies that covered patients treated at its facilities. The most recent report acknowledges VA has made some progress in correcting those shortcomings issue, but concludes many patient visits still are not billed to third-party insurers. "We found that VA didn't have the full range of reports they needed to manage this at a high level perspective," Daly said. "They didn't have information on the billing and collection process or formal procedures to provide them with that information." GAO found 10 medical centers took, on average, 109 to 146 days to bill third-party insurers. VA's goal is 60 days. "We also found these centers had significant documentation, coding, and billing errors and performed little or no management oversight of the billing function," the report stated. GAO said the lack of reporting was closely tied to problems in the design of VA's computer systems. The Veterans Health Information Systems Architecture, or VistA, a medical records system that includes accounts receivable, operates as a stand-alone system at each medical center. That prevents officials from directly accessing individual medical center data and requires officials to call each center to ask for information. To collect the data in one accessible location, VA developed the Performance and Operations Web-Enabled Reports System, which serves as a data warehouse for VistA data. GAO noted, however, that the system does not provide all the required standard management reports to conduct oversight and additional queries and data compilations are needed to collect the billing data. VA has undertaken initiatives to upgrade its systems. The Clinical Data Entry program will allow the department to capture clinical data automatically during a patient's first visit. The system also will compile procedures that are expensive and conducted frequently but are not billed. VA wanted to complete the system in MAY 07 but so far the department has yet to set a deployment date. Another major driver in VA's efforts to optimize revenue collection is the Patient Financial Services System, which will resolve business processes and technology issues in VA's revenue collection and financial management systems. [Source: GovExec.com newsletters Gautham Nagesh article 14 Jul 08 ++] ADVENTURE EXCURSIONS FOR OEF/OIF VETS: Outward Bound, an international non-profit outdoor education program, is offering fully funded outdoor adventure excursions to all OEF/OIF veterans. It doesnТt matter what your current military status is (active, inactive, discharged, retired) Ц youТre eligible to attend as long as you deployed in support of OEF/OIF combat operations while in the military. These five-day excursions offer adventure activities such as backpacking, rock climbing, canyoneering, canoeing, and dog sledding in wilderness areas in Maine, Texas, Colorado, California, and Minnesota. Scheduled courses from 8 SEP 08 thru 9 FB 09 are listed below, and future courses will be scheduled soon. All expedition costs for lodging, equipment, food, and instruction are completely funded by a multi-million dollar Sierra Club grant, including the participantsТ round-trip transportation between home and the wilderness site. The excursion is offered at no cost to the participant. To sign up for one of the prescheduled courses, contact Doug Hayward at 1-866-669-2362, ext. 8387, or e-mail him at obvets@outwardbound.org. To learn more about the OEF/OIF program, visit the website at www.outwardboundwilderness.org/veterans.html. You can also contact two of their retired Judge Advocates, Joe and Amy Frisk, who are working for Outward Bound on this program at vetsor@outwardbound.org, or at (303) 968-4420. The open enrollment course schedule is: Х Leadville CO - Backpacking and Rock Climbing in the Colorado Rockies: 3-7 SEP & 4-8 OCT 08. Х Newry ME - Backpacking and Canoeing: 7-11 & 19-23 OCT 08 . Х Big Bend TX - Back packing and Canyoneering: 2-6 & 15-19 NOV 08. Х Joshua Tree National Monument CA - Backpacking and Rock Climbing: December 3-7 & 14-18 DEC 08. Х Ely MN - Dog Sledding: February 3-7 FEB 09. [Source: Student Veterans of America John D. Mikelson Notice 10 Jul 08 ++] VET JOB UPDATE 02: Both Schneider National and Con-way Freight have implemented programs to attract former military personnel to the trucking business, helping train and prepare armed forces members for a life behind the wheel. The trucking industry needs good, quality workers. Former servicemen and women need a post-military career. It seems like a natural fit. Schneider National announced last week its Veterans Owner-Operator Program, which will give former military personnel the training, mentoring, financial incentives and purchasing power necessary to become an owner-operator, the carrier said. Schneider signed a Memorandum of Understanding with the U.S. Department of Veterans Affairs that will subsidize veteransТ commercial driversТ license training through their GI Bill benefits. The carrier added that it will work closely with veterans to ensure they are able to become owner-operators six months sooner than prospective owner-operators without a military background. According to Schneider, more than 25% of the companyТs employees have military backgrounds, and the carrier ranks sixth on G.I. JobsТ Top Military-Friendly Employer list. Con-way Freight is also looking to attract armed forces personnel, launching last week a public-private partnership with the U.S. Army Reserve that will allow both organizations to recruit, train and employ those interested both in serving their country and joining the commercial freight transportation industry. According to Con-way, the agreement gives Army Reserve soldiers employment opportunities with Con-way Freight after they complete their military occupational training, formally creating a relationship between the armed forces and the private sector. [Source: Fleet Owner Online Justin Carretta article 7 Jul 08 ++] MOBILIZED RESERVE 9 JUL 08: The Army, Air Force and Marine Corps announced the current number of reservists on active duty as of 9 JUL 08 in support of the partial mobilization. The net collective result is 2,267 fewer reservists mobilized than last reported in the Bulletin for 15 JUN 08. 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. The total number currently on active duty in support of the partial mobilization of the Army National Guard and Army Reserve is 85,517; Navy Reserve, 5,757; Air National Guard and Air Force Reserve, 11,499; Marine Corps Reserve, 8238; and the Coast Guard Reserve, 787. This brings the total National Guard and Reserve personnel who have been mobilized to 111,799, including both units and individual augmentees. A cumulative roster of all National Guard and Reserve personnel, who are currently mobilized, can be found at http://www.defenselink.mil/news/Jul2008/d20080709ngr.pdf . [Source: DoD News Release 576-08 9 Jul 08 ++] VA VET CENTERS UPDATE 05: Combat veterans will receive readjustment counseling and other assistance in 39 additional communities across the country where the Department of Veterans Affairs (VA) will develop Vet Centers by fall 2009. The existing 232 centers conduct community outreach to offer counseling on employment, family issues and education to combat veterans and family members, as well as bereavement counseling for families of service members killed on active duty and counseling for veterans who were sexually harassed on active duty. Vet Center services are available at no cost to veterans who experienced combat during any war era. They are staffed by small teams of counselors, outreach workers and other specialists, many of whom are combat veterans. The Vet Center program was established in 1979 by Congress, recognizing that many Vietnam veterans were still having readjustment problems. The centers have hired 100 combat veterans who served in Iraq and Afghanistan as outreach specialists, often placing them near military processing stations, to brief servicemen and women leaving the military about VA benefits. VA's 2009 budget proposal seeks $20 million more than this year's budget for Vet Centers, to include operating and leasing space for the new centers. Eighteen of the counties that will have new centers already have one or more; the other 21 do not. The communities receiving new VA Vet Centers will be: AL Ц Madison; AZ Ц Maricopa; CA - Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego; CT Ц Fairfield; FL - Broward, Palm Beach, Pasco, Pinellas, Polk, Volusia; GA Ц Cobb; IL - Cook, DuPage; MD - Anne Arundel, Baltimore, Prince George's; MI - Macomb, Oakland; MN Ц Hennepin; MO Ц Greene; NC Ц Onslow; NJ Ц Ocean; NV Ц Clark; OK Ц Comanche; PA - Bucks, Montgomery; TX - Bexar, Dallas, Harris, Tarrant; VA - Virginia Beach; WA Ц King; and WI Ц Brown. [Source: VA News Release 9 Jul 08 ++] OHIO VET TUITION: In an effort to attract more veterans to OhioТs public universities, Gov. Ted Strickland announced 8 JUL that the state would charge in-state tuition to all veterans attending college on the G.I. bill. The Ohio plan, the first of its kind in the nation, makes all veterans Уhonorary OhioansФ for the purpose of a college education. On 30 JUN, President Bush signed into law a new G.I. bill, doubling college benefits for eligible troops and veterans, essentially guaranteeing full scholarships at their in-state public colleges or universities, as well as providing monthly housing stipends. But generally, veterans can attend college under the law only in their home states. The Ohio plan, called the Ohio G.I. Promise, changes residence requirements at the stateТs 36 colleges and universities to allow all veterans, their spouses and dependents to attend Ohio colleges and universities at in-state tuition rates. Ohio, which has about 47,000 students enrolled in its public institutions, recently adopted a 10-year strategic plan with a goal of enrolling about 230,000 more over the next decade. Eric D. Fingerhut, chancellor of the Ohio Board of Regents said, УWe have for years had a net out-migration, not only for the state generally, but for people with college degrees. So one of our goals, specifically delineated in the strategic plan, is to reverse the out-migration of people with degrees. In order to achieve that, we have to graduate more students and keep them here, and also attract more from out of state.Ф Mr. Fingerhut said the veterans plan will work in tandem with other new programs to encourage students to stay in Ohio. УIf we are able to attract veterans to Ohio, we can link them and their families to internships, co-op and other opportunities, and if they get good jobs here, weТll have Ohioans. We want veterans to know Ohio wants them to come here, and that we think theyТre incredibly valuable high potential students. We already have a number of very good programs, which weТll be expanding, to provide the type of counselors, advisers, and mentors who can work one on one with veterans to help them make the transition to civilian life and navigate the academic environment.Ф Currently, out-of-state students make up about 7.2% of those enrolled in OhioТs state colleges and universities. [Source: New York Times Tamar Lewin article 9 Jul 08 ++] MEDICARE FRAUD UPDATE 08: Congressional investigators said 8 Jul 08 that Medicare has paid as much as $92 million since 2000 to medical suppliers who billed the government for wheelchairs and other home equipment purportedly prescribed by physicians who, according to records, were dead at the time. The Centers for Medicare and Medicaid Services (CMS) honored about 500,000 such claims despite pledging six years ago to correct the problem, which was identified by the Health and Human Services Department's inspector general in 2001. In more than half the cases studied, the doctor listed as having ordered the equipment had died more than five years earlier, said a report by the Senate Homeland Security and Governmental Affairs Committee's permanent subcommittee on investigations. The report is part of the committee's ongoing investigations into waste, fraud and abuse in the fast-growing federal health program, which serves more than 43 million elderly and disabled Americans. Medicare pays annually more than $400 billion in benefits and is a fixture on the Government Accountability Office's "high-risk" list of troubled programs. The Medicare program's durable medical equipment component, in particular, has been a frequent target of companies seeking to bilk the government. The subcommittee has scheduled a hearing on the problem. When the system works properly, a physician writes a prescription for home medical equipment for a Medicare beneficiary. He takes the order to a supplier, who sells or rents the equipment to him. The supplier, in turn, submits a claim for payment to a Medicare contractor for processing. The claim includes a number issued by Medicare that identifies the prescribing physician. Senate investigators obtained from the American Medical Association a computer file of