BACK

RAO Bulletin Update
15 June 2008
 
Note:  Anyone receiving this who does not want it request click on the
 automatic delete tab at the end of the Bulletin or hit reply and place
 the word "Remove" in the subject line!!!!!!!!!!!!!!!

THIS BULLETIN CONTAINS THE FOLLOWING ARTICLES

== Medicare Reimbursement Rates 2008 [02] ------ (18 Days Left)
== VA Report Card  ------------------------------------- (High Marks)
== Medicare Fraud [07]  ------------------------------- ($205 million)
== Mobilized Reserve 11 JUN 08  ---------------- (16,250 Increase)
== Tricare  Prior Authorization  --------------------- (Requirements)
== VA Home Loan [12]  --------------------- (Mortgage Assistance)
== Windows Vista [05]  --------- (Performance Impacts Revenues)
== NDAA 2009 [04]  ---------------------------- (Steps to Complete)
== Social Security Debit Card  --------------- (Initiated  Spring 08)
== VA Blue Water Claims [03]  ----------------------------- (Denied)
== VA Ombudsman's Office  ------------------------------ (H.R.2192)
== Tricare Fees Overseas  ------------------------------ (Action Alert)
== TERA [01]  -------------------------- (58,000 Retirees)
== SSA Prisoner Rules [01]  ---------------- (What is not Available)
== Expatriate Income Tax [01]  -------------------------- (Deadlines)
== IRS Statute of Limitations  ---------- (Expat False Assumptions)
== Tax on Negotiated Balances  ---------------------- (Credit Cards)
== Shad [06]  ------------------------------ (H.R.5954 Hearings)
== VA Lawsuit (Lack of Care) [08]  --------- (Perez’s PTSD email)
== Tricare Gray Area Retiree Bill  ------------------------ (H.R.6185)
== Fisher House Expansion [03]  ------------------- (Boost 38 to 62)
== Veteran Rural Health Advisory Committee  ------ (Appointees)
== WI Vet Educational Benefits  -------------------------- (Overview)
== PTSD [21]  -------------------------- (VA Denies Money a Factor)
== CT Vet Educational Benefits  -------------------------- (Overview)
== Walter Reed Data Breach  ---------- (Gov’t Breaches Continue)
== U of U Hospital Data Breach  ------------- (2.2 million @ Risk)
== Bank of NY Data Breach] ------------------ (4.5 million @ Risk)
== Alzheimer’s [04]  ------------------ (7 Stages)
== VA PTSD Claim Support [01]  ------------ (Stressor Symptoms)
== Medicare Fraud [06]  ------------------------ ($638 million in FL)
== National Monuments  --------------- (Pearl Harbor Considered)
== Veteran Legislation Status 13 JUN 08  ------ (Where we Stand)



MEDICARE REIMBURSEMENT RATES 2008 UPDATE 02:  The cut in Medicare
 payments to physicians that are scheduled to take place on 1 JUL. Unless
 legislation is passed before then, there will be a cut of 10% in Medicare
 physician payments. This is very important for military retirees
 because Tricare payments to physicians are the same as the Medicare payments.
  There is great concern that if the payments cuts are not reversed
 doctors will not take any new Medicare patients, and likely no new Tricare
 patients. On 12 June, by a vote of 54 yea (58%, 60% required for
 passage), 39 nay 7 not voting, the Senate failed to pass S.3101, the
 Medicare Improvements for Patients and Providers Act of 2008, which would have
 cancelled the 10% cuts in physician reimbursements and provided a 1%
 increase to those reimbursements. Inexplicably, Sen. Harry Reid switched
 his vote from Yea to Nay. Also, very interesting is that the three
 contenders for the Presidency: Sen. John McCain, Sen. Hillary Clinton, and
 Sen. Barack Obama did not vote on this important issue.

     As always seems to be the case, the battle is over where to find
 the money to pay for the reversal of the cuts, since the Medicare (and
 military health care) budget for FY2008 was predicated on the cuts going
 into effect. Senate Finance Committee Chairman Max Baucus (D-MT) has
 come up with a bill that would stop the cuts by replacing them with a
 0.5% increase in physician payments this year and an additional 1.1%
  increase in FY 2009. His bill would also improve Medicare benefits by
 expanding subsidies for low-income people, reducing co-payments for mental
 health treatment and increasing coverage for preventive health
 services. However, his bill is opposed by most Republicans because it would be
 paid for by cutting costs in privately run Medicare Advantage programs
 that have been championed by GOP lawmakers and President Bush. Senator
 Charles Grassley (R-IA), ranking member of the Senate Finance
 Committee, has drafted his own bill to fix the problem. The Grassley bill would
 give doctors the same increases as the Baucus bill, but would pay for
 them differently. Grassley’s bill would eliminate bonus payments that
 some Medicare Advantage plans receive for operating in areas with
 teaching hospitals, a provision also contained in the Baucus bill. But
 Grassley would provide additional money by making cuts in some Medicaid
 provisions. Medicaid is the federal government health program for the poor.
 Both sides agree that fixing the pending cuts is the biggest health care
 priority they face this year, but they are running out of time to fix
 it.

     To see how your Senator voted on this legislation refer to
  http://tinyurl.com/3z2yee.  After checking, you are encouraged to call
 and thank those who voted “Yea” and to ask why those who voted “Nay”
 did so. Calling your congressional representative in Washington D.C. is
 easier than you think.  Our government and the AMA have provided the
 following no charge numbers for constituents to talk to their elected
 official’s offices located in the Capital Building:
• 1-866-272-6622 Capital Operator Direct
• 1-800-833-6354 AMA Grass Roots Hotline - follow prompts
• 1-800-828-0498 Capital Operator Direct
• 1-800-833-6354 AMA Grass Roots Hotline – follow prompts
• 1-866-340-9281 Capital Operator Direct
• 1-866-220-0044 Capital Operator Direct

When the capitol operator answers:
1. Tell her which Senate or House office you want.
2. When the office answers, tell the staffer that you are a constituent
 and either thank the Senator for his Yea vote or ask why the Senator
 voted Nay. If Senator Reid's office, ask why he switched his vote from
 Yea to Nay.
3. Provide additional information requested by the staffer. Usually
 your zip code to confirm you are a constituent.
4. Be polite and courteous, remember the staffer is simply the
 "messenger".
5. For a listing of all other bills refer to http://thomas.loc.gov.
[Source:  TROA Washington Update & USDR Action alert 13 Jun 08 ++]


VA REPORT CARD:   A new “hospital report card” by the Department of
 Veterans Affairs (VA) gives the Department’s health care system high
 marks, with VA facilities often outscoring private-sector health plans in
 standards commonly accepted by the health care industry. Among the
 report’s finding were:
•  98% of veterans were seen within 30 days at primary care facilities,
 97% at specialty clinics.  (Veterans requiring emergency care are seen
 immediately.)
• All of VA’s 153 medical centers are accredited by the independent
 Joint Commission which accredits all U.S. health care facilities.
• The quality scores for older veterans are similar to those for
 younger veterans.
      
 Although screening for breast and cervical cancer for women in VA
 facilities exceeds screening in private-sector facilities, women veterans
 lag behind their male counterparts in some quality measurements, the
 report noted.  VA has already launched an aggressive program to ensure
 women veterans receive the highest quality of care, including placement of
 women advocates in every outpatient clinic and medical center.  Health
 care will be a major topic at VA’s National Summit on Women Veterans
 Issues scheduled for 20-22 JUN in Washington. The report also found
 minority veterans are generally less satisfied with inpatient and
 outpatient care than white veterans.  That disparity will be the focus of an
 in-depth study, based upon input from veterans, which will be completed
 this summer. The report card is available on the Internet at
 http://www.va.gov/health/docs/Hospital_Quality_Report.pdf.  In FEB
 Congress directed VA to complete the report card, highlighting measurements
 of quality, safety, timeliness, efficiency and patient-centeredness.
  James Peake, the Secretary of Veterans Affairs noted that, “No other
 health care organization provides this much information about its ability
 to care for its patients.” [Source: VA News Release 14 Jun 08 ++]


MEDICARE FRAUD UPDATE 07:  While Congress debates whether or not to
 reduce Medicare payments to practitioners, task force officials are
 uncovering increased amounts of fraud.    Over nearly four years a high
 school dropout named Rita Campos electronically submitted more than 140,000
 Medicare claims for unnecessary equipment and services. All it took to
 bilk the federal government out of $105 million was a laptop computer.
 After pleading guilty to filing false claims, she has helped
 authorities win indictments against more than half a dozen Florida doctors and
 patients who allegedly accepted kickbacks for pretending to receive
 costly HIV drug therapy. With her cooperation, FBI agents this week arrested
 three Miami-area men who, the government alleges, financed sham
 clinics that billed the government more than $100 million. Sentenced to 10
 years, Campos Ramirez, 60, may yet reduce her prison term by helping
 authorities unwind "the large web of medical clinics, doctors, nurses,
 money laundering companies and HIV clinic financiers who participated in
 this massive fraud," prosecutors wrote earlier this year in court papers.
 Her lawyer did not return calls seeking comment.

     By many accounts, Campos Ramirez was unusually successful.
 Prosecutors say that corrupt medical clinic owners anticipate that Medicare
 will cover a quarter of their phony claims. But Campos Ramirez persuaded
 authorities to cover 60% of all the bills she submitted on behalf of 75
 HIV clinics in South Florida, according to court filings. Health-care
 experts say the simplicity of Ramirez's scheme underscores the scope of
 the growing fraud problem and the need to devote more resources to
 theft prevention. Law enforcement authorities estimate that health-care
 fraud costs taxpayers more than $60 billion each year. A critical aspect
 of the problem is that Medicare, the health program for the elderly and
 the disabled, automatically pays the vast majority of the bills it
 receives from companies that possess federally issued supplier numbers.
 Computer and audit systems now in place to detect problems generally
 focus on overbilling and unorthodox medical treatment rather than fraud,
 scholars say.

     Daniel R. Levinson, the inspector general of the Department of
 Health an Human Services (HHS)  has warned repeatedly that the Medicare
 program is "highly vulnerable" to fraud, particularly in South Florida,
 where schemes center on expensive, infusion-based HIV medications and on
 equipment such as wheelchairs, walkers, canes and hospital beds.
 Officials from the Centers for Medicare and Medicaid Services (CMS), which
 oversees federally funded health programs, say they have stepped up
 their efforts to combat fraud over the past year by working closely with
 investigators, removing the requisite billing numbers of nearly 900
 companies and imposing new standards in high-fraud areas that would prevent
 people convicted of felonies from ever receiving a Medicare number.
 Investigators and prosecutors trained their focus on Miami after noticing
 two troubling patterns:

• HHS investigators discovered that nearly half of 1,581 medical
 equipment companies they visited in the Miami area did not comply with basic
 Medicare requirements to be open during scheduled hours and to have a
 telephone number. The inspector general and the Government
 Accountability Office have flagged weak oversight of these kinds of suppliers for a
 dozen years, according to congressional testimony.
• The South Florida region bills Medicare more than $2 billion each
 year for injectable HIV medications. That figure is 22 times as high as
 the amount of similar claims in the rest of the country, and is far out
 of line with demographic data in a population of 2 million people in
 Miami-Dade County.

