Legislative News Update 19 April 2010 


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


In this issue:

  • 21% Medicare/TRICARE Physician Cut Averted Again - Temporarily
  • TRICARE Affirmation Act Headed to President for Signature
  • VA Secretary Committed to Improving Claims Backlog


Just as the clock wound down, Congress passed legislation that postpones a 21 percent cut in Medicare/TRICARE payments to physicians until June 1.  Although the cut went into effect on April 1, the Centers for Medicare and Medical Services held all Medicare reimbursements claims for 10 business days, making April 15 the absolute deadline.

The Senate approved the bill by a 59-38 vote.  However, because the Senate's target date of June 1 is a month longer than the House-passed extension, the House had to scramble and rush through another vote. President Obama signed the legislation into law hours later.   

The extension only delays this mess for a while longer.  At the very minimum, lawmakers must find a way to push back the cuts until the end of the year.  Then they will face an even larger cut of 25 percent in January 2011. 

Officials estimate it would cost $240 billion to pay for a permanent fix.  Many legislators insist the cost should be offset with spending cuts in other programs; however, finding $240 billion in cuts would be no easy task.  Despite the challenge, House and Senate leaders must resolve this problem once and for all to preserve access to care for America's seniors and military families covered by TRICARE. 

Please add your voice to ours.  Go to the AUSA website, www.ausa.org, click on “Contact Congress”, type in your zip code beside “Elected Officials”, and scroll down to “Repeal the Medicare/TRICARE Physician Payment Formula”.


Legislation that secures full protection of military health care for service members, veterans and their families unanimously passed the Senate last week. 

The TRICARE Affirmation Act, introduced by Sen. Jim Webb, D-Va., explicitly states in law that TRICARE and other DOD health plans meet the minimum essential coverage standard required by the recently enacted health care reform law.

“Following months of confusion surrounding military health care programs, we can now definitively tell our service members and their families today that their health care is secure,” said Sen. Webb, who serves as chairman of the Senate Armed Services Personnel Subcommittee. 

Sen. Webb’s legislation mirrors legislation introduced in March by House Armed Services Committee Chairman Ike Skelton, D-Mo., which passed by a vote of 403 to 0.  The bill is now headed to President Obama to be signed into law.


The Secretary of Veterans’ Affairs told a key Senate subcommittee that “If there is frustration to go around [about the backlog of claims], I share it.” 

Testifying last week before the Senate Appropriations Military Construction subcommittee, Gen. Eric Shinseki, USA, Ret., said he is committed to “breaking the back of the backlog” in processing disability claims.

He said that while the VA processed more than 977,000 claims last year, another 1 million were filed.  The VA’s goal is to have a claim adjudicated in 120 days.  It is now running about 160 days.
Shinseki said that an additional 4,000 adjudicators will be added to the 11,400 already in place to reduce the backlog but the real answer to cutting the claims backlog lies in yet unfielded automation technology.

Shinseki’s testimony also addressed the increasing problem of veteran homelessness.  He provided a grim statistic in his written testimony:  “On any given night, there are about 107,000 Veterans who live on the streets, representing every war and generation, including those who served in Iraq and Afghanistan.” 

He said the VA will increase the number and variety of housing options available to homeless Veterans and those at risk of homelessness with permanent, transitional, contracted, community-operated, HUD-VASH provided, and VA-operated housing.

In addition to working with the Department of Defense in delivering health care to veterans, he said the VA is looking to expand its cooperative efforts with the Indian Health Service and the federal bureau of prisons.  He added the department is also looking at opening additional community outreach clinics in rural and very rural areas.

Shinseki said he was very concerned about increased suicide rates among veterans.  He told the panel that the VA’s suicide hot line, manned by mental health professional, has successfully intervened in 3,000 attempts since its establishment.  In additional each VA facility has a suicide prevention team on staff.

He said the 2011 budget continues the Department’s focus on improving the quality, access, and value of mental health care provided to Veterans.  The VA’s fiscal 2011 budget provides over $5.2 billion for mental health, an increase of $410 million, or 8.5 percent, over the 2010 enacted level.  
The VA will expand inpatient, residential, and outpatient mental health programs with an emphasis on integrating mental health services with primary and specialty care.

Shinseki said that more than one-fifth of the Veterans seen last year had a mental health diagnosis.  In order to address this challenge, VA has significantly invested in their mental health workforce, hiring more than 6,000 new workers since 2005.

Shinseki told the committee that the VA is committed to working with the Army in building a new joint regional health care facility at Fort Bliss, Texas, but that it does not have the money to start the project in fiscal 2011.

He said that the Army has its share of the money obtained through a combination of stimulus package funds, a supplemental appropriation for fiscal 2010 and in the base budget request for fiscal 2011, but “we don’t have the resources to do it” in fiscal 2011.

The VA plans call for a start the following year.  “I am hesitant to put up $20 million” for design in this fiscal year without the money in the fiscal 2011 request, Shinseki said.