BACK

RAO Bulletin Update
15 January 2008
 
 
THIS BULLETIN CONTAINS THE FOLLOWING ARTICLES
== NDAA 2008 [13] ---------------------------------- (Pocket Veto)
== Tricare EOBs [02] ------------------ (TFL Digital Conversion)
== SS Retirement Age [01] ---------------------- (Delay Decision)
== VA Eye Care -------------------------------------------- (Criteria)
== Medicare Eye Care ----------------------------------- (Coverage)
== VA Vet Centers [03] -------------------------------- (Wisconsin)
== Alabama Veterans Homes [01] ---- (New Home Opens 2011)
== USERRA [05] ---------------------- (Sole Jurisdiction of DOL)
== VA Lawsuit (Lack of Care) [04] ------ (Dismissal Overruled)
== Tricare Uniform Formulary [23] ----------- (More $22 Drugs)
== VA Budget 2008 [11] ------------------- (Emergency Funding)
== Reserve Retirement Age [12] ------------ (Retroactive to 911)
== Veteran Charities [05] ---------------------- (Educate Yourself)
== VA Performance --------------------- (Favorable CBO Report)
== IRS Data Breach [01] -------------------- (Problems Still Exist)
== Congressional Cola 2008 -------------------- ($4,100 Increase)
== Merchant Marine WWII Comp [01] ------ (Sponsor Increase)
== VA Fraud [06] ----------------------- (Wichita KS/Billings MT)
== Spin Code Lawsuit ------------------------------- (DD-214 Item)
== Medicare Part D [17] -------------------- (CMS Oversight Lax)
== Missouri Retiree Tax Exemption ------------------- (Proposed)
== VA Hospice Care [01] ------------------ (Program Expansion)
== SBP Paid Up Provision [04] ----------------------------- (FAQs)
== VA CWT & IT [01] --------------------------- (Ruled Tax-Free)
== Medicare Solvency [01] -------------- (Higher Costs Looming)
== SSA Future Benefits [01] --------- (Possible Broken Promise)
== CRDP/CRSC Option [01] ---------------- (2008 Open Season)
== Tricare Reserve Select [09] -------- (Reservists Overcharged)
== VA Insurance Dividends in 2008 ------ (Pmt of $349 million)
== VA SAH [03] ----------------------------------------- (New Rules)
== Mobilized Reserve 9 JAN 08] ------------ (Net Increase 1433)
== Sugar Substitutes ------------------------------- (Should you use)
== Military Comp Offsets ----------- (Crumbling Under Scrutiny)
== TFL Enrollment --------------------------------------- (Overview)
== CA & Federal Disabled Benefits ------------- (70 to 100% SC)
== California & Federal IU Benefits ----------- (Entitlement List)
== Veteran Legislation Status 13 JAN 08 ---- (Where We Stand)


NDAA 2008 UPDATE 13:   Ending its sine die adjournment (sine die
 adjournment is an adjournment that terminates a session of Congress), the
 House convened on 3 JAN to begin the second session of the 110th Congress
 as prescribed by the Constitution of the United States.  The House
 convened at 12 noon and pursuant to S. Con. Res. 61, 110th Congress,
 adjourned at 12:03 p.m. until noon on Tuesday, 15 JAN 08.  Similarly, the
 Senate met on Jan. 3 to convene the 2nd session of Congress as prescribed
 by the Constitution.  The Senate met for 46 seconds in a pro forma
 session from 12:04:26 and recessed at 12:05:12 noon.  It is scheduled to
 meet again in pro forma session at 9 a.m., on Monday, Jan. 7, with formal
 session scheduled on Jan. 22 pursuant to S. Con. Res. 61, 

      As previously reported, President Bush used a pocket veto to
 reject H.R. 1585, the FY 2008 National Defense Authorization Act (NDAA),
 because a provision in the bill would render the new Iraqi government
 responsible for compensation claims against the Saddam Hussein led former
 government.  The President’s pocket veto decision drew immediate
 criticism from several House and Senate leaders.  At question is the
 constitutionality of President’s ability to use the pocket veto.  Under Article
 1 Section 7 of the Constitution, the President has 10 days to approve
 or disapprove legislation (excluding Sundays) after it is presented.
  If the President doesn’t approve the bill—that is that he wishes to veto
 it—his obligation is to return it with his objections to the House
 where it originated, unless the Congress by its adjournment prevents its
 return, in which case the bill “shall not be law” if unsigned after
 10-days (the House adjourned sine die Dec. 19).  Withholding signature in
 such a case is known as a “pocket veto,” and unlike a regular veto, it
 cannot be overridden by a two-thirds vote in Congress.  It is absolute.
  Once a pocket veto occurs, the only way for Congress to enact the
 legislation would be to resubmit the measure in the form of a new bill
 once it returns from adjournment.

      House leader Nancy Pelosi (D-CA), has said the House may still
 vote to override the veto. She has said that because the Senate has been
 in Pro Forma sessions, President Bush cannot pocket veto the bill. The
 White House argues the bill originated in the House and because the
 House is in recess, the bill has been pocket vetoed. A Constitutional
 battle could ensue before a new authorization bill is developed. There is
 much at stake in resolving this issue quickly.  Passage of the NDAA
 authorizes a 3.5% military pay raise; reauthorizes enlistment,
 reenlistment, and specialty bonuses; expands Combat-Related Special Compensation to
 all combat-related disabled veterans; and provides full Concurrent
 Retirement and Disability Pay for disabled retirees rated as Individually
 Unemployable by the VA.  The bill also lowers the minimum Guard and
 Reserve retirement age by 90 days for every 3 months served on active duty
 and establishes a Special Survivor Indemnity Allowance beginning 1 OCT
 08.  Each of these items remains on hold as we await the resolution of
 this matter. [Source: NAUS Weekly Update 4 Jan 07 ++]


TRICARE EOBS UPDATE 02:   Tricare for Life (TFL) beneficiaries can soon
 print a copy of their Explanation of Benefits (EOB) from the
 convenience of their own homes. Starting in JAN 08, the only paper EOB’s that
 beneficiaries will receive are monthly summaries.  The exception to this
 is if a claim includes services that are rejected, and those services
 have appeal rights; or if the EOB is mailed with a payment to the
 beneficiary. In February, beneficiaries will have the option to receive an
 electronic notification every time a claim processes.  Beneficiaries can
 then log on to the secure web site at www.TRICARE4U.com, to view and
 print their EOB. The EOB will be available online and beneficiaries will
 have the ability to access EOB’s for any claim processed during the
 last 27 months.  Once a beneficiary signs up for this option, they will
 not receive a monthly paper summary. TFL beneficiaries will receive
 letters notifying them of the changes, either with their current EOB’s or
 any other correspondence. If there are any questions about the
 registration process beneficiaries can call 1-866-773-0404.  Those requiring a
 Telecommunications Device for the Deaf (TDD) can call 1-866-773-0405.
  [Source: TMA News Release 9 Jan 08 ++]


SS RETIREMENT AGE UPDATE 01:   About half of the
 soon-to-be-62-year-olds are expected to do just what their parents generally did: file for
 Social Security benefits at the youngest possible age, in exchange for a
 smaller benefit than they'd get if they waited to retire at 66. Many
 are relying on conventional wisdom that suggests they're better off
 filing for Social Security as soon as possible.  Yet if they follow that
 advice, millions of the oldest boomers may be about to make a colossal
 error — one that would be magnified by their record-setting longevity.
 Over time, taking benefits early could mean a smaller payout, hefty taxes
 on their retirement savings and a heightened risk of outliving their
 money. In fact, the roughly 50% of the oldest baby boomers who the Social
 Security Administration estimates will tap their benefits starting
 this year will absorb a permanent 25% cut in benefits. Up to
 three-quarters of them are expected to file for benefits before age 66, their full
 retirement age. How much their benefits will shrink depends on how close
 they are to full retirement age once they begin to take those
 benefits.

     Those who wait till after age 66 will enjoy an 8% annual increase
 in benefits until age 70. (After that, there's no advantage to delaying
 benefits.) Yet on the most fateful financial decision most of them
 will make, only about 5% of retirees wait until after they've reached full
 retirement age to claim benefits. And it's a trend that's likely to
 persist, says Stephen Goss, chief actuary for the Social Security
 Administration.
Many retirees who plan to start taking their benefits early assume it
 won't make much difference over time. In reality, boomers who live the
 longest stand to lose the most by taking benefits early, according to an
 analysis by the American Academy of Actuaries. Retirees who file for
 Social Security at age 62 and live into their mid-90s could lose nearly
 $150,000 in benefits, says Ron Gebhardtsbauer, senior pension fellow
 with the academy. Factors that could hurt boomers who take early Social
 Security benefits at age 62:

1.  Longevity
• There's a 41% chance that a 62-year-old woman today will live to 90;
 a 62-year-old man has a 29% chance. For a married couple, there's a 58%
 chance that one of them will live to 90 and a 29% chance that one will
 reach 95.
•  The Social Security Administration projects that the average
 retiree's "break-even" age for Social Security benefits is 77. A retiree who
 dies before then would have fared better by taking benefits at 62. Those
 who live past 77 would earn more by delaying benefits.
• Retirees who take reduced benefits at 62 and live to 90 would lose
 $39,000 in benefits; those who live to 95 would give up $54,000, the SSA
 says.

Some financial analysts say your losses would be far greater tansy’s
 projections. If, for example, you include the annual cost-of-living
 increases that boost Social Security checks, Gebhardtsbauer's estimate of
 how much you'd lose by taking benefits early far exceeds the SSA's:
 $83,000 for those who take benefits at 62 and live to age 90 and nearly
 $149,000 for those who live to 95. Gebhardtsbauer sets the break-even age a
 bit higher than the SSA does. That's because he takes into account
 interest earned by those who take benefits starting at 62. Even so, by
 including the annual cost-of-living increases, he calculates even more
 value in delaying benefits. The reason: The cost-of-living adjustments
 will apply to a larger sum. Thanks to compounding, "those cost-of-living
 adjustments will be huge, especially if you live long in retirement,"
 says James Mahaney, a retirement specialist at Prudential Financial. Even
 if you're convinced you won't live so long, taking your benefits early
 could hurt your spouse. When a married beneficiary dies, the survivor
 can continue receiving his or her own benefit or the deceased spouse's
 benefit, whichever is more. So spouses who take their benefits early
 don't just shrink their own payouts; they also reduce the amount the
 surviving spouse will be eligible for.

2.  Taxes. Analysts generally urge retirees to delay withdrawing money
 from their 401(k), IRA and other retirement savings accounts as long as
 possible. That way, the thinking goes, the tax-deferred investments
 can grow and compound. But that advice, Mahaney says, ignores the
 punishing effect of taxes on Social Security benefits. If all your income
 comes from Social Security, your benefits usually aren't taxable. But
 retirees with other income, including withdrawals from most retirement
 plans, could owe taxes on a huge chunk — 50% to 85% — of their benefits.
  The tax was originally designed to target wealthy seniors. But because
 the income thresholds weren't indexed to inflation, the tax has spread to
 middle-income retirees.
Married couples with $32,000 in combined income face taxes on half
 their Social Security benefits.
Couples with a combined income of at least $44,000 could owe taxes on
 85% of their benefits. (For the purposes of the tax, combined income
 includes half of a retiree's Social Security benefits, wages from a job,
 pensions and withdrawals from most retirement plans.) Retirees can avoid
 this by using their retirement savings to pay living costs in the
 early years of retirement, Mahaney says, and then taking their Social
 Security benefits later.

