Department personnel aren’t asking enough questions to determine whether veterans are suicidal, aren’t sharing information about suicide risks with the VA’s network of hospitals and clinics and aren’t implementing their own plans to improve the system, Ronald Maris, a University of South Carolina sociology professor, told U.S. District Judge Samuel Conti in San Francisco on the second day of the trial. A majority of the VA’s counselors, doctors, social workers and psychologists "don’t have the tools and the information that they need to intervene effectively with suicidal vets," said Maris, a former president of the American Association of Suicidology who has been a consultant to the Army on suicide prevention. He was particularly critical of the VA’s top health care administrator, William Feeley, who said in a pretrial deposition 9 APR that the agency has no systematic national plan for suicide prevention. Feeley also said he was unaware of any methods of tracking veterans at risk of suicide and that suicide rates "are not a metric we are measuring." "I would say he was singularly uninformed about suicide," Maris said. During cross-examination of Maris, Justice Department lawyer James Schwartz suggested that Feeley’s comment about suicide rates referred to factors he considered in evaluating VA division chiefs, not his own ignorance about the subject. But Maris said the statement contained no such indication.

The emotional nature of the case was underscored when an unidentified woman rose during Maris’ testimony and denounced "warmongers … eating our children for profit." The woman spoke for several minutes before being led off by a federal marshal. She was not arrested, the marshal’s office said.

During opening statements 21 APR, a lawyer for the veterans’ groups displayed an e-mail that a top VA mental health official, Ira Katz, sent in December in which he said veterans were committing suicide at the rate of 18 a day. In an interview Maris said Tuesday the suicide rate among veterans has been increasing since 2001, according to government reports he has studied. In court, Maris said a more recent study by top VA mental health official, Ira Katz showed a suicide rate among veterans that was 3.2 times as high as the rate among the general population. A May 2007 report by the VA’s inspector general found a suicide rate 7.5 times as high as the public rate for veterans who were in the department’s health care system, Maris said.

Among the reasons for the disparity, Maris said, is that veterans are mostly men, who generally have higher suicide rates than women; they suffer from depression more often, have higher rates of alcohol and drug abuse than the general population, are separated from their families for long periods and often have access to guns. Maris also faulted the VA’s standard procedure for screening returning soldiers for suicidal tendencies. He said they are asked whether they thought of harming themselves during the previous two weeks or decided life was not worth living. If they deny having any such thoughts, he said, they are classified as nonsuicidal and the questioning ends. That’s far short of the generally accepted standard of care, Maris testified. He said soldiers are often reluctant to admit psychiatric problems and should be asked numerous follow-up questions about such topics as alcohol use, medications, gun ownership, any past suicide attempts and any history of suicide in their family. [Source: San Francisco Chronicle BoB Egelko article 22 Apr 08 ++]

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THE lawsuit, filed in JUL 07 by two nonprofit groups representing military veterans, accuses the agency of inadequately addressing a “rising tide” of mental health problems, especially post-traumatic stress disorder. It contends the Department of Veterans Affairs isn’t doing enough to prevent suicide and provide adequate medical care for Americans who have served in the armed forces, a class-action lawsuit that goes to trial this week charges. But government lawyers say the VA has been devoting more resources to mental health and making suicide prevention a top priority. They also argue that the courts don’t have the authority to tell the department how it should operate. The trial began 21 APR in a San Francisco federal court. An average of 18 military veterans kill themselves each day, and five of them are under VA care when they commit suicide, according to a December e-mail between top VA officials that was filed as part of the federal lawsuit. The veterans groups wrote in court papers filed 17 APR that failure to provide care is manifesting itself in an epidemic of suicides. The "trial…does not seek monetary damages but asks the court to appoint a special master or otherwise intervene to make" the VA run more efficiently.

