These stories of survival and resiliency will appear in an hour-long special presented by the American Veterans Center and Military Order of the Purple Heart Service Foundation

Maj. Gen. Mark Graham and his wife know about loss — and the high cost of war.

He and his wife Carolyn lost not one, but two sons a year apart while Gen. Graham was serving as a top commander in the U.S. Army. Their family's story was told in "The Invisible Front: Loss and Love in the Era of Endless War."

"The Army told Jeffrey he didn't have to go because of the tragedy with experience with our son Kevin. And Jeff looked me in the eye and said, ‘Dad, I have to go,’" Gen. Graham, who spent 35 years in the Army said. He understood his son's wishes.

"Eight months later," Graham said, "Jeff was killed by an IED while he was on foot patrol outside of Fallujah in Iraq."

Their son Kevin was an ROTC Army cadet studying to be an Army doctor when depression led him to take his life. He stopped taking his medication because of the stigma associated with mental health issues and died by suicide. His brother Jeffrey was en route to Fort Riley in Kansas to join the 1st Infantry Division to deploy to Iraq.

"So our sons died fighting different battles. Kevin died fighting the battle of the mind and Jeffrey died fighting an enemy in a faraway land," Graham said.

"Our sons died fighting different battles. Kevin died fighting the battle of the mind and Jeffrey died fighting an enemy in a faraway land."

— Army Maj. Gen. Mark Graham

To cope with the loss, Graham started a national call center at Rutgers University called Vets4Warriors, which allows service members to speak to a Veteran within 30 seconds. He says he has seen an uptick in calls since the U.S. troop withdrawal from Afghanistan. The Department of Veterans Affairs saw 30% more calls to its suicide hotline (1-800-273-8255 press 1) from Aug. 15–31 as the U.S. military ended a 20-year presence in the Asian nation.

"We did see. We absolutely did," Graham told a live audience of military cadets at the U.S. Navy Memorial during the taping of "The Wounded Warrior Experience."

"Loneliness is one of the top reasons we get calls, and we've always gotten calls. And the loneliness has just grown and grown, exacerbated through the pandemic. And then when the Afghanistan withdrawal hit, it really impacted because they weren't near each other."

"Loneliness is one of the top reasons we get calls, and we've always gotten calls. And the loneliness has just grown and grown, exacerbated through the pandemic."

— Army Maj. Gen. Mark Graham

Allen Levi Simmons served with the U.S. Marines in Iraq and Afghanistan.

"So there was a gun in my hand, pillows on my bed, Bible on my nightstand. Paranoia tip toeing through the hallway of my home," Simmons said. "I had the gun in my mouth, finger on the trigger. I had the pills on my bed, and I was tired of feeling like somebody was trying to kill me."

Simmons was with an explosive ordnance disposal company in Marjah, Afghanistan, when he was blown up, hit by a rocket-propelled grenade.

"My ears were ringing like a smoke detector," Simmons said. "And little did I know that the rest of my life was going to be changed."

He suffers from PTSD after his traumatic brain injury, but finally asked for help. Writing poetry saved him.

"I had thoughts scrambling in my head. I had panic attacks. I wanted to blow a hole through my head. So that's part of my poem because I practice therapy through poetry, and that's how I got through my post-traumatic stress."

Last year he received his bachelor’s degree in engineering from the University of North Carolina in Charlotte and has his own podcast. His book is called "Can I Speak?"

Simmons described the anguish he felt watching the Afghan war end.

"That withdrawal sucked," Simmons told the audience arranged by the American Veterans Center. "It was like a lot of lives, a lot of blood, a lot of fathers and mothers have passed away. And what do we have to show for it?"

"That withdrawal sucked. It was like, a lot of lives, a lot of blood, a lot of fathers and mothers have passed away. And what do we have to show for it?"

— Allen Levi Simmons, former U.S. Marine

It took 10 years for Will Weatherford, a member of West Virginia’s Army National Guard, to ask for help.

"I battled post-traumatic stress," he said. "But I had trouble admitting that to myself."

He was on the verge of a divorce from his wife, until he got help from the Coalition to Support America’s Heroes.

"I thought that when he came back that everything would be normal again. Things would be like they were, but they weren't," his wife Megan McDonough recalled. "I was determined to find some resources and not just give up. It's not just the Veterans suffering a lot of times. There is a great impact to families and to marriages."

He and his wife Megan currently live on a small working farm in rural West Virginia, where they raise a menagerie of animals, such as alpacas and goats.

The Veterans Crisis Line is available for free, confidential support 24/7 by calling 1-800-273-8255 and pressing 1 or texting 838-255.

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The Department of Veterans Affairs and Consumer Financial Protection Bureau are warning consumers about a new scam targeting Veterans with VA guaranteed home loans.

According to a news release, there has been a recent jump in scams targeting Veterans with home loans. The scammers usually pretend to be affiliated with the government or a mortgage company and attempt to scam Veterans out of money by some new and novel methods, along with some techniques that have been around for years, albeit with either a new COVID-19 related twist or new technology that makes it easier for the scammers to conceal their identity.

The fraudsters try to get Veterans to refinance their homes, agree to loan modifications or even start sending their mortgage payments to a new address, according to the release.

With the recent financial crisis resulting from the COVID-19 epidemic, fraudsters are also trying to convince Veterans that their homes are facing foreclosure or they owe late fees.

Some Veterans have reported phone calls that appear to come from the local VA office, with the caller telling the Veteran their mortgage has been transferred to a new servicer. As a result of this supposed mortgage transfer, the Veteran now owes months' worth of mortgage payments, the fraudster claims. To avoid foreclosure, the Veteran is told they must make several hundreds or thousands of dollars worth of back payments to the new mortgage holder at a new address, usually through a money order or gift cards. These methods of payment cannot be traced.

Other calls and letters promise unusually low interest rates for refinancing a mortgage, but require the Veteran to pay several fees upfront, before receiving any services. Once the Veteran pays the fees, the "mortgage company" either denies the application or ceases communications with the Veteran, the release states.

Other new scams cite existing federal mortgage assistance programs related to COVID-19 financial relief initiatives. The scammers tell homeowners that the Veteran either must turn over the title to their property or sign confusing paperwork without reviewing it, claiming the relief programs are about to end and things must be done quickly.

As usual, the scammers play upon fear and confusion and rapidly disappear once they get what they seek -- your money.

The Consumer Financial Protection Board warns that if you suspect a scam, you should first contact the VA or your mortgage lender to determine whether the offer is real. If it is not, you should cease all communications with the scammer and contact your State Attorney General's Office and the Federal Trade Commission so that they hopefully can bring the bad actors to justice.

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The Department of Veterans Affairs has unveiled a plan that calls for closing 17 aging or underused medical centers, while shifting services to more than 30 new or rebuilt hospitals. In some cases, it would rely on private care.

Under the nearly $2 trillion proposal released Monday, the department would lose a net of three medical centers and 174 outpatient health clinics but would gain 255 health care facilities, including new clinics, stand-alone rehabilitation centers and nursing homes.

Medical centers in areas with diminishing Veteran populations are among those slated to close, while others would be built in growing urban centers, the West and the South -- areas where Veteran populations are growing.

The recommendations, which represent the VA's vision for future health care delivery to more than 12 million Veterans in the next 25 to 50 years, are the first step in an asset and infrastructure review required by Congress in 2018.

The infrastructure modernization proposals will be reviewed next by an independent commission, which will provide its own input. The final plan must be approved by Congress before being enacted.

Already, lawmakers are weighing in on the recommendations. Sen. Jon Tester, D-Mont., who chairs the Senate Veterans Affairs Committee, issued a statement Monday noting that a nursing home and two clinics would be closed in his state.

He called any "efforts to kneecap Veterans health care... a non-starter."

"I will fight tooth and nail against any proposals that blindly look to reduce access to VA care or put our Veterans at a disadvantage," Tester said.

Illinois Rep. Mike Bost, the ranking Republican on the House Veterans Affairs Committee, said he looks forward to seeing the commission complete its work, adding that "retaining the status quo is not an option."

"For far too long, VA's infrastructure has been slowly crumbling. Veterans in every corner of the country deserve better," Bost said.

VA Secretary Denis McDonough described the current VA medical infrastructure as unable to meet the health needs of today's Veterans. Many of its facilities were built in the early to mid-20th century and cannot accommodate modern technology or are inappropriately structured for the population they serve, he said.

"If we implement these recommendations, nearly 150,000 more Veterans will have primary care nearby; 200,000 more would have mental health care nearby; nearly 375,000 more Vets will have outpatient specialty care nearby; and all the care will be delivered in modern state-of-the-art facilities," McDonough said during an event last week with the Rand Epstein Family Veterans Policy Research Institute.

Under the plan, 17 medical centers in 12 states would close, 18 in 16 states would be completely replaced, and 13 new centers would be built in 11 states.

Of the 17 slated for closure, three are in New York City or its suburbs, including Castle Point, Manhattan and Brooklyn. Two each are in Pennsylvania (Philadelphia and Coatesville), Virginia (Salem and Hampton), and South Dakota (Fort Meade and Hot Springs).

Other medical centers on the proposed closure list include those in:

• Livermore, California
• Dublin, Georgia
• Fort Wayne, Indiana
• Alexandria, Louisiana
• VA Central Western Massachusetts
• Battle Creek, Michigan
• Chillicothe, Ohio
• Muskogee, Oklahoma

Some of these facilities would shift services to nearby civilian hospital networks or become multi-specialty community outpatient clinics, while others would shift their patients to newly built VA medical centers or bolstered existing hospitals nearby.

For example, in South Dakota, the plan calls to build a new, centrally located VA medical center in Rapid City. In Philadelphia, patients would have access to care at new state-of-the-art facilities in King of Prussia or just across the state line in Camden, New Jersey.

New medical centers also would be built at:

• Newport News and Norfolk, Virginia
• Macon and Gwinnett County, Georgia
• Huntsville, Alabama
• Summerville, South Carolina
• Grand Rapids, Michigan
• Everett, Washington
• Colorado Springs, Colorado
• Anthem, Arizona

Another 18 medical centers would be completely rebuilt, either on existing land nearby, as is planned for the VA medical center in Washington, D.C. -- or closer to other major health providers and hospitals in their areas, such as the VA medical center in Buffalo, New York, according to the recommendations.

Those include medical centers in Bedford, Massachusetts; Durham, North Carolina; Tuskegee, Alabama; Hines, Illinois; Shreveport, Louisiana; Reno, Nevada; Beckley, West Virginia; Wilkes- Barre, Pennsylvania; Miami, Florida; Atlanta; Phoenix; Indianapolis; Albany and St. Albans, New York; and Roanoke, Virginia.

According to the recommendations, however, the newly rebuilt facilities may offer different services and care than they currently provide. In Albany, for example, the facility will focus on inpatient mental health, nursing home care and residential rehabilitation treatment programs, and shift inpatient medical and surgical care elsewhere if the department can institute a strategic collaboration with existing civilian facilities.

As part of their deliberations, members of the Asset and Infrastructure Review Commission plan to hold public hearings and meet with those who have a vested interest in the future of VA health care, including Veterans service organizations, health care experts and institutions, and those who would be affected by the changes.

While most Veterans service organizations had not weighed in on the recommendations as of late Monday, the American Legion released a statement saying it generally doesn't support closing facilities but recognizes that changes must sometimes happen based on population shifts.

"The American Legion will always advocate for every U.S. Veteran, but we realize that for VA to properly serve America's Veterans, it must from time-to-time optimize, reallocate, and re-invest in some of its decades-old infrastructures," American Legion National Commander Paul E. Dillard said in a statement.

The conservative Concerned Veterans for America, a group that supports broader access for Veterans to private health care, issued a statement immediately after the recommendations were released saying it welcomed the proposals.

"Today's Veteran population is vastly different from what it was even five years ago, let alone decades ago. A rigid system that cannot adapt to the changing and unique needs of the Veterans it serves leads to waste, complications and, ultimately, an absence of care," CVA Deputy Director Russ Duerstine said.

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‘I woke up one morning, started typing a mission statement, and First There was born. Really it was out of necessity because I didn’t want my friend to kill himself.’

You never know who you might end up sitting next to in class one day. For example, biology students at the University of North Carolina – Chapel Hill between 2017 and 2019 may not have known that the quiet older guy in their classroom was a decorated Air Force commando who saved his entire team of U.S. and Afghan special operators from being overrun on a 2008 mission in Afghanistan, a mission where he repeatedly exposed himself to enemy fire and directed danger-close air strikes against the local militant group despite being shot through the leg.

As incredible as it sounds, that kind of story is fairly common in the world of Air Force combat control. Though many civilians and service members may not know about them, CCTs are some of the most elite special operators on the planet. Trained to the same physical capabilities as their better-known comrades in the Army Special Forces and Navy SEALs, CCTs are also technical experts who can call in deadly close air support within 10 meters of their position with a sucking chest wound while surrounded by enemy fighters.

“Nobody knows about us, even though we kill more people on the battlefield than anyone in the history of human warfare,” retired Air Force CCT Veteran Dan Schilling told Task & Purpose last year. “What CCTs do is they stitch everything together, and they determine whether everyone on the battlefield lives or dies.”

Retired combat controller Zac Rhyner certainly determined whether he and his buddies lived on that battlefield in Afghanistan in 2008. But while he had survived what one special operations commander described as “one of the most difficult situations” in combat, civilian life on a college campus presented a new kind of challenge.

“It was strange because I was in for 11 years and then all of the sudden I was a college student,” Rhyner, who medically retired from the military in 2015, told Task & Purpose. “Being a decade older than the other students – and it didn’t help that I wasn’t the friendliest guy on campus – I was pretty reserved.”

Rhyner had a tough last few years in the Air Force. On his last deployment in 2013, a gunshot shattered his right femur and severed a nerve. The commando spent more than a year in a wheelchair, often on a heavy dose of pain medication, as he wondered whether he would ever be able to rejoin his buddies in special operations.