3.  Risk of outliving your full benefit: Unless Congress acts, by 2017
 Social Security will start paying out more in benefits than it receives
 in tax revenue. By 2027, it will have to tap its trust fund to pay
 benefits. And by 2041, Social Security will be able to pay only about 75%
 of promised benefits, according to the agency's report to Congress. But
 the 79 million people born from 1946 through 1964 represent an
 extraordinarily potent voting bloc. Reducing their benefits "would be a huge
 political burden," Prudential's Mahaney says. He thinks lawmakers are
 more likely to raise payroll taxes on workers than reduce benefits for
 retirees.
[Source:  USA Today Sandra Block article 14 Jan 08 ++]


VA EYE CARE:  Eye-care services are available at the VA Medical Center.
 The following veterans are eligible to receive eye care and eyeglasses
 from VA:
• Veterans rated 10% or more service-connected for any condition;
• veterans rated service-connected for an eye condition that requires
 corrective lenses;
• former prisoners of war;
• veterans enrolled in a VA-approved Vocational Rehabilitation Training
 Program; and
• veterans in receipt of increased VA nonservice-connected pension
 based on need of regular aid.
For more information on VA eye care, call your local VA Medical Center.
 [Source: Honolulu Star Bulletin Gregg K. Kakesako article 13 Jan 08
 ++]


MEDICARE EYE CARE:   Medicare covers most doctor services and routine
 medical care required to keep you healthy. However, there are some
 services, such as eye care, that Medicare will only cover in very limited
 circumstances. For instance, Medicare will only pay for routine eye care
 if`
• You have diabetes. Medicare will pay for an eye exam once every 12
 months to check for vision loss due to the condition; or
• You are at high risk for glaucoma. Medicare will cover 80% of the
 cost of an eye exam by a state-authorized eye doctor once every 12 months,
 after you pay your Part B deductible. You are considered to be at high
 risk for glaucoma if you have diabetes; have a family history of
 glaucoma; are African American and age 50 or older; or are Hispanic and age
 65 or older.

Glaucoma is a group of eye diseases in which damage to the nerve
 located in the back of the eye (the optic nerve) results in loss of
 eyesight. Over three million Americans, and nearly 70 million people worldwide,
 have glaucoma. Experts estimate that half of them don’t know they have
 it.  Although the most common forms primarily affect the middle-aged
 and the elderly, glaucoma can affect people of all ages.  If glaucoma is
 not treated, vision loss may continue, leading to total blindness.
 There’s no sure way to prevent glaucoma, but early treatment helps slow
 the disease and prevent blindness.  Note: if you have Medicaid health
 coverage, then you are eligible for routine eye services through Medicaid.
 Medicare will also pay for certain nonroutine eye-care services if
 they are related to a chronic eye condition, such as cataracts or
 glaucoma. Medicare will cover
• Surgical procedures to help repair the function of your eyes due to
 these conditions. For example, Medicare will cover surgery to remove the
 cataract and replace your eye’s lens with a man-made intraocular lens.
• Eyeglasses or contacts only if you have had cataract surgery to
 replace your eye’s lens with a man-made lens (an “intraocular” lens).
 Medicare will cover the dark glasses that you must wear immediately after
 surgery to protect your eyes, as well as a standard pair of untinted
 prescription eyeglasses or contacts if you need them after surgery. If it is
 medically necessary, Medicare may pay for customized eyeglasses or
 contact lenses.
• An eye exam to diagnose potential vision problems. If you are having
 vision problems that may indicate a serious eye condition (for example,
 having constant double-vision, progressive blurring vision or the
 decrease of sight on the edges of your vision), Medicare will pay for an
 exam to see what is wrong, even if it turns out there is nothing wrong
 with your sight.
[Source: The Medicare Counselor Jan/Feb 08 ++]


VA VET CENTERS UPDATE 03:   U.S. Senator Russ Feingold led a letter
 from the Wisconsin congressional delegation in an effort to establish more
 Veteran Centers in Wisconsin. In the letter, Feingold and all nine
 other members of the delegation urged the Department of Veteran Affairs
 (VA) to open two additional Vet Centers in Wisconsin’s La Crosse and
 Brown counties. The delegation expressed its disappointment that none of
 the 23 new centers the VA plans to open in the U.S. this year would be
 built in Wisconsin, which ranks seventh worst in the nation for veterans’
 access to these centers. Approximately 40% of Wisconsin veterans do
 not have a Vet Center close enough for them to go on a regular basis. Vet
 Centers provide counseling in a non-medical setting to complement the
 services provided in VA medical centers and outpatient clinics.
 Wisconsin only has two Vet Centers, both in the southern part of the state, to
 serve the state’s 469,000 veterans. States with similar veteran
 populations have more than double this number of Vet Centers. Maryland, for
 example, has fewer veterans than Wisconsin and is one fifth its size but
 has four Vet Centers. Massachusetts is about one eighth the size of
 Wisconsin, and has only a slightly larger veteran population, but it has
 seven Vet Centers. If Vet Centers were established in La Crosse and
 Brown counties in Wisconsin, roughly 82% of Wisconsin veterans would be
 within an hour drive of a Vet Center. A copy of the letter can be viewed
 at http://feingold.senate.gov/pdf/ltr_vets_121107.pdf.  [Source: Sen.
 Feingold Press Release 7 Jan 08 ++]


ALABAMA VETERANS HOMES UPDATE 01:  Pell City won the competition 11 JAN
 to get Alabama's fourth veterans nursing home. The state Board of
 Veterans Affairs voted unanimously to place the home on a 27-acre site near
 the intersection of Interstate 20 and U.S. 231. The St. Clair County
 Economic Development Council offered the site, along with roads and
 water and sewer lines, worth $2.2 million to attract the nursing home. The
 veterans’ board, which was looking for a location convenient to the
 Veterans Administration Medical Center in Birmingham, also received
 proposals for sites in Helena and Tuscaloosa. Ken Rollins of Oxford, chairman
 of the board's nursing home committee, said the St. Clair County site
 stood out because it adjoins the Pell City campus of Jefferson State
 Community College. The college plans a nursing program at the campus, and
 is next to the proposed location of the St. Vincent's St. Clair
 Hospital. The board plans to begin work on the home in 2009 and open it in
 2011.

     The federal government has set aside $26 million toward building
 the home. The Department of Veterans Affairs plans to put up $12 million
 from the portion of the state property tax that it receives to help
 veterans. The $2.2 million in donations from Pell City will push the
 total project to $40 million, according to Alabama’s Veterans Affairs
 Commissioner Clyde Marsh. The state's three veteran’s nursing homes in
 Huntsville, Alexander City and Bay Minette are filled to capacity with 450
 people and have waiting lists. The Pell City home will be the state's
 largest with 280 beds. That will include 50 beds for Alzheimer's disease
 and dementia patients and, for the first time, 50 to 80 beds that will
 be more like assisted-living care than a nursing home. The cost of
 staying in one of the nursing homes is $156.82 per day, but the patient
 pays only $11.64, making it much cheaper than paying for a privately owned
 nursing home. The remainder of the cost is paid by the state and
 federal government. Changes approved by the board provide for the state to
 pay $73.76 and the federal government $71.42.  [Source: AP Phillip Rawls
 article 11 Jan 08 ++]


USERRA UPDATE 05:  The Labor Department once again has sole
 jurisdiction to investigate military service members' complaints about their
 federal employment, even though a study examining the processing of such
 claims was considered inconclusive. A pilot project created by Congress in
 2004 sought to determine which of two federal agencies -- Labor's
 Veterans Employment and Training Service (VETS) or the Office of Special
 Counsel -- was better suited to investigate alleged violations of the
 1994 Uniformed Services Employment and Reemployment Rights Act. The law
 protects veterans from employment discrimination resulting from their
 service. Lawmakers allowed the demonstration project to expire on 1 JAN
 08, and federally employed service members now must return to consulting
 VETS for initial investigation of their claims. The project, which was
 launched after criticism from Guard and Reserve personnel that VETS
 took far too long to investigate alleged violations of USERRA, was
 designed to determine whether OSC's expertise in enforcing federal sector
 prohibited personnel practices could strengthen the law's enforcement for
 government employees. But the project did not give lawmakers the
 definitive answer they expected.

     In July, the Government Accountability Office issued a report that
 did not reach a conclusion about which agency was better suited to
 handle USERRA cases. George Stalcup, director of strategic issues at GAO,
 testified at an OCT 07 hearing of the Senate Veterans Affairs Committee
 that data problems at both agencies affected GAO's ability to draw
 conclusions. Sen. Daniel Akaka, D-Hawaii, proposed at the hearing a
 one-year extension for the demonstration project. But a congressional aide
 said 11 JAN that lawmakers opted not to extend the project, largely
 because GAO had determined that further analysis would not be possible. Jim
 Mitchell, a spokesman for OSC, said that the major concern is
 stepped-up withdrawal of troops from Iraq and Afghanistan could result in a
 surge of claims to VETS. According to Pentagon figures released 9 JAN, the
 number of National Guard and Reserve personnel who have been mobilized
 currently stands at 92,673. Mitchell proposed allowing OSC to have
 jurisdiction over federal claims, which would free VETS to focus on
 providing services to USERRA claimants in the private sector.
OSC will continue to have a role in USERRA enforcement, however, if
 VETS is unable to resolve a federal sector claim. The claimant may request
 that VETS refer the matter to OSC, which may then represent the
 claimant before the Merit Systems Protection Board.

     The congressional aide noted that there may be an additional role
 for OSC in the future, but lawmakers have not yet decided what it would
 be. Akaka and Sen. Edward Kennedy (D-MA) recently introduced
 legislation that would strengthen USERRA by imposing deadlines on federal
 agencies to assist service members. The legislation also would implement the
 recommendations in GAO's report to reduce inefficiencies and improve
 data collection by the government on USERRA issues. The real issue, the
 aide said, is that federal response to USERRA claims has been lacking,
 especially when the government should be a model employer in enforcing
 the law. To address this, lawmakers are considering whether to require
 that an agency's Chief Human Capital Officer (CHCO) be notified when a
 USERRA claim is filed. CHCOs then could then determine whether more
 training and education on the law was necessary. He said, "This is a very
 complicated law and many may very well not understand it. I think it
 comes down to making sure that the education and outreach is there and
 that the federal government is setting the role as a model employer."
 [Source:  GOVExec.com Brittany R. Ballenstedt article 11 Jan 08 ++]


VA LAWSUIT (LACK OF CARE) UPDATE 04:   Veterans' advocates can proceed
 with a lawsuit claiming that the federal government's health care
 system for troops returning from Iraq and Afghanistan illegally denies care
 and benefits, a federal judge in San Francisco ruled 10 JA. U.S.
 District Judge Samuel Conti, a conservative jurist and a World War II
 veteran, rejected Bush administration arguments that civil courts have no
 authority over the Department of Veterans Affairs' medical decisions or how
 it handles grievances and claims. If the plaintiffs can prove their
 allegations, Conti said, they would show that "thousands of veterans, if
 not more, are suffering grievous injuries as the result of their
 inability to procure desperately needed and obviously deserved health care."
 He said federal courts are competent to decide whether those injuries
 were caused by flaws in the health care system and the VA's grievance
 procedures. Conti did not rule on the adequacy of the treatment system,
 which will be addressed in future proceedings. But he decided one
 disputed issue, finding that veterans are legally entitled to two years of
 health care after leaving the service. The government had argued that it
 was required to provide only as much care as the VA's budget allowed in
 a given year. A lawyer for the plaintiffs, Melissa Kasnitz of
 Disability Rights Advocates, said the judge had rejected the VA's "shameful
 effort to keep these deserving veterans from their day in court."

     The next step is a hearing on the plaintiffs' request for an
 injunction that would require the federal agency to provide immediate mental
 health treatment for veterans who suffer from stress disorders and are
 at risk of suicide, said Sidney Wolinsky, another Disability Rights
 Advocates lawyer. That hearing is scheduled for 22 FEB. The suit claims
 that the federal government's failure to provide timely treatment is
 contributing to an epidemic of suicides among returning soldiers. The suit
 was filed in July by two organizations, Veterans for Common Sense and
 Veterans United for Truth, as a proposed class action on behalf of
 320,000 to 800,000 veterans or their survivors. The groups said the VA
 arbitrarily denies care and benefits to wounded veterans, forces them to
 wait months for treatment and years for benefits, and gives them little
 recourse when it rejects their medical claims. The department has a
 backlog of more than 600,000 disability claims, the suit said. A Pentagon
 study group reported in June that the system was understaffed, prompting
 the VA to announce staffing increases in July. The study group also
 found that 84,000 veterans, more than one-third of those who sought care
 from the department from 2002 through 2006, had been diagnosed with
 post-traumatic stress or another mental disorder.

