Legislative Update

By Steve White

This is TROA’s legislative update for Friday, March 2, 2002

Issue 1: Legislative Tool Kit Now Available Online.

The 2002 edition of the TROA Legislative Tool Kit is now available on the TROA Web site at http://www.TROA.org/Legislative/ToolKit/default.asp.

The Tool Kit summarizes TROA’s 2002 legislative goals and provides legislative tips and fact sheets on selected key issues. It is designed to serve as a reference for Chapter and Council leadership and for all TROA members in an effort to further develop and strengthen TROA’s legislative activities at every level.

Issue 2: TRICARE For Life (TFL) Claims Update.

By the end of February, DoD had received over 7.6 million TFL claims and had completed processing on more than 7 million of them, paying out over $243 million in health care benefits. Claims processing contractors report that nearly all of the initial TFL claims “hiccups” either have been resolved or will be by mid-March. Here’s a recap of the status of the main initial problems:

Electronic Claims Omission. Approximately 13% of TFL beneficiaries were inadvertently left out of TFL’s initial data exchange with Medicare. Because Medicare was initially unaware that these people were TFL beneficiaries, their Medicare claims were not forwarded to TFL. This group was re-entered into the electronic process by mid-December. But the affected beneficiaries needed to file a paper TRICARE claim to receive reimbursement for doctor visits between October 1 and about December 7. Status: TFL contractors report they have already processed large numbers of these paper claims, but there is no way to tell whether all of them have been submitted. Beneficiary Action Needed: Affected beneficiaries who had unpaid claims for visits during that period last fall must file a paper TRICARE claim (Form DD2642), plus a copy of the Medicare Summary Notice (MSN) for the relevant visit.

Expired ID Cards. Many older beneficiaries who had let their military ID cards expire had their initial TFL claims denied. Status: TFL is centrally identifying and reprocessing all claims denied for this reason, and will pay them until July. The vast majority of corrected payments will be completed by mid-March. Beneficiary Action Needed: Beneficiaries with expired ID cards must renew them by July, or their subsequent TFL claims will be denied. Those who need help getting new ID cards can contact the Defense Manpower Data Center Support Office at 1-800-538-9522.

(See a related article submitted by Frank and Lou Rinehart later in this issue. Editor)

Excess Charges Payment. 3 to 4 percent of TFL beneficiaries visit doctors who do not “accept Medicare assignment.” Providers who don’t accept assignment may charge up to 115 percent of the Medicare-allowable charge. TFL will cover this extra 15-percent charge. However, the TRICARE claims processors initially didn’t get the word, and initially denied the extra payment. Status: TFL had identified and made corrected payments for all of the previously underpaid claims as of mid-February. Beneficiary Action Needed: None.

OHI Indicator. Some members who canceled other health insurance (OHI) in conjunction with switching to TFL coverage and advised TFL of the cancellation had initial TFL claims denied because the Medicare claim system still indicated their OHI was active. (By law, the OHI must pay first.) In some cases, this was a simple processing delay. In others, the other insurance company delayed notifying Medicare to avoid missing any delayed claims for medical visits before the cancellation. Status: TFL processes have been changed to override the Medicare OHI indication if the beneficiary has notified DoD of the OHI cancellation, either by mail or by phone. Erroneously denied claims are being centrally identified and reprocessed. Over 160,000 previously denied claims had been corrected and reprocessed by the end of February. Beneficiary Action Needed: None.

Beneficiary Notification Failure. Members who canceled their OHI but who did not notify TFL of such cancellation also may have their claims denied as discussed in the previous paragraph. Status: TFL can’t correct the problem unless they are made aware of the cancellation. Beneficiary Action Needed: If notified that your TFL claim was denied for this reason, call the TFL call center toll-free at 1-888-363-5433. The call center can provide a phone number for your state/region that you can call to update your TFL records to show your OHI has been canceled. Your claim then can be reprocessed automatically.

TMA leaders report that TFL claim denial rates are dropping. Initially 30%, the rate is now down to 23%, and this trend should continue with correction of initial processing problems.

The single most frequent reason for a denied claim (almost half of all denials) is that something in Medicare or TFL files shows the beneficiary has other health insurance (OHI). Despite intensive efforts by TMA, TROA and many others, only 63% of TFL-eligibles have told DoD of their intent to retain or drop any Medigap insurance coverage they may have had.

If you previously used other insurance, your claims history with Medicare or TRICARE usually will still reflect that you have OHI unless you report its cancellation date. And if the TRICARE system understands you still have Medicare supplemental insurance coverage, your claim will be denied. Another problem may occur if you have decided to keep your OHI and don’t tell DoD. In some cases, this can cause TFL to make a duplicate payment to your doctor (i.e., in addition to the payment from your other policy) that later may have to be recouped. This results in administrative problems for DoD, for your doctor, and for you. These administrative problems could result in TFL getting a bad name with providers and that could hurt all military beneficiaries.

The success of the program depends on TFL beneficiaries doing their part to make sure that the claims processors have accurate information about their coverage. So it is important for you if you are a Medicare-eligible member to confirm to DoD whether you have OHI and, if so, whether you plan to cancel or retain it, and the effective date of any planned cancellation.

Last summer DoD sent a TFL mailing to all 1.4 million Medicareeligible uniformed services retirees, family members and survivors requesting that they respond with their OHI intentions. If you didn’t respond to the mailing, it is not too late to update your files. You should call DoD today and furnish this important information toll free at 888-363-5433.