To go from the fast-paced life of a combat controller to the slower pace of convalescence was “pretty rough,” Rhyner said, but his physical therapist taught him how to walk again and gave him a sense of newfound purpose.

“Through my two years of rehab and recovery, I found this love for physical therapy,” said the former controller, who also credited the therapist with ”just trying to boost my morale through those hard times and pushing me when I needed it.”

Rhyner pushed on through recovery, through his undergraduate studies and into the Duke University Doctor of Physical Therapy Program to pursue his new dream. But recovering from war has highs and lows, and Rhyner hit a low along with many other Veterans while watching the U.S. military evacuation from Afghanistan last year.

“I think I really went downhill after that,” said Rhyner, who described feeling angry, irritable and upset that the civilians around him seemed oblivious to what was happening to the country he had fought and bled in so many times. That, plus his long hours of clinical rotations as a budding physical therapist, were chipping away at his well-being. Luckily, he had a few buddies looking out for him.

“I was fortunate that within the small combat control network some guys recognized that I wasn’t doing great,” Rhyner said.

The retired airman was about to become one of the first combat controllers to benefit from the First There Foundation, a new nonprofit devoted to helping CCTs and their families with mental health, career advancement, financial advice and other areas that can be difficult to navigate after the high-tempo world of special operations.

‘How come we don’t do this for combat controllers?’

There is a galaxy of nonprofits dedicated to helping Veterans, but First There founder Eric Hohman noticed during his own struggle after leaving the Air Force that the tight-knit, little-known community of combat controllers was not receiving the same support as other special operations Veterans. The reality hit home when he attended an event put on by the Special Forces Charitable Trust, a nonprofit “that provides meaningful and sustainable support to the Green Berets and their families,” according to the trust’s website.

“I was just like, ‘how come we don’t do this for combat controllers?’” Hohman asked.

There is one organization that exists already: the Combat Control Foundation, which has a similar set of goals as First There. In the first eight months of 2022 alone, the Foundation spent $203,608 on resiliency, education, health and heritage efforts within the CCT community, according to the foundation’s website. Still, Hohman described it as more of a “heritage foundation,” whereas his goal with First There is to connect with younger generations of CCTs.

“We want to include older guys too, but we’re also largely made up of Global War on Terror Veterans,” Hohman said.

Mike Lamonica, president of the Combat Control Foundation and its sister group, the Combat Control Association, disagreed with Hohman’s characterization of CCF/CCA as a ‘heritage foundation,’ saying that CCF/CCA proactively supports all controllers, families and teammates, though he agreed that the organization has a slightly older population.

“We have programs built to assist with resiliency, health, education and heritage,” for CCTs and their families and teammates, he said. “As with any organization there are generational gaps, whether real or perceived.”

The leaders of both the CCA and CCF “want nothing more than to see Eric and team be successful,” Lamonica added. “We are a small community filled with operators, family members, and teammates who sacrifice on a daily basis in service to this great nation. Those people deserve to be supported and recognized.”

Hohman also noticed that the only times his community rallied together was in mourning for a fallen brother.

“It was a very reactive thing,” he said. “We should be celebrating our dudes now instead of waiting until someone dies before we all come together and mourn this guy.”

The experience of special operations is often so intense, so high-tempo and so niche that leaving those communities can present a unique set of challenges compared to other Veterans. On top of that, the combat controller community sometimes suffers from its own success at being ‘quiet professionals.’ Hohman recalled applying for the same job as a former Navy SEAL, and though Hohman was more experienced and held a bachelor’s degree and the SEAL did not, the latter got the job.

“‘Nobody knows what a controller is,’” Hohman recalled one of the people who reviewed his application telling him. “’They know what a SEAL is.’”

Not getting that job was one of several rough moments Hohman went through after getting out of the military in 2013 with a beat-up body and survivor’s guilt.

“I couldn’t find a job, I couldn’t find a purpose,” Hohman said. “I was like ‘I used to be this rock star, I used to brief generals. And now I’m 35 and I’m living with my parents … What is wrong with me? I was an operator.’’”

Within a year, Hohman started thinking about running his car off a bridge or putting a gun to his head. Luckily, a Veterans Affairs psychologist managed to get the controller to open up about how he was feeling, which helped Hohman start to turn things around. After that, the Special Forces Charitable Trust helped him realize what the combat control community was missing, but the last straw did not break until the start of the COVID-19 pandemic, when Chris “AZ” Rush, a mentor to Hohman and a well-known figure in the CCT world, died by suicide. It was an unexpected blow for many controllers.

“That broke my heart, and we couldn’t say goodbye to him because of COVID,” Hohman said. Then another buddy who was struggling called Hohman and he figured “it’s up to me. So I woke up one morning and started typing a mission statement, and First There was born. Really it was out of necessity because I didn’t want my friend to kill himself.”

An extension of the team room

Hohman began approaching donors with a pitch in hand: an extension of the team room. A team room is like a common room for special operations teammates to debrief, get ready for missions, or just hang out and chat. The First There Foundation would create a lasting extension of that space into civilian life for controllers and their families.

“We’re a trusted source, like ‘I know this is run by team guys, and I can trust them,’” Hohman explained. “All I do is facilitate with our network and say ‘this guy needs a job, or this guy needs help writing a resume, or this guy is having a hard time getting his VA rating.’ All we are doing is connecting guys and getting them help when they need it.”

Hohman hopes that First There can help develop a professional network for combat controllers where the valuable skills they developed in the military are appreciated by employers. On the First There Foundation website is a list of CCT-owned businesses in industries like real estate, retail, construction, marketing and even skateboarding apparel.

“The SEALs and Green Berets have done so well at getting their people in high positions of business,” said Jonathan Howard, a former CCT who owns several real estate businesses and is a donor to First There. “We don’t really have that in CCT, just because the notoriety is not there.

“I’ve hired a few controllers to come work for me, but it’s not going to be that Fortune 500 company,” he added. “That’s a gap we’re trying to fill, to help them on that transition out.”

Beyond a network and a resource, Hohman hopes that First There will also be a kind of connective tissue for controllers after they leave the military, reminding them that no matter where life takes them, they can always count on their brothers in scarlet berets.

“Part of it is really just to look out for each other, and be proactive,” Hohman said. “When guys have babies we send them a baby blanket. When guys retire, we send them out to camp. It’s little things to let them know that we’re there.”

‘I really saw the change it did for them’

Having a trusted network can be particularly important for navigating the mental health turmoil CCTs sometimes encounter when leaving the military. Howard explained that it takes a while for many controllers to admit that they are struggling, and then it can take even longer to find a mental health provider they connect with.

“I saw a lot of mental health professionals, but the one I really connected with was former enlisted Marine infantry,” Howard said. “Someone like that I can connect with. He gets it, he knows the lifestyle, and I don’t have to explain a lot of things.”

There are plenty of well-intentioned, well-executed mental health programs out there, but not all of them are effective for the unique circumstances of a CCT. Several CCTs who spoke with Task & Purpose for this story mentioned how the traditional medication prescribed to them by VA doctors often made them feel dead inside. Howard hopes to help expose CCTs to alternative treatments, such as mushrooms, which he found to be more effective than pills.

“It really changed my life for the better,” he said. “It’s dental floss for your brain.”

Howard first got into mushrooms through a trusted source: his buddies from combat control and from Air Force pararescue, another elite field of special operations.

“I really saw the change it did for them, they just seemed happier and not as stressed,” he said.

Other treatments besides psychedelics have also worked for some controllers. Hohman felt a breakthrough after trying out reiki, “an energy healing technique that promotes relaxation, reduces stress and anxiety through gentle touch,” according to the Cleveland Clinic.

“I thought it was a crock of shit, but I think my mom was so worried about me that she was like ‘look I don’t care what you think about it, you’re going to do this,’” he said. “And it was the first time that I felt at peace. It was something to do with my soul.”

Psychedelics, reiki or other therapies classified as alternative medicine may not work for everybody, but Howard hopes that First There can provide a word-of-mouth network for CCTs to hear about those therapies and, if they are interested, try them out in safe, supportive environments among people they trust.

“That’s a big thing I wanted to put out there with the First There Foundation,” he said. “The VA won’t send you on a nature retreat with a medical professional for ayahuasca. But if we can pay that bill to send a guy there for four nights and get his life reset, I’m all about that.”

‘We’d say their name and just bury it down.’

In the combat controller world, Jesse Schrader has been around the block. He’s been on the teams since 2002, gone on 13 deployments, and knows every single controller who’s been killed in combat since 9/11. Losing so many friends made it difficult for Schrader to keep in touch with their family members after their deaths.

“We’d a toast, we’d say their name and just bury it down,” he explained. “Part of my burying it away and not ever having to deal with it is I would kind of push aside all the families. I’ve known every combat controller who has been killed since 9/11 and I knew their families as well, and I just completely stopped talking to their families because talking with them brought up survivor’s guilt or whatever you want to call it.”

Now, as Schrader prepares to retire later this year, he imagines that other controllers may be in a similar situation, and he wants to make sure Gold Star families are not forgotten or neglected.

“We’ve been going the extra mile to get contact information for all the Gold Star family members: where they are, what their needs are, do they need help paying a mortgage, is there anything they need help with,” Schrader explained.

The way Hohman sees it, the First There Foundation may be able to help those families the way their sons, husbands or fathers might have. Even if it’s just something simple, like paying to fix a garbage disposal.

“I want First There to be an extension of the team room, but I also want it to be there for Gold Star families to step in where their sons or husbands would have,” he said.

Veterans and family members are not the only ones who Schrader thinks First There can help. Active-duty controllers may also stand to benefit. Schrader said combat control units across the service have made a big push to create “human performance optimization teams,” to look out for CCTs’ physical and mental well-being while still in uniform. Those teams can include weight-lifting coaches, physical therapists and mental health providers.

“The problem is, the people at the units won’t use them,” the CCT explained. “They’re like ‘as soon as I walk over to the psych doc and tell them I’m having these issues, they’re going to take all my weapons away. They are going to tell me that I am grounded from flying, jumping, I can’t train, they are going to take me off the team. Everybody in the entire squadron is going to know and find out that I self-diagnosed and raised my hand because I have an issue. Even though they are going to applaud me because I am trying to get help, they are going to have that stigma on me, and then will I ever be able to recover from it?’”

Some CCTs may feel comfortable reaching out for that help, Schrader said, but the worst-case scenario weighs on many minds in the career field. Schrader hopes the First There Foundation may be able to help with that, especially since he still knows many active-duty controllers. For example, if a team sergeant at one squadron has an airman who just returned from a deployment and needs help, but does not want to risk that worst-case scenario of being seen getting help, then the sergeant could call Schrader, who hopefully could help send the airman on a retreat or some other form of help sponsored by First There.

“He takes leave, comes out to see us and we try to do the best we can to right the wrong,” Schrader said.

Recovering from war has ups and downs, and even CCTs who have been out for a decade or more may need help through the downs.

“People who we know who have gone through that trauma might be burying themselves away with alcohol in a trailer somewhere that no one knows about until someone finds out and then hopefully they get them to us,” Schrader said.

‘It’s up to us’

When Zac Rhyner took the stage at San Antonio, Texas on September 10, he was feeling much better than he had in the months following the Afghanistan withdrawal. He had finished his doctor of physical therapy program and, with the help of First There, gone on a mental health retreat for special operations Veterans which other CCTs recommended.

“Being around that environment of people you relate to and being able to focus on mental health for a couple days, that was incredible,” he said. “It was the catalyst that I needed to get back on the right track.”

That day, Rhyner shared his story with a room full of 134 CCTs, family members, donors and other guests at the First There Foundation’s first-ever Scarlet Beret Gala, a kind of coming-out for the budding non-profit. Adult beverages were consumed, fallen comrades remembered, and songs from the 80s danced to in what Hohman hopes will become the first of an annual tradition. But Hohman hoped the event also served as a call to action.

“It’s up to us,” Hohman reminded guests at the gala. “It’s up to us and only us to spread the word about what we can do here.”

Maybe First There can be a sort of homecoming, not just for all the combat controllers and families who have served and are serving now, but for all CCTs to come. Maybe soon Zac Rhyner will be just one of many controllers who First There helped get to a better place.

“It’s taking care of us. It’s having a place where, when guys get out and life gets difficult, they can say “hey, I can call this guy or that guy at First There and say ‘hey man I’m really struggling, how can you help?’” Hohman told Task & Purpose. “That’s all it is.”

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Hundreds of military installations show unsafe levels of toxic “forever chemicals” in their ground water, including a handful along the Chesapeake Bay, according to a study released Wednesday by the Environmental Working Group.

Using Defense Department records, researchers noted that there are eight bases with between 0.8 and 2.2 million parts per trillion of per- and polyfluoroalkyl substances, compared to the Environmental Protection Agency’s recommended limit of 70 parts per trillion.

“The chemicals have seeped into the bay, affecting its wildlife, and potentially harming residents’ food supply and livelihoods,” according to the report. “The contamination underscores the need for swift DoD cleanup.”

Affected sites include Aberdeen Proving Ground, Naval Research Laboratory Blossom Point, Martin State Airport Air National Guard Base, Naval Air Station Patuxent River, the Naval Academy and Naval Research Laboratory Chesapeake Bay, Maryland, as well as Joint Base Langley-Eustis and Naval Weapons Station Yorktown, Virginia.

Five of those installations show PFAS contamination above 70 parts per trillion.

Langley, home to Air Force fighter squadrons, reported the highest contamination rate, at more than 2.2 million parts per trillion. PFAS contamination in the military is largely attributed to the used of aqueous film-forming foam, a flame retardant used to put out aircraft and vehicle fires.

All of the sites, save Aberdeen and Blossom Point, are in some stage of remediation, whether it’s investigations or assessments.

“The records also show that PFAS may be present in the groundwater at several other bases near the Chesapeake Bay where DOD has not tested to confirm the presence of PFAS,” according to the report.

Those include Joint Expeditionary Base Little Creek-Fort Story, Fort Monroe, Cheatham Annex and Naval Fuel Depot Craney Island, Virginia, as well as Weide Army Heliport, Navy Recreation Center Solomons and Naval Training Center Bainbridge, Maryland.

