Medicare reimbursement rates 2013 update: A one-year “doc fix” has gotten nearly $7 billion more expensive, according to new estimates from the Congressional Budget Office, obtained by The Hill. Doctors are scheduled to see a 26.5 percent drop in their Medicare payments at the end of the year unless Congress steps in to delay the cut, as it does every year. Delaying the cut and freezing doctors’ payments for one year would cost $25 billion, according to CBO’s latest estimates - up from $18.5 billion in its last projection. Because the “doc fix” is now wrapped up with the end-of-year “fiscal cliff,” there’s a chance Congress might stop short of fixing it for a full year, postponing the Medicare cut - along with other parts of the fiscal cliff, the $600 billion of tax increases and spending cuts set to hit in January - until March, and trying to work out a longer solution then. House Republican doctors are pushing for a full year, and say they’re confident they’ll get one. A two-year doc fix would cost $41.5 billion, CBO said, while freezing doctors’ payments for 10 years would cost nearly $244 billion. [Source: The Hill Healthwatch | Sam Baker | 20 Nov 2012] Editor Note: If congress should allow the 26.5 percent cut required by current law to occur, it is anticipated the number of civilian physicians willing to accept lower fees for Medicare patient care and by extension Tricare patient care will be drastically reduced.

Medicare premiums 2013: Medicare officials have announced the new Part B premium rates for 2013 - and they were slightly lower across the board than what many had predicted. The basic monthly premium for Part B will jump 5 percent in 2013. The increase - which previously had been projected at 9 percent translates to a $5 monthly increase for single Medicare-eligible with incomes below $85,000 ($170,000 for married couples). For those with higher incomes, the monthly Part B increase will range from $7 to $16. By law, the premium must cover 25 percent of Medicare’s expenses for the basic category, and cover 35-80 percent of expenses for higher-income groups.

Military compensation update: The Congressional Budget Office has released a report on military compensation that puts a red laser dot on near-term pay raises, beneficiary health care fees and retirement of future forces as potential cost-saving targets Congress might want to consider in any debt-reduction deal. Thanks in part to what CBO says were pay raises that exceeded private-sector wage growth through much of the last decade, the report estimates that military cash compensation increased by 52 percent from 2002 to 2010 while private sector wages rose by only 24 percent. In 2012, a married E-4 (Army corporal) with four to six years of service will receive “regular military compensation,” or RMC, valued at $50,860. RMC is the “salary” yardstick for the military. It combines basic pay (in this case, $27,200 for that E-4) with subsistence allowance ($4,180), average Basic Allowance for Housing for the pay grade across U.S. housing areas ($14,820) and an estimated value for the tax advantages on tax-free allowances ($4,660). An officer example is given too. RMC for a married O-3 (Army captain) with six years of service is $92,220 this year. In addition, CBO notes that some members receive enlistment or re-enlistment bonuses, special or incentive pays for unique skills and pay for serving in dangerous or difficult assignments, including combat areas, which can mean tax breaks on part or all of their basic pay too.

CBO discusses RMC after advising that $150 billion, or more than one quarter of the Defense Department’s “base” budget (which excludes the cost of current operations in Iraq and Afghanistan) will be spent this year on military pay and benefits for current forces and retirees. It goes on to propose ways to curtail compensation costs.

One approach to cut costs is to “restrict basic pay raises” as Defense officials proposed last April, CBO says. The Department of Defense proposed a raise of 1.7 percent this January and in 2014. Even deeper pay caps are proposed for the next three years. The administration’s 2015 raise would be only 0.5 percent, followed by 1 percent in 2016 and 1.5 percent in 2017. Pay caps could hurt recruiting and retention, CBO concedes, but that can be mitigated with more and bigger enlistment and re-enlistment bonuses.

Another way to slow compensation growth, it says, is to raise Tricare enrollment fees, deductibles or co-payments, actions also proposed by the administration last April. For working-age retirees, those under 65, fee hikes should be phased over five years and use a “tiered approach” so that senior-grade retirees would pay higher fees than lower-ranking retirees.

CBO says restricting Prime access to retirees under 65 and their family members would save as much as $10 billion a year. Congress so far has rejected it too, along with calls to raise Tricare fees or to change military retirement for future recruits. The CBO report reviews options for changing retirement. It notes that a less generous plan, if only for new entrants, still would save on the DoD “accrual” costs, the funding required every year to cover obligations to future generations of retirees. Like most Americans, military people are confused and frustrated by the failure of Congress to reach a debt-reduction deal. The CBO report reminds the military community that how the deal gets made could be as consequential to their families as that fearsome drive off the “fiscal cliff.” [Source: The Lawton Constitution | Tom Philpott | 18 Nov 2012]

VA FDC Program update: Veterans Affairs has taken heat for some time now as it struggles with the expeditious and timely processing of claims for disability and pension for the veterans it serves. There are numerous reasons for this delay and seemingly endless processing time:

• New GI Bill. Congress and the administration decided in 2008 to improve the GI Bill benefits that provide funding for veterans’ education. Congress mandated an August 2008 start, even though the programs to administer this process had not yet been fully developed. The old Montgomery GI Bill was usually paying the veterans one similar payment nationwide. The new 9/11 GI Bill created a different pay structure for every veteran eligible for this benefit and added a tuition payment and book stipend. This took a monumental effort on the part of the VA to get these payments flowing. While there are still delays, the overall situation is much improved and the 9/11 GI Bill is a wonderful and very generous benefit compared to the older Montgomery GI Bill.

• ALS. Just as the VA was coming out of this crisis, the rules were changed for presumptive conditions for all veterans who have ALS. Any veteran who has served 90 days or more of active duty and is diagnosed with ALS is automatically service-connected for this condition, usually at the 100 percent rate. The VA in 2010 added leukemia type B, Parkinson’s disease and ischemic heart disease to the list of presumptive conditions for veterans who served with boots on the ground in Vietnam, and some very limited parts of Thailand and Korea. The floodgates were then opened to all veterans exposed to agent orange who had these conditions. There were many hundreds of thousands of claims filed almost immediately. The VA also had to go back and re-adjudicate the claims for these conditions that had been denied in the past, including settling claims for the widows and widowers of veterans who had died of these conditions since the 1970s.

• PTSD. On top of that, the VA liberalized the proof requirements for PTSD claims. The burden of proof went from having to prove explicit stressful combat incidents to just serving in a combat theater and having the VA diagnose the veteran with PTSD that was connected to the service in that combat theater.

One of the ways that the VA is making this happen is using a technique called Fully Developed Claim (FDC). This new and innovative program is designed to provide swift and expeditious settlement of eligible “fully developed” compensation or pension claims.

To participate, the FDC program requires that a veteran complete and submit a FDC Certification and either a VA Form 21-526EZ, FDC (Compensation) for a compensation claim, or a VA Form 21-527EZ, FDC (Pension) for a pension claim. The veteran must also submit, with the application and certification, all relevant and pertinent evidence to “fully develop” the claim. [Source: Daily Republic | Ted Puntello | 19 Nov 2012]

Flags: The American Legion Post 70 has on hand American flags, all of the military service flags, POW/MIA flags, and S.C. State flags. Contact a member of Post 70 to purchase flags; the cost is $5.

American Legion Post 70 meeting at 1800 on the third Tuesday of the month. For more information, please contact Thomas Crisp at 940-2793.

American Legion Post 24 of Newberry will meet on the second Tuesday of the month at 1830. The American Legion Auxiliary – Unit 24 meets the same day at 3 p.m. at Post 24.