Tricare beneficiaries who qualify for Medicare Part A will automatically be enrolled in Medicare Part B at an increased marginal cost unless declined by the beneficiary. However, subject to the exceptions noted below, the consequences for declining Medicare B can be potentially disastrous, as Tricare can pay nothing for care while a beneficiary is eligible for Medicare Part A unless the beneficiary also has Medicare Part B coverage. Tricare will also recoup any benefit payments made to physicians for a disqualified beneficiary for the period that the beneficiary was eligible for Medicare Part A but declined Medicare Part B. The same consequence would apply to Tricare beneficiaries who are awarded two years or more of retroactive Medicare Part A coverage because of a Social Security disability award but decline the option to take Medicare Part B for the period of retroactive Medicare Part A coverage. Any payments made to physicians during a period of retroactive Medicare Part A coverage for which Medicare Part B is declined will be recouped by Tricare.

The mandatory Medicare Part B enrolment rule does not apply if the beneficiary has an active duty sponsor, is enrolled in the US Family Health Plan, or is covered under Tricare Reserve Select. Tricare beneficiaries who are changing Tricare coverage, such as those switching to Tricare for Life and those Tricare beneficiaries with potentially successful Social Security claims should particularly take heed of the Medicare Part B requirement if they want to continue Tricare coverage. The clear message from Tricare Management Activity to Tricare beneficiaries covered by Medicare Part A is that if they decline Medicare Part B coverage, they do so at their peril as this could terminate Tricare payments of claims. It is possible to later enroll in Medicare Part B for those who decline the initial coverage but substantial penalties could apply. Questions on this requirement should be directed to your Tricare contractor. You can also visit the Tricare website for your region or program as follows.

• North Region: www.healthnetfederalservices.com

• West Region: www.triwest.com

• South Region: www.humana-military.com

• Tricare for Life: www.tricare-4u.com

[Source: NGAUS Leg Up 5 Sep 08 ++]

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The Heroes Earnings Assistance and Relief Tax Act of 2008, signed into law on 17 JUN 08, changed the federal income tax filing deadlines and the length of the look-back period for amended tax returns when retirees are affected by a retroactive VA disability compensation determination. Amended tax returns usually are required when you have paid income taxes on past retirement income that later becomes tax-free income as a result of the award of retro-VA compensation. For retro-VA compensation determinations as of 18 JUN 08 or later, retirees have up to one year to file their amended return from the date of the VA determination. The retiree now can amend tax returns going back five years. It used to be a three-year look-back. There also is a transition period allowed in the tax code change. For retro-VA compensation determinations from 1 JAN 01 through 17 JUN 08, retirees have until 17 JUN 09 to file amended returns for tax refunds for tax years 2001 to the present. Consult your tax specialist for more detailed information about how these changes affect you. Refer to H.R. 6081, Section 106, which amends the IRS Tax Code Section 6511(d) by adding a new paragraph (8). For a technical explanation of H.R. 6081 on the House of Representative’s Web site refer to www.house.gov/jct/x-44-08.pdf. additional reference can be located at www.govtrack.us/congress/billtext.xpd?bill=h110-6081 and

frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=110_cong_bills&docid=f:h6081enr.txt.pdf . [Source: MOAA News Exchange 10 Sep 08 ++]

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In SEP 06 the Department of Veteran’s Affairs (DVA) identified more than 133,000 recipients of Combat Related Special Compensation (CRSC) or Concurrent Retired Disability Payment (CRDP) potentially eligible for additional retroactive compensation. Since then the Defense Finance and Accounting Service (DFAS) in coordination with the DVA have processed all of the original cases as of 8 JUN 08. Throughout the project DVA identified additional retirees that were prospectively eligible for retroactive payments. The agency also resubmitted accounts, from the original 133,000, for potential supplementary entitlements. Those accounts, classified as “new and returning,” were processed as of 29 JUN 08. Those people identified with potential eligibility for retroactive payment after JAN 08, were placed in a category referred to as “On-Going.” The On-Going category documents the most recently received new and returning VA Retro cases. Those accounts as of 20 JUL 08, have been processed. To date a total of more than 230,000 accounts have been processed. Going forward, plans are to process all incoming claims within 30 days. While certain accounts may have received payment from DFAS, you may also be eligible for payment from the Department of Veteran’s Affairs (DVA). Once your account has been processed at DFAS, the information is forwarded to the DVA for additional validation and possible payment. There may often be a lapse of time between the payments from the two different agencies. Questions concerning the VA can be addressed by calling 1-800-827-1000. [Source: DFAS http://www.dfas.mil/retiredpay/retroactivepayment.html 5 Sep 08 ++]