Justice Department officials moved to freeze money in suspicious bank
 accounts controlled by medical equipment company owners and they created
 a Washington-based strike force to handle the issue. The strike force,
 in concert with a small group of U.S. attorney's offices, has in the
 past year opened nearly 900 criminal investigations and convicted 560
 defendants in health-care fraud offenses throughout the country.
 Authorities say the strategy is working. They point to a $1.75 billion drop in
 Medicare claims in Miami since the operation began a year ago. But even
 government officials hope for a more comprehensive solution.
 Christopher Dennis, the special agent in charge of the HHS inspector general's
 office in Miami, said fraudulent medical equipment companies appear to
 have shifted gears since the strike force arrived. After a crackdown in
 South Florida, at least some corporate owners moved to the north, he
 said. Investigators dubbed one initiative "Operation Whack-a-Mole," after
 the carnival game in which a creature pops up in different places
 after being hit with a hammer.
 
    The strike force recently established a base in Los Angeles,
 another area rife with fraud. Prosecutors announced criminal charges last
 month against two medical equipment company owners who are accused of
 falsely billing Medicare more than $2 million. Plans call for a similar
 rollout this fall in Houston, another potential fraud hot spot. Officials
 who oversee the Medicare program say they are vigilant despite time
 pressure and limited resources. Employees review fewer than 5% of the
 nearly 1 billion claims filed each year. The vast majority of claims
 shuttle through computer systems that are tweaked when authorities notice
 fraud patterns. This year, CMS is working to finalize a rule that would
 prevent convicted felons from obtaining Medicare billing numbers. At
 present, that regulation applies only in a few high-fraud regions.
[Source: Washington Post Carrie Johnson article 13 Jun 08 ++]


MOBILIZED RESERVE 11 JUN 08:  The Army, Air Force and Marine Corps
 announced the current number of reservists on active duty as of 11 JUN 08
 in support of the partial mobilization. The net collective result is
 16250 more reservists mobilized than last reported in the Bulletin for 28
 MAY 08. At any given time, services may mobilize some units and
 individuals while demobilizing others, making it possible for these figures to
 either increase or decrease. The total number currently on active duty
 in support of the partial mobilization of the Army National Guard and
 Army Reserve is 87,542; Navy Reserve, 5,982; Air National Guard and Air
 Force Reserve, 12,452; Marine Corps Reserve, 9,150; and the Coast
 Guard Reserve, 784. This brings the total National Guard and Reserve
 personnel who have been mobilized to 115,950, including both units and
 individual augmentees. A cumulative roster of all National Guard and Reserve
 personnel, who are currently mobilized, can be found at
 http://www.defenselink.mil/news/Jun2008/d20080611ngr.pdf .. [Source:
 DoD News Release 456-08 11 Jun 08 ++]


TRICARE PRIOR AUTHORIZATION:   Tricare Standard puts the power to
 manage your health care in your hands by not requiring referrals.  However,
 some services may require prior authorization.
Under TRICARE Standard prior authorization is required for the
 following services:
•  Adjunctive dental services
• Home health services
• Hospice care
• Non-emergency inpatient behavioral health care, including
 non-emergency inpatient admissions for substance use disorders
• Outpatient behavioral health care after the eighth visit in a fiscal
 year (Oct. 1–Sept. 30)
• Transplants (solid organ and stem cell)
• Tricare Extended Care Health Option services
 
Your network provider can coordinate the authorization with the
 regional Tricare contractor.  Once an authorization is granted, the contractor
 will also issue service beginning and ending dates for medical or
 surgical services.  For behavioral health authorizations, the contractor
 will specify a certain number of visits, in addition to the beginning and
 ending dates.  All authorized care must be received before the
 authorization's end date.  If not, your provider must acquire a new
 authorization.  Additional authorization rules may apply, so it's best to call
 your regional Tricare contractor if you have questions.  [Source: NAUS
 Weekly Update 13 Jun 08 ++]


VA HOME LOAN UPDATE 12:   Many home owners have found it difficult
 recently to pay their mortgages, VA guaranteed or otherwise, but
 intervention by loan counselors at the Department of Veterans Affairs (VA) has
 actually reduced the number of veterans defaulting on their home loans.
 Accounting for much of this success are VA counselors at nine regional
 loan centers who assist people with VA-guarantied loans avoid
 foreclosure through counseling and special financing arrangements.  The
 counselors also can assist other veterans with financial problems.  VA
 counselors have helped about 74,000 veterans, active-duty members and survivors
 keep their homes since 2000, a savings to the government of nearly $1.5
 billion. Depending on a veteran's circumstances, VA can intercede with
 the borrower on the veteran's behalf to pursue options -- such as
 repayment plans, forbearance, and loan modifications -- that would allow a
 veteran to keep a home. To obtain help from a VA financial counselor,
 veterans can call VA at 1(877) 827-3702.  Information about VA's home
 loan guaranty program can be obtained at www.homeloans.va.gov. Since
 1944, when home-loan guaranties were offered with the original GI Bill, VA
 has guarantied more than 18 million home loans worth $911 billion.
  Last year about 135,000 veterans, active-duty service members and
 survivors received loans valued at nearly $24 billion. About 2.3 million home
 loans still in effect were purchased through VA’s home-loan guaranty
 program, which makes home loans more affordable for veterans, active-duty
 members and some surviving spouses by protecting lenders from loss if
 the borrower fails to repay the loan.  More than 90% of VA-backed home
 loans were given without a downpayment. April 08 data shows that
 foreclosures are down more than 50% from the same months in 2003.  VA
 attributes this to prudent credit underwriting standards, its robust
 supplemental loan servicing program and VA financial loan counselors. [Source:
  VA News Release 12 Jun 08 ++]


WINDOWS VISTA UPDATE 05:   The negative perception of Windows Vista may
 be catching up to Microsoft in the bank. On 11 JUN a financial analyst
 firm lowered its revenue estimate for Microsoft's 2008 and 2009 fiscal
 years, citing a negative perception about the operating system that is
 affecting its adoption by businesses. The research report by Sanford
 C. Bernstein analysts also hinted at the release date for the next
 version of Windows code-named Windows 7. In the report, analysts said they
 expect Windows 7 to be released in the second quarter of 2010.  In the
 report, analysts Charles J. Di Bona, Maureen Murphy and Mariel A. Hardi
 lowered their revenue estimates for Microsoft by $49 million for fiscal
 2008 and by $395 million for fiscal 2009. While the 2008 revision
 didn't affect the firm's earnings estimate of $1.91 per share for that
 year, it lowered its 2009 estimate to $2.17 from $2.20, according to the
 report. "Support for Vista has been battered across all enterprise sizes
 and corporate constituencies," the report stated. "As a consequence,
 the Vista cycle looks likely to be materially less robust than indicated
 in our prior survey." The key factor has been "overwhelmingly bad
 publicity" for Vista, particularly about the option for enterprise licensees
 to downgrade to XP from Vista, and the potential for companies to skip
 Vista in favor of Windows 7. The downgrade option has been especially
 troublesome for Microsoft, which in some cases has had to extend the
 time it will sell XP due to customer demand. The negative publicity has
 left businesses with a perception that there is no good reason for them
 to upgrade, according to the Bernstein report. "Almost no feature of
 the new OS is now seen as a meaningful positive driver for adoption," the
 analysts said. Independent analyst Brian Madden concurred. "From a
 company standpoint, there is not a single damn reason people should use
 Vista," he said. "Will you sell another widget because of Vista? No. And
 besides, Vista has so many hardware requirements that you increase your
 costs." The Bernstein report also cites costs associated with Vista,
 which would require some companies to upgrade their desktop hardware
 because of the increased system requirements, a further impediment to
 adoption. Moreover, some features of Vista that Microsoft promoted as key
 reasons to upgrade, such as security, have been undermined by negative
 publicity around tools like User Account Control, a new security feature
 many customers have griped about, according to the report. [Source:
 IDG News Service Elizabeth Montalbano article 11 Jun 08 ++]


NDAA 2009 UPDATE 04:   The House and Senate have been working on their
 own versions of the 2009 NDAA, attempting to get a bill to the
 President's desk for signature into law by October 1, 2008.  The House approved
 their version, H.R.5658, on 22 MAU by a vote of 384-23.  The bill has
 $601.4 billion in regular funding (excludes war funding) for the
 Defense Department.  Included in the bill is a 3.9% pay raise; increases in
 full time manning for the Army and Air Guard; allows for Tricare cost
 share increases; initiates a 3-year sabbatical program; initiates a
 tuition-assistance program for military spouses; buys more aircraft such as
 C-17s, F-22s, C-130s, and F-35s; includes $750 million for Guard &
 reserve equipment purchases; and authorizes $65.4 million for reintegration
 programs.  The Senate version, S.3001, is still in committee and has
 not progressed to the floor for debate or vote yet.  The best guess is
 that the Senate will not take up this legislation until after the 4 JUL
 recess is over. This bill has $612.5 billion in regular funding.  It
 also increases full time manning for the Army and Air Guard; allows for
 no Tricare fee increases; includes the pay raise and sabbatical
 provisions; has $390 million for Guard homeland defense equipment but no
 equipment account; authorizes 21 days of paternity leave; and requires DOD
 and JCS and NGB to develop a strategic plan for the role of the Guard.
  Once the Senate votes their version of the bill, both bills go to
 conference committee to iron out any differences.  Then the compromise
 conference bill goes back to both chambers for ratification vote, and
 following that affirmative vote, it goes to the President for signature (or
 veto).  On May 22 MAY the White House issued a veto threat concerning HR
 5658, citing 27 different provisions of concern in the bill.  Among
 those provisions for which the President would veto the bill are: the pay
 raise (3.4% vs. 3.9%), purchase of additional C-17s, F-22s, and F-35s,
 and not increasing the Tricare cost share amounts to even higher
 levels.  [Source: EANGUS Minuteman Update 12 Jun 08 ++]


SOCIAL SECURITY DEBIT CARD:   For millions of Americans, accessing
 their Social Security benefits is now just a card swipe away. A new debit
 card being offered by the Treasury Department gives nearly 4 million
 recipients who have no bank accounts an alternative to paper checks that
 they must cash, usually at a price. The new debit card, issued by
 Comerica Bank, was quietly marketed to nearly 3.5 million recipients of
 Social Security and Supplemental Security Income (SSI) this spring. It's now
 available to any benefit recipient through enrollment at
  www.usdirectexpress.com. States already load child support payments and
 unemployment benefits onto debit cards. The federal government has used prepaid
 debit cards, too, for disaster relief aid. But the Social Security debit
 card is the largest push to date to switch from costly paper checks to
 electronic payments. "Our goal is to move to 100% electronic payments,"
 says Judy Tillman, commissioner of Treasury's Financial Management
 Service. "It's safer and more reliable for delivery" of funds.

