1 August 2003 Issue 1: New TRICARE For Life Claims Contract Late last week, DoD announced the award of a five-year, $487 million contract to Wisconsin Physician Service Insurance Corporation (WPS) to process claims, assist customers and provide administrative support for the 1.5 million beneficiaries dually eligible for Medicare and TRICARE. The contract will be implemented in region 11 (Northwest) beginning April 1, 2004, and will gradually expand to other regions in the months following. Over the next month DoD will award a number of other TRICARE contracts,
including under-65 health care (separated into North, South, and West
regions), customer service, and a national retail pharmacy contract. These
changes, scheduled to occur in mid-2004, will significantly alter the
management of military health care. Last Spring, the House and Senate Joint Budget Resolution set a $3.2 billion increase in VA health care above the amount requested by the administration. The budget resolution represents an agreement to allocate certain funding levels to each of the thirteen federal departments during the appropriations process that follows. But in a surprise move, House appropriators and the full House cut $1.8 billion from the agreed increase of $3.2 billion despite a bipartisan effort to stick to the budget resolution led by Reps. Chris Smith (R-NJ), Lane Evans (D-IL), and Rob Simmons (R-CT). The Senate won't take up the spending bill until September at the earliest. With the nation at war and hundreds of injured troops eventually being transferred to VA rehabilitation centers, it's imperative that the Senate honor the full $3.2 billion increase for VA health care services. On the plus side, House appropriators killed an administration proposal
to establish a $250 annual enrollment fee for veterans enrolled in
Priority Group 8 (those with no service-connected disabilities and incomes
above a zipcode-based means-test). The proposal also would have raised
prescription copays for these veterans from $7 to $15. VA suspended new
enrollments in Priority Group 8 earlier this year, but currently enrolled
veterans in that category would have faced the new payments. * Concurrent receipt of VA disability compensation and military retired
pay. Rep. Jim Marshall's (D-GA) discharge petition, coupled with the
Senate's full concurrent receipt provision, is putting a lot of pressure
on legislators to back up their co-sponsorship of concurrent receipt
legislation (H.R.303).
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8 August 2003 House and Senate Defense Authorization conferees will determine the fate of key MOAA and Military Coalition legislative goals, including concurrent receipt. The list is below. Below is a listing of the conferees on the FY 2004 National Defense Authorization Act, who have primary responsibility for resolving the House and Senate versions of the bill. We hope that all MOAA members will contact their legislators during the August recess, and especially if your senator or representative is on that list. If you haven't done so already, please contact your legislators and urge adoption of full concurrent receipt, active duty pay comparability, and a number of other benefits improvements for service members, retirees, and their families. Visit MOAA's Web site http://capwiz.com/moaa/home/ or use our toll-free Capitol Hill hotline (877-762-8762).
15 August 2003 DoD has published the long awaited interim final rule (IFR) titled "Elimination of Non-availability Statement and Referral Authorization Requirements and Elimination of Specialized Treatment Services Program" implementing sections of the FY 2001 and FY 2002 National Defense Authorization Acts (NDAA). MOAA has long lobbied for the elimination of the non-availability statement (NAS), which requires TRICARE Standard beneficiaries residing within 40 miles of a military treatment facility (MTF) to use the MTF as the first option for care when undergoing inpatient procedures or document that the MTF is unable to provide the care. Specifically, the proposed rule eliminates the requirement for:
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