Survivor Benefits  |  MOAA president visits Oval Office.

MOAA Raises SBP with President Bush

MOAA was pleased to be among four associations whose leaders were invited to the White House April 14 for a 35-minute meeting with President George W. Bush in the Oval Office.

The primary purpose of the meeting was to provide an update on Bush’s view of the Iraq situation and his determination not to abandon the U.S. mission to help Iraq establish a democratic government. But Bush also asked the association leaders about their top concerns.

MOAA President Vice Adm. Norbert R. Ryan Jr., USN-Ret., cited MOAA’s primary goal of eliminating the unfair age-62 benefit reduction imposed on older Survivor Benefit Plan (SBP) annuitants. Pointing out that no other federal annuitants are subject to such a penalty, Ryan asked for the president’s support to end this “military widows tax.”

Bush showed familiarity with the issue. He asked about the cost and said he thought the Senate had approved something on this. Ryan cited the relatively small price tag ($498 million over five years). He acknowledged that the Senate had, indeed, approved budget authority for an SBP fix in the budget resolution, but the issue is far from resolved, and leadership support for military survivors is urgently needed.

Although Bush offered no specific commitment, it certainly can’t hurt to have gotten his attention on this important issue.

Survivor Benefits  | Real test to come in Defense Authorization Act.

Discharge Petition Gathers Steam

At an April 28 Capitol Hill press conference, Rep. Chet Edwards (D-Texas) announced that 177 House members already had signed his Survivor Benefit Plan (SBP) discharge petition on H.R. 548, Rep. Jeff Miller’s (R-Fla.) bill that would phase out the age-62 SBP annuity reduction over five years.

“Reducing survivor benefits to those whose spouses have served their nation in the armed services is an insult,” Edwards said. “If just 218 of the 329 co-sponsors of H.R. 548 will sign the discharge petition, we can respect the sacrifices of our military widows with our deeds, not just our words.”

Edwards was joined by Rep. Bob Filner (D-Calif.), MOAA President Vice Adm. Norbert R. Ryan Jr., USN-Ret., and representatives of numerous other military and veterans’ organizations. All said cosponsorship alone is meaningless unless cosponsors back their stated support with real legislative action.

“It’s time to get upset about the lack of action,” Ryan said. “In the military, we vow to leave no one behind. It’s intolerable that the government has left our military widows behind for all these years. We need action this year.”

“You [members of the military and veterans’ communities] have the power to make this happen,” Filner said. “You need to tell your representatives you expect them not just to sign on as a cosponsor, but to sign Representative Edwards’ SBP discharge petition and bring it to the floor, where they can actually vote for it. If they get enough mail, something will happen.”

See a list of representatives who have signed the discharge petition at http://clerkweb.house.gov/108/lrc/pd/petitions/dis8.htm. At press time, none of the bill’s 138 Republican cosponsors had signed the petition.

MOAA’s hope is that these cosponsors will seek to include an SBP fix in the FY 2005 Defense Authorization Bill, which the House and Senate Armed Services committees were scheduled to begin drafting the first week in May. If the defense bill includes the appropriate fix, a discharge petition won’t be necessary.

Retired Pay | Pentagon publishes long-awaited rules, application form.

New CRSC Guidance Released

On April 27, DoD finally issued the long-awaited new rules for processing Combat-Related Special Compensation (CRSC) applications. Effective Jan. 1, 2004, this instruction replaces the guidance introduced last year. The major change is the expansion of eligibility to include all combat-related disabilities (previously, only disabilities rated at 60 percent or higher or disabilities associated with a Purple Heart could qualify).

The new guidance also addresses two previously unresolved issues—namely, Special Monthly Compensation (SMC) and compensation for individual unemployability (IU). Both issues will be assessed after the services have determined which of the applicant’s disabilities are deemed combat-related.

In the case of SMC, the services must resolve whether any of the combat-related disabilities constitute grounds for the SMC award. To make these determinations, the CRSC processing branches will be assisted by the VA. The VA will provide descriptions of SMC criteria and will provide counsel in unusual situations.

IU determinations will be based on the retiree’s overall combat-related disability percentage. If the services award CRSC at 60 percent or greater, and the applicant also has been determined by the VA to be unemployable, then CRSC will be paid at the 100-percent rate, retroactive to Jan. 1, 2004, as applicable.

Retirees eligible under both concurrent receipt and CRSC criteria must choose between the two forms of compensation. Recipients will have the option of changing their election on a yearly basis, so as to choose the more advantageous option, as concurrent receipt payment amounts will increase each year for the next nine years. The Defense Finance and Accounting Service (DFAS) is in the process of developing this election system. Applicants also have the option of authorizing DFAS to automatically pay whichever amount is higher.

The new application form is available on the Internet at www.moaa.org/legislative/retirement/CRSCfinalguidance.pdf.

Health Care | New rules will raise copayments on selected drugs.

DOD Issues Rx Guidance

MOAA met with DoD officials in April to discuss new regulations for the TRICARE prescription drug uniform formulary. The new rules eventually will add a third tier of copayments for medications designated as non-formulary drugs. Here’s how it will work:

For most medications, beneficiary copayments will stay at $3 (generic) and $9 (brand name). Under a new system still in the formative stages, some medications will be designated as non-formulary drugs, for which beneficiaries will see a higher, third-tier copayment:

• TRICARE retail pharmacies: $22 for a 30-day supply.
• TRICARE Mail-Order Pharmacy : $22 for a 90-day supply.
• Non-network retail pharmacies: $22 or 20 percent of the cost, whichever is greater.

