HOUSE COMMITTEE ON

VETERANS' AFFAIRS

 

 

February 10, 2005  Hearing Room C

8:30 A.M.                               Tapes 20 - 22

(corrected 07/28/05)

MEMBERS PRESENT:            Rep. Donna Nelson, Chair

Rep. Phil Barnhart, Vice-Chair

Rep. Debi Farr, Vice-Chair

Rep. Brian Boquist

Rep. Scott Bruun

Rep. Dave Hunt

Rep. Betty Komp

 

STAFF PRESENT:                  Jim Stembridge, Committee Administrator

Erin Seiler, Committee Assistant

 

MEASURES/ISSUES HEARD:        

                                                Healthcare for Veterans’ - Informational Meeting                                 

 

These minutes are in compliance with Senate and House Rules.  Only text enclosed in quotation marks reports a speaker’s exact words.  For complete contents, please refer to the tapes.

 

TAPE/#

Speaker

Comments

TAPE 20, A

002

Chair Nelson

Opens the meeting at 8:39 a.m. Opens an informational meeting on Healthcare for Veterans’

HEALTHCARE FOR VETERANS’ - INFORMATIONAL MEETING

020

Scott Celley

Vice-President for External Affairs, TriWest Healthcare Alliance. Submits copies of TriWest Healthcare Alliance: Serving America’s Finest PowerPoint presentation (EXHIBIT A). Explains who the military health system provides healthcare coverage and the region of the United States that they oversee (EXHIBIT A, Pages 4 - 5).

092

Celley

Explains the services and care provided by Military Treatment Facilities (MTF) (EXHIBIT A, Pages 6 – 7).

141

Chair Nelson

Asks if TriWest is a parent company of TRICARE or a separate company.

156

Celley

Clarifies that the parent company for TriWest is TRICARE and TriWest is the private sector contractor that delivers healthcare for the federal government.

186

Celley

Speaks to who is TriWest, length and scope of TriWests federal contract, and who is served by TriWest (EXHIBIT A, Pages 9 – 10).

224

Celley

Explains that TriWest works off a platform of Blue Cross/Blue Shield systems (BCBS) and it is BCBS who lines up the local doctors and specialists who provide the medical care.

246

Joe Nortz

National Guard/Reserve Liaison, TriWest Healthcare Alliance. Explains the Reserve Health Care Continuum model and how it was designed to serve National Guard and Reserve soldiers and their families (EXHIBIT A, Page 12).

284

Nortz

Gives the details of healthcare services available to National Guard and Reserve soldiers and their families when they reach each stage of the Reserve Health Care Continuum (EXHIBIT A, Page 12).

360

Nortz

Submits and explains the contents of the TRICARE Beneficiary Handbook (EXHIBIT B). Submits and explains the TRICARE Choices Handbook (EXHIBIT C). Submits copies of brochures titled TRICARE – Transitional Health Care Benefits (EXHIBIT D) and titled TRICARE – Choices for the Reserve Component (EXHIBIT E).

401

Rep. Hunt

Asks how TriWest advises returning National Guard and Reserve soldiers with regards to enrolling in just the TRICARE Health Plan or enrolling in a private healthcare plan in conjunction with TRICARE.

TAPE 21, A

009

Nortz

States that TriWest does not provide this type of advice to soldiers. Explains that TriWest focuses on providing soldiers with the appropriate information about healthcare benefits and directs them to seek benefits counseling.

021

Rep. Hunt

Asks if a soldier does decide to have dual coverage is the TriWest coverage limited.

027

Nortz

Explains that in cases of dual healthcare coverage, TriWest is the second payer.

060

Celley

Explains that National Guard and Reserve soldiers eligible for TRICARE are those who have served twenty years and have retired and it is those soldiers who have served any length of time and retire are eligible for Veterans’ Administration (VA) benefits.

099

Nortz

States that there are currently 1,875 mobilized Oregon National Guard. Therefore, there are roughly 5,000 Oregon National Guard and their families currently eligible for TriWest healthcare coverage.

115

Rep. Farr

Verifies that 1,875 are all mobilized Reserve soldiers from Oregon.  

121

Rep. Bruun

Verifies that the surviving spouse retains TRICARE healthcare benefits.  

137

Nortz

Clarifies that a twenty year National Guard or Reservist retiree is not eligible for retirement pay and benefits until the age of sixty.

151

Rep. Boquist

Explains that TRICARE coverage is for active duty personal, mobilized reserve components, and twenty year retirees, before, during, and after mobilization.

190

Chair Nelson

Asks how did the Department of Defense (DOD) determined who would be awarded the healthcare contract.

193

Celley

Responds that it was a delivery-based contract, based on an estimated per-person delivery cost.

203

Chair Nelson

Asks if the DOD determines the type of health services that TriWest provides.

209

Celley

Confirms that it is the DOD who determines what type of health services is provided.

223

Celley

Explains the local partnership, service delivery, and benefit to the local economy (EXHIBIT A, Page 17).

244

Celley

Concludes presentation with statement about commitment to the soldiers, their families, and their communities (EXHIBIT A, Pages 20 – 21).

278

Rep. Boquist

Referencing to the Reserve Health Care Continuum model, asks how a rural Oregon city and its soldiers would be served by TriWest.

307

Nortz

Presents a hypothetical situation and outlines the changes in an Oregon National Guard member’s healthcare eligibility from call up to demobilization.

