RAO Bulletin Update 01 May 2008

This bulletin update 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:

– If you’re planning a trip, say to visit family for Easter, visit AAA’s Fuel Cost Calculator at 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.
– A comprehensive site on gas prices is 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 AAA’s Daily Fuel Gauge Report which displays the average price by state and metro area.
– GasBuddy 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 won’t waste gas hunting cheap gas.
– If gas prices are too high, you can always share a ride! AlterNetRides alternetrides.com will hook you up with fellow commuters.
– Alternative fuel like propane or biodiesel locations can be found by entering your ZIP and the type of fuel you need at 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 “Americans art War” 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. Don’t forget to add your marriage anniversary and your spouse’s birthday:
– May 11 Mothers Day
– May 17 Armed Forces Day
– May 24 – 1 Senate Memorial Day recess (District work period)
– May 26 – 30 House Memorial Day recess(District work period)
– May 26 Memorial Day
– June 14 Flag Day
– June 15 Fathers Day
– 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 ‘‘Veterans Disability Benefits Claims Modernization Act of 2008’’. 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:

– Clarifying combat related disabilities;
– Readjusting the VA Schedule for Rating Disabilities;
– Changing the VBA’s work credit and management systems;
– Improving employee certification and training;
– Improving quality assurance measurements;
– Expediting fully-developed claims and improving VCAA notice requirements;
– Ensuring partial ratings for qualifying veterans
– Allowing substitution of qualifying survivors;
– Enhancing information technology; and
– 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, “The Dietitian’s Voice,” and a discussion forum, “Ask the DeCA Dietitian” on the agency’s Web site at www.commissaries.com. To find the link to the DeCA Dietitian page. click on the “Healthy Living” 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: thomas.loc.gov/cgi-bin/bdquery/z?d110:s.01315:

– Provide retroactive traumatic injury coverage under SGLI for qualifying injuries incurred between October 7, 2001 and December 1, 2005
– Authorize SGLI coverage for members of the Individual Ready Reserve (IRR)
– Raise the VA home mortgage life insurance rates to $200,000 by 2012
– 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.
– Increase supplemental burial benefits to $2100 in the case of a service-connected death and $900 for a non-service connected death.
– 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.
– Increase the maximum amount of supplemental Service-Disabled Veterans Insurance from $20,000 to $30,000.
– Expand eligibility for home improvement and structural alteration assistance to include permanently disabled servicemembers.
– Provide a specially-adapted housing grant to veterans and qualified servicemembers with severe burn injuries.
– Extend authority of the VA to assist individuals living temporarily in residences owned by family members.
– Provide automobile and adaptive equipment assistance to disabled veterans and servicemembers with severe burn injuries.
– Increase to $445 from the current $300 allowance for veteran burial plots.
– Provide a presumption of service-connection for osteoporosis for former POWs with post-traumatic stress disorder.
– Increase cost-of-living for additional dependency and indemnity compensation paid to certain surviving spouses with minor dependent children.
– 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 it’s not just Democrats who want to improve veterans’ education benefits through their Post-9/11 Veterans’ 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 veterans’ benefits to pay off existing student loans. It also would extend GI Bill benefits to service academy and Reserve Officers’ 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 veterans’ groups for not supporting Webb’s 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. “We don’t have beer money included,” 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 military’s 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 Veterans’ Affairs Committee and another co-sponsors of the new bill, said Webb’s 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, “means, 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 Webb’s bill.” The Pentagon has opposed Webb’s 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 veterans’ 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 veterans’ 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 veterans’ 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 “agreed” to the proposal but quickly amended that to say, “Well, I think they are going to agree.” The bill does meet the basic limitations on payments spelled out last week by defense officials in testimony before the House Veterans’ Affairs Committee. The Republican bill has three features not included in Webb’s proposal:

– 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.
– 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 bachelor’s 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.
– 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 member’s 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 “on educational benefits for career military officers while ignoring the 75% of service members that choose not to pursue a career in the military.” Hunter said. “S.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 veterans’ 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.” [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 — including at least a dozen U.S. military retirees — 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 — 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 — about $40 million — 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 — about 9,000 mostly retired military members and dependents — 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. — which owns hospitals and clinics in the Philippines — 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 EOB’s 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 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 VA’s 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. “Dr. Katz’s irresponsible actions have been a disservice to our veterans, and it is time for him to go,” said Murray, a member of the Senate Veterans Affairs Committee. “The No. 1 priority of the VA should be caring for our veterans, not covering up the truth.” Akaka, the committee’s chairman, said in a letter to the VA that Katz’s “personal conduct and professional judgment” 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 “Shh!” and claims 12,000 veterans a year attempt suicide while under department treatment. “Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?” the e-mail asks. Another e-mail said an average of 18 war veterans kill themselves each day — and five of them are under VA care when they commit suicide. A VA spokesman declined to comment.

“It is completely outrageous that the federal agency charged with helping veterans would instead cover up the hard truth — 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,” said Sen. Tom Harkin, D-Iowa. “Anyone at the VA who is involved in this cover-up should be removed immediately.” 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. Harkin’s 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 “world-class” 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 (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 “too old” 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 haven’t 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 won’t necessarily help you avoid the problem. While some of the major companies don’t 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.
– Shop Around. If one company where you’re traveling has an upper age limit for rental cars, another company in the same city may not.
– 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.
– 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.
– Don’t Count on the Web. Companies don’t always post rental car age restrictions on their Web sites in a place that is easy to find. If you’re 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 doesn’t 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 state’s DMV regulations regarding driver license revocation. In California:
– 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.
– 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.
– 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 “rising tide” of mental health problems, especially post-traumatic stress disorder. It contends the Department of Veterans Affairs isn’t doing enough to prevent suicide and provide adequate medical care for Americans who have served in the armed forces, a class-action lawsuit that goes to trial this week charges. But government lawyers say the VA has been devoting more resources to mental health and making suicide prevention a top priority. They also argue that the courts don’t have the authority to tell the department how it should operate. The trial began 21 APR in a San Francisco federal court. An average of 18 military veterans kill themselves each day, and five of them are under VA care when they commit suicide, according to a December e-mail between top VA officials that was filed as part of the federal lawsuit. The veterans groups wrote in court papers filed 17 APR that failure to provide care is manifesting itself in an epidemic of suicides. The “trial…does not seek monetary damages but asks the court to appoint a special master or otherwise intervene to make” the VA run more efficiently.

After government lawyers and attorneys representing the veterans made opening statements the executive director of the National Veterans Legal Services Program, testified that U.S. veterans returning from Iraq and Afghanistan don’t have sufficient access to lawyers to help them process health and medical claims when they encounter treatment delays or mistakes a witness for the veterans testified. “Even if we get 1,000 cases placed, there are hundreds of thousands of claims,” Abrams said. Veterans suffering disorders cannot get enough legal aid even though hundreds of lawyers from dozens of law firms have volunteered to help them free of charge, Abrams said. Staff shortages, inadequate care, long waits for therapy, and an adversarial appeals process when care is denied have led to an “epidemic of suicides,” lawyers for Veterans for Common Sense and Veterans United for Truth Inc. have argued. Coincidently the next day U.S. Senator Daniel K. Akaka (D-HI), Chairman of the Veterans’ Affairs Committee, called for the resignation of Dr. Ira Katz, Mental Health Officer for the Department of Veterans Affairs, following reports that Dr. Katz was involved in efforts to cover up the number of veterans attempting suicide.

