From: Director, RAO Baguio [firstname.lastname@example.org]
Sent: Saturday, January 14, 2006 5:09 PM
Subject: RAO Bulletin Update 15 January 2006
RAO Bulletin Update
15 January 2006
THIS BULLETIN UPDATE CONTAINS THE FOLLOWING ARTICLES:
== AOL Advisory ----------------------- (5700 Removed from directory)
== Cell Phone Use on Bases ---------------- (Prohibited while driving)
== NDAA Update  -----------------------(President as signed into law)
== Tricare User Fee  ---------------------(Endorsed by Joint Chiefs)
== Tricare User Fee  -------------------- (Savings questionable)
== SCSD  --------------------------------- (No longer applicable)
== GI Bill  -------------------------------- (Simplification sought)
== VA Insurance Dividends 2006 ---------- (1.2 million vets eligible)
== Jet Lag Avoidance ------------------------ (Tips to reduce impact)
== Medicare Rates 2006  --------------- (Not yet finalized)
== Reserve Reemployment Rights  --- (Implementation regs finalized)
== VA Disability Lump Sum --------------- (Under consideration)
== Thrift Savings Plan  ----------------- (Enrollment changes)
== Tricare Reserve Select  ------------- (Costly for users)
== Tricare Uniform Formulary  ------- (More drugs proposed)
== Medicare Part D  --------------------- (Cost exceed VA program)
== Tricare Prime Travel Impact ------------ (50% cost share)
== VA Hospice Care ------------------------- (Terminally ill care)
== Mobilized Reserve 11 JAN 06 ---------- (Decrease continues)
== In Memory Medal ------------------------- (H.R. 2370)
== AF Reservists Virtual Accounts -------- (Now available)
== Navy Reserve Bonus---------------------- ($15K available to some)
== Reserve Component Drill Pay 2006 ---- (Online calculator available)
== Identity Theft  ------------------------ (VA eligibles targeted)
== International Direct Deposit ------------- (Country list grows)
== Anheuser-Busch Hero Salute[ 01] ------- (Program extended)
AOL ADVISORY 05: Purging of AOL email addees from the Bulletin directory continues. Since 15 DEC over 5700 have been removed and are no longer being sent the Bulletin. All were sent a message advising them this would happen if they did not respond. To date only 76 have been reinstated due to responses that indicated they were able to receive the Bulletin via AOL. A couple of hundred submitted new email addee to receive the Bulletin at. The large number of non-responses confirms AOL's policy which prohibits the majority of their customers from receiving email from anyone they decide is not conforming to their standards. Because the Bulletin does not meet their standards they are not allowing any message traffic from our email addee to reach the majority of their customers. Nor, in the majority of cases do they notify the sender or intended recipient the email was blocked. Input from purged AOL users who were able to receive the deletion notice (about 6%) confirms AOL will not allow their customers any choice in what they want to receive. In upcoming weeks AOL deletions will continue for the remaining 60% of the directory that has not been purged. Those being blocked who cannot provide an alternate addee to send to can read the latest Bulletin at http://post_119_gulfport_ms.tripod.com/rao1.html .
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NDAA UPDATE 10: On 7 JAN 06 President George Bush signed the FY 2006 National Defense Authorization Act (NDAA) which became Public Law 109-163. The NDAA contains many provisions that benefit servicemembers and families reported in previous updates have. Some additional ones which will impact on the veteran/dependent community are:
* Moratorium on Commissary Privatization Studies through 31 DEC 08.
* Maximum Age for Enlistment increased from 35 to 42.
* Authorization for gray-area retirees to travel Space-A on same basis as retirees receiving retired pay.
Expansion of authority to cover dependent travel to visit hospitalized wounded
* Authorization of MGIB Benefits for mobilized members for Licensing and Certification tests up to $2K.
Authorization of credit for members mobilized in response to declaration of
federal emergencies in
* Authorization for Governors to order members to provide military support, on reimbursable basis, to civilian law enforcement agency for domestic counter-terrorism.
* Authorization of educational assistance for reserves supporting contingency operations. Secretary of Veterans Affairs must prescribe form and manner of eligible member's election among the multiple benefits. Break in service allowed if individual continues to serve in the Selected Reserve.
* Exemption for Guard/Reserve families from having to reapply for SSI for up to 24 months after a previous period of eligibility (vs. normal 12 months) if the Guard/Reserve member was called to active duty.
* Authorization for veteran's preference for members of Selected Reserve who are released from active duty.
* Requirement for service members to designate a person authorized to direct disposition of their remains should they die in military status to avoid challenges in family disputes.
* Continued TRICARE Prime coverage for children of members who die on active duty. Coverage eligibility is until age 21, or 23 if enrolled in higher education for deaths since 7 OCT 01.
* Increased SGLI coverage to $400,000, death gratuity to $100,000 for all deaths in the line of duty, retroactive to 7 OCT 01, and $150,000 free SGLI coverage in combat zones. Spousal notification is required if member elects less than maximum or changes beneficiary designation.
* Authorization for home of selection travel for dependents of deceased member up to three years after death of member.
