1. A total of 171,000 retirees Tricare Prime option
With the presidential election over, Defense officials are expected to announce soon that military retirees and their dependents living more than 40 miles from a military treatment facility or base closure site will lose access to Tricare Prime, the military’s managed care option.
These beneficiaries would be expected to shift to Tricare Standard, their fee-for-service insurance option, which would mean an increase in out-of-pocket costs for beneficiaries who are frequent users of health services.
A total of 171,000 retirees and dependents are expected to have to shift coverage when remote Prime networks go away. Tentative plans are for this to occur April 1 in the West Region, which would coincide with UnitedHealth Military and Veterans Services taking over the region’s support contract from TriWest Healthcare Alliance after 16 years.
The North and South Tricare regions are expected to close down Prime service areas beyond 40-mile catchment areas of bases or base closure sites by Oct. 1, 2013, the date when current Prime enrollment periods expire for most beneficiaries.
Active duty members and their families generally would not be impacted. Drilling National Guard members and reservists living far from military bases could see small increases to health costs. This would occur if they have been taking advantage of modest discounts available under Tricare Reserve Select when network providers are used. Such discounts would end in areas far from bases if the Prime option goes away.
The end of Prime outside of 40-mile catchment areas of military treatment facilities has been anticipated since 2007, when Defense officials drafted the third generation of Tricare support contracts. It called for returning the managed care option to its original concept of being a backup network to military clinics and hospitals when they can’t provide managed care to all beneficiaries living nearby or in areas where bases have been closed and military health facilities shuttered.
Through the first two Tricare contracts, on the assumption that managed care saved money for the government, contractors had financial incentive to establish networks beyond 40-mile catchment areas. In the South Region, for example, the contractor has offered Prime everywhere. But experience has shown that providing Prime far from bases can add costs to the system, Tricare officials concluded.
Though they wrote the new generation of support contracts to constrict Prime service areas, health officials wanted the shift to occur across all regions simultaneously. That hasn’t been possible until now because of delays in finalizing contract awards, the result of multiple protests and even a few reversals of original contract awards.
Contracts for every region are now settled. Health Net Federal Services has been running the North Region under the new contract since April 2011. Humana Military Healthcare Services has operated the South Region under the new contract since April this year. But all Prime service areas have been maintained with contract modifications, awaiting final word from Defense that Prime area restrictions are to be implemented.
The new contracts were drafted during the Bush administration and are intended to be more comprehensive and efficient. But sensitive to how a change in Prime eligibility might be used by politicians this fall, Defense officials ordered plans to end Prime for retirees living outside catchment areas, including draft notification letters, shelved until after the election.
Plans for implementation have not changed, congressional and health sources said. But they also have not been announced officially yet.
2. GOP senator outlines $68 billion in defense cuts
Defense spending could be slashed by $68 billion over 10 years if the military stopped spending millions on running grocery stores, operating its own schools and even developing a roll-up version of beef jerky, insists one of the Senate’s leading fiscal conservatives. In a new report, Republican Sen. Tom Coburn dubs the Pentagon the “Department of Everything.”
Coburn details how the Pentagon could save money — vital in a time of rampant federal deficits — if it eliminated duplicative and excessive programs that have nothing to do with the nation’s security. By turns sober and cheeky, the report points out that the Pentagon has spent more than $1 million on the 100-year Starship Project, including $100,000 for a workshop sure to attract Trekkies. One of the discussions was titled “Did Jesus Die for Klingons Too?”
“Our nation’s $16 trillion debt is the new red menace, posing perhaps a greater threat to our nation than any military adversary,” the report says in chilling Cold War terms.
The report from the Oklahoma lawmaker comes as President Obama and Congress are trying to figure out a way to make deep cuts in the deficit. A Republican pushing for significant reductions in Pentagon spending is certain to draw attention in the coming weeks as Congress’ defense hawks try to spare the military from anything more than the nearly $500 billion, 10-year cut in projected spending that lawmakers backed last year.
Coburn identified five areas that he said had nothing to do with national security yet represent a significant chunk of the annual $600 billion-plus Pentagon budget:
• Nonmilitary research, $6 billion.
• Education, $10.7 billion.
• Tuition assistance, $4.5 billion.
• Pentagon-run grocery stores, $9 billion.
• More than 300,000 military members performing civilian jobs and numerous general officers, $37 billion.
Coburn also said the Pentagon spent $700 million on alternative energy research that was duplicative or unnecessary.
Citing defense budget requests, previously published material and correspondence with the department, the report said the Foreign Comparative Testing program, dedicated to improving warfighter capability, has spent more than $1.5 million to develop a beef jerky in roll-up form.