Despite DoD efforts to filter drinking water on bases, Chesapeake contamination offers another risk, according to the EWG: seafood.

A 2020 study found PFAS, to the tune of thousands of parts per trillion, in rockfish, oysters and crabs caught in southern Maryland. The Food and Drug Administration does not have a safe consumption limit for PFAS in food.

Though DoD has known about contamination due to fire-fighting foam, efforts to clean it up have come in fits and starts. The services no longer use the foam in training, vastly cutting down exposure, but there have been no major efforts to clean up groundwater around bases beyond filtering what residents drink.

While advocates push for stronger EPA regulations, and legislation that would fund federal clean-up of military bases, a non-toxic firefighting foam still doesn’t exist.

“The rate of progress is defined primarily by the rules that govern our physical world. Physics, chemistry, science,” Richard Kidd, the deputy assistant defense secretary for environment and energy resilience told the House Appropriations Committee in May. “Based on what we know today — and known technology ― frankly, it will be years before we fully define the scope of the problem and with that definition can reflect it in our budget request, and after that, probably decades before cleanup is complete.”

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It was a sweet assignment right up my writing alley: A narrative about the D-Day invasion to commemorate the 50th anniversary of the Allied attack that marked the beginning of the end for Nazi Germany. My newspaper, the Daily Press of Newport News, Virginia, published an open invitation for those who had taken part in the grand and awful amphibious assault to contact us and share their stories. In the military-rich Hampton Roads region, we struck gold: From the pilots who flew the paratroopers to the infantrymen who stormed the beaches, I was able to relate the entire D-Day narrative chronologically, all through Veterans’ eyes.

A couple of weeks beforeJune 6, 1994, I was at my desk when the phone rang. A raspy voice inquired: Are you all still collecting D-Day stories? The story was essentially done at that point, but I said, “Sure. What did you do?”

“I was in the Army,” the voice replied. And? “I was a Ranger. At Pointe du Hoc.”

As you might imagine, I almost fell out of my chair. “You took part in one of the greatest assaults inU.S. military history?”

“Yep.”

Good grief, I thought. Too good to be true! In short order, photographer Ken Lyons and I were sitting in the fellow’s sun-splashed back yard. His story was detailed, yet he under played his role. He brought out a shadow box filled with decorations and a folded flag; his kids had made it for him, he said.

Back at the office, I started typing up my notes, shaking my head at times. I don’t know what stopped me, but I heard myself saying the words, “Too good to be true,” and decided to call the Ranger headquarters atFort Benning,Georgia. I asked the spokesman if he had a unit roster of some sort. No, he said, but a former Ranger up inNew York did. As it turned out, my guy wasn’t on the list. But, the former Ranger said, call this other former Ranger down inPennsylvania; he was in that unit. I called, telling this former Ranger that my guy had claimed to be the assistant platoon leader. That guy, the real Ranger told me, got killed on D-Day.

I called my alleged Ranger back, said I wanted to clear up the unit name and asked him twice to repeat it. Yep, that was my outfit, he said. I then told him what I’d learned and asked, “Did you lie to me?”

In a voice that suddenly sounded creaky and 10 years older — yet sort of childlike, as though fearing a reprimand — he replied, slowly, “Yes.”

Lucky me, I’d exposed the lie before the story went to press. But as I soon learned, this fellow was hardly the only person who has fabricated or exaggerated wartime exploits.

There is no hard count of how many people have lied about their military service, but one of the best sources on the topic thinks the number is in the millions.

“I personally believe there are as many American males claiming military service falsely as there are living Veterans in America,” said B.G. Burkett, author of the acclaimed 1998 exposé “Stolen Valor: How the Vietnam Generation Was Robbed of its Heroes and its History.” That’s a big number— approximately 23.6 million.

Burkett might be accused of hyperbole had he not spent the past 25 years uncovering military fakers, often working with authorities who’ve come to view him as the real authority. For the past three years, Burkett has worked “behind the scenes” with the Department of Veterans Affairs Office of the Inspector General on Operation Stolen Valor, aimed at uncovering people in the Pacific Northwest who’ve fabricated military service in order to obtain VA benefits.

In 2007 the effort snagged eight people who were receiving VA compensation for combat injuries, although none had served in combat and two had never served in the military. They got in the door with computer-generated or -altered discharge papers known as DD 214 forms. Their lies collectively cost the VA $1.4 million.

“That’s eight individuals in theSeattle area, in one bust,” said Doug Sterner, a longtime private watchdog who now maintains the Military Times newspapers’ Hall of Valor database. “Now, extrapolate that across the nation, and imagine the millions of dollars that this runs into.”

BetweenMarch 1, 2008, andFeb. 25, 2009, the VA investigated 96 cases of “stolen valor” fraud, according to James O’Neill, assistant inspector general for investigations. The work led to 48 arrests, the VA recovered $562,888, and authorities levied $1.23 million in fines. Type “falsify military service” into an online search engine window, and one yields tens of thousands of hits relating case after case in which someone has either exaggerated or completely fabricated their military service.

In 2000, upon hearing that the Library of Congress had launched its Veterans History Project, Burkett asked administrators if they were verifying any of the Vets’ records. They weren’t. Burkett predicted that half would be frauds.

Seven years later, Chuck and Mary Schantag, whose P.O.W. Network Web site listsU.S. prisoners of war, reviewed all the history project records. In 2007 the project listed 49 Medal of Honor recipients on its Web site. The Schantags discovered that 24 of those were false entries. So were 47 claiming to have earned service crosses. As were 45 claiming to have been prisoners of war.

The efforts of latter-day watch-dogs such as Sterner, Burkett, the Schantags, fake Navy SEAL–catcher Steve Robinson and others have given military fakery the appearance of being a modern phenomenon, particularly during theVietnam era. That’s not true.

“I run into far more than my share of World War II fakers,” said Sterner. “A long time ago, I had at least one case of a World War I guy, claiming a Medal of Honor that he’d received.”

Fakery was reportedly widespread during the Civil War and its long aftermath. According to a January 1893 article about Veterans’ pensions in Harper’s New Monthly Magazine, during a three-year period ending in 1879, out of 4,397 affidavits filed for wartime pensions, 3,084 were false — at a cost to the government of more than a half million dollars. Poor or nonexistent record keeping makes such fakery difficult to track much further back in history. The suspicion, however, is that it has probably been around as long as people have been on the planet.

More than a few 20th century men tried to pass themselves off as the last surviving Veterans of the Civil War. One of the best-known examples was Walter Williams, who claimed to have served in the Confederate army under Gen. John Bell Hood. Williams was said to be 117 years old at his death in 1959 inHouston,Texas. That same year, however, American journalist Lowell K. Bridwell wrote that he couldn’t find “one single scrap” of evidence to verify Williams’ age or Veteran status. According to research by historian William Marvel, published in a 1991 issue of Blue and Gray, Williams would have been too young to have served in the war.

“I think you can find fakers very far back,” said Bella DePaulo, a visiting professor of social psychology at theUniversity ofCalifornia,Santa Barbara, who studies the communication of deception. “I don’t think it’s particularly modern.”

“I can’t prove that there were phonies among King Arthur’s Knights of the Round Table,” Burkett said. “But I know this didn’t just occur starting with the modern wars. It was much easier to do before. You know, you could get yourself a sword and say, ‘Hey, I’m home from starving in theMideast with the Crusaders.’”

Nor has military fakery been limited to Americans. In 1932 a German, Oscar Daubmann, turned up in his homeland claiming he’d been a French prisoner of war for the previous 16 years after his capture at the 1916Battle of theSomme. After killing a prison guard, he said, he’d been transferred to a labor camp in French-governedAlgeria, where, after years of torture, good behavior had earned him a job as a prison tailor. Daubmann’s tale of escape from the colonial hellhole prompted the German government to treat him as a national hero. The Nazis, in particular, lionized him. Accounts vary as to how Daubmann’s lies unraveled, but five months after his glorious “return,” he admitted he’d never served in the German army. He was telling the truth about prison, it turned out; but he’d done time for burglary, not as a POW. Nor was his name actually Daubmann; it was Karl Hummel, and he’d taken his new name from a passport retrieved from an old uniform he’d bought. The real Daubmann had been killed in the war.

In this country, fakers did proliferate following the Vietnam War, according to Burkett. The My Lai Massacre and other news stories created for some a public image of troops as “baby killers,” an image since exacerbated by films such as 1986’s “Platoon.” The post-Vietnam period recorded countless news accounts of hundreds of thousands of angry and sometimes homeless and desperate Veterans.

That negative image was fresh in Burkett’s mind when he decided to help a friend inDallas raise money for Vietnam Veterans a quarter century ago. Reporters often interviewed local Veterans of the war, Burkett said, “and the things they [the Veterans] were saying were just bogus as hell. I was thinking, There’s something wrong here.”

After one local vagrant killed a policeman, the next day’s headline read, VIETNAM VETERAN GOES BERSERK. Burkett, who at the time was verifying records for the Texas State Archives, discovered he could get military records by request. He searched for the vagrant’s record and discovered the man had been kicked out of basic training after three weeks on a psychological discharge. “He wasn’t aVietnam Veteran,” Burkett said. That launched the financial planner into a new career.

Military fakery is hardly limited to the down-and-out, however. Take John M. Iannone, a Pittburgh- area oilman whom family members said had it all and was even more admired for his extensive community service. He apparently fabricated documents claiming he’d been awarded the Medal of Honor during his Vietnam War service. Oddly, his charitable endeavors included involvement with localVietnam Veterans’ groups, which ended in 1994 when he disappeared, only to resurface years later as a con man.

In 1997 Wes S. Cooley, a sitting first-term easternOregon congressman, was convicted on charges he’d lied about his military service in official state voter guides. Cooley had claimed Korean War service with Army Special Forces. AnOregon newspaper learned that Cooley hadn’t finished training until nearly a month after the signing of the 1953 armistice. A judge sentenced Cooley to two years’ probation, a $5,000 fine and 100 hours of community service.

Well-known actor Brian Dennehy often shared stories of his service with the Marines inVietnam. Burkett verified that the movie tough guy was indeed a former Marine but had been discharged in 1963, before any Marines were sent toVietnam. Dennehy did play football for a Corps team onOkinawa, Burkett reported.

Local community celebrities appear no less prone to telling such tales. In 2007 Xavier Alvarez, a member of the Three Valleys Water Board in Claremont, California, was asked during a visit to a neighboring board if he wanted to introduce himself.

“I’m a retired Marine of 25 years,” Alvarez told the attendees. “I retired in the year 2001. Back in 1987, I was awarded the Congressional Medal of Honor. I got wounded many times by the same guy. I’m still around.”

His words were recorded. The following year, Alvarez was sentenced to more than 400 hours of community service, three months’ probation and fined $5,000 for violating the Stolen Valor Act — a 2005 federal law named for Burkett’s book.

Any number of personality flaws might drive someone to fabricate a military background, no matter what their station in life. In Sterner’s experience, it’s all about the financial advantages fakers can obtain.

“It’s all done for personal gain,” he said. “That is the one common thread.”

In Burkett’s mind, most fakers do so because of low self-esteem. “All societies in history have revered the warrior,” he said. “The second you tell people that you are a Veteran, they look at you differently. Regardless of what they thought of you before, there’s suddenly more substance to you.”

The lie “often starts modestly,” Burkett said. “Someone says, ‘Hey, Joe, you’re of the age forVietnam. Did you get drafted, go in the military?’ Rather than say, ‘No, I avoided the draft,’ the guy says, ‘I don’t like talking about it.…Well, I was in the Army.’ ‘You serve overseas?’ ‘Yeah, I was inVietnam.’ The next thing you know, the guy’s being asked to join the VFW.”

DePaulo more or less agreed: “You say something, almost as a trial balloon. Or maybe you don’t even mean it consciously as a trial balloon, but you put something out there, and it works and maybe gets a good reaction. People are impressed. Once you start getting away with it, then I think you get more emboldened. And you think, Oh, no one’s ever going to catch me. Nobody’s going to care.”

DePaulo says it’s not surprising a person already held in high esteem would choose to fabricate a military background.

“If you are also in a position of power or authority or prestige, then you might also feel less vulnerable, because you think that people won’t challenge you,” she said.

But in a broader sense, DePaulo said, people lie for the same reasons, no matter what they claim to be.

“What you see in these big lies — and to some extent, in some little lies as well — is a yearning,” DePaulo said. “People want to be a certain kind of person they only wish they could be. And rather than doing the hard work of actually trying to become that person, they just do a shortcut of claiming to be that person.”

DePaulo believes that most people who tell such lies probably are doing so consciously. At the same time, she said, “I think it is possible that in some cases, they’ve told the lie for so long, and it’s so integrated into their perceptions of their life experiences, that, psychologically, it’s almost like a truth, because if they’ve been telling the lie for a long time, then they don’t have the challenge of someone who’s making it up for the first time.”

Perhaps the idea that the lie about military service ultimately becomes a “truth” in the phony Veteran’s mind explains what happened with my aspiring D-Day Ranger about two weeks after I’d caught him lying. It was Saturday night as the newspaper prepared my D-Day story for the Sunday edition. At about11 p.m., I remembered that local enthusiasts were reenacting theNormandy invasion on the beach atFortStory, an Army base nearby. So I turned the television on and checked the local news.

The news must have been slow that day, because the reenactment was the lead story. Men in period uniforms scrambled across the beach between mock explosions, as the reporter interviewed D-Day Veterans who came to watch.

And there he was, my false ranger, holding his shadow box of medals as he repeated his fake story. I could not believe it. Here I’d called him on his lie, and he had the gumption…the belief…the desire to somehow lie again, as if by lying many mines, the lie would turn true.

I don’t think I’ll ever know.

For further reading, William McMichael recommends: “Stolen Valor: How the Vietnam Generation Was Robbed of Its Heroes” and “Its History,” by B.G. Burkett and Glenna Whitley; “No Guts, No Glory: Unmasking Navy SEAL Imposters,” by Steve Robinson; and “Fake Warriors,” by Henry Mark Holzer and Erica Holzer.