[Source: NCOA DC msg. 11 JAN 06]
TRICARE USER FEE UPDATE 01: The Joint Chiefs are joining the Defense Department in seeking to more than triple annual enrollment fees for officers in Tricare Prime and double the fees for enlisted retirees by 2008. DoD wants Congress to jack up fees for those under-65 officer retirees from $240 a year for individual coverage to $750, and from $450 annually for family coverage to $1,500. The department wants to raise fees for enlisted retirees under age 65 to $450 for individuals and $900 for families. The deductible for Tricare Standard also would be raised, and an annual enrollment fee would be imposed. Medicare-eligible retirees also would take a hit, with copayments for retail generic drugs jumping from $3 to $5 and for brand name drugs from $9 to $15 retail and $10 by mail order. DoD claims it needs the money from the retirees to balance the defense budget. [Source: Armed Forces News 6 JAN 06]
TRICARE USER FEE UPDATE 02: At least a few Pentagon analysts believe the Bush administration will face a new credibility challenge if Tricare officials tell Congress, as they have the Joint Chiefs, that plans to raise Tricare fees and deductibles for retirees under age 65 and their families will save $25 billion over nine years. Documents used during talks on the planned fee increases for 3 million beneficiaries fuel rising skepticism. They show savings of $31.6 billion, an average of $3.5 billion per year from fiscal 2007 through 2015. About 80% of those savings, or $24.9 billion, is traced to the effect of higher Tricare fees. The higher fees will generate $5.4 billion in added revenues through 2015. The remaining 78% of projected savings ( $19.5 billion) hinge on an assumption that 600,000 beneficiaries, facing the higher fees, will stop using Tricare and shift to employer-provided health plans. The magnitude of the shift is said to be based on the experiences of civilian HMOs when they've raised fees.
Some officials don't think Tricare users will behave similarly. Even after Tricare Prime enrollment fees are tripled, as planned for officer retirees, it is likely relatively few will leave Tricare because most employer plans still will cost more. Officially, the planned fee increases aren't expected to be unveiled until after the administration's 2007 budget request and the Quadrennial Defense Review report are sent to Congress next month. DoD's 2005 report to Congress on Tricare shows that the percentage of under-65 military retirees who use private health insurance has slid from 46.9 percent in 2002 to 39.7 percent in 2004, a shift that alarms Defense health officials. The report also shows that a private sector employee's share of health costs rose by 50% from fiscal 2000 through 2004 while the relative cost of Tricare for under-65 retirees fell by 8%, thanks to stagnant Tricare fees and deductibles. The report presents bar charts showing out-of-pocket costs for under-65 retirees enrolled in Tricare Prime totaled $681 in fiscal 2004 compared to $3,684 in health insurance premiums paid by civilian counterparts.
Defense officials believe they already have authority to raise Tricare fees or deductibles and drug co-payments. Legislation might be needed, however, to set an enrollment fee for retirees who use Tricare Standard. The planned increase in pharmacy co-payments is expected to generate $6.7 billion in savings through 2015. They would affect all retirees and their families, including those 65 and older. Indeed, $3.7 billion of the projected cost savings would come from older beneficiaries. The goal is to discourage them from using the retail network, a more costly alternative than mail order or base pharmacies. The current $3 co-payment for generic drugs would rise to $5 in the retail network and fees would be dropped if ordered by mail. The current $9 co-pay for brand- name drugs would rise to $15 in the retail network and to $10 by mail. A proposal still under discussion would curb pharmacy costs still more by requiring retirees needing prescription refills to use mail order or base pharmacies rather than Tricare retail outlets. The mandatory mail-order policy for refills would save an additional $2.6 billion over nine years.
Opponents of the Tricare fee increases hope Congress will step in to stop them. Congressional staffers recently said the odds of that happening narrow if the Joint Chiefs, as expected, VIGOROUSLY endorse the fee increases as being critical for keeping health care costs under control. "If the uniformed guys support it, " said a seasoned armed services committee staff member, "I think it will be very difficult to turn. " "My gut feeling, " said another staff member, ¡§is that there will be expressions of concern and a careful assessment of what they plan to do. But I would not say that any effort by the department to get hold of these costs, by any means available, is unwarranted. " Military health care is expected to reach $64 billion and account for 12% of DoD's total budget by 2015.
The official plan to increase Tricare fees may not be released until the President submits his budget for FY07 later this month or in early February. Thus, what has been disclosed to date could change and may include additional elements. One of these is a likely initiative to include a proposal to increase the third tier $22 pharmacy copayment and establish a new fourth tier of drugs for which the beneficiary would have to pay the full cost. [Source: Stars and Stripes Tom Philpott article 11 JAN 05 ++]
SCSD UPDATE 01: SCSD became effective 1 OCT 99 for qualified retirees with VA disabilities rated 70% or more within 4 years of retirement. No benefits are payable under the Special Compensation Severely Disabled (SCSD) program for periods after 31 DEC 03 when it was replaced with the more generous benefits under the Concurrent Retirement Disability Pay (CRDP) program. Initially, members had to have 20 years of service for the computation of retired pay. Those retired under disability retirement provisions (i.e., chapter 61, title 10, United States Code) were excluded from eligibility. The criteria were relaxed 1 OCT 01, to include chapter 61 retirees so long as they had the required 20 years of service. Effective 1 FEB 02, the criteria were again relaxed to include those with disabilities rated 60% or more within 4 years of retirement. 37,000 members were eventually compensated. Members not compensated who provide evidence of their qualifications may be retroactively compensated for any months in which they met the requirements of law. Applications for SCSD were neither required nor accepted. Qualified members were identified and paid by DFAS using data in DoD and VA system files.
