Thomas McCaffery, recently sworn in as Assistant Secretary of Defense for Health Affairs, is the principal advisor to the Secretary of Defense on all DoD health policies, programs and activities. In addition to exercising oversight of all DoD health resources, the ASDHA serves as director of the Tricare Management Activity. 

The Defense Health Program provides healthcare to 9.5 million beneficiaries (service members, retirees and their families) through the TRICARE health benefit, at both military medical treatment facilities and through civilian networks.

He will now also oversee a series of reform efforts, including:

•Transfer the management of hundreds of military hospitals and clinics from the Army, Navy and Air Force to the Defense Health Agency (DHA), which assumed responsibility for U.S.-based medical facilities on Oct. 1, and will oversee all DoD treatment facilities around the world by October 2021.

•Deployment of a new electronic health record system, MHS GENESIS, which will enable the DoD to have a single record-keeping system for all medical care, from the battlefield to home-station facilities. The Department of Veterans Affairs is deploying a similar health record system. It will eventually provide seamless record-keeping from the time a service member enters the military until they enter the VA health system care.

 

COURT TELLS VA TO PAY FOR EMERGENCY CARE

The U.S. Court of Appeals for Veterans Claims recently ruled in Wolfe vs. Wilkie that federal law requires the Department of Veterans Affairs (VA) to pay for veterans’ emergency room expenses if they are not covered by private insurance.

The ruling resulted in part from a reimbursement sought by Coast Guard veteran Amanda Wolfe, who had a bout of appendicitis and sought care at a nearby civilian hospital because the nearest VA hospital was three hours away. She filed a claim for $2,558.54 of the $22,348.25 bill, representing the amount not covered by her employer-sponsored health insurance. The VA denied the claim, saying that amount was for copayments, coinsurance and deductibles that it was not required to pay.

The court decision overturns the VA denial and requires the agency to reimburse veterans for out-of-pocket emergency medical bills not covered by private insurance, other than copayments. Because the case was ruled a class action, the National Veterans Legal Services Program, which helped represent plaintiffs, said any affected veteran must be reimbursed. It said based on the VA’s past estimates, the decision could cost the department $1.8 billion to $6.5 billion in reimbursements for service-connected claims filed or pending for hundreds of thousands of veterans from 2016 through 2025. (Source: FRA NewsBytes, September 6, 2019)

It will be interesting to see this ruling applied. The VA will become the second payer after civilian health plans dealing with expensive emergency room visits.

Next month: Famous actors who were former military.

Veterans organizations in Houston:

American Legion Post 41 meets at 6 p.m. on the second Thursday of each month at the meeting hall on the west end of Chilton Oil Company in Houston (just north of Pizza Hut).

Fleet Reserve Association Branch 364 meets at 2:30 p.m. on the fourth Sunday of each month at the American Legion Post 41 meeting hall in Houston.

Houston resident Robert E. Simpson is a retired U.S. Navy chief electronics technician who served from 1969 to 1990. Email gfjjkaa@gmail.com.

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