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When a World War II Veteran turned 99, he had one regret. He had an opportunity earlier in life to meet some of the last living Civil War Veterans, but he didn't go.

Now 100-year-old Sidney Walton is giving people across the country the chance to meet one of the last living World War II Veterans.

Walton has been on a mission to visit all 50 states over the past year and a half, and he passed the halfway mark earlier this month. He's made it to 26 states, meeting with governors and anyone who will hear his story.

He wants people he meets to remember the sacrifice World War II Veterans made, especially as there aren't many left. Fewer than 400,000 of the 16 million Americans who served in World War II are alive, according to US Department of Veterans Affairs statistics.

In April 2018, Walton started sharing his message. He decided to leave his home in San Diego and meet with governors of each state as a way to reach a large number of people.

He first met with Rhode Island Gov. Gina Raimondo and would hit 25 more over the next 18 months, ending with Maryland Gov. Larry Hogan. He calls it his "No Regrets Tour."

"We're going to complete this tour," Paul Walton, Sidney Walton's 64-year-old son, told CNN. "We have 24 more governors to go and we're going to do it, as they say, 'Come hell or high water.'"

When Sidney Walton was 21, he left college in New York City to join the US Army.

At first, he was trained in chemical warfare and was sent to get a degree in chemical engineering from Virginia Polytechnic Institute, now known as Virginia Tech. He never had to use those skills, though.

He later was sent to India and served in the China-Burma-India Theater as a corporal, which some call the forgotten theater of the war.

Paul Walton said this tour is meant to keep the memory of Veterans alive and remember their sacrifices. He believes in the message his father is sharing so much, that he gave up his job to travel with him.

The journey isn't always easy. At 100 years old, the amount of traveling and planning can be difficult. Paul Walton said all their plans are made a month in advance at most. They never know what could happen, but they hope to finish the tour in style.

They drive a rental car with a magnetic sticker that tells people Sidney Walton, a 100-year-old World War II Veteran, is inside. The two have big dreams of getting a large campaign bus to travel through the remaining states so everyone knows that Sidney is there.

"We want everyone in the next 24 states to know that Sidney is on his way," Paul Walton said. "He's going to accomplish this mission like he always has all of his life."

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The list of the benefits the U.S. government offers Veterans is long. According to Military.com, these include disability compensation, pension programs, free or low-cost medical care through VA hospitals and medical facilities, education plans, home loan guarantees, vocational training, Small Business Administration loans, counseling, and burials.

The number of people eligible for these benefits is large. Pew Research reports there are 19 million Veterans. The percentage of those from WWII has dropped well under 1%. Korean war Veterans have dropped to 5%. Almost 70% of the total are Veterans from Vietnam and the Gulf War.

To determine the state with the best benefits for Veterans, 24/7 Wall St. reviewed an article on the Best and Worst States for Veterans from financial comparison site MagnifyMoney from financial comparison site MagnifyMoney. States were ranked based on the Veteran population, the quality and quantity of Veterans Affairs centers, and the economic circumstances for Veterans.

About a quarter of Veterans, 4.7 million people, have a service-connected disability. Veterans Affairs health care and other benefits provided to service members can be a crucial lifeline for those struggling with the physical and mental challenges they now face as a result of their service.

The quality of Veteran’s benefits also depends heavily on economics — some states give out much more significant tax breaks to former service members than others, saving them thousands of dollars on property taxes.

The state with the best benefits for Veterans is North Dakota. Here are the details:

> Score: 67.9/100

> Number of Veterans centers: 43.6 per 100,000 VA enrollees (4th highest)

> Median property tax range for Veterans: $1,600-$1,699

Click here to read States with The Best Benefits for Veterans

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Thousands of Veterans caregivers could see their Veterans Affairs stipends reduced or taken away completely under a series of case reviews planned over the next year to ensure long-time participants still qualify for the benefit.

Veterans Affairs officials said that no families currently in the Program of Comprehensive Assistance for Family Caregivers will see reductions in stipends before fall of next year, and families being removed from the program won’t have the financial support cut off until early 2023.

But the move still means the looming loss of thousands of dollars a month for some families of Veterans with serious, lingering service injuries.

About 33,000 individuals are currently enrolled in the program, which provides support services and monthly stipends to caregivers of Veterans unable to perform basic self-care activities.

Program Executive Director Colleen Richardson said the reviews will cover about 19,800 “legacy” participants, all of whom entered the program before October 2020. Before then, only Veterans who left the ranks after September 2001 were eligible to apply for the program.

Officials expect about one-third of that group — around 6,700 families — to be completely dropped from the program after the review, based on preliminary work. It’s unclear how many more could see reductions in the amount of financial support they receive each month.

In addition, some Veterans could see increases in the amount of payouts they receive, if reviews find they are eligible for more support.

Department officials hope to complete the reviews in the next six months, but Richardson said no stipend reductions will take place before October 2022, to ensure that families are given time to deal with the financial impact of the moves.

Caregivers being dropped from the program will get an additional five months of payments as they transition out, Richardson said.

“And even though they may not qualify for the stipend, they will still qualify for services within the caregiver support program” such as counseling and training offerings, she said.

The reviews will include medical exams and in-home visits (or virtual, if pandemic concerns linger) to determine Veterans’ independence and ongoing assistance needs. Veterans involved will not need to reapply; instead, program officials will contact them about the reassessments.

About 107,000 caregivers applied to the program in the past year, mostly connected to Veterans who served during the Vietnam War or in earlier eras. That group wasn’t eligible for the program until last fall. The approximately 13,000 individuals approved from that group in the last year will not be part of the new reviews.

Richardson said the new move also is not expected to disrupt plans scheduled for next fall to expand the caregiver program to Veterans of any era.

Stipend calculations are based on the severity of Veterans’ injuries and the cost of living in the area where they live.

For example, a caregiver tending to a severely injured Veteran living in the Washington, D.C. area could receive up to $3,100 a month in financial support. Individuals in a less costly area with less severe medical complications could see half that amount.

The new reviews are separate from potential changes linked to a U.S. Court of Appeals for Veterans Claims ruling earlier this year requiring a new appeal process for individuals rejected for the caregiver stipend program. Richardson said officials expect to have additional announcements on that issue in coming days.

More information on the reviews is available on the VA web site.

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MIDLAND, Texas (KOSA) - There’s an odd loophole in military benefits that keeps combat-wounded Veterans who served less than 20 years don’t get retirement benefits.

“You never should really have to think twice about whether your country is going to take care of you,” said Midland resident and Marine Jerry Fuentes.

The loophole affects Veterans like Fuentes, who served for more than a decade and did two combat tours before suffering serious injuries from IED explosion.

“I know it sounds a little odd that injured in combat, 13 years in, would have to fight for retirement, but I honestly did,” Fuentes said.

But what Fuentes gets in retirement is then taken from his disability. Even as he suffers from nerve damage that limits his mobility, as the current law stands, he can’t get both disability and retirement.

“I’ve never seen my military retirement to this date, and that’s where the Major Richard Star Act would come into play,” he said.

The Major Richard Star Act (H.B.1282/S.344) would expand retirement benefits to over 40,000 Veterans whose careers were cut short due to combat injuries. More than 6,000 of those Veterans live in Texas, the most of any state.

A version of the bill exists in both the House and Senate. In a devastating blow, it wasn’t included in the 2023 National Defense Authorization Act (NDAA).

That could’ve been the end of the Major Richard Star Act, but it’s garnered new life by garnering over 290 co-sponsors in the House. This newfound popularity allows it to potentially come to a vote on the House floor.

“We were all very surprised [we reached 290 sponsors], but we’ve done a fantastic effort engaging with lawmakers and making them aware of the bill,” Fuentes said.

One of those co-sponsors is Rep. August Pfluger (R, TX-11).

“Obviously, I’m a little disappointed that this wasn’t part of the NDAA this year, but that doesn’t mean it can’t come as a standalone bill,” Pfluger said. “I think that’s really the next action, to see how we can get this to the House floor.”

While it seems likely the bill will get to the House floor, the Senate might be more difficult. Support there isn’t as broad, and Texas senators John Cornyn and Ted Cruz have not sponsored the legislation. Fuentes said ‘Star Act’ supporters have repeatedly reached out to both senators without success.

CBS7 reached out to both Sen. Cornyn and Sen. Cruz for this story. Sen. Cornyn’s office said they are looking into the legislation. Sen. Cruz did not respond to our request for comment.

Despite not having success reaching some of the state’s highest lawmakers, Fuentes, other Veterans, and a growing number of lawmakers continue battling to help America’s forgotton wounded continues.

“I think in the last few years, the government has made steps in the right direction, but it’s still not to a point where it needs to be,” Pfluger said.

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SAN ANTONIO – A federal grand jury in San Antonio returned an indictment this week charging two Kerrville men and an Ingram man with distribution of narcotics.

According to court documents, Scott Mitchell Brown, 35, and John Henry Swiencki, 51, of Kerrville and David Jeffery Hughes, Jr., 42, of Ingram are all charged with one count of conspiring to distribute hydrocodone, oxycodone and amphetamines.

In addition to the distribution charge, Brown is charged with one count of theft of prescription medications; one count of possession of stolen mail; and one count of obtaining unauthorized health information from the Kerrville Veterans Affairs Medical Center. Hughes is also charged with one count of being a felon in possession of a firearm.

Swiencki and Hughes are scheduled to make their initial court appearances today before U.S. Magistrate Judge Henry Bemporad. Brown is scheduled for an arraignment on September 2, 2021, before U.S. Magistrate Judge Richard Farrer.

If convicted on the distribution charge the defendants face up to 20 years in prison. Brown faces up to an additional 10 years in prison on the theft of prescription medications charge and 10 years in prison on the obtaining unauthorized health information charge. He also faces an additional five years in prison for the possession of stolen mail charge. Hughes faces an additional sentence of up to 10 years in prison for the felon in possession charge. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

U.S. Attorney Ashley C. Hoff; Drug Enforcement Administration (DEA) Special Agent in Charge Daniel C. Comeaux, Houston Field Office; U.S. Postal Inspection Service (USPIS) Inspector in Charge Adrian Gonzalez, Houston Division; U.S. Department of Veterans Affairs Office of Inspector General (VAOIG) Special Agent in Charge Jeffrey Breen, South Central Field Office; and Kerr County Sheriff L.L. Leitha made today’s announcement.

The DEA, USPIS, VAOIG and the Kerr County Sheriff’s Office are investigating this case.

Assistant U.S. Attorney Priscilla Garcia is prosecuting this case.

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The new bill would expand GI Bill benefits to National Guard and Reserve members.

A bill that would expand eligibility for Post-9/11 GI Bill Benefits to members of the military’s National Guard and Reserve passed the House of Representatives last Wednesday without the support of 36 military Veterans and current members of the National Guard and Reserves who voted against the bill.

Among those 36 are members of all service branches, from former enlisted soldiers to general officers. It includes some notable names, from Rep. Don Young (R-Alaska), an Army Veteran and the House’s longest-serving member, to Rep. Dan Crenshaw (R-Texas), the former Navy SEAL known for his Saturday Night Live appearance and efforts to root out “woke ideology” from the military.

The nays represented a little less than half of the 76 members of the House who are military Veterans, according to the Congressional Research Service. The ostensible reason for the no votes was budgetary concerns. According to the Congressional Budget Office, the new bill could cost $1.9 billion over the next decade.

Rep. Mike Bost (R-Illinois), the ranking member of the House Veterans Affairs Committee and one of the Veteran lawmakers to vote no on the bill, agreed that Congress “must take a hard look at duty-status reform and the potential expansion of benefits regarding reservists, but this bill before us today would be an unwise expansion of benefits,” the Marine Corps Veteran said. “Training has never counted towards eligibility, and members of the Guard and Reserve know that when they sign up.”

The bill would allow any day in which service members were in uniform under federal orders to count towards eligibility for education benefits offered under the GI Bill.

“Not only are these National Guard and Reserve members risking their lives to serve our country, but they’re also forced to put their civilian lives on hold when they’re called up, leaving behind their families and interrupting civilian careers,” Rep. Mike Levin (D-Calif.), who sponsored the bill, said on the House floor. “In some of those settings, they are serving side by side with active-duty members doing similar jobs and facing similar risks, but they’re not earning the same GI Bill benefits as their peers. That’s unacceptable.”

Most active-duty service members acquire the full array of benefits after 36 months of service, but service members begin accruing eligibility for a portion of benefits after a minimum of 90 days, not including basic training. Those service members who are discharged because of a service-related injury are eligible for the entire range of benefits if they have served 30 days. But for National Guard members and reservists, not all of their time in uniform is considered to be active duty, meaning it does not count towards accruing eligibility for GI Bill benefits.

National Guard members drill under both Title 10 and Title 32 of the U.S. Federal Code. While Title 10 accrues active-duty time under orders to full-time federal service such as overseas deployment, under Title 32 orders, service members are in uniform and being paid with federal dollars but state governors retain nominal control. And those days don’t count towards education benefits. This also applies to days that Guard members and reservists are activated for training.

Passage of the bill comes at a time when National Guard members and reservists are more active than ever. They have been mobilized to support police during protests following the murder of George Floyd; to secure Washington, D.C. following the Jan. 6 Capitol attack; to help distribute vaccines for the novel coronavirus (COVID-19); to assist with the construction of the wall on the U.S.-Mexico border, and in response to natural disasters. In some cases, Guardsmen have even been activated to drive school buses.

Some of these events, such as coronavirus relief, are considered time served towards GI Bill benefits, as the pandemic was declared a national emergency. Others, like when more than 120,000 guardsmen mobilized amid large-scale protests around the country in June 2020, do not.

For now, the bill will move on to the Senate for the next round of voting. Meanwhile, an analysis conducted earlier this year by Pew Charitable Trusts shows that among military Veterans who borrowed student loans, nearly six in 10 used most of their loan money to pay for cost-of-living expenses..