A study released this week by the RAND Corp. estimates that 300,000 U.S. troops (about 20% of those deployed ) are suffering from depression or post-traumatic stress from serving in Iraq and Afghanistan. “We find that the VA has simply not devoted enough resources,” said Gordon Erspamer, the lawyer representing the veterans groups. “They don’t have enough psychiatrists.” The lawsuit also alleges that the VA takes too long to pay disability claims and that its internal appellate process unconstitutionally denies veterans their right to take their complaints to court. According to Erspamer the VA can take up to 12 to 15 years before it recognizes and compensates a veteran for stress disorder and that when veterans appeal their claims, the courts reverse or send the cases back to VA offices for correction 91% of the time.The department acknowledges in court papers that it takes on average about 180 days to decide whether to approve a disability claim. The groups are asking U.S. District Court Judge Samuel Conti, a World War II Army veteran, to order the VA to drastically overhaul its system. Conti is hearing the trial without a jury. But government lawyers have filed court papers arguing that the courts have no authority to tell the VA how to operate and no business wading into the everyday management of a sprawling medical network that includes 153 medical centers nationwide. The veterans are asking the judge “to administer the programs of the second largest Cabinet-level agency, a task for which Congress and the executive branch are better suited,” government lawyers wrote in court papers.

If the judge ordered an overhaul, he would be responsible for such things as employees workloads, hours of operations, facility locations, the number of medical professionals employed, and “even the decision whether to offer individual or group therapy to patients with PTSD. The VA also said it is besieged with an unprecedented number of claims, which have grown from 675,000 in 2001 to 838,000 in 2007. The rise is prompted not from the current war, but from veterans growing older. Government lawyers in their filings defended VA’s average claims processing time as reasonable, given that it has to prove the veterans disability was incurred during service time. They also noted the VA will spend $3.8 billion for fiscal year 2008 on mental health and announced a policy in June that requires all medical centers to have mental health staff available all the time to provide urgent care. They said that “suicide prevention is a singular priority for the VA. They have hired over 3,700 new mental health professionals in the last two and a half years, bringing the total number of mental health professionals within VA to just under 17,000. This hiring effort continues. [Source: Air Force Times AP Paul Elias article posted : 21 Apr 08 ++]

VA LAWSUIT (LACK OF CARE) UPDATE 06: Department personnel aren’t asking enough questions to determine whether veterans are suicidal, aren’t sharing information about suicide risks with the VA’s network of hospitals and clinics and aren’t implementing their own plans to improve the system, Ronald Maris, a University of South Carolina sociology professor, told U.S. District Judge Samuel Conti in San Francisco on the second day of the trial. A majority of the VA’s counselors, doctors, social workers and psychologists “don’t have the tools and the information that they need to intervene effectively with suicidal vets,” said Maris, a former president of the American Association of Suicidology who has been a consultant to the Army on suicide prevention. He was particularly critical of the VA’s top health care administrator, William Feeley, who said in a pretrial deposition 9 APR that the agency has no systematic national plan for suicide prevention. Feeley also said he was unaware of any methods of tracking veterans at risk of suicide and that suicide rates “are not a metric we are measuring.” “I would say he was singularly uninformed about suicide,” Maris said. During cross-examination of Maris, Justice Department lawyer James Schwartz suggested that Feeley’s comment about suicide rates referred to factors he considered in evaluating VA division chiefs, not his own ignorance about the subject. But Maris said the statement contained no such indication.

The emotional nature of the case was underscored when an unidentified woman rose during Maris’ testimony and denounced “warmongers … eating our children for profit.” The woman spoke for several minutes before being led off by a federal marshal. She was not arrested, the marshal’s office said.
During opening statements 21 APR, a lawyer for the veterans’ groups displayed an e-mail that a top VA mental health official, Ira Katz, sent in December in which he said veterans were committing suicide at the rate of 18 a day. In an interview Maris said Tuesday the suicide rate among veterans has been increasing since 2001, according to government reports he has studied. In court, Maris said a more recent study by top VA mental health official, Ira Katz showed a suicide rate among veterans that was 3.2 times as high as the rate among the general population. A May 2007 report by the VA’s inspector general found a suicide rate 7.5 times as high as the public rate for veterans who were in the department’s health care system, Maris said.

Among the reasons for the disparity, Maris said, is that veterans are mostly men, who generally have higher suicide rates than women; they suffer from depression more often, have higher rates of alcohol and drug abuse than the general population, are separated from their families for long periods and often have access to guns. Maris also faulted the VA’s standard procedure for screening returning soldiers for suicidal tendencies. He said they are asked whether they thought of harming themselves during the previous two weeks or decided life was not worth living. If they deny having any such thoughts, he said, they are classified as nonsuicidal and the questioning ends. That’s far short of the generally accepted standard of care, Maris testified. He said soldiers are often reluctant to admit psychiatric problems and should be asked numerous follow-up questions about such topics as alcohol use, medications, gun ownership, any past suicide attempts and any history of suicide in their family. [Source: San Francisco Chronicle BoB Egelko article 22 Apr 08 ++]

ACM/ICM UPDATE 03: The Department of Defense announced 21 APR that campaign stars are authorized for wear on the Afghanistan Campaign Medal (ACM) and Iraq Campaign Medal (ICM). The campaign stars recognize a service member’s participation in DoD designated campaigns in Afghanistan and Iraq. Service members, who have qualified for the ACM or ICM, may display a bronze campaign star on their medal for each designated campaign phase in which they participated. The stars will be worn on the suspension and campaign ribbon of the campaign medal. Those eligible should contact their respective Military Departments for specific implementation guidance. The three campaign phases and associated dates established for the ACM are:
(1) Liberation of Afghanistan – Sep. 11, 2001 to Nov. 30, 2001.
(2) Consolidation I – Dec. 1, 2001 to Sep. 30, 2006.
(3) Consolidation II – Oct. 1, 2006 to a date to be determined.

The four campaign phases and associated dates established for the ICM are:
(1) Liberation of Iraq – March 19, 2003 to May 1, 2003.
(2) Transition of Iraq – May 2, 2003 to June 28, 2004.
(3) Iraqi Governance – June 29, 2004 to Dec. 15, 2005.
(4) National Resolution – Dec. 16, 2005 to a date to be determined.
[Source: DoD Press Release No. 321-08 dtd 21 Apr 08 ++]

VA FLU SHOTS UPDATE 02: The current flu season has shaped up to be the worst in four years, partly because the vaccine didn’t work well against the viruses that made most people sick, health officials said 18 APR. This season’s vaccine was the worst match since 1997-1998, when the vaccine didn’t work at all against the circulating virus, according to the Centers for Disease Control and Prevention (CDC). The 2007-2008 season started slowly, peaked in mid-February and seems to be declining, although cases are still being reported, CDC officials said. Based on adult deaths from flu and pneumonia, this season is the worst since 2003-2004 – another time when the vaccine did not include the exact flu strain responsible for most illnesses. Each year, health officials – making essentially an educated guess – formulate a vaccine against three viruses they think will be circulating. They guess well most of the time, and the vaccine is often between 70 and 90% effective. But this year, two of the three strains were not good matches and the vaccine was only 44% effective, according to a study done in Marshfield WI which seemed to match the experience in other parts of the country.