physicians who had died between 1992 and 2002. They selected 1,500 at random and asked Medicare officials to turn over medical-equipment claims filed with those doctors' Medicare ID numbers between 2000 and 2007. During that time, the review said, ID numbers for 734 deceased doctors were used to file 21,458 claims that totaled $3.4 million. Investigators counted the claims only if the equipment was bought more than a year after the doctor's death. Extrapolating from the sample, investigators estimate that 384,730 to 572,238 such fraudulent claims were submitted during that period, and Medicare paid an estimated $60 million to $92 million. There are still active ID numbers in Medicare's system for as many as 2,895 dead physicians, investigators said. They examined separate data for Florida, home to many retirees and a perennial leader in Medicare fraud. They found that more than a quarter of deceased Medicare doctors there still have active ID numbers in Medicare's system. Medicare officials had promised to do a better job screening claims after the 2001 inspector general's report found that the agency had paid $91 million for medical supply claims with invalid or inactive physician ID numbers in 1999. Medicare officials said several new steps should help, including a plan to match monthly Social Security Administration data about U.S. deaths against a revamped Medicare provider-identification system. They also pointed to new accreditation requirements for suppliers under a new program, opposed by the industry, that sets some equipment prices through competitive bidding. [Source: Washington Post Christopher Lee article 9 Jul 08 ++] MEDICARE PART B PREMIUMS UPDATE 03: Some military retirees disabled in the wars in Iraq and Afghanistan pay more for health care than other retirees, and a new report recommends waiving their insurance premiums to correct the inequity. The report 8 JUL by inspectors general of the Department of Defense and the Department of Veterans Affairs suggests waiving for life the Medicare Part B premiums for service members who have been medically retired and are unlikely to get another job. Service members judged unfit for continued service after a service-related injury or illness are called Уmedically retiredФ and are eligible to continue receiving care through the military health care system. But those who donТt live near VA facilities can enroll in Medicare and go to civilian providers, the report said. Such retirees pay roughly $1,160 annually in monthly premiums until reaching the age of 65, while other retirees remain in the military health care system and donТt need the Medicare plan. The proposed change is among recommendations made after a review of services available for troops injured in Afghanistan and Iraq as they transition from active duty in the military to the responsibility of the VA. The review, started two years ago, didnТt study the quality of medical care or individual cases, but rather efforts to improve the transition process. Release of the report was delayed to take into account legislation passed or proposed since the study started Ч as well as recommendations by more than a half-dozen commissions and task forces that have looked at veteran and troop health care in recent years. Those other studies made more than 400 recommendations Ч now in varying stages of review or implementation. УSince 2005, DOD and VA made significant progress modifying, updating and improving the systems supporting injured service members and veterans,Ф the report said. УThe final step will be to ensure implementation.Ф Some veterans have complained about falling through the cracks of the bureaucracy as they leave the PentagonТs care and transition to the VA. Some have complained about long waits to get appointments or about being discharged at a fraction of their pay, then waiting for months before their full disability payments arrive. Cynthia O. Smith, a Pentagon spokeswoman, said that among other efforts, the two departments have provided coordinators to guide wounded warriors and their families through medical recoveries and have set up a pilot program to simplify what was two exhaustive medical exams into one at the start of the disability process. [Source: Air Force Times AP Pauline Jelinek article Posted 9 Jul 08 ++] TRICARE BACK SURGERY: A policy change is retroactive to 1 MAR 07 will allow beneficiaries with pain from fractured vertebrae to now seek surgery under Tricare. Percutaneous vertebroplasty and kyphoplasty, two minimally invasive back surgeries, are now covered. Either may replace spinal fusion, an invasive surgical procedure, for treatment of fractured vertebrae. Usually occurring in patients with osteoporosis, many vertebral fractures heal on their own with bed rest and anti-inflammatory medication in approximately three months. It is only when pain persists beyond three months that surgery is recommended. The traditional treatment was spinal fusion surgery which requires up to 12 hours in the operating room with days of hospitalization afterward. Percutaneous vertebroplasty and kyphoplasty are outpatient surgeries which have patients back to relative normality in 24 hours. Although minimally invasive, all surgeries come with risk and decisions need to be consulted with a doctor. Approval must be obtained from a provider for either surgery. Beneficiaries with questions about this procedure and its coverage under Tricare should contact their primary care manager. Check www.tricare.mil for this and other healthcare benefit information. [Source: Tricare News Release No. 08-64 dtd 8 Jul 08 ++] VET CEMETERY ARKANSAS UPDATE 01: Officials say a fifth veterans cemetery for Arkansas will be established by the state on 99 acres near this Cross County community. Of the four current veterans cemeteries in Arkansas, only three are open for new burials Ч national cemeteries at Fayetteville and Fort Smith and a third being developed by the state at Camp Robinson in North Little Rock. The Little Rock National Cemetery has no more room for gravesites. The new veterans cemetery, to be a state operation, will be developed on land bought from the Maurice Smith family of Birdeye, near the intersection of Arkansas 42 and Arkansas 163, northeast of Wynne and east of Cherry Valley. The Smith family sold the land for $150,000, but that is only a small part of the cost. Jerry Bowen, a former undersecretary in the federal Veterans Affairs Department Bowen said that, in addition to the land, the estimated cost of developing the cemetery will be $5.6 million. The state Legislature has appropriated $1.3 million to start the project. According to Bowen, 46% of all veterans in the state live in central Arkansas, 34% in northwest Arkansas, 16% in northeast Arkansas, 4% in southeast Arkansas and 5% in southwest Arkansas. The cost of development will be paid for by the federal government through the state. David Fletcher, director of the Arkansas Department of Veterans Affairs, said the need for a new veterans burial ground was made apparent by the large pool of World War II veterans living in the region. The cemetery will have a full-time staff of five and an estimated annual operating budget of $250,000. Officials estimate the first burial could be as early as Memorial Day or Veterans Day in 2010. [Source: Arkansas Democrat Gazette AP article 7 Jul 08 ++] RHODE ISLAND STATE DVA: A renewed proposal to establish a state Department of Veterans Affairs has been defeated again. Rep. Kenneth Carter, a North Kingstown Democrat and chairman of the House Committee on Veterans Affairs, resubmitted the measure that last year was passed by the Rhode Island General Assembly but vetoed by Governor Carcieri. This time, the bill won House passage but died in a Senate committee. Currently, veterans issues are dealt with by a division of the state Department of Human Services. [Source: Veterans Journal George W. Riley article 7 Jul 08 ++] TRICARE OVERSEAS PROGRAMS UPDATE 01: TRICARE Area Office Pacific (TAO PAC) has announced they will be establishing a Philippines Satellite Office with a target opening date by the end of 2008. Negotiations with JUSMAGPHIL and the Department of State for space in the Embassy compound are currently ongoing. Once the office is set up Tricare users will be able to call or visit the office for help with their Tricare issues and problems. In the interim, Philippine support will continue from the TAO PAC Okinawa office which can be reached via TPAO.CSC@med.navy.mil, or Commercial Tel: 81-611.743.2036 or DSN: 315.643.2036 or DSN FAX: 315.643.2037 or no cost Tel: 888-777-8343 Menu Option # 4. Within the month all Philippine Tricare users will be sent a letter from Wisconsin Physician Services (WPS) to inform them about the new Philippines rates that have been established to pay for inpatient (hospital) and outpatient care. If you do not receive a letter either you have not updated your current local address or you are still registered under a Tricare region in the states. The new rates will begin on 1 OCT 08. They were developed by the Tricare Management Activity (TMA) office to replace the Puerto Rico caps that are currently used for outpatient services and for the inpatient daily rates in the Philippines. TMA used the World Bank International Comparison Program index for the Philippines to establish more reasonable rates to reflect costs in the Philippines. Generally the new rate caps will be lower than the current caps, so it is important that users know what these rates are in order to avoid significant out of pocket costs. These rates will be published on the TRICARE website: http://www.tricare.mil/tma/foreignfee/ . Inpatient rates are already listed on the site and below. Outpatient rates will be listed soon. Philippines Inpatient Allowed Daily Per Diem Rates: Group # Description Current 1 OCT 08 01 Infectious Disease ............... $1,847 $1,144 02 Cancer ............................. $2,136 $1,196 03 Endocrine ........................ $2,119 $1,141 04 Mental Health ................. $909 $395 05 Nervous System ............... $1,906 $1,027 06 Circulatory ..................... $3,044 $1,769 07 Respiratory ..................... $1,828 $916 08 Digestive ........................ $1,888 $1,009 09 Genitourinary ................. $1,980 $1,152 10 Pregnancy and birth .......... $1,076 $555 11 Musculoskeletal and Skin .. $3,079 $1,998 12 Congenital anomalies .... $2,916 $1,657 13 Perinatal ......................... $731 $333 14 Symptoms, signs, etc. ..... $1,950 $1,080 15 Injuries ........................... $2,246 $1,249 16 Poisoning ........................ $1,801 $1,069 17 Complications ................ $2,333 $1,403 18 V-codes .......................... $1,640 $966 [Source: TAO PAC Notice 1 Jul 08 ++] Editors Note: The above rates changes will result in significant out-of-pocket medical care expense for Philippine users if they do not take steps to plan their health care in advance. It also sets the precedent to take similar steps in other overseas countries in which retirees reside. The revised rate structure for 1 OCT will result in all users in PI having to effectively pay higher Tricare fees than those in CONUS. By lowering the allowed amounts that can be reimbursed to providers the net result is that in addition to the 25% copay, retirees will also have to pay their providers the difference between what Tricare allows and what is charged to Philippine citizens. PI Tricare users should confirm that their current providers will accept the reduced rates before care is needed and, if not, attempt to locate alternate providers who will. At present less than 10% of the providers in the PI will accept direct reimbursement from Tricare. Since almost all PI providerТs require payment in advance, it would be prudent to set aside funds to make these payments as needed. Readers are encouraged to write their legislators and request they either conduct a congressional inquiry or hold hearings to justify why DoD has taken steps for Tricare users overseas to pay more than those in CONUS. ENLISTMENT WAIVERS UPDATE 01: This week the Department of Defense (DoD) and the nation celebrated the 35th Anniversary of the All Volunteer Force (AVF). Since its inception, our volunteer military has upheld the traditions of strong and selfless service to the nation. Presently, more than 1.4 million men and women choose to serve on active duty, along with nearly 1.1 million members of the National Guard and Reserves. DoD announced changes 27 JUN to improve the enlistment screening process by standardizing enlistment criteria and generating uniform reporting of waiver types across all services. The most noticeable change to the policy is in the area of conduct waivers. Previously, each service categorized offenses differently, making it impossible to provide reliable comparisons across services, over time. Under the new policy all conduct offenses will be classified into one of four different categories. The most severe offenses