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New TRICARE Contract Shakes Up Doctors

HUmanamil

By Debbie Gregory.

TRICARE’s 10-state South Region behavioral healthcare therapists have been notified that while they may continue to see their patients under the new behavioral healthcare network, they will do so under a revised fee deal. The deal is not in the practitioners’ best interest, and has some mental healthcare professionals deeply concerned.

The new contract, which will take effect on January 1, 2018, cuts therapy fees to 30 percent less than the Medicare approved rates. Medicare’s rates are already considered to be on the low end.

Humana Military will administer the contract for the new TRICARE East Region, which was formed by merging the current North and South Regions. The contract will cover approximately 6 million beneficiaries in a 32-state region, including Washington D.C., and is also scheduled to begin January 1, 2018.

The West Region contract will be administered by HealthNet.

While TRICARE officials monitor the progress of the two companies as they build their networks, there is concern that many of the current providers will be unwilling to accept the new fee structure.

“We hope, to the greatest extent possible, that providers currently providing care to our patients are able to reach agreement with Humana and that they can continue to provide that care so there’s no disruption,” said Navy Capt. Edward Simmer, deputy director of the TRICARE Health Plan.

“The goal is to negotiate a mutually agreeable reimbursement rate with providers,” said Matt Paynter, chief of staff for Humana Military. “Certainly, this is never a take-it or leave-it-you’re-going-to-get-kicked-out thing. We work with providers.”

Supply and demand certainly play a role in the therapists’ ability to negotiate their fees.  Depending on their location, the number of TRICARE beneficiaries in their area and the demand for their services, therapists may be able to negotiate a higher rate of reimbursement.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Does New Healthcare Bill Take Away Tax Credits from 7 Million Veterans?

americanhealthcareact

By Debbie Gregory.

Democratic senators have reached across the aisle to urge Republican senators to protect veterans’ access to healthcare in their health care replacement bill, expressing fears that the House-passed proposal could be particularly dangerous for veterans.

“We have known for months that the GOP healthcare bill could strip roughly 7 million veterans of eligibility for healthcare tax credit assistance,” said Rep. Julia Brownley, (D-CA).  “Despite warnings from our veterans service organizations, and pleas from veterans across the country, President Trump and Speaker Ryan have recklessly forged ahead despite the consequences,” stated Brownley. She continued, “While I am deeply concerned about many aspects of this bill, the rush to put politics ahead of people, and the impact it could have on our veterans as a consequence, is simply shameful.”

As the Senate creates its own version of the American Health Care Act, advocates claim the U.S. House of Representatives’ version hurts veterans by barring veterans eligible for care from the Veterans Affairs Department from receiving tax credits to buy insurance on the individual markets, reducing federal support for Medicaid and effectively ending Medicaid expansion.

The Paralyzed Veterans of America publicly opposed the bill. The group is particularly concerned about the end of a 6-percentage-point match enhancement for Community First Choice, which pays for home health aides for people with spinal cord injuries, dementia, multiple sclerosis, amyotrophic lateral sclerosis and more.

“If they’re non-service connected, they’re not going to have access to a state veterans’ home,” said Susan Prokop, senior associate advocacy director at Paralyzed Veterans of America.

Many veterans joined a Twitter campaign opposing the bill, using the hashtag #IAmAPreexistingCondition. Many said they were especially concerned about post-traumatic stress disorder being classified as a pre-existing condition, a change that would make their health care more expensive.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

VA to Go Live With Online Scheduling System

va health

By Debbie Gregory.

Beginning next month, the U.S. Department of Veterans Affairs plans to begin online scheduling of medical appointments nationwide.

The technological advance will allow the scheduling of primary-care appointments for more than 6 million patients via an app on their phones, tablets or computers.

“Do I think this is a huge step forward for the VA? Absolutely,” said Dr. Neil Evans, chief of the office of connected care for the Veterans Health Administration. “I think this is really, really, really important for us to be able to offer.”

Kathleen Frisbee, executive director for connected health at the VA’s office of connected care, added that the new software will open up in the agency’s health system for more public inspection as patients view open appointments and choose which times are best for them with the click of a computer mouse.

“I mean, we are exposing our availability to the world,” Frisbee said.

VA developers had first planned to offer online requests for appointments rather than actual scheduling, but veterans who use the VA’s online portal, called MyHealtheVet, advocated for actual do-it-yourself online scheduling. In fact, online scheduling was the most requested item of vets using the VA’s online portal.

The move comes after the VA scandal in 2014 when a whistleblower in Phoenix revealed that VA schedulers were pressured to fake records to make appointment wait times appear shorter. The new app software promises to remove the VA scheduler from the equation.

The portal software cost $3.2 million, and runs on technology infrastructure from Agilex Technologies, now Accenture Federal Services, and the VA’s internal development.

