RAO Davao City

United States Military Retiree Activities Office Davao City, Philippines

Archive for the 'Health News' Category

Decertified Tricare providers Philippines

Posted by Service Officer on 4th November 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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LONG TERM CARE AND MEDICAID 2 June 2008

Posted by Service Officer on 2nd June 2008

If you qualify for Medicaid, a federal and state program that covers medical care for people with low incomes and very little assets, it will pay for nursing home care and other long-term care (LTC) costs that Medicare does not cover. Medicaid may also pay for some LTC services provided at home. Medicaid is the country’s largest public payer of long-term care services. Most people with long-term care needs spend down their assets until they are eligible for Medicaid coverage. The Medicaid program varies a great deal from state to state, as well as within each state. This is because within broad national guidelines set by the federal government through the Centers for Medicare and Medicaid Services (CMS), each state can:

• Establish its own eligibility standards;

• Determine the type, amount, duration and scope of services;

• Set the rate of payment for services; and

• Administer its own program.

Each state has its own method of determining eligibility depending on your age, family size, medical condition and financial situation. Generally, to be eligible for Medicaid, your monthly income must be less than $867 in 2008* ($1,020 for couples). You also must have little or no assets (savings and investments). If you have high medical expenses, you may still qualify for Medicaid if your income is more than $867 in 2008* ($1,020 for couples). Income levels are based on the Federal Poverty Level (FPL), which goes up every year in February or March. For a list by state of Medicaid descriptions and plans refer to http://64.82.65.67/medicaid/states.html For a list of Medicaid benefits by state refer to http://www.kff.org/medicaid/benefits/state_main.jsp. [Source: Medicare Rights Center www.medicareinteractive.org May 08 ++]

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Combat-Related Special Compensation (CRSC) eligibility

Posted by Service Officer on 15th February 2008

CRSC UPDATE 37: The 2008 National Defense Authorization Act (NDAA) was signed into law on 29 JAN 08. The NDAA expanded Combat-Related Special Compensation (CRSC) eligibility to include those who were medically retired under Chapter 61with less than 20 years of service, effective 1 JAN 08. A Chapter 61 retiree is anyone who was medically retired from military service. Chapter 61 is a new component for CRSC. Medically retired Veterans must still provide documentation that shows a causal link between a current VA disability and a combat-related event. CRSC will not begin processing claims until the DoD provides program implementation instructions. Potentially eligible retirees can begin to gather the required documentation (VA rating decision, DD214, medical records) needed to submit their claim. Required documentation includes a signed claim form and:

1. Copy of Chapter 61 Board results (Chapter 61 claimants only).

2. Copies of ALL VA rating decisions which include the letter and the narrative summaries

3. Copies of ALL DD214′s

4. Medical records that support “HOW” the injury occurred for each claimed disability that meets the criteria for combat-related. Refer to CRSC website to learn what combat-related is.

The CRSC website www.crsc.army.mil will be kept updated with program guidance and claim information. For questions and further guidance send email to crsc.info@us.army.mil or contact the CRSC call center at 1(866) 281-3254. [Source: U.S. Army Wounded Warrior Program Northeast Team Ayandria Barry input 5 Feb 08 ++]

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Veterans Administration Enrollment Fee Update 15 February 2008

Posted by Service Officer on 15th February 2008

VA ENROLLMENT FEE UPDATE 01: The President’s proposed 2009 VA budget, once again, calls for an annual enrollment fee for veterans in priority 7 and 8 and an increase in the pharmacy co-pays. Fortunately, unlike DoD the VA did not budget the “savings” that adoption of such proposals would bring into to the healthcare budget. Therefore, if the Military Coalition is once again successful at stopping these proposed increases there will not be a hole in the VA’s healthcare budget. The Budget as submitted presently includes the following tiered annual enrollment fees based on veteran’s family income (Priority 7/8):

Family Income Annual Enrollment Fee

Under $50,000 None

$50,000 -$74,999 $250

$75,000 -$99,999 $500

$100,000 and above $750

It also calls for an increase in pharmacy co-payments from $8 to $15 (Priority 7/8). Last year Congress passed historic increases in the VA budget; $3.7 billion additional funding was given to the VA in emergency funding for this year. Hopefully, permanent additional funding can be added to this already increased budget. [Source: TREA Washington Update 8 Feb 08 ++]

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Veterans Emergency Care Fairness Act

Posted by Service Officer on 15th February 2008

When a veteran needs emergency medical treatment, the VA allows that veteran to go to the nearest private or community hospital. Once the veteran is stabilized, the veteran must then be transferred to a VA hospital for any necessary continued care. The problem arises when there is a wait for a bed in a VA hospital. Current law does not require the VA to reimburse the hospital for the care given after the point of stabilization. In rural areas, the problem with the current law is particularly pronounced. Often, a patient may be deemed stable but is not necessarily stable enough to make ambulance trips traveling long distances. More specifically, the Veterans Emergency Care Fairness Act of 2007:

• Requires (under current law, authorizes) the Secretary of Veterans Affairs to reimburse certain veterans without a service-connected disability enrolled as active participants of the Department of Veterans Affairs (VA) health care plan for the cost of emergency treatment received in a non-VA facility until such time as such veterans are transferred to a VA facility.

• Requires (under current law, authorizes) the Secretary to reimburse certain veterans with a service-connected disability or a non-service-connected disability associated with or aggravating a service-connected disability for the value of emergency treatment for which such veterans have made payment from sources other than the VA.