     In seeking dismissal of the suit, the Justice Department argued
 that Congress had barred federal courts from hearing complaints about the
 VA system when it established a special Court of Appeals for Veteran
 Claims in 1988 to review grievances over treatment and benefits. But
 Conti said the special court can examine only individual cases and has no
 power to consider "systematic, constitutional challenges." He said
 those belong in regular courts. Conti also said the VA system, originally
 intended as an informal procedure to help veterans resolve their claims,
 has morphed into an adversarial process in which claimants have to
 comply with formal legal rules, often without a lawyer. "It is within the
 court's power to insist that veterans be granted a level of due process
 that is commensurate with the adjudication procedures with which they
 are confronted," Conti said. Efforts to reach the Justice Department
 for comment were unsuccessful. [Source: San Francisco Chronicle Bob
 Egelko article 11 Jan 08 ++]


TRICARE UNIFORM FORMULARY UPDATE 23:   On 10 JAN the DoD Beneficiary
 Advisory Panel (BAP) met to review DoD proposals to elevate some
 cardiovascular disorder, prostate, and immune disease medications to the third
 tier, or $22 copay level. In the cardiovascular disorder category, the
 BAP concurred with keeping Zebeta, Coreg, Toprol XL, and Lopressor at
 $3 or $9 copays. Within the prostate medications, DoD proposed a "prior
 authorization" requirement which would require beneficiaries to try
 Uroxatral before Hytrin, Cardura, or Flomax unless they had a current
 prescription within the last 180 days. Even after trying Uroxatral without
 success, a "medical necessity" statement from a physician is still
 needed for Flomax or beneficiaries would have to pay a $22 copay. The BAP
 agreed to the prior authorization requirement but urged DoD to move
 Flomax back to a lower copay.

     The targeted immunomodulatory biologics (TIB) -- Enbrel, Kineret,
 Humira, Raptiva, and Amevive -- are used to treat various forms of
 arthritis, psoriasis, Chron's Disease, and ulcerative colitis. By a
 one-vote margin, the BAP concurred with moving Enbrel and Kineret to the third
 tier but recommended delaying implementation for 120 days to allow
 time for patients to consult with their doctor and a rheumatologist.
The BAP agreed to move Exforge, a combination drug for high blood
 pressure, and the contraceptive Lybrel to the third tier with a 60-day
 implementation period. However, the BAP did not concur with moving Vyvnase,
 used to treat ADHD, to a $22 copay. This is the first case where DoD
 has recommended third tier status when there was no clinically meaningful
 therapeutic disadvantage or cost advantage. The BAP concurred with
 DoD's recommendations to place the generic version of the hypertension
 drug Norvasc back on the formulary at a lower copay than the current $22
 price. All recommendations will be submitted to the Assistant Secretary
 of Defense (Health Affairs) for final decision. Beneficiaries can use
 the Formulary Search Tool located on  TRICARE's pharmacy web site
 http://www.tricare.mil/mybenefit/home/Prescriptions  for additional
 information about medications, their availability and cost. [Source: MOAA
 Leg Up 11 Jan 08 ++]


VA BUDGET 2008 UPDATE 11:   President George W. Bush recently signed HR
 2764, the Consolidated Appropriations Act, 2008; which, the Military
 Construction and Veterans Affairs and Related Agencies Appropriations
 Act of 2008 falls under Division "I" of this bill.  The 11-bill Omnibus,
 one that increases the VA budget by $6.6 billion above the 2007 level,
 calls for $3.7 billion above the President's request for fiscal year
 2008, which is the largest single increase in the 77-year history of the
 Veterans Administration. The $3.7 billion increase for veterans is
 designated as emergency funding under the final bill, and is contingent on
 approval by the President before it can be released to the VA prior to
 the 18 JAN deadline.   The president has indicated he will approve this
 by the deadline. VA needs the additional $3.7 billion in emergency
 funding to help reduce the unacceptable claims backlog and hire PTSD
 counselors and claims adjudicators to work with returning OEF/OIF veterans.
 [Source: AL Philippine DNL Jan 08 ++]


RESERVE RETIREMENT AGE UPDATE 12:   The President issued a pocket veto
 of the defense bill just after Christmas because of an unrelated
 provision about lawsuits against the current Iraq government. Lawmakers are
 expected to resolve this issue and resubmit it for the President's
 signature within the next few weeks. The vetoed legislation included
 language sponsored by Senator Saxby Chambliss (R-GA) that lowers the reserve
 retirement age below age 60 by three months for each cumulative 90 days
 of active duty served on "contingency operation" orders. The activation
 orders, whether involuntary or not, must indicate a contingency
 operation. The activated member need not be deployed to qualify. Reservists
 could retire as early as age 50 with 10 years' qualifying active duty
 service, if otherwise qualified for a reserve retirement. The pending
 change, however, is prospective only. That means only active duty service
 after the date the defense bill is signed into law (hopefully, later
 this month) will be credited toward reducing the retirement age. A second
 concern is that reservists who qualify under the new law to retire
 before age 60 would not be entitled to TRICARE until they reach age 60.

     The new retirement upgrade doesn't go far enough. But it's at
 least a first-ever beachhead on this issue. Now that Congress has
 explicitly recognized the obsolescence of a retirement system built 50 years ago
 for a different force and the Cold War, members of the Military
 Coalition (TMC) should pursue more comprehensive reform until it's achieved.
 The next step is to make the "90 days retirement credit for 90 days
 active service" change retroactive to cover active service in the post-911
 era. Since then, more than 600,000 Guard and Reserve warriors have
 served contingency operation active duty. More than 142,000 have served
 multiple tours.

     While Congress contemplates a remedy for the current National
 Defense Authorization bill, Representative Joe Wilson (R-SC) has taken a
 preemptive measure to address reserve retirement pay. Wilson has
 introduced H.R. 4930 a bill that would make the early reserve retirement pay
 language of NDAA Section 647 retroactive to September 11, 2001. The
 legislation would count any aggregate of 90 days of qualifying service
 performed in any fiscal year after 911 toward reducing the 60-year
 eligibility age by three months. Proposals that would simply change the reserve
 retirement age from 60 to 55, including H.R. 690 (Rep. Jim Saxton,
 R-NJ) and S. 1243 (Sen. John Kerry, D-MA), are also still in play. But it's
 more likely in the future that Congress will tie additional service,
 including operational service, to any broad plan to lower the reserve
 retirement age. Such proposals need to include TRICARE eligibility. It
 makes no sense to provide access to TRICARE (TRICARE Reserve Select) for
 Selected Reserve families and then cut off that coverage for "gray
 area" and other pre-age 60 reserve retirees. The evolution of the reserve
 forces from a strategic to an operational role means more service on
 active duty, more time away from home, and diminished civilian career
 prospects. Now that Congress has begun to recognize these realities, it's
 time for more aggressive steps by the military community in
 communicating with their legislators to improve the reserve retirement system.
  [Source: NGAUS LEGIT & MOAA Leg Up 11 Jan 08 ++]


VETERAN CHARITIES UPDATE 05:  Many people want to donate money and
 assets to help veterans. To help you make an informed decision, the Florida
 Department of Veterans’ Affairs has compiled a list of resources
 provided below:

• www.sunbiz.org• : For information on organizations registered with
 the Florida Department of State’s Division of Corporations, including
 non-profit organizations.
•  http://app1.800helpfla.com/giftgiversguide• : The Florida Department
 of Agriculture and Consumer Services’ Gift Givers’ Guide provides
 revenue information, as well as costs, surplus and more on charitable
 organizations.
•  www.charitynavigator.org• : This national Web site hosts information
 on large charitable organizations that take in at least $500,000 per
 year and have existed for a minimum of five years. Charity Navigator
 also includes helpful tips for donating.
•  www.charitywatch.org• : The American Institute of Philanthropy is a
 nationally prominent charity watchdog service whose purpose is to help
 donors make informed giving decisions.
If you want to donate money to help your fellow veterans or current
 servicemembers, a good rule of thumb to go by is to donate to
 organizations that you know are legitimate and well-established. The VA has
 published a Directory of Veterans Service Organizations, which you can access
 by logging onto www1.va.gov/vso.  [Source: eFlorida Vet News 11 Jan 08
 ++]


VA PERFORMANCE:   The health care system of the Department of Veterans
 Affairs (VA) received a highly favorable review in an interim report
 recently published by the Congressional Budget Office (CBO).  The report
 credits organizational restructuring and management systems,
 performance measurement and information technology (IT) as contributors to VA's
 success.  It also outlines ways in which VA can continue serving as a
 model for other health care systems.  The interim report is featured on
 CBO's Web site at www.cbo.gov.  The final report, expected in early
 2008, will address the potential for other public and private health care
 systems to apply similar approaches and other issues. The report,
 completed at the request of the chairmen of the House Committee on Veterans’
 Affairs and the Subcommittee on Military Construction, Veterans
 Affairs, and Related Agencies of the House Committee on Appropriations,
 reviews the quality of VA’s health care, examines VA’s achievements and looks
 at lessons learned from both its management initiatives and
 application of information technology. Key factors cited in the report included
 VA’s restructuring efforts to permit more shared decision making between
 VA’s central office, regional managers and facility directors;
 measuring performance, process and outcomes; and system-wide use of health
 information technology.

     The improvement in VA’s health care quality in recent years has
 been well-documented in a number of independent studies including those
 by the Institute of Medicine (IOM).  VA’s accomplishments are all the
 more noteworthy as they came during a period of increased demand for
 services. From 1999 through 2007, enrollment in the VA health care system,
 mandated by the Veterans’ Eligibility Reform Act of 1996, swelled from
 just over three million to nearly eight million veterans.
  Consequently, the number of veteran patients treated each year increased from
 approximately 3.2 million to more than five million. The CBO report pointed
 to VA’s structure as an integrated health care system that allows the
 use of two important tools: incentives given to managers and providers
 to meet quality of care and practice guideline targets; and health IT
 systems that provide reminders about tests and treatments recommended by
 the practice guidelines.  It also examined the low cost of care for
 veterans as an incentive for seeking care. VA has an electronic health
 record for every patient, which provides up-to-date information about a
 patient at the point of care, including his or her history, allergies,
 and medications.  It also consists of relevant diagnoses and laboratory
 tests, enabling providers to avoid duplicate tests and adverse drug
 interactions. Research indicates that computer reminders and prompts can
 significantly improve adherence to clinical guidelines, particularly for
 preventive care.

     The CBO said that VA’s integrated structure and appropriated
 funding may have helped VA focus on providing the best quality care for a
 given amount of funds as contrasted to fee-for-service incentives toward
 billable services and procedures. These and other issues will be
 addressed in the final report.
VA is the second largest cabinet department, with about 250,000
 employees, a health care budget last year of $32 billion and an overall budget
 exceeding $82 billion.  VA will provide care to more than 5.8 million
 veterans this year in its 153 hospitals and nearly 900 clinics.  VA
 also provides disability compensation and pensions to 3.5 million veterans
 and family members, and operates 125 national cemeteries. [Source: VA
 News Release 9 Jan 08 ++]


IRS DATA BREACH UPDATE 01:  In addition to addressing less than 30% of
 the information security weaknesses highlighted in a 2007 Government
 Accountability Office report, the Internal Revenue Service provided false
 claims about its progress, according to a Government Accountability
 Office auditor.
A new GAO report (GAO-08-211) released 9 JAN states that the agency
 corrected or mitigated 29 of the 98 information security weaknesses
 highlighted at the time of GAO's last review in 2007. Among other findings,
 the IRS failed to consistently enforce strong password management for
 identifying users, authorize user access according to job functions,
 encrypt sensitive data, monitor changes on the mainframe computer server
 that supports the agency's general ledger for tax administration, and
 physically protect computer resources. That, combined with failure to
 implement internal controls and system configuration policies, continues to
 threaten financial and taxpayer information, according to the report.
 "IRS needs to establish a risk-based approach for mitigating weaknesses
 and ... fully implement an information security program on an agency
 wide basis in order to ensure that issues don't reoccur later," said
 Gregory Wilshusen, director of information security issues at GAO.

