Working retirees win access to TRICARE supplement option. As of June 18, 2010, civilian employers of military retirees once again can offer a TRICARE supplemental plan with their cafeteria-style health insurance options so that workers who elect to use their TRICARE Standard benefit can buy coverage conveniently and with pre-taxed dollars. Employers are still prohibited from offering incentives for employees to leave employer-paid plans and use TRICARE instead.

TRICARE costs to retirees is still on the table. Advisory panels argue Military benefits are unsustainable. “Unless retirees contribute more for their TRICARE insurance, medical costs will not be brought under control and the national defense they served and for which they fought and sacrificed, will be harmed.” “DODs personnel accounts need to be brought under control by modernizing retirement, pay, health benefits and the up-or-out promotion system. The task force is also looking at elimination of 110,000 civilian jobs.” All this means that we can really expect a serious fight next year to protect your earned retirement benefits.

The Department of Defense is launching a push this week to remind service members and veterans who may be eligible for Retroactive Stop Loss Special Pay to submit their claim before the October 21st deadline. For information see: http://www.defense.gov/stoploss.

First wave of tax increases for next year: Expiration of 2001 and 2003 Tax Relief: (Bush tax cuts). The top income tax rate will rise from 35 to 39.6% (2/3rds of small businesses are here). The lowest rate will rise from 10 to 15%. All the rates in between will also rise (25% to 28%, 28% to 31%, & 33% to 36%). The “marriage penalty” will return from the first dollar of income. The child tax credit will be cut in half from $1000 to $500 per child. The dependent care and adoption tax credits will be cut and the death tax will return - 55% tax rate for estates over $1 million.

I recently attended an Army Nurse Corps Reunion in Washington DC. It was fun seeing old friends and seeing the young nurses I worked with as successful leaders. I am bringing this up because on Saturday, we wre treated to a tour which included the super physical therapy unit at Walter Reed Army Medical Center. This unit has “virtual reality” equipment, a fully equipped car donated by the Ford Motor Co. to teach driving, and a machine that can emulate any sport, to assist soldiers with amputated limbs regain balance and reintegrate into society. Of the 1,100 soldiers throught the unit, 147 have been sent back to full duty in the middle east artificial limbs and all.

Sadly, Walter Reed will be gone forever in August 2011. It will be cohabiting with the Navy on the Bethesda Campus. Yet to be determined - will floors be floors or decks, stairs or ladders, walls or bulkheads and so forth. Could be a problem. I will check the scuttlebutt later and let you know.

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As you all know by now, the 21% Medicare cutback has been fixed again until December.

Tax increases are coming next year, count on it. The Bush tax cuts are going away. The Obama care package reads like there would be a tax on health benefits next year. According to the Senate Finance Committee and National MOAA, that is not true. There isn’t any tax on health benefits value before 2018 and then only the “Cadillac” plans will be taxed. “Cadillac” plans are those costing more than $10,200 for an individual or $27,500 for a family. It is true that the new law requires an entry on the W-2 showing the cost of employer-provided care. The purpose of including it on the W-2 is to show employees what the benefit value is (much as the military services provide an annual statement of military benefits value to currently serving personnel). Insurers will be assessed 40% of whatever share of the value exceeds the $27,500 threshold. If the value of a plan is $30,000, the insurer will be taxed 40% of $2,500= $1,000. It’s not the employees, but the insurance companies providing those plans (and employers that self-insure) that could be subject to taxation on part of such value - several years downstream. (I will let you think about who actually pays those taxes.)

HR 4887 - “The TRICARE Affermation Act” passed the House ensuring Medicare, TRICARE, TFL and the VA healthcare systems are going to be deemed acceptable coverage and not taxed. Senator Webb has introduced a companion bill in the Senate that will have similar language to HR 4887.

HR 3787 will accord veteran status to Guard and Reserve retirees who were never called to active federal service during their military careers. Non-federal service such as 911, or Katrina did not count. At age 60, they are entitled to military retired pay, TRICARE and a number of veteran’s benefits, but they were not veterans under the law.

If you are a retiree with a combat-related disability and not receiving CRSC (Combat-Related Special Compensation), check with your parent service. Just over 2 years ago CRSC eligibility was extended to all combat/combat related disabled retirees, regardless of their years of service or VA disability rating percentage.

Special note: There is a difference between a Skilled Nursing Facility (SNF) and a Nursing Home. Medicare/TRICARE pay for one and not the other. Sometimes they are in the same building. According to Medicare: admission to a SNF must follow a minimum 3-day impatient hospital stay for a related illness or injury, and a doctor must certify that you need skilled nursing and rehabilitative services. Medicare fully covers the first 20 days, days 21 through 100 are partially covered. Then come the unlimited days allowed by TFL with the TRICARE catastrophic cap kicking in. As long as the Doctor prescribes “skilled” nursing facilities, the cost to families will be low.

Medicare currently covers Hospice care. Medicare cuts for dialysis and hospice care will begin in 2012 under Obamacare.

