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Legislation Congress approves Defense Bill. Pay-Raise Gains; No Concurrent Receipt The House and Senate overwhelmingly approved a compromise FY 2002 National Defense Authorization Act (NDAA) in mid-December, and the president signed it into law Dec. 28.
The act covers a wide range of compensation, health care, and other initiatives. The good news is that active duty and Guard/ Reserve troops won substantial pay and allowance increases. The bad news is that Congress again failed to end the disability offset to military retired pay.
The following is a synopsis of selected bill provisions of interest to the uniformed services community. The NDAA:
A quick-reference table highlighting selected authorization act issues appears on pages 24 and 25. Retired Pay Congress defers action again. Concurrent Receipt Letdown Despite overwhelming congressional support generated by grassroots activists at all levels, the FY 2002 National Defense Authorization Act provides no unqualified authorization for concurrent receipt of military retired pay and veterans' disability compensation. Rather than eliminate the disability offset as recommended by the Senate, the final act adopted House language that would do so only if the president offers the necessary funding. Realistically, the odds on that are slim to none, since the administration just formally notified Congress it opposes any such change. Notwithstanding this major disappointment, the act at least takes two new steps in the right direction - however small. First, it expresses in law for the first time Congress' formal support for ending this long-standing inequity. Even without funding, the expression of moral support gives us stronger leverage for real action this year. Second, it expands the number of disabled retirees that Congress agrees deserve at least some financial relief right away. By lowering the qualifying threshold for "special compensation for certain disability retirees" from 70 percent to 60 percent disability ratings, the act expands the number of special-compensation eligibles by almost two-thirds. The $50 a month this new group will receive is only a token, but it's an important symbol all the same. Congress' provision of even small increases in the special-compensation amounts serves to acknowledge the inadequacy of the current situation. The new law will increase special compensation by $25 a month effective Jan. 1, 2003, for eligibles rated 80 percent or more disabled and by another $25 in October 2004 for those rated 70 percent or higher. But these changes obviously are minor compared to the gross compensation inequity that continues for disabled retirees. Simply put, there's something wrong when 86 percent of House members and 76 percent of senators say they want to authorize concurrent receipt but then don't make it happen. If that's not lip service, it's hard to see much difference. Legislators blame congressional spending rules, but those rules can be overcome if congressional leaders want to do so. Next year, we must convince those hundreds of House and Senate cosponsors that cosponsorship alone is not enough. They must convince their leaders to put Congress' money where its mouth is. The challenge will be to get funding clearance in next year's Budget Resolution (due in March). We'll need strong grassroots activism to remind legislators there must be better linkage between what they say and what Congress does. Survivor Benefits Hutchison bill enacted. SBP for Active Duty Deaths Following years of effort by TROA and others, the FY 2002 National Defense Authorization Act finally authorizes Survivor Benefit Plan (sbp) coverage for survivors of members killed on active duty. The provision is reTROActive to cover the Sept. 11 terrorist victims. Previously, members killed on active duty were only covered by sbp if they had completed 20 or more years of service. Members who survived grave injuries long enough to be disability retired also previously received full sbp coverage. But members killed outright and not otherwise retirement-eligible had no sbp coverage for their survivors. Sen. Kay Bailey Hutchison (R-Texas) championed the successful effort to correct this inequity. Taxes Military capital gains fix stalled. No Home Tax Relief Efforts to restore equal capital gains tax treatment for military homeowners got a boost when Sen. John McCain's (R-Ariz.) S. 1678, the Military Homeowner's Equity Act, won endorsement to be included in the Senate version of the economic stimulus package. But hopes for action in 2001 died when the House and Senate could not agree on a bill before adjourning. The administration's Office of Management and Budget is solidly behind the initiative; members of the Joint Chiefs of Staff and the secretary of state all provided letters of support to McCain's office. The Taxpayer Relief Act of 1997 allowed homeowners to exempt up to $250,000 ($500,000 a couple) in capital gains from federal income taxes for a home occupied at least two of the five years before sale. But this change inadvertently penalized military homeowners assigned away from home for more than three years before the sale. McCain's bill would exempt time away from home on military orders from counting against the "two of the last five years" residency test. TROA hopes this fix can be enacted in the 2002 congressional session. Veterans' Benefits Enrollment extended, copayments changed. VA Adjusts Rules In a late-November meeting with representatives of TROA and other military and veterans' service organizations, Department of Veterans Affairs (VA) Secretary Anthony Principi announced that the White House had given the green light to extend its open enrollment policy for veterans seeking va health care. Principi also announced that outpatient copayments were being lowered from $50 to $15, effective Dec. 1, 2001. Earlier, a projected funding shortfall had forced Principi to consider denying further enrollment of nondisabled veterans or those with noncompensable disabilities and incomes above the va means test. But the White House decided to work with Congress to find money to keep the program going. About 129,600 uniformed services retirees are enrolled in the category at issue, known as Priority Group (PG)-7. Principi's announcement of the reduced $15 outpatient copayment was a pleasant surprise. It applies to pg-7 enrolled veterans and certain other veterans being treated for non-service-connected conditions. But the va also announced that prescription copayments would increase in February - from $2 to $7 for medications for non-service-connected conditions - to keep pace with rising pharmaceutical costs. Health Care Administration, Congress at odds. "Forced Choice" Battle Not Over Congress has acted - twice - to prevent the administration from pursuing its stated goal of forcing military retirees to give up either their military TRICARE or their Department of Veterans Affairs (VA) health care benefits. But the administration isn't giving up.
