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■ dramatically raising TRICARE fees for beneficiaries under age 65;
■ barring working-age retirees and families from using TRICARE Prime;
■ eliminating concurrent receipt of VA disability compensation and military retired pay;
■ changing the COLA formula for military and federal civilian retired pay and VA compensation; and
■ replacing military personnel with civilians in certain positions.
Many of these proposals have been rejected by Congress before. Others are new — most notably the proposal to end concurrent receipt of VA disability compensation and military retired pay for disabled military retirees.
In this political and budget environment, legislators pressed to come up with a budget package quickly might be disposed simply to grab some off-the-shelf options and worry about consequences later. That means we could see some of these proposals surface in the next few months. The proposals to cut COLAs and raise TRICARE fees are ones to keep a close eye on.
COLA News
COLA in the Hole The Consumer Price Index dropped in the first month of the new fiscal year. How far down did it go? Follow the trends for yourself at
www.moaa.org/cola.
Medicare/ TRICARE Fix?
Permanent solution gains momentum.
The House Ways and Means and Senate Finance committees are working together on bipartisan legislation that aims to finally repeal and replace the flawed Medicare/TRICARE physician reimbursement rate.
Current law calls for nearly a 25-percent cut in Medicare/TRICARE reimbursement rates to doctors Jan. 1. Allowing such a large cut to take place would devastate access to care for beneficiaries.
For years, Congress has passed patchwork legislation to block these cuts. The annual cycle of uncertainty wreaks havoc on physicians participating in Medicare and TRICARE and threatens access to care for millions of beneficiaries.
The proposed fix would repeal the Sustainable Growth Rate that drives the annual cuts, replace it with a 10-year freeze of physician reimbursement rates at current levels, and seek to boost efficiency in the health care system by giving physicians incentives to use alternative payment models that focus more on value than on volume.
Starting in 2024, doctors participating in fee-for-service plans would see a 1-percent annual adjustment, and those using more efficient alternative payment methods would see a 2-percent increase.
The plan also would offer payments for care coordination, value-based reporting systems, and meaningful use of electronic health records. Under the proposal, doctors would be held to accountability standards for quality and resource utilization.
The total cost of the legislation is roughly $139 billion. Although it’s far less expensive than previous proposals, the challenge for Congress is coming up with the offsets to pay for it and convincing physicians to agree to a 10-year pay freeze.
Who Moved the Goalpost?
New Pentagon math does not check out.
Secretary of Defense Chuck Hagel outlined six budget priorities that will shape the Pentagon’s FY 2015 budget proposal, which includes protecting investments while seeking “significant savings” in the areas of personnel and compensation.
36 MILITARY OFFICER JANUARY 2014
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