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Doctor also faces charge involving overdose death

WAYCROSS, GA: Three healthcare professionals have been charged in a 52-count federal indictment unsealed Wednesday, Sept. 15, 2021, in the U.S. District Court for the Southern District of Georgia.

The indictment describes an alleged conspiracy to distribute “massive quantities” of controlled substances, including highly addictive opioids, in violation of federal law, said David H. Estes, Acting U.S. Attorney for the Southern District of Georgia. The charges include one count of Distribution and Dispensation of Controlled Substances Resulting in Death by Dr. Wallace Steven Anderson, 67, of Douglas, Ga., a charge that carries a minimum statutory sentence of 20 years in prison, up to life. There is no parole in the federal system.

“Our efforts to eradicate the illegal distribution of dangerous and addictive drugs in our neighborhoods target both the shadowy street dealers and white-coated prescribers alike,” said Acting U.S. Attorney Estes. “With our law enforcement partners, we will continue to bring to justice those who would spread poison in our communities.”

Named in the indictment are:

• Dr. Anderson, charged with Conspiracy; Distribution and Dispensation of Controlled Substances Resulting in Death; 48 counts of Unlawful Distribution and Dispensation of Controlled Substances; Conspiracy to Commit Healthcare Fraud; and Conspiracy to Launder Monetary Instruments;
• Bridgett Stephanie Taylor, 55, of Broxton, Ga., a Nurse Practitioner working under Anderson, charged with Conspiracy; eight counts of Unlawful Distribution and Dispensation of Controlled Substances; Conspiracy to Commit Healthcare Fraud; and Conspiracy to Launder Monetary Instruments; and,
• Wandle Keith Butler, 57, of Douglas, a Physician Assistant working under Anderson, charged with Conspiracy; three counts of Unlawful Distribution and Dispensation of Controlled Substances; Conspiracy to Commit Healthcare Fraud; and Conspiracy to Launder Monetary Instruments.

As described in the Indictment, Anderson is the owner of Steve Anderson, PC, and Steve Anderson Behavioral Health, both located in Douglas, Ga. Taylor and Butler worked for Anderson. The indictment alleges that from February 1, 2016, to September 30, 2020, the three operated or assisted in operating “nominal pain management and addiction facilities which dispensed controlled substances without any legitimate medical purpose.”

Criminal indictments contain only charges; defendants are presumed innocent unless and until proven guilty.

The case was investigated under the Organized Crime Drug Enforcement Task Forces (OCDETF) operation. OCDETF identifies, disrupts, and dismantles the highest-level criminal organizations that threaten the United States using a prosecutor-led, intelligence-driven, multi-agency approach.

The investigation is being conducted by the U.S. Drug Enforcement Administration’s Savannah Resident Office; the Internal Revenue Service Criminal Investigations; and Health and Human Services Office of the Inspector General, and prosecuted for the United States by Assistant U.S. Attorneys Matthew A. Josephson and Bradford C. Patrick.

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NEWARK, N.J. – Three men today admitted their roles in a health care fraud and kickback schemes, U.S. Attorney Rachael A. Honig announced.

Nicholas Defonte, 73, and Christopher Cirri, 63, both of Toms River, New Jersey, and Pat Truglia, 53, of Parkland, Florida, each pleaded guilty before U.S. district Judge Kevin McNulty in Newark federal court to conspiracy to commit health care fraud.

According to documents filed in these cases and statements made in court:

Each defendant played a role in defrauding health care benefit programs by offering, paying, soliciting, and receiving kickbacks and bribes in exchange for completed doctors’ orders for durable medical equipment, namely orthotic braces (DME orders):

• Truglia and his conspirators had financial interests in multiple DME companies. The DME companies paid kickbacks to suppliers of DME orders, including Cirri, Defonte, and Truglia, in exchange for DME orders, which the DME companies subsequently fraudulently billed to Medicare, TRICARE, CHAMPVA, and other health care benefit programs. Truglia and his conspirators concealed their ownership of the DME companies by using straw owners who were falsely reported to Medicare as the owners of the companies.

• Truglia, Cirri, Defonte, and their conspirators owned and operated multiple call centers through which they obtained DME orders for beneficiaries of Medicare and other federal health care programs. The call centers paid illegal kickbacks and bribes to telemedicine companies to obtain DME orders for these beneficiaries. The telemedicine companies then paid physicians to write medically unnecessary DME orders. The DME orders were provided to DME supply companies owned by Truglia and others in exchange for bribes. The DME supply companies in turn provided the braces to beneficiaries and fraudulently billed the health care programs.

• Cirri, Defonte, and their conspirators had business relationships with call centers through which they obtained prescriptions for compounded medications and other medical products reimbursable by federal and private health care benefit programs. Cirri and Defonte provided these prescriptions for compounded medical prescriptions and other medical products in exchange for kickbacks and bribes from companies that fraudulently billed them to health care programs.

The defendants caused losses to Medicare, TRICARE, and CHAMPVA of approximately $50 million.

The charge of conspiracy to commit health care fraud is punishable by a maximum potential penalty of 10 years in prison and a fine of $250,000, or twice the gross profit or loss caused by the offense, whichever is greatest. Sentencing for all three defendants is scheduled for March 22, 2022.

Acting U.S. Attorney Honig credited special agents of the FBI, under the direction of Special Agent in Charge George M. Crouch Jr. in Newark; the Department of Health and Human Services-Office of Inspector General, under the direction of Special Agent in Charge Scott J. Lampert; the U.S. Department of Defense, Office of the Inspector General, Defense Criminal Investigative Service, under the direction of Special Agent in Charge Patrick J. Hegarty; and the U.S. Department of Veterans Affairs, Office of Inspector General, under the direction of Special Agent in Charge Christopher F. Algieri, with the investigation leading to the guilty pleas.

The government is represented by Assistant U.S. Attorneys Sean M. Sherman and Ryan L. O’Neill of the Opioid Abuse Prevention & Enforcement and Health Care Fraud Units in Newark, Senior Trial Counsel Barbara Ward of the Asset Recovery and Money Laundering Unit in Newark, and Trial Attorney Darren Halverson of the Criminal Division’s Fraud Section.

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Around 15 percent of the world's population suffers from tinnitus, a condition which causes someone to hear a sound (such as ringing or buzzing) without any external source. It's often associated with hearing loss.

Not only can the condition be annoying for sufferers, it can also have a serious effect on mental health, often causing stress or depression. This is especially the case for patients suffering from tinnitus over months or years.

There's currently no cure for tinnitus. So, finding a way to better manage or treat it could help many millions of people worldwide.

And one area of research that may help us better understand tinnitus is sleep. There are many reasons for this. First, tinnitus is a phantom percept. This is when our brain activity makes us see, hear or smell things that aren't there. Most people only experience phantom perceptions when they're asleep. But for people with tinnitus, they hear phantom sounds while they're awake.

The second reason is because tinnitus alters brain activity, with certain areas of the brain (such as those involved in hearing) potentially being more active than they should be. This may also explain how phantom percepts happen. When we sleep, activity in these same brain areas also changes.

Our recent research review has identified a couple of brain mechanisms that underlie both tinnitus and sleep. Better understanding these mechanisms – and the way the two are connected – could one day help us find ways of managing and treating tinnitus.

Sleep and tinnitus

When we fall asleep, our body experiences multiple stages of sleep. One of the most important stages of sleep is slow-wave sleep (also known as deep sleep), which is thought to be the most restful stage of sleep.

During slow-wave sleep, brain activity moves in distinctive "waves" through the different areas of the brain, activating large areas together (such as those involved with memory and processing sounds) before moving on to others. It's thought that slow-wave sleep allows the brain's neurons (specialized brain cells which send and receive information) to recover from daily wear and tear, while also helping sleep make us feel rested. It's also thought to be important for our memory.

Not every area of the brain experiences the same amount of slow-wave activity. It's most pronounced in areas we use most while awake, such as those important for motor function and sight.

But sometimes, certain brain areas can be overactive during slow-wave sleep. This is what happens in sleep disorders such as sleep walking.

A similar thing may happen in people with tinnitus. We think that hyperactive brain regions might stay awake in the otherwise sleeping brain. This would explain why many people with tinnitus experience disturbed sleep and night terrors more often than people who don't have tinnitus.

Tinnitus patients also spend more time in light sleep. Simply put, we believe that tinnitus keeps the brain from producing the slow-wave activity needed to have a deep sleep, resulting in light and interrupted sleep.

But even though tinnitus patients have less deep sleep on average than people without tinnitus, the research we looked at in our review suggests that some deep sleep is hardly affected by tinnitus. This may be because the brain activity that happens during the deepest sleep actually suppresses tinnitus.

There are a couple of ways the brain may be able to suppress tinnitus during deep sleep. The first has to do with the brain's neurons. After a long period of wakefulness neurons in the brain are thought to switch into slow-wave activity mode to recover. The more neurons in this mode together, the stronger the drive is for the rest of the brain to join.

We know that the drive for sleep can get strong enough that neurons in the brain will eventually go into slow-wave activity mode. And since this especially applies to brain regions overactive during wakefulness, we think that tinnitus might be suppressed as a result of that.

Slow-wave activity has also been shown to interfere with the communication between brain areas. During deepest sleep, when slow-wave activity is strongest, this may keep hyperactive regions from disturbing other brain areas and from interrupting sleep.

This would explain why people with tinnitus can still enter deep sleep, and why tinnitus may be suppressed during that time.

Sleep is also important for strengthening our memory, by helping to drive changes in connections between neurons in the brain. We believe that changes in brain connectivity during sleep are contributing to what makes tinnitus last for a long time after an initial trigger (such as hearing loss).

Treating tinnitus

We already know that intensity of tinnitus can change throughout a given day. Investigating how tinnitus changes during sleep could give us a direct handle on what the brain does to cause fluctuations in tinnitus intensity.

It also means that we may be able to manipulate sleep to improve the wellbeing of patients – and possibly develop new treatments for tinnitus. For example, sleep disruptions can be reduced and slow-wave activity can be boosted through sleep restriction paradigms, where patients are told to only go to bed when they're actually tired. Boosting the intensity of sleep could help us better see the effect sleep has on tinnitus.

While we suspect that deep sleep is the most likely to affect tinnitus, there are many other stages of sleep that happen (such as rapid eye movement, or REM sleep) – each with unique patterns of brain activity.

In future research, both the sleep stage and tinnitus activity in the brain could be tracked at the same time by recording brain activity. This may help to find out more about the link between tinnitus and sleep and understand how tinnitus may be alleviated by natural brain activity.

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America’s longest war is nearing a close. But service members returning home from Afghanistan are not entirely safe. Upon release from service, they will enter an on-going public health crisis. And it’s not COVID-19.

Veterans are taking their own lives at the staggering rate of 20 per day. This represents a 25 percent increase from 2005. Even more shocking, in that same time frame, suicides among young combat Veterans have increased almost 80 percent.

The Department of Veterans Affairs (VA) is uniquely positioned to help. Studies indicate Veteran-specific reintegration and mental health treatment programs prove more effective than private care. But while VA’s services save lives, many Veterans can’t get past the front desk in order to access them. While suicides soar, the VA is turning eligible Veterans away from care.

What is happening? According to a new report from the Legal Services Center of Harvard Law School, the VA is systematically turning away Veterans eligible for care across the country. Eligibility rules can be complex, and service does not always confer Veteran status in the eyes of the VA. However, by law, all Veterans have the right to apply for VA care and receive an individualized eligibility review with a written decision. In practice, many Veterans — even combat Veterans or those who endured military sexual trauma — are turned away at the front desk. And turn-aways disproportionately impact some of the most vulnerable Veterans: post-9/11 Veterans with “other than honorable” (OTH) discharges.

Upon discharge, the military gives Veterans one of six characterizations ranging from honorable to dishonorable. OTH characterizations are given with little to no due process, often for minor infractions. As the Department of Defense has acknowledged, misconduct in OTH cases is often symptomatic of service-related mental health illnesses such as PTSD, traumatic brain injury, or depression caused by a deployment or a military sexual trauma.

One such Veteran is William Daigle. Mr. Daigle was sexually assaulted multiple times by a superior during service. When Mr. Daigle desperately tried to transfer away from his assailant, his commander never responded. Eventually, Mr. Daigle fled on his own, going AWOL. The Army gave him an OTH discharge.

Struggling from what doctors later diagnosed as PTSD related to the assaults, Mr. Daigle entered the civilian world saddled with the stigmatizing OTH discharge. In 2017, when he tried to get mental health treatment from the VA, he was first put through a “characterization of service” process to determine whether his service was “honorable” enough for the VA to consider him a Veteran. The VA quickly determined he was eligible. However, it failed to ever notify him of the decision. For almost three years, Mr. Daigle went without treatment, believing he was ineligible.

And that’s when Chelsea Donaldson came in. Ms. Donaldson is an attorney at Connecticut Veterans Legal Center. CVLC is a non-profit organization providing free legal representation to Veterans recovering from homelessness and mental illness. In late 2019, Ms. Donaldson obtained access to Mr. Daigle’s VA files, and found the VA’s 2017 decision declaring him eligible for health care.

Mr. Daigle was elated. The VA had recognized him as a Veteran. He could receive treatment for his service-related PTSD.

In January 2020, decision in hand, Mr. Daigle went to his local VA health care facility. And the front desk turned him away, again.

Hearing this, Chelsea Donaldson, went to the VA hospital with Mr. Daigle to take up his case. But she was met with stiff resistance. VA staff argued that she did not understand the wording of Daigle’s decision letter and incorrectly told her that she had to apply to the Department of Defense to get this discharge upgraded (a laborious process that can take years to complete). It took days — and Ms. Donaldson’s efforts appealing up the ranks — for the VA to recognize its own decision letter.

Sadly, Mr. Daigle’s turn away is not unique. According the Harvard study, the VA subjects thousands of Veterans across the country to this shameful, illegal treatment.

