• 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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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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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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• 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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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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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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