RAO Davao City

United States Military Retiree Activities Office Davao City, Philippines

Tricare Philippines Newsletter 20120402

Posted by Service Officer on April 1st, 2012

U.S. Military Retirees of the Philippines Group

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Tricare Philippines Newsletter 20120402

Background of TRICARE in the Philippines and the policies implemented under the guise of fraud prevention

As military retirees living in the Philippines know their TRICARE plan is inherently different from any other plan offered by the TRICARE Management Activity (TMA).  TMA generally refuses to discuss these differences with affected retirees while claiming the policies are necessary to preclude fraud. The truth is TMA is responsible for much of the fraud through their past neglect, lack of action and because of some policies that promote fraud and poor controls over their contractor.
Why did TMA feel these policies were necessary in the Philippines?
The TRICARE Overseas Program (TOP) became reality in 1996 which extended benefits to eligible beneficiaries overseas. TMA was ill prepared to initiate, manage and monitor this program as the DODIG indicated in multiple investigations. In the U.S. fraud prevention for government sponsored medical programs like TRICARE is accomplished by other agencies so TMA had no background or experience with dealing with fraud and resisted involvement, claiming it wasn’t their responsibility. This standoff allowed the fraud to continue unabated for ten years. The second largest overseas population of beneficiaries was in the Philippines. It was also distinguished in that TMA had no local representation to monitor the program or educate beneficiaries unlike in places like Germany where every military hospital had multiple Health Benefits Advisors who assisted with obtaining care on the local economy and filing claims. So beneficiaries in the country with the second largest overseas population were left to their own devices and to fend for themselves. This combination made the Philippines ripe for fraud and should have come as no surprise to TMA.
Defense Criminal Investigators tell me that about 10% of providers in the states are involved in fraud and the same percentage was valid in the Philippines, based on their 12 years of working with fraud here. So it was not surprising when fraud got a foothold in the Philippines TRICARE program. Even then it wasn’t Filipinos but an American that developed the first major fraud through Health Visions Corp. (HVC). Within the first year of operation retirees reported that they suspected fraud and continued to report fraud for ten years. Yet TMA did little or nothing to stop the fraud and even ignored DODIG recommendations to use administrative controls that would have put a stop to the fraud early on. Instead they allowed the fraud and bleeding to continue for ten years and then tried to place the blame on retirees for using these services. See page 17, Audit Response, of the DODIG report 06-051. TMA continued to ignore the remedies they had at hand and continued to ignore the DODIG calls for administrative action in favor of more draconian measures. See DODIG report 08-045
In November 2006 TMA started to implement measures which would have far reaching affects on beneficiaries.
What are these policies that were unique to the Philippines?
1.      Stop Paying Health Visions Corporation (HVC)
2.      Legislative Changes to Sanction Beneficiaries
3.      Review Supplemental Insurance Plans for validity
4.      Cap Coverage and Adequacy
5.      Eliminate Third Party Billing
6.      Increase Medical Reviews on Claims
7.      Develop a Provider Network
Stop Paying Health Visions Corporation (HVC): TMA stopped paying HVC in November 2006 but also secretly stopped paying claims from beneficiaries without notifying them by ceasing payment of claims involving about 95% of all hospitals within the Philippines. This process appears to have been applied deliberately to harm the very people they were charged with providing health care. Most of the hospitals that were on the denial list did not benefit from the HVC fraud and their investigations had to have shown that.
Finally, about six months later, beneficiaries were notified of the freeze on payments via a notice on the internet. An uproar resulted and they dropped all but six facilities owned by HVC from the freeze. I suspect they realized they were on shaky ground. Their 2006 Report on Fraud conveniently ignores that they did this but thousands of beneficiary filed claims were not paid for more than six months. This was followed by threatening letters to a significant number of the original hospitals, many of which were not involved in the fraud. While TMA later backed off from these threats, they never apologized to those falsely accused and it set the tone for how hospitals and physicians feel about TRICARE in the Philippines from that point forward.
Legislative Changes to Sanction Beneficiaries: They went to congress and asked that they be given administrative authority to unilaterally suspend benefits, for up to ten years, of any retiree they felt was a party to fraud or hadn’t paid their co-pays. There was no appeal process and no due process. Congress did not approve this back in 2007 but that hasn’t stopped them from continuing to ask congress for this power to this day.
Review Supplemental Insurance Plans for validity:  The initial outcome of this policy was TMA notifying their claims contractor to deny all Philippine claims where the beneficiary indicated they had OHI on the claim form but failed to provide an EOB; most often due to the family having Philhealth. The new policy required that the beneficiary include an EOB from Philhealth before the claim would be considered. Since Philhealth doesn’t provide a standard EOB recognized by TMA, these claims were simply denied. Our group worked with TMA and after about six months we got them to recognize a local form we created and they modified that, when submitted with claims from the Philippines, would be recognized in lieu of an EOB from Philhealth. However TMA doesn’t seem inclined to advertise this or make it easy to find. A copy is available from us, OHI Checklist.
Cap Coverage and Adequacy: This is better known as the CMAC or CHAMPUS Maximum Allowable Charge table and one of the major causes for limited access to care and claims denial and to a large extent because TMA had little idea of how to do it. Nor were they too concerned with the consequences to beneficiaries or providers; it was just one of their rapidly put together methods to stop fraud to pacify the DODIG and congress. TRICARE CMACs in the U.S. are a derivative of Medicare CMACs so this was their first attempt at developing one from scratch and they wanted to make it fast and simple. Their approach was to tag onto a report from the World Bank, International Comparison Program (ICP), and from that extract what is called Purchasing Power Parity (PPP) rates for the Philippines. In a nutshell the medical PPP rate is an average across all levels of care in a country, public and private, and reported as a percentage of U.S. cost based on the current exchange rates at the time the data was gathered. It’s well documented that these rates are not appropriate to use as TMA intend to use them but it met the fast and simple criteria. History now clearly demonstrates that retirees are required to shoulder an increasing share of legitimate health care costs because the allowable charges computed with this system are generally lower than local normal and reasonable costs charged to local citizens.