     The new debit card will eliminate the need for consumers without
 bank accounts to use costly check-cashing services, the Treasury
 Department says. It will also save the government money. The Treasury
 estimates that if all 4 million recipients without bank accounts signed up for
 the card, it would save $42 million a year. As with any other debit
 card, using it won't always be free. For instance, holders will get one
 free ATM withdrawal per month. After that, they'll be charged 90 cents
 for each withdrawal. A fee of 75 cents per month also applies if card
 holders want paper statements mailed to them. Still, the fees are among
 the lowest in the industry for such services, says Nora Arpin, director
 of government electronic solutions for Comerica. About 80% of the 57.3
 million Social Security and SSI recipients have their benefits directly
 deposited into their bank accounts.  The challenge will be to get the
 remaining consumers to switch from checks to electronic payments such as
 direct deposit or the new debit card. The card "might be confusing if
 they're not savvy about electronic payments and don't have (experience
 with) a bank account," says Chris Allen, a director for Hitachi
 Consulting.  [Source: USA Today Cathy Chu article 10 Jun 08 ++]


VA BLUE WATER CLAIMS UPDATE 03:   The Montgomery Advertiser published
 the following article that is reflective of the frustrations of many of
 our veterans who served during the Viet Nam conflict: 

     Joe Moody and Dave Sanderson volunteered to serve their country
 when that wasn't a popular thing to do. They joined the Navy. Both served
 on ships off the shore of Vietnam in the 1960s. Joe is 64, Dave is 60,
 and they're both sick. They feel abandoned by their country now; when
 they need her help the most. Joe was an engineer who served on the USS
 Oklahoma City, the flagship of the Seventh Fleet. Dave was a gunfire
 technician on the USS Lang. Both received com¬bat pay, as did others of
 the 70,000 or so veterans who served as "blue water sailors" during that
 war. Both have developed diabetes mellitus, one of the diseases
 con¬nected to Agent Orange, a highly toxic herbicide used to defoliate combat
 areas in Vietnam. Both have been denied service-connected compensation
 because Veterans Administration rules recently upheld by the courts
 say that only those who set foot in Vietnam are eligible. They don't care
 so much about the pension. But the medical benefits paid to other
 Vietnam veterans would be welcome. Joe has had medical costs taken out of
 his Social Secu¬rity check. Dave has congestive heart failure and other
 medical problems related to the diabetes. They are among "500 to 1,000"
 members of a group called "Blue¬watersailors.org," who have mailed
 their Vietnam service med¬als to Sen. Daniel Akaka of Hawaii and Rep. Bob
 Filner, chairmen re¬spectively of the Senate and House Veterans Affairs
 committees. "We were going to have a march on Washington," Joe said
 Friday in a Prattville restaurant. "But most of us were too sick to
 march." Dave laughed. "It would have been a pretty short march," he said. "I
 was doing good to walk to the mailbox to mail my medals back." He had
 driven from Huntsville. He had on a Navy veteran's cap and a blue water
 sailor T-shirt that said, "Still Fighting."

     The reasoning goes that they were not exposed to the defoliant
 because they weren't in-country. But they both had photos of their ships
 firing on inland positions in Vietnam. You could see the moun¬tains in
 the background. Joe said he had been as close as five miles. Dave's ship
 routinely operated within 3,000 to 6,000 yards from the shore. Their
 drinking water came from desalinized seawater, and they produced copies
 of studies that showed the pesticides could have drifted miles
 offshore, in the water and in the east-to-west winds. Given the way the water
 was produced, they feel they and their shipmates may have re-ceived a
 more concentrated dose of the poison. Their clothes were washed in the
 same water. Their mail came from Danang in canvas bags -- Agent Orange
 has been proven to cling to canvas. Joe said a guy came on their ship
 selling canvas hats from Vietnam. Almost every¬body on board bought one.
 Ships carried Agent Orange to Vietnam in the first place. Both had
 helped load the 55-gallon drums that had the identifying or¬ange band around
 the top. They physically touched the containers. Dave recalled that
 his ship docked in Vietnam near the end of the war. He got off, walked on
 the dock for a few minutes, just to be able to say he'd set foot in
 Viet¬nam. "If I had a picture of that, or if I could find enough
 eyewitnesses to say I had done that, I'd be eligible for benefits," he said.
 "That's just crazy."

     The blue water sailors from Australian and New Zealand ships that
 supported operations off the Vietnam shore have been granted aid from
 their countries. The men know the denials of their claims are about
 money. But they feel it's an insult to the Navy, and to their legacy. It
 sets a bad precedent for future veterans -- the thousands who are serving
 off¬shore in support of troops in Iraq and Afghanistan today, right
 now. Other Vietnam veterans have a beef, Joe said. Air Force vets who
 flew over the country would not qualify. Navy pilots would not qualify,
 unless they were shot down. They both believe in the good will of their
 countrymen. People just don't know about it. "All we want is to be
 heard," Joe said. "Let the people know about this, and then let the public
 decide what's right." (Note: to obtain additional info on this subject
 refer to http://bluewaternavy.org/).
[Source: Montgomery Advertiser article 8 Jun 08 ++]


VA OMBUDSMAN'S OFFICE:    Citing the confusion veterans face when
 trying to arrange benefits, the House Veterans' Affairs Health Subcommittee
 passed H.R.2192 on 5 JUN which would create an Ombudsman office within
 the Veterans Affairs Department (VA).  The bill introduced on 7 MAY 07
 and  sponsored by Rep. Paul Hodes D-NH) was adopted by unanimous voice
 vote, along with the adoption by voice vote of a substitute amendment
 from Veterans' Affairs Health Subcommittee Chairman Michael Michaud
 (D-ME).  The bill instructs the VA secretary to create an office of the
 ombudsman, and designate the head of the office. The office would act as a
 one-stop shop for information on benefits administered by the VA,
 including medical, housing and education. When testifying in support of his
 bill before the Health Subcommittee on 14 JUN 07, Hodes said the VA
 has separate hotlines for different benefits, and the process can be
 confusing to veterans returning from overseas. Michaud's substitute
 amendment expanded the duties of the new office. Under the amendment, the VA
 secretary will designate an ombudsman director in each of the
 department’s three administrations, health, benefits and cemeteries. The
 ombudsman director in each administration will report to the head ombudsman.
 The amendment also defines the official duties of the office of the
 ombudsman as providing patient advocacy and problem resolution, provide
 assistance in understanding benefits, provide information on claims
 submissions, and field complaints from veterans.
The VA secretary will also designate six regional ombudsmen throughout
 the United States for both the health and benefits administrations.
 However, the VA does not support the bill. VA Undersecretary for Health
 Michael Kussman testified at the Health Subcommittee hearing on the bill
 that it would create an unnecessary level of bureaucracy within the VA.
 Kussman added the VA already has officers such as patient advocates
 and benefit counselors, and many state level veterans departments also
 have counselors. The bill currently has 43 cosponsors. [Source: Congress
 Daily Andy Leonatti article 9 Jun 08 ++]


TRICARE FEES OVERSEAS:   U.S. Military retirees and  dependents of both
 active duty and retiree members’ of the U.S. Militar residing outside
 of the United States will soon be experiencing increased out of pocket
 expense of up to double or more for using Tricare. This is happening in
 spite of Congress’ continued refusal in past years and their refusal
 in MAY 08 to allow DoD’s proposed Tricare fee increases requested in the
 2009 NDAA. All active duty military, retirees and dependents are
 covered by Tricare for their health care. Tricare is a Department of Defense
 Health Insurance Program developed and authorized by Congress.
 Military member’s dependents, retirees and their dependents living in foreign
 countries that are covered under the Tricare Standard Program will soon
 have a new “country specific index” applied to all medical claims they
 submit to Tricare. This new index is a product of the World Bank’s
 survey of the average cost of goods and services in a specific country and
 resulted in the development of a percentage factor that reflects what
 amount of goods and services $1.00 would buy in the foreign currency.
 Unfortunately, this survey was taken in 2005, prior to the decline of
 the U.S. dollar overseas and does not accurately reflect the cost of
 those goods and services in today’s dollar. Worst yet, since this survey
 results are an average of the cost of goods and services, it mixes
 private health care cost with the foreign government health care cost, (which
 are normally provided free or at a nominal fee, much like Medicaid).

     The program is due to take effect in AUG 08 and will be phased in
 using a higher allowed percentage for the first year and then the World
 Bank’s percentage starting on 1 MAR 09. The implementation of this
 program is being done under the DOD’s rule making authority; however, it
 in effect skirts the U.S. Congress’ directions which established a 25%
 co-pay for Tricare Standard beneficiaries. DoD has apparently
 rationalized they can do this through the use of survey data from the World Bank.
 Data that even the World Bank states, in it’s handbook on this survey,
 must take into consideration the foreign exchange rate, (and
 presumably the inflation rate), for a specific country at the time of making use
 of their data. The DOD has ignored that part of the study handbook,
 and is going to ignore the vast difference in health care cost in rural
 vs. urban settings and private vs. government health care. The program
 is scheduled to start in the Philippines and Panama first with the
 intent to later make it the standard for all foreign countries where Tricare
 has beneficiaries residing. An example of how this program will affect
 the pocket books of the dependents and retirees in the Philippines is;
• A Beneficiary is admitted to a Hospital in Manila for a coronary
 bypass and is hospitalized for 10 days.
• The hospitals’ legitimate charges, (the charges that the same
 procedure would cost a Philippine citizen), is $11,200.
• Tricare will only allow $6971 for this procedure based on the country
 specific index.
• Thus, the beneficiary must pay the hospital the additional $4,229
 that Tricare will not pay.
• Tricare will only reimburse the beneficiary 75% of the allowed
 amount. The beneficiary is mandated by Federal statute to pay 25% of what
 ever Tricare pays. Thus, only $5,228.25 of the$11,200 will be at
 government expense.
• The beneficiary will pay the outstanding hospital bill of $4,229 plus
 the co-pay of $1,742.75 for a total of $5,971.75 (or 53.32% of the
 total hospital bill).

Other examples for out-patient care have shown a beneficiary cost of
 60-70-80% of the total amount of the bill. And then comes the kicker. In
 most third world countries, such as the Philippines, the patient must
 pay the hospital bill and doctors/laboratory bills in full prior to
 discharge from the hospital or prior to receiving medical care. Some
 hospitals require a deposit of 110% of the estimated hospital bill prior to
 admission. In the Philippines, unlike the U.S., a hospital is not
 required to admit a patient or treat a patient without getting paid for the
 medical care given. Using the above example there are very few Tricare
 users who could come up with $11,200 within a day in order to get
 treated for a life threatening medical condition.

