Volume 24 Number 4 Jul - Aug 2010

Transcription

1 Volume 24 Number 4 Jul - Aug 2010 Proposed Regulation Change Adds Illnesses to List of Diseases Subject to Presumptive Service Connection for Herbicide Exposure Well over 100,000 Veterans exposed to herbicides while serving in Vietnam and other areas will have an easier path to qualify for disability pay under a proposed regulation published by the Department of Veterans Affairs (VA) that adds three new illnesses to the list of health problems found to be related to Agent Orange and other herbicide exposures. This is an important step forward for Vietnam Veterans suffering from these three illnesses, said Secretary of Veterans Affairs Eric K. Shinseki. These warriors deserve medical care and compensation for health problems they have incurred. The regulation follows Shinseki s October 2009 decision to add the three illnesses to the current list of diseases for which service connection for Vietnam Veterans is presumed. The illnesses are B cell leukemias, such as hairy cell leukemia; Parkinson s disease; and ischemic heart disease. The Secretary s decision is based on the latest evidence of an association with widely used herbicides such as Agent Orange during the Vietnam War, as determined in an independent study by the Institute of Medicine. Even though this is a proposed rule, VA encourages Vietnam Veterans with these three diseases to submit their applications for compensation now so the Agency can begin development of their claims and so they continued on page 4 by Chuck Partridge Government Relations The Doc-Fix Throughout the late winter and early spring of this year, Congress has enacted a series of temporary fixes, termed the Doc Fix, to prevent automatic cuts in Medicare payment rates to doctors of 21 percent. To solve the problem over the long term would require some $240 billion which many Congressmen believe should be offset by spending cuts somewhere else. Other members of Congress believe the problem should be solved by other means. By extending temporary fixes Congress has more time to work on a more permanent solution. The reason the amount, 21 percent, is so large is that Congress has delayed solving the problem for several years, so the problem has gotten more expensive and more difficult to solve because they kept putting it off. Since TRICARE and TRICARE for Life payments and co-payments are based on Medicare rates, military beneficiaries of all ages have a stake in how this is resolved. Reductions in reimbursement rates for doctors and hospitals have resulted in more physicians and institutions refusing to take Medicare or TRICARE. One of the nation s premier medical facilities, Mayo Clinic, recently announced that it would no longer take Medicare. The State of Massachusetts, which has a statewide health care program similar to the recently enacted National Health Care Reform, is facing huge funding problems. Insurance companies in Massachusetts are starting to issue policies that largely bar patients from seeking care at some popular hospitals which are also expensive. We have already seen the same thing in some TRICARE areas which do not include some popular medical care providers in their networks. Some providers have stopped accepting new TRICARE patients because of reimbursement rates too low to cover the full cost of providing care. Secretary of Defense Bill Gates, and former DOD Secretary Donald Rumsfeld, as well as senior uniformed military officials, have all expressed concern with the cost of military health care. Indeed, DOD has tried to increase various TRICARE fees for the past several years only to be repeatedly blocked by Congress. The fact is, actions by the Department of Defense are responsible for some of the increase in the cost of care. The fact that we are in a war and are sending troops back for repetitive combat tours rather than increasing the size of the force is also responsible. Increasing the number of medical personnel and increasing the capability of Military continued on page 3

2 E D I T O R S C O L U M N John P. May AMS has been informed that the Department of Defense is setting up the 50 th Anniversary of the Vietnam War Commemoration Commission. The commission is congressionally mandated and chartered by the Department of Defense to plan and conduct this commemorative program which may include activities and ceremonies to achieve the following objectives: (1) To thank and honor veterans of the Vietnam War, including personnel who were held as prisoners of war or listed as missing in action, for their service and sacrifice on behalf of the United States and to thank and honor the families of these veterans. (2) To highlight the service of the Armed Forces during the Vietnam War and the contributions of Federal agencies and governmental and non-governmental organizations that served with, or in support of, the Armed Forces. (3) To pay tribute to the contributions made on the home front by the people of the United States during the Vietnam War. (4) To highlight the advances in technology, science, and medicine related to military research conducted during the Vietnam War; and (5) To recognize the contributions and sacrifices made by the allies of the United States during the Vietnam War. The Commission s activities will last until 2025 