The CDC compares flu season by looking at adult deaths from the flu or pneumonia in 122 cities. This year, those deaths peaked at 9% of all reported deaths in early March, and remained above an epidemic threshold for 13 consecutive weeks. In 2003-2004, they peaked at more than 10% of all deaths, and surpassed the epidemic threshold for nine weeks. Pediatric deaths are another way flu seasons are compared. So far this season, 66 children died, including 46 who were not vaccinated. In 2003-2004, 153 children died. Each year, the flu results in 200,000 hospitalizations and 36,000 deaths, according to official estimates. The elderly, young children and people with chronic illnesses are considered at greatest risk.
Type B Florida strain, also absent from this year’s vaccine, has also been causing illness. Marshfield data showed that the vaccine was completely ineffective against the Type B virus, and was 58% effective against the Brisbane virus.
The deputy director of the CDC’s influenza division acknowledged that some people may lose faith in the flu vaccine and skip it next year. But he noted even this year’s mismatched vaccine still offered 44% protection overall and likely reduced the severity of illness in those who got the flu. The Marshfield study and a flu season update are published in a CDC publication, Morbidity and Mortality Weekly Report. The CDC started working with the Marshfield Clinic in central Wisconsin to get a better gauge of vaccine effectiveness while a flu season was in progress. Almost the entire population in the Marshfield area – about 50,000 people – gets health care at clinic offices, which has complete vaccination and electronic medical records. This year, most of the illness has been due to Type A H3N2 Brisbane strain, which was not in the vaccine. That strain tends to cause more hospitalizations and deaths, contributing to this season’s severity, CDC officials said. [Source: ABC News AP Medical Writer Mike Stobbe article 17 Apr 08 ++]

PTSD UPDATE 19: A new study released 17 APR by the RAND Corp. estimates 300,000 U.S. troops are suffering from major depression or post-traumatic stress disorder as a result of serving in the wars in Iraq and Afghanistan, and 320,000 received brain injuries. Of these only about half have sought treatment. The 500-page study is the first large-scale, private assessment of its kind — including a survey of 1,965 service members across the country, from all branches of the armed forces and including those still in the military as well as veterans who have left the services. Its results appear consistent with a number of mental health reports from within the government, though the Defense Department has not released the number of people it has diagnosed or who are being treated for mental problems.

The Department of Veterans Affairs said in APR that its records show about 120,000 who served in the two wars and are no longer in the military have been diagnosed with mental health problems. Of the 120,000, about 60,000 are receiving PTSD treatment. VA is responsible for care of service members after they have left the service, while the Defense Department covers active-duty and reservist needs. Terri Tanielian, the project’s co-leader and a researcher at the nonprofit RAND said in an interview with The Associated Press, “The lack of information from the Pentagon was one motivation for the RAND study. There is a major health crisis facing those men and women who have served our nation in Iraq and Afghanistan. Unless they receive appropriate and effective care for these mental health conditions, there will be long-term consequences for them and for the nation.”

The most prominent and detailed military study on mental health that is released is the Army’s survey of soldiers at the warfront. Officials said last month that its most recent one, done last fall, found 18.2% of soldiers suffered a mental health problem such as depression, anxiety or acute stress in 2007 compared with 20.5% the previous year. The Rand study, completed in January, put the percentage of PTSD and depression at 18.5%, calculating that about 300,000 current and former service members were suffering from those problems at the time of its survey. The figure is based on Pentagon data that show more than 1.6 million military personnel have deployed to the conflicts since the war in Afghanistan began in late 2001. RAND researchers also found:
– About 19%, or 320,000 service members, reported that they experienced a possible traumatic brain injury while deployed. In wars where blasts from roadside bombs are prevalent, the injuries can range from mild concussions to severe head wounds.
– About 7% reported a probable brain injury and current PTSD or major depression.
– Only 43% reported ever having been evaluated by a physician for their head injuries.
– Only 53% of service members with PTSD or depression sought help during the past year.
– Various reasons were given for not getting help, including that they worried about the side effects of medication; believe family and friends could help them with the problem; or that they feared seeking care might damage their careers.
– Rates of PTSD and major depression were highest among women and reservists.

The report is titled “Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery.” It was sponsored by a grant from the California Community Foundation and done by 25 researchers from RAND Health and the RAND National Security Research Division, which also has done work under contracts with the Pentagon and other defense agencies as well as allied foreign governments and foundations. [Source: ArmyTimes AP article by Pauline Jelinek posted 18 Apr 08 ++]

VA HOME LOAN UPDATE 10: The Senate passed a large housing package aimed at increasing housing opportunities for veterans and offering mortgage relief for returning servicemembers. It also increased VA Home Loan limits to the levels offered in the Economic Stimulus package for other federal home loans. The bill now moves to the House for action. The Dodd-Shelby Housing bill includes:
– An increase in the length of time a lender must wait before starting foreclosure involving a returning servicemember, from three to nine months.
– One year of relief from increases in mortgage interest rates for returning servicemembers.
– The establishment of a counseling program carried out by DOD to assist servicemembers and veterans with financial issues.
– Eligibility for VA-provided home improvement and structural alteration payments to totally disabled members of the Armed Forces before their discharge or release from the Armed Forces.
– Extension of specially adapted housing benefits to certain veterans and servicemembers with severe burns
[Source: VFW Washington weekly 18 Apr 08 ++]

MILITARY STOLEN VALOR UPDATE 04: To report suspected fraud involving veterans benefits, other crimes such as Stolen Valor, fraud, waste or mismanagement in the VA, contact the Office of Inspector General Hotline at 1(800) 488-8244 or email at [email protected] or write to VA OIG HOTLINE, PO Box 50410, Washington, DC 20091-0410. [Source: www.va.gov 15 Apr 08]

SBP PAID UP PROVISION UPDATE 05: The Defense Finance and Accounting Service (DFAS) is reviewing all military retiree accounts affected by Section 1452(j) of Title 10 U.S. Code, commonly referred to as “Paid-up SBP.” Under the law, reductions in retired pay for the Survivor Benefit Plan will be terminated effective 1 OCT 08 for eligible retirees. The law applies to retired members who are 70 years old and have paid SBP or Retired Serviceman’s Family Protection Plan premiums for at least 360 months, or 30 years. Retirees who are at least 70 years old and have paid at least 360 months of premiums on 1 OCT will have their monthly premiums terminated. The change will be reflected in the NOV 08 pay statement. If a retiree does not meet the eligibility criteria on 1 OCT, the premiums will stop when the retiree has met both criteria: reached age 70 and paid SBP premiums for 360 months. Eligible retirees will be notified by the DFAS via mail regarding the status of their account and premium payment count. [Source: DFAS Release No. 04-07-08 dtd 18 Apr 08 ++]

VA HOMELESS VETS UPDATE 09: U.S. Department of Veterans Affairs Secretary James B. Peake and U.S. Housing and Urban Development Deputy Secretary Roy A. Bernardi have announced $75 million to provide permanent supportive housing for an estimated 10,000 homeless veterans nationwide. Bernardi and Peake made the announcement with Mayor Michael R. Bloomberg at a newly renovated housing program for homeless veterans in Queens NY, and emphasized the Federal and local government’s partnership to house and support America’s homeless veteran population. HUD’s Veterans Affairs Supportive Housing Program (HUD-VASH) will provide local public housing agencies with rental assistance vouchers specifically targeted to assist homeless veterans in their area. In addition, the VA and HUD will link local public housing agencies with VA Medical Centers to provide supportive services and case management to eligible homeless veterans. HUD will allocate the housing vouchers to local public housing agencies (PHAs) across the country that are specifically targeted to homeless veterans based on a variety of factors, including the number of reported homeless veterans and the proximity of a local VA Medical Center with the capacity to provide case management. New York City and the greater Los Angeles area received the greatest number of vouchers using this criterion.