     DOD has refused to use a prevailing rate system for the
 Philippines, even though this is the manner in which they determine allowable
 charges in the U.S., (and the U.S. rates are adjusted by zip codes and
 localities to account for the differences in health care cost in different
 parts of the U.S.). This and the use of a new country specific index
 will force overseas dependents and retirees to shoulder a higher
 percentage of their health care cost than is required of their counterparts in
 the U.S. Speculation as to why this is happening is:
• DOD does not think anyone will notice. They need to find funds to
 help with the Iraq war cost. They know, due to all the newspaper articles
 concerning poor treatment of active duty and retired military in U.S.,
 that they could not extract the savings from U.S. military health
 system in the U.S. But the service members and retirees overseas don’t
 normally make the news, so why not get the dollars from them.
• Though intentional misuse of data from the World Bank they can ignore
 the exchange rate, inflation rate and take an average cost analysis to
 derive a reduction in benefits to the overseas retiree and dependent
 community. 
• By reducing future overseas reimbursements DoD can recoup losses due
 to Tricare fraud intensified by inaction of their overseas regional
 contractor WPS. (i.e. $100 million over 6 years by Health Visions).

Government should treat equally all active and retired military members
 who served their country honorably.  If you feel to not do so is wrong
 you are encouraged to contact your Senate and House representatives
 and tell them to stop DOD from eroding our overseas military community’s
 benefits.  Attachment 3 to this Bulletin contains a suggested letter
 for mailing to one or more of your Congressional representatives.
 Attachment 4 contains extensive background on how we would up in this
 situation. Congressional contact information can be obtained from
 https://forms.house.gov/wyr/welcome.shtml  . [Source: Various 9 Jun 08
 ++]


TERA UPDATE 01:   Public Law 102-484 granted temporary authority for
 the military services to offer early retirements to members with more
 than 15 but less than 20 years of service. The retired pay was calculated
 in the usual way except that there was a reduction of 1% for every year
 below 20 years of service. Part or all of this reduction can be
 restored at age 62 if the retired member works in a qualified public service
 job during the period from the date of retirement to the date on which
 the retiree would have completed 20 years of service. Unlike members
 who leave military service before 20 years with voluntary separation
 incentives or special separation benefits, these early retirees are
 generally treated like regular military retirees for the purposes of other
 retirement benefits. This authority expired on 1 SEP 02. As of 30 SEP 06 &
 07, there were approximately 58,000 TERA retirees receiving retired
 pay. In FY 2006, TERA retirees were paid approximately $769 million in
 2006 and $841 million in 2007.  [Source: DoD FY07 Military Retirement
 Fund Audited Financial Statement 30 Nov 08 ++]


SSA PRISONER RULES UPDATE 01:   Social Security disability benefits can
 be paid to people who have recently worked and paid Social Security
 taxes and are unable to work because of a serious medical condition that
 is expected to last at least a year or result in death. The fact that a
 person is a recent parolee or is unemployed does not qualify as a
 disability. Social Security retirement benefits can be paid to people who
 are 62 or older. Generally, you must have worked and paid Social
 Security taxes for 10 years to be eligible. Social Security benefits are not
 paid for the months you have been sentenced to a jail,
prison or correctional facility or confined to certain public
 institutions for committing a crime. And, no benefits can be paid for any month
 in which you violate a condition of your probation or parole. Although
 you cannot receive monthly Social Security benefit payments while you
 are confined, your spouse or children can be paid benefits on your
 record if they are eligible. And if you have worked and paid Social Security
 taxes, survivors benefits also may be paid to certain family members
 if you die. SSI can be paid to people who are 65 or older, or who are
 blind or disabled and whose income and resources are below certain
 limits. No benefits are payable for any month in which you reside in a jail,
 prison or certain other public institutions. Also, you cannot receive
 an SSI payment for any month in which you violate a condition of your
 probation or parole.

     If your Social Security or SSI benefits were suspended because you
 were incarcerated, you can request that they be started again when you
 are released from prison. You will need to contact Social Security and
 provide a copy of your release documents before they can take action
 on your request. If you were not receiving benefits prior to your
 incarceration or your benefits were terminated, you will need to file a new
 application for benefits if you think you may be eligible. You should
 contact Social Security for more information about filing a claim for
 benefits. They will require proof of your release from prison, in addition
 to a new application and other documents. If your institution has a
 prerelease agreement with the local Social Security office, it will
 notify them if you are likely to meet the requirements for SSI or Social
 Security benefits. SSA can then process an application several months
 before your anticipated release so that benefits can start as soon as
 possible after your release. You should contact institutional or social
 service staff to find out if the institution has a prerelease agreement
 with Social Security. If there is no agreement, when you know your
 anticipated release date, contact Social Security to apply for benefits if you
 think you may be eligible so SSA can take prompt action on your
 application.  For what you can do online refer to
 http://www.socialsecurity.gov/onlineservices/ [Source:
  http://www.socialsecurity.gov/pubs/10133.html Jun 08 ++]


EXPATRIATE INCOME TAX UPDATE 01:    For American expatriates, the tax
 filing deadline this year is 16 June. This means that the tax return
 must be at the IRS Service Centre in Austin, Texas by the due date.
 Postmarks do not count. For this reason, electronic filing is the better
 option over snail mailing. The due date can be extended by filing Form 4868
 - Application for Automatic Extension Of Time to File U.S. Individual
 Income Tax Return. This form extends the due date to 15 OCT 08. However
 you will owe interest on any unpaid taxes that were due 14 APR for the
 2007 calendar year. IRS may also assess a late payment penalty of 1/2
 of 1% of any tax not paid by the regular due date up to 25%. A late
 filing penalty of 5% per month up to 25% can also be assessed if the
 return is filed late. Form 4868 can either be filed electronically or by
 post. Expatriates making a payment with the Form should send to the IRS
 Service Centre at: PO Box 660575, Dallas TX 75266-0575. Those not making
 a payment can send to: Austin, TX 73301-0215.   [Source: The Tax Barron
 Jun/Jul 08 ++]


IRS STATUTE OF LIMITATIONS:   Often American expatriates do not file a
 US tax return under several mistaken assumptions. The three main ones
 are:
• They file and pay taxes to a foreign country of residence.
• They earn less than the foreign earned income exclusion.
• After many years of not filing to remain under the radar.

Actually US tax laws require US citizens and resident aliens to report
 their worldwide income annually unless their income is below the
 combination of a Standard Deduction and Exemption amounts. In 2007 a Single
 filer's Standard Deduction was $5,350 and Exemption $3,400. So unless as
 a Single filer you were below this $8,750 ($5,350 + $3,400) threshold,
 filing an income tax return in a foreign country does not excuse you
 from filing stateside. The Foreign Earned Income Exclusion (FEIE), worth
 $85,700 in 2007, is intended to help US filers from being taxed twice
 on their foreign income. But FEIE cannot be applied against investment
 and other forms of income. Nor can it be taken if IRS challenges a
 nonfiler to report prior year foreign earnings and decides against allowing
 FEIE. So even if those foreign earnings are excluded from US taxation,
 they are still reportable. Staying under the radar is risky,
 especially as IRS is steadily increasing its reach via international tax
 treaties and auditors. The worst scenario is to be discovered and face
 possible criminal sanctions for tax avoidance. Under IRS Statute of
 Limitations, taxpayers have three years to claim a tax refund. IRS has three
 years to audit a tax return or assess additional taxes. And ten years to
 collect outstanding tax liabilities. Anyone who has not filed a US tax
 return for some years from overseas should take the offensive approach by
 filing rather than being put on the defensive by an aggressive and
 suspicious IRS auditor. The Service asks that three years returns be
 filed.  [Source: The Tax Barron Jun/Jul 08 ++]


TAX on NEGOTIATED BALANCES:  Veterans should be aware of the tax
 ramifications of negotiating a credit card debt. If you or a member of your
 family that you claim as a dependent on your tax form become
 over-extended on their credit card balances it is possible to negotiate with many
 credit card companies for a reduced balance to clear the debt. However,
 once payment is made the credit card company will issue you a Form
 1099-C reporting the amount not paid as a discharge of indebtedness
 income. This can later be taxed as income by the IRS. [Source:  The Tax
 Barron Jun/Jul 08 ++]


SHAD UPDATE 06:   Veterans who believe they're suffering health
 problems from secret chemical and biological weapons testing conducted years
 ago will testify before Congress the week of 9 JUN on House bill
 H.R.5954 introduced on 1 MAY by Rep. Mike Thompson, Mike [CA-1]. Thompson and
 some of the bills 25 cosponsors  have been trying for nearly seven
 years to get the U.S. Defense Department to acknowledge that the tests
 occurred and that affected veterans should be compensated and given
 treatment for their diseases.  The bill is to amend title 38, United States
 Code, to provide veterans for presumptions of service connection for
 purposes of benefits under laws administered by Secretary of Veterans
 Affairs for diseases associated with service in the Armed Forces and
 exposure to biological, chemical, or other toxic agents as part of Project
 112, and for other purposes. It also requires the secretary of Veterans
 Affairs to notify all veterans subject to the testing of the potential
 hazards.  It is estimated there are about 500 veterans still surviving
 that were affected by the project. Rep. Denny Rehberg (R-MT) said in a
 prepared statement, "This is great news for all of the Project 112
 veterans who have waited decades to receive proper health care. It's obvious
 we've gotten the committee's ear and they're interested in finally
 righting this wrong."

     The Defense Department now says 6,440 service members took part in
 50 tests under Project 112 between 1962 and 1973, including open-air
 tests above a half-dozen U.S. states. In testimony prepared for the
 hearing, obtained in advance by The Associated Press, Bradley Mayes, the
 Veterans Affairs Department’s director of compensation and pensions,
 calls the legislation unnecessary, “due to the lack of credible scientific
 and medical evidence that adequately demonstrates any statistically
 significant correlation” between the tests and participants’ diseases.
 Last year, the Institute of Medicine, which advises the government on
 medical and health matters, found no specific health effects as a result of
 Project SHAD Rep. Thompson and others argue that the report was
 shoddily done and left out key information. During the tests, conducted amid
 Cold War concerns about the Soviet Union’s weapons capabilities, the
 military tested germs such as bacteria that could cause tularemia and Q
 fever, serious diseases more commonly found in animals. Also used were
 nonlethal simulated agents, including E. coli now known to pose health
 dangers. Some of those veterans now suffering from various maladies say
 test participants were given experimental vaccines but weren’t told of
 any risks, only that the shots were a protective measure.  Dr. Michael
 Kilpatrick, the Pentagon’s deputy director for force health protection
 and readiness, acknowledges that some participants weren’t fully
 informed about the project they were part of but says safety precautions
 taken then were appropriate for the time.