In the future, VA officials plan to add online appointment scheduling capabilities for optometry, audiology and mental-healthcare.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Most Private Sector Doctors Unprepared to Treat Veterans

vethealth

By Debbie Gregory.

While many veterans get some health care from private doctors, those doctors often fall short when it comes to identifying service-related illness.

Jeffrey L. Brown, M.D., a clinical professor of pediatrics at New York Medical College who also teaches at Weill Cornell Medicine, said, “While everybody seems to be mostly focused on the health care that veterans are getting at the VA, it sort of went unnoticed that 80 percent of veterans get most of their health care from civilian providers.”

According to a 2015 government survey of health and health care use, about 40 percent of veterans get some health care from the VA, but only about 20 percent of all veterans rely totally on the VA.

Dr. Brown, a retired U.S. Army medic, read a New York Times article that alerted him to his possible Agent Orange exposure. The carcinogenic defoliant that was used to kill thick plant growth and expose hiding Vietnamese fighters also exposed U.S. servicemembers to  serious illness such as cancer, diabetes and heart disease.

Dr. Brown learned of the risk from a newspaper, not his doctor. This prompted him to educate physicians about service-specific ailments.

“The biggest deficiency: Most health care providers don’t ask patients as they come through the door if they’ve ever served in the military,” the pediatrician said.

Service-related issues also could affect women’s health, especially when it comes to bearing and delivering children, according to Dr. Brown.

Pediatricians also seldom are trained to identify psychological and learning problems among veterans’ children related to their parents’ service or the effects after returning from deployment, he said.

“Unless you speak up and say you are a veteran or your spouse is a veteran, the issue might not even come to light,” said Richard R. Silbert, M.D., a psychiatrist and senior medical director for the Community Care Behavioral Health Organization.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

VA Budget for 2017 Addresses Increased Care and Benefits for Veterans

va

By Debbie Gregory.

The 2017 VA budget will continue to support the largest transformation in VA history, expanding access to healthcare and benefits, while attempting to end homelessness among those who have served.

The budget includes $78.7 billion in discretionary funding, which is earmarked largely for healthcare, which is almost 5 percent more than the 2016 enacted level.

Healthcare is being provided to over 922,000 veterans who served in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn/Operation Inherent Resolve (OIR) and Operation Freedom’s Sentinel (OFS).

The budget provides for continued implementation of the Veterans Benefits Administration’s (VBA) robust Transformation Plan, which will continue to improve the quality and efficiency of claims processing. Additionally, the budget supports increasing the VBA’s workforce to address staffing needs so it can continue to improve the delivery of benefits to veterans.

As VBA continues to receive and complete more disability compensation rating claims, the volume of non-rating claims correspondingly increases. The request for $54 million for 300 additional full-time equivalent employees (FTE) and claims processing support will allow VBA to provide more timely actions on non-rating claims.

The budget also proposes a simplified appeals initiative to provide veterans with a simple, fair, and streamlined appeals process in which they would receive a final appeals decision within one year from filing an appeal, by 2021. The current appeals process is complicated and ineffective, and veterans are waiting, on average, about 5 years for a final decision on an appeal that reaches the Board of Veterans’ Appeals, with thousands waiting much longer.

The Obama Administration has made the ending of veteran homelessness a national priority. The new budget requests $1.6 billion for programs to prevent or reduce veteran homelessness, including: Supportive Services for Veteran Families (SSVF) to promote housing stability; the HUD-VASH program, wherein VA provides case management services for at-risk veterans and their families, and HUD provides permanent housing through its Housing Choice Voucher program; and grants/per diem payments that support temporary housing provided by community-based organizations.

The budget also provides for the MyVA initiative, the Veterans Choice Act and other key services for veterans.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

 

Is Privatizing the VA a Good Idea?

VA

By Debbie Gregory.

Top Republicans’ growing support for privatization of the Department of Veterans Affairs health care system has Hillary Clinton vowing to fight “as long and hard as it takes.”

The Democratic presidential candidate has said that veterans’ issues would be a priority of her administration, unveiling a comprehensive plan to revamp the delivery of health care to veterans, while holding the VA more accountable.

Clinton said the secretaries of defense and veterans affairs will be told that “there will be zero tolerance for the kinds of abuses and delays we have seen.”

Veterans advocates acknowledge the need for reform at the VA. But they do not believe private insurance or medical care is capable of accommodating veterans’ specific needs. They maintain that a voucher program for purchasing care outside the VA system will inevitably fall short of veterans’ expenses.

Clinton agrees that privatization will throw veterans into the private insurance market. “I believe in giving vets more choice on when and how you receive care, and I think there should be more partnership between the VA and private hospitals and community health care providers. But we cannot and I will not put our vets at the mercy of private insurance companies without any coordination, or leave them to fend for themselves with health care providers who have no expertise in the unique challenges that are facing our veterans,” Clinton said. “Privatization is a betrayal, plain and simple, and I’m not going to let it happen.”