HUD will provide housing assistance through its Section 8 Housing Choice Voucher (HCV) program which allows participants to rent privately owned housing. The VA will offer eligible homeless veterans clinical and supportive services through its medical centers across the U.S and Puerto Rico. Last year, the VA provided health care to more than 100,000 homeless veterans and other services to over 60,000 veterans in its specialized homeless programs. The Bush Administration’s proposed FY 2009 Budget seeks to double the amount of funding announced to provide an additional $75 million to support the housing and service needs of an additional 10,000 homeless veterans across America. Local communities or “Continuums of Care” that receive HUD homeless assistance will work with local VA Medical Centers to identify eligible participants. The VA will then screen homeless veterans to determine their eligibility. Those eligible vets will receive treatment and regular case management to retain the voucher. VA Medical Center case managers will also work closely with local housing agencies to help participants find suitable housing. Participating PHAs will also determine income eligibility in accordance to HUD regulations for the HCV program. [Source: TREA Washington Update 18 Apr 08 ++]

TFL HOSPITAL COVERAGE: The retired enlisted Association (TREA) has learned that some hospitals are playing games with Medicare and as a result, some Tricare users are ending up owing hospitals large amounts of money. The rule that if medical care providers accept Medicare they must accept Tricare apparently is not always applicable. It turns out that the hospitals still accept Tricare, and they still accept Medicare payments if the patient has previously been treated in that hospital. However, they are not accepting any new Medicare patients. Thus, if the Tricare insured has not previously been a patient at that hospital, the patient ends up having to pay the Medicare portion of the bill out of pocket. The Medicare portion for TFL beneficiaries is normally 80% but under these conditions payment under Tricare Standard should apply the same as it does for overseas users. They pay 25 % of the bill in addition to the $150 deductible since Medicare provides no coverage outside the USA. Although this seems very unfair and is really “playing games” with Medicare and with patients, it is legal. Accordingly, Medicare eligibles need to make sure anytime they are having scheduled hospitalization that the hospital will take both Tricare and Medicare if they are a new patient in that hospital. If not, verify with your Tricare regional office if Tricare Standard rules will apply. Also, it might be prudent to check with your local hospital what their policy is in the event you will have to use them for emergency treatment in the future. [Source: TREA Washington Update 18 Apr 08 ++]

ASTHMA UPDATE 01: A comprehensive review of 54 dust-control strategy studies found that none was effective enough in reducing exposure to dust mites that it would improve one’s asthma. The methods looked at included using chemicals to kill the little buggers, encasing mattresses and pillows in mite-proof covers, frequently washing linens in hot water or bleach, and even tossing toys, plants and furniture out of a home. Peter Gotzsche, director of The Nordic Cochrane Centre in Copenhagen, Denmark, said in a prepared statement, “We can conclude with confidence that there is no need to buy expensive vacuum cleaners or mattress covers or to use chemical methods against house dust mites, because these treatments do not work. If you are wondering why it is that mattress covers and the other strategies are not effective, the likely answer is that all these treatments do not have a large enough effect on the occurrence of allergens from house dust mites. The level of allergens is so high in most homes that what remains after the treatment is still high enough to cause asthma attacks.” The review was just published in The Cochrane Library.

Dust mites are microscopic arthropods that carry allergens that irritate bronchial passages and trigger asthma attacks. For years, people have tried to defeat dust mites, but they apparently outnumber and outmaneuver human ingenuity. Asthma attacks can be brought on in mite-sensitive people even when allergen levels are very low. For example, while some of the anti-dust methods reviewed cut allergen levels in half, even 90% elimination proved inadequate to help many asthma sufferers,. Gotzsche said the review, shows people are being mislead by the 2007 U.S. guidelines from the National Asthma Education and Prevention program. The program recommends actions such as putting mattresses and pillows in dust-proof encasings, and weekly hot water washings of sheets, blankets and stuffed toys. “Reviews and guidelines should reflect the facts,” he said. “It is difficult, perhaps, to realize that we cannot really do anything, but there is no evidence to support these guidelines, and they are misleading. It is about time specialists start becoming honest with patients.” [Source: Health Behavior News Service news release 15 Apr 08 ++]

VET HUNTING PERMITS:
– Vermont Gov. James Douglas signed into law a special moose permit lottery for veterans of the wars in Iraq and Afghanistan. This year, five of Vermont’s 1,260 moose-hunting permits will be set aside for returning veterans and they will be allowed to apply for the regular, statewide lottery, as well as the special one for them. If you’re a Veteran and possess, or are eligible to receive, a campaign ribbon for Operation Iraqi Freedom or Operation Enduring Freedom, and a Vermont resident, check box 4 on the 2008 Vermont Moose Permit Application to be included in a special priority drawing. For more information refer to www.vtfishandwildlife.com/hunttrap_lottery.cfm.
– A recent decision by the Missouri Conservation Commission extended small-game hunting and fishing permit exemptions to all nonresident military veterans who have service-related disabilities of 60% or more or who were prisoners of war during military service the same hunting and fishing permit exemptions as resident disabled veterans and allowing such nonresident veterans to purchase resident permits. The change is not an exemption from all permit requirements. They still must purchase Missouri deer and turkey hunting, migratory bird hunting and trapping permits if they want to engage in those activities. Exempt veterans must carry a certified statement of eligibility from the U.S. Department of Veterans Affairs (VA) when purchasing permits or exercising permit privileges. For more information, contact the Missouri Department of Conservation, P.O. Box 180, Jefferson City, MO 65102-0180 or refer to mdc.mo.gov.
[Source: NAUS Weekly Update 18 Apr 08 ++]

VA BLUE WATER CLAIMS UPDATE 02: The Department of Veterans Affairs (VA) has rescinded provisions of its Adjudication Procedures Manual M21-1. 72 FR 66218 (i.e. Manual M21-1) that were found by the U.S. Court of Appeals for Veterans Claims (Veterans Court) not to have been properly rescinded. This rescission was effective April 15, 2008. Steps leading to this change started on 27 NOV 07 when VA proposed to rescind certain provisions of its Manual M21-1. The notice was necessitated by the opinion rendered by the Veterans Court in Haas v. Nicholson, 20 Vet. App. 257 (2006). Although VA’s appeal of that decision has been submitted to the U.S. Court of Appeals for the Federal Circuit, that court has not yet issued a decision in the case. In the interim the comment period has ended which allowed VA to proceed with the proposed changes. VA received more than 75 comments, most of which were very similar and can be addressed in three categories:
(1) Citation to scientific evidence, in particular a 2002 study performed for Australia’s Queensland Health Scientific Services by their National Research Center for Environmental Toxicology, titled, Examination of the Potential Exposure of Royal Australian Navy Personnel to Polychlorinated Dibenzodioxins and Polychlorinated Dibenzofurans Via Drinking Water (the Australian study);
(2) Personal stories about the commenter’s experiences during service and/or their current illnesses;
(3) Arguments presented in connection with the Haas litigation.