     Also of concern to GAO were incorrect reports from the IRS about
 steps made to improve information security. "Our objective was to follow
 up on previously reported weaknesses to see progress," Wilshusen said.
 "Interestingly, they reported several weaknesses as being mitigated,
 but when we went in to do our follow-up exam, we found they had not been
 corrected." Wilshusen could not specify which vulnerabilities the IRS
 erroneously claimed to have been dealt with, saying that release of
 specific information could spur malicious attacks against its networks.
 The IRS declined comment for this article. The agency has made some
 progress, tightening access controls for certain critical servers, limiting
 computer room access to authorized individuals, developing a security
 plan for a key financial system, and updating servers that were running
 unsupportable operating systems. In addition, the IRS began efforts to
 establish security policies, procedures and practices with six
 enterprise wide goals that would help protect and encrypt data, secure
 information technology assets, and build security into new applications. GAO
 also made seven recommendations to improve information security,
 including updates to policies and procedures for configuring mainframe
 operations, specialized training, expanded testing, enhanced contractor
 oversight and contingency planning. In addition to implementing a strict
 information security program, the IRS will initiate a performance standard
 focused on resolving security weaknesses and reporting the security
 compliance status of computer systems connected to its network.

     The IRS is not alone. In APR 07, GAO reported (GAO-07-751T) that
 24 major federal agencies continue to have weaknesses with information
 security controls. A number of other GAO reports highlight the failures
 by specific agencies to deal with problems. "The guys at GAO are
 wonderful, but this report could have been written every year for the past
 eight years -- at least -- and for nearly every agency," said Alan
 Paller, director of research at the SANS Institute, a nonprofit cybersecurity
 research organization in Bethesda, Md. In SEP 07, IT security firm
 Symantec released its Internet security threat report, which found that
 one in four security breaches occurred in the government sector. "It's
 almost like Groundhog Day -- we're entering 2008 with this report on IRS,
 but the title of the agency could just as easily be left blank," said
 Jim Russell, vice president for public sector at Symantec. "A lot of
 the issues cited can be solved through policy compliance. IRS needs to
 get a handle on what their environment looks like, but more importantly,
 they need to look at endpoints and servers and make sure they they're
 standardized with the latest security software and have the latest
 patches.  [Source: GovExec.com Newsletter 9 Jan 08 ++]


CONGRESSIONAL COLA 2008:   Fortunately for members of Congress, their
 pay isn’t tied to their approval ratings. Lawmakers in 2008 will receive
 salaries of $169,300, a boost of $4,100 over the pay they have lived
 with since January 2006.  That 2.5% increase is mirrored by similar
 raises for associate justices of the Supreme Court, who will see their pay
 go from $203,000 to $208,100, and Chief Justice John Roberts, whose pay
 will rise to $217,400 from $212,100.  House Speaker Nancy Pelosi,
 D-Calif., will get a pay boost from $212,100 last year to $217,400, the
 same as Chief Justice Roberts. The majority and minority leaders of the
 House and Senate and Senate president pro tempore Robert Byrd, D-W.Va.,
 will get increases from $183,500 to $188,100. Dick Cheney, in his last
 year as vice president, will receive $221,100, up from $215,700.
 President Bush’s salary of $400,000 is unchanged.

     The salary figures were published in the 8 JAN edition of the
 Federal Register.  Last year was the first since 1999, when the pay was
 $136,700, that members of Congress did not receive a cost-of-living
 allowance raise along with other federal employees. Democrats, newly elected
 to the majority, had vowed to block an increase in their paychecks
 until Congress raised the minimum wage.  With the minimum wage increase
 accomplished last year, House Democratic leaders joined with their
 Republican counterparts to oppose a procedural vote to bring the COLA issue to
 the floor, leaving the way clear for their automatic raise. The
 congressional COLA is linked, under a complicated formula, to the
 cost-of-living increase awarded civil servants. As part of a 1989 ethics bill,
 Congress gave up its ability to accept pay for speeches and made annual
 cost-of-living pay increases automatic unless lawmakers voted otherwise.
  Rep. Jim Matheson (D-UT) a leading critic of the COLA process, said
 in an interview that he’s not proposing that members of Congress never
 get a pay raise. But he said that, in a time of budget deficits when
 many people are undergoing economic hardships, “at least we ought to have
 an up-and-down vote on it. The whole process appears so secretive.”
  Reluctance to openly discuss the salary issue comes at a time when
 Congress has been suffering low public approval ratings. In a December
 AP-Ipsos poll, only 25% of those surveyed approved of the job Congress was
 doing. [Source: AP Jim Abrams article 9 Jan 08 ++]


MERCHANT MARINE WWII COMPENSATION UPDATE 01:   Thousands of civilians
 who ferried troops and supplies through World War II's combat zones are
 closer than ever to receiving lifetime federal pensions, but things
 don't look so good for their wives. Legislation in Congress (HR 23) that
 would give merchant mariners $1,000 a month for life passed the House
 last year and, for the first time, has a healthy list of Senate sponsors.
 But the bill's new version eliminates the provision that passed the
 benefit on to surviving spouses, as long as their mariner husbands were
 living when the bill was approved. Cutting the spousal benefit was
 proposed in the House last year as a cost savings. The VA continues to
 oppose the bill, saying the monthly payments would be greater than what some
 disabled veterans receive and that mariners already receive other VA
 benefits. The Senate version (S. 961) could be heard by the U.S. Senate
 Committee on Veterans Affairs within the next few months. Sen. Larry
 Craig of Idaho, who staunchly opposed the measure because he believed it
 might open the door to compensating other civilian service groups, no
 longer is the committee's chairman. And the number of sponsors has risen
 from 37 last year to 57.

     The benefit is to compensate the mariners for not being included
 under the GI Bill, which gave money to returning World War II soldiers
 and sailors for home loans and college tuition. People in the Merchant
 Marine were classified as civilians, even if they served in combat
 zones, and did not receive veteran status until 1988. Today, mariners and
 some other civilian groups, such as the Women Airforce Service Pilots,
 can get health care, disability and burial benefits through the U.S.
 Department of Veterans Affairs. About 250,000 mariners served during World
 War II. The Congressional Budget Office estimated about 16,000 mariners
 would meet the pension requirements and apply. The bill allocates
 about $605 million to the Merchant Mariner Equity Compensation Fund, enough
 to fund pensions for an initial 10,000 mariners through 2012. Mariners
 would need an honorable discharge and proof they served "in harm's
 way" from 7 DEC 41 through 31 DEC 46. The Merchant Marine, which sometimes
 took boys too young to join the Army or Navy, lost 7,000 to 9,000 men
 during the war. [Source: South Florida Sun-Sentinel 10 Jan 08 ++]


VA FRAUD UPDATE 06:   A Wichita man has been federally indicted for
 claiming he was a Purple Heart recipient.  Albert Barker, 58, is charged
 with one count of making a false claim to the U.S. government, and one
 count of making a false statement in writing that he was awarded a
 Purple Heart medal. Prosecutors say the crimes occurred in OCT 05 and JAN 06
 in Sedgwick County KS. The indictment alleges that in 2005, Barker
 applied to the Department of Veteran’s Affairs for a disability rating
 based on his suffering from post traumatic stress disorder. He caused
 documents to be filed in support of the claim falsely stating he had served
 in a combat infantry and had received a Bronze Star. In JAN 06 he
 caused his American Veterans representative to submit a fraudulent Army
 General Order 164 claiming Barker had been awarded a Purple Heart medal.
 If convicted, he faces a maximum penalty of 5 years in federal prison
 and a fine up to $250,000 on the charge of making a false claim to the
 U.S. government, and a maximum penalty of 1 year and a fine up to
 $100,000 on the misdemeanor charge of making a false claim of receiving a
 Purple Heart medal.
Man gets probation in fraud

     A Billings man who stole Veterans Affairs checks sent to a man who
 was incarcerated out of state will spend four years on probation and
 have to pay $11,778 restitution. U.S. District Judge Richard Cebull on
 Wednesday sentenced James Gus Georgacopoulos, 61, at the low end of the
 guideline range, noting he had no previous record and the crime
 appeared to be an isolated incident. Georgacopoulos offered no excuses. He
 said it was the "first time I've ever done something stupid like this and
 it will never happen again." Prosecutors said Georgacopoulos, while
 working as a desk clerk at the Esquire Hotel, stole the victim's mail and
 VA checks, forged the victim's signature and gave them to a
 co-defendant, Lowell Timothy Howell, to cash and deposit. The two split the
 proceeds. The victim is incarcerated in Florida. Cebull previously sentenced
 Howell, of Georgia, to six months in prison and also ordered him to pay
 restitution. [Source: Lakeland KS KAKE 10 News & Billings MT Gazette
 10 Jan 08 ++]


SPIN CODE LAWSUIT:   This case was originally filed in the US District
 Court, Northern District of New York, Syracuse and aspects of it are
 still being litigated. The lawsuit began in MAR 76 when Edwin Cosby with
 an Honorable Discharge discovered he had a bad “Spin Code” (i.e.
 Separation Program Number). Unknown to him and most other veterans beginning
 11 JUN 56 under D.O.D. Instruction 1336.3 DOD ordered the military
 departments to begin putting a coded number on the main employment
 reference document of veterans. This document known as the DD-214 is often by
 employers of veterans seeking employment and benefits.  DoD prepares
 eight or more copies of a veteran’s DD-214 of which copy one goes to the
 veteran and others are eventually sent to State Adjutant General, VA
 Data Processing Center, Austin, TX. State Director Selective Service, and
 National Military Records Center, St. Louis MO.  At a congressional
 hearing in 1974 DoD told Congress that only a couple hundred thousand
 documents had a code number and the "SPN" coding system would be stopped.
 However, in 1972, DoD started changing their “SPN” system to the "SPD"
 (separation program designator) and by 1977 nearly 20 million veterans
 with Honorable Discharges had a coded number. Congress subsequently
 attempted to pass a law regarding the use of the coded numbers; however,
 this failed to pass.

     Numerous major corporations have admitted to having the codes and
 use them in their employment decisions regarding veterans.  Banks, life
 insurance companies, State Government & Federal Government Agencies
 have them as well.  Lists of the codes were sent to FAA, (federal
 aviation admin.), HUD, (housing & urban development), and Office Personnel
 Management. Even on an Honorable discharge, a "Spin Code” can hurt a
 veteran's chance of being hired by a prospective employer, obtaining a loan,
 and/or obtaining insurance.  A few examples of spin codes and their
 meanings are:
SPN 258 - Unfitness, multiple reasons
SPN 263 - Bedwetter
SPN 41A - Apathy, lack of interest
SPN 41E - Obesity
SPN 46C - Apathy / Obesity
SPN 463 - Paranoid personality

     A complete listing of spin codes can be found at
 http://www.landscaper.net/discharg.htm. Veterans can request a new DD
 214 with the spin codes removed. If you were in the US Army, written
 requests for having a SPN code removed from your DD 214 (Report of
 Separation from Active Duty) or earlier discharge papers, should be sent to:
 Commander, Reserve Components Personnel & Administrative Center, Box
 12479, Ollivette Branch, St. Louis, MO 63132.  Additional info on this
 subject is available at http://veterancourtcodes.com which contains a 90
 minute video on the subject.  [Source: Veteran’s Forum 9 Jan 07 and Ed
 Crosby ecrosby1@rochester.rr.com ++]
 

MEDICARE PART D UPDATE 17:   The Centers for Medicare & Medicaid
 Services (CMS) may have overpaid private contractors millions of dollars for
 services tied to the start-up of the Part D prescription drug benefit,
 according to a recent study by the Government Accountability Office
 (GAO). From 2004 to 2006, CMS was provided $1 billion in federal funds for
 administrative start-up of the Medicare drug benefit. The vast
 majority (81%) of the funds were used in private sector contracts for support
 services, including call center support, media buys, promotional tours
 and research reports. According to the GAO, 45% of CMS contracts were
 awarded without competitive bidding, while 78% were structured for the
 government to assume the risk of cost overruns. GAO identified close to
 $90 million in questionable payments to private companies with federal
 contracts. For these contracts, CMS did not conduct the audits,
 monitoring and other oversight to verify contractor charges, as required by
 federal regulation.