     Among the various Project 112 tests was SHAD, an acronym for
 Shipboard Hazard and Defense, which was conducted during the 1960s. SHAD
 encompassed tests designed to identify US warships' vulnerabilities to
 attacks with chemical or biological warfare agents and to develop
 procedures to respond to such attacks while maintaining a war-fighting
 capability. The Defense Department for years denied that the testing occurred.
 Although it now acknowledges the tests, it won't provide health
 benefits through Veterans Affairs for those exposed veterans who are now
 suffering various cancers and illnesses. During the SHAD tests crewmembers
 were inside ship’s sealed quarters when they were sprayed with
 biological and chemical agents in the Pacific Ocean. Participants claim that
 paper filters designed to prevent the agents from getting through the air
 ducts to the sealed spaces often deteriorated.  They were required to
 wash down the boats after the spraying, but they wore the same gear
 every day and it was cleaned with cancer-causing agents. Their bunks,
 clothes and lockers also were exposed during the cleaning.   The following
 are ships used in the SHAD operation along with the tests they were
 involved in:

• USS George Eastman (YAG-39): 63-1 Eager Belle I; 63-1 Eager Belle II;
 64-2 Flower Drum I;  65-17 Fearless Johnny; ; 66-13 Half Note; 65-4
 Magic Sword.
• USS Granville S. Hall (YAG-40): 63-1 Eager Belle II, 63-2 Autumn
 Gold; 64-2 Flower Drum I; 64-4 [Red Beva] Shady Grove; 65-6 Big Tom; 65-17
 Fearless Johnny; 66-13 Half Note; 68-50 Speckled Start [68-11]; 69-32.
• USS Hoel (DDG-13): 63-2 Autumn Gold.
• USS Berkeley (DDG-15): 65-13 High Low.
• USS Navarro (APA-215): 63-1 Eager Belle II; 63-2 Autumn Gold.
• USS Okanogan (APA-220): 65-13 High Low.
• USS Fort Snelling (LSD-30): 69-10.
• USS Tioga County (LST-1158): 63-1 Eager Belle II; 63-2 Autumn Gold.
• USS Wexford County (LST-1168): 65-13 High Low.
• USS Carpenter (DD-825): 63-1 Eager Belle II; 63-2 Autumn Gold.
• USS Herbert J. Thomas (DD-833): 66-5 Purple Sage; 66-6 Scarlet Sage;
 69-31.
• USS Power (DD-839): 65-1 Copper Head.
• USS Fechteler (DD-870): 65-13 High Low.
• USS Carbonero (SS-337): 65-6 Big Tom; 66-13 Half Note; 68-71 Folded
 Arrow.
• USNS Samuel Phillips Lee (T-AGS 31): 70-C.
• USNS Silas Bent (T-AGS 26): 70-C
[Source: Billings Gazette Mike Dennison article 6 Jun 08 ++]


VA LAWSUIT (LACK of CARE) UPDATE 08:    A federal judge considering a
 lawsuit that alleges inadequate veterans’ medical care on 5 JUN ordered
 government lawyers to explain an e-mail by a Veterans Affairs
 psychologist suggesting that counselors diagnose fewer post-traumatic stress
 disorder cases in soldiers. The hearing ordered by U.S. District Court
 Judge Samuel Conti follows a two-week trial that ended last month.
 Veterans groups had sued VA, saying it inadequately addressed a “rising tide”
 of mental health problems, especially post-traumatic stress disorder
 and suicides. The plaintiffs asked Conti to reopen the case in light of
 the e-mail discovered after the trial ended. The judge agreed, saying
 “the e-mail raises potentially serious questions that may warrant further
 attention.” He ordered lawyers for both sides to appear in court 10
 JUN to discuss whether the e-mail has any bearing on the case.

     The document in question is a 20 MAR memo written by Norma Perez,
 who helps coordinate a post-traumatic stress disorder clinical team in
 central Texas. “Given that we are having more and more
 compensation-seeking veterans, I’d like to suggest that you refrain from giving a
 diagnosis of PTSD straight out,” Perez wrote to VA counselors. “We really
 don’t or have time to do the extensive testing that should be done to
 determine PTSD.” The e-mail was forwarded to VoteVets.org, an Iraq and
 Afghanistan war veterans lobbying group opposed to the Bush
 administration’s handling of the war and veterans issues. Lawyers for the veterans
 groups argue that Perez’s e-mail goes to the heart of their case, showing
 VA’s indifference to treating mental health. “This is not Joe the
 janitor writing this,” said vets’ lawyer Arturo Gonzalez. “This is a
 supervisor and it shows how the VA thinks.” Gonzalez wants the judge to add
 the e-mail to the evidence given to him at the nonjury trial in support
 of the lawsuit. On 4 JUN, DOJ lawyer James Schwartz wrote the judge a
 letter arguing that the e-mail was a mistake, that Perez had been
 “counseled” and that it has nothing to do with the lawsuit. “It was the
 action of a single individual that in no way represented the policies of VA,
 that, once discovered, was dealt with quickly and appropriately,”
 Schwartz told the judge. [Source: Air Force Times AP Paul Elias article
 Posted 6 JUN 08 ++]


TRICARE GRAY AREA RETIREE BILL:    Rep. Bob Latta (R-OH) has sponsored
 legislation (H.R.6185) that would let reservists who are enrolled in
 Tricare Reserve Select (TRS) to continue that coverage after they retire
 until they reach age 60, when they become eligible for free Tricare
 coverage under current law. Reservists and MOAA who worked closely with
 Rep. Latta's staff in crafting the legislation believe strongly that it's
 unfair to extend Tricare coverage to drilling reservists, and then
 drop them from coverage between the time they stop drilling and the time
 they attain age 60. Their career of service demands some option for
 continuity of coverage.  Under the new bill, these "gray area" retirees
 would pay full-cost premiums to participate in Tricare, contrasted with
 those currently drilling, who pay 28% of the premium, with the remaining
 72% subsidized by the military. How much the gray area retirees would
 have to pay is not quite clear yet. Under current TRS rules, it would be
 $289 a month for a single person and $975 a month for a family. But a
 recent GAO report concluded that current TRICARE premiums are 45-75%
 too high based on actual program costs. As the excessive premiums charged
 by DoD do not accurately reflect the actual cost of coverage, GAO
 recommended an Executive Order to correct the overcharging, which has not
 yet occurred. In the interim both the House and Senate versions of the
 FY2009 Defense Authorization Bill direct the Pentagon to recompute the
 premiums based on actual costs. Reservists and veterans who would like
 to see this inequity corrected are encouraged to go to
 http://capwiz.com/moaa/issues/bills/?bill=11460441 where they can find
 a preformatted message urging their U.S. representative to cosponsor
 H.R. 6185 and the means to send it to their legislators.  [Source: MOAA
 Legislative Update 6 Jun 08 ++]


FISHER HOUSE EXPANSION UPDATE 03:   Bracing for a generation of war
 veterans needing long-term medical care, the Fisher House Foundation plans
 to build two dozen homes near military and Veterans Affairs hospitals
 in the U.S. By 2011, the non-profit foundation plans to boost its
 network of 38 homes to 62, said James Weiskopf, executive vice president of
 communications for the Rockville MD based Fisher House Foundation, Inc.
 He said the foundation is expecting an influx of veterans from the
 wars in Iraq and Afghanistan with such ailments as traumatic brain injury
 and post-traumatic stress disorder. The foundation, created in 1990,
 builds homes near military or VA medical facilities for families of
 patients needing a place to stay while their loved ones receive care.
 Donations allow families to stay at the homes for free. "We’ve largely taken
 care of the needs of the Army, Navy and the Air Force, but the needs of
 the [Veterans Affairs] is absolutely huge," Weiskopf said 4 JUN while
 on a visit to Landstuhl Germany. "They really need these houses. These
 young men and women have got to have their families with them when
 they’re going through their rehabilitation, and the house is the means that
 allows them to do that." The foundation plans to finish building five
 homes by the end of this year. Four of those homes are near VA
 hospitals and clinics. "Our future is really with the [Veterans Affairs
 clinics]," Weiskopf said. "The long-term signature wound of this war is the
 traumatic brain injury and that has a long-term period of rehabilitation,
 and that will be done by the VA." Landstuhl Regional Medical Center,
 the largest military hospital outside the U.S., has two Fisher Houses
 that offer 19 rooms. The hospital serves war wounded and patients
 stationed at bases across Europe. Weiskopf said there are no plans to build
 any additional houses at Landstuhl because they currently have enough
 space to accommodate the need.  [Source: Stars and Stripes Scott Schonauer
 article 6 Jun 08 ++]


VETERAN RURAL HEALTH ADVISORY COMMITTEE:  Secretary of Veterans Affairs
 Dr. James B. Peake has appointed 13 people to a new Veterans Rural
 Health Advisory Committee, which will advise him on health care issues
 affecting veterans in rural areas. The 13-member group will examine ways
 to enhance Department of Veterans Affairs (VA) health care services for
 veterans in rural areas by evaluating current programs and identifying
 barriers to health care. The committee, chaired by James F. Ahrens,
 former head of the Montana Hospital Association, includes affected
 veterans, rural health experts in academia, state and federal professionals
 who focus on rural health, state-level veterans’ affairs officials, and
 leaders of veterans service organizations. Members appointed are:

• James F. Ahrens of Cascade MT - Former member of Montana governor's
 task force on health care.
• Dr. Robert Moser of Tribune KS -  Physician who practices in rural
 Kansas and Colorado.
• Cynthia Barrigan of Centreville VA -   Veteran, now acting executive
 director of Virginia Telehealth Network.
• Charles Abramson of Missoula MT - Air Force veteran who served on the
 medical staff ethics committee of St. Patrick Hospital.
• Maj. Gen. John W. Libby of Sidney ME -  Adjutant general of the Maine
 National Guard.
• Hilda Heady of Morgantown WV -  Social worker and associate vice
 president for West Virginia Rural Health Association.
• Dr. Ronald Franks of Theodore AL -  Psychiatrist and vice president
 of the College of Medicine at the University of South  Alabama.
• Bruce Behringer of Johnson City TN -  Assistant vice president at
 East Tennessee State University for Rural and Community Health.
• Rachel Gonzales Hanson of Uvalde TX -  Member of National Association
 of Community Health Centers.
• Tom Ricketts, Ph.D., of Chapel Hill NC -  Director of North Carolina
 Rural Health Research Program.
• Michael Dobmeier of South Grand Forks ND -  National Judge Advocate
 of the DAV and president of the North Dakota Veterans Home Foundation.
• Terry Schow of Ogden UT - Veteran and executive director of the Utah
 Division of VA.
• James Floyd of Salt Lake City UT -  Native American and director of
 the Salt Lake City VA Medical Center.
[Source: VA News Release 5 Jun 08 ++]


WI VET EDUCATIONAL BENEFITS:   The Wisconsin G.I. Bill is a state
 program that is entirely separate from the federal VA's Montgomery G.I.
 Bill. It provides a full waiver (remission) of tuition and fees for
 eligible veterans and their dependents for up to 8 full-time semesters or 128
 credits at any University of Wisconsin System (UWS) or Wisconsin
 Technical College System (WTCS) institution for continuing education, or for
 study at the undergraduate or graduate level. In accordance with 2005
 Wisconsin Act 468 effective with the 2007-08 academic year, the tuition
 remission is a full 100% of tuition and fees for eligible veterans.
  There is no post-service time limitation (such as the federal Montgomery
 G.I. Bill 10-year delimiting date) on the use of the benefit. The
 veteran may attend full-time or part-time. The benefit may be used for
 continuing education, or for study at the undergraduate or graduate level.
 Eligibility prerequisites are Wisconsin resident at the time of entry
 onto active duty (Character of service and active duty service
 requirements apply) and recipient must reside in Wisconsin.