After government lawyers and attorneys representing the veterans made opening statements the executive director of the National Veterans Legal Services Program, testified that U.S. veterans returning from Iraq and Afghanistan don’t have sufficient access to lawyers to help them process health and medical claims when they encounter treatment delays or mistakes a witness for the veterans testified. "Even if we get 1,000 cases placed, there are hundreds of thousands of claims," Abrams said. Veterans suffering disorders cannot get enough legal aid even though hundreds of lawyers from dozens of law firms have volunteered to help them free of charge, Abrams said. Staff shortages, inadequate care, long waits for therapy, and an adversarial appeals process when care is denied have led to an "epidemic of suicides," lawyers for Veterans for Common Sense and Veterans United for Truth Inc. have argued. Coincidently the next day U.S. Senator Daniel K. Akaka (D-HI), Chairman of the Veterans’ Affairs Committee, called for the resignation of Dr. Ira Katz, Mental Health Officer for the Department of Veterans Affairs, following reports that Dr. Katz was involved in efforts to cover up the number of veterans attempting suicide.

A study released this week by the RAND Corp. estimates that 300,000 U.S. troops (about 20% of those deployed ) are suffering from depression or post-traumatic stress from serving in Iraq and Afghanistan. “We find that the VA has simply not devoted enough resources,” said Gordon Erspamer, the lawyer representing the veterans groups. “They don’t have enough psychiatrists.” The lawsuit also alleges that the VA takes too long to pay disability claims and that its internal appellate process unconstitutionally denies veterans their right to take their complaints to court. According to Erspamer the VA can take up to 12 to 15 years before it recognizes and compensates a veteran for stress disorder and that when veterans appeal their claims, the courts reverse or send the cases back to VA offices for correction 91% of the time.The department acknowledges in court papers that it takes on average about 180 days to decide whether to approve a disability claim. The groups are asking U.S. District Court Judge Samuel Conti, a World War II Army veteran, to order the VA to drastically overhaul its system. Conti is hearing the trial without a jury. But government lawyers have filed court papers arguing that the courts have no authority to tell the VA how to operate and no business wading into the everyday management of a sprawling medical network that includes 153 medical centers nationwide. The veterans are asking the judge “to administer the programs of the second largest Cabinet-level agency, a task for which Congress and the executive branch are better suited,” government lawyers wrote in court papers.

If the judge ordered an overhaul, he would be responsible for such things as employees workloads, hours of operations, facility locations, the number of medical professionals employed, and “even the decision whether to offer individual or group therapy to patients with PTSD. The VA also said it is besieged with an unprecedented number of claims, which have grown from 675,000 in 2001 to 838,000 in 2007. The rise is prompted not from the current war, but from veterans growing older. Government lawyers in their filings defended VA’s average claims processing time as reasonable, given that it has to prove the veterans disability was incurred during service time. They also noted the VA will spend $3.8 billion for fiscal year 2008 on mental health and announced a policy in June that requires all medical centers to have mental health staff available all the time to provide urgent care. They said that “suicide prevention is a singular priority for the VA. They have hired over 3,700 new mental health professionals in the last two and a half years, bringing the total number of mental health professionals within VA to just under 17,000. This hiring effort continues. [Source: Air Force Times AP Paul Elias article posted : 21 Apr 08 ++]

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For American expatriates used to the tax filing deadline in mid-June, the 15th of April tax paying deadline can easily be overlooked. So down the road when those 2007 taxes are finally paid with the tax return, Expats can be surprised to receive an IRS interest assessment for late payment. So if the 2007 tax return has not yet been prepared, the best strategy - after 15 April and before 15 June - is to estimate and pay any taxes owed. When IRS receives your tax return, they first check the return for mathematical accuracy. If taxes are owed, they bill the taxpayer and charge interest from 15 April on the federal short-term rate plus three percent. Interest is compounded daily. A penalty for late payment of one-half of one percent of the tax owed for each month may also be assessed until the full 25% maximum penalty is applied for non-payment. For reasonable cause, penalties can be abated, but not interest. Assessed taxpayers can send an explanation together with the bill to the IRS service center in Austin for consideration. However IRS will not act to abate until the taxes owed are first paid. To assure payment is properly made, a check or money order should be payable to UNITED STATES TREASURY. Also on the check, remember to enter the tax year, form number and your telephone number. Form 1040-V should accompany payment. The expatriate mailing address is: Internal Revenue Service Centre, PO Box 660335, Dallas, TX 75266-0335. [Source: The Tax Baron Report MAR/APR08 ++]