In VA’s view the comments were not substantial enough to halt changes to M21-1 because:
– The cited scientific studies were of minimal relevance due to the manner in which they were conducted
– VA cannot presume exposure to herbicides simply because a veteran has a disease linked to exposure to herbicides.
– VA does not agree with statutory-interpretation arguments that have been presented
to the Federal Circuit in the Haas litigation. Specifically, that the language of 38 U.S.C. 1116 plainly requires that offshore service be considered service “in the Republic of Vietnam” for purposes of that statute. In VA’s opinion, the Veterans Court held that neither the language nor the legislative history of Sec. 1116 reflects a clear intent to treat offshore service as service in the Republic of Vietnam (Haas, 20 Vet. App. at 264- 68). However, they did note that this issue remains pending before the Federal Circuit.

The result of the changes is that you will no longer be able to argue that the receipt of the Vietnam Service medal has any bearing on your veterans claim to exposure to agent orange. (NOTE: if you have a pending claim in effect before or after the original Haas decision, but before the 15 APR08 VA change, whatever the Federal Appeals court decides will govern your entitlement). Bottom line Blue Water Navy can still attempt to show exposure to Agent Orange, but not based on receipt of the Vietnam Service medal (if a claim is filed after April 15, 2008). For additional info refer to bluewaternavy.org [Source: VALAW.org Ray B. Davis msg. 17 Apr 08 ++]

WINDOWS VISTA UPDATE 04: Following Microsoft’s announcement that it will stop selling and supporting most versions of Windows XP from 30 JUN 08, online forums and blogs have attracted impassioned consumer comments opposed to the decision by the software giant. On the IT website InfoWorld, Galen Gruman launched the ‘Save Windows XP’ online campaign that has received 111,543 responses to date. The petition states, “Millions of us have grown comfortable with XP and don’t see a need to change to Vista. It’s like having a comfortable apartment that you’ve enjoyed coming home to for years, only to get an eviction notice”. As the disappearance of Windows XP computers from retailers and the phasing out of technical support looms, an increasing number of blog posts on the website are adopting a panicked tone. In an apparent attempt to placate fans of XP, Microsoft recently extended the availability of Windows XP Home for ultra-low-cost PCs until 2010, and system builders will be able to sell Windows XP until JAN 09. Ullrich Loeffler, program manager A/NZ for analyst firm IDC said Microsoft has made the right move by weaning users off the popular operating system gradually. “It makes sense for Microsoft to keep customers happy in the meantime, while working on a successor version of Windows.” In a recent article he noted that Bill Gates reportedly said the new version of Windows would include features related to mobility and touch screen technology. Loeffler predicted the new Windows 7 operating system to be released in a few years will most likely be based on the Vista code. Consequently, Microsoft is faced with the challenge of elevating consumer opinion of Vista, he stated. “A lot of companies that I’ve dealt with are of the opinion ‘if it aint broke don’t fix it’. XP is a stable environment and has a huge footprint in the market so for a lot of companies to move away from this stable system there has to be major benefits,” he explained. “From what I can see a lot of companies don’t see that in Vista, they don’t see an incentive in moving across.” [Source: IT News Leanne Mezrani article 16 Apr 08 ++]

REAP UPDATE 02: A bipartisan group of U.S. Senators—including Blanche Lincoln (D-AR) Sherrod Brown (D-OH), Bob Casey (D-PA), Amy Klobuchar (D-MN), Mike Crapo (R-ID), Gordon Smith (R-OR), John Kerry (D-MA), Barbara Mikulski (D-MD), Ken Salazar (D-CO), and Evan Bayh (D-IN.)— unveiled their plan 16 APR to provide the men and women of our National Guard and Reserves with benefits that better reflect their increased service to our country. The Reserve Educational Assistance Program (REAP) Enhancement Act of 2008 (S.2871) would make three much-needed improvements to the structure and value of the Montgomery G.I. Bill education benefits for our citizen soldiers by:
– Providing accruable benefits for those who have served multiple deployments;
– Replacing the current three-tiered formula for REAP benefits with one that more accurately reflects service rendered; and
– Shifting jurisdiction of REAP benefits from the Department of Defense to the Veterans Administration (i.e. from Title 10 to Title 38).

The REAP Enhancement Act builds on the progress of Sen. Lincoln’s Total Force Educational Assistance Enhancement and Integration Act of 2007 (S.644). A significant provision of that bill—allowing citizen soldiers who have served combat tours to access their educational benefits for up to ten years following their service, just as active duty soldiers have been able to do—was signed into law as part of the 2008 National Defense Authorization Act. The REAP Enhancement Act is endorsed by the Military Officers Association of America and the Enlisted Association of the National Guard of the United States. [Source: Sen. Sherrod Brown Press Release 16 Apr 08 ++]

SOLE SURVIVOR UPDATE 02: Congressman, Rep. Devin Nunes, is leading an effort to pass a bill that would ensure basic benefits to all soldiers who are discharged under an Army policy governing sole surviving siblings and children of soldiers killed in combat. The rule is a holdover from World War II meant to protect the rights of service people who have lost a family member to war. The Hubbard Act (H.R.5825), introduced 16 APR, would for the first time detail the rights of sole survivors, and extend to them a number of benefits already offered to other soldiers honorably discharged from military service. The bill, co-sponsored by Rep. Jim Costa (D-CA), would waive payback of their enlistment bonuses, allow them to participate in G.I. educational programs, give them separation pay and access to transitional health care. H.R.5825 has strong bi-partisan support with 248 co-sponsors. Additionally, Sen. Diane Feinstein (D-CA) has introduced a Senate companion bill, S.2874. cosponsored by Sen. Saxby Chambliss, R-Ga. The Department of Defense has identified 52 sole survivors since the Sept. 11 attacks. According to Army spokesman Maj. Nathan Banks the Army will adopt to any changes in policy springing from the legislation. [Source: ArmyTimes AP Garance Burke article 17 Apr 08 ++]

VA REGULATIONS CHANGE UPDATE 01: The Veterans Affairs Department is engaged in a massive project to rewrite benefit claims regulations using plain language with the goal to make them clearer and more consistent. For example, VA used its plain language policy on 12 APR, when it issued a proposed rule for claims dealing with disability and death benefits. The new rule also covers claims based on new and material evidence, claims based on hospitalization, and requests to increase benefits. In the introduction to the new rule, VA officials said the purpose of the plain language project was to reorganize “compensation and pension rules in a logical, claimant-focused and user-friendly format.” Steve Smithson, deputy director for the Veterans Affairs and Rehabilitation Commission at the American Legion, said the term plain language will be interpreted by what he called “the VA mind-set. . . . It’s as plain as they are going to get.” The department started the Regulation Rewrite Project in 2002 in response to recommendations made in the VA Claims Processing Task Force Report, which was released in OCT 01. The project is a “huge, complex task dealing with thousands of regulations” in Part 38 of the Code of Federal Regulations, Smithson said. VA is attempting to make this mass of regulations more understandable by putting them in one coherent area rather than spreading them all over the place.