     A 100% remission is also provided to the qualifying dependents of
 an eligible veteran (i.e. Spouse; or Unremarried Surviving Spouse; or
 child between the ages of 18 and 25) where the qualifying Wisconsin
 veteran:
• Is currently rated by the federal VA with a combined
 service-connected disability rating of 30% or greater; or
• Died in the line of duty while on active, Reserve, or Guard duty; or
• Died as the direct result of a service-connected disability, as
 determined by the federal VA.
For qualifying spouses and unremarried surviving spouses, the benefit
 must be used within 10 years of the date of death or the initial
 disability rating of 30% or greater. The spouse or unremarried surviving
 spouse may attend full-time or part-time. For qualifying children, the
 benefit is available only if they attend full-time.

      The Veterans Education (VetEd) grant program provides a
 reimbursement grant following successful course completion at an eligible UW,
 technical college, or approved private institution of higher learning.
 The grant is based on a credit-bank system that is based on length of
 active duty military service to eligible veterans who have not yet been
 awarded a bachelor's degree for the reimbursement of tuition and fees.
 The veteran and spouse's combined annual income may not exceed $47,500
 plus $500 for each dependent in excess of two dependents. Veterans may
 concurrently receive Chapter 30 Montgomery G.I. Bill (VA) benefits and
 VetEd for the same semester. However, individuals eligible for Wisconsin
 G.I. Bill benefits must apply for, and use those benefits in order to
 be eligible for VetEd reimbursement. VetEd reimbursement will be reduced
 to the extent that tuition and fees have already been paid by other
 grants, scholarships, and remissions provided for the payment of tuition
 and fees.

     Service members, reservists, and veterans pursuing a college
 education may be able to obtain academic credit for military courses they
 have completed through the military. Prior to enrollment individuals
 should discuss possible credit with the Veterans’ Coordinator at the
 college or university they plan to attend; credit received may reduce
 attendance time and cost. They may obtain information regarding transcripts
 and potential credit for military experience from the links below.

• The American Council on Education's (ACE): Their College Credit
 Recommendation Service (CREDIT) provides access to academic credit for
 formal courses and examinations taken outside traditional degree programs.
  The ACE Guide to the Evaluation of Educational Experiences in the Armed
 Services contains recommended credit awards for formal military
 courses and occupations. http://www.acenet.edu.
• The Department of Defense Activity for Non-Traditional Education
 Support (DANTES): Coordinates several programs that advance the acceptance
 of military education and experience at civilian colleges and
 universities. Additionally, DANTES maintains the educational records of service
 members who have completed DSSTs, CLEP examinations, USAFI (United
 States Armed Forces Institute) and GED tests
 .http://www.dantes.doded.mil/dantes_web/danteshome.asp?Flag=True .
• Military Transcript Services: Each branch of service provides
 transcripts for current and former service members that include individual
 military education, training, and experience, which are evaluated
 according to ACE standards for recommended college credit. Refer to Army
 http://aarts.army.mil. ; USN & USMC
 https://www.navycollege.navy.mil/transcript.html; and USAF
 http://www.maxwell.af.mil/au/ccaf/transcripts.asp;
• The DANTES Subject Standardized Tests (DSSTs): Approved by ACE and
 accepted or administered at over 1,900 colleges and universities
 nationwide. DSSTs enable people to use the knowledge acquired outside the
 classroom to accomplish educational and professional goals. The website
 includes downloadable forms, practice tests, and other information.
 http://www.getcollegecredit.com.
• Servicemembers Opportunity Colleges (SOC): A consortium of over 1800
 colleges and universities pledged to support the higher education needs
 of military personnel. SOC works with civilian and military educators
 to overcome obstacles associated with gaining a college education when
 pursued through traditional means.  Among its key goals is the award of
 credit for military training and experience.  The SOC Consortium Guide
 provides specific information for awarding credit for national testing
 programs, military experience, and other non-traditional learning.
 http://www.soc.aascu.org/socgen/SOCGuide.html.
[Source: http://dva.state.wi.us/Ben_education.asp Jun 08 ++]


PTSD UPDATE 21:   A Veterans Affairs Department psychologist denies
 that she was trying to save money when she suggested that counselors make
 fewer diagnoses of post-traumatic stress disorder in injured soldiers.
 Norma Perez, who helps coordinate a post-traumatic stress disorder
 clinical team in central Texas, indicated she might have been out of line
 to cite growing disability claims in her 20 MAR e-mail titled
 “Suggestion.” She said her intent was simply to remind staffers that stress
 symptoms could also be adjustment disorder. The less severe diagnosis could
 save VA millions of dollars in disability payouts. “In retrospect, I
 realize I did not adequately convey my message appropriately, but my
 intent was unequivocally to improve the quality of care our veterans
 received,” Perez said in testimony prepared for delivery4 JUN before a Senate
 panel. The Senate Veterans’ Affairs Committee and the VA inspector
 general are investigating whether there were broader VA policy motives
 behind the e-mail, which was obtained and disclosed last month by two
 watchdog groups. VA has strenuously denied that cost-cutting is a factor in
 its treatment decisions. “One question that was raised repeatedly
 about this latest e-mail was, ‘Why would a clinician be so concerned about
 the compensation rolls?”’ said Sen. Daniel Akaka (D0HI) who chairs the
 Senate panel. “As an oversight body, we must know whether the actions
 of these VA employees point to a systemic indifference to invisible
 wounds.”

     VA Secretary James Peake has called Perez’s e-mail suggestion
 “inappropriate.” VA officials this week said her e-mail was taken out of
 context. “The e-mail, as characterized by others, does not reflect the
 policies or conduct of our health care system,” said Michael Kussman,
 VA’s undersecretary for health, in testimony prepared for the Senate
 hearing. “We certainly agree that it could have been more artfully drafted.”
 In her e-mail to staffers at the VA medical center in Temple, Texas,
 Perez wrote, “Given that we are having more and more
 compensation-seeking veterans, I’d like to suggest that you refrain from giving a
 diagnosis of PTSD straight out. ... We really don’t or have time to do the
 extensive testing that should be done to determine PTSD.” Many veterans and
 injured troops have long charged that the government might seek to
 reduce disability costs by assigning a lower benefits rating. Last year,
 retired Lt. Gen. James Terry Scott, chairman of the Veterans’ Disability
 Benefits Commission, said he believed the Army might at least
 subconsciously consider cost. A lawsuit filed in San Francisco accuses VA of
 misclassifying PTSD claims.

     In her testimony, Perez said symptoms for PTSD and adjustment
 disorder are often similar, as are the treatments for them. She said by
 making an initial diagnosis of a lesser disorder, VA staff can begin
 treatment right away without going through the arduous process of diagnosing
 PTSD. Perez also noted that awarding disability benefits is not part
 of her staff’s work, but she did not say why she chose to cite that as a
 factor in urging fewer PTSD diagnoses. Veterans diagnosed with PTSD
 are eligible to receive up to $2,527 a month in government benefits. A
 recent Rand Corp. study found about 300,000 U.S. military personnel who
 served in Iraq or Afghanistan are suffering from PTSD or major
 depression, potentially saving the government millions of dollars if lesser
 diagnoses are used in disability benefits decisions. “Although our clinic
 is a treatment clinic, we all fully support the compensation process and
 the department’s policy of erring in the best interest of the veteran
 whenever there is any doubt,” Perez wrote. Perez’s testimony comes
 after Peake was called to Capitol Hill last month to answer questions about
 internal e-mails suggesting that VA officials were hiding the number
 of veterans trying to kill themselves. One of the e-mails, disclosed
 during a San Francisco trial, started with “Shh!” Some lawmakers have said
 the VA’s top mental health official who wrote it, Dr. Ira Katz, should
 be fired, but Peake has said he has no plans to do so. [Source: Air
 Force Times AP article Posted 4 Jun 4 08 ++]


CT VET EDUCATIONAL BENEFITS:  Veterans may attend Connecticut Public
 Colleges and Universities tuition free. Connecticut statutes provide that
 tuition may be waived for qualified veterans attending the University
 of Connecticut, Connecticut State Universities and the 12
 Community-Technical Colleges. Waivers cover only the cost of tuition for
 credit-bearing undergraduate and graduate programs. Other charges, such as for
 books, student activity and course fees, parking, and room and board, are
 not waived. To qualify for a waiver at the University of Connecticut
 and Connecticut State Universities, veterans generally must be
 matriculated, that is, admitted to a degree program. The Community-Technical
 Colleges are more flexible. Remember to take a copy of your separation
 papers with you when applying for admission and registering for courses.
 Tuition waivers for veterans cover 100% of tuition for General Fund
 courses at all public colleges and universities and 50% for Extension Fund
 and summer courses at Connecticut State Universities. Waivers cover only
 the cost of tuition for credit-bearing undergraduate and graduate
 programs. Other charges, such as for books, student activity and course
 fees, parking, and room and board, are not waived. 