The rates applicable over various periods were as follows and based on the disability rating compensated by the VA for the month of entitlement:
1. Oct 1999: 60%(n/a); 70%($100); 80%($100); 90%($200); 100%($300)
2. Feb 2002: 60%($50); 70%($100); 80%($100); 90%($200); 100%($300)
3. Jan 2003: 60%($50); 70%($100); 80%($125); 90%($225); 100%($3325)
4. Program repealed in Jan. 2004
[Source: NCPOA Don Harribine Newsletter 2 JAN 05]
GI BILL UPDATE 10: The Partnership for Veterans' Education, a group of more than 50 military and education organizations, is seeking to simplify the GI Bill program and increase the benefits for reserve and National Guard troops. Currently, the Department of Veterans Affairs administers education benefits for active-duty members and former active-duty veterans, and the Defense Department handles Reserve Component benefits. This split of responsibility has created major differences in payments, fees, time lengths of eligibility and the types of education and training authorized. The partnership proposes a three-level plan consisting of (1) active-duty members and former active-duty veterans, (2) drilling reservists, and (3) reservists mobilized for at least 90 days. A panel from DoD and the VA is studying the recommendations. [Source: Armed Forces News 16 Dec 05]
VA INSURANCE DIVIDENDS IN 2006: The VA has announced more than 1.2 million veterans nationwide are in line to receive $414 million in annual insurance dividends over the coming year. The dividend payments from VA will be sent to an estimated 1,239,600 policyholders on the anniversary date of their policies. Sent automatically through different payment options, the specific dividend amount will vary based on the age of the veteran, the type of insurance, and the length of time the policy has been in force. Dividends are paid each year to veterans holding certain government life insurance policies and who served between 1917 and 1956. The dividends are drawn from the earnings on the trust fund into which veterans have paid insurance premiums over the years, and are linked to returns on investments in U.S. government securities.
World War II veterans comprise the largest group receiving 2006 insurance dividend payments. One million veterans holding National Service Life Insurance ("V") policies are expected to receive total payments of $322.6 million. Another 45,000 World War II era veterans with Veterans Reopened Insurance ("J", "JR" and "JS") policies will share a dividend of $11.4 million. Over 186,000 Korean War era veterans who have maintained Veterans Special Life Insurance ("RS" and "W") policies can expect to receive dividends totaling $79.1 million. Dividends totaling $1.2 million will be paid to 8,600 veterans holding U.S. Government Life Insurance ("K") policies, which are held by veterans who served between World War I and 1940.
VA administers a wide range of additional life insurance programs that provide comprehensive coverage and security for veterans and their families while not paying a direct annual dividend. They include special life insurance for disabled veterans, home mortgage life insurance coverage, and the widely utilized Servicemembers' Group Life Insurance (SGLI) and Veterans' Group Life Insurance (VGLI) programs. Veterans who have questions about their policy may call the VA Insurance offices at 1(800) 669-8477; by e-mail to VAinsurance@vba.va.gov, or on the Internet at www.insurance.va.gov. [Source: VA News release 8 DEC 05]
JET LAG AVOIDANCE: Jet lag is very common after long flights, and is especially difficult for older adults and people with health problems. It occurs because crossing multiple time zones tends to disrupt your circadian rhythms, confusing your natural 24-hour body clock, which regulates your waking and sleeping hours and keeps you aligned with your environment. Symptoms of jet lag may include: fatigue; insomnia; disorientation; swollen hands and feet; headaches; digestive problems; and lightheadedness. The symptoms feel especially acute if you fly from west to east, because it is more difficult for your body to adjust to losing time when you journey east than to gaining time when you fly from east to west. You can avoid jet lag altogether by following these 10 simple steps
1. Adjust your bedtime by a hour a day, a few days before your trip. Change your sleep pattern to match the schedule you will keep at your destination. This will help you avoid jet lag during your trip.
2. Resetting your watch at the beginning of your flight may help you adjust more quickly to the time zone you will be visiting.
3. Drink plenty of water before, during and after your flight. The air on planes is extremely dry, and some experts believe that dehydration is a leading cause of jet lag. Virtually everyone agrees that dehydration can make jet lag worse.
4. Avoid drinking alcohol or anything with caffeine during your flight. (That includes many soft drinks as well as coffee or tea.) Both alcohol and caffeine increase dehydration.
5. Sleep on the plane if it is nighttime at your destination. Use earplugs, headphones, eye masks or other sleep aids to help block out noise and light, and a travel pillow to make yourself more comfortable so you can sleep.
6. Stay awake during your flight if it is daytime at your destination. Read, talk with other passengers, watch the movie, or walk the aisles to avoid sleeping at the wrong time.
7. Exercise as much as you can on the flight, but review the two preceding tips. If you need to sleep to match nighttime at your destination, do that. Many airlines include instructions for in-flight exercises on a card or in the airline 's magazine; check the seat pocket in front of you. Try these in-flight exercises:
- Stretch your back, arms and leg muscles
- Walk up and down the aisle when the seat belt sign is turned off
- Squeeze a rubber ball or a pair of socks to stimulate good circulation in your hands and arms; alternate hands.
- While sitting in your seat, lift one knee and flex your foot for the count of 10; repeat with the other leg
8. Eat lightly but strategically. Remember that high-protein meals are likely to keep you awake, foods high in carbohydrates promote sleep, and fatty foods may make you feel sluggish.
9. Take supplements. Some people claim that melatonin, a natural hormone produced by our bodies, will cure jet lag by promoting sleep. Others swear by a homeopathic product called "No Jet Lag". Melatonin can be purchased online or at most health food stores. No Jet Lag is available online and at many retail outlets that sell travel supplies.
10. Relax on the first day at your destination. If you have the luxury of arriving at your destination a day or two before you have to engage in important activities that may require a lot of energy or sharp intellectual focus. Give yourself a break and let your body adjust to the time change a little more gradually.