Using this rate they proposed to take the average CMAC rate in the U.S., there are hundreds of rates designed for every state by urban and rural areas to account for regional differences, to create one set of rates for the entire Philippines. The percentage they proposed was 22.9% of that in the U.S. which the PPP rate suggested. Our group fought these rates as to low because the percentage included an average that included government hospitals, where as TRICARE beneficiaries would be using private facilities and physicians which were at the higher end of medical care costs. We were successful in getting them changed to 52% for outpatient and inpatient care and raised to 100% of the Puerto Rico rates for ancillaries including laboratory and radiology. However even this did not truly address the actual local costs and rate setting and didn’t solve many of the problems with the CMAC. What these are and how to overcome some of them will be discussed in later newsletters.
Eliminate Third Party Billing: The plan was to remove the ability of someone, other than the actual provider, from submitting claims for the provider in the name of the billing activity. This is one of the tactics HVC used. They would use a local provider to see a beneficiary, pay them the local rate, and then bill TRICARE 3 to 5 times the local rate in their name. Their plan failed primarily because their contractor failed to enforce this policy and in, at least the past, extracted payments from these groups to certify them even though they did not meet requirements.[i]
Increase Medical Reviews on Claims: The purpose of this policy was to place some providers and beneficiaries under increased scrutiny if they were suspected of fraud. However the rules or criteria are not published but we know, based on recent written comments by TMA, that they claim 64% of all Philippine providers are under prepayment review and 77% of all beneficiaries. They further claim 90% of all their fraud resources are dedicated to checking these claims. To put this into prospective, a family of four would have three beneficiaries suspected of being involved in fraud. If this same family of four sees a total of four providers then two to three of them are suspected of being involved in fraud as well. Obviously these figures are questionable but further TMA’s case to congress to approve their ability to unilaterally impose beneficiary sanctions and maybe the reason they claim they are so high.
From a beneficiaries’ prospective this means that a growing number of providers refuse to accept TRICARE and process claims; many are now even refusing to be certified as shown by the recent wholesale refusal to be certified by two national pharmacy chains; not the comment on the bottom of the Certified Provider web page. WebPage Beneficiaries on prepayment review find that their claims take longer to process and every minute detail is questioned including the double proof of payment requirement being triggered at a much lower dollar threshold. In the case of beneficiaries on prepayment review many items that would normally be approved without question are kicked back for further proof of care or denied.
Develop a Provider Network: According to an article by Mr. Daniel M. Boucek, Special Agent in Charge, Defense Criminal Investigative Service, DoD all the members of a workgroup accept TMA agreed that the best and most effective approach to reducing fraud while maintaining a high level of access to care was a locally contracted network such as a local PPO and even recommended at least one such group[ii]. The article goes on to indicate that TMA tends to resist changes and in particular changes they did not bring to the table. So instead of taking this approach which would have greatly increased access to care, eliminated the need for beneficiaries to pay for care up front and eliminate most of the fraud they opted, as indicated in the article, to implement the more draconian measures they came up with and addressed above; most of which have proven to be ineffective in stopping fraud but instrumental in greatly reducing access to care and reducing reimbursement of claims to almost nothing. The full article describing the workgroup, the issues involved and the recommendations can be seen by going to Boucek Article.
Recently TMA started looking into a modified local provider network, they call it their “Closed Network”, but instead of leveraging a local group as recommended by every other member of the group they are trying to design one with the look and feel of a Prime network in the U.S. and based on U.S. standards including detailed coding and costing of claims all of which is completely foreign to the local medical community. A later newsletter will address what we know of this proposed program and the issues we see coming from it.
What next?
In future newsletters we will address in more detail the consequences of these policies that negatively impact on access to care and reimbursement for care. We will explain how they work in practice, how and why they cause reduced access and increased claims denial. We will provide work-a-rounds and other steps beneficiaries can take to alleviate or minimize the adverse affects these policies have on their ability to obtain and be reimbursed for care.
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[i] The implementation of the Certified Provider requirement occurred as an administrative action shortly after HVC can into existence and has been a contributor to fraud in the Philippines since. When TMA added the Philippine unique requirement that claims would be paid for care provided by certified providers, the stated purpose was to insure that only care provided by licensed and properly trained providers would be considered. In reality the contractor and or its staff used this process to their own advantage. We have proof that the contractor used to extract payment to certify providers who were not eligible for certification in exchange for a fee. (We reported this and other fraud for years but no action was taken. But recently TMA posted on the TRICARE Pacific webpage a notice declaring their contractor does not charge fees for certification and asks to be notified if it happens. While this seems to be an admission of past fraud there is still no apparent action against the contractor.) WebPage But even today we know of admin offices certified as Physician Groups and local providers certified as working at these groups so the local group can still pay the provider for care provided in their office and bill TRICARE at well over the local rates. Even as late as 2010, we were aware that some physicians that the contractor certified as a hospital were still billing as a hospital and being paid although it was reported to TMA by us in 2007. This may be still going on. A review of the 2009 claims data also points to the TMA contractor over charging for Prime care that they paid for and then processed claims for reimbursement; similar to what HVC did. These and other acts on the part of the contractor have a continued detrimental effect on our access to care and claims payment because TMA wrongly points to beneficiaries and local providers as the responsible parties for this fraud.