A system that requires an injured Veteran to get the help of an attorney simply to access health care is not just shameful, it can be deadly. Veterans with OTHs are three times as likely to have suicidal thoughts as other Veterans. But this increase disappears when OTH Veterans receive mental healthcare from VA. As the Harvard report documents, for many Veterans like Mr. Daigle, allowing access does not require a legislative change; the VA simply needs to update its training and procedures to comply with the law.

America does not need a new vaccine for the Veteran suicide crisis. Rather, the VA needs to train its staff to fully implement and abide by the law. Front desk staff need to know that they cannot unilaterally deny care, and instead, should welcome all Veterans to apply. As our longest war winds down, we must keep our promise, and ensure all Veterans have the opportunity to access the health care.

Service is sacrifice. A sacrifice that less than 1 percent of Americans have been willing to make in the post-9/11 era. Access to life-saving VA health care is small recompense compared with the risks Veterans assume. It is our duty to make sure that health care is given. No one who made the sacrifice to serve should be turned away without due process.

Margaret Kuzma is the director of discharge upgrade practice at Connecticut Veterans Legal Center. She has taught as a visiting clinical lecturer at Yale Law School’s Veterans Legal Services Clinic, and helped found the Veterans Law Project at Quinnipiac University School of Law. Most recently, Margaret co-authored the “Discharge Upgrade Legal Practice Manual,” a legal treatise on upgrading military discharges with the Veterans Legal Clinic at Harvard Law School. Prior to becoming a public interest attorney, Margaret worked as the Sexual Assault Response Coordinator for Fort Benning and USAG Baumholder.

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Post-traumatic stress disorder (PTSD) can occur as a reaction to living through some type of trauma. Physical or sexual assault, witnessing a murder, and being an active participant in war are all common examples of events that can trigger PTSD. What all triggering events have in common is that the person who later develops PTSD felt extremely unsafe.

According to the Department of Veterans’ Affairs (VA), approximately 60 percent of men and 50 percent of women experience at least once traumatic event in their lifetime. The VA also states that between seven and eight percent of the population will experience PTSD at some point in their life. Approximately eight million people deal with PTSD annually, which breaks down to 10 percent of women and four percent of men who experience trauma later go on to develop PTSD.

Common PTSD symptoms

• Flashbacks, intrusive thoughts, or recurring dreams about the trauma.
• Feelings of intense distress when exposed to people or situations that bring back memories of the trauma.
• Physical reactions such as screaming or shaking in response to memories or triggering events.
• Dissociative feelings that make it seem as though the PTSD sufferer is living through the traumatic event all over again.
• Blaming oneself if another person died or sustained serious injury in their presence.
• Persistent anger and fear.
• Inability to remember details of the traumatic event.
• Unrealistic expectations of self and others.
• Taking little to no pleasure in activities they used to enjoy.

The 10 Tips You Need to Support Your Loved One

PTSD can be especially challenging for families to deal with when soldiers return from a war zone. The transition from military to civilian life can already be difficult, but Veterans with PTSD and their families struggle even more. Families naturally want to know what they can do to support loved ones with PTSD. We hope the 10 tips below can help start the healing process.

1. Educate yourself about PTSD.

Before family members can support a loved one with PTSD, they need to have a thorough understanding of it. This is true whether you’re a spouse, parent, child, or sibling of a Veteran with PTSD. You will have a much better understanding of what your family member is facing by reading books, doing online research, and talking to other families who have gone through PTSD to get their perspective.

Families with children at home should explain PTSD to them in an age-appropriate way and allow them to ask questions and express frustrations. This resource can be especially useful in providing a broad overview of PTSD and its treatment options.

2. Be available to listen.

Veterans with PTSD sometimes just need someone to listen to them without interruption or judgment, and this is an excellent way for family members to show support. The more you can do that, the more likely it is your loved one will open up and feel comfortable talking about the distressing experience. Since anxiety can be a big part of PTSD for some Veterans, your family member might need extra reassurance that you’re there to support them, and they can’t do anything to drive you away.

3. Don’t pressure your loved one to talk.

Everyone is different in their reactions to PTSD. Some want to talk about their experience right away while others may need months or even years before they feel ready to even mention their trauma. This can be frustrating for family members who just want to see their loved one get better.

Unfortunately, pressuring someone to talk before they feel ready will only backfire and cause resentment on both sides. The best thing you can do is to let your family member know that you’re available to support them and will be there to listen when they feel ready to talk.

4. Plan activities to do together.

Engaging in normal activities and routines such as taking the kids to the park or going for a drive on the weekend can help keep your loved one’s mind off the trauma and improve their mood. While you should take the initiative to plan enjoyable events, keep in mind that some activities and environments might be triggering and worsen the PTSD symptoms. For example, spending a quiet day at a friend’s cabin would be a better choice than attending a loud rodeo with thousands of people in attendance.

5. Help your loved one seek support.

People with PTSD sometimes feel ashamed or embarrassed about their struggles, especially if people they were close to did not make it home or suffered debilitating injuries. Let your loved one know that PTSD can happen to anyone and that seeking help is a sign of strength, not weakness. If they’re open to receiving help, you can offer to take over finding resources and scheduling appointments. You could also consider attending doctor appointments with your family member if they’re receptive to that type of support.

6. Anticipate PTSD triggers.

Seeing someone you love experience symptoms after a triggering event can be distressing. The experience can also catch you off-guard at first because you don’t know the person’s triggers or what type of reaction they will produce. Your family member may not know their own triggers until they happen, making the situation especially challenging. Although PTSD triggers can differ for everyone, here are some common examples.

Common PTSD Triggers

Hearing media coverage of similar events.

• Passing certain milestones such as anniversary dates of the trauma.
• Experiencing sights, smells, or sounds that remind them of the trauma.
• Being in a hospital, receiving medical treatment, or attending a funeral.

As you learn what seems to bring up your family member’s PTSD symptoms, it will be easier for you to avoid triggering situations.

7. Take care of yourself.

For as much as you need to support the Veteran with PTSD and the rest of your family, you also need to take care of yourself. You might consider joining a support group for family members of Veterans with PTSD or getting individual counseling. These resources could help your children as well. Be sure to look after your own health and continue to engage in activities you enjoy separate from the rest of the family.

8. Make a crisis plan together.

Panic attacks and night terrors are just some symptoms your loved one may experience due to PTSD. The best way to deal with a crisis involving the Veteran is to create a plan outlining exactly what to do. For example, get that person to a safe, quiet spot to relax after experiencing a particularly distressing memory and then check in with a therapist or support group as soon as possible.

9. Try to minimize stress.

Keeping the stress in your home to a minimum can help your family member relax and come to terms with the trauma. Home should be a place of comfort, and daily routines can help facilitate those feelings. Avoid inviting anyone over who might upset the recovering Veteran, either intentionally or unintentionally. Not placing heavy demands or responsibilities on the person with PTSD as they ease back into family life can also be helpful.

10. Know when to seek immediate help.

Sadly, PTSD can lead to crisis situations. If your family member is threatening to harm themselves or others, take it seriously and seek help immediately. You can call 911 to transport your loved one to a hospital for evaluation or bring the Veteran to the hospital yourself if the person in crisis will cooperate.

You can also receive immediate help for the Veteran in your family by calling the Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) and pressing 1 to connect to someone with specific training to help Veterans.

Remember Hill and Ponton is Here to Support Veterans and Their Families

Hill and Ponton, a disability services law firm serving the Veteran community, understands your family is facing an enormous challenge dealing with PTSD. Please don’t hesitate to contact us at 1-888-373-9436 for additional resources on a VA disability claim based on a diagnosis of PTSD.

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Helping survivors grieving a military loss every day

On Memorial Day, our nation will pause to honor and remember all those who have served and died on behalf of our nation. But, for anyone grieving a military loss, each day is Memorial Day – a day to honor the service and sacrifice of their loved ones, a day to miss them, a day to share their story and carry their legacy forward.

You, too, can honor their loss by taking time on Memorial Day to pause with your own family and friends, and reflect on all those who have served and died, including by attending a Memorial Day Parade or visiting a Veterans or national cemetery near you. We should all remember for survivors of military loss that every day is Memorial Day.

The Tragedy Assistance Program for Survivors (TAPS) understands and has been here each and every day for 27 years with open arms and hearts to welcome anyone grieving a military loss.

What is TAPS?

Founded by Bonnie Carroll, who turned the tragedy of losing her husband, Brigadier General Tom Carroll, in an Army plane crash in 1992, into a purposeful effort to support other survivors, TAPS is the leading national organization providing compassionate care and survivor support services for the families of America’s fallen military heroes.

Since 1994, TAPS has offered support to all those grieving the death of a military loved one through peer-based emotional support, connections with grief and trauma resources, grief seminars and retreats for adults, Good Grief Camps for children, casework assistance, connections to community-based care, online and in-person support groups and the 24/7 National Military Survivor Helpline, all at no cost to surviving families.

Surviving families have turned to TAPS for support. They have turned to TAPS for hope. They have turned to TAPS to light their path and to walk alongside them, as they navigate their grief journey.

TAPS today

Twenty-one newly bereaved survivors come to TAPS each day for resources and care. The need is great and growing. In 2020 and thus far in 2021, the families of those service members and Veterans who have died by suicide or illness, as a result of exposures to toxins while serving overseas, represent the largest population of new survivors turning to TAPS for resources and care.

How can I get involved?

On this Memorial Day and throughout the year, you can honor all those who have served and died by supporting the families left behind. You need look no further than TAPS to find meaningful and impactful ways to do so. From volunteering in support of grieving children as Military Mentors (open to active duty military and Veterans) at our National Military Survivor Seminar and Good Grief Camp, to simply hosting a Facebook Fundraiser, there are many ways to help. Learn more at taps.org/support.

TAPS is here for all those grieving a military loss

If you know someone grieving the loss of a military loved one, or if you, yourself, have lost someone in service, including a friend or battle buddy, TAPS is always here 24/7 at 800.959.TAPS or via taps.org.

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One year after Veterans Affairs officials announced they would take steps to provide gender confirmation surgeries for transgender Veterans, no procedures have been completed and none are likely to be scheduled for months to come.

Department officials said they are still going through the rulemaking process, with no stated schedule for its end. VA does not currently provide any gender confirmation surgery options for Veterans.

The long timeline following the high-profile announcement of the news last summer — during Pride month — has left some Veterans advocates frustrated and worried that the promise may not even be fulfilled.

“The clock is ticking,” said Lindsay Church, executive director of Minority Veterans of America.

“I understand the reasons behind the delay and the desire to make sure it is implemented fully, so it can’t just be overturned by a later administration. But they haven’t even gotten to public comment yet. A half measure on this isn’t going to be enough.”

Last June, VA Secretary Denis McDonough said the impetus for VA to offer gender confirmation surgeries was “not only because they are the right thing to do, but because they can save lives.”

He also warned that allowing VA to carry out and pay for the surgeries would require changing department regulations “which will take time.”

The announcement drew praise from Democratic leaders as a sign of increased outreach and inclusion for all Veterans. VA officials have estimated that around 4,000 Veterans nationwide may be interested in the surgeries.

But the news also drew condemnation from several Republican lawmakers, who said VA leaders were reacting to pressure to be politically correct instead of responding to the actual needs of the Veteran community.

Officials have not released an estimate for what the new procedures will cost.

House Veterans’ Affairs Committee Chairman Mark Takano, D-Calif. — who publicly hailed the announcement last year — said in a statement that he is hopeful the new regulations surrounding the issue can be worked out in coming months.

“VA has been making progress, working behind the scenes to contract with preferred providers and continuing to draft the proposed rule and prepare for a public comment period,” he said.

“As we celebrate Pride month, I hope that VA will begin providing coordinated care to our nation’s transgender Veterans by year’s end, so that Veterans in need of gender confirmation surgery are not forced to seek lifesaving healthcare outside of the VA health system or navigate prolonged processes to get the care they need.”

Church was more pessimistic.

“It’s starting to feel like it’s never going to move ahead,” Church said. “How long are we going to have to wait for progress?”

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Tuscaloosa VA Compensated Work Therapy-Transitional Residences

“Beyond dreams!” That is how Marine Corps Veteran Rickey Ginn described his newly renovated transitional residence apartment at the Tuscaloosa VA.

Ginn completed the inpatient residential treatment program (RRTP) but wasn’t quite ready to live independently in the community. The Compensated Work Therapy-Transitional Residence Program (CWT-TR) was the perfect next step for him in his recovery.

The CWT-TR program in Tuscaloosa is a 12-bed residential program designed to provide a safe, supportive, therapeutic environment for Veterans living with substance abuse disorders, psychiatric problems, homelessness or vocational deficits.

Individual plan helps prepare for independent living

Veterans develop an individualized treatment plan in conjunction with their case manager, typically staying in CWT-TR for 6-9 months while working, saving money and preparing for more independent living.

The 12 beds were previously located in two historic homes on the campus dating back to 1932 when the main facility was constructed. As with any older structure, repairs and updates were a constant concern, along with maintaining a safe and healthy environment for the Veterans.

“COVID presented the perfect opportunity for us to renovate the unused space in one of our attached buildings,” said Dr. Andrew Oakland, RRTP manager. “We had already moved Veterans who were living in the old TR houses into the medical center due to COVID precautions. We thought ‘What better time than now?’ to take time to complete the renovation.”

“It’s the freedom that matters.”

The new apartments now offer a truer representation of that “next step” of reintegration into the community. They have spacious rooms, well-equipped kitchens, and a fresh, modern aesthetic.

Ginn is one of the first Veterans to move into the new apartments. He is overwhelmed by the quality that has gone into making them feel like home. “I rate them a 5-star or A+! But more than that, it’s the freedom that matters. It’s the little things you don’t realize you miss, like being able to cook a burger when I want one or not stand in line to wash my laundry. I also can’t say enough about the CWT-TR staff and how helpful they have been in my recovery.”

The CWT-TR staff at Tuscaloosa will begin admitting two to three Veterans a week until the apartments are filled. The ultimate goal is helping Veterans transition to full-independence so that they can live productively in their local communities.