     To be eligible for veterans’ tuition benefits at any college or
 university, a veteran must be honorably discharged from the U.S. Armed
 Forces with 90 days or more active Military duty during war, and must
 have resided in Connecticut for at least one year upon enrolling in
 college, and have been accepted to an approved institution.  A veteran’s
 dependents can also qualify for tuition waiver if the veteran is declared
 missing in action while serving in the armed forces after 1 JAN 06. On
 23 May 08 Connecticut Governor M. Jodi Rell signed SB 48 into law. The
 new law requires state institutions of higher learning to waive tuition
 for any state resident who is a dependent or surviving spouse of an
 active duty military member who was a Connecticut resident and killed in
 action after September 11, 2001. Also, Local Boards of Education may
 award high school diplomas to those World War II veterans who did not
 receive them when they left high school before graduation for military
 service. [Source: NMFA eNews & www.ct.gov/ctva/site/default.asp 3 Jun 08
 ++]


WALTER REED DATA BREACH:    Sensitive information on about 1,000
 patients at Walter Reed Army Medical Center and other military hospitals was
 exposed in a security breach, sparking identity theft concerns and an
 investigation by the Army. The chairman of the House Armed Services
 Committee, Rep. Ike Skelton (D-MO), said he wants to hear from the Army
 about its investigation. Names, Social Security numbers, birth dates and
 other information were released, hospital officials said 2 JUN. The
 computer file that was breached did not include information such as medical
 records, or the diagnosis or prognosis for patients, they said. Walter
 Reed officials declined to explain exactly how the information was
 compromised, pending an ongoing investigation by the hospital and the
 Army. They would only say that the computer file was found on a
 "non-government, non-secure computer network."  The medical center learned of the
 breach on 21 MAY from an outside data mining company, which officials
 did not identify. They said the company was working for another client,
 found the file and contacted Walter Reed. The hospital said it is
 working to notify all of the people named in the data file. Letters or
 e-mails were being sent out, beginning Monday. Officials declined to say how
 many patients were from Walter Reed and how many were from other
 military hospitals.

     Walter Reed plans to offer free credit protective services to
 patients whose information was revealed. The hospital also has set up a hot
 line for people to call to see if their information was disclosed
 (1-877-854-8542, ext. 9). The disclosure marked the latest in a series of
 breaches of government computer records. The federal government has been
 stung by a rash of data breaches in recent years.
• At the Agriculture Department, a hacker broke into the computer
 system in June 2006 and may have obtained names, Social Security numbers and
 photos of 26,000 Washington-area employees and contractors.
• The Veterans Affairs Department acknowledged a massive breach in May
 2006, in which personal data on up to 26.5 million veterans was lost.
• At the Health and Human Services Department, personal information for
 nearly 17,000 Medicare beneficiaries may have been compromised in
 early 2006 when an insurance company employee called up the data through a
 hotel computer but didn't delete the file.
•  At the Energy Department, Social Security numbers and other data for
 about 1,500 people working for the National Nuclear Security
 Administration may have been compromised when a hacker gained entry to its
 computer system in 2005.
[Source: Washington Post Jennifer C. Kerr article 2 Jun 08 ++]


U of U HOSPITAL DATA BREACH:    University of Utah Hospital and Clinics
 patients are bracing for the unknown as police and prosecutors
 investigate the theft of 2.2 million billing records filled with personal
 information.  Authorities say the records, stolen out of a courier's
 personal vehicle earlier this month, put the private data of patients from
 the past 16 years at risk. Measures taken so far include offering free
 credit monitoring services for at least 1.3 million patients whose Social
 Security numbers were compromised, and a $1,000 reward for the return
 of the tapes - no questions asked.  Salt Lake County Sheriff Jim Winder
 and Lorris Betz, a senior vice president for health sciences for
 University Health Care, say the stolen records were on backup tapes designed
 to safeguard the records in case materials housed in the hospitals and
 clinics were destroyed. The tapes were taken from the vehicle of an
 employee of Sandy-based Perpetual Storage Inc. near the employee's Kearns
 home on 2 JUN. The employee had been assigned to pick up the tapes in
 a secure company van and transport them to an off-site vault, said
 James Nowa, a vice president for sales and marketing for Perpetual Storage.
 He violated company policy by taking them home and leaving them in his
 car.  A thief then broke into the employee's vehicle stealing a metal
 box holding the tapes, Winder said. Nowa said the 18-year veteran
 employee has been fired, and the incident is the first of its kind he knows
 of in the company's 40-year history.

    An investigation is ongoing, but the theft appears to be the work
 of inexperienced criminals, who likely believed the metal box containing
 the tapes was filled with cash, said Winder. After collaborating with
 the FBI, Winder said it's unlikely the tapes were stolen to commit
 identity theft. There's no evidence any of the information on the tapes has
 been accessed; besides, anyone trying to use the tapes would need
 specialized equipment to view the contents, Winder said. But there are also
 no guarantees.  Melodie Rydalch, spokeswoman for the U.S. Attorney's
 Office, said the FBI and the Utah Identity Task Force, which includes
 local and county law enforcement agencies, is investigating the thefts.
 She warned of federal penalties for anyone who uses stolen identities.
 Betz said the university delayed releasing news of the security breach
 to the public until the sheriff's office had completed an initial
 investigation. The university had worked with Perpetual Storage for 12 years
 before the theft but suspended deliveries after the incident. An
 assessment of university data security policies and procedures is under way,
 Betz said. [Source: Salt Lake Tribune Melinda Rogers article 11 Jun 08
 ++]


BANK of NY DATA BREACH:    The Connecticut attorney general announced
 that a Bank of New York Mellon contractor lost a laptop containing the
 personal information of some 4.5 million bank customers. An unencrypted
 backup tape holding the personal information disappeared on 27 FEB
 while in possession of a third-party vendor. Potential victims did not
 learn of this until 27 MAY giving them little chance of protecting
 themselves.  Andy Kicklighter, director of product marketing for GuardianEdge,
 provider of mobile data protection solutions, said businesses must
 prioritize the need for laptop encryption and search for solutions that
 allow for simple implementation and manageability. "IT organizations are
 afraid that it will be a big project," he said, adding that companies
 who have never experienced a data-loss incident also have difficulty
 understanding the ramifications of a breach. "It just hasn't reached their
 priority level," Kicklighter told SCMagazineUS.com. (Editor’s Note:
 From the preceding it is once again evident that the government it not the
 only entity having limited control over data breaches resulting from
 human error.  Veterans need to protect themselves against personal
 losses through some form of identity theft insurance).

     An undisclosed number of management-level workers at AT&T have
 been notified that their personal information was stored unencrypted on a
 stolen laptop. The laptop was stolen 15 MAY from the car of an
 employee. The data on the computer was not encrypted -- a violation of company
 policy -- and included names, Social Security numbers and in some
 cases, salary and bonus information. Walt Sharp, a spokesman for AT&T said
 the company would not disclose the number of affected individuals, but
 indicated there is no reason to believe any of the data was being
 targeted when the machine was stolen. "Usually these are property crimes in
 which the drive is wiped clean and resold for profit," he said. The
 employee who was in possession of the laptop when it was stolen has been
 disciplined. "There are a number of rules governing the handling of
 encrypted material and the mobile devices handling that material that
 employees must follow," Sharp said. "It is up to the employee to ensure that
 any sensitive material is encrypted." AT&T began notifying victims on
 23 May through email and standard mail and is offering them free credit
 monitoring. AT&T used the breach as a reminder that employees must
 follow policies. [Source: SC Magazine Dan Kaplan article 4 Jun 08 ++]


ALZHEIMER’S UPDATE 04:    More than a third of U.S. adults have a
 family member or friend who has Alzheimer’s. Half of those who live past age
 85 will succumb to Alzheimer's disease.  It is a progressive
 neurological disorder that leads to personality changes, memory loss,
 intellectual slowing and difficulty with regular activities. Although each person
 with Alzheimer's is different, most individuals affected by the
 disease progress through a series of stages. Each stage is characterized by
 more serious symptoms.  Although the stages provide a blueprint for the
 progression of Alzheimer's disease, not everyone advances through the
 stages similarly. Caregivers report that their loved ones sometimes seem
 to be in two or more stages at once, and the rate at which people
 advance through the stages is highly individual. Still, being aware of the
 stages will help you understand the disease and prepare for potential
 symptoms and their accompanying challenges. The following seven stages
 were developed by researchers and physicians to describe how your or
 your loved one's functioning will change over time. Your doctor might
 consolidate the seven stages into early/middle/late or
 mild/moderate/severe, so these classifications are provided as well:

Stage 1 (Absence of Impairment): There are no problems with memory,
 orientation, judgment, communication, or daily activities. You or your
 loved one is a normally functioning adult.

Stage 2 (Minimal Impairment): You or your loved one might be
 experiencing some lapses in memory or other cognitive problems (i.e.faculty for
 processing of information, applying knowledge and changing preferences)
 , but neither family nor friends are able to detect any changes. A
 medical exam would not reveal any problems either.

Stage 3 (Noticeable Cognitive Decline): Family members and friends
 recognize mild changes in memory, communication patterns, or behavior. A
 visit to the doctor might result in a diagnosis of early-stage or mild
 Alzheimer's disease, but not always. Common symptoms in this stage
 include:
• Problems producing people's names or the right words for objects.
•  Noticeable difficulty functioning in employment or social settings.
•  Forgetting material that has just been read.
•  Misplacing important objects with increasing frequency.
•  Decrease in planning or organizational skills

Stage 4 (Early-Stage/Mild Alzheimer's): Cognitive decline is more
 evident. You or your loved one may become more forgetful of recent events or
 personal details. Other problems include impaired mathematical ability
 (for instance, counting backwards from 100 by 9s), a diminished
 ability to carry out complex tasks (for example, throwing a party or managing
 finances), moodiness, and social withdrawal.

Stage 5 (Middle-Stage/Moderate Alzheimer's): Some assistance with daily
 tasks is required. Problems with memory and thinking are quite
 noticeable, including symptoms such as:
• An inability to recall one's own contact information or key details
 about one's history.
• Disorientation to time and/or place.
• Decreased judgment and skills in regard to personal care
     (Note: Even though symptoms are worsening, people in this stage
 usually still know their own name and the names of key family members and
 can eat and use the bathroom without assistance.)

Stage 6 (Middle-Stage/Moderate to Late-Stage/Severe Alzheimer's): This
 is often the most difficult stage for caregivers because it's
 characterized by personality and behavior changes. In addition, memory continues
 to decline, and assistance is required for most daily activities. The
 most common symptoms associated with this stage include:
• Reduced awareness of one's surroundings and of recent events.
• Problems recognizing one's spouse and other close family members,
 although faces are still distinguished between familiar and unfamiliar.
• Sundowning, which is increased restlessness and agitation in the late
 afternoon and evening.
• Difficulty using the bathroom independently.
• Bowel and bladder incontinence (i.e. strong, sudden urges to go to
 the bathroom , frequent trips to the bathroom, and leakage).
• Suspicion.
• Repetitive behavior (verbal and/or nonverbal).
• Wandering

Stage 7 (Late-Stage/Severe Alzheimer's): In the final stage, it is no
 longer possible to respond to the surrounding environment. You or your
 loved one may be able to speak words or short phrases, but communication
 is extremely limited. Basic functions begin to shut down, such as
 motor coordination and the ability to swallow. Total care is required
 around the clock.
[Source:
 http://alzheimers.about.com/od/symptomsofalzheimers/a/symptoms.htm Jun
 08 ++]


VA PTSD CLAIM SUPPORT UPDATE 01:  Post traumatic stress disorder (PTSD)
 happens after a person faces some traumatic incident that affects the
 mind and soul of the person deeply.  It involves intense fear,
 helplessness and horror that happens because of previously experienced events.
 A person is not able to forget the incident and the memories and the
 picture of the incident keep coming back which ultimately becomes a big
 stressor which affects their behavior and/or health. The person gets
 overly worried about the incident and becomes depressed. PTSD stress
 disorder shows many symptoms that work as stressors. Symptoms are:

•  Poor concentration and short term memory.
• Depression and Apathy.
• Difficulty in communicating.
• Physical problems.
• Emotional numbing.
• Difficulty in trusting others.
• Stress.
• Anger & Rage.
• Frustration.
• Irritability.
• Isolation.
• Poor self esteem.
• Negative self image.
• Lack of feelings.
• Hypervigilant.
• Easily startled.
• Sleep disturbance or insomnia.
• Flashbacks.
• Anxiety.
• Loss of interest and motivation.
• Poor judgment.
• Guilt and Survivor guilt.
• Intrusive memories.