While Ben Carson’s proposal to basically disband the VA health system is the most radical of the GOP presidential contenders’ plans, other candidates are not far behind. Donald Trump’s plan would have VA medical facilities compete with non-VA care providers.

Clinton said mental health and substance abuse treatment should be readily available for veterans, calling the frequency of veteran suicide and homelessness rates a “national disgrace.”

And, she said, pharmacies that price gouge veterans would be subject to the “full power of the federal government.”

Which side of the argument do you agree with?

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

AMVETS Supports VA Healthcare Overhaul: Military Connection

AMVETS Supports VA Healthcare Overhaul

By Debbie Gregory.

In February of this year, the Concerned Veterans for America (CVA) issued the Veterans Independence Act, a report with a set of policy recommendations to overhaul the VA healthcare system. Although originally drawing public criticism and apathy from traditional veteran service organizations, AMVETS has now voiced its support.

AMVETS, one of the largest veterans groups in the country, characterized the report’s ideas as “a necessary first step” in reforming the care delays and patient wait times. The group feels that ultimately, veterans should be able to choose where, when and how to get the best quality healthcare.

Already a topic among the 2016 Republican presidential hopefuls, Sen. Marco Rubio and former Florida Gov. Jeb Bush have endorsed parts of the CVA report, while neurosurgeon Ben Carson has called for merging the Veterans Health Administration with the Defense Department.

According to the task force plan, veterans would use their “earned health care funds” to access VA services or civilian physicians, as part of a broader expansion of the concept behind the current VA Choice Card program. Veterans seeking private care would have to pay additional co-pays and deductibles in some cases. The Paralyzed Veterans of America attacked the proposal as limiting veterans’ options, rather than expanding them.

According to the CVA website, the VA health care system was originally created to serve service-connected disabled veterans. Additionally, the priority group system was created by Congress to ensure that those veterans with higher disability ratings received a higher priority for care within the VA health care system, in addition to the higher levels of benefits associated with a higher disability rating. CVA officials have lobbied for a broader discussion of the idea on Capitol Hill, to build support for legislative action mandating the changes. AMVETS officials said they will broach those same topics in their legislative discussions.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Military Connection: Companion Veteran Legislation

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By Debbie Gregory.

As a service member, you supported and defended the Constitution and the American way of life. As a Veteran, it’s important to continue that patriotism and citizenship by taking part in the processes that run your country. This means voting, being aware of current legislation and policies, and contacting your elected leaders and telling them how best to represent you, especially when it comes to Veteran-centric legislation.

On March 16, 2015, a pair of bills were introduced, one into each house of Congress, that are designed to provide Veterans with greater access to long-term care centers in their communities.

The Veterans Access to Extended Care Act has been introduced into the House as H.R. 1369 and into the Senate as S. 739. Together, this set of companion bi-partisan legislation is paving the way for improved programs for older Veterans and Veterans who need long-term care.

H.R. 1369 was introduced by Representative Jackie Walorski (R-Indiana) and co-sponsored by Rep. Tulsi Gabbard (D-Hawaii),and  Rep. Don Young (R-Alaska), Rep. Ryan Costello (R-Pennsylvania).

S. 739 was introduced by Senator John Hoeven (R-North Dakota) and cosponsored by Joe Manchin (D- West Virginia).

The summary of both forms of the legislation read as:

Veterans Access to Extended Care Act of 2015

This bill modifies the treatment of Department of Veterans Affairs (VA) agreements with service providers to furnish veterans with nursing home care, adult day health care, or other extended care services.

Any such agreement shall:

  • not be treated as a federal contract for the acquisition of goods or services and shall be not subject to any provision of law governing federal contracts for the acquisition of goods or services, and
  • include specified requirements (such as for medical licensing and VA review of staff and facilities) to ensure the safety and quality of care furnished to veterans pursuant to such agreement.

The failure of a provider to comply with a provision of the agreement may result in VA termination of the agreement.

Such agreements are exempted from the application of certain public contract labor laws.

Both bills were read on the floors of their respective chambers, and referred to their houses’ Committee on Veterans Affairs. Be sure to frequent www.Congree.gov to check on the Veterans Access to Extended Care Act in both forms of the bill, H.R. 1369 and S. 739. Be sure to contact your representatives and senators and tell them how you want them to vote on these and other bills on your behalf.

Military Connection proudly serves those who serve in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve, Veterans and their Families. We are the go to site for Veteran Employment and information on Veteran education. Militaryconnection.com provides Veterans with and Directory of Employers, a Job Board, information on the Post-9/11 GI Bill, and a blog that offers Veterans boundless information. Be sure to visit Militaryconnection.com, the go to site.