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On 22 APR Sens. Daniel Akaka, D-Hawaii and Patty Murray, D-Wash., said Dr. Ira Katz, the VA’s mental health director, withheld crucial information on the true suicide risk among veterans and called for his resignation saying he tried to cover up the rising number of veteran suicides. “Dr. Katz’s irresponsible actions have been a disservice to our veterans, and it is time for him to go,” said Murray, a member of the Senate Veterans Affairs Committee. “The No. 1 priority of the VA should be caring for our veterans, not covering up the truth.” Akaka, the committee’s chairman, said in a letter to the VA that Katz’s “personal conduct and professional judgment” had been called into question by his response to veteran suicides. A number of Democratic senators said they were appalled at e-mails showing Katz and other VA officials apparently trying to conceal the number of suicides by veterans. An e-mail message from Katz disclosed this week as part of a lawsuit that went to trial in San Francisco starts with “Shh!” and claims 12,000 veterans a year attempt suicide while under department treatment. “Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?” the e-mail asks. Another e-mail said an average of 18 war veterans kill themselves each day — and five of them are under VA care when they commit suicide. A VA spokesman declined to comment.

“It is completely outrageous that the federal agency charged with helping veterans would instead cover up the hard truth — that more and more Americans coming home after bravely fighting for their country are suffering from mental illnesses and, in the most tragic circumstances, committing suicide,” said Sen. Tom Harkin, D-Iowa. “Anyone at the VA who is involved in this cover-up should be removed immediately.” Harkin, Murray and Sen. Russ Feingold, D-Wis., introduced legislation 22 APR calling on VA to track how many veterans commit suicide each year. Currently, VA facilities record the number of suicides and attempted suicides in VA facilities but do not record how many veterans overall take their own lives. The agency, however, is reluctant to disclose specific numbers, veterans advocates complain. The new bill would require VA to report to Congress within 180 days the number of veterans who have died by suicide since 1 JAN 97, and continue reports annually. Harkin’s office said statistics provided earlier this year by VA showed that 790 veterans under VA care attempted suicide in 2007. That figure is contradicted by the e-mail revealed this week. Two veterans groups last year filed the class-action lawsuit against a sprawling VA system that handled a record 838,000 claims last year. A government lawyer urged a judge Monday to dismiss the lawsuit, saying the agency runs a “world-class” medical care system. [Source: Air Force Times AP Matthew Daly article posted 23 Apr 08 ++]

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A federal grand jury has indicted an Edmond OK man on making false claims about injuries and awards while serving in the Vietnam War. James Hull 66, faces three counts of using false documents and one count of falsely receiving a military medal. Charges arose from an investigation by the U.S. Department of Veterans Affairs Office of Inspector General Division. Hull is accused of signing and submitting fraudulent forms in MAR 05 and MAR 06 to the Veterans Administration to support his claims for disabilities that happened as a result of combat in Vietnam. According to court documents, Hull also submitted fraudulent citations for a Silver Star and Meritorious Service Medal he claimed he received as a result of his military service in Vietnam between 1964 and 1965. An investigation revealed that Hull was assigned to military units in the Republic of turkey, Fort Walters, Texas, and San Francisco during the times he claimed to be in Vietnam, according to court documents. [Source: NewsOK.com article 22 Apr 08 ++]

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The Army, Air Force and Marine Corps announced the current number of reservists on active duty as of 23APR 08 in support of the partial mobilization. The net collective result is 4,257 more reservists mobilized than last reported in the Bulletin for 26 MAR 08. At any given time, services may mobilize some units and individuals while demobilizing others, making it possible for these figures to either increase or decrease. The total number currently on active duty in support of the partial mobilization of the Army National Guard and Army Reserve is 79,049; Navy Reserve, 5,211; Air National Guard and Air Force Reserve, 9,554; Marine Corps Reserve, 8,496; and the Coast Guard Reserve, 347. This brings the total National Guard and Reserve personnel who have been mobilized to 102,657, including both units and individual augmentees. A cumulative roster of all National Guard and Reserve personnel, who are currently mobilized, can be found at http://www.defenselink.mil/news/Apr2008/d20080423ngr.pdf . [Source: DoD News Release 196-08 12 Mar 08 ++]