Gerald Manar, deputy director of the Veteran of Foreign Wars’ national veterans service, said, as he understands the rewrite process, the new plain language code eventually will contain electronic hooks, which will make it easier to search regulations and link from one to another. Manar said he considered the term plain language to be somewhat misleading, because VA regulations are complex and quite hard to understand, although the new regulations may have less legalese. VA could end up with wordier regulations, he said, because it could take longer explanation to make benefits requirements clearer. He drew an analogy between the old and new way of writing regulations, saying trying to understand the rewritten regulations could create a headache treatable with only two aspirin, while trying to comprehend the old regulations may have resulted in a headache that would have required an entire bottle to treat.
Manar predicted that the new regulations would be a boon to lawyers representing veterans who have disputed compensation claims because the lawyers will view new language and definitions as a basis for litigation. The House on 14 APR passed a bill requiring federal agencies to use plain language in commonly-used forms. The legislation covers tax, benefit and Social Security forms, grant applications and other public documents, but not federal regulations. [Source: GOVExec.com Bob Brewin article 15 Apr 08 ++]

VA INDEPENDENT LIVING PROGRAM UPDATE 01: On 15 APR Senator Daniel K. Akaka (D-HI), Chairman of the Veterans’ Affairs Committee, introduced the proposed Training and Rehabilitation for Disabled Veterans Enhancement Act of 2008 (S.2864). The bill stems in part from a 5 FEB 08 congressional hearing on vocational rehabilitation, as well as Committee oversight. In addition, it responds to a DEC 07 VA Inspector General report. If enacted, this bill will improve the Department of Veterans Affairs’ Independent Living (IL) program conducted under the authority of chapter 31 of title 38, United States Code, which serves veterans whose disabilities render them unable to work. VA’s IL Program was first established in 1980 by Public Law 96-466, the Veterans Rehabilitation and Education Amendments of 1980. Initially, that law provided for the establishment of a four-year pilot program designed to provide independent living services for severely disabled veterans for whom the achievement of a vocational goal was not reasonably feasible. The number of veterans who could be accepted annually into the pilot program was capped at 500. In 1986, the program was extended through 1989 and then, in 1989, it was made in Public Law 101-237, the Veterans’ Benefits Amendments of 1989. In 2001, the 500 annual cap on enrollees was increased to 2,500. The VA’s Inspector General found, in a report issued in DEC 07, that the effect of the statutory cap has been to delay IL services to severely disabled veterans. This delay happens because VA has developed a procedure that holds veterans in a planning and evaluation stage when the statutory cap may be in danger of being exceeded. By removing the cap on the number of enrollees in the program and making it an official objective of the program to improve veterans’ quality of life Akaka believes it will lead to bettering program participant’s chances of rehabilitation and future employment. [Source: SCVA Press Release 15 Apr 08 ++]

MEDICARE PART D UPDATE 21: President Bush recently submitted a bill to Congress that would raise Medicare Part D premiums for seniors. The proposal would increase prescription drug premiums for individuals with incomes exceeding $82,000 and for couples with incomes greater than $164,000. Premiums would more than triple for individuals with incomes over $205,000 and couples with incomes over $410,000. Although fewer than 5% of people with Medicare drug coverage would be affected at first, increasing numbers of middle-income seniors and the disabled would pay higher premiums in the future. The President’s proposal also would freeze the income thresholds, with no annual adjustment. This would cause a problem similar to one currently affecting the taxation of Social Security benefits. When the tax was first enacted in 1983, the public was told that only higher income seniors would be affected. But because the income thresholds are not adjusted, and have remained at $25,000 for individuals and $32,000 for couples, middle-income seniors pay taxes on their benefits today.

The proposal comes in response to a forecast by Medicare Trustees that by 2013 more than 45% of Medicare’s spending will come from general tax revenue, as opposed to dedicated payroll taxes and premiums paid by beneficiaries. Under the 2003 Medicare drug law, the President must propose legislation to limit the government portion of Medicare spending and Congress is required to give the proposals expedited consideration. The law, however, does not force Congress to vote. The President’s Medicare bill does not include proposals to cut payments to hospitals or other health care providers. He did, however, submit an annual budget that would cut an estimated $481 billion from Medicare over the next ten years, according to the Congressional Budget Office. Despite the deep and widespread cuts, President Bush did not cut subsidies for private Medicare Advantage plans. The plans cost the government about 12% more than it pays for seniors enrolled in traditional Medicare. Since 2000, Social Security benefits have increased 22%, but Part B premiums have increased 111%.” [Source: New York Times article 16 Feb & CBO report 3 Mar 08 ++]

VA COMP PAYMENT DISPARITY UPDATE 10: Ohio ranked second-to-last in compensation for disabled veterans, and federal lawmakers are looking at why cases in other states collect thousands of dollars more. More than 85,000 veterans in Ohio receive disability payments, and they routinely trail their peers from other states, according to the U.S. Department of Veterans Affairs survey from 2006. Only Indiana’s disabled veterans earned less. Rep. Zack Space (D-OH-18) is pushing for the VA to have a national standard for payments. Veterans in Ohio receive as much as $4,800 less than those in New Mexico. Veterans in Oklahoma receive $4,185 more than their Ohio peers, and those in West Virginia earn $3,857 more. Space and his colleagues on the House Committee on Veterans’ Affairs are looking into the disparity. Part of the reason for the gap is that each state’s veterans’ system sets its own standards for disability. For instance, a soldier in one state might be classified as only partially disabled and thus eligible for small payments. The same veteran could be seen as a more serious case in another state and eligible for greater payment. Towards this Rep. Space introduced H.R.5709 on 3 APR which would instruct the VA to watch over the system and evaluate how states rate disabilities. The bill has been referred to the House Committee on Veterans’ Affairs and presently has no cosponsors. VA spokesman Steven Westerfeld said the department has started training workers who decide each veteran’s level of disability. He also said the VA is considering consolidating the grading system. [Source: ArmyTimes AP article 14 Apr 08 ++]

VA DENTAL TREATMENT UPDATE 02: U.S. Representative Mark Kirk (R-IL) joined with local veterans 15 APR to introduce bipartisan legislation that would significantly boost dental care for service-connected disabled veterans. The “Make Our Veterans Smile Act” (H.R.5595) was co-introduced on 12 MAR by Congressman Kirk and Congressman Chris Carney (D-PA), the U.S. House’s only actively serving U.S. Navy Reserve intelligence officers. Currently, only 100% disabled, homeless or prisoner-of-war veterans are eligible for dental benefits. The bill expands dental coverage to any service-connected disabled veteran, regardless of disability rating starting 1 JAN 09. This legislation also allows the VA to use contractor facilities if they find it necessary to meet the demands for dental care. The bill was referred to the House committee on Veteran Affairs and has already gained 44 cosponsors. According to the U.S. Veterans Administration, 258,000 veterans currently are eligible for dental benefits. More than 2.5 million additional disabled veterans would receive coverage under the Kirk-Carney bill. In Illinois, coverage would expand from nearly 5,000 veterans to more than 60,000 veterans, according to the Congressional Research Service. [Source: Rep. Christopher P. Carney Press release 13 Mar 08 ++]