and will involve Vietnam War Commemoration programs conducted by the federal government, state and local governments, and international, commercial and private organizations. It is hard to believe that it has been almost 50 years since the start of the Vietnam War, a war that was perhaps the most controversial in our nation s history. But it is gratifying to know that this commemoration is being set up and that recognition will be given to all those who served in Vietnam and in the war effort. Whatever the opinions about that war, or any war, may be there is no denying that those who served, and serve now, deserve thanks and recognition from their fellow citizens. We need to remind all Americans that members of the Armed Forces do not make the policy. They simply take an oath to carry out the orders of their superiors and to serve the nation in the manner that is asked of them. As we receive more information about this commemoration we will let you know. * * * * * In his article elsewhere in this issue, Chuck Partridge tells about the new National Commission on Fiscal Responsibility and Reform that has been set up by the President and which has begun to meet to discuss ways to solve the massive federal budget debt. As Chuck mentioned, one of the members of that commission is Andy Stern, the former president of the Service Workers International Union. At the beginning of the deliberations of the committee, Stern stated that all entitlement programs, including Social Security, as well as the imposition of new taxes, should be on the table as the commission debates about what to do. Labor unions have traditionally been strong opponents of reducing Social Security and/or Medicare benefits as a way of dealing with the soaring federal debt, so Sterns comments took many people by surprise. AMS believes that if a former union president says, in effect, that some reduction of Social Security ought to be considered as a partial solution, TRICARE and all military retirement benefits will also be on the table. We are very concerned about what recommendations the commission will make and we will be monitoring it very closely. If we ask you in future issues of the Advocate to contact your Senators and Representative about the commission s recommendations, it is important that you take action. Your promised and earned military retirement benefits could be at stake. * Happy 4th of July!

3 Report from the Hill continued from page 1 Treatment Facilities to accept more beneficiaries rather than turning them away and forcing them to use commercial providers would save billions of dollars. Increasing fees and copayments will not do it. As one Defense official said, increasing fees might save millions, increasing our MTF capability will save billions. National Commission on Fiscal Responsibility and Reform In our last edition of the Advocate, we reported that the President established a commission by executive order to make recommendations to bring down the federal deficit to 3 percent of the GDP (Gross Domestic Product). The deficit is now over 9 percent of GDP. The panel will look at ways to reduce costs of government programs such as Medicare, Medicaid and Social Security. It will also take aim at other federal entitlements including military and federal retired pay. President Obama said that nothing was off the table. In addition to the co-chairs, former Senator Alan Simpson and former White House Chief of Staff Erskine Bowles, the President appointed Andy Stern, President, Service Employees International Union; Dave Cote, CEO Honeywell Corp: Ann Fudge, former CEO of Young and Rubican Brands; and Alice Rivlin, former Director of the Congressional Budget Office and Vice-Chair of the Federal Reserve. Senators on the Panel appointed by Majority Leader Harry Reid are: Richard Durbin, (Ill.); Max Baucus, (Mont.); and Kent Conrad, (N.D.). Senators appointed by Minority Leader Mitch McConnell are: Tom Coburn, (Okla.); Judd Gregg, (N.H.); and Michael Crapo, (Idaho). Members of the House of Representatives appointed by Speaker Nancy Pelosi are: John Spratt, Jr, (S.C.); Xavier Becerra, (Calif.); Janice Schakowsky, (Ill.). Members of the House of Representatives appointed by Minority Leader John Boehner are: Paul Ryan, (Wisc.); Dave Camp, (Mich); and Jeb Hensarling, (Texas). Many AMS members live in the states and districts of these commission members. We recommend you contact them. Let them know you are a constituent and that you expect them to protect your earned benefits. Relationship between TRICARE and Employer- Sponsored Group Health Coverage The National Defense Authorization Act for fiscal year 2007 prohibited employers from offering financial or other incentives to TRICARE-eligible employees to use TRICARE instead of enrolling in an employer-provided Group Health Plan. The prohibition is so broad that it rules out legitimate cases in which military retirees elect to use TRICARE as their primary health care plan and pay for it or a supplemental insurance plan through their cafeteria plan on a pre-tax basis. The law includes a provision which allows the Secretary of Defense to make an exception. When Congress passes a law designed to address a social or economic need or problem, they typically write the broad outline of the law but then the appropriate