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The clinic where Dr. Alberto Marzan allegedly played his role in a $100 million swindle of the U.S. military’s health insurance program sits abandoned, along with the adjacent family home. But a legacy remains, with a U.S. Navy retiree saying scams are still rife even after a federal judge ordered a Philippines company to pay back the money it skimmed. Marzan, one of the longest-wanted fugitives in the probe, recruited dozens of military retirees to falsely claim they and their relatives were confined at his clinic and received expensive medical services, U.S. prosecutors say. He made fraudulent claims of $1.5 million to the program and was paid more than $1 million, prosecutors add. In return, he typically paid kickbacks to the retirees. A U.S. federal grand jury returned a 35-count indictment against Marzan in 1999, but he has apparently remained free in the Philippines after vanishing from Moncada RP. Neighbors, village leaders, police and former co-workers in the Moncada town hall, where he used to sit as councilor, say the doctor’s family slipped out of town more than three years ago and remains underground. Claro de Castro, head of the National Bureau of Investigation’s Interpol division, said his office has arrest warrants for a doctor and a beneficiary. But he refused to identify them or say if the wanted doctor was Marzan because agents are still working on the case.

Jerry Minor, a Navy retiree and administrator of Lifeline Medical Center - a Tricare-accredited clinic in western Olongapo city near the former U.S.-run Subic Naval Base - said many accredited doctors and clinics in the city continue to overprice their services. Retirees are usually lured into the scheme because the clinics do not charge them the required 25% share of the cost, instead sending the whole bill to Tricare, Minor said. One clinic blacklisted by Tricare for fraudulent claims simply changed its name and is back in business, he told The Associated Press in an interview 25 APR. Minor said a retiree’s wife who was convinced by a clinic four years ago to sign a stack of blank claim forms - one is filled out every time a beneficiary goes to a clinic - was shocked to find out last December that several women were collecting on claims using her details. "It was like signing a blank check," he added. He said he tried to find out for himself about the overpricing by going to a doctor, who told him he would be charged 850 pesos ($20) for a 15-minute consultation. The price was higher than the 500 peso ($12) fee per consultation under Tricare regulations. Minor said when he brought up his share of the cost, the doctor told him, "Don’t worry about it, you pay nothing. Tricare does." He said he has reported the anomalies to Tricare officials but the scams continue.

Vicky Gross, a retiree’s widow who used to work for Health Visions, said many doctors and clinics don’t charge beneficiaries their share of costs but she did not know what they were charging to Tricare. Austin Camacho, a spokesman for the Pentagon’s Tricare Management Activity, said the program has implemented new controls to combat fraud in the Philippines in recent years. Among other things, the program looks for patterns of aberrant practices and reviews claims that appear excessive. In 2001-07, the program refused to pay $288 million in fraudulent or excessive claims from the country, he said. Still, he said it is hard to catch all fraud overseas and Tricare does not exclude providers "without sufficient evidence. This can be difficult in an environment where law enforcement resources are limited, providers are not always cooperative and are not subject to the U.S. government’s subpoena power," he said. Rufino Bayao Jr., a Navy retiree who served a 1.5-year U.S. prison term and three years of probation for taking part in the scam with Marzan, advises retirees not to fall for the bait. "If they are caught, they will also suffer," he told AP in his home in northern Tayug town. "It’s not worth it." Aside from the prison term, Buyao is having more than a third of his $800 monthly pension deducted to pay for $132,390 in restitution that a U.S. court ordered him to pay. He says he got only 200,000 pesos ($4,760) from Marzan for signing false claims, with much of the money going for drinking binges. [Source: Military.com AP article 28 apr 08 ++]

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: A federal judge ordered a Philippines company to pay back $100 million (euro63 million) it swindled from the US military’s health insurance program. Health Visions (HV) Corp., which pleaded guilty to mail fraud, was ordered to liquidate all assets within 10 months and give the proceeds to the US government. Federal prosecutors say the company bilked the military’s Tricare program out of $99.9 million (euro63.35 million) between 1998 and 2004. The company routinely inflated claims by more than 230%, operated a phony insurance program and billed for medical services never delivered, court records showed, and the Pentagon moved slowly to uncover the scheme. Assistant US Attorney Peter Jarosz described Health Visions as the biggest violator yet in a long-running investigation into Tricare fraud in the Philippines. "This is basically a death sentence for the company. It will no longer exist and that will protect the Tricare program since it was the biggest violator," he said after the hearing. "We got what we needed out of this prosecution."