[ii] TMA’s continued reluctance to take any action to address the HVC fraud prompted the formation of this group made up of the Defense Criminal Investigative Service (DCIS), the investigative arm of the Department of Defense (DoD) Office of Inspector General (OIG), along with the United States Attorney’s Office in Madison, Wisconsin and TMA. It appears TMA brought the draconian measures to the table while the rest brought one recommendation which was a contract with a local, in country, contractor to provide the care such as a PPO or HMO, which has yet to be considered by TMA.

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U.S. Military Presence in Philippines January 27, 2012

Posted by Service Officer on January 27th, 2012

Talks Ongoing

U.S. Military Presence in Philippines: Two decades after evicting U.S. forces from their biggest base in the Pacific, the Philippines is in talks with the Obama administration about expanding the American military presence in the island nation, the latest in a series of strategic moves aimed at China. Although negotiations are in the early stages, officials from both governments said they are favorably inclined toward a deal. They are scheduled to intensify the discussions in late JAN in Washington before higher-level meetings in March. If an arrangement is reached, it would follow other recent agreements to base thousands of U.S. Marines in northern Australia and to station Navy warships in Singapore. Among the options under consideration are operating Navy ships from the Philippines, deploying troops on a rotational basis and staging more frequent joint exercises. Under each scenario, U.S. forces would effectively be guests at existing foreign bases.

