22 April 2013 Legislative News Update 

4/22/2013 

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




In this issue:

  • AUSA on the Hill
  • Solution to the VA Claims Backlog?
  • Senator's Hear TMC's Message  

★★★
AUSA ON THE HILL

Along with other representatives from various military and veteran service organizations, AUSA Vice President for Education Lt. Gen. Guy Swan attended a roundtable discussion hosted by House Veterans’ Affairs Committee Chairman Jeff Miller, R-Fla.

The discussion covered such topics as access to mental health care providers and the VA’s benefits claims backlog. Specifically, how the claims process has been slowed by the addition of Agent Orange claims and the fact that first-time claims errors added to the process time.

Rep. Paul Ryan, Chairman of the Budget Committee, offered an in-depth explanation of the House budget as it relates to veterans. He noted that the budget includes no cuts for the Department of Veterans’ Affairs.

In fact, the recently-released President’s Budget has proposed a $152.7 billion budget for the VA, a 10.2 percent increase over fiscal 2013. The budget includes $66.5 billion in discretionary spending, largely for healthcare, and $86.1 billion for mandatory programs – mostly disability compensation and pensions for veterans.

Chairman Miller said after the conclusion of the roundtable that, “Today’s event was a great opportunity to have a candid discussion about what our committee has been doing to improve the lives of veterans, our priorities for the 113th Congress as well as those of the VSO community. The input and support of America’s VSOs has been invaluable to our work at the committee over the past two years, and I look forward to strengthening our partnership as we work to ensure our veterans receive the care and benefits they deserve.”

SOLUTION TO THE VA CLAIMS BACKLOG?

Speaking of the VA and the claims backlog, the VA announced that they are implementing an initiative to expedite compensation claims decisions for veterans who have waited one year or longer. Effective April 19, the VA will begin to make provisional decisions on the oldest claims in inventory, which will allow veterans to begin collecting compensation benefits more quickly, if eligible. This initiative provides a one-year safety net to submit further evidence should it become available and protects the veteran’s right to appeal the decision.

--For the oldest claims, VA will make a provisional rating based on all current evidence associated with the claim.

* When benefits are awarded in the provisional decision, the veteran will begin receiving compensation immediately.

* These will be decisions based on all evidence VA has received to date and during the time the claim has been pending.

* Provisional rating notices will note the evidence on which the decision was based and list any documentation that has not been provided or VA has been unable to obtain.

* Exams will be provided by VHA in an expedited manner if they are required for a rating

--The veteran has a safety net – up to one year to submit additional evidence or request VA obtain additional evidence to change the provisional decision.

* Any awarded benefits will be retroactive to the original date the claim was submitted.

* If no additional evidence is obtained, the provisional decision will become final after one year (or earlier if the veteran requests), at which time a final decision and appeal rights will go into effect.

* These veterans then will have the standard year to appeal the decision, effectively extending the current appeal window, while also providing them with near-term decisions and benefits, if eligible, based on the evidence in the claims file.

* As a result of this initiative, metrics used to track benefits claims will experience significant fluctuations. Average Days to Complete (ADC) – the average amount of time it takes VA to process a claim – will rise significantly in the near term as the oldest claims are completed.

* Average Days Pending (ADP) – the average age of a claim in the inventory – will decrease since the oldest claims will no longer be part of the inventory.

--The most vulnerable veterans will continue to be fast tracked.

* Wounded, ill and injured veterans from the wars in Iraq & Afghanistan will continue to have priority through the Integrated Disability Evaluation System.

* VA will continue to prioritize veterans who are homeless, terminally ill, former Prisoners of War, and Medal of Honor recipients, those facing financial hardship and our most seriously injured.

* Fully Developed Claims will continue to receive priority processing

Veterans can learn more about disability benefits on the joint Department of Defense—VA web portal eBenefits at www.ebenefits.va.gov.

SENATORS HEAR THE MILITARY COALITION’S MESSAGE

Members of the Senate Armed Services Personnel Subcommittee heard directly from representatives of The Military Coalition (TMC) on why the Defense Department’s latest proposal to increase/enact fees for military retiree health care is just plain wrong. AUSA is a member of the TMC.
 
This is the TMC message that was presented to the lawmakers:
 
For decades, critics have claimed military personnel costs are “rising out of control” and, if left unchecked, would consume future defense budgets. But those charges have proved unfounded.
 
* Defense spending as a percentage of GDP during wartime is much lower than during past conflicts
 
* Personnel and healthcare costs today are the same share of the defense budget today (less than one-third) that they’ve been for more than 30 years
 
* Personnel/health costs are a lower share of the budget for DoD than for many most-similar corporations (61% for UPS, 43% for FedEx, and 31+% for Southwest Airlines)
 
* At 10% of the defense budget, DoD healthcare costs are a bargain compared to the health cost share of the federal budget (23%), the average state budget (22%), household discretionary spending (16%) and GDP (16%)
 
* Far from “exploding out of control,” Pentagon documents show military healthcare account surpluses have been raided to fund other programs ($708 million diverted in FY12 and total of nearly $2.5 billion over last three years)
 
* Reprogramming document acknowledged retiree health costs went down 2.5% for FY12
 
* DoD projections of future defense health care costs have declined steadily for the last three years, and will decline further based on recent law/policy changes
 
* Claims of “cost growth since 2001” overemphasize 10-year-old data. Growth peaked in 2002-03 with the enactment of TRICARE For Life, and has been declining fairly steadily ever since. It was less than 1% for FY12, and will decline further in the future based on administrative and statutory changes taking effect in FY13
 
* Rather than seeking to raise beneficiary costs, defense leaders should be held accountable for improving efficiency and consolidating redundant, counterproductive health systems. Options to reduce costs include:
 
o Establish a single authority over the three separate military systems and multiple contractors that now compete counterproductively for budget share
 
o Stop ignoring multiple studies urging consolidation of healthcare budget and delivery
 
o Revamp an archaic healthcare contracting system that doesn’t obtain the best value
 
o Restructure accounting and record systems that cannot be validated
 
o Optimize use of military treatment facilities (25% cheaper but 27% underused)
 
o Eliminate pre-authorization requirement that incentivizes emergency room visits over far-less-costly urgent care clinics
 
o Establish coordinated care programs for all beneficiaries with chronic conditions
 
* Decades of dire predictions about “unaffordable” personnel costs have proved consistently wrong
 
* The only times the all-volunteer force has been jeopardized have been due to budget-driven benefit cuts failed to offset the extraordinary demands and sacrifices of a service career
 
* Congress has consistently recognized the cost of sustaining the current military career incentive package is far more acceptable and affordable than the alternative
 
THE BOTTOM LINE: TMC does not support the additional array of proposed TRICARE fee increases proposed in the FY2014 defense budget. In view of fee increases and statutory and policy benefit limitations already imposed in 2011 and 2012, TMC believes it is time to hold Defense officials accountable to implement efficiencies that don’t affect fees or care.