The US closed its military bases in the Philippines in 1992 and withdrew its active-duty forces, but thousands of retirees remained. Formed in 1997, Health Visions owned and operated hospitals and clinics in the Philippines and billed Tricare on behalf of other health care providers. On top of the $99.9 million (euro63.35 million) in restitution, US District Judge Barbara Crabb ordered the company to forfeit an additional $910,000 (euro577,000) and pay a $500,000 (euro317,000) fine. Health Visions will be required to sell off land, office buildings and hospitals in the Philippines and an airplane and houses in the US under Crabb’s order. The company has run into problems selling hospitals because of ownership disputes, and Jarosz said it was uncertain whether the U.S. government would ever recover the full amount. The company’s lawyer, Christopher Kelly, declined to comment. He told Crabb he had nothing to add beyond a plea agreement, which was unsealed on 24 APR. Health Visions and its former president, Thomas Lutz, were hit with a 75-count indictment in 2005. Lutz, a US citizen who turned 41 on 24 APR, has pleaded guilty to his role in a kickback scheme and could face up to five years in prison when he is sentenced. A date for that hearing will be scheduled shortly now that the company has been sentenced, Jarosz said. No word has been released yet on what action will be taken against the hundreds of military vets/dependents who knowingly aided and abetted this fraud. All were required to sign Tricare claim forms verifying treatment and all received EOB’s identifying what had been billed to Tricare by HV.

The case has been an embarrassment to the Pentagon, where different branches have blamed one another for allowing the company’s fraud to slip through the cracks. The fraud was so extensive that claims from the Philippines increased by 2,000% between 1998 and 2003 even as the number of Tricare beneficiaries remained the same. Payments to the country went up from less than $3 million (euro1.9 million) to more than $60 million (euro38.05 million) during that time. The Office of Inspector General has criticized Tricare’s managers for waiting years to cut off payments to Health Visions after suspecting the company of fraud. William Winkenwerder, former assistant secretary of defense for health affairs, said that the inspector general’s office was partly to blame because it refused his requests to send additional investigators to the country. He said he worked hard to stop the problems after they came to his attention in 2003. Asked how the company was able to defraud the program of $100 million (euro63.42 million), Winkenwerder said: "There were some very deceptive practices that were occurring. The fact that this was a faraway location did add to the challenge of uncovering problems. And they didn’t get away with it ultimately, which is the good news." The investigation has been handled by prosecutors in Wisconsin because WPS Health Insurance, a Madison company, is the subcontractor that handles most overseas claims. About three dozen others have been indicted to date, mostly US military veterans and Philippine doctors. [Source: AP Ryan J. Foley article 24 Apr 08 ++]

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A Republican GI Bill plan, the Enhancement of Recruitment, Retention and Readjustment through Education Act, with many features attractive to active-duty service members and their families was unveiled 22 APR. No bill number has been assigned to date. It is their effort to show that it’s not just Democrats who want to improve veterans’ education benefits through their Post-9/11 Veterans’ Educational Assistance Act S.22. The Republican plan includes increases in basic benefits, a new book allowance, broad rights to transfer unused benefits to family members, and the ability to use veterans’ benefits to pay off existing student loans. It also would extend GI Bill benefits to service academy and Reserve Officers’ Training Corps scholarship graduates, who are currently ineligible for payments, and would allow about 5,000 people who entered active duty between 1977 and 1985 to sign up for the benefits plan from which they were excluded. The package is intended as an alternative to a GI Bill plan introduced last year by Sen. Jim Webb (D-VA) that has the support of most House and Senate members. It also helps Sen. John McCain, (R-AZ) Republican presidential candidate and ranking minority party member of the Senate Armed Services Committee, who has faced increasing pressure from veterans’ groups for not supporting Webb’s bill, S.22 which now has 57 cosponsors.