The sudden rush by many in the Asia-Pacific region to embrace Washington is a direct reaction to China’s rise as a military power and its assertiveness in staking claims to disputed territories, such as the energy-rich South China Sea. “We can point to other countries: Australia, Japan, Singapore,” said a senior Philippine official involved in the talks, speaking on the condition of anonymity because of the confidentiality of the deliberations. “We’re not the only one doing this, and for good reason. We all want to see a peaceful and stable region. Nobody wants to have to face China or confront China.” The strategic talks with the Philippines are in addition to feelers that the Obama administration has put out to other Southeast Asian countries, including Vietnam and Thailand, about possibly bolstering military partnerships. The United States already has about 600 Special Operations troops in the Philippines, where they advise local forces in their fight with rebels sympathetic to al-Qaeda. But the talks underway between Manila and Washington potentially involve a much more extensive partnership. Officials in the Philippines — which has 7,107 islands — said their priority is to strengthen maritime defenses, especially near the South China Sea. They indicated a willingness to host American ships and surveillance aircraft.

Although the U.S. military has tens of thousands of troops stationed at long-standing bases in Japan, South Korea and Guam, as well as the island of Diego Garcia in the Indian Ocean, it is seeking to solidify its presence in Southeast Asia. Some of the world’s busiest trade routes pass through the South China Sea and the nearby Strait of Malacca. Instead of trying to establish giant bases reminiscent of the Cold War, however, Pentagon officials said they want to maintain a light footprint. “We have no desire nor any interest in creating a U.S.-only base in Southeast Asia,” said Robert Scher, a deputy assistant secretary of defense who oversees security policy in the region. “In each one of these cases, the core decision and discussion is about how we work better with our friends and allies. And the key piece of that is working from their locations.” The distinction is critical in the Philippines, which kicked the U.S. military out of its sprawling naval base at Subic Bay in 1992 after lawmakers rejected a new treaty. Along with the nearby Clark Air Base, which the Pentagon abandoned in 1991 after a volcanic eruption, Subic Bay had served as a keystone of the U.S. military presence in Asia for nearly a century.

.Manila and Washington signed a subsequent agreement that allows U.S. forces to visit the archipelago or deploy there periodically while remaining under U.S. legal jurisdiction. The constitution of the Philippines forbids foreign military bases without a treaty. “There are political sensitivities, and the U.S. is aware of that,” said a senior Philippine official, speaking on the condition of anonymity to discuss confidential deliberations. “So how can we achieve that presence without it costing too much in terms of political friction?” Philippine officials said they favor allowing the United States to deploy more troops or ships, as long as they rotate periodically or are considered temporary. Temporary, however, can still mean a long time. The 600 U.S. Special Operations troops in the Philippines have been on the southern island of Mindanao since 2002, and there is no firm timetable to withdraw them. The number of port visits by U.S. Navy ships has soared in recent years. The Philippines recently acquired a cutter from the U.S. Coast Guard and is seeking two more of the ships to boost its naval forces. It also wants to buy F-16 fighter jets from Washington.

In interviews, neither Philippine nor Obama administration officials would rule out a return by U.S. ships or forces to Subic Bay. The harbor is now a thriving economic hub and free-trade zone, so any American military presence would pale in comparison with the old days. But even a small, visiting U.S. force in the Philippines would send a strong signal to Beijing. Although Washington has said it is not trying to contain China’s rise as an economic and military superpower, Obama announced a new military strategy this month under which the Pentagon will “rebalance” the armed forces toward the Asia-Pacific region in the aftermath of the wars in Iraq and Afghanistan. Some advocates said the shift in emphasis to Asia was long overdue, given its economic importance and China’s rise. “I don’t really see this as a pivot. .?.?. What I see now is a return to a necessary normal,” said Sen. James Webb (D-VA), chairman of the Senate Foreign Relations subcommittee on East Asia and Pacific affairs. “The presence of the United States has become the essential ingredient for stability.”