federal regulatory agency then creates regulations necessary to implement the law. The Department of Defense has made the final rule regarding this provision and they made an exception which allows retired military employees to pay co-pays and deductibles and supplemental insurance on a pre-tax basis through a cafeteria plan. Although not an ideal fix, this provision does provide some relief for military retirees so that they can take advantage of the tax relief in a cafeteria plan. However, the final rule does still prohibit the employer from paying for the TRICARE health benefit. This has been a longstanding issue that AMS has led the fight on to get corrected. It is a gross injustice to discriminate against military retirees in this fashion. The original prohibition was so discriminatory that military retirees could not pay for their insurance on a pretax basis while other employees could. We are pleased that this change provides some relief and we will continue seeking full relief. National Health Care Reform When Congress was working on the massive health care bill that passed this past spring, AMS and other military and veterans groups received verbal assurances from the Administration and leaders in Congress that military health care and veterans health care would be recognized as meeting minimum essential coverage standards as required in the new law, and therefore military and veteran beneficiaries would not be required to purchase care under the new health care law. However, there was nothing explicitly stating that fact in the legislation. AMS and other military and veterans associations were not satisfied with that and the Chairman of the House Armed Services Committee agreed with us. That s why Chairman Ike Skelton (D-Mo.), introduced HR This bill would insure that all TRICARE plans, TRICARE for Life and the DoD non-appropriated fund health care benefits were recognized. The bill passed unanimously in the House. Senate Armed Services Personnel Subcommittee Chairman, Jim Webb (D-Va.), promptly introduced S 3148, a companion to the House Bill. It cleared the Senate quickly and went to the President for his signature. Legislation providing the same type of protection to VA health care has not yet passed as this is written but we expect that it will be by the time you read this. There is still a lot we do not know about the National Health Care Law. In fact, all of the provisions of the bill won t even go into effect until 2014 and the regulations that implement the law will be worked on for the next six months. The reality is that we could be affected in unexpected ways. Many experts are continuing to study the law and we will keep you informed. This is going to be a turbulent election year and we urge all AMS members to keep in touch with their elected representatives. *

4 Proposed Regulation Change Adds Illnesses to List of Diseases Subject to Presumptive Service Connection for Herbicide Exposure continued from page 1 can receive benefits from the date of their applications once the rule becomes final. Comments on the proposed rule were accepted for 30 days. The final regulation will be published after consideration of all comments received. We must do better reviews of illnesses that may be connected to service, and we will, Shinseki added. Veterans who endure health problems deserve timely decisions based on solid evidence. Over 80,000 of the Veterans will have their past claims reviewed and may be eligible for retroactive payment, and all who are not currently eligible for enrollment into the VA healthcare system will become eligible. During the Vietnam War, the U.S. military used more than 19 million gallons of herbicides for defoliation and crop destruction in the Republic of Vietnam. Veterans who served in Vietnam anytime during the period beginning January 9, 1962, and ending on May 7, 1975, are presumed to have been exposed to herbicides. Used in Vietnam to defoliate trees and remove concealment for the enemy, Agent Orange and other herbicides left a legacy of suffering and disability that continues to the present. The new rule will bring the number of illnesses presumed to be associated with herbicide exposure to 14 and significantly expand the current leukemia definition to include a much broader range of leukemias beyond chronic lymphocytic leukemia previously recognized by VA. In practical terms, Veterans who served in Vietnam during the war and who have a presumed illness don t have to prove an association between their illnesses and their military service. This presumption simplifies and speeds up the application process for benefits. Other illnesses previously recognized under VA s presumption rule as being caused by exposure to herbicides during the Vietnam War are: AL Amyloidosis, Acute and Subacute Transient Peripheral Neuropathy, Chloracne or other Acneform Disease consistent with Chloracne, Chronic Lymphocytic Leukemia, (now being expanded) Diabetes Mellitus (Type 2), Non-Hodgkin s Lymphoma, Porphyria Cutanea Tarda, Prostate Cancer, Respiratory Cancers (Cancer of the lung, bronchus, larynx, or trachea), and Soft Tissue Sarcoma (other than Osteosarcoma, Chondrosarcoma, Kaposi s sarcoma, or Mesothelioma). Additional information about Agent Orange and VA s services for Veterans exposed to the chemical are