[Source: About Senior Living article 21 DEC 05 http://seniorliving.about.com]
MEDICARE RATES 2006 UPDATE 03: The Senate passed its budget reconciliation bill (S. 1932) late in 2005, which included language to repeal the 4.4% cut in Medicare reimbursement rates slated to take effect on 1 JAN 06 and freeze Medicare and TRICARE reimbursement rates at 2005 levels. It also included some some last minute changes in unrelated parts of that bill. Before the bill could be sent to the White House, it required additional approval from the House because of the changes. Unfortunately, the House had already recessed for the year, so the measure could not be passed before the 1 January deadline. As a result, Medicare was required by law to institute the 4.4% reduction in reimbursement rates.
When the House reconvenes at the end of January, lawmakers will consider the Senate measure. Speaker Dennis Hastert (R-IL) has tentatively scheduled a House vote for 1 FEB. While a close vote is predicted, the House is expected to pass the measure. Once approved and signed into law, Medicare will automatically reset reimbursement rates effective 1 JAN. Medicare then will automatically reprocess all claims filed since the first of the year, and reimburse each provider accordingly. However, Medicare has acknowledged that it could take until July before all the claims have been reprocessed. Doctors who choose to stop seeing Medicare beneficiaries because of the temporary cut will be given a 45-day reenrollment period to rejoin the program. Tricare officials announced that Tricare will continue to pay claims at the 2005 rate on the assumption that the legislation will be passed soon, as expected. [Source: FRA Newsbytes 13 Jan 06 ++]
RESERVE REEMPLOYMENT RIGHTS UPDATE 02: More than a decade after the passage of a law designed to protect the employment rights of military service members, the Labor Department has finalized the first-ever set of regulations addressing its implementation. The 1994 Uniformed Services Employment and Re-employment Act (USSERA) builds on the Veterans' Re-employment Rights law passed in the 1940s by barring discrimination against military members and veterans, and by establishing re-employment rights for those who want to return to the jobs they held prior to serving. Written by the Veterans' Employment and Training Service, the rules are intended to explain and clarify the 1994 law. The nearly 70-page document was published in the Federal Register and will take effect on 18 JAN 06. The regulations come at a time when the mobilization of National Guard and Reserve service members is the largest since World War II, with a total of 529,310 called to duty since the Sept. 11, 2001, terrorist attacks.
Complaints of USERRA violations are correspondingly on the rise since 2002, though there was a dip in fiscal 2005. According to a Labor spokesman, a lack of awareness and understanding has been the biggest cause of USERRA complaints. The new regulations provide comprehensive guidance on USERRA, which works to preserve the seniority, promotion, health care, pension and other benefits of citizen soldiers when they return home to the jobs they left to serve the country. Publication of regulations was mandated in the original USERRA law, but Labor did not complete a draft until 20 SEP 04. It yielded 80 comments from a
variety of sources. A report published last year by the American Bar Association was critical of
USERRA enforcement efforts. According to the report the Veterans' Employment and Training Service, which is charged with reviewing initial complaints of USERRA violations, was taking too long to investigate cases,
The regulations are written in plain English and are intended to be used by human resource departments and not lawyers. The Labor Department's Veterans' Employment and Training Service typically is the first to see complaints that the law has been violated. But in February 2005, the Office of Special Counsel began investigating the USERRA claims of federal workers with Social Security numbers ending in an
odd-numbered digit. The effort was a demonstration project and was intended to relieve some of Labor's burden. Labor has continued to handle state and local government claims. Along with the final regulations, Labor has also published the final version of information leaflets. [Source: GOVEXEC.com article by Daniel Pulliam 23 DEC 05]
VA DISABILITY LUMP SUM: The Department of Veterans Affairs is considering a controversial change in disability benefits that would provide a one-time lump sum, rather than monthly payments, to those with low-rated disabilities. Veterans' groups do not like the idea, recommended in a May report from the VA's inspector general as a way to cut costs. Donald Mooney of the American Legion, testifying 7 DEC before the House Veterans' Affairs Committee about problems in processing disability claims, said such lump-sum payments would create a number of problems. For example:
- If a service-connected condition worsened over time, it is unclear if or how the veteran could get an increase in disability compensation.
- It is unclear whether a spouse would be entitled to service-connected death benefits in such cases.
- Since the VA often inaccurately assigns an initial disability rating, if a veteran is paid too little or too much, the process for getting more money or repaying money would be problematic.
The idea of lump-sum disability benefits was first raised in 1996 by the Veterans' Claims Adjudication Commission, which noted that veterans making multiple claims for the same disability were a large reason for a backlog of claims, and that most of the repeat claims came from veterans with comparatively less-severe disabilities who were trying to get their disability ratings increased. The Government Accountability Office (GAO), which has been studying VA claims processing, noted that about 65% of disabled veterans have disabilities rated at 30% or less, which consume a large amount of the VA's administrative time and resources . A survey of veterans in 2000 showed that about one-third of those with newly received disability rates expressed interest in the idea of a one-time payment instead of monthly disability pay. The GAO's representative noted that a one-time benefit would be potentially useful to some veterans as they make the transition from military to civilian life. However, this was talked about only as an option, with veterans retaining the choice to get traditional monthly disability pay if they did not want a lump sum.