The VA-Housing and Urban Development (HUD) Appropriations Act for FY 2002, signed into law Nov. 26, denies funds to implement the "forced choice" initiative.
The White House press release on this legislation acknowledged the restriction but also said the president still believes the idea is a good one. "The va/DoD Medical Care Choice initiative would ensure that all military retirees annually choose either the Department of Defense [DoD] or the [VA] as their health care provider," the release said. "This would enhance quality and continuity of care and prevent duplication of services and costs."
TROA cannot agree with this budget-driven initiative to curtail retiree health benefits. DoD and va care are significantly different, in terms of both services and beneficiary population served. Many retirees are willing to drive long distances to obtain specialized va care for spinal injuries, prosthetics, etcetera, but obtain routine care through local doctors under TRICARE. TROA believes strongly that they earned access to both systems and should not be forced to give up one or the other.
The House and Senate Armed Services committees agree. At House Committee Chairman Bob Stump's (R-Ariz.) initiative, the FY 2002 National Defense Authorization Act also includes a provision prohibiting DoD from imposing restrictions on retirees' other care options. While the va/hud appropriations act language mentioned above applies only to FY 2002, the authorization act provision is in permanent law.
Veterans Affairs Committee leaders also believe that administrative or budgeting problems must not be solved on the backs of military retirees. House Committee Chairman Chris Smith (R-N.J.), Senate Committee Chairman John D. Rockefeller III (D-W.Va.), and others wrote last summer to Secretary of Defense Donald Rumsfeld and Secretary of Veterans Affairs Anthony Principi expressing their opposition to forced choice.
TROA is committed to ensuring members are not forced to give up their earned health care entitlements for the government's administrative convenience.
TRICARE For Life Initial glitches and fixes. TFL Claims Update We are now several months into implementation of TRICARE For Life (TFL) - the equivalent of a Fortune 500 company, started from scratch in less than one year, affecting 1.3 million beneficiaries worldwide. One has to expect some initial administrative hiccups in a program of this complexity and size ($3.9 billion annually), and there have been some. Electronic claims omission. In October, the Department of Defense (DoD) discovered that 13 percent of TFL beneficiaries were temporarily omitted from the electronic claims process whereby their TFL cost shares would be paid automatically if Medicare paid its share of the claim. These beneficiaries now have been included in the automated process for claims on or after Dec. 7. All members affected have been notified by letter. Beneficiary action needed: Those in this group who had doctor visits or other TFL-covered services between Oct. 1 and Dec. 7 must file a paper TRICARE claim (dd Form 2642 plus the Medicare Summary Notice) for each claim processed by Medicare in this period. Excess charges payment. Another initial hiccup affected 3 percent to 4 percent of beneficiaries who visited doctors who do not accept Medicare assignment. Providers who don't accept assignment may charge up to 115 percent of the Medicare-allowable charge. TFL will cover this extra 15-percent charge. However, the TRICARE claims processors initially didn't get the word and at first denied the extra payment. All of these underpaid claims have been identified, and TRICARE is reprocessing them to make the correct payments. Beneficiary action needed: None. All affected claims can be identified centrally and are being reprocessed for payment. OHI indicator. Some members who canceled other health insurance (OHI) in conjunction with switching to TFL coverage and advised TFL of the cancellation had initial TFL claims denied because the Medicare claim system still indicated their OHI was active. (By law, the OHI must pay first.) In some cases, this was a simple processing delay. In others, the other insurance company delayed notifying Medicare to avoid missing any delayed claims for medical visits before the cancellation. TFL processes have been changed to override the Medicare OHI indication if the beneficiary has notified DoD of the OHI cancellation. Beneficiary action needed: None. TFL is identifying the affected claims centrally and will reprocess them automatically. Beneficiary notification failure. Members who canceled their OHI but who did not notify TFL of such cancellation also may have their claims denied as discussed in the previous paragraph. TFL can't correct the problem unless it is made aware of the cancellation. Beneficiary action needed: If notified your TFL claim was denied for this reason, call the TFL call center toll free at (888) 363-5433. The call center can provide a phone number for your state or region that you can call to update your TFL records to show your OHI has been canceled. Any wrongly denied claim then can be reprocessed automatically. Through Dec. 20, 2001, more than 2,750,000 TFL claims had been filed, and almost 1,900,000 already had been processed. Weekly volume has increased steadily, with more than 800,000 claims filed during the week of Dec. 17. As the initial speed bumps are resolved, the process should only improve. Members with TFL-related questions can call the TFL call center toll free at (888) 363-5433 (DoD-life). The call center is operational Monday through Friday from 8 a.m. to 11 p.m., Saturdays from 9 a.m. to 8 p.m., and Sundays from 10 a.m. to 5:30 p.m. (Eastern time). |