IRS COLLECTION POLICY UPDATE 01: On 15 APR the House of Representatives today approved the Taxpayer Assistance and Simplification Act of 2008 (H.R.5719) by a vote of 238 to 179. The legislation, introduced by Rep. Charles B. Rangel (D-NY) and Oversight Subcommittee Chairman John Lewis (D-GA) of House Ways and Means , would modernize Internal Revenue Service functions to provide protections to taxpayers and improve outreach. Additionally, the bill repeals the IRS Private Debt Collector program, an imprudent outsourcing of an inherent government function that to date has spent $75 million to collect just $35 million. The bill is the result of hearings conducted by the Oversight Subcommittee. The provisions included in H.R. 5719 as agreed to by the Committee would:

– Repeal the IRS’s authority to use private debt collection companies to collect Federal taxes.
– Eliminate the special requirements for individuals to keep detailed records of calls made on employer-provided cell phones.
– Delay for one year the imposition of a three-percent withholding requirement on government payments for goods and services made after 31 DEC 10.
– Stop federal contractors from using foreign subsidiaries to evade Social Security and other employment taxes.
– Make the administrators of state and local government programs liable for paying the employment taxes on amounts paid by government programs to in-home care workers provided to elderly and disabled persons.
– Prohibit the misuse of Department of the Treasury names and symbols in misleading websites and phishing schemes.
– Protect low-income taxpayers by prohibiting IRS debt indicators for predatory refund anticipation loans, allowing IRS employees to refer taxpayers to qualified low-income taxpayer clinics, and authorizing funding for Volunteer Income Tax Assistance (“VITA”) programs.
– Require the IRS to notify taxpayers if it suspects theft of a taxpayer’s identity.

The bill will now go to the Senate for approval and if ultimately signed into law by the President its provisions will be added to the federal tax code. At present the federal income tax code is nearly 1.3 million words long, 282 times as many words as the Constitution. In 2006, the IRS estimated individuals and businesses spent 6.65 billion hours complying with the tax laws. The 1040EZ form, which is supposed to be the simplest form in IRS inventory, on average required 3 hours and 46 minutes to complete. In the interim, the current Senate Budget Resolution includes plans for a tax increase of $1.2 trillion. If the budget is enacted, 116 million taxpayers will see a tax increase and the national debt will increase to $2 trillion by 2013. Under the Senate-passed proposal, 43 million families will see their taxes increase by an average of $2,300, 18 million seniors will pay $2,200 more in taxes, and 27 million small business owners will face a tax increase of $4,100. The resolution passed the Senate by a vote of 51 to 44. [Source: House Ways & Means Committee Press Release 15 Apr 08 ++]

SCHOLARSHIP APPLICATION DEADLINE SEASON: The approach of spring marks many events, but one event that seldom comes to mind is Scholarship Application Deadline Season (SADS). There is no such date on the calendar, but the truth is most scholarship application deadlines occur between March and June. This means that if you or a loved one are considering going to school in September, you should start applying for some of the available military and veteran related scholarships. Of the more than $300 million being offered many go unclaimed because students don’t know where to look or find them too late to apply. A useful online resource to help the military community find scholarships and learn how, where, and most importantly, when to apply is the Military.com’s Scholarship Finder. At aid.military.com/scholarship/search-for-scholarships.do you can complete an interactive form to Learn about schools and programs that can help reach the educational goals of you and your dependents. Some quick tips to help your search are:

– Do your homework. Take advantage of the free online scholarship search at Military.com‘s Scholarship Finder. The Scholarship Finder lists over 1,000 scholarships from a variety of sources.
– Don’t limit yourself. You qualify for non-military related scholarships too. Visit your local library to find scholarship directories that list awards based on age, state of residence, cultural background, and field of study.
– Search in your military community. Many service aid organizations and associations, like the Navy Marine Corps Relief Society, offer scholarships, grants, and low interest loans to help cover education expenses. Click here to find out more about your Service Aid Organization’s education assistance programs.
– It’s never too soon to start your scholarship search. Many scholarship application deadlines are as early as a year in advance.
[Source: Military.com 14 Apr 08 ++]

TRICARE AUTISM CARE: The Department of Defense (DoD) and Tricare announced 15 MAR a demonstration project to care for active duty military dependents diagnosed with Autism. This program allows reimbursement for educational intervention services, such as Applied Behavior Analysis (ABA), delivered by paraprofessional providers. ABA is a systematized process of collecting data on a child’s behaviors and using a variety of behavioral conditioning techniques to teach and reinforce desired behaviors while extinguishing harmful or undesired behaviors. Time-limited, focused ABA methods have been shown to improve communication abilities, reduce or eliminate specific problem behaviors and teach new skills to some individuals with autism. Tricare is in need of ABA professionals, or supervisors, and paraprofessionals, or tutors, to provide services that will enhance the effectiveness of academic instruction and provide training in life skills (language, communication, self help, activities of daily living, etc.). DoD has been a leader in providing coverage for health and special education services for children with autism. Tricare is one of the very few health plans providing coverage for special education services. In recent years, the per month special needs benefit for qualifying active duty family members under Tricare’s Extended Care Health Option (ECHO) was increased from $1,000 to $2,500; however, Tricare beneficiaries still find it difficult to obtain services from authorized ABA providers.

Tricare authorized providers are currently limited to those recognized by the Behavior Analyst Certification Board (BACB). However, the professionalization of the field remains in its infancy and the number of BACB-certified behavior analysts is limited. These certified professionals are for the most part providing behavior analysis evaluation and intervention planning services rather than the one-on-one technical intervention that is the actual tool effecting behavior change in autistic children. This new field has yet to define the provider class that delivers the one-on-one technical services to children. ABA tutors will increasingly be asked to provide services to the many children being diagnosed with ASD. Tricare’s three Managed Care Support Contractors are building a referral network of ABA providers who will agree to be reimbursed for Tricare-eligible beneficiaries referred for care. Providers and beneficiaries wanting more information should contact:
– TRICARE North Region – Health Net Federal Services (877) 874-2273. This region provides health care services and support in Connecticut, Delaware, the District of Columbia, Illinois, Indiana, the Rock Island Arsenal area of Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, the St. Louis area of Missouri, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, the Fort Campbell area of Tennessee, Vermont, Virginia, West Virginia and Wisconsin.
– TRICARE South Region – Humana Military Healthcare Services (800) 444-5445. This region provides health care services and support in Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Oklahoma, South Carolina, most of Tennessee and the eastern portion of Texas.
– TRICARE West Region – TriWest Healthcare Alliance (888) 874-9378. This region provides health care services and support in Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (except for the Rock Island Arsenal area), Kansas, Minnesota, Missouri (except for the St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, the extreme western portion of Texas, Utah, Washington and Wyoming.