In addition to the Philippines, Vietnam — another country that once shunned the U.S. military — is restoring ties. In August, a U.S. Navy ship visited the Vietnamese naval base at Cam Ranh Bay for the first time in 38 years. Cam Ranh Bay is a deep-water harbor that served as one of the largest American military installations during the Vietnam War. Vietnam, which has its own territorial disputes with China, has slowly opened its bases to the U.S. Navy for port visits and ship repairs since 2009. “I don’t see in the near future an American base in Vietnam, but we have seen much more increased military cooperation,” said Webb, a former Navy secretary who fought in Vietnam as a Marine. “They’re not shutting down their relationship with China, but they’re attempting to balance it.” Adm. Jonathan W. Greenert, chief of naval operations, has called Southeast Asia the region with “perhaps the greatest potential in the future” for the Navy to increase its presence through military partnerships. In a Jan. 10 speech to the Center for a New American Security in Washington, he singled out the Philippines as a country “where perhaps there will be more opportunities emerging,” although he didn’t elaborate. Greenert cautioned that some of those partnerships would be limited, saying, “Not everybody is interested in getting in an alliance and getting tied up in a long term.” He cited Vietnam as an example. “We don’t want to push it too hard,” he said. “If you move a little too fast, there’s a hesi¬ta¬tion.” [Source: Washington Post Craig Whitlock article 25 Jan 2012 ++]

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TRICARE Provider List Philippines

Posted by Service Officer on January 25th, 2012

17 JAN 2012

TRICARE Provider List Philippines: The current TMA and ISOS provided Certified Provider list available at http://www.tricare.mil/tma/pacific/pacificCertifiedProviders.aspx does not offer any mechanism to easily identify added or removed providers nor is there any way to determine when existing previously certified provider’s addresses or cities have changed. This is of concern to beneficiaries who have submitted or will be submitting claims because:

• Providers that have changes made to their addresses or city are of some importance as the changes may trigger disapprovals of previously approved claims for a provider when the receipts may no longer match the new addresses.

• Beneficiaries should be able to easily identify providers that have been decertified without having to check every provider on the list in their provider base every two weeks.

• Beneficiaries should be able to easily find added providers for those that have claims pending certification of a provider.

• There should be a convenient way for beneficiaries to determine new additions to the provider base in their area without having to review each and every provider in the entire list every two weeks.

Because of these concerns and to assist TRICARE beneficiaries residing in the Philippines the U.S. Military Retirees of the Philippines have produced a supplemental list to the 17 January 2012 Certified Provider List. The supplement is in 5 sections:

• Introduction

• Providers Added Since 1 January 2011

• Providers Removed Since 1 January 2011

• Providers with Changed Addresses Since 1 January 2011

• Providers with Changed Cities Since 1 January 2011

This listing will be updated with each TMA/ISOS update of the certified provider list and the updates can be accessed at http://db.tt/3fROsC4T or viewed by opening the attachment to this message. When the names or addresses of your providers do not match the “official” list, WPS must send ISOS a request to conduct a “new provider” certification, which has and will slow the reimbursement of the claim. It is recommended that beneficiaries verify the name, (spelling), and how it is listed on the certified provider list. Some examples of variance of the official receipts verses the certified provider list that have caused delays in the past are;

• Santos,John R., MD instead of Santos, John R., MD, (the missing space after the comma has caused the claims processor to request a new certification);

• Santos, John Reyes, MD instead of Santos, John R., MD, which will also cause the claims processor to request a new certification.

The same problem will occur with addresses that are not identical on the “official receipt” as to that of the official certified provider list. Beneficiaries are encouraged to check the newest certified provider list for any provider that they have or are going to use and ensure that the official receipt name and address is identical to the certified provider list. If they find that it is not identical they should request the provider to give them a receipt that is identical. If that is not possible, then it is suggested they annotate the variances on the copy of the receipt sent with the claim and explain that this is the same provider as listed on the certified provider list. [Source: U.S. Military Retirees of the Philippines notice 23 Jan 2012 ++]

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January 09, 2012 EMERGENCY MESSAGE-Feast of the Black Nazarene

Posted by Service Officer on January 9th, 2012

EMERGENCY MESSAGE-Feast of the Black Nazarene

January 09, 2012



Feast of the Black Nazarene

The U.S. Embassy advises U.S. Citizens in the Philippines to avoid areas of Manila where devotees of the Black Nazarene of Quiapo are expected to hold a procession on January 9, 2012. In a nation-wide address January 8, President Aquino noted the risk of possible terrorist activity associated with the procession and subsequent observances. The President of the Philippines counseled that security would be facilitated if celebrants would remain in their homes instead of attending the public procession. Failing that, participants were asked not to bring cell phones, fireworks, or backpacks to the celebrations. Those visiting or residing in the Metro Manila area should expect to see enhanced security precautions, and should comply with all requests by security officials. Maps of the procession routes and related traffic disturbances can be found at http://www.mmda.gov.ph/192012-rerouting.html.