will be classified as "major misconduct," while less severe offenses will be considered "misconduct," "non-traffic," or "traffic" offenses. Also new is a coding system allowing services to track the level of the misconduct and the specific offense in question. Recent research suggests patterns of smaller offenses such as underage drinking and curfew violations are often more problematic over a career than a single major youthful offense such as burglary, which is the most common offense in the "major misconduct" category. About one in five recruits receives exceptional admission to the military by means of a waiver. About one third are for medical waivers- most frequently for high body fat - and nearly two thirds involve youthful misconduct waivers. The standardization of data will allow the department to better analyze the relationship between offenses or categories of offense on the one hand, and attrition or performance concerns on the other. This new policy, will go into effect on 1 OCT 08, does not prohibit further changes in the management of the military's screening for service in the armed forces, but it does represent another affirmative step in sustaining the pattern of success that has come to characterize AVF. Today's AVF is highly educated with nearly 95%t of recruits holding a high school diploma, compared to about 75% of contemporary youth. Moreover, two thirds are drawn from the top half of American youth in math and verbal aptitude. The new policy can be viewed online at http://www.defenselink.mil/news/d20080627DTM08-018%20Final%20Signed%20compressed.pdf . [Source: DoD News release No.560-08 dtd 2 Jul 08 ++] VA BRACHYTHERAPY TREATMENTS: On 2 JUL VA notified the major veteran service organizations about a medical treatment problem at the VAMC in Philadelphia. Specifically, VA had discovered that a specific treatment for prostate cancer, called brachytherapy, had not been conducted properly in a number of cases from 2002 to 2008. At this time this problem is known to exist at the Philadelphia VAMC only. Actions are underway to contact all patients who have received brachytherapy treatment at the Philadelphia VAMC during this time frame by mail. These letters will provide information on the error in treatment, information on obtaining follow-up care, a contact number for additional information, an apology, and assurances that any co-pays for additional testing will be waived. All other veterans who are concerned should call the VA hospital where they were treated. Following are responses to some anticipated questions from those who have received brachytherapy: Х What will happen next to me? In order to determine which patients have a problem, VA will be performing repeat CT scans on some patients. Using these scans, they will then calculate the dose to the prostate and determine whether it was adequate. If it is determined that the dose was adequate, VA will inform you, and nothing further will be done except for routine follow-up. If it turns out that the dose was inadequate, see items 4 and 5 below. Х What does inadequate dosage mean? Prostate brachytherapy is based on the delivery of a certain dose of radiation to the entire prostate gland using radioactive seeds. Based on a review of dosing to the prostate gland, VA determined that some doses may have been lower than optimal. Patients whose prostate gland received lower than optimal doses have a higher chance of their cancer returning than patients who received higher doses. Х Will additional tests be required, and if so what tests? VA is requesting a repeat CT scan on patients who they suspect may have been under dosed. They will also be obtaining PSA levels on our patients, which is something which would be done even if there were no suspicion of under dosing. If there is a rising PSA, VA may obtain a bone scan. In some cases, a prostate biopsy might be recommended. Х If it turns out that I received an inadequate dose, does it mean that I will have a relapse of my prostate cancer? Not necessarily. Properly delivered brachytherapy cures early stage prostate cancers in 90-95% of patients meaning that there is a 5-10% chance of the cancer returning. If it turns out that you received an inadequate dose, your risk is higher. However, it is still possible that it will never return. Х If it is determined that I was under dosed, will I require more treatment? We is reviewing your case to determine whether to recommend further treatment at this time and if so what that therapy should be. This is an individualized decision based on many factors, including how long ago your implant was performed and your current and past PSA levels. If it is felt that your risk of relapse is high, VA may recommend further treatment such as a second implant. Alternatively, VA may recommend no further treatment and may continue to follow your PSA levels. Х If no further treatment is recommended but only follow-up, how long do I need this? Prostate cancer can be very slow growing and may relapse many years later. For this reason, it is recommended follow-up at least every six months for a minimum of five years following treatment and preferably for ten years. Х If I do have a relapse what further treatment could be given? After radiation therapy to the prostate has been given, most urologists are unwilling to perform surgery. The most likely course of action would be to place you on hormonal therapy (injections given every 3 months and oral pills). Х Do I have the right to sue? Yes; for more information about filing a claim contact the Office of Regional Counsel (Mr. Jose Lopez). He may be reached by telephone at (215) 823-7811, or by mail at Jose H. Lopez, Regional Counsel, Office of Regional Counsel (642/02), Department of Veterans Affairs Medical Center, 3900 Woodland Avenue, Philadelphia, PA 19104 . [Source: NVS Weekly Updates 2 July 08 ++] DOD PDBR: Former servicemembers who disagree with the disability ratings they received when they were discharged as unfit for military duty can now apply to have those ratings reviewed by a new Physical Disability Board of Review (PDBR). The Defense Department announced formation of the new board to reassess the accuracy and fairness of disability ratings assigned to discharged troops. Several task forces and studies cited inconsistencies in the way the military departments assigned disability ratings for similar conditions. The Army tended to assign the lowest ratings, according to the studies. The findings were enough to warrant the creation of a PDBR. The board won't second-guess service determinations of fitness for continued service; it will only review the combined disability ratings associated with the specific unfitting conditions cited by the service Physical Evaluation Board. Their recommendations will be final and won't be reviewable by a service Board for Correction of Military Records. Any servicemember who meets eligibility qualifications (or the surviving spouse, next of kin, or legal representative) can submit a written request to the parent service to have his or her case considered by the PDBR if the servicemember: 1) Was separated from the Armed Forces between 11 SEP 01 and 09 due to a disability that made him or her unfit for continued military service; and 2) Received a combined disability rating of 20% or less from the parent service; and 3) Was not eligible for retirement. The new board could potentially affect almost half the 20,000 servicemembers processed through the Disability Evaluation System each year. Of these, about 10% have combat- or training-related injuries. Disability ratings have a significant financial impact, determining if the servicemember qualifies for retired pay and military benefits such as health care and base privileges for life, or a one-time severance pay with no additional benefits. Those who receive 30% or higher disability ratings -- 1,296 during fiscal 2007 -- are medically retired. In addition, more than 4,200 servicemembers were put on a temporary disability retired list last year, a status they can retain for up to five years. If the combined rating is 20% or lower, troops are typically discharged with severance as unfit for duty. During fiscal 2007, almost 4,000 servicemembers processed through the Disability Evaluation System were returned to duty. Of those separated as no longer fit for duty, more than 9,200 received a severance. Another 1,150 did not receive a severance, typically because their disabilities were due to misconduct or pre-service conditions. Not all were happy with their disability rating findings. About 10% appealed their cases. Now, under the PDBR troops will have one additional method of recourse. Retherford said he anticipates the board will review about 900 cases per year, all by request. Former servicemembers separated from the military after 11 SEP 01, must apply to have their case reviewed. The Defense Department plans to launch an awareness campaign to ensure people who qualify for a records review know about the new board and how to apply. The Defense Department designated the Air Force to operate and manage the new board, but it will include representatives from each military department. Board members will include line officers as well as medical experts, who will review documentary evidence. No former servicemember will appear in person before the board. The board can recommend that the appropriate service secretary increase a disability rating, uphold the previous finding, or issue a disability rating when the previous board did not assign one. However, the board cannot recommend a lower rating. Undersecretary of Defense for Personnel and Readiness David S. C. Chu called the board an important step in ensuring affected servicemembers are treated fairly. "The PDBR has no greater obligation to our wounded, ill and injured servicemembers and former servicemembers than to offer fair and equitable recommendations pertaining to the assignment of disability ratings," he said. [Source: AFPS Donna Miles article 1 Jul 08 ++] DOD PDBR UPDATE 01: The Defense Department announced formation of the new Physical Disability Board of Review (PDBR) to reassess the accuracy and fairness of disability ratings assigned to discharged troop. The Air Force is to recommend someone to lead the PDBR immediately, and then the other services will determine who will represent them on the board. According to the legislation, the new board was supposed to be in place by the end of April. David S.C. Chu, undersecretary for personnel and readiness, in a memo dated 27 JUN wrote, УThe purpose of the [board] shall be to reassess the accuracy and fairness of the combined disability ratings assigned service members who were discharged as unfit for continued military service. The [board] shall operate in a spirit of transparency and accountability, and shall impartially readjudicate cases upon which review is requested or undertaken on its own motion.Ф One sentence of the new directive already has veterans service organization representatives concerned: УOnly the medical condition(s) determined to be specifically unfitting for continued military service, as previously determined by the Military Department [physical evaluation board], will be subject to review by the [board].Ф The legislation makes no such limitations. Retired Army Lt. Col. Mike Parker, who has worked as an advocate for service members going through the physical evaluation board process, said there are at least two categories of veterans who could be hurt by this limitation: Х He gave an example of a sergeant who was originally sent to the medical evaluation board because of a congenital cornea condition that caused his vision to be distorted. According to the surgeon general of the ArmyТs policy, soldiers may not wear hard contact lenses to the field, as this soldier was required by his doctor to do. But when he went to the board, he was found fit for his cornea condition, which would have brought him a rating of at least 30%, and found unfit for two other lesser conditions and given a total rating of 10%. УTheyТve been cherry-picking which unfitting condition to use,Ф Parker said. The new board would not be allowed to make sure the СfitТ determination for the soldierТs cornea problem was fair. Х The Physical Evaluation Board is required to include all current medical conditions, but the Walter Reed scandal showed that often, medical records were lost or not included in board packets. If that happens, the Physical Evaluation Board doesnТt get a chance to rate for all conditions, but those cases would not be covered by the new board. Pentagon Spokesman Lt. Col. Les Melnyk said in an e-mail, УConditions that were not identified as unfitting are not within the scope of this board. A determination of unfitting is generally unique to the demands of the service memberТs military department. These decisions are best made by the military departments.