available at As this issue of the Advocate goes to press the rule had not been finalized. However, we urge all those to whom this new rule may apply to submit their applications for compensation if they have not already done so. * Decision Driving You may never have had a collision, or received a citation for speeding, or even paid a parking ticket. But no matter how well you drive, it always helps to keep in mind these four proactive pointers: Extend your vision. Rather than staring directly in front of your vehicle, focus on where it will be positioned 10 to 12 seconds down the road the zone where an accident is more likely to occur. Scan the entire scene. Shift your focus every few seconds from the windshield to the rear and side mirrors to check for pedestrians, bicyclists, erratic drivers, construction, traffic congestion, oncoming trucks and motorcycles, and changing road conditions. Demonstrate your intentions. Whether using your signal to indicate a right or left turn, hazards to warn that you need to slow down because of a flat tire, or horn to assert your right of way, it always helps other drivers and pedestrians make their own appropriate decisions when they understand yours. Plan an escape route. Based on your speed and the proximity of other cars on the road, give yourself enough time and space to maneuver smoothly and stop if necessary. For instance, never tailgate and always estimate conservatively the time it will take to pass another car if you want to avoid a crash. Each of these four practices depends on your ability to focus, stay alert and take decisive action. Be proactive, not reactive, and you ll increase your confidence behind the wheel. This information brought to you by Liberty Mutual and the American Military Society. Our partnership with Liberty Mutual offers competitive rates and superior service to AMS Members. For more information please visit us at Liberty Mutual Group. All rights reserved. *

5 Landmark Bill to Care for Women Veterans and Provide Support for Veteran Caregivers Passes Congress and President Signs into Law House Veterans Affairs Committee Chairman Bob Filner (D-Calif.) recently announced that the U.S. House of Representatives voted to approve S. 1963, the Caregivers and Veterans Omnibus Health Services Act, with a vote of The bill creates a caregiver support program, improves health care services for America s women veterans, and expands the mental health services provided by the Department of Veterans Affairs (VA), among other things. Provides Caregiver Support S provides immediate support for veteran caregivers by creating a program to offer caregiver training, access to mental health counseling, and 24-hour respite care in the veteran s home. This allows caregivers temporary relief without having to leave the veteran at a medical facility. Veterans who served in Operation Enduring Freedom/ Operation Iraqi Freedom (OEF/OIF) are eligible to select a caregiver to receive a financial stipend along with travel and lodging expenses associated with the veteran s care. Welcomes Home Women Veterans S expands and improves VA services for the 1.8 million women veterans currently receiving VA health care -- and goes one step further by anticipating the expected increase of women warriors over the next five years. This bill seeks to build a VA health care system respectful of the unique medical needs of women veterans. For the first time, VA will be authorized to provide health care for newborn infants of women veterans. Prevents Veteran Homelessness S essentially expands the number of places where homeless veterans may receive supportive services. For veterans struggling without a roof over their heads, this small change in the law will make a big difference in their lives. Rural Health Care S includes key provisions to improve the health care provided to our rural veterans by authorizing stronger partnerships with community providers and the Department of Health and Human Services. These collaborations will allow VA to offer health care options to service members living far from the nearest VA medical facility. S also requires the VA to establish a grant program for veteran service organizations to provide transportation options to veterans living in highly rural areas. Increases Mental Health Care Access S addresses the troubling reality of post-traumatic stress and troubling incidents of suicide among the veteran population. This bill requires a much-needed and longawaited study on veterans suicide and requires the VA to provide counseling referrals for members of the Armed Forces who are not otherwise eligible for readjustment counseling. Other Veteran Health Care Provisions Creates a National Quality Management Officer to act as the principal officer responsible for the Veterans Health Administration s quality assurance program. Provides for a pilot program studying the use of community organizations and local and State government entities in providing care and benefits to veterans. Requires the VA to contract with the Institute of Medicine to study the health impact of Project Shipboard Hazard and Defense. Creates a pilot program, which would provide specified dental services to veterans, survivors, and dependents of veterans through a dental insurer. Prohibits the VA from collecting copayments