Legislative Newsletter Update 23 November 2009 


Legislative News is AUSA Government Affairs Directorate's 
weekly electronic newsletter, and is published 
every Monday when Congress is in session. 


In this issue:

  • Call to Action!!!
  • Senate Approves Legislation to Improve Treatments
    of Troops, Military Families
  • Department of Defense, Senate Committee Open
    Investigation into Fort Hood Killings   



Your letters to the House of Representatives worked!  The House passed legislation that would permanently reform the broken Medicare physician payment system.  The "Medicare Physician Payment Reform Act" (H.R. 3961) passed by a vote of 243-183.  The bill repeals a 21 percent fee reduction scheduled for January 2010, and replaces the physician payment formula with a more stable system that ends the unrealistic cycle of threats of ever-larger fee cuts followed by short-term patches.  The bill also includes statutory PAYGO legislation.

"Congress has an obligation to make sure seniors, people with disabilities and our men and women in uniform continue to have access to the care they need, and doctors are fairly compensated for their important work,” said Ways and Means Committee Chairman Charles B. Rangel, D-N.Y.  “Today’s bill strengthens Medicare and helps in our overall effort to reform our health care system and improve the reliability and quality of care for millions of patients nationwide."

But wait!!  Now we need to convince the Senate to consider whether to take up the legislation again.  Senators rejected a similar bill (S. 1776) in October, voting down a procedural motion, 47-53.

Majority Leader Harry Reid, D-Nev., promised to bring the physician payment bill back up in the chamber after the Senate finishes work on a health care overhaul; however, that could be sometime in 2010!  The cuts take effect on Jan 1. 

Add your voice to ours by sending your own letter.  Go to www.ausa.org, click on the “Contact Congress" button at the upper right-hand corner of our homepage, enter your zip code and then click on the “Stop the 21 Percent Medicare/TRICARE Cut!” 

Declining participation of providers in Medicare and TRICARE due to low reimbursements is a serious healthcare problem facing Medicare-eligibles and military beneficiaries of all ages.  Finding doctors who accept TRICARE is already an enormous problem for the military community - particularly for Guard and Reserve families, retirees, and survivors who live in areas with a small military population.  Payment cuts will make the situation even worse.  It’s time for the Senate to stop this yearly nonsense once and for all.


Last week, the Senate approved key provisions of an AUSA-supported bipartisan bill that would improve the treatment of service members and veterans suffering with Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injuries (TBI).  These provisions, part of the Honoring Our Nation's Obligations to Returning Warriors Act (HONOR) sponsored by Sens. Kit Bond, R-Mo., Barbara Boxer, D-Calif., and Joseph Lieberman. ID-Conn., were passed as part of the Veterans Health Care Authorization bill.

One of the provisions in the Bond-Boxer-Lieberman legislation that was adopted will give active duty service members access to Vet Centers - the community-based counseling centers veterans use for mental health care services.  Opening the doors to local mental health counseling services will ease the burden among practitioners and active troops caused by over-utilization and two wars overseas.

Also, Vet Centers will be authorized to counsel former service members on their rights to present their medical records for review.  The Senators stressed that this authorization is critical to service members who may have been improperly diagnosed with a personality disorder and subsequently discharged.  According to Pentagon reports, some service members who suffered combat-related psychological injuries such as PTSD or closed head injuries such as TBIs were inappropriately and inconsistently discharged. 

Other provisions in the bill include:

• Extension of survivor benefits to families of military personnel who commit suicide and have service-related mental health conditions, including PTSD and TBI;

• Establishment of a scholarship for service members who have served in a combat zone to seek professional degrees in behavioral sciences to provide assistance to active and former service members afflicted with psychological mental health conditions connected with traumatic events during combat;

• Creation of a program to employ and train combat veterans as psychiatric technicians and nurses to provide counseling for active duty service members in immediate need of treatment;

• Establishment of an annual joint review and report on the effectiveness of re-integration programs from the Department of Veterans Affairs and the Department of Defense.

Additional original co-sponsors of the bill include Sens. Sam Brownback, R-Kan., Susan Collins, R-Maine, Chuck Grassley, R-Iowa, Claire McCaskill, D-Mo., Jeff Merkley, D-Ore., Barbara Mikulski, D-Md., Lisa Murkowski, R-Alaska, Chuck Schumer, D-N.Y., Arlen Specter, D-Pa., and Mark Udall, D-Colo. 


Defense Secretary Robert Gates announced that former Army secretary, Togo West, and former chief of naval operations, Adm. Vernon Clark, USN, Ret., will a co-chair a broad Pentagon review of the circumstances surrounding the Fort Hood shootings and report back its findings in 45 days.
Gates said, “As part of this review, each service will appoint a senior officer to work” with the two.  Adding, “The Army will conduct a more in-depth detailed assessment whether Army programs, policies and procedures reasonably could have prevented the Nov. 5 shootings.”  That assessment will be included in the longer-range DoD review that is expected to take up to six months to complete.

The Defense Department announcement was the latest step in clarifying the circumstances surrounding the shootings at Fort Hood that left 12 soldiers and one civilian dead and dozens wounded.   Maj. Nidal Hasan, an Army psychiatrist, has been with charged with 13 counts of murder in the wake of the attack.  He is recovering from wounds at Brooke Army Medical Center in San Antonio.

Gates said West and Clark will also assess personnel reliability programs, medical screenings, release and discharge policies and procedures.  They also will “examine the sufficiency of both the department’s domestic physical security program [and] its emergency response capabilities for mass casualty events at our facilities.”

Gates said that the initial review is “almost entirely separated from the criminal investigation” because it is concentrated on security concerns and responding to mass casualty events.

Also probing the killings is the Homeland Security and Governmental Affairs Committee who opened their investigation with testimony from witnesses expert in the military, Islamist extremism and self-radicalization, and federal intelligence collection and information sharing.

"We will look at the Fort Hood murders not as an isolated event, but as part of a larger pattern of homegrown terrorism that has emerged over the past several years," said Committee Chairman Joseph Lieberman, ID-Conn.  "Our purpose is to determine whether that attack could have been prevented, whether the federal agencies and employees involved missed signals or failed to connect the dots in a way that enabled Hasan to carry out his deadly plan.  If we find such errors or negligence we will make recommendations to guarantee, as best we can, that they never occur again."

After acknowledging the intelligence information-sharing improvements made in the wake of 9/11, Susan Collins, R-Maine, the ranking member said, "The shootings at Fort Hood may indicate that communication failures and poor judgment calls can defeat systems intended to ensure that vital information is shared to protect our country and its citizens.  The case also raises questions about whether or not restrictive rules have a chilling effect on the legitimate dissemination of information, making it too difficult to connect the dots that would have allowed a clear picture of the threat to emerge.

Since 2006, the Committee has held 10 hearings and issued a report on the phenomenon of violent Islamist extremism and self radicalization in the U.S., and the role the internet plays in both.