Under the Republican bill active-duty members, monthly GI Bill benefits would rise 1 OCT to $1,500, up from the current $1,101, enough to cover the average cost of a four-year public college including room, board, tuition and fees, said Sen. Lindsey Graham (R-SC), ranking Republican on the Senate Armed Services personnel subcommittee. Another $500 annual payment would help cover the cost of books and supplies. Asked if he thought a living stipend was needed in addition to the basic benefit, Graham said room and board is factored into the cost. “We don’t have beer money included,” he said. That is less than what Webb proposes in his bill S.22, which would provide GI Bill benefits plus a living stipend in amounts varying by state. Webb proposed basic benefits that matched college tuition and fees, up to a maximum payment set by the most expensive four-year public college in a state. The monthly living expense proposed by Webb would match the military’s basic allowance for housing for an E-5 with dependents in the area of the school being attended, estimated to be $1,000 a month or more. Sen. Richard Burr (R-NC), ranking Republican on the Senate Veterans’ Affairs Committee and another co-sponsors of the new bill, said Webb’s plan could take a year or more to implement because of the difficulty in setting a benefits cap for each state, and would create inequities between states. Burr said increases called for by the Republican bill would take effect this year, and veterans would get the same payment no matter where they went to school.

Patrick Campbell of Iraq and Afghanistan War Veterans said the provisions noted by Burr are not necessarily advantages. Basing payments on average tuitions, Campbell said, “means, by definition, that half of the people are not going to be paid enough to cover the cost of their college education. That is why I still prefer Webb’s bill.” The Pentagon has opposed Webb’s bill, arguing that it would encourage people to get out of the military to use the benefits. Defense officials do not want GI Bill benefits to be more than about $1,500 per month. In response to military concerns, the Republican bill promises to phase in additional increases for those who have served 12 or more years on active duty. Monthly benefits would increase by $150 in 2009, $150 in 2010 and $200 in 2011, capping at $2,000. Benefits for reservists also would increase to $1,200 a month for people who have been mobilized since 11 SEP 01, a jump from the current $880. Benefits for other Guard and reserve members would increase to $634 a month, double the current rate. Recognizing that veterans’ benefits are insufficient to pay for every school, the bill includes a provision encouraging colleges and universities to forgive loans accumulated by veterans. Schools can receive $1,000 for forgiving 25% of a veterans’ debt, $2,000 for forgiving 50% of debt and $3,000 for forgiving 100% of debt, Graham said. The proposal allowing transfer of GI Bill benefits to family members would be a retention boost for active, Guard and reserve forces, Graham said. It would allow those who have served six years to transfer 18 months of GI Bill benefits to a spouse or child, and allow 36 months of GI Bill benefits to be shared after 12 years of service.

While the Republican bill is more generous than the plan envisioned by the Pentagon earlier this year, when President Bush endorsed the idea of sharing veterans’ educational benefits with family members, Graham said he did not expect administration opposition. Asked about the Pentagon view, Graham said he had spoken with defense officials who “agreed” to the proposal but quickly amended that to say, “Well, I think they are going to agree.” The bill does meet the basic limitations on payments spelled out last week by defense officials in testimony before the House Veterans’ Affairs Committee. The Republican bill has three features not included in Webb’s proposal:

• Service academy graduates and Senior ROTC graduates who are excluded from the current GI Bill plan, unless they earned benefits through prior enlisted service, would get full benefits, including transfer rights, if they serve in uniform for five years beyond their initial obligation.

• About 5,000 active-duty members who entered service between 1977 and 1985, when the only education benefits plan available was the low-paying Veterans Education Assistance Program, or VEAP, would be allowed to enroll in the GI Bill. They would have to pay a $2,700 contribution, more than the $1,200 payment for other service members. They would also be limited to using the benefits only to pay for a bachelor’s degree and would not have the op