from veterans who are catastrophically disabled. Provides higher priority status for certain veterans who are Medal of Honor recipients. Requires the VA to provide hospital care, medical services, and nursing home care for certain Vietnamera veterans exposed to herbicide and Gulf-War era veterans who have insufficient medical evidence to establish a service-connected disability. Establishes a position for the Director of Physician Assistant Services in the central VA office reporting to the Chief of the Office of Patient Services. Creates a Committee on Care of veterans with traumatic brain injury. It is simply our duty as a Nation, when we put our men and women in harm s way, to care for them when they return, said Chairman Filner. S demonstrates America s commitment to the dedicated service members who have served in uniform and puts front and center the health care needs of veterans and their families. It is our pledge to them, that we have not forgotten the sacrifices they have made in defense of this country. We owe our veterans a debt of gratitude -- and this bill represents an understanding that the sacrifices of our veterans are shared among us all as Americans. Just a day after the bill was passed by the House, the Senate passed it by a unanimous voice vote. It was then sent to the President for his signature and has now become law. *

6 House Passes Bills Package to Eliminate Homelessness, Provide Job Opportunities and Protect Home Ownership for Veterans House Veterans Affairs Committee Chairman Bob Filner (D-CA) announced that the U.S. House of Representatives recently voted to approve seven measures that would improve benefits and services to veterans provided by the Department of Veterans Affairs (VA). H.R End Veteran Homelessness Act of 2010 (Filner) This bill increases funding to successful programs for homeless veterans, requires each VA medical center that provides supporting housing services to provide housing counselors, requires housing counselors to conduct landlord research, strengthens permanent housing programs, and pays special interest to the needs of homeless women veterans and homeless veterans with children. This bill includes provisions from H.R (Teague); H.R. 2559, as amended (Hare); H.R. 2735, as amended (Rodriguez); and H.R (Teague). the House seized the opportunity to take bold action to combat veteran homelessness by passing H.R. 4810, said Chairman Filner. Fortunately, Congress has a willing partner in the Obama Administration, which has committed the resources and necessary support to achieve the goal of ending veteran homelessness in 5 years. It is unacceptable that even one of our veterans sleep on the streets or in shelters after risking their lives on behalf of this country and I am proud the House of Representatives took this vote to fight for each and every veteran. H.R National Guard Employment Protection Act of 2009 (Coffman) One of the protections provided by the Uniformed Services Employment and Reemployment Rights Act, or USERRA, is to require employers to support a service member s absence for up to five years if called to active military duty. Since September 11, 2001, the National Guard has played a critical role in federal missions, and a small but increasing number of National Guard members are bumping against the five-year USSERA protection for their civilian jobs. This bill provides necessary reemployment rights for certain individuals ordered to full-time National Guard duty. H.J.Res Honoring the Blinded Veterans Association on its 65th anniversary (Halvorson) House Joint Resolution 80 recognizes the fundamental role that the Blinded Veterans Association has played in ensuring that visually impaired veterans receive the recognition, care, and benefits they deserve. The measure recognizes this organization that has done much to make Congress and the American people aware of the challenges facing those who have become visually impaired through military service to our nation. H.R Helping Heroes Keep Their Homes Act of 2009 (Perriello) During the peak of the home foreclosure crisis in 2008, Congress passed the HEART Act, a comprehensive housing and economic recovery bill. Among the critical protections included in the legislation was a provision to prohibit foreclosure of property owned by a service member for nine months following a period of military service. This bill extends expiring protections that safeguard veteran homeowners from foreclosure for nine months following deployment. H.R Veterans Compensation Cost-of- Living Adjustment Act of 2010 (Perriello) This bill increases the rates of compensation for veterans with service-connected disabilities and the rates of dependency and indemnity compensation for the survivors of certain disabled veterans, and for other purposes. The bill would go into effect December 1, H.R Energy Jobs for Veterans Act (Teague) This bill increases job opportunities for veterans by reimbursing energy employers for the cost of providing on-the-job training for veterans in the energy sector. Specifically, the bill creates the pilot Veterans Energy Related Employment Program which would award competitive grants to three states that are able to serve a population of eligible veterans, boast a diverse energy industry, and have the ability to carry out such