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The California MOAA Team had a very successful “Storming The Hill” with National MOAA this month. At the meeting for “Storming The Hill” all states including Puerto Rico were represented. Your California team met with a large number of California Representatives and the two Senators to discuss key issues that National MOAA is working on with Congress. Topics of discussion included: Upgrading Military Pay; Fixing the Reserve Retirement;Eliminating the SBP/Concurrent Receipt;and eliminating the Military Widows Tax (SBP-DIC Offset). We also highly recommended that the Legislators quickly end the threat of a 21% cut in Medicare/Tricare Payments. A majority of Legislators were in agreement with all of the initiatives. We felt positive of our discussions with the California Legislators. Many of the Legislators are aware of the over 40,000 military retirees in California represented by MOAA. Overall, a successful effort by our California Team in conjunction with National MOAA.

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The TRICARE Affirmation Act has passed. TRICARE plans are now considered as minimal acceptable coverage under the new health care law. No further coverage is required.

Medicare is another issue. The Senate passed legislation to delay the 21% cutback in payments to doctors but only until June. Then the process starts all over again. There is a lot of talk about doctors refusing to take Medicare patients because the fees do not cover their expenses. My clinic is just - confused.

The Military Surviving Spouses Equity Act (HR 775) which would repeal the DIC offset to SBP is still stuck in the House Armed Services Committee.

What effects our health care. VADM (Dr.) Harold Koenig writes: “Today we make 17,000 new doctors every year. We have a population of 300 million and we are short of MDs. The average new doctor has over $100,000 in educational debt on graduation.” To add to that, the new doctor has spent almost a decade in school. The new health care bill will regulate his practice, pay him less and take more in taxes (if he makes over $250,000). I am wondering, if a child can make over a million a year as a rock star, actor, or ball player with little or no education, a lot of partying and drug and alcohol use, and no real personal responsibility for what they say and do, why would anyone want to be a doctor. continue reading

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MEDICARE PHYSICIAN PAYMENT CUTS

Dear Mr. Dunn:

Thank you for writing to me regarding the Medicare physician payment cuts. I appreciate hearing from you on this important issue, and I welcome this opportunity to respond.

I believe that doctors should be paid fairly for the services they provide, and that Medicare reimbursements are essential for patient access. As you know, current law requires the Centers for Medicare and Medicaid Services (CMS) to adjust the Medicare Physician Fee Schedule payment rates annually based on an update formula which includes application of the Sustainable Growth Rate, or SGR, that was adopted in the Balanced Budget Act of 1997. continue reading

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CONGRESSWOMAN SUSAN DAVIS RESPONDS

Dear Mr. Dunn,

Thank you for taking the time to share you support for fixing the Sustainable Growth Rate (SGR) for Medicare and TRICARE. I appreciate hearing from you on this crucial issue and apologize for the delay in my response. Each week I receive more than 2,000 letters and emails and cannot always respond as quickly as I would like.

You should know that I’m frustrated with the SGR as well! Doctors shouldn’t have to worry about significant drops to Medicare and TRICARE reimbursement rates. It only takes away from the time they should be spending with their patients.

As you are aware, a cut of 21 percent was scheduled to go into effect on March 1, which is an outrageous amount. After being held up in the Senate, a temporary extension blocked the cut.

I regret that physicians have to worry about Medicare cuts and I will continue advocating for a long-term fix to the SGR.

Once again, thank you for contacting me. As your representative, I both need and value your perspective. Please sign up for my E-Newsletter on my website, www.house.gov/susandavis, if you would like to receive monthly updates about what is happening in Congress.

With warm regards,

SUSAN A. DAVIS

Member of Congress

Source: Ivan Dunn

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SENATOR PROVIDES CONTACT INFORMATION

Dear Mr. Dunn:

Thank you for taking the time to write and share your views with me. Your comments will help me continue to represent you and other Californians to the best of my ability. Be assured that I will keep your views in mind as the Senate considers legislation on this or similar issues.

If you would like additional information about my work in the U.S. Senate, I invite you to visit my website, http://boxer.senate.gov. From this site, you can send a message to me about current events or pending legislation, access my statements and press releases, request copies of legislation and government reports, and receive detailed information about the many services that I am privileged to provide for my constituents. You may also wish to visit http://thomas.loc.gov to track current and past federal legislation.

Again, thank you for sharing your thoughts with me. I appreciate hearing from you.

Barbara Boxer

United States Senator

Source: Ivan Dunn

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POTENTIAL HEALTH CARE CHANGES

Previously, I told you that, while we respect members’ strong opinions on both sides of the national health care reform argument, MOAA would refrain from taking a position on the social and political aspects and devote our limited resources to safeguarding military/VA beneficiaries’ health care benefits, protecting against taxation of those benefits, improving access to providers, and ensuring long-term sustainment of Medicare and TRICARE For Life (TFL).

MOAA members have generated more than 130,000 messages to Congress in support of these goals, and legislators of both parties have responded by including provisions aimed at holding military and VA beneficiaries harmless.

That said, there’s never any guarantee that Congress won’t change something about Medicare, TRICARE, TFL, or VA coverage, and we fully expect such changes could come in the future.

In that context, it’s important not to miss the forest for the trees.

It’s the next round of “adjustments” that poses the greatest concern – the ones that will be required to address the problem of the millions of baby boomers about to become eligible for Medicare, which the current legislation doesn’t address at all. continue reading

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