Weekly newsletter of the Fleet Reserve Association

February 9 2018

In this issue:

CR Includes DoD FY2018 Budget

VA Secretary Calls for VA Caregiver Expansion

Subcommittee Reviews Coast Guard EHR Program

Lower TRICARE Co-pays for Maintenance Drugs 

CR Includes DoD FY 2018 Budget

The House passed another Continuing Resolution (CR-H.R.1892) (240-186) that provides the complete FY2018 Defense spending appropriations and keeps the rest of government open until March 23, 2018. The bill also extends the federal debt ceiling until March 1, 2019. As this CR passed the House, Republican and Democratic leaders in both the House and Senate were finalizing negotiations on lifting sequestration spending caps on Defense for two years. The agreement on Defense spending caps that will increase the sequestration spending caps on Defense by $80 billion in FY2018 and by $85 billion for FY2019. This provision was added to the CR as a Senate floor amendment. The Senate approved the bill as amended and sent it back to the House to approve the Senate amendment. The bill was just signed into law by President Trump.    

VA Secretary Calls for VA Caregiver Expansion

Department of Veterans Affairs (VA) Secretary David Shulkin recently testified before the House Veterans Affairs Committee (HVAC) urging the Committee to expand the VA Caregiver program to include catastrophically disabled veterans who were injured before September 11, 2001.  Currently, the program only provides benefits to veterans disabled on or after September 11, 2001. FRA's 2018 Legislative Agenda calls for extending the VA Caregivers Act to full-time caregivers of catastrophically disabled veterans from conflicts before September 11, 2001. 

The Senate Veterans Affairs Committee (SVAC) passed the "Caring for Our Veterans Act" (S.2193) that will reform the VA health care system by providing veterans easier access to meet with private-sector doctors and will expand the VA's care givers assistance program. The bill, unlike its House companion bill (H.R.4242), includes expansion of the VA Caregiver program. 

Members are strongly urged to use the FRA Action Center to ask their Senators to support S.2193 and the "Military and Veteran Caregiver Services Improvement Act" introduced in the House and Senate (H.R.1472 and S.591 respectively). They are standalone bills that expand the VA Caregivers program to include veterans catastrophically disabled before September 11, 2001. 

Subcommittee Reviews Coast Guard EHR Program

The House Transportation and Infrastructure Subcommittee on Coast Guard and Maritime Transportation recently held an oversight hearing on the Coast Guard's failed implementation of Integrated Health Information System (IHiS). The hearing was triggered by a released Government Accountability Office audit that found financial, technical, schedule and personnel risks led to the Coast Guard's decision to cancel IHiS and that the service allowed program managers to handle the project without sufficient oversight by acquisition professionals. Following a failed Electronic Health Record (EHR) implementation, the U.S. Coast Guard is currently conducting an acquisition process that is considering both government and commercial EHRs as possible solutions. 

"After wasting more than $66 million over a five-year period, the Coast Guard cancelled its electronic health records effort, referred to as the Integrated Health Information System project," said Rep. Duncan Hunter (R-Calif.), chairman of the House Subcommittee on Coast Guard and Maritime Transportation, during the hearing. "The service has nothing to show for the time and money expended and finds itself in a worse position than before it awarded the first contract almost eight years ago."

In her testimony before the subcommittee, Director of Health, Safety and Work-life for the Coast Guard Rear Admiral Erica Schwartz, said, "The service 'sincerely' regrets the botched development of IHiS by several contractors, which she described as a "simple" EHR that "increased in scope and expanded into a much larger concept."

While Schwartz testified that the project was well intentioned as a software-as-a-service initiative, she acknowledged that it "lacked appropriate oversight and governance," resulting in "significant mission creep, untimely delays and increased cost." Schwartz told lawmakers that the Coast Guard has learned valuable lessons from the failure of IHiS, which the service is incorporating into its plans as it moves forward with a new EHR project. 

Still, Hunter expressed concern that the Coast Guard is currently "handling all medical information using paper records—records that cannot be shared with the Department of Defense or Department of Veterans Affairs systems." GAO's Director of Information Technology Management Issues David Powner, told the subcommittee that "using paper is inefficient and dangerous." 

Schwartz testified that it is the service's goal to acquire and implement a system as soon as possible that is "interoperable with the DoD and one that allows our members to efficiently transition to the VA."

FRA wants to ensure Coast Guard parity with DoD on EHR and DoD, VA and Coast Guard resource sharing in delivering seamless, cost effective, quality services to personnel injured in the line of duty or wounded in combat.

Lower TRICARE Co-pays for Maintenance Drugs 

TRICARE beneficiaries taking certain maintenance drugs for diabetes or high cholesterol are now paying lower or no copayments as part of a pilot program. The Medication Adherence Pilot Program, started February 1, 2018, affects prescriptions purchased at in-network retail pharmacies and through the TRICARE Pharmacy Home Delivery. 

"Patients who take their medications as prescribed enjoy improved health outcomes compared to those who don't," said U.S. Air Force LTCol. Ann McManis, Pharmacy Operation Division at the Defense Health Agency. "We're excited to offer this program to beneficiaries who are living with these common, chronic conditions."

The Defense Health Agency (DHA) chose two high-value medications for the pilot program: Lantus® Pens, insulin shot to manage diabetes, and Rosuvastatin, the generic version of Crestor®, to manage high cholesterol. Lantus Pens will be offered at reduced cost. Rosuvastatin will be offered at no cost at a retail network pharmacy and through home delivery. 

Participation is automatic. DHA authorized the pilot program to run for up to five years.

Learn more about the TRICARE Pharmacy Program. 

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