If you received a diagnosis of PTSD while on active duty and are
 suffering from any of the above symptoms you have the basis for a VA claim
 for PTSD.  If your medical records do not show you  were previously
 diagnosed or treated for PTSD and you are suffering from any of the above
 which you feel is related to your service you can submit a claim but must
 provide proof of  involvement in a combat scenario if your claim is
 based on a combat stressor.  The VA concedes that receipt of any of a
 Decoration denoting Combat Service (Combat Action Ribbon, Combat Infantry
 Badge, etc.), a Decoration for Valor in Combat (Service Achievement or
 Commendation Medal, Bronze Star, etc.), with “V” for Valor, or a Purple
 Heart Medal, are  grounds to file a claim with the VA for
 service-connection of PTSD. To initiate the claim  the Veteran just needs to make a
 simple written statement of the symptoms he (or she) is experiencing
 at present.  When veterans are in denial and won't admit the severity of
 their disability it is helpful if a relative or close friend also
 makes a separate written statement of the symptoms they've observed in the
 Veteran. Call the VA at 1(800) 829-1000 and ask for the location of the
 nearest VA Veterans Center or Healthcare Facility that can assist you.
 [Source:  VFW VSO Scott H. Langhoff article 2 Jun 08 ++]


MEDICARE FRAUD UPDATE 06:  Fraud and abuse costs Medicare an estimated
 16 billion dollars every year and leads to higher costs for everyone
 with Medicare in the form of higher premiums, deductible and other costs.
  Doctors and other health care providers who commit Medicare fraud may
 be dishonest about other things as well. Reporting fraud can help
 Medicare ensure that people with Medicare receive health care only from
 health care professionals who provide quality services. If you report
 fraud that cost Medicare more than $100, Medicare may pay you up to 10% of
 the money you helped recover, up to $1,000. To report  Medicare fraud,
 call the Medicare fraud hotline at (800) 447-8477  or send Fax to (800)
 223-8164 or email HHSTips@oig.hhs.gov, or mail to Office of Inspector
 General , Department of Health and Human Services, Attn: HOTLINE,  PO
 Box 23489, Washington, DC 2002 and provide the following:
• Personal Data - Your Name,  full mailing address and email addee.  If
 you would like your referral to be submitted anonymously indicate in
 your correspondence or phone call.
• Subject/Person/Business/Department that allegation is against and the
 accused full mailing address.
• A brief summary relating to your allegation.

Last year 20% of all Medicare Fraud cases in the U.S. were prosecuted
 in South Florida. This a much greater amount than other larger
 metropolitan areas around the country. In 2007, U.S. Attorney R. Alexander
 Acosta and the Justice Department established a South Florida strike force
 of federal agents and prosecutors to target fraudulent providers. The
 South Florida strike force prosecuted 120 criminal and civil cases
 against 200 defendants who were charged with more than $638 million in
 fraudulent Medicare claims. It is considered Medicare fraud is when doctors
 or other providers deceive Medicare into paying when it should not or
 paying more than it should. This is against the law and should be
 reported. Some types of fraud include
• Billing Medicare for services you never received;
• Billing Medicare for services that are different than the ones you
 received (usually more expensive);
• Continuing to bill Medicare for rented medical equipment after you
 have returned it;
• Offering or performing services that you do not need in order to
 charge Medicare for more services;
• Telling you that Medicare will pay for something when it won’t;
• Using another person’s Medicare number or card
[Source: Medicare Rights Center 2 Jun 08 ++]


NATIONAL MONUMENTS:   President Bush has asked his defense and interior
 secretaries to look into designating Pearl Harbor and other historic
 World War II sites in the Pacific a national monument. A 29 MAY
 presidential memo to Defense Secretary Robert Gates and Interior Secretary Dirk
 Kempthorne said such status could offer the sites additional
 protection. “These objects of historical and scientific interest may tell the
 broader story of the war, the sacrifices made by America and its allies,
 and the heroism and determination that laid the groundwork for victory
 in the Pacific and triumph in World War II,” Bush said. The letter,
 posted on the White House Web site, doesn’t say what specific places Bush
 has in mind aside from Pearl Harbor. Parts of the naval base which are
 already under some form of protection or have historic designation. The
 USS Arizona, an underwater grave for over 1,100 sailors and Marines
 unable to escape the ship before it sank during the Dec. 7, 1941,
 Japanese attack, is currently part of the USS Arizona Memorial run by the
 National Park Service. Ford Island, where several of the Navy’s battleships
 were moored during the attack, is a National Historic Landmark. The
 island, located at the center of Pearl Harbor, is home to historic
 airplane hangers that survived the aerial assault. A red and white striped
 airplane control tower on Ford Island delivered the first radio broadcast
 of the attack. Next door to Pearl Harbor, the top Air Force commander
 in the Pacific today has his headquarters in a building that served as
 barracks for Army airmen in 1941. Bullet holes left by Japanese machine
 guns are still visible on the outside of the structure’s concrete
 walls.

     Outside Hawaii, crucial battles were fought at Midway, Wake and
 Guam islands. All are still U.S. territory. Today, Midway is mainly a
 wildlife bird refuge and key node in the island chain making up the
 Papahanaumokuakea Marine National Monument that Bush established in 2006. The
 former naval base, where the U.S. defeated Japan in June 1942 to turn
 the tide of World War II in the Pacific, was named a National Historic
 Landmark in 1986. Many areas — particularly Pearl Harbor, Hickam Air
 Force Base, and Guam — that would likely be eligible for inclusion in the
 monument are still actively used today by the U.S. military. Making
 them part of a monument could complicate daily operations for the
 services. But Bush’s memo told Gates and Kempthorne that national monument
 classification shouldn’t interfere with the military’s business. The
 Antiquities Act of 1906 gives the president the authority to make national
 monuments of “historic landmarks, historic and prehistoric structures,
 and other objects of historic or scientific interest.” The president
 doesn’t need Congressional approval to do designate monuments. Other
 national monuments include the Statue of Liberty, designated by Calvin
 Coolidge in 1924, and the Grand Canyon, made a national monument by Herbert
 Hoover in 1932. [Source: Navy Times AP Audrey McAvoy article posted 1
 Jun 08 ++]


HAVE YOU HEARD:   A guy is driving around the back woods of Tennessee
 and he sees a sign in front of a broken down shanty-style house:
 "Talking Dog for Sale" He rings the bell and the owner appears and tells him
 the dog is in the backyard. The guy goes into the back yard and sees a
 nice looking Labrador retriever sitting there. "You talk?" he asks.
 "Yep," the lab replies. After the guy recovers from the shock of hearing a
 dog talk, he says "So, what's your story?" The Lab looks up and says,
 "Well, I discovered that I could talk when I was pretty young. I wanted
 to help the government, so I told the CIA and they had me sworn into
 the toughest branch of the armed services...the United States Marines.
 You know one of their nicknames is "The Devil Dogs." In no time at all
 they had me jetting from country to country, sitting in rooms with spies
 and world leaders; because no one figured a dog would be eavesdropping.
 I was one of their most valuable spies for eight years running, but
 the jetting around really tired me out, and I knew I wasn't getting any
 younger. So, I decided to settle down. I retired from the Corps (8 dog
 years is 56 Corps years) and signed up for a job at the airport to do
 some undercover security, wandering near suspicious characters and
 listening in. I uncovered some incredible dealings and was awarded a batch of
 medals. I got married, had a mess of puppies, and now I'm just
 retired."

     The guy is amazed. He goes back in and asks the owner what he
 wants for the dog. "Ten dollars," the guy says. "Ten dollars? This dog is
 amazing! Why on earth are you selling him so cheap?" "Because he's such
 a liar. He never did any of that stuff. He was in the Navy!"


VETERAN LEGISLATION STATUS 13 JUN 08:    Refer to the Bulletin’s House
 & Senate attachments for a listing of Congressional bills of interest
 to the veteran community that have been introduced in the 110th
 Congress. Support of these bills through cosponsorship by other legislators is
 critical if they are ever going to move through the legislative process
 for a floor vote to become law.  A good indication on that likelihood
 is the number of cosponsors who have signed onto the bill. A cosponsor
 is a member of Congress who has joined one or more other members in
 his/her chamber (i.e. House or Senate) to sponsor a bill or amendment. The
 member who introduces the bill is considered the sponsor.  Members
 subsequently signing on are called cosponsors. Any number of members may
 cosponsor a bill in the House or Senate. At http://thomas.loc.gov you
 can review a copy of each 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.
 You can also reach his/her Washington office via the Capital Operator
 direct at (866) 272-6622, (800) 828-0498,  or (866) 340-9281 to express
 your views. You can locate on http://thomas.loc.gov who your
 representative is and the phone number, mailing address, or email/website to
 communicate with a message or letter of your own making.  Refer to
 http://www.thecapitol.net/FAQ/cong_schedule.html for future times that
 you can access your representatives on their home turf.  [Source: RAO
 Bulletin Attachment 29 May 08 ++] 


Lt. James “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: (951) 238-1246 in U.S. or Cell: 0915-361-3503 in the Philippines.
Email: raoemo@sbcglobal.net Web:
 http://post_119_gulfport_ms.tripod.com/rao1.html
AL/AMVETS/DAV/FRA/NAUS/NCOA/MOAA/USDR/VFW/VVA/CG33/DD890/AD37 member

BULLETIN SUBSCRIPTION NOTES:
== To subscribe first add the above RAO email addee to your address
 book and/or white list and then provide your full name plus either the
 post/branch/chapter number of the fraternal military/government
 organization you are currently affiliated with (if any) “AND/OR” the city and
 state/country you reside in so your addee can be properly positioned in
 the directory for future recovery. Subscription is open to all veterans,
 dependents, and military/veteran support organizations.  This Bulletin
 sent to 66,484 subscribers.
== To automatically change your email addee or remove yourself from
 Bulletin distribution click the below or send a message which includes
 your full name plus your old & new email.