Military Health Care Update July 2010 

7/1/2010 

BILL TO REVERSE THE MEDICARE CUT PASSES HOUSE. 

A bill that reverses a 21 percent cut in Medicare payments to physicians passed the House and was signed into law by President Obama. 

Although House Speaker Nancy Pelosi previously said that the legislation was “inadequate” and "dead on arrival", she later said she decided to clear the Medicare bill now because the Senate remains deadlocked on the broader bill, which would extend unemployment benefits and other expired programs and tax breaks.

 The bill, passed by the Senate on June 18, reverses a 21 percent cut in Medicare payment rates for doctors through Nov. 30 and gives doctors a 2.2 percent increase in payments.  A previous short-term measure to prevent the payment cut expired June 1, with the Centers for Medicare and Medicaid Services holding off on processing Medicare claims at the lower rates until June 18.  The agency said it would swiftly process retroactive payment claims.  The measure’s $6.4 billion cost is fully offset.

AUSA President Gen. Gordon R. Sullivan, USA, Ret., applauded the House’s action to reverse the cut.  He had contacted congressional leaders urging the action while noting that the cut also affected physicians in the TRICARE program.  “The cut, if it stood, put into question how many physicians would continue in the Defense Department’s health care provider system.”

Now AUSA and its partners in the Military Coalition will press Congress to find a permanent solution to this problem.  Thanks to all of you who took the time to contact Congress on this important matter.

 BEHAVIORAL COUNSELING OPTIONS FOR COUPLES

Are you aware that marital, couples and family therapy is available to eligible married couples enrolled in TRICARE Prime, TRICARE Prime Remote and TRICARE Prime Overseas?

“Military life can often cause stress for couples and families,” said Rear Adm. Christine Hunter, deputy director of the TRICARE Management Activity. “Long deployments, worries about job-related danger, and frequent moves can take their toll. For these reasons, TRICARE considers marital therapy an essential part of behavioral health care.” 
  
Marital therapy or counseling can be covered by TRICARE Prime when it’s based on a behavioral health diagnostic evaluation by a TRICARE provider. TRICARE Prime-enrolled spouses of active duty service members can seek marital therapy or counseling in the U.S. or overseas as part of the first eight outpatient behavioral health care visits allowed per fiscal year. This can be done without a referral from a primary care manager or prior authorization from their regional health care contractor. Active duty service members need a referral for all behavioral health care received in the TRICARE network.

Professionals in the TRICARE network authorized to provide marital therapy include psychiatrists, psychologists, certified psychiatric nurse specialists, clinical social workers and certified marriage and family therapists. TRICARE-authorized pastoral and mental health counselors can provide therapy or counseling services under a physician’s supervision.

After the first eight visits, non-active duty beneficiaries must get authorization from their regional health care contractor to continue treatment. To reduce their out-of-pocket expenses, beneficiaries are encouraged to use a TRICARE network provider.

Active duty family members enrolled in TRICARE Prime or TRICARE Prime Remote can call their regional Behavioral Health Care Provider Locator and Appointment Assistance Line for help locating and making appointments with network behavioral health care providers in their area. The toll-free numbers are: North Region, 1-877-747-9579; South Region, 1-877-298-3514; and in the West Region, 1-866-651- 4970. Hours vary according to region. TRICARE Prime Overseas beneficiaries can get information about host nation providers from their local military treatment facility or TRICARE Service Center. The nearest TRICARE Service Center can be found at www.tricare.mil/overseasTSC.

To view TRICARE’s behavioral health options visit their Mental Health Resource Center at www.tricare.mil/mentalhealth