“Beef jerky so good it will shock and awe your taste buds,” the report said. “That is the goal of an ongoing Pentagon project, which is attempting to develop its own brand of jerky treats that are the bomb! Only, the money is coming from a program specially created to equip soldiers with the weapons they need.”
One of the costliest programs for the Pentagon is education. The department operates 64 elementary and secondary schools on 16 military facilities in the United States, teaching 19,000 students. The cost is more than $50,000 per student, far above the national average of about $11,000 per student. The schools have 2,000 teachers and staff.
Initially, the schools were justified because the military after World War II was integrated while some of the local schools were not, the report said. The schools are in Alabama, Georgia, Kentucky, New York, North Carolina and South Carolina.
At the Naval Surface Warfare Center in Dahlgren, Va., the Pentagon operates an elementary and junior high school with just 90 students even though the Potomac Elementary School is less than a mile away. And recently, Congress approved a $1.48 million request to upgrade a new kitchen and computer room for Dahlgren.
The report argued that the money could be spent instead on lightweight machine guns for warfighters in Afghanistan.
3. Other Commission business
On Thursday, staff attended the quarterly VSO/MSO forum at the Pentagon. The forum is hosted by the Army Department of Public Affairs. Topics presented included pending sequestration cuts to the defense budget, current developments in TBI/PTSD diagnosis and treatment, and improving support for separating service members. Also discussed was the ongoing effort to gain a uniform policy allowing certain organizations, such as The American Legion, access to military installations.
1. In testimony, Petraeus says he always saw Benghazi as terrorism
Former CIA Director David Petraeus told lawmakers at a closed-door briefing Friday the agency believed the assault on the U.S. Consulate in Libya was a terrorist attack from the beginning.
Petraeus also indicated the talking points used by U.S. Ambassador to the United Nations Susan Rice in several cable television appearances after the attack were different from the ones prepared by the CIA, Rep. Peter King (R-N.Y.) told reporters. The suggestion from Petraeus is that someone inside the administration shifted the talking points.
“The original talking points prepared by the CIA were different from the ones that were finally put out,” King, the chairman of the House Homeland Security Committee, told reporters after Petraeus testified before the House Intelligence Committee Friday.
Republicans have hammered Rice over her comments about the attack and have suggested the administration played up the idea a demonstration was behing the attack for political purposes.
Petraeus himself appeared to indicate at earlier testimony to the Senate Intelligence panel in September — just days after the attack — that intelligence suggested it resulted from a protest. The former director has not made public comments about the attack, but senators interviewed after that closed-door hearing said they did not hear it was a terrorist attack.
2. House Foreign Affairs Committee hearing on Benghazi attack
On Thursday, Freddy Gessner, assistant director of national security/foreign relations attended a hearing held by the House Foreign Affairs Committee regarding the attack the U.S. Embassy in Benghazi, Libya, that killed four Americans. It was announced that Secretary of State Hillary Rodham Clinton will testify before Congress.
Rep. Ileana Ros-Lehtinen (R-Fla.), who chairs the committee, said at the hearing that Clinton “has committed to testifying before our committee and the Senate Foreign Relations Committee” on a report by the Accountability Review Board, a five-member panel formed to investigate the attack and make recommendations. Ros-Lehtinen did not specify when Clinton would testify but noted that the board is expected to finish its report by “early to mid-December.”
The Benghazi attack has become the subject of intense controversy because of conflicting accounts of how it originated and charges that the U.S. government should have heeded warnings to strengthen security at its posts in the eastern Libyan city.
“We are committed to identifying what went wrong and what needs to be done to prevent any further American lives from being lost in such attacks,” Ros-Lehtinen said at her committee’s hearing on the Benghazi attack Thursday morning.
Testimony was provided by the sole witness attending the hearing, Mr. Michael Courts of the U.S. Government Accountability Office (U.S. GAO). Mr. Courts described staffing shortages up to 25% throughout the Department of State, a lack of language skills training, and lessons to be learned from this incident.
3. U.S. and Afghanistan start talking to reach security pact
The United States and Afghanistan faced potentially divisive issues such as immunity for U.S. troops as the two sides began talks Thursday on a security agreement that will shape America’s military presence in the country after the withdrawal of most foreign combat troops in two years.
However, the talks could last up to a year, and questions about specific military operations or the exact number of U.S. troops that will remain in the country were being put off until later, according to a senior U.S. official.
U.S. and Afghan officials also indicated that the issues of legal jurisdiction will be left until later, after easier topics are negotiated. The officials spoke on the condition of anonymity because of the sensitivity of the negotiations.
Earlier this week, Defense Secretary Leon E. Panetta said the Obama administration expected a decision in the next few weeks on how many U.S. troops will remain in Afghanistan after 2014. He added that Marine Corps Gen. John Allen, the top U.S. commander in Afghanistan, had developed several options but would not reveal what troop levels were being considered.