A new DoD Pharmacy and Therapeutics (P&T) Committee will recommend selected drugs to be put into the non-formulary third tier. These will include only drugs the committee determines do not have a “significant, clinically meaningful therapeutic advantage” over other drugs in the same class or are not cost-effective relative to other drugs in a class—considering safety, effectiveness, and outcome.

Before the Pentagon adopts the committee’s recommendations, it also must consider inputs from a beneficiary advisory panel, which will include representatives from MOAA and other beneficiary groups.
Even after a drug is put into the non-formulary category, it still might be available to you for the $9 copayment if your physician determines it should be prescribed for reasons of medical necessity. This will require documentation from your provider stating that other medications in the class that are included in the formulary aren’t effective for you or cause adverse side effects.

It will be several months before beneficiaries see any changes. The P&T Committee will meet this summer and will take several more months to review all the categories and make its recommendations. Further, there will be a delayed effective date once specific drugs are designated for non-formulary status. That will allow beneficiaries currently taking those medications to consult with their doctors about switching medications or requesting continued use of that drug for medical necessity reasons.

We’ll provide continuing updates on this issue as more information becomes available.

Note: Drugs obtained from military pharmacies still will be provided without a copayment.

Health Care | H.R. 3474 follows up on “Class Act” lawsuit.

Keep Promises” Support Increasing

Rep. Chris Van Hollen’s (D-Md.) H.R. 3474 has enjoyed a substantial increase in cosponsors since it was introduced last November, and the list stood at 219 House members at press time. Sen. Tim Johnson’s (D-S.D.) Senate companion bill (S. 2065) got a later start, and only has 10 cosponsors so far.

These bills are the legislative follow-up vehicles to the Class Act health care lawsuit introduced by Col. Bud Day, USAF-Ret., that was denied by the U.S. Supreme Court. Lower court rulings expressed sympathy for retirees who were promised free lifetime health care, but said any solution would have to come from Congress, not the courts. The bills have two main goals:

• exempt military retirees who entered service before Dec. 7, 1956 (the date of the first statutory reference to “space available” care) from having to pay Medicare Part B premiums; and
• make military retirees eligible for the Federal Employees Health Benefits Program.
  MOAA strongly supports these bills. However, their path is complicated because the provisions in the bills cross the jurisdictions of multiple congressional committees. To improve their chances of enactment, the bills need more cosponsors.

You can use MOAA’s Web site (http://capwiz.com/moaa/issues/bills/) and toll-free Capitol Hill hot line, (877) 762-8762, to ask your legislators to cosponsor this important initiative.

Health Care | DoD will survey providers and beneficiaries.

DoD Offers TRICARE Outreach Plan

In late March, Assistant Secretary of Defense for Health Affairs Dr. William Winkenwerder sent a report to Congress on DoD’s plan to improve outreach services to TRICARE Standard beneficiaries. Congress mandated the report in response to complaints that many Standard beneficiaries were left on their own to find providers and navigate the TRICARE system. The report tells how DoD plans to educate beneficiaries under the new TRICARE contracts and evaluate their level of satisfaction with TRICARE Standard services.

Under the new TRICARE contracts, contractors will have a financial incentive to provide high levels of performance and service in specific areas such as telephone access, claims payments, and quality medical outcomes. Contractors will be required not only to provide information on providers who are in the network, but they must also provide Standard beneficiaries a toll-free number for direct assistance in finding a provider.

The new contractors propose extensive provider networks to enhance access for all categories of TRICARE beneficiaries, including addition of trained staff to help find providers for beneficiaries who live in remote areas.

The outreach program includes surveys on availability of civilian providers. The initial survey will target at least 20 TRICARE market areas—mostly away from military treatment facilities. Eventually, the entire nation will be surveyed.

To evaluate the outreach program’s effectiveness in meeting beneficiary needs, DoD is:

• forming a TRICARE “Delphi Council” made up of 250 volunteer beneficiaries whose opinions will be sought on educational products, services, and communication methods;
• collecting and evaluating feedback from a variety of sources—TRICARE Service Centers, TRICARE call centers, Web sites, and military treatment facilities; and
• conducting telephone surveys with TRICARE beneficiaries about their health care benefit, information needs, and sources of information.

DoD’s Active Outreach Program will be phased in between June and November of this year as the new TRICARE contracts are launched.

This is a high-interest item for MOAA, and we see it as only the first step in our efforts to improve information and assistance to all TRICARE beneficiaries, attract more providers to participate in TRICARE, and improve beneficiary access to TRICARE providers.

Education Benefits | H.R. 4188 would restore MGIB comparability.

Reserve GI Bill Upgrade Sought

Over the past four years, GI Bill benefits for National Guard and Reserve servicemembers haven’t kept pace with benefits for active duty members. Congress raised active duty GI Bill benefits by more than 43 percent but made no increases to the Guard and Reserve program. A bill introduced in mid-April would reestablish a relationship between the two.

Sponsored by Reps. Frank LoBiondo (R-N.J.) and Mike McIntyre (D-N.C.), H.R. 4188 would raise Selected Reserve Montgomery GI Bill rates to 50 percent of active duty benefits over five years.

H.R. 4188 also would allow reservists who are activated for a cumulative total of 24 months’ active duty within a five-year period to enroll in the active duty Montgomery GI Bill program. MOAA and The Military Coalition urged implementation of both of these changes in recent testimony before Congress earlier this year.

MOAA is grateful for the leadership of LoBiondo and McIntyre in sponsoring H.R. 4188. With more than 320,000 Guard and Reserve members already mobilized for the war on terrorism, and thousands more in the deployment pipeline, it’s time to recognize the need for these changes. Increasing their GI Bill benefits will help these members transition back to civilian life when their combat duty is completed.