The Department of State remains concerned about the continuing threat of terrorist actions and violence against U.S. citizens and interests throughout the world. The Worldwide Caution reminds U.S. citizens that terrorism can occur anywhere.

We encourage all U.S. citizens in the Philippines to enroll with the Department of State’s Smart Traveler Enrollment Program or at the U.S. Embassy in Manila. By enrolling, you can receive the Embassy’s most recent security and safety updates during your trip. Enrolling also ensures that we can reach you, or your designated emergency points of contact, during an emergency. The U.S. Embassy is located at: 1201 Roxas Boulevard, Manila, Philippines, tel. 63-2-301-2000. The American Citizens Services (ACS) section’s fax number is 63-2-301-2017, and you may reach the ACS Section by email at ACSinfoManila@state.gov. The ACS Section’s website includes consular information and the most recent messages to the U.S. citizen community in the Philippines.

U.S. citizens should also review the Department of State’s Country Specific Information for the Philippines and stay up to date by bookmarking the Bureau of Consular Affairs website, which contains the current Travel Warnings and Travel Alerts as well as the Worldwide Caution. Follow us on Twitter and become a fan of the Bureau of Consular Affairs page on Facebook as well. You can also download our free Smart Traveler iPhone App to have travel information at your fingertips. If you don’t have internet access, current information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the United States, or for callers from other countries, a regular toll line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).


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Posted by Service Officer on November 12th, 2011



DATE                           DESTINATION(S)                     SHOW TIME          SEATS/Remarks


14 Nov 2011 Kadena AB Oki *                                        0830                             UNK

15 Nov 2011 Kadena AB Oki *                                        1100                             UNK

16 Nov 2011 Kadena AB Oki *                                        0830                             UNK

18 Nov 2011 Futenma MCAS Oki *                                0930                              UNK

19 Nov 2011 Kadena AB Oki *                                        0830                              UNK

20 Nov 2011 Kadena AB Oki *                                        1000                              UNK

22 Nov 2011 Guam *                                                        1200                              UNK





(3)          Please call for Baggage limits on (*) flights… flights limited to 30lbs checked bags plus one 10 lb carry-on

(4)          Space A is conducted at the Haribon Passenger Terminal, Air Force City, Clark Field Philippines

(5)          MCAS Iwakuni JP & NAF Atsugi JA travel is limited to persons assigned to Japan on Status of Forces Agreement status.

(6)          All flight  information is subject to change without notice

(7)          JUSMAG/AMC CONTACT: 045-499-7279/0920-970-5030 [Note: Please call for info vice text. This will allow the called facility to answer all your questions and serve more customers in less time.]





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Posted by Service Officer on November 5th, 2011



DATE                           DESTINATION(S)                     SHOW TIME          SEATS/Remarks


02 Nov 2011 Kadena AB Oki *                                        0630                              5

02 Nov 2011 Futenma MCAS Oki *                                1000                             UNK

03 Nov 2011 Kadena AB Oki *                                        2100                              75

05 Nov 2011 Kadena AB Oki *                                        0630                              20

05 Nov 2011 Elmendorf Alaska *                                     0630                              20

05 Nov 2011 Travis AFB CA *                                        0630                              20

07 Nov 2011 Kadena AB Oki *                                        0830                             UNK

10 Nov 2011 Kadena AB Oki *                                        0830                             UNK






(3)          Please call for Baggage limits on (*) flights… flights limited to 30lbs checked bags plus one 10 lb carry-on

(4)          Space A is conducted at the Haribon Passenger Terminal, Air Force City, Clark Field Philippines

(5)          MCAS Iwakuni JP & NAF Atsugi JA travel is limited to persons assigned to Japan on Status of Forces Agreement status.

(6)          All flight  information is subject to change without notice

(7)          JUSMAG/AMC CONTACT: 045-499-7279/0920-970-5030 [Note: Please call for info vice text. This will allow the called facility to answer all your questions and serve more customers in less time.]


