Letter To Adm. Hunter‏ From The: Us_Military_Retirees_Of_The_Philippines

[Art2ro]

Re: [uS_Military_Retirees_Of_The_Philippines] Re: RAO Manila Letter To Adm. Hunter‏From: us_military_retirees_of_the_philippines@yahoogroups.com on behalf of Verge A. Medina (pauverge_lynne@yahoo.com)Sent: Saturday, May 15, 2010 2:54:07 AMTo: US_Military_Retirees_Of_The_Philippines@yahoogroups.com To all active, retired military veterans and their families:RAO Manila have formed together to make this appeal. The said letter, hereunder quoted, was accompanied by a signature campaign of multi hundreds in number, mailed on 12 Apr 10, addressed to Adm Hunter with copies to 16 others who we believed and anticipated might be able to looked at the problem with serious in dept realization, since practically from the off-set of the Tricare Program, problems after problems had existed with unending solutions. At this point, we hope to hear, at least, from someone anyways, where if this plight prosper, should and will be beneficial to us, retirees and our dependents.May GOD be with us!Here's the letter in its entirety: RAO:VAM:ma 12 April 2010 RADM C. S. HUNTER, MC, USNAssistant Secretary Of Defense, Health AffairsSkyline Five,Suite 810, 5111 Leesburg Pike Falls Church, Virginia 22041-3206 URGENTDear Admiral Hunter: We sincerely thank the Admiral for taking the time of answering in your letter dated 23 Nov. 2009 to my Endorsement letter in behalf of Chief Petty Officer Roberto C. Alza, USN-Ret. concerns with TRICARE in general in the Philippines. On another latest new development, for the last several days, floods of U.S. military retirees as well as medical providers were storming in our office claiming that a good number of providers have now closed down their operation or will cease their operation for caring and/or treatment of TRICARE beneficiaries for reason of NON-PAYMENT by TRICARE on their reimbursement claims, indicating multiple denials on the Explanation Of Benefits (EOB), among others as CODE 018 (PROVIDER NOT TRICARE AUTHORIZED) and some recent denials were CODED 132 (SERVICE MUST BE SUBMITTED BY THE PROVIDER OF CARE) as a violation of CFR 199.6. More over, these denial factors are associated with lengthy notification to providers of action taken, i.e., "date of service" as far back as March 2009 taking over 1 year in many instance to notify providers of such action taken. Drug companies and manufacturers here in the Philippines are not licensed as a clinic or providers,therefore, they are not capable of the administrative procedures or requirements of the Tricare Program, thus, they only sell drugs. Where this is practically a nationwide critical concern of retirees and their dependents in this country at the present time, providers claims they will cease treating Tricare beneficiaries having advanced all relevant medical bills particularly in-patient hospitalization cases which accumulates fairly larger medical expenses and volumes and volumes of maintenance medicine being dispersed to the patients, where it'll take almost Act of Congress to get paid . Several retirees as well as medical providers claims where it reflects Code 018 and latest as Code 132 on their EOB's revealed that upon consultation with local ISOS here in Manila as well as with WPS reveals that the problem is on the "pharmacy" issues indicating "ECONOMIC INTEREST" on Code 18 and "SERVICE MUST BE SUBMITTED BY THE PROVIDER OF CARE" on Code 132 respectively. In ordinary layman's point of view, with exception of few 5 Star hospitals with their own pharmacy who dispense prescribed medicines, most providers in this country depends on buying prescription medicines from Drug Stores/Pharmacy outlets. We, Tricare beneficiaries derived a great value and benefits from the services provided and so grateful to providers in facilitating our healthcare needs despite the risk involve in the filing of medical claims like delays and non-payment of claims. We do understand their sentiments. From what we understand for the past years, the services provided by medical providers are not without proper certification/authorizations by the Tricare Certification Unit of ISOS when they were first certified as a Tricare provider and as confirmed by WPS/Tricare when they processed and paid the claims. Providers laments the lack of prior notices and coordinations by the agencies involved when flaws in the system happened. Tricare beneficiaries, sad to say always suffer the consequences. Further consultations to various service organizations, research in the internet, TRICARE Manual, directives, etc., were also made in order to ascertain these reasoning by Tricare resulting no where indicated. Additional consultations were made with various hospitals, revealed they have little knowledge or absence of familiarity with the Tricare Program where they are not interested or capable of submitting claims to Tricare due to bureaucratic requirements, in addition to the one known practitioner ancillary or support service essential or useful for the general welfare of retirees in early 2004 encountered