Ф However, he said conditions that were not rated because they were determined to be pre-existing, as was the case of thousands of service members discharged with no benefits for personality disorders, would be eligible for review by the new board. Parker said the new board needs to address all situations that can lead to a combined disability rating of less than 30% Ч otherwise, service members may have to take their cases to several boards to try to correct specific errors in their cases. УIf the new board does not address all of these factors, I fear a service member may have to spend years going to multiple review boards to fix all the issues that led to an erroneous rating,Ф Parker said, which is exactly the kind of bureaucratic quagmire the Wounded Warrior legislation sought to correct. Melnyk said a different board should, in fact, look at those other issues. УService members may appeal those issues to the Military Department Board of Corrections for Military Records or the Discharge Review Boards,Ф he said. But that could also cause a problem: After they receive a recommendation from the new review board, service members will not be eligible for review by the Board for the Correction of Military Records, according to ChuТs directive and the legislation. [Marine Corps Times Kelly Kennedy article 8 Jul 08 ++] VA FRAUD UPDATE 11: The Department of Justice announced 30 JUN that the director of the Hines IL Department of Veterans Affairs Consolidated Mail Outpatient Pharmacy (CMOP) has agreed to plead guilty to participating in a conspiracy that allowed a subordinate to make contracting decisions regarding a company owned by the subordinate's spouse. The director also has agreed to plead guilty to accepting illegal gratuities. In a plea agreement filed in U.S. District Court in Chicago , Joel M. Gostomelsky , admitted to conspiring with a subordinate between 2000 and 2007 to allow the subordinate to be involved in the hiring and supervising of temporary pharmacist employees supplied to the CMOP by a company owned by the subordinate's spouse. Among other actions, Gostomelsky falsely represented to VA officials that the subordinate had no role at the CMOP in the ordering of these services, and that the subordinate would be removed from making decisions affecting the employees of the temporary staffing company. He also agreed to plead guilty to receiving illegal gratuities from 1998 through approximately 2005 from another vendor that provided supplies to the CMOP acknowledging that because of the gifts he received, he helped steer orders for mailing supplies to the vendor. According to the terms of the plea agreement, which is subject to court approval, he has agreed to cooperate in the government's ongoing investigation. His sentence will be determined by the court. Gostomelsky was the Director of the CMOP in Hines from 1995 until April 2007 . The CMOP in Hines is one of seven such pharmacies throughout the nation, and currently processes and sends more than 100,000 prescriptions to veterans daily. The conspiracy charge carries a maximum penalty of five years of imprisonment and a fine of $250,000 and the acceptance of illegal gratuities charge carries maximum sentence of two years of imprisonment and a fine of $250,000. The maximum fine for each of these violations may be increased to twice the gain derived from the crime or twice the loss suffered by the victims of the crime, if either of those amounts is greater than the statutory maximum fine. George J. Opfer, Inspector General of the Department of Veterans Affairs said, "The VA Office of Inspector General investigates every credible allegation against VA employees who betray the trust of our veterans and taxpayers by acts of bribery, graft, and criminal conflict of interest. Former managers of two other VA Consolidated Mail Outpatient Pharmacies currently serving multi-year prison sentences for similar, yet unrelated, criminal acts have learned just how seriously we take these allegations." Anyone with information concerning bid rigging, fraud, kickbacks, bribery or other crimes relating to violations of federal procurement laws meant to foster competition concerning any of the VA's CMOP's should contact the Chicago Field Office of the Antitrust Division at 312-353-7530 or the VA Office of Inspector General at 1-800-488-8244. [Source: U.S. Department of Justice News Release 30 Jun 08 ++] VETERANSТ BENEFIT EXPIRATION UPDATE 01: Many of your benefits have an expiration date. Below are a few important federal ones to remember so you donТt lose out. Most veterans are not aware, that their benefits can expire. For more detailed information of these programs go to http://www.military.com/benefits/veteran-benefits/veterans-benefit-expiration-dates or: www.va.gov: Education, Training, and Employment Programs: 10 years from date of last discharge or release from active duty. Veterans Education Assistance Program (VEAP): 10 years from last discharge or release from active duty. Montgomery GI Bill for Selected Reserve (MGIB-SR): 14 years from the date of eligibility for the program, or until released from the Selected Reserve or National Guard. (Some extensions available if activated.) Reserve Educational Assistance Program (REAP): No time limit, while remaining in the same level of the Ready Reserve. Vocational Rehabilitation and Employment (VocRehab): Generally, 12 years of separation from service or within 12 years of being awarded service-connected VA disability compensation. VA Insurance Programs: Х ServicemembersТ Group Life Insurance (SGLI): Coverage ends 120 days after separation or Can be extended up to 1 year for totally disabled veterans. Х Family Group Life Insurance (FGLI): Coverage ends 120 days after separation or Can be extended up to 1 year for totally disabled veterans after separation. Х Veterans Group Life Insurance (VGLI): Within 120 days of separation. Х Service Disables Veterans Insurance (SDVI): Within 2 years from the date of being notified of service-connected status. Х Veterans Mortgage Life Insurance (VMLI): Must apply before age 70 Veterans Health Care Administration (VHA) PROGRAMS: Х Veterans Health care: No Time Limit Х Combat Veterans Health Care: 5 years from release from active duty. Х Dental Treatment: Within 90 days of separation. VA Pension And Compensation Programs: Х Disability Compensation: No Time Limit. Х Disability Pension: No Time Limit. Х VA Home Loan Guaranty Program: No Time Limit. [Source: CFVI Newsletter Jun 08 ++] ATRIAL FIBRILLATION: This subtle condition can have serious consequences for your health. Fortunately, diagnosis is easy and treatment reduces long-term effects. To understand this condition you need to know how the heart works. It has four chambers Ц two atria on top and two ventricles below them Ц that subsequently fill with blood and contract to circulate blood throughout the body. The timing and sequence of the contractions are crucial and are controlled by the heartТs own internal cardiac pacemakers. Normally each chamber contracts about 70 times am minute, allowing it to fill with blood and empty, thus moving the blood efficiently. Atrial fibrillation occurs when the top two chambers of the heart flutter or quiver, rather than contracting rhythmically. These quivers are so fast and erratic that the atria does not have time to fully fill or empty. This means the ventricles, in turn, cannot fully fill or pump enough oxygenated blood throughout the body. As the heartТs internal pacemakers try to regulate atrial fibrillation, the heart might beat too quickly or slowly. If too slowly there is not enough oxygenated blood circulated to meet the body needs and too quickly there is not enough time for the ventricles to fill between beats causing a similar reduction in oxygenated blood availability. In addition, if blood pools in the atria, clots can form and then travel to the brain causing a stroke. Though atrial fibrillation can have serious consequences, for many people it goes unnoticed for years. A doctor often will recognize the irregular irregularity of the atrial fibrillation heartbeat when he or she takes a patientТs pulse or listens to the heart with a stethoscope during a physical examination. An EKG will show the altered electrical pathways and the irregular irregularity of the heart rate and confirm diagnosis of atrial fibrillation. Treatment depends on many factors. A doctor will look for predisposing conditions, such as hypoglycemia (low blood sugar), hypoxia (low oxygen) from lung disease, abnormal thyroid function, alcohol or drug use, etc. and treat them first. If the heart is beating too fast medication such as digoxin or propanolol can be used to slow ventricular rate. These medications may be needed for years. If too slow an antrioventicular sequential pacemaker can be inserted to signal the atria and ventricles so they will contract more normally and improve circulation and oxygenation. Anticoagulants such as aspirin or warfarin can reduce clots and the risk of stroke in chronic atrial fibrillation. If atrial fibrillation is of relatively recent onset, the heart is normal, and a patient is otherwise healthy, cardioversion can be used to electrically shock the heart back to its normal rhythm. Although this is the best procedure for some patients, it has serious risks and should be considered carefully. Almost 20% of people over 80 years of age have (or have had) atrial fibrillation. For more information click on УarrhythmiasФ on the American Heart AssociationТs web site www.americanheart.org. [Source: Military Officer Ask the Doctor article Apr 05] FORGOTTEN MILITARY ORPHANS: There are some statutory and regulatory problems that adversely effect many of the orphans of deceased military personnel. The problems are the result of how current Federal laws are written and thus need Congressional action to fix them. 1. Orphans (the children of a deceased military person) who are not the children of the deceased and his or her current spouse do not receive any of the death gratuity (DG). 2. Where there are minor children, but no spouse, the guardian of the minor child must go into state court and be declared the Guardian of the MinorТs Estate in order for the Defense Finance and Accounting Service (DFAS) to pay the DG out. 3. Minor orphans who do not live in the deceasedТs household at the time of death do not usually get commissary and exchange shopping privilege. The original purpose of the death gratuity was to off set extra expenses that oneТs loved ones incur when there is a death and to bridge the gap between the military pay stopping and the other long term benefits such as social security, dependency indemnity compensation (DIC), and survivorТs benefits starting up in a month or two. If one has a spouse and dies in the military, the DG is directed first to go to the surviving spouse. This is not a problem if the children of the deceased are all from the current spouse. The deceasedТs children only get the DG if there is no spouse. It is not uncommon for a deceased serviceman to have children from relationships with other people. Upon death of the serviceman the child support these other children are receiving stops. Thus, they suffer the same income interruption as the spouse but do not get any stopgap DG payment. A solution would be to change the current law at Sec. 1477 (a) (1) to give all the DG to the spouse if the deceased does not have children fathered or mothered from people other than his or her current spouse. If there are children that are not issue from the current spouse, then the widow or widower gets half the DG and the deceasedТs children from relationships other than with the current spouse equally share the other half of the DG. Death Gratuity (DG) money that is paid out for the benefit of minor children must be paid into a trust account which usually requires the hiring of an attorney to set up a УGuardianship of the ChildТs EstateФ which is needed for them to set up a trust account at a bank in the childТs name. DFAS does not recognize the mere fact that the natural parent or someone else has custody of the child, even if from a divorce or other legal proceeding. DFAS requires an adult member, usually the person with physical custody of the minor child, to have a state court name them as the guardian of the minor childТs assets/estate. After this is done, the guardian then must open up a trustee bank account in the childТs name. Only then will DFAS send a check on the childТs behalf payable to the childТs trust account. In many cases, this requires the guardian/trustee to spend $1000 or more in legal fees to get the DG. This often takes months to do which tends to defeat the original purpose of the DG, help with immediate expenses. A solution would be for Congress to add new wording to Title to Title 10 US Code Sections 1475 to 1477 stating the person with physical custody of the minor child would have the right to go to Legal Aide or the closest military operated legal assistance office for help. The legal services would include not only preparing the paperwork, but