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An upcoming change to Tricare soon could give military retirees living overseas reason to smile. Beginning 1 OCT, those retirees will have access to the Tricare Retiree Dental Program (TRDP) insurance benefits that have been previously unavailable outside the United States, Tricare officials said in an e-mail to Stars and Stripes on 5 SEP. Jeff Album, spokesman for Delta Dental, the California-based contractor that handles Tricare’s dental coverage, said the company expects about 14,000 of the 35,000 eligible retirees to take advantage of the optional program in its first year. While the change is good news for many, it might not be cost-effective for every retiree living overseas, said Ed Chan, the Tricare Pacific director. For instance, out-of-pocket expenses for dental care in the Philippines are generally much less than monthly insurance premiums, he said. “In some cases, they may not get back what they paid into it,” he said. In South Korea and Japan, he said, retirees might have national insurance if they’re married to citizens of those countries, which includes some dental coverage. In some places in Japan and Okinawa, officials say, retirees can receive free space-available care on base. Retirees in South Korea have very limited on-post care. They are authorized emergency care and can get cleanings during special events such as retiree appreciation days and noncombatant evacuation exercises, said Chris Vaia, chairman of the retiree counsel at Yongsan Garrison in Seoul.

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Following are some September significant events that occurred in military history:

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Less than one month from now, private insurance companies will begin marketing their 2009 Medicare health and drug plans, hoping to convince people with Medicare to sign up for coverage for the new year. The open season for seniors to initiate or switch carriers is 15 NOV through 31 DEC. The marketing of Medicare private health plans has been plagued by abuse. Unscrupulous agents who troll senior housing complexes and even nursing homes have misrepresented or outright lied about the plan benefits and coverage, and cajoled or tricked frail older adults into signing enrollment forms in order to gain the commissions, bonuses and prizes the insurance companies award for these enrollments. The passage this summer of the Medicare Improvement for Patients and Providers Act over President Bush’s veto sets some new ground rules for marketing this fall, including a ban on cold-calling and other unsolicited contact (such as accosting patients in hospital parking lots), and federal regulation of agent commissions. How these new rules are implemented and enforced will determine whether the Bush administration seizes, or squanders, its last chance to stop the abuse that has so far characterized the market for Medicare private health plans.

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Exploring how best to extend telehealth services to veterans living in rural areas will be one of the key missions of three Veterans Rural Health Resource Centers to be opened by the Veterans Affairs Department on 1 OCT. The centers, to be located at the White River Junction VA Medical Center in Vermont, at the Iowa City VA Medical Center, and at the Salt Lake City VA Medical Center, will serve as satellite offices for VA’s Office of Rural Health. Patricia Vandenberg, assistant deputy undersecretary of veterans affairs said in an interview, “The rural resource centers are envisioned not to be providers of services but rather enablers of systematic care for veterans in rural communities.

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Former Army serviceman Randall Moneymaker was sentenced to three years in prison 5 SEP for embellishing a brief military career into that of a decorated combat veteran. Moneymaker is part of the growing problem of “phony war heroes,” across the nation, Assistant U.S. Attorney Craig “Jake” Jacobsen said. “As the wars drag on in this country, you have more and more wannabes” who make claims of sacrifices never suffered and medals never earned, Jacobsen said. Unlike other imposters who seek only bragging rights or political gain, Moneymaker was motivated mostly by greed, the government contended — making his false claims to collect more than $18,000 in disability and military benefits. Moneymaker was sentenced by Judge James Turk following a March trial in U.S. District Court in Roanoke. After hearing testimony that Moneymaker made up tales of firefights, Ranger missions and hundreds of parachute jumps, a jury convicted him of six charges of fraud and theft. “I’m sorry for what I’ve done,” Moneymaker told the judge, apologizing to his family, his country, his fellow soldiers and “anyone else that I’ve done wrong.”

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The Internal Revenue Service has met its goal of hiring a minimum of 1,000 additional veterans in fiscal 2008. With three weeks to go before the fiscal year ends on 30SEP, IRS officials said they had hired 1,052 veterans. “We are not going to stop there,” IRS Commissioner Doug Shulman said in a statement. “We will continue to recruit from this talented pool of people who already have demonstrated their leadership, work ethic and dedication.” To hire the veterans, the IRS worked with major advocacy groups like the American Legion, Veterans of Foreign Wars, Blinded Veterans of America and Paralyzed Veterans of America. The IRS also worked with the Pentagon and Veterans Affairs Department, which have veteran’s employment programs.

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Healthcare providers and insurers put a dollar value on medical services using policies so inscrutable that they leave patients unable to determine a fair price for any treatment. This is most evident in trying to evaluate the differences between what medical providers bill and what insurers’ pay. “It’s a Byzantine system,” said Jim Lott, executive vice president of the Hospital Assn. of Southern California. “There’s no question about that.” Peggy Hinz, a spokeswoman for Anthem Blue Cross, said the insurer “relies on the latest medical pricing data and experts in the field” to determine how much it will pay for specific services. “We always strive to reimburse a fair amount based on a provider’s cost and based on what is reimbursed to other providers for like services,” she said. Most physicians will not discuss how they arrive at their billing amounts and often claim they have nothing to do with setting prices for their practice or negotiating contract terms with insurers.

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