VA Expansion Comes a Year Early to Help Combat Vets
The Department of Veterans Affairs (VA) announced recently that its program to open Vet Centers, which provide readjustment counseling and outreach services to returning combat veterans, is well ahead of schedule. In February 2007, VA announced it would open 23 new centers during the next two years. Fifteen of those centers are already operational, and five others are seeing patients in temporary facilities while finalizing their leases. The other three facilities will begin operations later this year.
The community-based Vet Centers are a key component of VA’s mental health program, providing veterans with mental health screening and post-traumatic stress disorder (PTSD) counseling, along with help for family members dealing with bereavement and loved ones with PTSD. Vet Centers provide counseling on employment, plus services on family issues, education and outreach, to combat veterans and their families. Vet Centers are staffed by small teams of professional counselors, outreach specialists and other specialists, many of whom are combat veterans themselves.
[Source: http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1456]
Humana Military Healthcare Services and Shepherd Center Partnership
Humana Military Healthcare Services (HMHS) and the Shepherd Center, an Atlanta-based hospital specializing in the medical care and rehabilitation of people with spinal cord and brain injuries, has announced a partnership with Home Depot co-founder Bernie Marcus. This partnership will assist military Servcemembers wounded during their service in Operation Iraqi Freedom and Operation Enduring Freedom, as well as their families, in obtaining additional care that will aid in their recovery from combat related injuries. The SHARE Initiative, began in January 2008, and will primarily focus on wounded Servicemembers in the Southeast, subsequently expanding to encompass a larger population. For more information, please contact Susan Johnson at the Shepherd Center, 404-352-2020.
[Source: http://www.ausa.org/Webpub/DeptFamilyPrograms.nsf/byid/LLOG-7CNMXV]
Veterans Affairs Grant and Per Diem Program Helps Homeless Vets
VA's Homeless Providers Grant and Per Diem Program is offered annually (as funding permits) by the Department of Veterans Affairs Health Care for Homeless Veterans (HCHV) Programs to fund community agencies providing services to homeless veterans. The purpose is to promote the development and provision of supportive housing and/or supportive services with the goal of helping homeless veterans achieve residential stability, increase their skill levels and/or income, and obtain greater self-determination. More information about the program and application materials are available from http://www1.va.gov/homeless/page.cfm?pg=3.
Transitional Medical Benefits Available for Separating Servicemembers
TRICARE’s Transitional Assistance Management Program (TAMP) provides 180 days of transitional health care benefits to certain Uniformed Services members and their families, if the Servicemember is:
- Involuntarily separating from Active Duty under honorable conditions.
- A National Guard or Reserve member separating from Active Duty after a period of more than 30 consecutive days in support of a contingency operation.
- Separating from Active Duty following involuntary retention (stop-loss) in support of a contingency operation.
- Separating from Active Duty following a voluntary agreement to stay on Active Duty for less than one year in support of a contingency operation.
For those who qualify, the 180-day TAMP period begins upon the Active Duty sponsor's separation.
[Source: http://www.tricare.mil/pressroom/news.aspx?fid=369]
TRICARE Clarifies Shingles Vaccine Benefit
For beneficiaries 60 and older, TRICARE now covers Zostavax, the vaccine designed to prevent shingles. TRICARE officials caution that “covered” doesn’t necessarily mean “free” for TRICARE Standard or TRICARE for Life beneficiaries. Zostavax is covered under the TRICARE medical benefit but is not reimbursable under the pharmacy benefit. Vaccines are not a part of the TRICARE pharmacy benefit because they cannot be self-administered. Beneficiaries must have vaccinations administered in a doctor’s office.
According to TRICARE officials, the physician should supply the Zostavax and include its price on the itemized bill for the office visit and the injection. TRICARE will reimburse a provider for administering the Zostavax vaccine in its office as a part of the TRICARE medical benefit. Just as with any TRICARE medical benefit, beneficiaries are responsible for their deductibles and cost shares.
[Source: http://www.tricare.mil/pressroom/news.aspx?fid=371]
Department of Veterans Affairs
News Release
FOR IMMEDIATE RELEASE
February 26, 2008
Five Years of VA Health Care for Combat Veterans
Peake: Honoring Commitment to Newest Combat Veterans
WASHINGTON – Military veterans who served in combat since Nov. 11, 1998, including veterans of Iraq and Afghanistan, are now eligible for five years of free medical care for most conditions from the Department of Veterans Affairs (VA). This measure increases a two-year limit that has been in effect nearly a decade.
“By their service and their sacrifice, America’s newest combat veterans have earned this special eligibility period for VA’s world-class health care,” said Secretary of Veterans Affairs Dr. James B. Peake.
The five-year deadline has no effect upon veterans with medical conditions related to their military service. Veterans may apply at any time after their discharge from the military --even decades later --for medical care for service-connected health problems.
The new provision, part of the National Defense Authorization Act of 2008 signed by President Bush on Jan. 28, 2008, applies to care in a VA hospital, outpatient clinic or nursing home. It also extends VA dental benefits --previously limited to 90 days after discharge for most veterans --to 180 days.
Combat veterans who were discharged between Nov. 11, 1998 and Jan. 16, 2003, and who never took advantage of VA’s health care system, have until Jan. 27, 2011 to qualify for free VA health care.
The five-year window is also open to activated Reservists and members of the National Guard, if they served in a theater of combat operations after Nov. 11, 1998 and were discharged under other than dishonorable conditions.
