washington scene
VA disability compensation and survivor benefits: These programs are treated like entitlements but, in fact, are subject to annual appropriations. According to a 2008 Congressional Research Service report, during previous shutdowns, “multiple services [for veterans] were curtailed, ranging from health and welfare to finance and travel.”
Medicare and TRICARE For Life: They’re entitlements, but claims could be delayed if staff have to be furloughed.
TRICARE: Money to pay claims could be delayed. Much could depend on whether contractors would continue to deliver services and process claims if the federal government stops paying.
\\ COLA News //
COLA Prediction The Consumer Price Index (CPI) ticked up slightly in August to 1.5-percent above the 2013 baseline. The 2014 COLA will be based on the CPI average from July through September. With one month remaining, MOAA predicts a 2014 COLA between 1.3 and 1.7 percent. Follow the trends at
www.moaa.org/colawatch.
TRICARE/ VA Care Coordination
Changes have been made for non-service-connected care.
Effective Oct. 1, some military retirees in the TRICARE For Life (TFL) program who also are enrolled in the VA health care system might be asked to pay higher copayments for their non-service-connected care at VA facilities.
By law, VA hospitals and clinics can’t bill Medicare for the care of veterans. Consequently, veterans who are Medicare-eligible and pay Part B premiums, including military retirees in TFL, can be billed by TRICARE for higher copayments for non-service-connected care from the VA.
The announcement has caused considerable confusion about billing for non-service-connected care in VA facilities. Here’s what has not changed:
■ Veterans with 50 percent or higher service-connected disabilities get care at no cost at all times, and
■ Care for service-connected conditions for all enrolled veterans is free. TFL enrollees who schedule care in a VA clinic or hospital for a non-service-connected condition could be billed 80 percent of the cost of care under existing rules because Medicare can’t be “first payer” in VA facilities.
The VA says it has not changed any policy or procedure. TFL enrollees are encouraged to discuss their options with a VA patient coordinator when they schedule care.
Medicare Spending Slows
Is there a reason for optimism?
A recent Congressional Budget Office (CBO) report revealed a surprising finding: the growth of Medicare spending is slowing. Pinpointing the exact reasons for this growth is unclear, however, it’s likely the result of both provider and beneficiary behaviors.
Predictably, some on Capitol Hill attribute this good news to health care reform, while others point to the economic downturn as a reason for the slowed growth.
The report points out the complexity of reasons but does affirm the change in how care is delivered is a significant factor. For instance, there are now fewer higher-cost inpatient hospital admissions and a greater shift to outpatient settings, particularly for surgical services.
This trend is welcome news, but could it have an impact on recent attempts to finally fix Medicare’s flawed sustainable growth rate, commonly known as the “doc fix”?
Unfortunately, it most likely won’t. The reimbursement rate for Medicare and TRICARE providers is based, in large part, on the annual changes in economic growth as measured by the gross domestic product (GDP). Physician spending exceeding the growth in GDP in any given year results in an automatic, proportional cut in physician reimbursement the following year. For 2014, the formula calls for about a 25-percent cut.
38 MILITARY OFFICER NOVEMBER 2013
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