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Decertified Tricare providers Philippines

Posted by Service Officer on November 4th, 2011

All Hands [11/3/11]

A Watchdog group of retirees residing in the Philippines has provided the below list of Tricare providers which appeared on the 1 OCT TAO-P certified provider list as decertified. No notice has been published by ISOS, WPS nor TMA regarding the decertification or the date that claims submitted would no longer be honored. However, some claims are reportedly being denied to beneficiaries who filed for reimbursement for services obtained prior to the appearance of these providers on the list. The Watchdog group has brought this matter to the attention of TRICARE Area Office – Pacific and is awaiting their response on how to proceed for past, present and future claims. Recertification is contingent on the willingness of a former provider who remains open for business to cooperate with the certification process. Philippine beneficiaries are cautioned to always check the TAO-P certified provider list at http://www.tricare.mil/tma/pacific/pacificcertifiedproviders.aspx prior to seeking health care or medications in order to avoid potential denial of their claims for reimbursement.

Lt. James ”EMO” Tichacek USN (Ret)
Editor/Publisher RAO Baguio Bulletin

Provider Name City Address Specialties Notes

• Professional Andres Dental Clinic Ilocos Norte Room 205 Isabel Building I (5 Sisters Superstore), J P Rizal Street, Laoag City

• Professional Centralle Medical Diagnostics & Polyclinic Inc. Bulacan No. 361 Mcarthur Highway, Wawa, Balagtas

• Professional De Villa Manlapaz,Luisa,Md Quezon City Rm 519 E Rodriguez Sr Ave “Pediatrics Neonatology”

• Professional Gnc Live Well Muntinlupa City Alabang Town Center Expansion 2, Alabang-Zapote Road

• Professional Luis Skin Clinic Ilocos Norte Room 207 Isabel Building I (5 Sisters Superstore), J. P. Rizal Street, Laoag City

• Professional Medical Center Trading Corporation Pasig City Pioneer Street Corner Shaw Boulevard

• Professional Mercury Drug Corporation All Cities All Locations Pharmacy Removed But Replaced With Provider CityAnd Provider Address

• Professional Piores-Roderos, Olivia Md Cavite Room 2115 De La Salle University Medical Center, Congressional Avenue, Bagong Bayan, Dasmarinas

• Professional South Star Drug Angeles City Teresa Ave St Joseph S Sto Ros Robinsons Nepo Mall Dona Pharmacy

• Professional South Star Drug Cavite Tirona Highway, Binayan, Kawit

• Professional South Star Drug Iriga City Alfelor St Cor Rotary Rd

• Professional South Star Drug Pasay City Km 12 Access Rd Balagbag

• Professional South Star Drug, Inc. Batangas Balintawak Highway, Lipa City

• Professional Unicare Pharmacy Angeles City 1520 Jesus St Lourdes Sur Pharmacy

• Professional Unicare Pharmacy Pampanga 1520 Jesus Street, Angeles City

• Professional Zarate General Hospital Las Pinas City Atlas Compound, Naga Road, Pulang-Lupa


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Tricare Stars and Stripes Article

Posted by Service Officer on October 31st, 2011


Good morning! My apologies for the mass email. I’m a Japan-based reporter for Stars and Stripes (www.stripes.com), the international newspaper that has been covering the U.S. military since World War II. I got your emails from the RAO at Clark and I’m hoping you can help us.

We are preparing to publish a story on the upcoming Tricare pilot program, which will create a closed network of health care providers in the Philippines as a way to cut down on fraud. I’ve been speaking with veterans there who have told me there are deep problems with the current system and its ability to reimburse veterans in a fair and timely way. Namely, the up-front payments and the certified provider list are making it difficult for veterans to get the benefits they earned.

I’m looking to speak with more veterans who have personal stories about problems with Tricare, especially those who may not be seeking needed health care because they worry they won’t get reimbursed. I have heard of at least one veteran who may have died partly because he did not want to spend his savings and not get reimbursed. If this is happening to others, we want to know about it.

Please let me know if you can help. Just send me an email if you are interested and we can arrange a time to talk.

Feel free to pass this email along to other veterans. Thanks in advance for your help!