also appearing in state court if necessary on that matter. The minor children of a deceasedТs current spouse or those who were living in the deceasedТs household automatically get full commissary and exchange privileges. Other orphans only qualify for these two privileges if they can establish at the time of death that the deceased was providing the residence they were living in and over 50% of their support. This unfairly penalizes the minor children from prior marriages and those born out of wedlock. These same children qualify for all other Federal benefits automatically. A solution would be to change current Federal law and DoD policies to state that all minor children of deceased military personnel receive full commissary and exchange privileges. There would be no need to establish any level of support being provided prior to the death of the military member. [Source: CDR Wayne Johnson, JAGC, USN (Ret) 5 Jun 05 wayneljohnson@hotmail.com] LEGAL RESIDENCY: What follows is aimed at active duty military personnel who are covered under the Servicemembers Civil Relief Act (SCRA) of 2003. As to whether their nonmilitary spouses and dependent children get the same protections; one must look at state law. Most states allow the family members to maintain the same state of legal residence as the military spouse, but do not assume this to be so. Check with a legal assistance office. Under the Act (formerly known as the SoldiersТ and SailorsТ Civil Relief Act of 1940), a military memberТs state of legal residence (Home State) does not change every time they are transferred. If one is a legal resident of Ohio when one comes on full time active duty, that person stays an Ohio citizen so long as they are on active duty, even if they spend 20 years on active duty and never step foot in Ohio during the who period. This means they stay a legal resident of their home state for such things as their driverТs license, car registration, income taxes, personal property taxes, and voting. Even if a service member no longer has any form of address in their home state, the member stays a legal resident. In some counties, for voting purposes, if you no longer have a physical address there the county makes your address the local courthouse. This is contrary to what happens to the average civilian or retiree who gets transferred or moves to another state since, by operation of law, they become a citizen/legal resident of the new state. Another effect of the Act is that a military member may obtain a state drivers license and/or register his or her car in the state in which he or she is assigned under orders. Under the Act doing either or both of these things does not automatically make one a legal resident of the state one is assigned to. You probably know someone who has kept a stateТs plates on their car after transferring to another state even though they are a legal resident of a third state. The danger is a person who keeps the plates or license of the host state they had been residing in after they transfer. Doing so could be used by the host state to argue you now owe them income taxes since keeping your license with them after you left the state shows that you are now a legal resident of that state. It could also lead to a traffic citation and fine. Remember, your registration and license can only be from your home state or where you are currently stationed/residing pursuant to military orders. If a military member wants to become a legal resident of the state they are physically present in due to PCS orders, they may do so by avowing that, for the foreseeable future, he or she desires to make that state their legal residence for the rest of their life. Thus, you must have both physical presence and the intent at the same time in order to make this change. You must also actually be living there for more than just a few weeks. If one decides to change their legal residence, one would do certain things to reflect this change to the rest of the world. DEFINITE INDICATORS are where one votes and where one files their state income tax returns as to oneТs military pay if the home state has a tax. Even if a return is not required, it is frequently a good idea to file a return and have a paperwork trail reaffirming your state of legal residence/home state. MAYBE INDICATORS are your driverТs license and vehicle registrations. Some states, such as Florida, have a written affidavit one can file at the local courthouse that attests to a person becoming a legal resident of that state. If one does that, get a few certified copies from the court clerk of the newly filed affidavit and send one copy to your old home state with your income tax return for that year so they will know why you have quit filing with them. Legal residence or Home State is not to be confused with УHome of RecordФ which is a purely military term. Usually they are one in the same but УHome of RecordФ cannot be changed during oneТs enlistment. The main purpose of УHome of RecordФ is that it sets the limit the distance the government is willing to pay to move you when you get off of active duty. Retirees, however, get to move anywhere in the country when they retire compliments of the military. Retirees do not get the protections of the Act and must file taxes and do everything else that the state they are living in requires. Having said that, anyone who is, or has been in the military, should check with their state of residence to see if under state law they are entitled to any perks. Most states give military, veterans, retirees, and in some cases their family members some sort of special treatment when it comes to taxes and licenses. This is particularly true for wounded, disabled, or deceased personnel. Many states exempt all or part of a military pension from state income tax. Every state has its own УstateФ veterans affairs office which can provided such information. Do not confuse it with the local federal Department of Veterans Affairs office, which is a separate entity. The SCRA covers other matters The major areas the SCRA covers include the stay of legal actions, rent, installment contracts, mortgages, liens, assignment, leases, life insurance, taxes and public lands, powers of attorney, professional liability protection, health insurance reinstatement, guarantee of residency for military personnel, and business or trade obligations. To review the Servicemembers Civil Relief Act of 2003refer to http://www.servicemembers.gov/scratext.htm and http://legalassistance.law.af.mil/content/legal_assistance/cp/scratext.pdf. Some useful web sites containing Summaries and "How To" Guides are: Х http://www.abanet.org/legalservices/lamp/downloads/SCRAguide.pdf. Х http://www.justice.gov/usao/az/rights/Servicemembers_Civil_Relief_Act.pdf. Х http://www.abanet.org/family/military/scrajudgesguidecklist.pdf. Х http://legalassistance.law.af.mil/content/content.php?qrylvl=3&lvl1id=1&lvl1folder=yes&lvl2id=11&lvl2folder=yes [Source: Cdr Wayne Johnson, JAGC,USN (Ret) MAY 2008 wayneljohnson@hotmail.com SSA INTERNATIONAL AGREEMENTS: In today's global environment people often relocate from one country to another, either permanently or on a limited time basis. This presents challenges to businesses, governments, and individuals seeking to ensure future benefits or having to deal with taxation authorities in multiple countries. To that end, the Social Security Administration has signed treaties, often referred to as Totalization Agreements, with other social insurance programs in various foreign countries. Overall, these agreements serve two main purposes. First, they eliminate dual Social Security taxation, the situation that occurs when a worker from one country works in another country and is required to pay Social Security taxes to both countries on the same earnings. Second, the agreements help fill gaps in benefit protection for workers who have divided their careers between the United States and another country. Normally, non-resident aliens of foreign countries without a Totalization Agreement are taxed by the U.S. at a rate of 30% on all income derived in the U.S. To ensure payment the tax is normally withheld at source from payments forwarded to a SSA beneficiary overseas. The following countries with effective dates have signed Totalization agreements with the SSA: Australia (October 1, 2002) Austria (November 1, 1991) Belgium (July 1, 1984) Canada (August 1, 1984) Chile (December 1, 2001) Finland (November 1, 1992) France (July 1, 1988) Germany (December 1, 1979) Greece (September 1, 1994) Ireland (September 1, 1993) Italy (November 1, 1978) Japan (October 1, 2005) Luxembourg (November 1, 1993) Netherlands (November 1, 1990) Norway (July 1, 1984) Portugal (August 1, 1989) South Korea (April 1, 2001) Spain (April 1, 1988) Sweden (January 1, 1987) Switzerland (November 1, 1980) United Kingdom (January 1, 1985) [Source: Wikipedia Online Encyclopedia 1 Jul 08 ++] HAVE YOU HEARD: Think what you will of Ronald Regan and his politics but most cannot dispute the following comments of his regarding our government: Х 'Here's my strategy on the Cold War: We win, they lose.' Х 'The most terrifying words in the English language are: I'm from the government and I'm here to help.' Х 'The trouble with our liberal friends is not that they're ignorant; it's just that they know so much that isn't so.' Х 'Of the four wars in my lifetime, none came about because the U.S. was too strong.' Х 'I have wondered at times about what the Ten Commandments would have looked like if Moses had run them through the U.S. Congress.' Х 'The taxpayer: That's someone who works for the federal government but doesn't have to take the civil service examination.' Х 'Government is like a baby: An alimentary canal with a big appetite at one end and no sense of responsibility at the other.' Х 'The nearest thing to eternal life we will ever see on this earth is a government program.' Х 'It has been said that politics is the second oldest profession. I have learned that it bears a striking resemblance to the first.' Х 'Government's view of the economy could be summed up in a few short phrases: If it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it.' Х 'Politics is not a bad profession. If you succeed, there are many rewards; if you disgrace yourself, you can always write a book.' [Source: Words of wisdom by Margaret Gee 2001 ++] VETERAN LEGISLATION STATUS 13 JUL 08: Refer to the BulletinТs House & Senate attachments for or a listing of Congressional bills of interest to the veteran community that have been introduced in the 110th Congress. Support of these bills through cosponsorship by other legislators is critical if they are ever going to move through the legislative process for a floor vote to become law. A good indication on that likelihood is the number of cosponsors who have signed onto the bill. A cosponsor is a member of Congress who has joined one or more other members in his/her chamber (i.e. House or Senate) to sponsor a bill or amendment. The member who introduces the bill is considered the sponsor. Members subsequently signing on are called cosponsors. Any number of members may cosponsor a bill in the House or Senate. At http://thomas.loc.gov you can also review a copy of each billТs content, determine its current status, the committee it has been assigned to, and if your legislator is a sponsor or cosponsor of it. To determine what bills, amendments your representative has sponsored, cosponsored, or dropped sponsorship on refer to http://thomas.loc.gov/bss/d110/sponlst.html. The key to increasing cosponsorship on veteran related bills and subsequent passage into law is letting our representatives know of veteranТs feelings on issues. At the end of some listed bills is a web link that can be used to do that. You can also reach his/her Washington via the Capital Operator direct at (866) 272-6622, (800) 828-0498, or (866) 340-9281 to express your views. Otherwise, you can locate on http://thomas.loc.gov who your representative is and his/her phone number, mailing address, or email/website to communicate with a message or letter of your own making. Refer to http://www.thecapitol.net/FAQ/cong_schedule.html for future times that you can access your representatives on their home turf. [Source: RAO Bulletin Attachment 13 Jul 08 ++] Lt. James УEMOФ Tichacek, USN (Ret) Director, Retiree Assistance Office, U.S. Embassy Warden & IRS VITA Baguio City RP PSC 517 Box RCB, FPO AP 96517 Tel: (951) 238-1246 in U.S. or Cell: 0915-361-3503 in the Philippines. Email: raoemo@sbcglobal.net Web: http://post_119_gulfport_ms.tripod.com/rao1.html AL/AMVETS/DAV/FRA/NAUS/NCOA/MOAA/USDR/VFW/VVA/CG33/DD890/AD37 member