     As contract awards more than doubled, CMS increased oversight
 staff by only 11%. As a result, many contracted agencies were reimbursed
 for costs not directly related to the contract or at rates higher than
 market value. In one audit where the GAO found that CMS paid out $40.6
 million for unsubstantiated costs, the contracted agency had charged CMS
 for property depreciation, grounds maintenance and recycling services,
 and placed questionable items such as basketball goals within its
 invoice package. In another audit, two companies that were contracted for
 similar services were found to have subcontracted the services to each
 other and billed CMS for $4.2 million in overlapping indirect costs. For
 many contracts, CMS reimbursed labor costs at inflated rates, which
 included vacation or sick time, or rates that were far higher than wage
 rates within the company. One research firm charged CMS for labor at 14
 times its average rate. The GAO recommended that CMS review its
 oversight policies, improve training for audits and pursue reimbursement of
 unsubstantiated costs outlined in the report. CMS responded to GAO that it
 will continue to update its policies, but otherwise defended its
 contracting practices. CMS said the agency has been exemplary in its use of
 competitive contracts.

     The Medicare prescription drug benefit (Part D) saves enrollees $9
 or less per month, according to researchers who tracked purchases of
 over 100,000 older adults before and after the benefit began in 2006.
 The program will cost about $1 trillion over the next ten years but these
 small savings to beneficiaries is the result of the Part D benefit
 being run by private companies and not by Original Medicare. According to
 Consumer Union most Medicare Drug Plans continue to hike costs into
 2008 two-to-three times rate of inflation, Consider these two facts from a
 recent overview of health spending published in Health Affairs by
 researchers for the Centers for Medicare & Medicaid Services:
• Of the $41 billion in Part D spending in 2006, $5.3 billion, or 13%
 went for administrative costs and the profit siphoned off by the
 insurance companies offering Part D. By contrast, just 3% of spending for
 coverage of doctor visits and hospital care under Original Medicare goes to
 administrative costs.
• The Part D plans cannot negotiate discounts and rebates from drug
 manufacturers that come close to matching what Medicaid received, when
 that program provided drug coverage for low income people with Medicare.
 In fact, even though enrollment in Part D plans is more than double the
 number of people enrolled in Medicare and Medicaid, the total amount of
 rebates received by Part D companies are less than Medicaid received
 before Part D took over coverage.

It is becoming more and more clear that the privatized structure for
 Part D has created a boondoggle for drug manufacturers and insurance
 companies even as it has fallen woefully short in providing people with
 Medicare the kind of drug coverage they need. It is time to for Congress
 to eliminate the middle man and provide a drug benefit directly through
 Medicare. Older adults and people with disabilities deserve that
 choice.  [Source: Medicare Watch www.medicarerights. org 8 Jan 08 & Consumer
 Advocacy Update ++]


MISSOURI RETIREE TAX EXEMPTION:   Military retirees in Missouri might
 have a state tax cut coming, if lawmakers go along with a proposal by
 Gov. Matt Blunt. The governor proposed to eliminate the state income tax
 on military pensions for tens of thousands of veterans in Missouri. The
 tax cut would cost the state about $24 million a year, Blunt said.
 Veteran’s officials said the tax cut was one of their priorities. Of the
 41 states that have an income tax, 12 do not tax military pensions,
 including neighboring Illinois. Blunt outlined the proposal at a Veterans
 of Foreign Wars post in Springfield, the first of several statewide
 stops to promote the tax cut. The tax change would need approval by the
 legislature, which started its 2008 session 7 JAN. “I think there will be
 strong support in the legislature,” Blunt said. He was flanked by state
 Sen. Jason Crowell, R-Cape Girardeau, head of that chamber’s veteran’s
 affairs committee, and House counterpart Rep. David Day, R-Dixon. Both
 men said they supported the tax cut. “The best that we can do to help
 is to let you keep more of your money in your wallet,” Crowell said.
 The governor said state economic growth made the tax break possible
 without having to cut any programs or raise taxes elsewhere. The proposed
 tax cut for military veterans follows one enacted last year for retirees
 in general. The 2007 law exempted additional Social Security benefits
 and certain other retirement benefits from the state income tax. Those
 tax cuts are projected to cost $154 million when fully phased in by
 2012.  [Source:  Columbia Missourian AP article 7 Jan 07 ++]


VA HOSPICE CARE UPDATE 01:   The Department of Veterans Affairs (VA) is
 providing hospice and palliative care to a growing number of veterans
 throughout the country as the need continues to rise for care and
 comfort at the end of life. VA provides palliative care consultation
 services at each of its medical centers and inpatient hospice care in many of
 its nursing homes throughout the country.  VA contracts with
 community-based hospice programs to enhance VA’s ability to provide this critical
 service when and where needed. Nearly 9,000 veterans were treated in
 designated hospice beds at VA facilities in 2007, and thousands of other
 veterans were referred to community hospices to receive care in their
 homes.   The number of veterans treated in VA’s inpatient hospice beds
 increased by 21% in 2007.  In addition, the average daily number of
 veterans receiving hospice care in their homes paid for by VA increased by
 30% this past year. Because of the large number of World War II and
 Korean era veterans and a tripling of the number of veterans over the age
 of 85 from 2000 to 2010, the increase in the need for hospice care is
 expected to continue. The proportion of Vietnam-era veterans over the
 age of 65 will continue to increase through 2014, when Vietnam veterans
 will account for nearly 60% of all veterans in that age group.

     VA’s expansion of its hospice and palliative care capabilities
 came about through collaboration with community-care providers.  In 2001,
 the National Hospice-Veteran Partnership Initiative began to build
 partnerships between VA facilities and community hospice providers, funded
 in part by the VA and by nonprofit groups such as the National Hospice
 and Palliative Care Organization and the Advanced Illness Care
 Coordination Center. To date, VA has partnered with community hospice programs
 in 35 states to promote hospice services that are not provided directly
 by VA staff.  These partnerships help veterans transition from VA
 hospitals to their homes in the community.  Palliative care adds a focus on
 quality of life and comfort to veterans with life-limiting illness,
 and their families.  Palliative care consultation teams include
 physicians, nurses, social workers and chaplains.  Additional support may be
 provided by pharmacists, rehabilitation therapists, recreation therapists,
 mental health professionals and other specialists. VA provides
 palliative care consultation teams at all of its hospitals nationwide,
 although such services are provided at only about one-fourth of all American
 hospitals.  Nearly half of all veterans who died in VA facilities
 received care from a palliative care team prior to their deaths.  For more
 info on VA’s programs and obtaining services refer to
 http://www1.va.gov/geriatricsshg/page.cfm?pg=65.  [Source: VA News
 Release 8 Jan 07 ++]


SBP PAID UP PROVISION UPDATE 04:

1) What is Paid-up SBP?  Paid-up SBP refers to a provision of the
 Survivor Benefit Plan (SBP) law passed by Congress in OCT 98and which is due
 to take effect in OCT 08. This change in the law applies to qualified
 members who will no longer be required to pay SBP premiums once they
 satisfy certain age and premium payment requirements.

2) Who is eligible to have their SBP premiums stopped? Any retiree who
 is age 70 or older and whose retired pay has been reduced for SBP
 premiums for at least 360 months will qualify to have their SBP costs
 terminated.

3) Are retirees with Reserve Component SBP (RCSBP) coverage eligible?
 Yes. Any reference made to SBP premiums also includes RCSBP premiums.

4) Is a retiree who has paid SBP premiums for 360 months or more but
 has not reached age 70 eligible to have premiums terminated? No. In order
 to qualify for the termination of SBP premiums, a retiree must satisfy
 both requirements of the law. The retiree must be age 70 or older and
 made payments for at least 360 months of SBP costs.

5) Does the termination of premium payments also apply to retirees with
 RSFPP coverage? Yes. Congress amended the law in OCT 99 to include
 Retired Serviceman’s Family Protection Plan (RSFPP) participants. Any
 retiree who is age 70 or older and currently enrolled in the RSFPP is
 eligible to have their RSFPP costs terminated.

6) When does Paid-up SBP begin? The earliest effective date that a
 qualified retiree may stop paying SBP premiums is 1 OCT 08. The first
 retired pay payment affected will be the payment dated 1 NOV 08.

7) What if the retiree has paid more than 360 months of premiums before
 1 OCT 08? Will there be a refund? No. There will be no refund of
 excess premiums paid prior to the 1 OCT 08, effective date of Paid-up SBP.

8) When will SBP premiums stop for retirees who reach age 70 and have
 paid 360 months of premiums after 1 OCT 08? Retirees who fall into this
 category will not be charged SBP premiums beginning with the month they
 reach age 70 and have paid 360 months of premiums.

9) How will the 360 months of paid-up premiums be determined? The
 retiree will receive a one-month credit for each month retired pay was
 reduced. This will be determined by using both current election records and
 historical records of the initial SBP election.

10) What if the retiree does not have 360 months of paid-up premiums on
 1 OCT 08? A retiree who does not have 360 months of paid-up premiums
 on 1 OCT 08 is not eligible to have the SBP costs stopped. In these
 cases the retiree will receive an additional one-month credit for each
 month retired pay is reduced until 360 months of paid premiums is reached.

11) What if the retiree does not have SBP costs deducted from retired
 pay but pays by direct remittance? For the purpose of computing the
 number of months of retired pay reductions, direct remittance payments
 shall apply as if retired pay was reduced.

12) Will retirees be notified of their paid-up status? Notices will be
 mailed to retirees informing them of the number of months of coverage
 that have been credited to their account toward paid-up status.

13) When will retirees receive notification from DFAS? Details
 regarding a retiree’s personal account will not be ready for release until May
 2008. DFAS will begin the notification process at that time.

14) Who can expect to receive notification letters from DFAS in May
 2008? Retirees enrolled in either the SBP or RSFPP programs that are at
 least 68 years of age or have been retired and paying premiums for at
 least 27 years will receive notification letters in MAY 08.

15) What type of information will be provided in the notification
 letter? The notice retirees will receive will provide Paid-up SBP
 information as well as specific information about their account, the number of
 months of paid-up premiums and their current paid-up status. The notice
 will also instruct retirees of the right to challenge their paid-up
 status if they disagree with the number of months of paid-up premiums
 calculated by DFAS.

16) What if the retiree does not agree with the number of months of
 coverage provided on their notice? If the retiree does not agree with the
 number of months of coverage credited to their retired pay account the
 retiree will have the option to prove differently.

17) What information must the retiree provide to have their months of
 coverage adjusted? The retiree must submit DD Form 2656-11, “Statement
 Certifying Number of Months of SBP Premiums Paid.” In addition, the
 retiree may be requested to provide documentary evidence for each month of
 Paid-up SBP credit claimed. Upon receipt of the DD Form 2656-11, DFAS
 will review and adjust the retired pay record to reflect the number of
 months that the retiree certifies has been paid.

18) Can the DD Form 2656-11 be filed at any time? No. Retirees who
 elect to submit a DD Form 2656-11 must do so within one year after initial
 notification of the number of months of Paid-up SBP credited.