Veterans who take advantage of this five-year window to receive VA health care can continue to receive care after five years, although they may have to pay copayments for medical problems unrelated to their military service. Copayments range from $8 for a 30-day supply of prescription medicine to $1,024 for the first 90 days of inpatient care each year.
TRICARE Uniform Formulary Update Announced
March 10, 2008
No. 08-16
FALLS CHURCH, Va. – The placement of five additional, non-formulary (or third tier), medications on the TRICARE Uniform Formulary has been announced by Army Maj. Gen. Elder Granger, deputy director, TRICARE Management Activity. Three of the medications change to non-formulary status on April 16, 2008, and two on June 18, 2008. A sixth medication, Flomax, will remain non-formulary (third tier) under the Uniform Formulary, although additional step therapy/prior authorization requirements will begin on April 16, 2008.
No non-formulary (third tier) medications were identified in another reviewed class, the adrenergic beta-blocking agents. The following chart shows the medications and their status as formulary (first-tier generic or second-tier brand name medications) or non-formulary (third tier), along with the date the decision will be implemented.
| Medication | Tier | Implementation Date of
Nonformulary Status |
 |
| Adrenergic Beta-Blocking Agents | | |
| Betapace, Betapace AF (sotalol) | 1 | |
| Blockadren (timolol) | 1 | |
| Coreg (carvedilol) | 1 | |
| Corgard (nadolol) | 1 | |
| Corzide (nadolol / bendroflumethiazide) | 1 | |
| Inderal (propranolol) | 1 | |
| Inderal LA (propranolol extended release) | 1 | |
| Inderide (propranolol / hydrochlorothiazide) | 1 | |
| Kerlone (betaxolol) | 1 | |
| Levatol (penbutolol) | 1 | |
| Lopressor (metoprolol tartrate) | 1 | |
| Lopressor HCT (metoprolol / hydrochlorothiazide) | 1 | |
| Sectral (acebutolol) | 1 | |
| Tenoretic (atenolol/chlorthalidone) | 1 | |
| Tenormin (atenolol) | 1 | |
| Toprol XL (metoprolol succinate) | 1 | |
| Trandate, Normodyne (labetalol) | 1 | |
| Visken (pindolol) | 1 | |
| Zebeta (bisoprolol) | 1 | |
| Ziac (bisoprolol / hydrochlorothiazide) | 1 | |
| Coreg CR | 2 | |
| Alpha Blockers for Benign Prostatic Hypertrophy | | |
| Cardura (doxazosin) | 1 | |
| Hytrin (terazosin) | 1 | |
| Cardura XL | 2 | |
| Uroxatral | 2 | |
| Flomax | 3 | April 16, 2008† |
| Targeted Immunomodulatory Biologics | | |
| Amevive | 2 | |
| Humira | 2 | |
| Raptiva | 2 | |
| Enbrel | 3 | June 18, 2008 |
| Kineret | 3 | June 18, 2008 |
| Drug Classes Previously Reviewed | | |
| Renin Angiotensin Antihypertensive Agent | | |
| Exforge | 3 | April 16, 2008 |
| Attention Deficit Hyperactivity / Narcolepsy Agent | | |
| Vyvanse | 3 | April 16, 2008 |
| Contraceptive | | |
| Lybrel | 3 | April 16, 2008 |
| † Remains non-formulary; step therapy / prior authorization requirements will apply to patients newly starting on Flomax, effective April 16, 2008 | | |
First-tier medications (formulary generics) are available through a TRICARE Retail Pharmacy for $3 co-pays for up to a 30-day supply, and through the TRICARE Mail Order Pharmacy for $3 co-pays for up to a 90-day supply. Beneficiaries may purchase second-tier medications (formulary brand-name) for $9 for up to a 30-day supply through a TRICARE Retail Network Pharmacy, or up to a 90-day supply through the TRICARE Mail Order Pharmacy, with third tier (non-formulary) medications costing $22. If beneficiaries use a TRICARE Retail Non-Network Pharmacy, the cost share for second tier medications (formulary brand name) up to a 30-day supply is the higher of $9 or, 20% and for third tier medications (non-formulary) the higher of $22, or 20%.
Beneficiaries taking third-tier medications may consult their health care providers about changing to a first-or second-tier alternative. When providers prescribe medications, beneficiaries should ask if a generic alternative is in that drug class available that would provide the same clinical results.
Beneficiaries can also ask providers if establishing medical necessity for the third-tier medication is appropriate. If medical necessity is established for a third-tier medication, the co-payment is reduced to $9. Third-tier medications are not available at military treatment facility (MTF) pharmacies unless an MTF provider establishes medical necessity and writes the prescription. Medical necessity forms and criteria are available at www.tricare.mil/pharmacy/medical-nonformulary.cfm.
For a complete list of medications, their formulary status and where they are available, beneficiaries may visit www.tricareformularysearch.org/dod/medicationcenter/default.aspx.
Beneficiaries may find more information on the TRICARE Retail Pharmacy and locations, and the TRICARE Mail Order Pharmacy at www.express-scripts.com/TRICARE. They may also call 866-363-8779 for the retail pharmacy or 866-363-8667 for the mail order pharmacy.
For more information about the Uniform Formulary Beneficiary Advisory Panel review process, visit www.tricare.mil/pharmacy/BAP.