TRICARE Management Activity, the Defense Department activity that administers the health care plan for the Uniformed Services, retirees and their families, serves more than 9.2 million eligible beneficiaries worldwide in the Military Health System (MHS). The mission of the MHS is to enhance the Department of Defense and national security by providing health support for the full range of military operations. The MHS provides quality medical care through a network of providers, military treatment facilities, medical clinics, and dental clinics worldwide. For more info on what coverage is provided by Tricare for autistic children of active duty and retirees refer to one of the three Managed Care Support Contractors above. For more about the MHS refer to www.health.mil. For more information on neurological disorders such as autism or research programs funded by the National Institute of Neurological Disorders and Stroke refer to www.ninds.nih.gov. [Source: MHS News Release 15 Apr 08 ++]

TRICARE SELECTION CONSIDERATIONS: One of the first things on a new retiree’s checklist after leaving active duty is health care. With the Tricare fee increase proposals the decision on where it will be obtained from is even more critical. Factors that must be considered are extent of family protection, cost, and whether or not supplemental insurance will be required. Many retirees start a second career and enroll in their new employer’s health care plan. Others stay with Tricare and are comfortable with the process. A prime consideration whether you are a new military retiree or a seasoned one is does your current or potential health care program cover all costs? For a number of years now DoD has drafted plans that will drastically increase Tricare enrollment fees and deductibles for 3 million retirees under age 65 and their families to help slow the government’s increasing cost of health care. One aim of these proposals is to encourage working-age retirees to enroll in an employer’s program or switch to other available plans.

If the proposals are approved some retirees will have no choice except to use the Tricare program. Others have options. As with any new program, the key is to get all the facts. Depending on your options Tricare may no longer be the best deal for you. It is recommended you get all the information you can on your own and compare prices. Some employer health care programs provide the employee with limited options. The following questions will guide you toward the best purchase:
– Must I meet a deductible before the plan begins to pay?
– Is there a maximum limit on benefits?
– Is there a pre-existing condition clause?
– Is there a waiting period before the policy becomes effective?
– Will the plan cover amounts beyond what Tricare allows?
– Does the plan pay for services that aren’t covered by the policy?
– Does the plan specifically not cover certain conditions?
– Must certain kinds of care be approved before treatment?
– Is inpatient care covered?
– Is there outpatient or long-term care coverage?
– Will the plan pay the outpatient deductible?
– Will a new plan pay the same as my cost-share under the Tricare diagnosis-related group payment system?
– Will the plan cover enrollment fees or co-payment?
– Does the plan offer reduced premiums or premium adjustments if I participate in managed health care plans?
– Does the plan convert to a Medicare supplement? If so, must it be in force for any specified length of time before conversion?
– Will the plan cover me overseas?
– How will the plan require premium payments? Monthly? Quarterly?
– Can premium payments be increased?
– Does the plan offer rates based on military retired status or based on an age scale?
– Does coverage continue for surviving spouses at no charge?
– What’s the time limitation, if any, for filing a claim?
– If I am a smoker, does the plan have higher rates?

The Defense Department has expressed concern over the recent influx of military retirees into the Tricare program and away from employer-provided health care. Certainly, this concern shouldn’t override the promise Congress made to its sons and daughters who wore the military uniform, protected our country, and gave their all when unique demands were placed upon them and their families. Unfortunately, our military retirees will have to dig deeper into their pockets. [Source: Air Force Times article by Alex Keenan MCPO USCG (Ret) 9 JAN 05 ++]

VETERAN LEGISLATION STATUS 29 APRIL 08: For a listing of Congressional bills of interest to the veteran community that have been introduced in the 110th Congress refer to the Bulletin’s 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 thomas.loc.gov you can also review a copy of each bill’s 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 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 veteran’s 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 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 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 Apr 08 ++]

HAVE YOU HEARD: How to know when you are in the presence of a ‘Real Chief Petty Officer’:
– The CHIEF doesn’t sleep with a night light. The CHIEF isn’t afraid of the dark. The dark is afraid of the CHIEF.
– The CHIEF’s tears can cure cancer.
– The CHIEF once visited The Virgin Islands. They are now simply called The Islands.
– The CHIEF has counted to infinity . . . twice!
– The CHIEF frequently donates blood to the Red Cross, just never his own.
– Superman owns a pair of CHIEF pajamas.
– The CHIEF has never paid taxes. He just sends in a blank form and includes a picture of himself.
– If the CHIEF is late, then time had damn well better slow down.
– The CHIEF actually died four years ago, but the Grim Reaper can’t get up the courage to tell him.
– The CHIEF refers to himself in the fourth person.
– The CHIEF can divide by zero.
– If the CHIEF ever calls your house, be in!
– The CHIEF doesn’t leave messages; he leaves warnings.
– The CHIEF can slam a revolving door.
– The CHIEF was sending an email one day, when he realized that it would be faster to run.
– When the Incredible Hulk gets angry, he transforms into the CHIEF.
– When the CHIEF exercises, the machine gets stronger.
– Bullets dodge the CHIEF.
– The CHIEF once took an entire bottle of sleeping pills. They made him blink. . . once.
– The first lunar eclipse took place after the CHIEF challenged the sun to a staring contest. The sun blinked first.
– The REAL CHIEF never used a question mark in his entire life. He believes that the interrogative tense is a sign of weakness.
– REAL CHIEFS think Ensigns should be seen and not heard, and never, ever be allowed to read books on leadership.
– REAL CHIEFS do not have any civilian clothes.
– REAL CHIEFS have CPO Association Cards from their last 5 commands.
– REAL CHIEFS do not remember any time they weren’t Chief’s.
– REAL CHIEFS favorite national holiday is CPO Initiation.
– REAL CHIEFS keep four sets of dress khaki uniforms in the closet in hopes they will come back.
– REAL CHIEFS favorite food is shipboard SOS for breakfast.
– REAL CHIEFS don’t know how to tell civilian time.
– REAL CHIEFS call each other ‘Chief.’
– REAL CHIEFS greatest fear is signing for property book items.
– REAL CHIEFS dream in Navy blue and gold, white, haze Gray and occasionally khaki.
– REAL CHIEFS have served on ships that are now war memorials or tourist attractions.
– REAL CHIEFS get tears in their eyes when the Chief’ dies in the movie ‘ Operation Pacific.’
– REAL CHIEFS Don’t like Certified Navy Twill. Wash Khaki is the only thing to make a uniform out of.
– REAL CHIEFS can find their way to the CPO Club blindfolded, on 15 different Navy Bases.
– REAL CHIEFS have pictures of ships in their wallets.
– REAL CHIEFS do not own any pens that do not have ‘Property of U.S. Government’ on them.
– REAL CHIEFS do not get the mandatory flu shots.
– REAL CHIEFS do not order supplies, they swap for them.
– REAL CHIEFS favorite quote is from the movie Ben Hur, ‘We keep you alive to serve this ship.’
– REAL CHIEFS think excessive modesty is their only fault.
– REAL CHIEFS hate to write evaluations, except for their own.
– REAL CHIEFS turn in a 4 page brag sheet for their evaluation.
– REAL CHIEFS last ship was always better.
– REAL CHIEFS know that the black tar in their coffee cup makes the coffee taste better.
– REAL CHIEFS idea of heaven: Three good PO1’s and a Division Officer who does what he is told.
– REAL CHIEFS think John Wayne would have made a good Chief, if he had not gone soft and made Marine movies.
– REAL CHIEFS use the term ‘Good Training’ to describe any unpleasant task such as scraping the sides of the ship or having to sleep on your seabag in the parking lot because there was no room in the barracks.
[Source: A Real Chief 21 Apr 08 ++]

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