19) How often may retirees challenge their paid-up status by filing a
 DD Form 2656-11? Retirees will be permitted to challenge their paid-up
 status only once. They will not be permitted to submit multiple forms to
 DFAS.
[Source: Retiree Activities Office 314AW/CVR 7 Jan 08 ++]
 

VA CWT & IT UPDATE 01:  Payments provided to veterans under two
 specific programs of the Department of Veterans Affairs (VA) -- the
 Compensated Work Therapy (CWT) and Incentive Therapy (IT) programs— are no longer
 taxable, according to the Internal Revenue Service.  Veterans who paid
 tax on these benefits in the past three years can claim refunds.
 Recipients of CWT and IT payments no longer receive a Form 1099
 (Miscellaneous Income) from VA.  Veterans who paid tax on these benefits in tax
 years 2004, 2005 or 2006 can claim a refund by filing an amended tax
 return using IRS Form 1040X.  Nearly 19,000 veterans received CWT benefits
 last year, while 8,500 received IT benefits. The IRS agreed with a U.S.
 Tax Court decision earlier in 2007 that CWT payments are tax-free
 veteran’s benefits.  In so doing, the agency reversed a 1965 ruling that
 these payments were taxable and required VA to report payments as taxable
 income. The CWT and IT programs provide assistance to veterans unable
 to work and support themselves.  Under the CWT program, VA contracts
 with private industry and the public sector for work by veterans, who
 learn new job skills, strengthen successful work habits and regain a sense
 of self-esteem and self-worth.  Veterans are compensated by VA for
 their work and, in turn, improve their economic and social well-being.
  Under the IT program, seriously disabled veterans receive payments for
 providing services at about 70 VA medical centers.  [Source:  VA News
 Release 7 Jan 07 ++]


MEDICARE SOLVENCY UPDATE 01:   Cutting government spending on Medicare
 will take a top priority this year for President Bush and Members of
 Congress as a new provision of law is put to the test for the first time.
  Last year, for the second year in a row, the Medicare Trustees issued
 a “Medicare funding warning.”  The funding warning alerts the
 President and Congress that the Medicare Trust Funds’ financing is inadequate,
 and the amount of general federal revenues required to cover program
 costs is becoming unduly large. When two such warnings are issued
 consecutively, the President is required to submit proposed legislation to cut
 Medicare spending.  Congress is then required to consider this
 legislation on an expedited basis. Medicare is financed from two distinct
 sources — “dedicated revenues,” like the Medicare payroll tax, premiums,
 and tax on Social Security benefits— and general federal revenues, like
 income taxes. By law the federal government is required to pay the
 federal share of Part B and Part D costs out of general tax revenues.  In
 addition, current law requires that the interest on the non-marketable
 government bonds or IOUs held by the Medicare Part A and Part B Trust
 Funds as well as redemption of those IOUs, must be paid out of general tax
 revenues.

     To cut Medicare costs, last fall President Bush proposed that
 upper-income seniors enrolled in Medicare Part D should pay higher premiums
 as they already do for Medicare Part B premiums.  But economists say
 Means Testing Part D alone won’t be enough to put Medicare on sound
 financial footing, and that bigger, much broader cuts are required.  In his
 newly published memoirs, former retired Federal Reserve chairman Alan
 Greenspan said that Medicare benefits would need to be cut by half. In
 2007 the Congressional Budget Office released the following proposals
 for Congress to consider as options to cut Medicare costs.

• Increase the portion of the Part B premium that seniors must pay to
 35% of program cost and reduce the government portion to 65%. —
 Currently, beneficiaries pay 25% and the government pays 75%.  If this were to
 become effective in 2008, for example, the standard premium that most
 seniors would pay for Part B would be $135 per month instead of $96.40.
• Increase deductibles and hospital co-pays and impose new co-pays and
 deductibles on services that have none now.
•  Bar Medigap supplements from covering Medicare deductibles and limit
 coverage of co-insurance costs, requiring seniors to pay as much as
 $2,750 per year in out- of-pocket cost - sharing. 

The Senior Citizens League is highly concerned that one or more of the
 above proposals may make their way into the President’s plans to cut
 government spending on Medicare.  The League is monitoring proposals that
 are being put forward and opposes legislation that would add any
 further cost burden to already over-stretched seniors’ budgets.  [Sources:
 2007 Medicare Trustees Report 23 APR 07,  The Age of Turbulence, Alan
 Greenspan Penguin Press 2007 & Budget Options CBO Feb 07]


SSA FUTURE BENEFITS UPDATE 01:  Cuts to Social Security, as well as
 Medicare, may come under consideration of lawmakers this year.  The
 Congressional Budget Office is predicting that surplus Social Security
 payroll taxes will start to decline in just two or three years.  Program
 costs will begin to exceed cash revenues in just ten years, thus putting
 pressure on other parts of the federal budget. In his recently published
 book, retired Federal Reserve Chairman Alan Greenspan said that
 “resolving the funding shortfall for federal social insurance (Social
 Security) is going to require benefit cuts.”  “In short,” he says, “the
 promises may have to be broken.” Yet, despite the gloomy financial outlook for
 Social Security, Congress recently considered “piecemeal approach”
 legislation that would legalize illegal immigrants.  Just three months
 after Congress failed to pass guest worker immigration amnesty last year,
 legislation was once again introduced in the Senate that would give
 conditional legal status to young illegal immigrants.  The measure failed.
 

     Without changes to current Social Security law, should illegal
 immigrants gain legal work authorization and a work-authorized Social
 Security number, they eventually would be able to claim Social Security
 benefits.  Under current Social Security policy, when determining benefits
 the Social Security Administration counts all reported earnings, even
 those earned for unauthorized work using an invalid or fake Social
 Security number.  If Congress adds millions of illegal immigrants to Social
 Security’s rolls it would make Social Security’s troubled finances
 even worse, and could trigger benefit cuts for seniors and future retirees
 who earned their benefits legally.  To counter this Representative
 Dana Rohrabacher (CA) has introduced the “No Social Security for Illegal
 Immigrants Act”. The legislation would ban Social Security credit for
 earnings from illegal work, and wages from unauthorized work could not be
 used to determine entitlement to benefits.  [Source: TSCL Social
 Security and Medicare Advisor 7 Jan 07 ++]


MEDICARE VACCINATIONS:   In 2008, the way vaccinations are covered by
 Medicare private drug plans (Part D) will change. Medicare Part B covers
 vaccinations for the flu, pneumonia and hepatitis B (for patients at
 medium to high risk). In addition, Part B covers vaccines if you need a
 particular shot because you were exposed to the disease, such as
 tetanus shot because you were bitten by a dog. All vaccinations that are
 covered by Part B will continue to be covered under Part B. If you received
 a Medicare-covered vaccination that was not covered by Part B any time
 in 2007, it was covered by a combination of Part B and Part D. The
 drug itself was paid for by your Part D prescription drug plan. An example
 of a vaccine typically covered by Part D plans is the one used to
 treat shingles (Herpes zoster) called Zostavax.  However, Part B paid for
 the doctor to give you the shot, the office fees and the costs of the
 materials needed to administer the vaccine, like a syringe or gauze. In
 2008, however, vaccines not covered under Part B will have both
 administration and the drug itself covered by Part D (once you have met your
 annual deductible). This may change where you can get your Part D-covered
 vaccinations and what you pay for them. You should:

1.  Check with your plan to make sure the vaccine you need is on your
 plan’s list of covered drugs (formulary). If the vaccine you need is on
 your Part D plan’s formulary, the plan will pay for the vaccine itself,
 the fee for dispensing the drug, as well as the cost of administering
 it. If a vaccination is not on your plan’s formulary, you will need to
 make a formal request to your plan—an “exception” request—to ask that
 the drug be covered for you. Part D plans are supposed to quickly add
 new vaccines to their formularies.
2.  Ask your plan where you can get your shot so that the vaccination
 will be covered for you at the lowest cost. The amount you pay for your
 vaccination could vary based on where you get vaccinated. You will pay
 the least for your vaccinations if:
• You are given the vaccine by a pharmacist or at a clinic within a
 pharmacy that is in your drug plan’s network (an “innetwork” pharmacy); or
• You get the vaccine at a doctor’s office that can work with a
 pharmacy that will bill your Part D plan for the entire cost of the
 vaccination process (the doctor is not getting the drug from the pharmacy, but
 collaborating with the pharmacy to streamline the billing process); or is
 going to bill your plan for the drug using a special computer billing
 system that allows your doctor to bill your drug plan directly for your
 vaccine.

In the above circumstances, the cost of the vaccination will be viewed
 as in-network. For in-network vaccinations, you will pay the plan’s
 approved coinsurance or copayment for the drug and service either to the
 doctor or to the pharmacist. If you have Extra Help, you can go to any
 doctor or in-network pharmacy and you will only be responsible for your
 Extra Help copayment. However, you may need to pay more for your
 vaccination if your doctor cannot submit the bill to your Part D plan through
 a partnering pharmacy; and/or does not directly bill your plan for the
 drug using the electronic billing system. In these circumstances, the
 doctor will bill you for the entire cost of the vaccination process and
 you will have to pay the entire bill up front. You will then have to
 mail your receipt to your drug plan for reimbursement. The doctor is not
 limited in how much to charge you for the vaccine, but Part D plans
 will still pay only their approved amount for the vaccine costs. Thus,
 when you are reimbursed by the plan, you will only be
reimbursed for your Part D plan’s approved payment. If the amount your
 doctor charged for the vaccination is above the Part D plan’s approved
 amount, you will not be reimbursed for the difference between the
 doctor’s charge and the plan’s approved payment. For general info on
 Medicare vaccinations refer to
http://www.cms.hhs.gov/AdultImmunizations.  For info on the new
 coverage rules refer to
 http://www.moshp.com/aboutus/Medicare_Part_D_Resources.htm and/or
  http://www.cms.hhs.gov/PrescriptionDrugCovContra/Downloads/MemoVaccineAdministration_05.14.07.pdf.
  [Source: The Medicare Counselor www.medicarerights.org/thecounselor.pdf
 Jan/Feb 08 ++]


CRDP/CRSC OPTION UPDATE 01:   January is open season for retirees to
 change their selection of receiving either combat related special
 compensation or concurrent receipt (if he or she is entitled to both).  There
 are two factors that retirees need to consider in making an election.
  CRDP is taxable whereas CRSC is not and the CRDP payments increase each
 year during the 10 year phase in period.  A retiree’s election will
 remain in effect until the next open season. You should have already
 received in the mail a CRSP/CRSC Open Season Election Form. The form should
 include a comparison of what you would receive in either program and
 the tax consequences in each program. If you wish to change your
 designation you must send back the completed form with a postmark no later
 than 31 JAN. The change in the payment will be effective the first
 business day of FEB 08. Since DFAS has a 30 day processing time frame you may
 not see your first payment until 1 MAR (with a retroactive payment for
 the February payment.  For more information you can go to the DFAS
 (Defense Finance and Accounting Service) website at www.dfas.mil and go to
 the retired pay home page. Please remember that the selection is in
 effect for all of the year. [Source: TREA Washington Update 4 Jan 08 ++]


TRICARE RESERVE SELECT UPDATE 09:   A DEC 07 report by the Government
 Accountability Office (GAO) reviewed the Defense Department's cost of
 providing the new TRICARE Reserve Select (TRS) coverage vs. its
 premium-setting methodology and concluded that the premiums set by the Pentagon
 were significantly too high -- just as The Military Coalition have
 contended since the program was enacted.
When the program was first implemented, DoD based the TRS premiums on
 the cost of the Blue Cross Blue Shield option of the Federal Employee
 Health Benefit Plan (FEHBP) -- and promptly raised those premiums by 8%
 even before the first enrollees made their first payment. At the time,
 the Coalition argued strongly against using federal civilian program
 data and against the premature premium increase. Their view was that DoD
 had plenty of actual cost data from past TRICARE Standard claims. For
 the past two years, the Coalition has convinced Congress to bar any
 further premium increase pending a review of the methodology.

     The GAO found that DoD based the premiums on projected program
 costs of $70M for FY05 and $442M for FY06. But DoD's actual costs proved
 to be $5M in FY05 and about $40M in FY06. Beneficiary premiums were
 intended to cover 28% of program costs. GAO concluded that current premiums
 are 72% too high for single coverage and 45% too high for family
 coverage. In other words, the monthly premium for individual coverage should
 have been $48 instead of $81. The monthly family premium should have
 been $175 instead of $253. The report says, "DoD's cost projections were
 too high largely because it overestimated the number of reservists who
 would purchase TRS as well as the associated cost per plan of
 providing benefits through the program." GAO recommended that DoD stop basing
 TRS premiums on Blue Cross Blue Shield data and use the actual costs of
 providing the TRICARE benefit. DoD concurred with the recommendations,
 saying the Pentagon "remains committed to improving the accuracy of TRS
 premium projections." But the Department made no commitment to start
 using actual TRICARE data by any specific date nor any indication of a
 premium refund. [Source: MOAA Leg Up 4 Jan 07 ++]


VA INSURANCE DIVIDENDS IN 2008:   More than a million veterans are in
 line to share $349 million in annual insurance dividends during 2008,
 according to the Department of Veterans Affairs (VA). VA operates one of
 the nation’s largest life insurance programs, providing more than $1
 trillion in coverage to 7.1 million service members, veterans, and family
 members. The dividend payments will be sent to an estimated 1.1
 million holders of VA insurance policies on the anniversary date of their
 policies.  Sent automatically through different payment plans, the amounts
 will vary based on the age of the veteran, the type of insurance, and
 the length of time the policy has been in force. The dividends come
 from the earnings of trust funds into which veterans have paid insurance
 premiums over the years, and are linked to returns on investments in
 U.S. government securities. VA officials caution veterans about a
 long-running scam in which various groups charge fees to “locate” veterans who
 are eligible for the dividends.  Veterans eligible for the dividends
 have had VA life insurance policies in effect since they left the
 military and have received annual notifications from VA about the policies. 

