- The Washington Times - Tuesday, April 19, 2011

Dear Sgt. Shaft:

My doctor has approved use of the Phillips Self Testing PT/INR machine. Medicare will pay 80 percent of the test strip cost. Does TRICARE cover PT/INR self testing? Thank you.

Anna G.
Via the Internet

Dear Anna:

I am told that TRICARE for Life (TFL) will cover this testing, as Medicare now does. See description below:

On March 19, 2008, the Centers for Medicare & Medicaid Services (CMS) announced that it will significantly expand coverage for home monitoring of prothrombin time (PT/INR) for Medicare beneficiaries to include patients with chronic atrial fibrillation and venous thromboembolism. Since 2002, Medicare has covered home PT/INR monitoring solely for patients with mechanical heart valves. The expanded coverage will now include Medicare beneficiaries meeting the following conditions:

• The beneficiary requires chronic oral anticoagulation with warfarin for a mechanical heart valve, chronic atrial fibrillation, or venous thromboembolism;

• The beneficiary has been anticoagulated for at least three months prior to use of the home INR device;

• The beneficiary has undergone a face-to-face educational program on anticoagulation management and demonstrated the correct use of the device prior to its use in the home;

• The beneficiary continues to use the device correctly in the context of the management of the anticoagulation therapy following initiation of home monitoring; and

• Home-testing with the device occurs no more frequently than once a week.

Shaft Notes

• Kudos to Rep. Jeff Miller, Florida Republican, chairman of the House Veterans Affairs Committee, and Rep. Bob Filner, ranking member of the House Veterans Affairs Committee for their bipartisan support of our nations veterans. Mr. Miller and Chairman Marlin Stutzman, Indiana Republican, of the committee’s Subcommittee on Economic Opportunity introduced H.R. 1383, the Restoring GI Bill Fairness Act of 2011.

This bill will temporarily authorize the Department of Veterans Affairs (VA) to pay tuition and fees on behalf of eligible veterans attending non-public education and training institutions under the Post 9/11 GI Bill, in an amount that is the greater of $17,500 or the maximum in-state rate for undergraduate tuition and fees in effect on Oct. 27, 2010.

This temporary change would prevent students who have already enrolled in high-cost non-public schools from experiencing a reduction in tuition and fees paid by VA on their behalf due to changes made under Public Law 111-377, the Post-9/11 Veterans Educational Assistance Improvements Act of 2010.

“I am pleased to introduce this legislation to restore fairness and to ensure that no current student veteran will see their tuition and fee payments reduced,” Mr. Miller said. “I am also pleased that this bill is fully paid for and does not increase the deficit or create new spending.”

Rep. Bob Filner, California Democrat, has reintroduced H.R. 814, legislation to allow veterans to use their earned Medicare benefits to receive health care and services from the VA.

“There are veterans who have earned VA health care benefits with their service to our country,” Mr. Filner said. “They have also earned Medicare benefits by contributing to the Medicare program during their working years. Because VA cannot bill Medicare, elderly veterans are unable to use their Medicare benefits, even if they may prefer to receive care at a VA facility among their fellow veterans. So for those veterans, they basically forgo the hard-earned dollars that they contributed toward Medicare benefits during their working years.”

Under current law, VA has the authority to bill enrolled veterans and their private health care insurers for the treatment of veterans’ non-service-connected conditions. Current law, however, prohibits the billing of Medicare, barring elderly veterans from using their earned Medicare benefits at VA health care facilities. H.R. 814, the Medicare Reimbursement Act of 2011, would require VA to develop a program that would allow VA to bill Medicare for services rendered to veterans enrolled in Medicare Part A or B.

“I am pleased to introduce this legislation to restore fairness and to ensure that no current student veteran will see their tuition and fee payments reduced,” stated Miller. “I am also pleased that this bill is fully paid for and does not increase the deficit or create new spending.”

“I am proud to join Chairman Miller in supporting this common sense solution to help our nation’s student veterans,” commented Stutzman. “If H.R.1383 is not passed into law, students at non-public schools in several states including Florida, New York, Michigan, and Texas could have to pay a significant portion of their tuition out of their own pockets. This was never the intent of the Post 9/11 GI Bill and I am happy that we have introduced legislation to address the problem.”

Ranking Democratic Member Bob Filner (D-CA) reintroduced H.R. 814, legislation to allow veterans to use their earned Medicare benefits to receive health care and services from the Veterans Health Administration at the Department of Veterans Affairs (VA).

“There are veterans who have earned VA health care benefits with their service to our country,” stated Bob Filner. “They have also earned Medicare benefits by contributing to the Medicare program during their working years. Because VA cannot bill Medicare, elderly veterans are unable to use their Medicare benefits, even if they may prefer to receive care at a VA facility among their fellow veterans. So for those veterans, they basically forgo the hard-earned dollars that they contributed towards Medicare benefits during their working years. This bill is important legislation that would allow elderly veterans to access both VA health care and their Medicare benefits.”

Under current law, VA has the authority to bill enrolled veterans and their private health care insurers for the treatment of veterans’ non-service-connected conditions. Current law, however, prohibits the billing of Medicare, barring elderly veterans from using their earned Medicare benefits at VA health care facilities. H.R. 814, the Medicare Reimbursement Act of 2011, would require VA to develop a program that would allow VA to bill Medicare for services rendered to veterans enrolled in Medicare Part A or B.

Send letters to Sgt. Shaft, c/o John Fales, P.O. Box 65900, Washington, D.C. 20035-5900; fax 301/622-3330, call 202/257-5446 or e-mail sgtshaft@bavf.org.

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