A lump-sum payment system saves money only if the payment received is less than a veteran would get in a lifetime through monthly payments and if a veteran waives the right to a re-evaluation of the disability in the future. The 1996 commission asked Congress to approve paying reduced lump-sum disability payments, but lawmakers never acted. No immediate action is expected on the new IG recommendation either, but a new panel (the Veterans' Disability Benefits Commission) is looking at possible changes to veterans' compensation, particularly for those with low-rated disabilities. That 13-member commission, appointed in February, is due to complete its work next August, but its members already have been talking about the need for an extension. [Source: Times staff writer Rick Maze article 26 DEC 05]
TRICARE RESERVE SELECT UPDATE 03: Effective in 2006, civilian and military employees may contribute the full amount to their Thrift Savings Plan (TSP) accounts that is allowed by the Internal Revenue Service ($15,000 for 2006). They may start, change, stop or resume their TSP contributions at any time (except those in the 6-month non-contribution period following a financial hardship in-service withdrawal). Service members also may invest all or part of their bonuses, special pay or incentive pay, as long as they contribute from basic pay. Those serving in tax-free combat zones are allowed up to $44,000 in annual contributions. Military participants can enroll or change their contribution amount at https://mypay.dfas.mil/mypay.aspx, or by filling out a form TSP-U-1 at local finance offices. They can change contribution allocations by calling 1 (877) 968-3778 from the 50 States, Virgin Islands, Puerto Rico, Guam, American Samoa and Canada; calling 1 (404) 233-4400 from elsewhere, or visiting www.tsp.gov. [Source: Armed Forces News 16 Dec 05 ]
TRICARE RESERVE SELECT UPDATE 04: In the final version of the FY2006 Defense Authorization Act Congress has agreed to extended eligibility to Tricare Standard on a premium basis to any drilling member of the National Guard or Reserve who agrees to continue in uniform, not just to those who have been mobilized in support of a contingency operation. Premiums will differ, depending on the status of the Guard or Reserve member and their access to other health insurance. The legislation creates three categories of beneficiaries in Tricare Reserve Select (TRS):
1) A category for those who deploy for a contingency operation and are entitled to participate at a cost
share of 28/72 (those currently eligible for TRS);
2) A new category for those who are unemployed or are not offered employer sponsored health
care, who will now be eligible to buy into Tricare at a cost share of 50/50; and
3) A new category for all others who may participate in Tricare Standard at a cost share of 15/85.
This makes nearly all members of the Selected Reserve eligible for military Tricare coverage, but the price will be steep for those who haven't been mobilized since 9/11. Unmobilized members who don't have access to health care through a civilian employer will have to pay almost twice the premiums paid by those previously mobilized -- about $145/mo vs. $81 for single and $452/mo vs. $253 for family coverage, respectively. Tricare premiums for unmobilized members with access to employer-sponsored coverage will be set even higher, at $246/mo and $768/mo for single and family coverage. [Source: NMFA Government and You News 21 DEC 05 ++]
TRICARE UNIFORM FORMULARY UPDATE 07: On 19 DEC the Defense Department convened the Beneficiary Advisory Panel (BAP) to review recommendations to move certain Alzheimer's medications, nasal steroids, antidepressants, and antibiotics to the third ($22-copayment) tier of the TRICARE formulary. The drugs involved are:
a) Alzheimer's: Cognex.
b) Nasal Corticosteroids: Beclovent AQ, Vancenase AQ/DS, Rhinocort AQ, and Nasacort AQ.
c) Antibiotics: Azithromycin (Zmax only) and Ketek.
d) Antidepressants: Prozac Weekly, Sarafem, Lexapro, Paxil CR, Cymbalta, and Wellbutrin XL.
They also recommended that a prior authorization be required for Mescasermin (increlex). The beneficiary panel expressed two general concerns with the recommendations.
ƒÞ The full range of medications should be made available to active duty members if deemed medically necessary by the doctor. Currently, active duty personnel are denied access to third-tier drugs except when special-ordered by a military pharmacy. In many cases, members are assigned out of the vicinity of military facilities, and they should have the same medical-necessity access as all other TRICARE beneficiaries.
ƒÞ In some cases, the beneficiary panel urged a longer transition period to ensure beneficiaries are informed about the changes and have an opportunity to discuss alternative medications with their doctors. It was noted that the panel had not yet seen a DoD communication plan to inform the TRICARE Standard population and their providers about such changes.
All committee recommendations and comments must be forwarded to the Director of Tricare Management Activity for final approval or modification. [Source: MOAA Leg Up 21 DEC 05 ++]
MEDICARE PART D UPDATE 04: A study by FamiliesUSA reports prices for the most commonly used prescription drugs will be significantly higher under the new Medicare drug plan than comparable prices under the Veterans Affairs drug plan. The survey by the consumer health group said the annual costs of the 20 drugs most use by seniors under the Medicare program will exceed VA prices by as much as 689% -- or $1,156 -- for 20 mg of the cholesterol drug Zocor. The survey showed that half of the top 20 drugs exceeded the lowest VA prices by 48.2%, or $261. Of the 20 most prescribed drugs all but one of the prices under the VA drug plan were lower than the Medicare plan. Following are the most significant difference:
-- A one-year supply of the the heartburn pill Nexium supply in a Medicare drug plan is $836.28, compared with $968.40 under the VA plan.
-- A one-year supply of the osteoporosis treatment Fosamax is $493.32 under the VA plan, compared with the lowest available Medicare prescription drug plan price of $709.68.