Military Connection: Companion Veteran Legislation: By Debbie Gregory

Military Connection: VA Offering Relief to Whistleblowers

VA Whistle Blowers

By Debbie Gregory.

On January 20th, the U.S. Department of Veterans Affairs (VA) announced that it will be offering “whistleblower” relief to over two dozen VA employees. The employees, who had been threatened with retaliation from their superiors, had filed complaints about wrongdoing at VA medical facilities and clinics throughout the country.

Last year, a settlement was reached with three VA employees who blew the whistle on issues concerning unacceptable appointment wait times and falsified waitlists at the Phoenix VA Hospital. These events prompted a national response from Congress, Veterans, and the general public, including legislative measures and the forced resignation of then-VA Secretary General Eric Shinseki. And the settlement has prompted the VA to offer relief to others.

The VA’s actions offer relief to approximately 25 VA employees who faced reprimands, poor evaluations or threats of repercussions after reporting errors and misconduct within the VA healthcare system.

Currently, more than 120 complaints of retaliation are under investigation throughout the VA’s 970 facilities nationwide, following employee allegations about improper patient scheduling, understaffing and other problems.

VA Secretary Robert McDonald had previously promised to eliminate retaliation against whistleblowers as the VA looks to change its image and its culture. The VA has a decades-long reputation for providing service to Veterans that is slower than private sector healthcare.

The VA is now being applauded for its willingness to change, taking steps to protect its employees who file whistleblower complaints, and implementing widespread changes in policy throughout the department.

The VA is committed to holding those who retaliated against the whistleblowers accountable.VA employees who blow the whistle on their superiors because they have identified a legitimate problem should not be punished, they should be protected. And in the opinion of Deputy VA Secretary Sloan Gibson, they should be praised.

Military Connection proudly serves those who serve in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve, Veterans and their Families. We are the go to site for Veteran Employment and information on Veteran education. Militaryconnection.com provides Veterans with and Directory of Employers, a Job Board, information on the Post-9/11 GI Bill, and a blog that offers Veterans boundless information. Be sure to visit Militaryconnection.com, the go to site.

Military Connection: VA Nurse’s Deed Disproves Media Stereotype

VA Nurse

The Department of Veterans Affairs (VA) has had a lot of negative press lately, and bad news seem to spread like wildfire. Stories about long wait times, corruption and rude and unsympathetic VA employees are commonplace. That’s why it is important when a story like this one comes along, it should be given the same coverage.

In November 2014, Nurse Chuck Maulden was working a shift in the Emergency Department of the Salisbury VA Medical Center in Salisbury, North Carolina. A homeless Veteran came in, seeking treatment for large, painful blisters on his feet.

Maulden took the Veteran out of the waiting room into the examination area to triage his complaintMaulden couldn’t help but notice that the Veteran was wearing dirty compression stockings that clung to the wounds.

A VA physician examined the Veteran and instructed Maulden to give him a fresh pair of compression stockings.

Maulden could have just handed the homeless man a new pair of socks and sent him on his way. But instead, this VA nurse went above and beyond to provide care for the Veteran.

Maulden washed the man’s feet with soap and water and then treated them with non-stick dressing so that the man would have a better chance of having his feet heal. Then Maulden obtained a few extra pairs of compression stockings for the Veteran to take with him.

Again, Maulden could have stopped there and sent the man on his way; after all, he had already gone above and beyond to care for this Veteran.

But as the man prepared to leave, Maulden saw that the Veteran’s shoes were worn out and in no shape to provide for proper protection. Maulden asked the Veteran what size shoes he wore. The man answered with the exact same size that Maulden wears. Without a word, Maulden took his shoes off and placed them on the Veteran’s feetMaulden wore medical shoe covers over his socks for the remainder of his shift.

This story is not intended to suggest that every VA employee needs to give away their possessions to the Veterans that they treat. But with all of the negative publicity about the VA and its employees, Mr. Maulden’s tremendous act of humanity and attentiveness to a patient’s needs are at the core of the VA’s purpose and values.

We at MilitaryConnection.com applaud Mr. Maulden and his noble deed. Thank you and all of the employees at the VA for the work you do, for caring for our nation’s Veterans.

Military Connection proudly serves those who serve in the ArmyNavyAir ForceMarinesCoast Guard,Guard and ReserveVeterans and their Families. We are the go to site for Veteran Employment and information on Veteran education. Militaryconnection.com provides Veterans with and Directory of Employers, a Job Boardinformation on the Post-9/11 GI Bill, and a blog that offers Veterans boundless information. Be sure to visit Militaryconnection.com, the go to site.

Military Connection: VA Nurse’s Deed Disproves Media Stereotype: By Debbie Gregory