a training program. H.R Major Charles R. Soltes, Jr., O.D. Department of Veterans Affairs Blind Rehabilitation Center (Campbell) This bill designates the Department of Veterans Affairs blind rehabilitation center in Long Beach, California, as the Major Charles R. Soltes, Jr., O.D. Department of Veterans Affairs Blind Rehabilitation Center. Over the last three years, [Congress] increased the VA health care budget by 55%, instituted advance funding, provided a G.I. Bill for the 21st Century, revamped the VA home loan program, and expanded access to VA health care for more veterans, said Chairman Filner. During these tough economic times, we must do more. Today, the House committed to ending veteran homelessness, worked to provide employment protections and opportunities, and passed a bill to support veterans during reintegration by protecting homeownership following deployment. Congress continues to take bold action to support veterans. The bills will next be heard in the U.S. Senate. *

7 American Military Society Membership Application Form P.O. Box Washington, D.C (800) Yes, I want to join in support of a strong national defense and take advantage of the great benefits AMS offers. I also understand that I am joining an organization that fights for the compensation, benefits, and entitlements of all military personnel of the uniformed services. Name: Rank: Branch of Service: DOB: / / Address: City: State: Zip: Telephone:( ) q Active Duty q National Guard q Reserve q Retired q Honorably Separated q 1 Year ($20) q 2 Year ($40) q 3 Year ($60) q Lifetime Membership ($300)* Make your check payable to: American Military Society q Visa q Mastercard Card No. Exp. Date / Signature: * Lifetime Membership may be paid in 10 quarterly payments 1st payment of $30 is enclosed. The AMS Advocate is published bi-monthly by the American Military Society: 1 (800) Executive Editor Catherine Tavarozzo Managing Editor/Designer Sue Boyles Membership: 1 (800) Insurance Coverage/Billing: 1 (800) Insurance Claims: 1 (800) Material may be quoted or reprinted in part or whole as long as proper credit is given to AMS. Membership in the American Military Society is open to all members from all branches of the armed forces, both officers and enlisted personnel, including Active Duty, Reserve, National Guard, Retired and Veterans, as well as spouses and widows of the uniformed services family. Any individual who supports the aims and purposes of AMS is eligible for Associate Membership. Any business entity, local government, or civic group that supports the aims, objectives, and purposes of AMS is eligible for sustaining membership. AMS Benefits and Services For information about any of these programs, call our Customer Service Representatives, Toll-Free at 1 (800) TRICARE Supplement Plans: Acceptance guaranteed for comprehensive benefits that not only pay your DRG cost-shares, but also pay 100% of your out-of-pocket share of eligible excess expenses. Benefits include a unique premium-paying Survivors Benefit and deep discounts on all your dental, vision, and hearing care. Medicare Supplement Plans: Your choice of coverages when you are eligible for Medicare. Benefits increase automatically with any increase in federal deductibles. Call (800) to request an information kit. Cancer Protector Plan: Guaranteed acceptance, regardless of age, for Members who have lived 10 years or more cancer-free. Dental Insurance Program: Low cost comprehensive coverage that allows you to use your own dentist while covering preventive care and more than 150 treatments and procedures. Long-term Care Insurance: Comprehensive protection that protects your hard-earned assets from the high cost of long-term care. Affordable group rates and discounts for married couples. Life Insurance For information about AMS sponsored Life Insurance, call Toll-Free at 1 (800) Term Life Insurance: Our AMS sponsored term life insurance portfolio offers extremely competitive 10, 15 and 20-year guaranteed level premiums. Variable Universal Life: Designed for the investment savvy, this product allows you to build cash value through a broad array of investment portfolios while providing the strength of permanent life insurance. It offers flexibility to anticipate future changes in your life - all inside a financial product that has unique tax advantages. Disability Income Insurance: Protects your most valuable asset - your income. Variable Annuities: Provides you an attractive way to create a personalized retirement income strategy with market-based investment options, while providing extra protection for your financial future. Auto/Homeowner s Insurance, call (800) , Client #3825 AMS Credit Card (Visa), call 1 (800)

8 American Military Society P.O. Box Washington, D.C Address Service Requested Non-Profit Org. US Postage PAID American Military Society Proposed Regulation Change Adds Illnesses to List of Diseases Subject to Presumptive Service Connection for Herbicide Exposure page 1 Report from the Hill page 1 Editor's Column page 2 Decision Driving page 4 Landmark Bill to Care for Women Veterans and Provide Support for Veteran Caregivers Passes Congress and President Signs into Law page 5 House Passes Bills Package to Eliminate Homelessness, Provide Job Opportunities and Protect Home Ownership for Veterans page