     Dividends are paid each year to veterans holding certain
 government life insurance policies and who served between 1917 and 1956.  World
 War II veterans holding National Service Life Insurance ("V") policies
 comprise the largest group receiving 2008 insurance dividend payments.
  They are expected to receive total payments of $269.6 million. An
 additional group of World War II era veterans, those who have Veterans
 Reopened Insurance ("J," "JR" and "JS") policies, will in total receive
 dividends of $9.2 million. Korean War era veterans who have maintained
 Veterans Special Life Insurance ("RS" and "W") policies can expect to
 receive dividends totaling $69.3 million. Dividends totaling $875,000 will
 be paid to veterans who served between World War I and 1940 and who
 hold U.S. Government Life Insurance ("K") policies. Veterans who have
 questions about their policies may contact the VA insurance toll-free
 number at 1-800-669-8477 or send an email to VAinsurance@va.gov.  They may
 also visit VA on the Internet at www.insurance.va.gov.  [Source:  VA
 News release 3 Jan 07 ++]


VA SAH UPDATE 03:   The VA announced 4 JAN that s change in the law
 that allows certain seriously injured veterans and servicemembers to
 receive multiple grants for constructing or modifying homes has resulted in
 many new grants.  Before the change, eligible veterans and
 servicemembers could receive special adaptive housing grants of $10,000 or $50,000
 from VA only once. Now they may use the benefit up to three times, so
 long as the total grants stay within specified limits outlined in the
 law. In order to ensure all previous recipients are aware of this
 opportunity, VA has mailed more than 16,000 letters to eligible veterans,
 reaching out to those who used only a portion of their grant or who decided
 not to use the grant even after initially qualifying.  The response
 over the past year has been dramatic, with more than 4,600 applications
 received thus far.  Of these, approximately 3,900 veterans have been
 determined eligible under the new law, and more than 200 grants already
 awarded.  VA has averaged about 1,000 adaptive housing grant applications
 per year during the past 10 years.  Since the program began in 1948,
 it has provided more than $650 million in grants to about 34,000
 seriously disabled veterans. 

     To ensure veterans’ and servicemembers’ needs are met and grant
 money is spent properly, VA works closely throughout the entire process
 with contractors and architects to design, construct and modify homes
 that meet the individuals’ housing accessibility needs. Eligible for the
 benefit are those with specific service-connected disabilities
 entitling them to VA compensation for a “permanent and total disability.”  They
 may receive a grant to construct an adapted home or to modify an
 existing one to meet their special needs.  VA has three types of adapted
 housing grants available.
• The Specially Adapted Housing grant (SAH), currently limited to
 $50,000, is generally used to create a wheelchair-accessible home for those
 who may require such assistance for activities of daily living. VA’s
 Home Loan Guaranty program and the Native American Direct Loan program
 may also be used with the SAH benefit to purchase an adaptive home.
• The Special Housing Adaptations (SHA) grant, currently limited to
 $10,000, is generally used to assist veterans with mobility throughout
 their homes due to blindness in both eyes, or the anatomical loss or loss
 of use of both hands or extremities below the elbow.
• A third type established by the new law, the Temporary Residence
 Adaptation (TRA) grant, is available to eligible veterans and seriously
 injured active duty servicemembers who are temporarily living or intend to
 temporarily live in a home owned by a family member. 

While the SAH and SHA grants require ownership and title to a house, in
 creating TRA Congress recognized the need to allow veterans and active
 duty members who may not yet own homes to have access to the adaptive
 housing grant program. Under TRA, veterans and servicemembers eligible
 under the SAH program would be permitted to use up to $14,000, and
 those eligible under the SHA program would be allowed to use up to $2,000
 of the maximum grant amounts.  Each grant would count as one of the
 three grants allowed under the new program.  “The goal of all three grant
 programs is to provide a barrier-free living environment that offers the
 country’s most severely injured veterans or servicemembers a level of
 independent living,” said Secretary of Veterans Affairs Dr. James B.
 Peake. Other VA adaptive housing benefits are currently available through
 Vocational Rehabilitation and Employment Service’s “Independent
 Living” program, the Insurance Service’s Veterans Mortgage Life Insurance
 program, and the Veterans Health Administration’s Home Improvement and
 Structural Alterations grant. For more information about grants and other
 adaptive housing programs, contact a local VA regional office at
 1-800-827-1000 or local veteran service organization.  Additional program
 information and grant applications (VAF-26-4555) can be found at
 http://www.homeloans.va.gov/sah.htm.  [Source: VA News Release 4 Jan 08
 ++]


MOBILIZED RESERVE 9 JAN 08:  The Army, Air Force and Marine Corps
 announced the current number of reservists on active duty as of 2 JAN 08 in
 support of the partial mobilization. The net collective result is 1433
 more reservists mobilized than last reported in the Bulletin on 28 NOV
 07. 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 72,343; Navy Reserve, 5,039; Air National Guard and Air
 Force Reserve, 6,281; Marine Corps Reserve, 8,684; and the Coast Guard
 Reserve, 326. This brings the total National Guard and Reserve personnel
 who have been mobilized to 92,673, including both units and individual
 augmentees. A cumulative roster of all National Guard and Reserve
 personnel, who are currently mobilized, can be found at
 http://www.defenselink.mil/news/Jan2008/d20080109ngr.pdf. [Source: DoD
 News Release 9 Jan 08 ++]


SUGAR SUBSTITUTES:   Some people try to limit the amount of sugars they
 consume to lose weight or because they have certain medical
 conditions, such as diabetes mellitus. The FDA has approved several alternative
 sweeteners; however, anecdotal reports continue to question the safety
 of some of these products. Sugar alternatives are of two basic types:
 nonnutritive and nutritive sweeteners. Nonnutritive sweeteners are
 low-calorie sweeteners and include saccharin, aspartame, acesulfame K, and
 sucralose. Early concerns about saccharin causing human urinary bladder
 cancer based on animal studies have not been substantiated in later
 human studies.  Nutritive sweeteners have the same calories as sugar (i.e.
 the calories are what make them nutritive) so they are not useful in
 low-calorie diets. They are metabolized more slowly than sugar, so they
 don’t cause a rapid increase in blood glucose which is an advantage for
 diabetics. Nutritive sweeteners include mannitol and sorbitol, which
 can cause diarrhea if taken in large amounts. Consumers should read
 labels to find out which sweetener is used when a product says it is sugar
 free.

     It is difficult for the home cook to replace the sugar called for
 in recipes with sugar substitutes. Sugar (and chemically related
 products such as honey, brown sugar, corn syrup, molasses, and maple syrup)
 has a significant effect on the texture, appearance, and other
 characteristics of home-cooked food - it adds more than sweetness. Eliminating
 sugar and replacing it with substitutes generally results in an inferior
 product. If you want to eat sweet yet minimize consumption of sugar
 and its relatives, it is probably easiest to tour your local grocery
 store to see what commercially available products there are with sugar
 substitutes.
The list continues to grow - ice creams, frozen fruit pies, yogurts,
 pudding mixes, chocolate and other candies, etc. These can easily be
 combined to make novel low-sugar desserts. For example, a root beer float
 can be made with “diet root beer” and ice cream made with a sugar
 substitute.

     For those who want to try cooking with sugar substitutes consider
 the individual characteristics of each sweetener before you use it.
 Many are not heat stable and should not be used in cooked products.
• Aspartame when heated loses its sweetness so it does not work well in
 cooked products. Since it doesn’t have an aftertaste, it can be used
 in products that aren’t heated.
• Saccharin can be used in cooking. However, when used in the larger
 amounts needed to sweeten custards and other products it has a noticeable
 aftertaste.
• Acesulfame-K is in between saccharin and aspartame with little
 aftertaste and some heat stability.
• Sucralose is packaged to be sold as a sugar substitute for cooking,
 and can be found in many grocery stores in the baking section.

Read the label - some products sold as a substitute for sugar are
 actually a combination of sucralose and table sugar. Using them only reduces
 calories by about 25%. An alternative is just to reduce the amount of
 sugar in the recipe. This works for most recipes except for some cakes
 and candies, which need the sugar for the desired texture and
 consistency. In general, it is difficult to substitute artificial sweeteners for
 sugar. When small amounts are used and the sugar doesn’t contribute to
 the texture of the product - such as a sweetener sprinkled on fruit or
 cereal, or added to beverages such as tea or coffee - they work quite
 well. [Source: MOAA Health and Wellness 21 Mar 06]


MILITARY COMPENSATION OFFSETS:   For most of the century, the military
 compensation system has been riddled with a confusing maze of offsets
 (i.e., benefit deductions) intended to constrain compensation payments
 and limit government costs. More than a decade of intensive education
 efforts by The Military Coalition, along with the graphic examples of
 inequities facing veterans and survivors of current and past conflicts,
 have convinced Congress that many of the offsets are unfair, as indicated
 by the following list of victories:
• 1999: repealed retired pay penalty for officers working as federal
 civilians;
• 1999: won the first easing of the disability offset to retired pay
 for severely disabled retirees;
• 2001-03: expanded full concurrent receipt to all combat-disabled
 servicemembers with 20 or more years of service and won a 10-year phase-out
 of the disability offset for others with 20-plus years;
• 2004: won a four-year phase-out of the Survivor Benefit Plan (SBP)
 annuity reduction imposed on survivors age 62 and older (intended as an
 offset to Social Security);
• 2004: won full, immediate concurrent receipt for 100-percent disabled
 servicemembers with 20-plus years; and
• 2005: accelerated the effective date of full concurrent receipt for
 unemployables.

And those changes proved only a start, as the tide of philosophical
 change has generated more and more cracks in the logic behind the offsets.
 In 2007, there have been several new developments of major
 significance:
• The Dole-Shalala wounded warrior task force recommended (and the Bush
 administration endorsed) repeal of the deduction of military
 disability separation pay from VA disability compensation.
• The Veterans Disability Benefits Commission recommended elimination
 of any deduction of service-earned retired pay from VA disability
 compensation and elimination of the deduction of VA Dependency and Indemnity
 compensation from survivors' SBP annuities if the death was caused by
 service.
• The new FY 2008 Defense Authorization Act authorizes full concurrent
 receipt for all combat-disabled servicemembers forced into medical
 retirement before 20 years of service, full concurrent receipt for
 unemployables, and at least some modest payment to SBP-DIC survivors in
 recognition of the inequity of the offset.

Unfortunately, most of these improvements were won despite strong
 objections from DoD and whichever (Clinton or Bush) administration was in
 place at the time (the notable exception being the Dole-Shalala
 recommendation on military disability separation pay, which the current
 administration has endorsed).