-- A one-year supply of the acid reflux medication Protonix is $253.32 under the VA plan, compared with
the lowest available Medicare prescription drug plan price of $1,080;
-- A one-year supply of the cholesterol-reducing medication Lipitor is $497.16 under the VA plan, compared with the lowest available Medicare prescription drug plan price of $717.84
The complete study results can be viewed at http://www.familiesusa.org/resources/newsroom/press-releases/drug-prices-in-medicare-plans.html. It should be noted the VA plan limits drug choices and requires members to use VA pharmacies, while Medicare plans cover at least two medications from every major drug category and allow beneficiaries to fill prescriptions at retail drug stores. As part of the Medicare prescription drug law, Congress barred Medicare officials from negotiating with pharmaceutical companies. The VA, by contrast, leverages its position as a large-scale purchaser of drugs to lower overall prices for veterans' drugs. The study compared recent prices in two Medicare regions, one covering the Washington, D.C., Maryland and Delaware, and one covering Ohio. FamiliesUSA Executive Director Ron Pollack, stated at a news conference that since the government covers about three-fourths of the drug costs, "bottom line" is "millions of seniors will be burdened with unaffordable costs and the American taxpayers will be fleeced. The drug program was promoted on the basis that competition among drug companies would lower medication prices. Their study indicates that did not happen. Separately, the Pharmaceutical Care Management Association, which represents pharmacy benefit managers, criticized the study, saying seniors will save an average of 31% on drugs bought at retail pharmacies and 45% by mail order. The Medicare drug plan goes into effect in January for Medicare recipients who signed up for the program. [Source: Kaisernetwork.org Daily Health Policy Report 22 DEC 05 ++]
TRICARE PRIME TRAVEL IMPACT: Tricare Prime is great for people who live near a military hospital or other military treatment facility. They get priority access to free care without concerns about space availability (usually); drugs are free; even a stay in a civilian hospital is dirt cheap. But Tricare Prime is not a good choice for people who travel frequently and range far from their primary care manager (PCM). Anytime you get non-emergency care from a provider that is not your PCM, or if your PCM did not refer you to that provider, your claim falls under the Tricare Prime Point of Service Option, called POS. A Tricare claim for those services will have an automatic $300 deductible. And then, if there is anything left for Tricare to pay on, you will have a 50% cost share on whatever Tricare allows. If you have to be hospitalized, the 50% cost share can put an end to your travels for a long while because, unlike Tricare Standard or even Tricare Prime, there is no catastrophic cap on deductibles and cost shares under the POS.
Ordinarily, when a family has paid $3,000 in cost shares and deductibles in a fiscal year, the catastrophic cap is activated. Tricare will pay 100% of the amount it allows on each claim. No more cost shares will be withheld from Tricare's payments for the rest of that fiscal year. That is not the case under the Tricare Prime POS. There is no limit to the amount of cost shares you can be responsible for paying. Tricare Prime members have priority access to military medical care only at their home base. At any other military hospital, they are subject to space-available considerations as if they were not enrolled in Prime. Considering the possible out of pocket cost with Prime, it might be to your advantage to utilize your other Tricare Standard option and obtain a good Tricare supplement from a recognized insurer. [Source: NavyTimes James E. Hamby article 5 DEC 05 ++]
VA HOSPICE CARE: Hospice is a movement to another mode of care giving when a terminal illness no longer responds to cure-oriented treatments and when the primary goal of care is comfort and care of the bereaved friends and family. The Veterans Health administration (VHA) is committed to providing compassionate and humane care to terminally ill veterans and their families. The now include Hospice and palliative care in the Medical Benefits Package for eligible enrolled veterans. While many aspects of hospice activities have been incorporated into VA's approach to the care of terminally ill patients in the past, a formally structured hospice program provides them an opportunity to focus their efforts in providing compassionate care in a timely and coordinated manner. Hospice and palliative care optimize the comfort and dignity of the patient through the effective management of pain and other symptoms. All VA medical centers assure that hospice care is made available to all enrolled veterans who need and select this type of care.
A variety of organizational models may be utilized at any particular VA medical center. The VA medical center designates a Palliative Care Consultation Team consisting of, at a minimum, a physician, nurse, social worker, chaplain and administrator. The role of the team will be to consult with the patient's primary care team on pain management and other care issues. The team recommends policies and procedures to hospital management; assumes a leadership role in promoting the hospice concepts of care; facilitates communications with community hospice agencies, and conducts educational programs for the VA medical center and community staff. The team is expected to maintain expertise in palliative care and in the ethical issues involved in the care of patients approaching the end of life.
If hospice care is appropriate for the enrolled veteran the VA medical center in which the veteran is enrolled may provide hospice care directly in their facility or purchase it from community hospice agencies. The veteran may prefer to use their Medicare, Medicaid or private insurance coverage for hospice. In most situations there is no charge for hospice care regardless of payer source. Hospice care services are available to patients of any age, religion, or race. Hospice services are appropriate for many end-stage terminal diagnoses including cancer, AIDS, end-stage heart disease, respiratory and lung disease and end-stage Alzheimer's disease. Patients with a life expectancy of 6 months or less are appropriate for hospice. In most cases hospice services are provided to veterans in their homes but having hospice care at home does not mean a person must die at home. Hospice may also be provided in VA Healthcare facilities, freestanding hospice centers, hospitals, nursing homes or in other long-term cares facilities.
Whether the care is provided in the home or in an institution, the hospice team includes the patient's personal physician, a hospice physician or medical director, nurses, home health aides, social workers, clergy or other counselors, trained volunteers and speech physical and occupational therapists if needed. The job of the hospice team is to manage the patient's pain and symptoms, assist the patient with the emotional and psychosocial and spiritual aspects of dying, provide needed drugs, medical supplies and equipment, coach the family on how to care for the patient, deliver special services like speech and physical therapy when needed, make short-term inpatient care available when pain or symptoms become too difficult to manage at home. Hospice also provides regular in-home nursing visits and 24-hour telephone access to nursing staff for information, support and visits if needed.. Hospice provides bereavement care and counseling to surviving family and friends. Discussion of death and dying is not forced but support staff remains available to discuss any issues that the patient/family chooses with regard to the care of someone who is terminally ill.