370

Nortz

Explains how soldiers know that they are eligible for TriWest healthcare coverage and addresses the difficulty of educating soldiers and their families about eligibility and availability of benefits.

TAPE 20, B

023

Chair Nelson

Asks if TriWest will reimburse National Guard soldiers for out-of-pocket payments made for medical care after receipt of delayed-effective date orders.

028

Nortz

Responds that if the National Guard soldier has been coded in the DEERS system as eligible for delayed-effective date orders, the soldier could turn in medical receipts for expenses incurred after the date the orders were given.

046

Celley

Explains that there is a psychological health component in the DOD approved healthcare benefit package.

050

Celley

Explains how the DOD expanded healthcare benefits for National Guard and Reservists in 2003 and 2004.

084

Rep. Boquist

Identifies two of the primary problems preventing a National Guard soldier from attaining or using healthcare benefits.

123

Rep. Farr

Asks for the identification of the website that is the best resource for military personal to access information about coverage and benefits.

135

Nortz

States that the TRICARE website (www.TRICARE.osd.mil) is the most comprehensive resource for eligibility, benefits, and provider information.

141

Nortz

Details the eligibility requirements, benefits, and coverage for TRICARE Prime (EXHIBIT B, Pages 14 - 22).

176

Chair Nelson

Asks if National Guard soldiers can be treated at a VA hospital.

187

Nortz

States that as of January 2005, all VA hospitals will be considered TRICARE providers and treat guard soldiers, but only if there is space available.

201

Nortz

Addresses questions about TRICARE Extra and TRICARE Standard plan.

237

Celley

Addresses questions about the meaning of indemnity and the co-payments associated with TRICARE Extra and TRICARE Standard plans.

269

Celley

Explains that psychological health coverage is included in TRICARE Standard and TRICARE Prime benefit package, it is only if a soldier accesses services outside the network that additional fees are attached.

283

Rep. Boquist

Asks how does TriWest know when a National Guard or Reserve soldier has been activated and how does a soldier know when TriWest covers them.

317

Celley

Explains how TriWest works with family support coordinators to educate soldiers on the availability of benefits.

332

Celley

Addresses the difficulties associated with identifying and locating all of the families of soldiers who have been called up and the problems with the DOD issuing, rescinding, and then reissuing call up orders.

390

Celley

Cites communication pilot project conducted in Idaho by TriWest to educate soldiers and their families dispersed over a wide geographic area in Idaho.

TAPE 21, B

027

Celley

Expresses willingness to go to any Oregon Military unit was has been called up and conduct a briefing on the availability of TriWest healthcare benefits.

047

Rep. Hunt

Questions why the mental health benefits are less comprehensive in comparison to medical coverage.

081

Nortz

Verifies that DOD has established mental health benefits and has recognized the need for reevaluating these mental health benefits.

141

Celley

Explains that provider lists can be found online at www.triwest.com.

156

Rep. Farr

Asks what the general turn around time is from the mail order pharmacy, particularly regarding emergency need for medication.

180

Celley

Explains that there are network pharmacies for soldiers and their families to get prescriptions.

193

Nortz

Confirms that TriWest does cover emergency care and emergency situations when the person is unable to access a network provider. 

234

Rep. Boquist

Asks when TriWest learns when a unit really has been mobilized or has received their mobilization order.

258

Nortz

Explains that TriWest typically receives a request from a family support person, but that is often the only source of contact.

318

Jim Stembridge

Committee Administrator. Submits written material on behalf of Gerald Lorang explaining the Federal Definition of Veteran (EXHIBIT F); submits Veterans’ Administration Funding report on behalf of Congresswoman Darlene Hooley (EXHIBIT G); submits data report on Incarcerated Veterans’ on behalf of Max Williams (EXHIBIT H).

343

Mac MacDonald

Representative, Veterans’ Organizations. Discusses the lack of TRICARE Dental benefits, in particular, the lack of dental care providers willing to contract with TRICARE.

369

Celley

Addresses the ongoing difficulty with provider payments.

TAPE 22, A

016

Herb Columb

Retired Veteran, Marion County. Discusses the difficulty finding a healthcare provider in the Marion County area.

027

Celley

Addresses the number of contracted providers in the Salem area.

057

Mike Sullivan

Lobbyist, Association of Western Pulp and Paperworkers. Speaks to the need to have mandatory funding for medical care for all veterans.

090

Chair Nelson

Closes the informational meeting on Healthcare for Veterans’. Adjourns the meeting at 10:34 a.m.

           

 

 

 

EXHIBIT SUMMARY

 

  • A.     Healthcare for Veterans’, TriWest Healthcare Alliance: Serving America’s Finest PowerPoint Presentation, Scott Celley, 20 pp
  • B.     Healthcare for Veterans’, TRICARE Beneficiary Handbook, Joe Nortz, 48 pp
  • C.     Healthcare for Veterans’, TRICARE Choices Handbook, Joe Nortz, 24 pp
  • D.    Healthcare for Veterans’, TRICARE – Transitional Health Care Benefits Brochure, Joe Nortz, 16 pp
  • E.     Healthcare for Veterans’, TRICARE – Choices for the Reserve Component Brochure, Joe Nortz, 20 pp
  • F.      Veterans’ Benefits Administration, Definition of A Veteran Report, staff, 9 pp
  • G.    Veterans’ Issues, Veterans’ Administration Funding Report, staff, 26 pp
  • H.    Veterans’ Issues, Incarcerated Veterans’ Report, staff, 2 pp