numerous legal problem due to fraudulent claims by way of rampant "Third Party Billings", now "out-of-commission". It further revealed Tricare beneficiaries is only a small portion for them to deal with as opposed to the general population of the country where no hustle and red tapes are involved. Please also note the effectivity on 1 April 2010 of the 21% cut on Doctor's fee, now a law, imposed to the Providers and Hospitals, where if this new policy is not outlawed soon, NO medical practitioners will be entertaining Tricarebeneficiaries any more for reason of similar "ECONOMIC INTEREST" stipulated by Tricare where medical practitioners will have little or no income at all which they claim to be better off in just concentrating with local population. It is for this reason we are writing the Admiral again and by copies of this letter to the addresses, with all due respect to all concerned, we are respectfully requesting cognizant officials, to intervene, review, verify and/or FIX the newly imposed restrictions by Tricare whereby the present problems being encountered by providers directly affected us, retirees and our dependents expecting foreseeable crisis leaving us without healthcare sustenance. We have been advised to pay up front and claim under "individual claim" for any medical cure which is no problem for those that can afford, however, for those that cannot afford or has no savings at all are the once heavily assaulted by this denials of Tricare. Over half of the retirees and their dependents' population residing in this country numbering conservatively in excess of 15,000 (Army, Navy, Air Force, Marine Corps & Coast Guard) are in their twilight years where medical/healthcaremaintenance is of UTMOST IMPORTANCE. Most of them are all demanding, as to "WHAT IS HAPPENING WITH TRICARE NOW, WHY ARE WE SUFFERING FOR THESE INEQUITIES BY TRICARE OR ITS SYSTEM? WHAT HAPPENED WITH THE PROMISES FOR A FREE LIFETIME HEALTHCARE DURING OUR ENTRY INTO ACTIVE SERVICE, WHERE TO THE BEST OF OUR KNOWLEDGE AND UNDERSTANDING, TRICARE WAS INSTITUTED TO CORRECT SUCH BROKEN PROMISE TO BEGIN WITH? From the onset, we are all convinced that Tricare existence was the best ever awarded to us retirees as a reward for our hard earned benefits as a result of our military service spanning from WWII, Korean War, Cuban Crises, Balkan Wars (break up of Soviet Union and Warsaw Pact), Vietnam War, Grenada, Gulf Wars (Libian Crises, Kuwait, Iraq, Iran & Afghanistan) which at times were in "harms way". We proudly served the military service with honor and dignity, upheld and protect the constitution of the United States of American and why are we being treated like this; MUST WE SUFFER? No doubt there is something wrong somewhere in the system and we, retirees are demanding to have TRICARE SYSTEM FIXED OR REPLACE THEM WITH A GOOD WORKING SYSTEM. We only have short time to live and we certainly would like to spend our remaining days in harmony without any obstruction and difficulties leaving us problem free. Please don't let us die and carry with us to our graves the idea that the U.S. Government failed us with the proper medical care we rightfully deserved. Trusting that the aforesaid problems presented is self explanatory and should the Admiral and ALL other concerned require additional details, this office and its members will be glad and available to answer any queries you may have. GOD BLESS US ALL, GOD BLESS AMERICA! Yours in patriotism, In behalf of all RAO Members By V. A. MEDINA, PNC, USN-RET Director, RAO Manila Copy to:Honorable Robert Gates, Secretary of National DefenseHonorable Charles L. Rise, M.D., Ass't Secretary of Defense for Health AffairsSenator Daniel Akaka, Chairman, Senate Committee on Veterans AffairsCongressman Bob Filner, Chairman, House Veterans Affair's CommitteeCongressman Mike Michaud, Chairman, Subcommitte on Health AffairsHonorable John M. McHugh, Secretary of the ArmyHonorable Raymond Edwin "Ray" Mabus, Jr., Secretary of the NavyHonorable Michael Bruce Donley, Secretary of the Air ForceHonorable Raymond H. "Ray" La Hood, Secretary of Transportation (In behalf of the United States Coast Guard)General Eric K. Shinseki, Secretary of Veterans AffairGeneral James T. Conway, Commandant of the Marine CorpsMr. James Riordan, President, Wisconsin Physician ServicesMr. James Baker, President & CEO, Humana Military Health ServicesSgt. Maj. Robert D. Wojtaszczyk, Senior Enlisted Advisor to the Assistant Secretary of Defense for Health Affairs Courtesy Copy to:Senator Daniel Inouye (As Champion of Veterans Welfare)

Edited May 15, 2010 by Pinoy Art

[Jake]

Thank you Art for that encouraging letter. I think it may be awhile to see any improvementsfor US veterans health care in the Philippines. Like you said before, have sufficient amount ofemergency cash and wait for the reimbursement. It would be nice if the system could preventfuture fraudulent cases.Respectfully -- Jake

[United Army]

This is not good.

[United Army]

Well, I'm going to file my first tricare claim soon for inpatient care,,,it will be interesting to see what happens.