It is believed that the U.S. wants to retain up to 20,000 troops in Afghanistan after 2014 to train and support Afghan forces and go after extremists and groups, including al Qaeda.
Afghanistan now has about 66,000 U.S. troops, and it remains unclear how many will be withdrawn next year as they continue to hand over security to Afghan forces. The foreign military mission is evolving from combat to advising, assisting and training Afghan forces.
The two countries also are grappling with the potentially divisive issues of whether U.S. troops can be prosecuted under Afghan law — an issue that nixed America’s security deal with Iraq last year — the U.S. military footprint, and what bases and facilities Americans will use after 2014.
4. POW/MIA Update
• AIRMAN MISSING IN ACTION FROM VIETNAM WAR IDENTIFIED
On October 16, 2012 the remains of two U.S. servicemen, missing in action from the Vietnam War, were identified and buried, as a group, with full military honors.
Air Force Col. Wendell Keller, 34, of Fargo, N.D., and Capt. Virgil K. Meroney III, 25, of Fayetteville, Ark., will be buried as a group, in a single casket representing the crew, on Oct. 19 in Arlington National Cemetery. Meroney was interred individually on June 9, in his hometown.
On March 1, 1969, Keller and Meroney were the crew of an F-4D Phantom II aircraft that crashed while carrying out a nighttime strike mission in Khammouan Province, Laos. Nearby U.S. aircrews reported seeing the aircraft hit by enemy fire. No parachutes were seen after the aircraft was hit. Heavy enemy presence in the area prevented recovery efforts.
From 1994 to 2011, joint U.S./Lao People’s Democratic Republic (L.P.D.R.) teams, led by Joint POW/MIA Accounting Command (JPAC), conducted several investigations and excavations of the crash site in Khammouan Province, Laos. The teams located human remains, military equipment, a military identification card, and aircraft wreckage of an F-4, including an engine data plate and radio call-sign plate. During the 17 years, analysts evaluated the material evidence and the accounts of more than 40 eyewitnesses to confirm the information correlated with the crew’s loss location.
To identify the remains, scientists from JPAC used circumstantial evidence and forensic identification tools including dental comparisons and radiograph comparisons.
Today, 1,655 Americans remain unaccounted for from the Vietnam War. The U.S. government continues to work closely with the governments of Vietnam, Laos, and Cambodia to recover Americans lost during the Vietnam War.
Military Review Boards
This week, our Military Review Boards staff assisted 30 former service members with new, upcoming and pending petitions prepare their case for review by the Military Discharge Review Boards and Boards for Correction of Military Records. Case development included: 36 phone calls, 24 emails, 4 correspondences, and 3 service officer inquiries.
One of our success stories for this week was a former Marine Corps Lance Corporal, now 26 years of age, separated Under Other Than Honorable Conditions in July 2006 following 1 year and 11 months of total active duty service due to misconduct.
This former Marine’s record of service was marred by a Summary Court Martial (SCM) on 20060414 for violation of the Uniformed Code of Military Justice (UCMJ) Article 112a: wrongful use of a controlled substance – cocaine.
The Applicant contends that Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI) related to his combat service contributed his misconduct.
The Board’s review of the service record shows that on 14 December 2005, during combat operations in Iraq, the vehicle that the Applicant was driving struck an improvised explosive device; the Applicant sustained a Level III concussion in which he experienced loss of consciousness, disorientation, and amnesia with related physical injuries of bleeding from the ears. He was awarded the Purple Heart. However, there is no evidence in the Applicant’s medical or service record documenting that the Applicant was diagnosed with PTSD or TBI. The Navy Discharge Review Board (NDRB) requested and did review the Applicant’s medical records, to include any and all Department of Veterans Affairs (VA) treatments and Mental Health evaluations. The Applicant’s records from the VA did not document any treatment for, or diagnosis of, PTSD or TBI.
During his personal interview, the Applicant stated that he has not been diagnosed with PTSD or TBI, but that he was suffering from unreported symptoms while home on leave following his combat deployment, which he contends, contributed to his misconduct. The Applicant further testified that he had not sought VA treatment due to the bar to benefits resulting from his Other Than Honorable discharge characterization. The Applicant’s official military service record does not document a diagnosis of PTSD; however, in review of the additional post-service documentation and testimony provided by the Applicant, the NDRB determined that his PTSD was a mitigating factor associated with the in-service misconduct. Moreover, the NDRB determined that the unique circumstances of this individual case, coupled with the Applicant’s meritorious service in combat, warranted additional consideration in the determination of overall characterization of service.
By a vote of 5-0, the NDRB found that the awarded characterization of service was inequitable and that relief in the form of an upgrade in the characterization of service to General (Under Honorable Conditions) is warranted.
Director, National Security / Foreign Relations Division