On occasion caregivers may need a break or some respite from daily care giving. For patients receiving Medicare, caregivers relief and respite care may be provided in a Medicare-approved facility such as a freestanding hospice facility, a hospital, nursing home or other long-term care facility which is covered by Medicare for up to five days at a time. A hospice patient has the right to stop receiving hospice care at any time for any reason. On occasion a terminally ill hospice patient's health improves, or his or her illness goes into remission. A patient's condition may become stable to the point that the hospice team and physicians believe that the patient cannot be certified as terminally ill and therefore is not longer eligible for the hospice benefit. However, at any point in time, a patient can return to hospice care as long as the eligibility criteria is met and certification by the physician and hospice team is received. At www.va.gov/sta/guide/division.asp you can determine the locations & phone numbers of all VA medical centers. Contact the one nearest you and request to speak with a Social Worker for assistance if you are interested in this VHA program. [Source: VA web site www1.va.gov/geriatricsshg/docs/HPCare.DOC Oct 05]
MOBILIZED RESERVE 11 JAN 06: Army National Guard and Army Reserve on active duty in support of the present partial mobilization is now 113,476. In addition the other services have mobilized 4,014 Navy Reserve; 7,670Air National Guard and Air Force Reserve; 7,115 Marine Corps Reserve; and 414 Coast Guard Reserve. As of 11 JAN this brings the total National Guard and Reserve personnel, who have been mobilized, to 132,689, including both units and individual augmentees. This is a decrease of 11,399 from last month's 7 DEC total mobilization announcement. At any given time, services may mobilize some units and individuals while demobilizing others, making it possible for these figures to either increase or decrease. A cumulative roster of all Reserve contingent personnel can be found at www.defenselink.mil/news/Oct2005/d20060111ngr.pdf for those now mobilized. [Source: DoD News Release No. 1266-05 7 JAN 11]
IN MEMORY MEDAL: Rep. Bob Filner (D-CA) introduced on 16 MAY 05 the "In Memory Medal For Forgotten Veterans Act" (HR 2370) which was referred to the House Committee on Armed Services. This is a bill to direct the Secretary of Defense to issue a medal to certain veterans who died after their service as a direct result of that service, or who were presumptively exposed to ionizing radiation, herbicide agents, or chemical agents during their service in the Armed Forces. For deceased personnel the medal shall be issued to the next-of-kin or representative of such person, as designated by the Secretary of Defense. The bill establishes a medal, to be known as the 'Jesus (Chuchi) Salgado Medal', to be issued to any of the following:
(1) Veterans who died as a result of their service in the Vietnam war and whose name is not eligible for placement on the Vietnam Veterans Memorial
(2) Veterans exposed to ionizing radiation who are or were at the time of death eligible to receive benefits from the VA attributable to the presumption of service-connection.
(3) Veterans exposed to herbicide agents in the Republic of Vietnam who are or were eligible at the time of death eligible to receive benefits from the VA attributable to the presumption of service-connection.
(4) Veterans exposed to certain chemical agents who served on active duty in the Southwest Asia theater of operations during the Persian Gulf War who are or were entitled at the time of death to receive compensation from the United States attributable to the presumption of service-connection.
[Source: New Mexico e-Veterans News 21 May 05]
AF RESERVISTS VIRTUAL ACCOUNTS: Air Force reservists can now create their own account on the Reserve Personnel Center's Virtual Personnel Center-Guard Reserve portal. Interested reservists should go to https://arpc.afrc.af.mil/support/newaccount.asp and fill out all required blanks on the electronic form.Reservists with no e-mail address can establish one at www.gimail.af.mil/login.asp. Once the account is activated, the reservist can make address updates, find assignment information, review benefits and entitlements and search career opportunities.. They also can get a reissue of the 20-year letter and/or a mortgage letter. The following sections will provide:
- Points management section provides the number of points accumulated.
- Promotions section will help individuals prepare for promotion boards.
- Retirements section will provide what is needed for retirement and what is available to accomplish it.
- Retraining section will provide alternate career fields members can go to and eligibility criteria important documents for Reserve Airmen.
[Source: Armed Forces News 6 JAN 06]
NAVY RESERVE BONUS: The Navy Reserve is offering Naval Reserve affiliation bonuses of $15,000 to certain petty officers leaving active duty as well as to former Sailors. Candidates must agree to serve six years in the selected reserve and cannot have completed more than 16 years of total service. They must possess one of the following skills or be trainable for one: master-at-arms, hospital corpsman, gunner's mate, intelligence specialist, builder, steelworker, construction electrician, construction mechanic, diver, explosive ordnance specialist, SEAL, or special warfare combatant crewman. Retention is high in the Navy's active duty ranks, but the Navy Reserve has not met its recruiting goals since JAN 85. Additional information is available at www.navyreserve.com or call 1(800) 872-8767. [Source: Armed Forces News 6 JAN 06]
RESERVE COMPONENT DRILL PAY 2006: The 2006 Reserve and National Guard Drill Pay online calculators are now available at www.military.com/Reserve_Drill_Pay and www.military.com/NG_Drill_Pay. These pay rates are effective as of 1 JAN 06. Typically, one drill weekend includes four drill periods. E-1 personnel with less than four months of service earn $39.27 per drill period. To utilize the calculators all you need do is select your pay grade, minimum time in service, and number of drill periods. [Source: Military.com newsletter JAN 05]
IDENTITY THEFT UPDATE 07: There appears to be an identity theft scam going on in Mississippi, Alabama and possibly Pensacola, Florida. Individuals are calling VA beneficiaries and advising them that their VA files have been destroyed as a result of Hurricane Katrina. The caller advises that VA is trying to rebuild their files and requests their Social Security Numbers and other personal information. VA OIG has agents looking into this with local police agencies. [Source: Jim Gaughran, VA OIG Special Agent in Charge, Criminal Investigations Division]
INTERNATIONAL DIRECT DEPOSIT: The Defense Finance and Accounting Service (DFAS) recently initiated International Direct Deposit (IDD) for U.S. military retirees and annuitants living outside the United States. The first five countries included Australia, Canada, France, Germany and the United Kingdom where IDD availability was effective with the 1 DEC 05 pay date. The program allows U.S. military retirees and annuitants to have their monthly payments sent electronically to their local banks where they reside. Deposits are made in the local currency rather than U.S. dollars, saving many the expense of converting dollars for use in the local economy. Payments arrive in bank accounts on the same day they are released from DFAS and the Federal Reserve Bank in New York. For those receiving checks via mail, IDD also offers an alternative to lost, misrouted or stolen mail, thus reducing the chances of check and identity theft. Nations chosen for IDD eligibility have met the financial responsibility and system requirements of the Federal Reserve Bank. Simply put, the banks and other financial institutions in those countries provide secure and trustworthy services and have systems compatible with transferring funds from the U.S. to your account.
