 This proposed VA health care change could save you time — and save VA billions:

Administration officials this year are re-upping a series of reforms to the veterans disability system they estimate  would cut down on tens of thousands of unneeded medical exams and save billions of dollars.

 VA spokesman Curt Cashour said the change reflects a larger number of exams and rising health care costs. A  steady increase in benefits claims combined with more complex and expensive exams translates into larger   savings if the reforms are enacted.

Administration officials argue that court rulings on the veterans disability process have shown that current VA   medical standards for benefits are excessive compared to the legal evidence needed to establish eligibility.  Many   check-ups, reexaminations and VA appointments duplicating private-sector medical evaluations could be cut,   saving veterans time and the federal government money. VA estimates that more than 180,000 unnecessary  medical appointments were conducted in 2016 and more than 210,000 in 2017, a small but significant portion of  the department’s workload.

The reforms package also includes changing disability compensation benefits to remove annual income from the eligibility calculation, a move that could increase the number of eligible beneficiaries but also save time and staff  in calculating those payouts.

 “This helps VA standardize the calculation and potentially automate payments, allowing veterans to get payments  faster,” the budget document stated.

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 VA to offer new nasal spray for treatment-resistant depression:

            The VA announced March 19 that its healthcare providers will now be able to offer the newly approved Spravato nasal spray for treatment-resistant depression. The treatment will be made available to veterans based on their individual medical needs, combined with providers’ clinical assessments. The move follows the March 5 Food  and Drug Administration (FDA) approval of Spravato (esketamine) nasal spray. Spravato was approved for use in conjunction with an oral antidepressant for the treatment of treatment-resistant depression in adults.

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VA is at it again

The VA revealed this week that the first of a two-phase expansion of its comprehensive family caregiver support program will be delayed-yet again.

To avoid lengthy delays in processing applications and providing support services to family caregivers, the VA MISSION Act of 2018, requires VA to first “implement” and then “certify” a new IT solution to manage the expansion of the program to all severely injured veterans who depend on family caregivers. 

Once the IT solution is certified by VA, the first phase of expansion would begin by accepting applications from veterans who were severely injured in the Vietnam War and earlier. The second phase would begin two years after the date of certification for veterans severely injured between May 1975 and September 2001.

When VA missed the first IT “implementation” deadline of October 1, 2018, VA officials gave assurances they were working to meet the next and more important “certification” deadline of October 1, 2019.  The VA now says they are working to certify the IT solution by June 2020, a full eight months later.  Even this new deadline is uncertain and it is unclear today whether VA has even implemented the new IT solution to test its capabilities in supporting the caregiver program expansion.

We urge you to visit your elected officials during the week of March 18-22, while they are in your district, or use the prepared email or write your own to contact your elected officials to voice your concern over another delay by VA in supporting dedicated family caregivers who for decades have sacrificed so much of themselves to care for their severely injured veteran.

 Take Action 

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• Senators urge VA not to fumble expansion of caregiver benefits:

            “VA continues to miss deadlines and not get it right, “Senator Patti Murray said in a phone interview Wednesday.     “And we have got to make them step up to the plate and make this work.”  In a Feb. 28 letter to Wilkie, Murray and nine other Senate Democrats, including ranking members on the Veterans’ Affairs and Armed Services committees, contend VA already is months behind in needed upgrades to information technology to begin to    extend caregiver benefits to qualified veterans of the Vietnam and Korean War eras by Oct. 1, 2019, as Congress directed.

 The letter also charges VA officials with a lack of transparency as they draft regulations to implement caregiver  expansion, and criticizes some steps VA has said it wants to take to hold down future program costs, for example,    by tightening access to caregiver benefits and changing methods for calculating caregiver stipends. The letter warns Wilkie that VA lacks authority to make some of the changes eyed without getting Congress to make changes in law.

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• VA Medical Marijuana – H.R.1151/S.445 | Veterans Medical Marijuana Safe Harbor Act:

Sen. Brian Schatz (D-HI) and Rep. Barbara Lee (D-CA reintroduced legislation to let Veterans Affairs doctors prescribe medical marijuana in the 33 states where it’s legal. The bill also would direct VA to research how medical marijuana might help manage chronic pain and reduce opioid misuse. “There is now abundant evidence that, where medical marijuana is available, opioid abuse goes down,” Schatz previously told POLITICO’s Sarah Owermohle.  The bill has a chance to pass Congress: The Veterans Medical Marijuana Safe Harbor Act, (116) / H.R. 1151 (116), is also backed by numerous veterans organizations and pain groups. “It will be difficult for even the most ardent cannabis opponents to deny veterans access to cannabis, especially considering worries about opioid addiction,” Cowen analyst Vivien Azer wrote in a note to investors late last year

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• H.R. 553, the Military Surviving Spouses Equity Act:

On January 15, 2019, Congressman Joe Wilson introduced H.R. 553, the Military Surviving Spouses Equity Act.    This bill would eliminate an unfair offset placed on many surviving spouses of service members who pass away during active duty or spouses of retirees who die of a service-connected disability. Currently, purchased Survivor Benefit Plan (SBP) annuities are offset by the amount of any benefit payable under   the VA Dependency and Indemnity Compensation (DIC) program.  SBP is not a government gratuity benefit;  rather, it is a type of insurance purchased out-of-pocket by military retirees for their survivors while DIC is a VA       benefit intended to provide spouses of veterans who died from a service-connected condition some semblance of financial security.  Thousands of survivors of military retirees are adversely affected by this unfair offset between SBP and DIC benefits. Upon the retiree’s death, the SBP annuity is paid monthly to eligible beneficiaries; however, if a surviving spouse             is also entitled to DIC, the SBP benefit is reduced by the amount of the DIC benefit (currently $1,283.11 per month).  In general, when DIC benefits are payable but the monthly rate is equal to, or greater than, the monthly           SBP payment amount, beneficiaries lose the entire SBP payment.             This bill would eliminate the offset and allow surviving spouses to receive both the purchased SBP annuities and      their earned DIC benefits. This bill is in accordance with DAV Resolution No. 014, which calls for Congress to repeal the offset between SBP annuity payments and DIC payments.

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 UCMJ update – applicability to retirees upheld by Supreme Court:

The U.S. Supreme Court has upheld the Defense Department’s authority to prosecute retired service members for crimes they commit, even after retirement. The court on 22 FEB chose not to hear the case of a retired Marine who was court-martialed for a sexual assault he committed three months after leaving the service in August 2015. By not accepting the case, Larrabee v. the United States, the court upheld the status quo: that military retirees are subject to the Uniform Code of Military Justice. The denial of Larrabee’s petition marks the high court’s second rebuff in a year of a case involving a military retiree accused of non-military crimes in retirement.

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 VA RAMP update – program to end ahead of implementation of new Veteran appeals law:

The U.S. Department of Veterans Affairs (VA) announced it will discontinue the Rapid Appeals Modernization Program (RAMP), which provided eligible Veterans with early resolutions to their appealed claims, ahead of full implementation of the Veterans Appeals Improvement and Modernization Act of 2017.   VA will not accept RAMP elections from Veterans with a legacy appeal after March 01, 2019; however, RAMP claims pending on or after 15 FEB will continue to be processed until the inventory is complete.  Veterans who appeal a VA decision will have three decision review choices: Higher-Level Review, Supplemental Claim, and appeal to the Board of Veterans’ Appeals. VA will now offer Veterans greater choice in how VA reviews their claim is committed to ensuring the claims process is accurate, timely and fair. “VA has been preparing for full implementation of the Appeals Modernization Act over the past 18 months to ensure the new, streamlined process is available to Veterans who have long sought reform of the broken legacy system,” said VA Secretary Robert Wilkie. “We encourage Veterans whose appeal is currently in the legacy system to opt in to RAMP to take full advantage of the benefits of the new process.”

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 VA disability claims update – priority processing for Purple Heart Awardees:

On 26 FEB at a congressional hearing before the House Appropriations Subcommittee on Military Construction, Veterans Affairs, and Related Agencies, VA Secretary Robert Wilkie announced that effective in April, VA will provide priority disability benefits claims processing for the initial claims from discharged combat Veterans who have been awarded the Purple Heart Medal. “Those who hold the Purple Heart, the recognition of wounds taken in battle, will now receive priority consideration when it comes to claims before the Department of Veterans Affairs,” said Secretary Wilkie. The Veterans Benefits Administration will amend its priority processing categories to include initial claims received from Purple Heart recipients on or after April 1, 2019.  Purple Heart recipients are already treated on a priority basis at VA hospitals and are exempt from co-payments for their medical care

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 Vet small businesses – new law offers surplus equipment to vet entrepreneurs for free:

Scattered in warehouses throughout the country are the kinds of federal resources that can help make small businesses thrive — laptops and office furniture, construction equipment and farm tools that have been gathering dust, unused and unseen, year after year. Meanwhile, thousands of American service members are returning home from war, taking off their uniform then taking a chance: trying to scrounge up enough resources to start their own small businesses, all too often struggling to stay in the black if and when they get off the ground.

After both branches of Congress overwhelmingly voted for its passage in December, my Veterans Small Business Enhancement Act became law earlier this month, allowing veteran small business owners to acquire those pieces of equipment and personal property that the federal government no longer has any use for, effectively free of charge. A win-win, by anyone’s estimation. · Now that farmer in southern Illinois might not have to stay up at night, worried about how he’ll possibly be able to pay for that generator. · Now that veteran who returned from war and went back to school can get the computers she needs to open the doors to her very own practice. · And now American taxpayers will no longer have to foot the bill to store all those resources that belong in office buildings and cornfields.

And all you have to do to begin laying claim to those unused items and their untapped potential is contact your local state agency.[Source| Sen. Tammy Duckworth]

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