Thus, HR 3819 would simply close that loophole and require the VA to reimburse the private hospital for care. Those interested in seeing this legislation become law should contact their legislator and request his/her support of the bill. A suggested editable letter with automatic transmission means can be found at http://capwiz.com/usdr/issues/alert/?alertid=10912651&queueid=[capwiz:queue_id] to assist in this endeavor. [Source: USDR Action Alert 1 Feb 08 ++]

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Military Health System

Posted by Service Officer on 15th February 2008

On 28 JAN 07, the 2008 Military Health System (MHS) “Caring for America’s Heroes” conference began. The goal of this year’s conference was to illustrate the MHS’ role in global healthcare delivery, while featuring plenary sessions aligned with the MHS strategic plan, goals and objectives.

The event brought together over 3,500 military and civilian health professionals, contractors, and veteran advocates. In his opening remarks, Assistant Secretary of Defense for Health Affairs Dr. S. Ward Casscells called on everyone to share lessons learned to make the care of wounded, injured and ill even better Dr. James B. Peake, Secretary of Veterans Affairs (VA), also addressed the group, promising greater collaboration between the two departments in the months to come.

One of the major issues discussed was the need to make a single seamless pathway for our military from point of illness to, and through the VA system. The electronic personal health record is essential, said Dr. Casscells, to clearing a seamless pathway between DoD and VA as well as a critical element to maintain healthcare costs by tracking the progression and treatment of chronic disease.

For years DoD and VA have been developing individual systems that were not interchangeable. More recently, the two departments have undertaken a series of initiatives that will allow data to move rapidly between the two agencies.

Another item receiving heavy emphasis during the conference was accession and retention of health care professionals. The need for physicians, clinicians and nurses has been a continuing concern for the military services. Health care leaders pledged to take a serious look at this area and hope to increase incentives for these critical healthcare providers. Unlike previous years, the issue of retiree health care and the possibility of Tricare fee increases were not on the agenda. [Source: NAUS weekly Update 1 Feb 07 ++]

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PROSTATE PROBLEMS UPDATE 04 February 2008

Posted by Service Officer on 15th February 2008

Whether or not to treat prostate cancer is one of the biggest medical dilemmas today. The disease is the most common cancer in American men — about 220,000 cases will be diagnosed this year — but most tumors grow so slowly they never threaten lives. There is no sure way to tell which tumors will. Older men with early stage prostate cancer are not taking a big risk if they keep an eye on the disease instead of treating it right away, suggests the largest study to look at this issue since PSA tests became popular. Only 10% of the 9,000 men in the study who chose to delay or skip treatment had died of prostate cancer a decade later. The vast majority were alive without significantly worsening symptoms or had died of other causes. Even the 30% who eventually sought treatment were able to delay it for an average of 11 years. Chief medical officer of the American Cancer Society Dr. Otis Brawley said, “It is important news. It may persuade some middle-of-the-roaders that we are over treating this disease,” and that PSA testing may be amplifying the problem, he said. The PSA blood test to help detect tumors has been widely used since the 1990s.

PSA tests can help find tumors many years before they cause symptoms, but routine screening of men at average risk of the disease is not recommended, because there is no proof it saves lives. Prostate cancer treatments are tough, especially on older men. Many men are left with sexual or bladder control problems. Some doctors instead recommend “watchful waiting” to monitor signs of the disease and treat only if they worsen, but smaller studies have given conflicting views of the safety of that approach. The new study looked at the natural course of the disease in men who chose that option. It is the first involving so many older men — half were over 75 — and so many whose tumors were found through PSA tests. Using the federal government’s cancer database, researchers studied 9,018 men diagnosed from 1992-2002 with early-stage prostate cancer who did not get surgery, radiation or hormone therapy for at least six months. Most never got any treatment at all. A decade later, 3 to 7% of those with low- or moderate-grade tumors — rated by how aggressive the cells appear — had died of prostate cancer, versus 23% of those with high-grade tumors. Overall, prostate cancer killed 10% of them.

Grace Lu-Yao of Robert Wood Johnson Medical School in New Jersey led the study and will report results at a cancer conference in FEB in San Francisco. “The great majority of patients … are going to die of something else,” so most older men with early-stage tumors could delay treatment, Lu-Yao said. “If people are younger or have more advanced disease, I wouldn’t say this is a safe option,” but most cases are diagnosed in men 68 or older, and most are early stage, she noted. Dr. Howard Sandler, a radiation and prostate specialist at the University of Michigan, cautioned, “there are exceptions to every rule,” and some very active, healthy older men may do better having treatment right away, along with older men who have higher-grade tumors. Earlier this month, a scientific review published in the Annals of Internal Medicine concluded that evidence was too thin to recommend treatment over watchful waiting, or one treatment over another. Studies do show that prostate cancer surgery mostly helps men under 65, said Dr. Timothy Wilt of the Minneapolis VA Center for Chronic Disease Outcomes Research, who led the review. The new study shows that for men older than that, “observation is a very reasonable approach,” he said. “Many men do quite well for a long period of time with no treatment.” Although routine PSA testing is not recommended for all men, the cancer society does advise giving men information and the option to have it starting at age 50. Screening is recommended starting at age 45 for men with a family history of prostate cancer and for black men, because of their higher risk of the disease. [Source: Associated Press article 13 Feb 08 ++]

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