The IDD program for DFAS will enter another phase in February 2006. Enrollment packages will be sent to retirees and annuitants living in an additional 38 countries which are: Anguilla , Antigua & Barbuda, Austria, Bahamas, Barbados, Belgium, British Virgin Islands, Cayman Islands, Cyprus, Denmark, Dominican Republic, Finland, Greece, Grenada, Haiti, Hong Kong, Hungary, Ireland, Israel, Italy, Jamaica, Malta, Mexico, Netherlands, Netherlands Antilles, New Zealand, Norway, Panama, Poland, Portugal, South Africa, Spain, St. Kitts, St. Lucia, St. Vincent & Grenadines, Sweden, Switzerland, Trinidad & Tobago. Each enrollment package will include the necessary instructions, form, and return envelope to begin requests for IDD service. DFAS can only offer IDD for your military retired or annuitant pay. If you want your Social Security, VA, OPM or railroad retirement also sent to your local bank, you must contact these agencies to enroll.
At www.dtic.mil/whs/directives/infomgt/forms/eforms/of1199i.pdf you can obtain an enrollment packages if you do not receive one in the mail. Your bank representative must complete and sign Section C and you must sign section D and E (as appropriate). Then mail your application using the return envelope provided to: Federal Reserve Bank of New York International Treasury Services E. Rutherford Oper. Ctr, 1st Floor 100 Orchard Street East Rutherford, NJ 07073. DFAS Retired and Annuitant Pay officials urge each enrollee to make sure the form is accurately completed and signed. Incomplete or incorrect bank account numbers, names or addresses will require sending the form back and delaying the process. One item that might be overlooked is the name used in an individual's bank account ¡V it must match the name in their DFAS pay account. Otherwise, it may be misrouted once it is received by the bank. Processing time should be around four weeks from the time DFAS received your request. For additional information military retirees and annuitants without Internet access can call 00-1-216-522-5955 to speak with a Retired and Annuitant Pay customer service representative. Those with Internet access can send their questions online via https://ca.dtic.mil/dfas/s-retired/ret1-pay.htm (for retirees) or https://ca.dtic.mil/dfas/s-retired/annuity1-pay.htm (for annuitants). [Source: DFAS Retired Pay Newsletter 13 Jan 06]
ANHEUSER-BUSCH HERO SALUTE UPDATE 01: A tribute program that provided free admission to Anheuser-Busch theme parks to more than 900,000 members of U. S. and coalition armed forces and their families has been extended through 2006. The program provides a single day's free admission to any one SeaWorld or Busch Gardens park, Sesame Place, Adventure Island or Water Country USA for the servicemember and as many as three of his or her direct dependents. Any active duty, active reserve or Ready Reserve servicemember or National Guardsman is entitled under the program. He or she need only register, either online at www.herosalute.com or in the entrance plaza of a participating park, and show a Defense Department photo ID. Also included in the offer are members of foreign military forces serving in the coalitions in Iraq or Afghanistan or in the United States attached to American units for training. Inactive, standby and retired reserve members, military retirees, U. S. Merchant Marine and civilian DoD employees are ineligible for the program. Dependents may take advantage of the offer without their service member, though an adult must accompany minor dependents.
Busch Gardens Williamsburg and SeaWorld San Antonio are seasonal operations that will remain closed until spring 2006. The remaining parks, SeaWorld Orlando, Busch Gardens Tampa Bay and SeaWorld San Diego are open year round. Personnel interested in visiting those parks can check operating schedules at www.herosalute.com. Here's to the Heroes is the fourth tribute to military personnel offered by Anheuser-Busch since Yellow Ribbon Summer welcomed servicemembers home from the Gulf War in 1991. More than 3 million people have visited Anheuser-Busch Adventure Parks free under these programs [Source: American Forces Press Service 5 JAN 06]
Lt. James "EMO" Tichacek, USN (Ret)
Director, Retiree Assistance Office, U.S. Embassy Warden & VITA Baguio City RP
PSC 517 Box RCB, FPO AP 96517
Tel: (760) 839-9003 or FAX 1(801) 760-2430; When in RP: (74) 442-7135 or FAX 1(801) 760-2430
Email: email@example.com. When in Philippines firstname.lastname@example.org
Web: http://post_119_gulfport_ms.tripod.com/rao1.html or http://Wildfleckenveterans.com
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