     The past years of progress, along with the dramatic developments
 in 2007, show that "it's always been that way" arguments are losing
 their credibility. Now, we're winning more focus on what the payments
 actually are for and whether offsets serve that purpose. Congress has
 recognized that the disability offset to retired pay and the DIC offset to
 SBP are wrong, and we're now only talking about finding the money to fix
 those inequities. The next logical move is to examine the various
 separation pays that are subject to offset by VA disability compensation and
 reserve retired pay. Current law, in effect, treats separation pays as
 advances on retired pay. MOAA among others, disagrees with that. We
 think a main purpose of separation pay is to help servicemembers offset
 the expense of transition to post-military life, and amounts paid for
 that purpose shouldn't be subject to later recoupment from reserve
 retired pay or VA compensation. Past progress on the disability and survivor
 offsets gives hope for the future on easing separation pay inequities,
 too.  [Source: MOAA News Exchange Steve Strobridge article 2 Jan 08 ++]


TFL ENROLLMENT:   When TRICARE beneficiaries become entitled to
 Medicare Part A and B on the basis of age, disability or end-stage renal
 disease, they are eligible for Tricare for Life (TFL).  TFL is Tricare’s
 Medicare-wraparound coverage available worldwide to Tricare beneficiaries
 who are also entitled to Medicare.  Beneficiaries entitled to Medicare
 Part A who decline Medicare Part B coverage will lose their former
 Tricare health care benefit (with the exception of active duty family
 members). TFL is available to all Tricare and Medicare dual-eligible
 Uniformed Services beneficiaries, regardless of age, including retired members
 of the National Guard and Reserve who are in receipt of retired pay,
 family members, widows/widowers and certain former spouses.  Dependent
 parents and parents-in-law are not eligible for TFL. Uniformed Services
 beneficiaries entitled to Medicare Part A are required by law to have
 Medicare Part B coverage to retain their Tricare benefits with one
 exception.  Active duty family members entitled to Medicare Part A are not
 required to purchase Medicare Part B coverage.  When the active duty
 service member retires, family members must have Medicare Part B coverage
 in place upon the date of retirement to avoid loss of Tricare benefits.
 

     There are no enrollment fees for TFL.  Eligible Medicare-Tricare
 beneficiaries must pay Medicare Part B premiums if other than active
 duty family member.  DoD encourages beneficiaries to purchase Medicare
 Part B when they are first eligible.  Although beneficiaries may delay
 Medicare Part B sign up for up to eight months in certain circumstances,
 they will not be covered by Tricare until Part B coverage begins.
  Beneficiaries should confirm that their Medicare status is current in the
 Defense Eligibility and Enrollment Reporting System (DEERS) by calling
 the DSO Telephone Center at 1(800) 538-9552 or for the Deaf (TTY/TDD)
 1(866) 363-2883.  Beneficiaries can visit Tricare’s DEERS Web site
 www.Tricare.osd.mil/deers/update-info.cfm to learn how to update their
 personal information. Beneficiaries are signed up for Medicare Part B during
 their initial enrollment period, which begins three months before the
 month beneficiaries turn 65 and ends seven months after the month
 beneficiaries turn 65.  Those who do not sign up for Medicare Part B when
 first eligible may sign up for Part B during the general enrollment period
 that occurs 1 JAN through 31 MAR of each year.  For those who enroll in
 Part B during the general enrollment period, Part B and TFL coverage
 begin 1 JUL of that year. Beneficiaries pay a Medicare Part B premium
 penalty surcharge of 10% for each year or portion thereof they failed to
 sign up when first eligible. (NOTE: Although the eligibility age for
 full Social Security benefits is changing, the eligibility age for
 Medicare is not).

     Beneficiaries with group health plan coverage based on their
 current employment or that of a family member are not required by Medicare
 to sign up for Part B.  They may sign up for Medicare Part B without
 paying the surcharge for late enrollment as long as they were covered by
 an employer group health plan or they may delay signing up for up to
 eight months after employment or health plan coverage ends, whichever
 comes first.  Although Medicare does not require beneficiaries with group
 health coverage to sign up for Part B, TRICARE coverage will not begin
 until Medicare Part B coverage begins.  For information about Medicare
 Part B, beneficiaries can visit the Social Security Administration Web
 site, www.ssa.gov, or call 1(800) 772-1213.  Beneficiaries can also
 visit the Medicare Web site, www.medicare.gov.  [Source: Tricare Help
 E-mail Service Office of the Surgeon General msg 20 Mar 06]


CALIFORNIA & FEDERAL DISABLED BENEFITS (70 TO 100% SC):  Veterans who
 are residents of California who are rated 70%, 80%, or 90% disabled by
 the VA as a result of a service connected (SC) determination are
 entitled to the following state and federal benefits. This list was last
 updated OCT 06. For residents of other states the federal benefits are the
 same but the state benefits will be in accordance with that state’s
 laws.  To determine what they are check the VA website associated with the
 state in question:

1. Eligibility for a rating of total disability because of individual
 unemployability.
2. Eligibility for additional allowance for dependents—spouse,
 children, dependent parent(s).
3. Eligibility for additional aid and attendance allowance for disabled
 spouse.
4. VA fee basis outpatient medical card (all conditions requiring
 treatment, whether SC or not, except dental).
5. Enrollment in VA Healthcare Priority Group 1 (no co-payments
 required).
6. Eligibility for sensorineural aids—hearing aids, eyeglasses, contact
 lenses—without regard to whether the condition producing need for such
 is service-connected.
7. Eligibility for long-term VA Nursing Home care for any condition.
8. Eligibility for Service-Disabled Veterans’ Insurance (RH).
9. Possible eligibility for special monthly compensation for loss or
 loss of use of a creative organ; loss of a female breast; loss or loss of
 use of one hand, one foot, or one eye; or, loss of use of both
 buttocks (80%).
10. Possible eligibility for payment of annual clothing allowance for
 specified SC disorders resulting in need for prosthetic appliance or use
 of a wheelchair, or for certain skin conditions.
11. Possible eligibility for one-time assistance in purchase of
 specially-adapted automobile.
12. Possible eligibility for Automobile Adaptive Equipment Allowance.
13. Eligibility for education or training under VA Vocational
 Rehabilitation.
14. Golden Access Passport for U.S. National Parks.
15. California State Park pass (requires SC wartime-incurred
 disability) ($3.50 one-time fee). Entitles the holder to the use of all basic
 State Park System operated facilities at no further charge. Not valid at
 units operated by local government, private agencies or concessionaires.
16. Reduced fee for hunting license.
17. Reduced fee for basic sport fishing license.
18. Eligibility for 10-point preference for Federal Civil Service
 employment. Under certain circumstances, may be employed on a noncompetitive
 basis.
19. Eligibility for 15-point preference for State of California
 employment.
20. Home loan guaranty funding fee exemption.
21. Possible eligibility for Home Improvement and Structural Alteration
 (HISA) home modification grant.
22. Eligibility for CAL-VET College Tuition and Fee Waiver for children
 (Plan B).
23. Possible eligibility for DMV Disabled Person Parking Placard.
24. If a 20-year military retiree, possible eligibility for CDRP or
 CRSC.
25. Possible eligibility for the California Disabled Veteran Business
 Enterprise (DVBE) and the Federal Service Disabled Veteran Owned
 Business (SDVOB) programs.
[Source: CA Dept of VA website Nov 07 ++]


CALIFORNIA & FEDERAL IU BENEFITS:  Veterans who are residents of
 California who are rated totally disabled (i.e. 100%) by the VA as a result
 of service connected (SC) with an Individual Unemployability (IU)
 determination are entitled to the following state and federal benefits. This
 list was last updated OCT 06. For residents of other states the federal
 benefits are the same but the state benefits will be in accordance
 with that state’s laws.  To determine what they are check the VA website
 associated with the state in question:
1. Eligibility for additional allowance for dependents—spouse,
 children, dependent parent(s).
2. Eligibility for additional aid and attendance allowance for disabled
 spouse.
3. VA fee basis outpatient medical card (all conditions requiring
 treatment, whether SC or not).
4. Eligibility for all necessary dental care.
5. Enrollment in VA Healthcare Priority Group 1 (no co-payments
 required).
6. Eligibility for sensorineural aids—hearing aids, eyeglasses, contact
 lenses—without regard to whether the condition producing need for such
 is service-connected.
7. Eligibility for long-term VA Nursing Home care for any condition.
8. Eligibility for health care coverage under CHAMPVA for spouse and
 children (unless they are also eligible for TRICARE).
9. Eligibility for Service-Disabled Veterans’ Insurance (RH), including
 $20,000 supplemental insurance beyond regular amount.
10. Waiver of VA life insurance premiums, if under age 65 (but not on
 additional amounts).
11. Possible eligibility for special monthly compensation for loss or
 loss of use of a creative organ; loss of a female breast; loss or loss
 of use of one hand, one foot, or one eye; or, loss of use of both
 buttocks.
12. Possible eligibility for payment of annual clothing allowance for
 specified SC disorders resulting in need for prosthetic appliance or use
 of a wheelchair, or for certain skin conditions.
13. Possible eligibility for one-time assistance in purchase of
 specially-adapted automobile.
14. Possible eligibility for Automobile Adaptive Equipment Allowance.
15. Eligibility for education or training under VA Vocational
 Rehabilitation.
16. Golden Access Passport for U.S. National Parks.
17. California State Park pass (requires SC wartime-incurred
 disability) ($3.50 one-time fee).
18. Reduced fee for hunting license.
19. Reduced fee for basic sport fishing license.
20. Home loan guaranty funding fee exemption.
21. Possible eligibility for Special Adapted Housing Assistance.
22. Possible eligibility for Home Improvement and Structural Alteration
 (HISA) home modification grant.
23. Possible eligibility for Veterans’ Mortgage Life Insurance (VMLI).
24. CAL-VET Home Loan Disability Insurance.
25. Eligibility for property tax exemption on principle residence.
26. Eligibility for 10-point preference for Federal Civil Service
 employment. Under certain circumstances, may be employed on a noncompetitive
 basis. The 10-point preference is also applicable for the spouse
 and/or natural mother of a permanently totally service-disabled veteran.
27. Eligibility for 15-point preference for State of California
 employment.
28. Eligibility for Survivors’ and Dependents’ Education Assistance for
 spouse and/or children under 38 U.S.C., Chapter 35.
29. Eligibility for CAL-VET College Tuition and Fee Waiver for spouse
 and children (Plan A). Requires wartime service. May not be authorized
 concurrently with VA education assistance under Chapter 35.
30. Eligibility for CAL-VET College Tuition and Fee Waiver for children
 (Plan B). May be authorized concurrently with VA education assistance
 under Chapter 35.
31. Eligibility for son(s) and/or daughter(s) to compete for admission
 to military academies.
32. Possible eligibility for DMV Disabled Person Parking Placard.
33. If a 20-year military retiree, possible eligibility for CDRP or
 CRSC.
34. Withdrawal from SBP program participation (military retirees) after
 having been rated SC, totally disabled for 10 continuous years, or, if
 out of service less than 10 years, having been rated SC, totally
 disabled for at least 5 continuous years from date of last active duty.
[Source: CA Dept of VA website Nov 07 ++]


VETERAN LEGISLATION STATUS 13 JAN 08:   After completing work 19 DEC,
 the House and Senate officially recessed until the New Year.
 (Technically, only the House adjourned; the Senate is keeping pro forma sessions
 to stop the President from making any recess appointments.) Although
 some pro forma sessions were scheduled, the full House will not return
 until 15 JAN, while the Senate will reconvene 22 JAN 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 http://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
 http://thomas.loc.gov/bss/d110/sponlst.html.  The key to increasing
 cosponsorship on veteran related bills and subsequent passage into law is
 letting our representatives know of 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 http://thomas.loc.gov who your
 representative is and his/her phone number, mailing address, or email/website to
 communicate with a message or letter of your own making.  [Source: RAO
 Bulletin Attachment 13 Jan 08 ++] 


Lt. James “EMO” Tichacek, USN (Ret)
Director, Retiree Assistance Office, U.S. Embassy Warden & IRS VITA
 Baguio City RP
PSC 517 Box RCB, FPO AP 96517
Tel: (760) 839-9003 when in U.S. & Cell: 0915-361-3503 when in
 Philippines.
Email: raoemo@sbcglobal.net Web:
 http://post_119_gulfport_ms.tripod.com/rao1.html
AL/AMVETS/DAV/FRA/NAUS/NCOA/MOAA/USDR/VFW/VVA/CG33/DD890/AD37 member
BULLETIN SUBSCRIPTION NOTES:
== To subscribe first add the above RAO email addees to your address
 book and/or white list and then provide your full name plus either the
 post/branch/chapter number o