THIS BULLETIN CONTAINS THE FOLLOWING ARTICLES == Bereavement Check Cashing ------------- (New Rules Requested) == VA Budget 2009 [04] --------------------- (Bush Threatens Veto) == Sole Survivor [03] ---------------------------- (House Passes Bill) == Mobilized Reserve 30 JUL 08 ----------------- (3,789 Decrease) == Tricare Uniform Formulary [25] ----- (JUL Recommendations) == Senior Corps ---------------------- (Service Opportunities) == VA Lawsuit (Lack of Care) [10] ----------------- (Appeal Filed) == DIC+SBP [04] -------------------------------------- (Offset Impact) == Traumatic Injury Insurance -------------- (Payments to increase) == Military Stolen Valor [08] ------------ (Ex-Atlantic City Mayor) == Disabled Veterans Memorial [01] ------ (Commemorative Coin) == GI Bill [26] ------------------- (Post 911 Bill Primer) == South Carolina Vet Cemetery [01] ----- (Fort Jackson National) == CRSC [39] ------------------------- (Glitch Surfaces) == Agent Orange Equity ------------------------ (H.R.6562) == Prostate Problems [05] ---------- (Abiraterone Clinical Results) == Will [01] --------------------------------- (Guidelines) == Overseas Absentee Voting [02] -------------- (2008 Guidelines) == Government Vet Expenditures ---------- (1947 High Exceeded) == Military Stolen Valor [07] --------- (Xavier Alvarez Sentenced) == Tricare User Fee [27] -------------------- (Woes Demand Action) == Amyotrophic Lateral Sclerosis [04] ------- (All Vets to be Rated) == Walking Impact on Disability Risk ------- (41% Risk Decrease) == Windows Vista [06] -------------------- (XP Downgrade Option) == VA Voter Registration Ban [01] --------------- (VA Still Resists) == Medicare Prescriptions ------------------- (Electronic Prescribing) == COLA 2009 [02] --------------------------- (5.7% YTD) == Foreclosure [02] ---------------------- (Take it to Court) == VA Independent Living Program [02] ---------- (High Demand) == Contact Info for Vets -------------------------------- (Who to Call) == Cost of Government Day ---------------------------- (16 July) == VA Retro Pay Project [12] --------- (Recheck of 25,448 Denials) == VA - How to File a Claim [01] ------ (Online Now Authorized) == National Park Passports [01] ----------------- (JAN 07 Change) == Vet Jobs [03] ------------------ (Federal Age Restrictions) == Pay as You Drive ------------------------ (CA Bill AB 2800) == VA Claim Backlog [18] -------------- (8,763 Vets Die Waiting) == Medicare Reimbursement Rates 2008 [12] --- (Veto Overridden) == Medicare Reimbursement Rates 2008 [13] ---- (Middlemen Cut) == Death Gratuity [02] --------------------------- (More Choices) == Blood Thinners ------------- (Possible Warfarin Replacement) == Know Your Food ----------------------------- (Read the Label) == Veteran Legislation Status 29 JUL 08 ------- (Where we Stand) BEREAVEMENT CHECK CASHING: A complaint was filed with federal regulators 30 JUL against a savings and loan that refused to waive check-cashing procedures last month so a couple could pay for the funeral of their son who was killed in Afghanistan. Downey Savings and Loan Association refused to immediately cash two federal bereavement checks totaling $100,000 when they were presented at its Hemet CA branch by the parents of Navy Hospitalman Marc Retmier, attorney Gloria Allred said at a news conference. Allred said the bank wanted the family to wait more than a week while it verified the checksТ authenticity Ч well after the planned date of the sailorТs funeral. Allred has sent a letter of complaint to John Reich, head of the federal Office of Thrift Supervision, asking for an immediate investigation into the incident. She also asked regulators to adopt new rules requiring all thrifts and savings and loans to immediately cash federal bereavement checks. УIt is shameful that parents of a child killed in action are treated by a regulated savings and loan as if they were potential СcriminalsТ by requiring that government-issued bereavement checks be held to verify the authenticity,Ф Allred said. Downey issued a statement saying it sympathizes with the family but was forced to abide by its procedures. The bank said its Уcheck hold policy conforms with federal banking regulations and industry practices.Ф Retmier, 19, of Hemet was killed 18 JUN in a rocket attack in the northern Paktika province. The next day, Joy and Steve Retmier were given two U.S. Treasury checks to use for defraying expenses, including the cost of their sonТs funeral, planned for 25 JUN. When they tried to deposit the checks on 20 JUN, officials at the local branch of Downey Savings & Loan told them that the checks would be held until at least 1 JUL to verify their authenticity. Allred said the parents pleaded with a teller to contact the military to immediately verify the checks but she and the bank manager refused. A military recruiter also made the request but was refused by someone at DowneyТs corporate offices. The next day the family found a credit union that deposited the checks and advanced $20,000 for the funeral, which was held June 25 in Corona del Mar. [Source: NavyTimes AP article 31 Jul 08 ++] VA BUDGET 2009 UPDATE 04: On 30 JUL the White House Wednesday threatened to veto a spending measure for veterans and military construction unless Congress finds offsets in other spending bills that would amount to $2.9 billion -- the sum exceeding President Bush's fiscal 2009 budget request. Furthermore, if Congress cannot find offsets for that measure, the White House said it would consider a veto of the remaining 11 appropriations bills. "If Congress determines that additional resources above the president's request are needed, Congress must provide reductions in other appropriations bills to offset this increase and meet the president's topline [discretionary spending cap] of $991.6 billion," OMB said. "If Congress ... does not offset this increase with spending reductions in other bills, the president will veto any of the other bills that exceed his request until Congress demonstrates a path to reach the president's top line." OMB added veterans' spending is "104% above the level when the president took office," and therefore "provides ample resources to ensure veterans receive the quality care they deserve." The House could begin debate on the bill 30 JUL. If approved by the House, it would be the first of the 12 annual spending bills. The White House communiquщ comes as Democratic leaders have said that they do not intend to finish work on all the spending bills, in part because of Bush's unwillingness to negotiate on spending levels. Under the $72.7 billion fiscal 2009 Military Construction-VA Appropriations bill, the Veterans Affairs Department would receive $47.7 billion, which is $4.6 billion above the fiscal 2008 funding level and $2.9 billion over Bush's fiscal 2009 budget request. The overall measure is $3.4 billion more than the $69.3 billion sought by Bush. Congress provided $63.9 billion for the measure in fiscal 2008. "This Congress is dedicated to meeting the needs of our nation's veterans, no matter the political maneuvering of a callous president," a Democratic aide to the House Appropriations Committee said. "Veterans are not political bargaining chips." Bush issued a similar threat last year, but ultimately agreed to increases for the VA. [Source: Congress Daily Humberto Sanchez article 30 Jul 08 ++] SOLE SURVIVOR UPDATE 03: Jason Hubbard and his two younger brothers all served in Iraq. He was the only one to return home alive. After the deaths of his brothers Jared and Nathan, Hubbard left the Army under the military's "sole survivor" policy, which allows sole surviving siblings to be discharged before their enlistment period is over. But Hubbard soon found that the Army was denying him benefits he would otherwise have been entitled to, including health coverage and access to the GI Bill. He was asked to repay some of his enlistment bonus. The House moved 29 JUL to restore those benefits to Hubbard and others in his position. By voice vote lawmakers passed the "Hubbard Act," which ensures that sole survivors are entitled to the same benefits as others who honorably leave the military, including transitional health care, educational support and separation pay that compensates for inability to continue service. Rep. Devin Nunes (D-CA) who is Hubbard's congressman noted that the sole survival policy was established some 65 years ago after the widely publicized death of the five Sullivan brothers at sea during the Battle of Guadalcanal in World War II. "In all that time, no law has been passed on behalf of sole survivors," Nunes said. "The Hubbard Act rectifies this oversight and honors the patriotic service and enormous sacrifice of the Hubbards." Companion legislation is being sponsored in the Senate by Sen. Dianne Feinstein (D-CA) and Saxby Chambliss (R-GA). They hope to move it quickly through Congress so it can go to President Bush for his signature. The Defense Department has counted at least 50 sole survivors since 911 according to Nunes' office. Most of the act is retroactive to that date. [Source: AP Erica Werner article 29 Jul 08 ++] MOBILIZED RESERVE 30 JUL 08: The Army, Air Force and Marine Corps announced the current number of reservists on active duty as of 30 JUL 08 in support of the partial mobilization. The net collective result is 3,789 fewer reservists mobilized than last reported in the Bulletin for 15 JUL 08. 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. The total number currently on active duty in support of the partial mobilization of the Army National Guard and Army Reserve is 82.075; Navy Reserve, 5,814; Air National Guard and Air Force Reserve, 11,218; Marine Corps Reserve, 8126; and the Coast Guard Reserve, 777. This brings the total National Guard and Reserve personnel who have been mobilized to 108,010, including both units and individual augmentees. A cumulative roster of all National Guard and Reserve personnel, who are currently mobilized, can be found at http://www.defenselink.mil/news/Jul2008/d20080730ngr.pdf. [Source: DoD News Release 644-08 30 Jul 08 ++] TRICARE UNIFORM FORMULARY UPDATE 25: On 24 JUL the Beneficiary Advisory Panel (BAP) met to provide comments to the Department of Defense (DoD) Pharmacy and Therapeutics CommitteeТs (P&T Committee) recommendations on formulary status, pre-authorizations, and the effective date for a drugТs change from formulary to non-formulary status. Moving a drug to non-formulary status means it will still be available to beneficiaries, but usually at a higher price. It may also require medication authorization. Current and new drugs were reviewed during this meeting. BAP recommendations for drugs currently on the DoD Uniform Formulary are as follows: Hydroxytryptamine (Triptans) drugs: Х sumatriptan (Imitrex), sumatriptan/naproxen (Treximet), eletriptan (Relpax), rizatriptan (Maxalt), zolmitriptan (Zomig) will be classified as formulary, and Х almotriptan (Axert), frovatriptan (Frova) and naratriptan (Amerge) will be non-formulary within a 90-day implementation period. Osteoporosis Agents: Х alendronate (Fosamax), alendronate/vitamin D (Fosamax plus D), risedronate (Actonel), risedronate with calcium (Actonel with calcium), ibandronate (Boniva), raloxifene (Evista), teriparatide (Forteo), recombinant calcitonin (Fortical) will be maintained on the Uniform Formulary, and Х salmon-calcitonin (Miacalcin) will be placed on the non-formulary status within a 90-day implementation period. Newly approved drugs by the Federal Drug Administration were considered by the BAP. Those recommended to be classified as non-formulary with a 60-day implementation period were: Х nebivolol (Bystolic) is used to treat hypertension, Х levocetirizine (Xyzal) is used to treat seasonal and perennial allergic rhinitis and chronic idiopathic urticaria, Х zileuton extended release (Zyfol CR) is used to treat asthma, and Х olmesartan/amlodipine (Azor) is used to treat hypertension. New drugs that were recommended for formulary status were: Х fenofibrate meltdose (Fenoglide) is used for the treatment of hyperlipidemia and mixed dyslipidemia, Х simvastatin/niacin extended release (Simcor) is used for the treatment of hyperlipidemia, Х birmonidine/timolol maleate (Combigan) is used to reduce the increase intraocular pressure; aliskiren/H, and Х aliskiren/hysdrochlorothiazide (Tekturna HCT) is used for the treatment of hypertension. Axert was placed on non-formulary status. For additional information on the recent BAP meeting, refer to www.tricare.mil/pharmacy/bap. [Source: NMFA e-News 29 Jul 08 ++] SENIOR CORPS: Americans over 55 have a lifetime of experience to share, and the potential to make a real difference in their world. TheyТve managed households, been business owners and nurses, farmers and salespeople, artists and executives. Those who now have time can put their unique talents and expertise to work in their communities, and enrich their own lives in the process. Senior Corps connects todayТs over 55s with the people and organizations that need them most. It helps seniors to become mentors, coaches or companions to people in need, or contribute their job skills and expertise to community projects and organizations. Conceived during John F. Kennedy's presidency, Senior Corps currently links more than 500,000 