Contacting DoD has no effect on your current Medicare supplement. If you wish to make any changes to your existing supplemental coverage, you will still have to contact your insurance carrier to make those arrangements. You are under no obligation to cancel your Medicare supplement, but you do need to communicate your intentions to DoD to guard against having a claims problem.

If you need additional TFL information visit the TRICARE Web site at http://www.tricare.osd.mil/ or call toll free 888-DOD-LIFE (888-363-5433) for assistance with resolution of any claims problems. To subscribe or unsubscribe to TROA’s legislative update, send a request to legis-update@TROA.org (Provide your TROA membership number if you are a member, OR, your full name and full mailing address including city, state and zip code with a note stating NON-member if you are not a TROA member. Without this information we CANNOT process your request.) Any requests received after Tuesday will not be processed until the following week. If you have questions regarding the update, please address them to legis@TROA.org.

Copyright © 2002, The Retired Officers Association (TROA), all rights reserved. Part or all of this message may be retransmitted for information purposes, but may not be used for any commercial purpose or in any commercial product, posted on a Web site, or used in any non-TROA publication (other than that of a TROA affiliate, or a member of The Military Coalition) without the written permission of TROA

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Renewing Dependent Identification Cards

By Frank and Lou Rinehart

 The Dependents Military Identification for Retired Personnel expires periodically. Before TRICARE for Life (TFL) and the pharmacy program began in the last year, the need for a current card was not too critical. But a current card is essential for these programs. Expiration of the card and onset of a serious illness could be financially disastrous. The identification card can be renewed at any military Installation.

At Kirtland, the Customer Service Office is located in the former Commissary building on Fourth Street just off of Wyoming near the intersection of Wyoming and Gibson. If you are unable to travel to Kirtland, you can apply by mail.

The first step is to call Customer Service at Phone Number 1-505-846-5459. Ask for instructions for Mail Out ID Card. Instructions and a form will be sent to you. The instructions are included in this article. Please note that there are at least three mailings between you and Kirtland. Plan for a minimum of one month to complete and receive your new card. Appearing in person is strongly recommended as a speedier alternative. Once in the Customer Service building the process is quick and the waiting time is usually short. The trip can be made in one day. If you arrive in Albuquerque by noon and you should be able to start home by 4:00 P.M. (or earlier).

Call Frank or Lou Rinehart at 326-2904, if you should have any questions.

 Mail Out ID Card Instructions
Per AFI 36-2036

Step 1
Sponsors:
Please verify and correct any information on the DD Form 1172 and sign block 90 and have the form notarized. Return the form with the photograph.

Applicant Receiving Card:
Send an 8"x10" portrait photograph that is notarized on the back along with physical characteristics (eye color, hair color, height, and weight). Please complete block 110 of the DD Form 1172.

Step 2
Customer Service will send the ID Card by certified mail to the applicant.

Applicant Receiving Card:
Please sign the ID Card in the signature block above your name and return the card to Customer Service.

Step 3
Customer Service will laminate the ID Card and mail to the applicant by certified mail.

Customer Service:

377 MSS / DPMPS
1451 4th Street / BLDG 20245
Kirtland AFB, NM 87116

PUT YOUR NAME AND PHONE NUMBER ON ALL CORRESPONDENCE

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President's Page

By Al Garcia

FULL COURT PRESS ON CONGRESS:

TROA and other VETERAN organizations are putting on a full court press to convince House and Senate Budget Committee members to include funding in the FY 2003 Congressional Budget Resolution for concurrent receipt of military retired pay and veterans' disability compensation

According to a TROA letter dated; February 13, 2002 from Lieutenant General, Michael A. Nelson, "We've been battling to eliminate the offset of retired pay for disability compensation for many years. We firmly believe these two compensations are for two entirely different things--retired pay is for a career in the uniform of this country; and, disability compensation is for the pain and suffering, and loss of future earnings potential, caused by a service-connected disability. The FY 2002 Defense Authorization Act contained language eliminating this disability offset--but only if the President submitted the funding in his new budget. But that didn't happen, because the Administration already has told Congress that (like previous Administrations of both parties) it opposed changing the law. So now the ball is back in Congress' court."

General Nelson asks Council and Chapter presidents to help make a difference by writing letters to our legislators on behalf of our members, urging legislators to do everything they can to ensure concurrent receipt funding is included in this year's congressional budget resolution. I will take care of this request.

The March issue of The Retired Officers Magazine will have pre-addressed postcards to legislators who have cosponsored this legislation (H.R. 303 or S. 170), urging them to back up their stated support with funding in the FY 2003 Budget Resolution. I encourage each member to clip these cards and mail them as soon as possible after you receive your magazine.

One of our Chapter goals is to help support TROA objectives. Let's get behind this effort.

News on Joe Ziems as received from Jack Morgan:

This is just a note, in case you did not already know, that our good friend and loyal TROA member, Joe Ziems is in the Rehab Center (across from the San Juan Regional Medical Center), and has been for some time. I did not know of it until this morning when I visited with his son, Paul, and daughter, Christine.

Paul and Christine told me that Joe has been sick since sometime in January. The best time to visit his is around 4 pm, as he undergoes therapy treatments at other times. I intend to go out and see him either today or tomorrow.

Just thought I should let you know. A card from TROA, or a visit from you might give him a boost.