"Latest Update from National Headquarters"
April 24, 2020
The Defense Health Agency (DHA) announced that many TRICARE Prime, TRICARE Select, and US Family Health Plan beneficiaries will receive notices sating they may be eligible for refunds if they paid more than $2,400 out of pocket towards their annual maximum payment in 2018, 2019, and 2020. This issue only affects those TRICARE-eligible households who exceeded or came close to exceeding their catastrophic cap in 2018, 2019, and 2020.
In 2018, the DHA directed that the annual fee paid by retirees no longer counted toward the yearly out-of-pocket max. That meant some families were faced with an increase of about $600 in their yearly TRICARE spending, up to $3,600 for most retirees.
Retirees, who are eligible should being getting a refund notification letter from TRICARE's contractors - HealthNet in the west region and Humana in the east. The reimbursements are paid in the form of an account credit that applies to future enrollment fees. Retirees will have the option of requesting a cash refund.
VA and IRS Working to Get COVID-19 Payments to Veterans
The recently enacted Coronavirus Aid, Relief and Economic Security Act (CARES-H.R.748, P.L.116-136) allows the Department of Veterans Affairs (VA) to work directly with the Internal Revenue Service (IRS) and U.S. Treasury Department to ensure the delivery of Economic Impact Payments (EIP) to veterans and survivors who receive VA Compensation and Pension (C&P) benefit payments. This will be done without the beneficiary doing additional paperwork or IRS filings.
This law authorizes the Treasury Department to automatically issue to recipients of non-taxable VA benefits who did not file annual income tax returns for 2018 or 2019. The VA and the IRS have been collaborating since the passage of the Act (3/27/20) to ensure veterans receive their EIP. "Many have expressed concern that veterans and their beneficiaries would be overlooked during the distribution of Economic Impact Payments from the CARES Act simply because they don't file an annual tax return," said VA Secretary Robert Wilkie. "This collaboration will ensure our veterans receive CARES Act payments without any additional action or paperwork required." EIP will be automatic for non-tax filing VA beneficiaries. For VA beneficiaries who filed Form 1040 for 2018 or 2019, payments will be automatic, no further action is needed. Payment status can be tracked online with the, "Get My Payment" tool on IRS.gov. For non-tax filing VA beneficiaries, please note your information will be available on this site within the next few weeks.
For VA beneficiaries who didn't file a tax return in 2018 or 2019 and have a dependent, there is a special step you need to take, and the sooner the better. You should visit the Non-Filer: Enter Payment Info Here tool on the IRS website. By quickly taking steps to enter information on the IRS website about you and your qualifying children, you can receive the $500 per dependent payment in addition to your $1,200 individual payment. The VA claims that many non-tax filing beneficiaries have already begun using the IRS EIP Payment portal to provide the necessary data to the IRS. There will be no interruption to payments being processed using the IRS portal, and veterans with internet access are encouraged to continue providing information and track their EIP. For those who do not have access, or choose not to use the IRS portal, your EIP will be processed without any further action. While no date for distribution has been set at this time, the VA is securely sharing necessary beneficiary data with the treasury, which will start EIP distribution. For more information on CARES Act 'Economic Impact Payments,' go online.
HVAC Chairman and Ranking Member Ask VA to Postpone Changes to Claims Process
House Veterans' Affairs Committee Chairman Mark Takano (Calif.) and Ranking Member Dr. Phil Roe (Tenn.) sent a bipartisan letter to Secretary of Veterans Affairs, Robert Wilkie calling on the VA to postpone their planned elimination of the 48-hour review period in the disability claims process and work with Veterans Service Organizations (VSOs) to consider alternatives to a complete elimination of this review. Six major VSOs expressed their concern with the decision in a letter to Secretary Wilkie, stating that "VA made this decision without consulting with VSO partners about the impact this change would have on veterans" in addition to changing rules "amidst the chaos of the COVID-19 crisis."
They wrote, "Our country is facing an unprecedented emergency in light of the current COVID-l9 pandemic. Therefore, we urge the Department to consider postponing any change to the 48-hour review period until after VA, VSOs and Congress are able to have a more thorough discussion about this policy change."
"VSOs as well as other representatives and agents, provide veterans and their loved ones with invaluable assistance while navigating the Department's disability claims process," the members wrote. "The 48-hour review period provides a brief opportunity for VSOs to review rating decisions for errors or technical corrections before the decisions are finalized, thereby quickly and efficiently improving the accuracy of claims and reducing the need for appeals. VSOs tell me that elimination of this review period could result in delayed benefits for veterans and an increase in appeals or other formal corrective action."
Many Veterans to Get Letter from VA on Medical Cost Reimbursement
Certain veterans who were denied reimbursement for non-department emergency medical care will be getting a letter from the Department of Veterans Affairs (VA) informing them that they will be reimbursed for veteran's emergency room expenses if they were not covered by private insurance.
On Sept. 9, 2019, the U.S. Court of Appeals for Veterans Claims ruled (18-6091) that the VA's current regulation for veterans seeking non-department medical care violates existing federal law. They ordered VA officials to re-examine more than 72,000 rejected claims and update their rules, arguing the VA has a responsibility to cover the costs of the unexpected medical visits. This case (Wolfie v Wilkie) was first reported in the Sept. 20, 2019 issue of News Bytes.
The case centers on veterans whose unpaid emergency room expenses were denied by VA officials under existing policies. The plaintiffs' both had part of their bills paid for by other insurance but were left with several thousand dollars of personal costs.
VA officials argued in court that they did not need to handle the unpaid balance because the veterans were primarily covered under other insurance plans. The court ruled that violates both existing law and past legal precedent. The ruling invalidated all VA decisions denying reimbursement for deductibles and co-insurance costs not covered in emergency visits at non-VA facilities. VA officials have estimated that full compliance with the court order could cost between $1.8 billion and $6.5 billion. Reimbursements may date back to cases decided by the VA in 2016. The letters come as many veterans are facing new debts related to work interruptions and other financial problems related to the ongoing coronavirus pandemic. However, processing of the claims is likely to take several months and may be stalled further by ongoing legal appeals.
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