Americans to service opportunities. Their contributions of skills, knowledge, and experience make a real difference to individuals, nonprofits, and faith-based and other community organizations throughout the United States. Senior Corps offers several ways to get involved. Volunteers receive guidance and training so they can make a contribution that suits their talents, interests, and availability. Following are programs in need of volunteers: Х The Foster Grandparent Program connects volunteers age 60 and over with children and young people with exceptional needs. Volunteers mentor, support, and help some of the most vulnerable children in the United States. For more on this program refer to www.seniorcorps.org/about/programs/fg.asp. Х The Senior Companion Program brings together volunteers age 60 and over with adults in their community who have difficulty with the simple tasks of day-to-day living. Companions help out on a personal level by assisting with shopping and light chores, interacting with doctors, or just making a friendly visit. For more on this program refer to www.seniorcorps.org/about/programs/sc.asp. Х RSVP connects volunteers age 55 and over with service opportunities in their communities that match their skills and availability. From building houses to immunizing children, from enhancing the capacity of non-profit organizations to improving and protecting the environment, RSVP volunteers put their unique talents to work to make a difference. For more on this program refer to www.seniorcorps.org/about/programs/rsvp.asp. Senior Corps is a program of the Corporation for National and Community Service, an independent federal agency created to connect Americans of all ages and backgrounds with opportunities to give back to their communities and their nation. For information on joining one of the Senior Corps programs call 1-800-424-8867, email help@joinseniorservice.org, or visit www.getinvolved.gov. [Source: AARP About Senior Living Sharon OТBrien article 29 Jul 08 ++] VA LAWSUIT (LACK of CARE) UPDATE 10: As promised, the advocacy group Veterans for Common Sense has filed an appeal in a case in which it accuses the Veterans Affairs Department of putting veterans at risk for suicide and mental health issues through shortfalls in care. In June, Judge Samuel Conti of the 9th Circuit Court of Appeals in California ruled that the case was out of his jurisdiction because Veterans for Common Sense could not prove that the problems cited Ч delays in benefits, lost records, long waits for doctorsТ appointments, not enough oversight and veterans turned away from hospitals with suicidal thoughts Ч applied to every veteran, and were therefore not systemic. However, Conti said in his ruling that those problems need to be tended to, and that individual veterans could sue VA. He said the power to change the system ultimately rests with Congress and VA. But Veterans for Common Sense, in conjunction with Veterans United for Truth, appealed because they believe the courts do have jurisdiction and can force change. They have requested an expedited hearing, citing new statistics that show a veteransТ suicide hotline receives 250 calls a day from people in distress. The case brought to light several problems within the system, including an e-mail from a woman who oversees mental health workers at a Temple, Texas, VA facility in which she said her center did not have the resources necessary to diagnose veterans with post-traumatic stress disorder and advised them instead to diagnose Уadjustment disorderФ Ч a short-term diagnosis no longer applicable to veterans who have had symptoms for more than six months. The case also disclosed an e-mail that showed more than 1,000 veterans in VAТs care attempt suicide every month. УFor these reasons, plaintiffs believe they should continue to fight, that their cause is valid, and that Judge Conti was incorrect in holding that the courts are without power to grant veterans a remedy,Ф [Source: AirForceTimes Kelly Kennedy article posted 29 Jul 08 ++] DIC+SBP UPDATE 04: The husband of Anne Parks-- a military policeman exposed to the defoliant Agent Orange during two tours in Vietnam -- paid 30 years of premiums on their Defense Department Survivor Benefit Plan (SBP) insurance policy the couple believed would allow her to pay the bills and live comfortably after his death. When he died in 2006, Parks learned that the law allows the government to significantly cut -- and in many cases eliminate -- that Defense Department insurance payment if the surviving spouse elects to receive a Veterans Affairs benefit (DIC) established to compensate for the loss of a family member whose death was service-related. DoD refunded the Parks' premiums, but it paid no interest on the money, which was counted as income and taxed. Called an "offset," the dollar-for-dollar cut was created to limit how much compensation payments cost the government. Nearly 57,000 surviving spouses of military retirees argue that the benefits are separate. One is insurance, bought and paid for through premiums, and the other is a federal benefit for surviving dependents. In most cases, surviving spouses were unaware they wouldn't get that money after their husbands or wives died. The offset has forced some elderly surviving spouses to live solely on the VA benefit -- with a base rate of about $13,100 a year -- or to get a job to make the rent or house payments. Eliminating the offset between the SBP and DIC programs is estimated to cost between $6 billion and $8 billion over the first 10 years, an argument used by some people who oppose eliminating the offset. "That cost is a cost of war," said Jeanne Thompson, president of the El Paso del Norte Chapter of the Gold Star Wives of America. "They don't mind spending money" on equipment and operations in Iraq and Afghanistan. The Gold Star Wives have been at the forefront of the effort eliminate the offset. "They (members of Congress) don't feel they need to find the money because we're not a very vocal group," said Edith Smith, a Virginia resident who is on the Gold Star Wives Government Relations Committee and has been trying to persuade lawmakers to remove the offset since 1999. "Most of our members don't understand the process of government and how important it is to participate --just to call their representatives in Congress." Legislation has been introduced in the past years and amendments to the NDAA have been proposed but neither has gained the support of enough legislators to change the law. Currently S.935 in the Senate has 50 cosponsors but even if it passes it is doubtful the House, which has no bill on the issue, will act by the end of the 110th Congress. Thus, new legislation will have to be introduced in the 111th Congress to keep this issue alive. SBP, for the most part, is offered to military retirees who pay a monthly premium of 6.5% of their retirement pay. It is supposed to provide the surviving spouse up to 55% of that retirement pay. After the 911 terrorist attacks, the benefit was expanded to include military members who die on active duty. DIC is paid to surviving dependents of service members who die on active duty and military retirees who die of a service-related condition. The basic payment is $1,091 a month. If the surviving spouse elects to receive this benefit, that amount is deducted from the SBP payment, in some cases wiping it out completely. Most surviving spouses choose the VA's DIC benefit because it is not taxed. The Defense Department annuity is. Anne Parks' husband died of pneumonia after paying 30 years of SBP premiums. His death was considered service-connected. It took eight months to be approved for the VA benefit, and she was paid retroactively to the date of her husband's death. But that triggered cuts in her SBP payments, which took her by surprise. The Defense Department paid her a lump sum of $24,000 for the 30 years of premiums the couple had paid, and the federal government immediately took $7,000 of that back in taxes. The cuts to her SBP payment amounted to about $1,100 a month, she said. "It seems that it's unfair because they give it to you and then they take it away," Parks said. Melitta Pisarcik's husband died at the relatively young age of 57. He had been exposed to Agent Orange. She received a refund of $5,000 for payments to the Survivor Benefit Plan, which was taxed. "What happened to the interest?" Pisarcik asked, adding that she was faced with living on $833 a month. [Source: El Paso Times Chris Roberts article 27 Jul 08 ++] TRAUMATIC INJURY INSURANCE: Traumatic injury insurance is part of the ServicemembersТ Group Life Insurance program. A monthly premium of $1 is charged on top of the normal SGLI premium for coverage aimed at helping troops and their families with the financial difficulties of severe injuries. More than 1,600 severely disabled veterans could receive retroactive traumatic injury insurance payments as a result of a newly released review of how benefits have been paid under the 3╜-year-old supplemental benefits program. The payments, which range from $25,000 to $100,000, could be paid as early as this fall as a result of discussions between the Department of Veterans Affairs, which runs the program, and doctors who are treating severely wounded combat veterans. The average retroactive payment would be $32,000, according to the JUL dated review. About 4,400 people have received traumatic injury insurance payments since the program was created in 2005. The estimated 1,640 people who would receive retroactive benefits as a result of the review include some who did not previously qualify and some who received payments but now would get more, according to VA officials. Officials said the report offers 11 recommendations to expand definitions of traumatic injury for insurance purposes, and all are expected to be included in a revised regulation likely to be issued by VA this fall. No payments can be made until final regulations are issued, but the new definitions would apply to new injuries and also retroactively to injuries since 7 OCT 01. Officials said that although the recommendations are not controversial and appear to have widespread support, the regulations that will spell out the changes are not final. More than three-quarters of the people due payments as a result of the review suffered a traumatic brain injury or another traumatic injury that resulted in their being hospitalized for 15 consecutive days or more since 11 SEP 01, but did not qualify for insurance payments under the existing criterion. Those criterion use a six-part test to determine who can receive financial help by measuring a personТs ability to carry out daily activities: eating, bathing and using a toilet. That criterion would still be used, but inpatient hospitalization for 15 continuous days would be a new way to qualify. The average insurance payment would be $25,000 for those retroactively covered by the change, the report said. Traumatic brain injuries and similar trauma have accounted for 2,550 of the 4,400 payouts of traumatic injury insurance. Another proposed change would extend coverage to about 300 people who suffered limb injuries so severe that amputation was possible but who, instead, have undergone multiple surgeries to save the limb. VA officials said doctors at Walter Reed Army Medical Center in Washington and at Brooke Army Medical Center in San Antonio said limb salvage requires more rehabilitation than amputations. The services, especially medical staff, are heavily involved in the process because, for a service member to receive the benefit, a medical professional must document the injury. One recommended change would provide an insurance payment if a service member loses sight in both eyes for 120 days, a change from the current standard that requires total and permanent loss of sight. The program provides $100,000 for loss of sight in both eyes and $50,000 for the loss of sight in one eye. The definition of amputation of a hand or foot would change to include the loss of four fingers on a hand or four toes or more on a foot, or the loss of a thumb or big toe. The benefit would be $50,000 for one affected hand and $100,000 if both are affected, and $25,000 for one affected foot and $50,000 if both are affected. The standard for determining when someone is severely burned also would change. The current standard provides payment for a third-degree burn covering at least 30 percent of the face or body. The review recommends payment for second-degree burns covering 20% of the face or body after military doctors said that second-degree burns require the same rehabilitation as third-degree burns. The benefit for severe burns is $100,000. Facial reconstruction, not currently covered, would be added, with payments ranging from $25,000 to $75,000, depending on the severity of the injury and the surgery required. Complete and total paralysis of a limb also would be added as a traumatic injury, worth a payment of $50,000. [Source: ArmyTimes Rick Maze article 28 Jul 08 ++] MILITARY STOLEN VALOR UPDATE 08: The judge's tone was sympathetic, bordering on sorrowful. He listened as the former mayor of Atlantic City described how he assisted an elite unit behind enemy lines during the Vietnam War, insisting it was real, that he was there, and lived through it. But before and after Robert Levy spoke in a federal courthouse in Camden on 25 JUL, U.S. District Judge Jerome Simandle cited evidence from prosecutors and Department of Veterans Affairs officials that it couldn't have happened, that Levy was making up important parts of it. Known as the "Missing Mayor" because he dropped out of sight for two weeks last fall, he admitted that he had lied about his Vietnam War service, embellishing it to include dangerous exploits with elite special operations forces in order to fatten his veteransТ benefits check. The judge let Levy off without a prison term, although the disgraced former mayor will have to repay the $25,198 he wrongly got from the government, plus a $5,000 fine, and serve three years' probation. Levy stepped down as mayor in October, after admitting his two-week absence was to attend a clinic for treatment of substance-abuse and mental-health issues. During yesterday's hearing, Simandle said Levy unquestionably suffers from post-traumatic stress disorder. The judge said Levy continues to exaggerate his military service, specifically by saying he did work for an elite pathfinder unit, which set up landing zones during the war and made other combat preparations in enemy-controlled territory. Levy insisted he had done several missions with the unit even though he was not a member of it. But Simandle noted that Veterans Affairs officials interviewed commanders and members of the special unit Levy claimed to have served with, and none remembered him. The judge said afterward that "there's no record and no recollection of his service [with the special unit] other than Mr. Levy's." Yet Levy insisted that he had helped the pathfinder unit from time to time. "Being young, 17 years old, I wanted to help and do whatever I could for my country," Levy said. "I just volunteered and went. There were no orders; I picked up my M-16 and my radio and went along. On occasion, they would ask me, and I said yes. I was 17 - young, strong and dumb." Levy is now unemployed, without an income (the Veterans Benefits Administration has stripped him of all benefits, including those he had been receiving for physical injuries) and still dealing with mental health issues from the war. Simandle repeatedly praised Levy's service, which included two tours in Vietnam that left him with serious psychological ailments that went untreated for years. The judge said Levy continues having trouble determining what is real and what is not. Jacobs said Levy emerged from the war "with severe psychological wounds." Since leaving the Army in 1984, Levy has grappled with anxiety and depression, Jacobs said. Those problems worsened after the Sept. 11, 2001, terror attacks. The stress of running for and serving as mayor - he falsely claimed in campaign literature to have served with the Green Berets - also took its toll. "He couldn't function as mayor," the judge said. "All the other stuff was catching up to him. What he went through was a crisis. He didn't come out of it well." [Source: Philadelphia Daily News AP Wayne Parry article 26 Jul 08 ++] DISABLED VETERANS MEMORIAL UPDATE 01: On 18 JUL President Bush signed the American Veterans Disabled for Life Commemorative Coin Act into law. The bill authorizes the U.S. Treasury Department to mint a coin in 2010 to honor the millions of veterans who became disabled while serving in the U.S. Armed Forces. Proceeds from the sale of the coin will go to help construct the American Veterans Disabled for Life Memorial. Congress has authorized the American Veterans Disabled for Life Memorial to be placed on a site adjacent to the National Mall. The Disabled Veterans' LIFE Memorial Foundation describes the memorial's purpose as a way to "embody America's lasting gratitude for the men and women whose lives are forever changed in service to our country." By precedent, only two commemorative coins are minted each year. Though the commemorative coin will help to raise a portion of the funds needed to construct the memorial, more money is needed for construction. For more information on the Disabled Veterans memorial or how to make a donation visit www.avdlm.com, write Disabled Veterans LIFE Memorial Foundation, Inc., 2300 Clarendon Boulevard, Suite 302, Arlington VA 22201-3367 or send an email to info@dvlmf.org. [Source: NAUS Weekly Update 25 Jul 08 ++] GI Bill Update 26: The new GI Bill will be a great benefit for service members when it goes into effect until 1 AUG 09. The new education bill, commonly called the Post-9/11 G.I Bill, will govern payment and reimbursement plans for veterans and servicemembers who seek to further their education. The new plan will be open to most servicemembers who served on active duty after 11 SEP 01. This includes people who have not been eligible for the Montgomery G.I. Bill, such as Air Force Academy or ROTC graduates, those who declined to participate in the program, and those whose service started before it went into effect in 1985. It is expected people who have already elected to participate in the Montgomery Bill program will have the option to use the new plan, if they wish; however, it may be in a member's best interest to stick with the Montgomery Bill for certain distance-learning programs or if they would prefer money be sent directly to them..Although the tuition benefit will be available to most people while they are on active duty, in many instances it will be most advantageous to use all the benefits after separating. Many of the details are being worked out between the DoD and VA but this is what we know for sure: Tuition - The Post-9/11 G.I. Bill will cover tuition with payments sent directly to the school. The formula for determining the amount of tuition and fees paid will be based on the highest cost of a state-supported bachelor's degree program. The tuition amount will be paid directly to the college. Housing - A housing allowance will be made available to prior service members who attend as civilian full-time students. The rate will be that of a staff sergeant (E5) with dependents. Books & Supplies - A maximum of $1,000 per year will be allotted to the member to cover the costs of books and supplies needed for classes. The stipend will be divided by terms, so if someone attends a two-term school, the allotment will be $500 per semester, whereas the student will receive $333 if they attend a three-semester school. Tutoring - $100 a month for 12 months will be available for tutor programs should the service member require extra help outside of his or her studies. Availability Ц Service members can use the program up to 15 years after they are honorably discharged or retire from the service. Certification Ц An extra $2,000 is available to pay for one license or certification test as approved by the VA. Transferability Ц A portion of the tuition stipend, as well as the tutoring allowance, may be available for service members to transfer to family members. Details for this are still being worked out between DOD and the VA. [Source: NAUS Weekly Update 25 Jul 08 ++] SOUTH CAROLINA VET CEMETERY UPDATE 01: The Department of Veterans Affairs (VA) has named the national cemetery to be built near Columbia SC as the Fort Jackson National Cemetery. VA also awarded a $2.53 million construction contract for the initial phase of development to International Public Works, LLC, of North Charleston. The new 585-acre cemetery will be located in Richland County just east of the city of Columbia and south of Interstate Highway 20 on property donated by the Fort Jackson Army post. VA expects construction of a 15-acre area to begin this summer and burials to begin there later this year. The cemetery staff will work initially from a temporary office, committal service shelter and equipment facility building until construction is completed. That area will include 1,400 full-casket gravesites and 1,100 in-ground cremation burial sites. When the cemeteryТs 50-acre first phase of development is finished, it will contain 5,000 full-casket gravesites, including 4,200 pre-placed crypts and approximately 2,000 columbarium niches. It will provide burials for more than 170,000 veterans and their families who live in central South Carolina. The cemetery will include an administration/public information center, public restrooms, a maintenance building and two committal service shelters. Other infrastructure will include roadways, landscaping, utilities and irrigation. Veterans with a discharge issued under conditions other than dishonorable, their spouses and dependent children are eligible for burial in a national cemetery. Other burial benefits for eligible veterans include a burial flag, a Presidential Memorial Certificate and a government headstone or marker Ц even if they are not buried in a national cemetery. VA burial benefits information can be obtained from national cemetery offices, a VA Web site on the Internet at http://www.cem.va.gov, or by calling VA regional offices at (800) 827-1000. For information about the Fort Jackson National Cemetery, call the cemetery staff at (866) 577-5248. To make burial arrangements, call the national scheduling office at (800) 535-1117. [Source: VA News Release 25 Jul 08 ++] CRSC UPDATE 39: The services began processing in JUN 08 Combat-Related Special Compensation (CRSC) claims based on expanded CRSC eligibility to members with less than 20 years of service (YOS) who were retired for medical reasons (Chapter 61) or retired under the Temporary Early Retirement Authority (TERA) during the 1990s force reduction. Compensation amounts vary widely based on several key factors, including rank, years of service, DoD and VA disability ratings, and the portion of the disability thatТs the result of combat. Based on individual circumstances, retirees may receive CRSC awards that restore part or all their longevity-based retired pay. In certain other cases, they may see no change in their pay. A few key factors in understanding the CRSC guidance for compensation are: - Years of Service: the more service, the easier to qualify (more ret pay earned by service alone -- 2.5% of pay/yr) . - Relative VA vs. DoD disability rating: the bigger the difference, the easier to qualify for CRSC % disability due to combat: The more due to combat, the easier to qualify for CRSC. - Key issue: Any retired pay above 2.5% x YOS is still subject to offset by VA disability comp. - Multiple factors mean results not always predictable Thousands of retirees will benefit from the CRSC expansion. However, some with combat-related disabilities who currently lose their entire retired pay to the disability offset will still see no CRSC payment because of an unanticipated glitch in the statutory payment formula. With the many factors which go into the calculation, there's no clear cutoff to explain exactly who will get less than expected. In general, those most likely to be affected are enlisted members with fewer than 14 years of service who have a high VA disability percentage but a significantly lower percentage that's due to combat. Some retired officers are also affected. For example, MOAA has noted under the statutory formula the CRSC award for a E-7 with 12 years active duty service rated 100% by both DoD and VA, but only 60% is combat-related would be computed as follows: DoD Disability Retirement: $2,376 Less Service-Earned Retirement Pay: $950 DoD Pay for Disability would be: $1,426 Max CRSC for 60% combat related: $921 Less DoD Pay for Disability: $1,426 (formula requires this deduction even when member doesn't actually receive any pay from DoD) CRSC Award would be: $0 DoD and DFAS aren't the culprits here...they have to pay according to the statutory formula. MOAA has briefed the Armed Services Committee staffs on the problem and a potential legislative fix. Informally, service and finance officials agree that the formula doesn't work as it should in some cases. But for the majority it works fine as in the case of an E4 with 4 YOS and rated 100% from both DoD and VA (100% combat-related): DoD Disability Retirement: $1,412 (75% of base pay) Less Service Earned Retirement Pay: $188 (4 Yrs x 2.5% x pay) DoD Pay for Disability would be: $1224 Max CRSC 100% combat related: $2527 Less DoD Pay for Disability: $1224 CRSC eligibility: $1303 cannot exceed service earned pay of $188 CRSC Award would be = $188 Best advice to combat-disabled retirees: APPLY! [Source: MOAA Leg Up 25 Jul 08 ++] AGENT ORANGE EQUITY: On 23 JUL House VeteransТ Affairs Committee Chairman Bob Filner (D-CA) held a press conference to announce the introduction of H.R. 6562, the Agent Orange Equity Act of 2008. The bill restores equity to all Vietnam veterans that