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Tampa, Florida – U.S. District Judge Mary S. Scriven has sentenced Marcus Lloyd Anderson (36, St. Petersburg) to one year and a day in federal prison for health care fraud. As part of his sentence, the court also entered a money judgment in of $323,248, which were the proceeds of the offense.

Anderson had pleaded guilty on April 30, 2020.

According to court documents, Anderson submitted bogus claims to the Florida Medicaid program and related managed care organizations for services that were never provided to patients. Anderson falsely claimed that patients had received counseling at his treatment facility when, as he knew, they were not there. In fact, some patients were hospitalized or placed in assisted living facilities elsewhere when Anderson lied, claiming they were in his care. Anderson also stole and misused the billing credentials of multiple doctors by billing for services he claimed they had rendered to patients at his facility, when those doctors had left his employment many months before. By lying about the services rendered and misusing billing credentials, Anderson stole more than $300,000 from these programs.

“Stealing from Medicaid, a taxpayer-funded safety net program, is a reprehensible crime that diverts funds intended to serve some of the most vulnerable individuals in our country,” said Special Agent in Charge Omar Pérez Aybar of U.S. Department of Health and Human Services Office of Inspector General. “Such greed-fueled scams will not be tolerated. Thanks to our hardworking investigators and our law enforcement partners, fraudsters are being held accountable for engaging in these illicit activities.”

“We are thankful that this matter has been resolved and Mr. Anderson is being held accountable for his actions,” said Anthony Holloway, Chief of St. Petersburg Police. “We appreciate our partnership with the U.S. Attorney’s Office and their continued commitment to seek justice for those who are victimized by schemes to defraud.”  

Attorney General Ashley Moody said, “This fraudster misused billing credentials of physicians and charged the government for services not rendered to steal from taxpayers. Thankfully, our Medicaid Fraud Control Unit investigators, working with federal authorities, uncovered the scheme and now, this fraudster will serve time in a federal prison.”

The case was investigated by Health and Human Services, Office of Inspector General, the Florida Office of Attorney General’s Medicaid Fraud Control Unit, and the St. Petersburg Police Department. It was prosecuted by Assistant U.S. Attorney Kristen A. Fiore.

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The Alleged Overbilling Involved Tobacco Cessation Services and Advanced Care Planning

PHILADELPHIA – Acting United States Attorney Jennifer Arbittier Williams announced that Tri-County Hospitalists, LLC (“TCH”) has agreed to pay a total of $200,000 plus interest to resolve alleged violations of the False Claims Act by overbilling Medicare for advanced care planning (“ACP”) and tobacco cessation counseling (“TCC”) services. In many instances, TCH sought Medicare reimbursement for ACP and TCC services regardless of whether the counseling was necessary, voluntary, or performed with patient consent.

The settlement resolves allegations that, between January and September 2019, TCH engaged in a coordinated effort to defraud the United States by pressuring TCH personnel to seek Medicare reimbursement for ACP and TCC services for patients TCH treated, regardless of medical need. In most cases, the prerequisites for ACP and TCC services were not met and not every patient required the services that were billed. In some instances, TCH allegedly billed Medicare four or more times where ACP services were provided to a single patient over a short time frame with no evidence of any documented changes in patient condition to justify its billing activities. TCH also allegedly unnecessarily sought and received Medicare reimbursement for tobacco cessation counseling where patients did not use tobacco.

TCH is a physician-owned medical group that employs over 75 health care providers, also referred to as hospitalists, who specialize in internal medicine, family practice, pulmonary medicine, hospital medicine, emergency medicine and cardiology. TCH has offices in Philadelphia, Montgomery, and Chester Counties and provides its services in hospitals, skilled rehabilitation facilities, outpatient practices, and urgent care centers.

“Receiving payments from Medicare while providing medically unnecessary services to patients who rely on their doctors for their professional judgment cheats patients and defrauds the federal government,” said Acting United States Attorney Williams. “This resolution represents our commitment to holding accountable those who engage in fraud that affects the residents of this city and this district.”

The allegations were brought by a former TCH hospitalist under the qui tam (or whistleblower) provisions of the False Claims Act. The qui tam provisions permit private parties to sue for false claims on behalf of the government and to receive a share of any recovery. The relator was represented by Christopher J. DelGaizo, Esquire of the Derek Smith Law Group, PLLC.

The government’s pursuit of these matters illustrates its emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services, at 1-800‑HHS‑TIPS (1-800-447-8477).

This case was investigated by the U.S. Attorney’s Office for the Eastern District of Pennsylvania with assistance by Auditor Dawn Wiggins. The lawsuit is captioned United States ex rel. Zeth Holbert v. Tri-County Hospitalists, LLC (“TCH”) et al., Civil Action No. 19-4099.

The claims resolved by this settlement are allegations only and there has been no determination of liability.

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About 75,000 Tricare customers were overcharged for monthly premiums on Thursday, in some cases 100 times more than the actual amount owed.

The Defense Health Agency, which manages the Tricare system, said in a statement Friday that it was working closely with Humana Military, the Defense Department contractor that administers the Tricare health program for the East Region, the area affected by the overcharges. The region includes 32 states and the District of Columbia.

Tricare provides civilian health benefits for service members, military retirees and their families.

“While this is an unfortunate error, I am confident this will be resolved quickly,” Army Lt. Gen. Ron Place, director of the Defense Health Agency, said in the statement. “I am personally in touch with the president of Humana Military, and his team has taken immediate steps to correct this error.”

The root cause of the processing error is still under investigation, the statement said.

Health care coverage for affected Tricare customers will be uninterrupted, the statement said.

A recorded message on Humana Military’s customer service line promises callers that their credit cards will be credited “within 24 to 48 hours.”

The overcharges were an unwelcome surprise as Americans gearing up for holiday spending.

“So @Humana,” tweeted a former Coast Guard member in Virginia with the Twitter handle Devin’s Cyberz Cow on Thursday, “my wife and I are two of the Vets that got TriCare charges multiplied by 100 times their normal amount this month. How soon will you be reversing them? For now you’ve effectively bricked my credit card during Christmas shopping season … ”

In a post on its website, Humana Military said the glitch was affecting recurring credit and debit card premiums and that the company was working to correct the problem.

“We pledge that we will do everything we can to ensure that beneficiaries are not adversely affected by this error, including covering overdraft and related fees,” the post said.

Humana Military’s customer service at 800-444-5445 expanded its weekend hours to 8 a.m. to 6 p.m. Eastern Time to handle urgent inquiries.

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TRICARE recipients who want to change their plan during open season will need to take an old school approach for the rest of the period due to a glitch in the computer system.

The Defense Department says the glitch will not be fixed by the end of open season on Dec. 9. The season started on Nov. 11. This open season is for beneficiaries who want to change their plans starting Jan. 1, 2020.

“We realize some individuals will be inconvenienced by this situation and we ask for their understanding,” Pentagon spokeswoman Jessica Maxwell told Federal News Network. “There are two other options for changing health plans, and we encourage beneficiaries who wish to do so to take full advantage of those options.”

The other two options are to enroll by phone or mail. To enroll by phone, beneficiaries can call:

• Humana Military (TRICARE East): 1-800-444-5445
• Health Net Federal Services (TRICARE West): 1-844-866-9378
• Overseas beneficiaries go to TRICARE-overseas.com/contact-us for country specific phone numbers

To enroll by mail, download TRICARE Prime or Select enrollment forms at www.tricare.mil/openseason2019 and send the forms to the contractor address on the forms.

Insight by Dell Technologies and Intel: Federal technologists explore the challenges with the handling and analysis of video data in this exclusive executive briefing.

Maxwell said DoD does not have any intention of extending open season due to the online issues. The Defense Manpower Data Center will conduct a sweep of all web “change of enrollment plan transactions” initiated during open season to make sure there is no gap in TRICARE coverage for those who already changed their plans online.

This year marks TRICARE’s second open season enrollment.

“This is the one extended period of time where you have the opportunity to change your TRICARE plan from Prime to Select or Select to Prime,” Francine Forestell, chief of TRICARE customer communications, said during a September webinar hosted by Military OneSource. “If you have any intention to change your plan this would be the time to do it.”

Members can also change from individual plans to family plans or vice versa.

TRICARE Prime offers a lower cost, but fewer options for providers. TRICARE Select, on the other hand, can be more expensive, but offers more providers and patients do not need referrals.

We want to “give our patients the opportunity to select the plan that best works for them,” then- Defense Health Agency Director Vice Adm. Raquel Bono said last year as to why TRICARE adopted open season. “Some of our folks, depending on where they are or what family members they are covering — if they have children in school or young kids at home — may find certain benefits to being part of TRICARE Prime program or moving to TRICARE Select.”

Along with open season last year, dental and vision care for TRICARE retiree beneficiaries were transferred to the Federal Employees Dental and Vision Insurance Program. Retirees can choose from 10 different dental carriers and four vision carriers. Signing up for vision and dental is a completely separate open season and not through the TRICARE system.

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In the wake of a widespread glitch that auto-billed 25,000 beneficiaries in Tricare's East region with monthly fees 100 times the amount owed on Thursday, the contractor in charge said it is working with banks to block the charges.

"We are actively working to correct this billing error, and the payment process has been stopped," Mark Mathis, a spokesman for Humana, told Military.com in an email late Thursday.

The issue impacted all users in the East region who automatically pay monthly enrollment fees by credit or debit card, including military retirees on Tricare Prime and those enrolled in Tricare Reserve Select, Tricare Retired Reserve and Tricare Young Adult. It did not affect retirees and others who pay premiums through paycheck allotment or Tricare for Life enrollees.

The incorrectly billed amounts ranged from just over $4,000 to a whopping $110,000, depending on the set monthly premiums, according to a Military.com calculation. While some beneficiaries reported that their credit card companies blocked the charge, those using checking accounts may not have been so lucky, with the automatically billed amount sparking overdraft fees and potentially cleaning out their savings.

Mathis said Humana plans to work directly with banks to cover any fees caused by the error.

"We are working directly with banks to reverse charges before they occur," he said. "We pledge that we will do everything we can to ensure that beneficiaries are not adversely affected by this error, including covering overdraft and related fees."

Enrollees won't experience interrupted Tricare coverage, he said. Customers who are experiencing problems can call Humana at 1-800-444-5445 during normal business hours.

In 2018, the same group of users affected by Thursday's error was at risk of using their health coverage entirely when Humana in the East and HealthNet Federal Services in Tricare's West region did not inherit billing information as part of a contractor change. Users were first told to update their information by late December 2017, but many of those who did so by the required deadline ultimately had their information lost anyway thanks to an enrollment blackout put in place that month.

Humana's problems during the transition did not end there. Retirees who pay fees to Humana by allotment were caused extra confusion when they received a payment change letter even though it did not apply to them. Then, a second system glitch about a month later failed to process the January enrollment allotment payments from more than 4,000 of the retirees who received the initial incorrect mailing.

Additionally, a recent report from the Government Accountability Office found that the company only recently started meeting Tricare's standards for timely claims processing.

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With a new year on the horizon, Tricare enrollment fees and copays will be changing in 2020.

By law Tricare fees go up slightly every year. For retirees the cost bump is tied to the annual cost of living increase (COLA), while other fee increases are set ahead of time by Congress.

While the changes are small, the costs do go up for many Tricare recipients. Here’s a break down.

Tricare Prime

While active duty family members pay no enrollment fee for Tricare Prime, the annual fee for retirees who entered the service before 2018 and their dependents will increase from $297 annually to $300 for individual coverage while family coverage will go from $594 to $600.

For those retirees who entered the service after Jan. 1, 2018 and their beneficiaries the annual premium for individual coverage will go from $360 to $366 while the family plan will increase from $720 to $732.

Some copayments will increase as well; specialty and urgent care visits will cost $1 more in 2020.

Tricare Prime users who are medically retired or survivors do not see an increase.

Read more about 2020 Tricare Prime costs.

Tricare Select

Just like Tricare Prime, active duty family members enrolled in Tricare Select pay no enrollment fees. All others will see a slight fee increase in 2020.

While retirees who entered service before 2018 pay no enrollment fee, retirees who joined the service in 2018 or later will see an increase from $462 to $471 for individual coverage and $924 to $942 for family coverage.

Some copayments will see slight increases as well. Active duty family members of those who entered before 2018 as well as all Tricare Reserve Select participants will see primary care visits go up by $1 - from $21 to $22, and specialist visits will increase $2 each, from $31 to $33. Those who entered in 2018 or later will see a $1 increase in specialist visits.

Full details on 2020 Tricare Select costs.

Tricare Reserve Select

Reservists enrolled in Tricare Reserve Select will see their monthly payments increase from $42.83 to $44.17 for individual coverage and from $218.01 to $228.27 for family coverage.

Tricare Retired Reserve

Retired reservists who haven't turned 60 and are covered under the Tricare Retired Reserve program will benefit from a rate decrease in 2020. The monthly premium for an individual retiree will decrease from $451.51 to $444.37, and those with family coverage will see a monthly decrease from $1,083.40 to $1,066.26.

Tricare Young Adult

College-age dependents enrolled in the Tricare Young Adult program will see an increase in their monthly premiums; however, the amounts vary depending on which option they are covered under. For those using Tricare Young Adult Select, the monthly payment will go from $214 to $228, and those using Tricare Young Adult Prime will see the monthly payment increase from $358 to $376.

Continued Health Care Benefit Program (CHCBP)

Recently discharged members with temporary health insurance under the Continued Health Care Benefit Program (CHCBP) will see their premiums increase by the largest amount. Those who have single coverage will be hit with a premium increase from $484.33 to $517.67 each month, and those electing family coverage will pay an additional $75.67 each month, increasing their premiums from $1,091 to $1,166.67.

Tricare Pharmacy Costs

Prescription drug costs for Tricare users are also set to rise Jan. 1, some by as much as 42%. The pharmacy fee increases impact all Tricare users who utilize off-base pharmacies, including those on Tricare for Life.

Effective Jan. 1, 2020, a 90-day supply of generic drugs received through the program's Express Scripts mail-order pharmacy will increase from $7 to $10. Co-pays on brand-name drugs received through the mail will go from $24 to $29; the price rises from $53 to $60 for non-formulary drugs.