Travis J. Tritten
Stars and Stripes
Okinawa, Japan
Military DSN: 645-3358
Cell: 080-6748-9904
Office: 098-970-3358
From outside Japan: (81) 80-6748-9904

Global military news around the clock at stripes.com

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The Return and Rebirth of the Abu Sayyaf

Posted by Service Officer on February 22nd, 2009

Insurgency is self propagating. The ASG has never really been Ideologically driven; the have been Pirates for as long as they have been Muslim. Remember the "shores of Tripoli"?

MANILA, Philippines – Not long ago, the al-Qaida-linked Abu Sayyaf group was dismissed as all but dead, thanks to a much-heralded joint effort against terrorism by the U.S. and the Philippine military.

Now there is fear that the Abu Sayyaf may be coming back.

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RAO BULLETIN 1 February 2009

Posted by Service Officer on February 1st, 2009



== AF Recall Program —————— (Retired Rated Officers)

== Legislation of Interest [11] ———————- (4 New Bills)

== Medicare Part D [33] ————— (Alternative Legislation)

== VA Vocational Rehabilitation [01] — (Counselor Shortage)

== Alaska Territorial Guard ——- (Retirement Pay Reduction)

== Filipino Vet Inequities [12] ———— (ECS 2009 Funding)

== Property Insurance ——————- (State Farm FL Pullout)

== Veterans Issues [01] ——- (HVAC Roundtable Discussion)

== Military History Anniversaries ———- (January Summary)

== Mobilized Reserve 27 JAN 09 ————— (357 Decrease)

== VA Data Breaches [42] ——————- ($20M Settlement)

== Rhode Island Vet Home ————— (Under Investigation)

== Nursing Homes [09] ———————- (Medicaid Criteria)

== Arthritis [01] ——————————— (Common Myths)

== VA SmartPay 2 Contract Glitch —– (Bounced VA Checks)

== Agent Orange Lawsuits [14] ——– (Haas Appeal Refused)

== GI Bill [36] —————————— (Rule Freeze Impact)

== ECS 2009 ————————————- (Impact on Vets)

== Medication Lists —————— (Importance of Accuracy)

== Senior Drinking —————————– (Health Benefits)

== Tricare Reserve Select [12] ———– (Gray Area Retirees)

== VA Special Programs ——————— (Where to Locate)

== VA Funding 2009 ————————— (Budget Flawed)

== DOD Disability Eval System [14] ——— (Expedited DES)

== Veterans Inaugural Ball ————– (Supporters Scammed)

== Tricare Overseas Claims [01] ———— (Filing Extension)

== PTSD [24] ——————— (Higher Numbers Diagnosed)

== PTSD [25] ————————– (VA Email Investigation)

== Prostate Cancer [08] ————- (FDA Approves Degarelix)

== VA Claim Denial [01] ———- (Private Medical Opinions)

== VA Claim Denial [02] —— (Legal Representation Impact)

== CBO Health Care Budget Options ———– (2010 Options)

== DoD to VA Transition [07] —————— (Health Records)

== NY Vet Benefits [01] ————————— (Property Tax)

== U.S. Embassy Manila Holidays ———— (Days of Closure)

== VARO Manila [01] ———————— (No More Walk-ins)

== Passport Issuance in RP [01] ————————- (Fee Pmt)

== COLA 2010 [02] ————————— (1% Dec Decrease)

== Tricare Uniform Formulary [27] —– (7 3rd Tier Proposals)

== GI Bill [35] ————————- (Post-9/11 Transferability)

== Tricare Prime [03] ——————— (Right of First Refusal)

== Health Care Availability ————- (Federal health centers)

== DoD PDBR [05] ——————— (Accepting Applications)

== Mortality Rates Active/Reserve —————— (Differences)

== VA Hospitals [01] —————————– (Every State Bill)

== Traumatic Brain Injury [06] ——- (Outreach Center Opens)

== Senior Vehicular Fatalities] —————— (1974 thru 2007)

== VA Copay [06] ——————— (Impact of Drug Increase)

== VA Insurance Dividends in 2009] ———– ($319.8 million)

== VA VistA [02] ———————– (Medical Error Glitches)

== VA VistA [03] ——————————- (HVAC Concerns)

== Veteran Legislation Status 30 JAN 09 —- (Where we Stand)

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