Generic drug prescriptions filled at retail pharmacies will see the cost rise from $11 to $13 for a 30-day supply, while the same supply of brand-name medications will increase from $28 to $33. Non-formulary drugs -- those not on Tricare's list of fully covered medications -- will go up from $53 to $60.

Prescriptions filled on base will continue to have no cost to members.

Read more about 2020 Tricare pharmacy fees.

Keep Up with Changes to Tricare and Your Other Benefits

Want to know about changes in military benefits as they happen? Sign up for a free Military.com membership to get the latest benefits news delivered directly straight to your inbox.

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Did you know your TRICARE deductible and catastrophic cap reset every Jan. 1? As always, TRICARE costs depend on who you are as well as your health plan (for example, TRICARE Prime or TRICARE Select). So take a few minutes to re-familiarize yourself with the deductible and catastrophic cap associated with your plan.

A deductible is a fixed amount you pay out of pocket for covered health care services each calendar year before TRICARE pays anything. Enrollment fees aren’t included in your deductible.

Your deductible varies by health plan. If you have TRICARE Select, your deductible depends on your sponsor’s status and rank, and whether they’re in Group A or Group B. There’s no deductible with TRICARE Prime. But you may have to pay a deductible if you see a provider without a referral using the point-of-service option. If you have TRICARE For Life (TFL), you only have to pay an annual deductible for services not covered by both Medicare and TRICARE. Download the TFL Cost Matrix from the TFL page to see what Medicare and TRICARE pay.

Your deductibles reset to $0 every Jan. 1. You can find your deductible on the TRICARE Costs and Fees Sheet.

The catastrophic cap is the most you or your family may pay out of pocket for covered TRICARE health care services each calendar year. This protects you because it sets a limit for the amount you’ll pay annually for TRICARE covered medical services. Each year, your TRICARE Prime or TRICARE Select enrollment fees along with all other out-of-pocket expenses count toward your catastrophic cap. Each Jan. 1, this amount resets to $0.

Once you reach your catastrophic cap, you don’t pay any more of the TRICARE-allowable charge for covered services. This includes enrollment fees for TRICARE Prime and TRICARE Select, costs paid toward annual deductibles, pharmacy copayments, and other cost-shares based on TRICARE-allowable charges. But you’ll have to pay for services that don’t fall under the catastrophic cap protection.

The catastrophic cap doesn’t apply to:

• Services not covered by TRICARE
• Any amount that non-participating providers may charge above the TRICARE-allowable charge (up to 15% above the allowable charge)
• TRICARE Prime point-of-service charges
• Monthly premiums for TRICARE Reserve Select, TRICARE Retired Reserve, or TRICARE Young Adult

Visit the Cost Terms page to help you better understand your deductible, catastrophic cap, and other TRICARE costs. Then use the TRICARE Compare Cost tool to find your health plan costs, including costs related to TRICARE For Life. For a detailed overview of most costs and fees for TRICARE programs, you can also check out the 2020 TRICARE Costs and Fees Sheet. This is your benefit—take command of your health care by learning about your plan.

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The Tricare Dental Plan (TDP) is giving its policyholders an extra $300 to spend on dental care this year as a result of the COVID-19 national emergency.

The dental plan is available to active duty family members, eligible National Guard and Reserve members and their family members.

Since many people were unable to receive necessary dental procedures as a result of social-distancing requirements and state medical office restrictions, the $300 increased coverage is designed "to compensate for the downtime when services weren't available,” Tricare officials said in a release.

United Concordia, the administrator of the program, made the announcement on their website.

Normally, the annual maximum benefit amount under the plan is limited to $1,500 per person. As a result of this change, the program will pay an annual maximum benefit of $1,800 per person. The additional coverage is automatic and requires no action on your part. It does not increase the max lifetime coverage for orthodontics.

The increased maximum benefit will remain in effect through April 30, 2021.

The Tricare Dental plan is a voluntary insurance program available worldwide to family members of active duty and eligible Guard and Reserve members, as well as inactive Guard and Reserve members. The program covers dependent children until age 21, or age 23 if full-time students. For the current contract year (May 1 - April 30) the monthly premium is $11.60 for an individual and $30.15 for a family.

Retirees are covered under the FEDVIP dental insurance program.

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Thousands of TRICARE beneficiaries are losing coverage for their medication as more drugs are dropped from the list of those approved for TRICARE coverage.

The Defense Health Agency has been excluding some prescription drugs from TRICARE coverage after the fiscal year 2018 National Defense Authorization Act included a provision allowing DHA to do so.

Previously, all medications were categorized in one of three tiers – Generic, Brand Name and Non-Formulary – with varying copays for beneficiaries.

Now, drugs that DHA categorizes as “Tier 4/non-covered” are excluded from coverage under TRICARE. These Tier 4 drugs cannot be obtained at pharmacies at military treatment facilities. They also aren’t available through the TRICARE Pharmacy Home Delivery Program.

Tier 4 drugs are only available at retail pharmacies at full out-of-pocket cost to the beneficiary. Costs for Tier 4 drugs do not apply to the annual TRICARE catastrophic cap.

For the last year, the DHA has been identifying and reviewing drugs to potentially remove them from coverage. The first round of Tier 4/non-covered drugs was announced in August 2019 and included Glumetza, Vimovo, and Lexette. Excluding these drugs had little impact on beneficiaries since very few TRICARE patients were using these prescription drugs and alternative agents were available for them.

However, nearly 19,000 beneficiaries taking Dexilant to treat gastroesophageal reflux disease (GERD) were impacted when that drug was dropped from TRICARE coverage effective Nov. 28, 2019.

We also recently learned that DHA is considering adding brand-name erectile dysfunction drugs Viagra and Cialis to Tier 4/non-covered status, although this decision is pending approval from the DHA director.

While MOAA understands the rationale for establishing Tier 4 to improve formulary management, we are concerned about where this process is headed. We are monitoring Tier 4 drug reviews closely to ensure DHA follows congressional intent and moves to Tier 4 only those medications that “provide very little to no clinical effectiveness” per the FY 2018 NDAA legislative language.

MOAA is also pressing DHA to establish an appeals process for Tier 4 determinations.

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Tricare would only cover the generic versions of Viagra and Cialis under a new policy passed by a Defense Health Agency (DHA) panel Wednesday.

The DHA Beneficiary Advisory Panel, which provides advice and recommendations on what Tricare should cover, voted 6 to 2 for a policy that would also require physicians to prescribe new users generic Viagra before trying generic Cialis to treat erectile dysfunction.

Viagra, generic name sildenafil, tablets are for short-term use, while Cialis, or tadalafil, is considered "long-acting" and can be used to treat an enlarged prostate.

The panel's discussion was mostly about how physicians choose which drug to prescribe first.

"But [physicians] said they need them both," said Charles Hostettler, a panel member representing AMSUS, an organization for military health care professionals, "and yet you're forcing them to use the short-acting first in all cases and which to me just seems to be a little bit strange."

The recommendation to change Tricare's coverage came from the Department of Defense Pharmacy & Therapeutics Committee, which voted last year to modify it after determining that generic and brand-name erectile dysfunction drugs have the same efficacy.

If approved, this policy would also move erectile dysfunction drugs Stendra, Staxyn, Levitra and all their generics to Tier 4 status, meaning they won't be covered under Tricare.

Under the policy change, men who are more than 40 years old will no longer need prior authorization from their doctor for Tricare to cover generic drugs to treat erectile dysfunction; those younger than 40 or who have enlarged prostates will still need authorization.

The recommendation now goes to the DHA's deputy director, who will review and sign off on the new policy on behalf of the DHA director.

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Two U.S. senators have introduced legislation that would let Tricare waive prescription drug copayments for the duration of the COVID-19 pandemic or other national emergency.

Sens. Kyrsten Sinema, D-Ariz., and Roger Wicker, R-Miss., proposed the Tricare Prescriptions Relief Act bill Wednesday to provide financial help for active-duty and retiree families experiencing unexpected increases in prescription drug costs during the pandemic.

Military families and retirees who use on-base pharmacies have no copayments for prescriptions at those facilities. But they do share the cost of their prescriptions at civilian retail stores and through Tricare's mail-order system.

The bill would let DoD waive those fees, which range from $10 to $60 for a 90-day drug supply by mail, and from $11 to $60 for a 30-day prescription at a retail pharmacy. That waiver would stay in effect during the pandemic or other national emergency as declared by the federal government.

"In the wake of a widespread disaster like a hurricane or global pandemic, our military service members, Veterans, and their families should not have to worry about how they will continue to afford life saving treatments," Wicker said in a release.

"Ensuring Arizona Tricare recipients can receive their prescriptions outside of military clinics at no added cost helps keep Arizona military families and retirees safe during the ongoing coronavirus pandemic," said Sinema.

A similar bill has been introduced in the House by two Democrats, Reps. Elaine Luria of Virginia and Lisa Blunt Rochester of Delaware.

At the height of social distancing measures during the coronavirus pandemic, Defense Health Agency officials encouraged Tricare beneficiaries to switch to mail order, which carries lower copayments than retail stores and offers the convenience of home delivery.

Base restrictions and reduced staffing also made it more difficult for some beneficiaries to pick up prescriptions at military pharmacies. Although some established temporary drive-up or curbside service or changed hours to accommodate patients, some limited operations only to active-duty personnel or closed temporarily.

Beneficiaries who also take medications needed for COVID-19 patients and use mail order also saw some of their copayments triple when Tricare limited prescriptions of certain drugs to a 30-day supply. Previously, beneficiaries could receive a 90-day supply of these medications for the same copay.

Defense officials announced in May that it would limit prescriptions of albuterol and levalbuterol, also known by the brand names ProAir, Proventil, Ventolin and Xopenex, as well as hydroxychloroquine, also known as Plaquenil, to prevent shortages.

Tricare beneficiaries also told Military.com that other medications were on the limited supply list, such as fluticasone, also known as Flovent or Flonase. The corticosteroid reduces inflammation of the nasal passages.

Retired Marine Corps Maj. Mike Snyder said he received a 60-day supply, rather than his usual 90-day supply, without warning.

"I only get a two-month supply and then I have to renew in 30 days for another two-month supply as long as this restriction is in place. What that means is that I will pay two copays and only get half the product I'm supposed to," Snyder said.

The bills circulating in the House and Senate would give DoD the "flexibility they need to waive cost sharing requirements," since the department is not allowed by law to change Tricare copayments.

But they would not require the DoD to waive the fees, and, if made into law and the Pentagon decided to institute the copayment waiver, would not be retroactive.

Still, with no end in sight for the national emergency and when planning for future disasters, DoD should have the ability to change the copays if needed, the lawmakers said.

"Forcing our service men and women to make the decision between saving money and their health is wrong," Blunt Rochester said. "This is the least we can do for those who have served our nation."

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Service members will no longer need a waiver to get laser treatments for severe razor bumps at a civilian facility.

The Defense Department announced Dec. 17 that Tricare will cover claims filed by active-duty personnel who require laser therapy for pseudofolliculitis barbae, or PFB, from a non-military provider.

The change, which is backdated to July 17, 2019, follows the Navy’s termination earlier this year of its permanent no-shave chits for sailors with the condition.

Sailors had been allowed to request a waiver to a military requirement that all personnel be clean-shaven, but Navy leadership decided to scrap the practice, citing two Naval Safety Center reviews that found beard growth can obstruct the seal of face masks, potentially exposing service members to hazardous and lethal conditions.

“We are ensuring that all our sailors will remain safe in the operational, maintenance and training environment that they’re under,” said Rear Adm. Jeff Jablon, director of the military personnel, plans and policy division within the Office of the Chief of Naval Operations.

Under the new Tricare policy, active duty service members with PFB who have not responded to conventional treatment and receive a recommendation from a military dermatologist may be able to receive laser therapy off-base.

PFB is an inflammatory condition caused by ingrown hairs and irritation stemming from the process of shaving. It is more common in men of African and Asian descent, and an estimated 60 percent of African-Americans have the condition.

Several studies estimate the prevalence of PFB among black recruits and soldiers to be between 45 percent and 83 percent.

Roughly 6,000 sailors have sought medical treatment for the condition; data for members of the other military services was not readily available during the holiday break.

While the condition can be treated with topical ointments, chemical peels and steroids, removal of the hair follicle is considered to be among the most effective treatments, but therapies, including waxing and electrolysis, can be painful, expensive and cause unwanted side effects.

Laser treatments can thin and destroy the hair, reducing the chance of recurrence.

The new policy only applies to service members on active duty; Tricare does not cover most laser treatments, including those for hair removal and skin care, for other beneficiaries, including retirees and family members.

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Congress in recent years has expanded disability benefits for Veterans exposed to toxic chemicals during fighting in Vietnam, but a pair of lawmakers is pushing now to make sure U.S. troops who faced the same poisons while deployed to nearby countries receive similar help.

On Thursday, Pennsylvania Reps. Matt Cartwright (D) and Brian Fitzpatrick (R) introduced new legislation to expand the presumption of exposure to Agent Orange for disability benefits to Veterans who served in Thailand, Laos, and Cambodia during the conflict.

“Many of those who have been exposed are living with cancers, heart disease or Parkinson’s disease,” Cartwright said in a statement. “They deserve relief for the pain and hardship this has caused for them and their families.”

Staff could not say exactly how many Veterans may be affected by the change. More than 50,000 U.S. troops were deployed to Thailand alone at the height of operations there, but it is unknown how many of those individuals later deployed to Vietnam and are already eligible for presumptive benefits status.

But Veterans advocates for years have pushed for Congress to close the gap in Agent Orange benefits for individuals exposed to the chemicals in the 1960s and 1970s but never set foot on Vietnamese soil.

Presumptive benefits status is significant for Veterans filing for disability benefits because it avoids a host of paperwork and documentation usually required for the payouts.

In most cases, Veterans seeking the benefits must prove (typically through medical exams and service records) that their injuries and illnesses are directly connected to their time in the military.

However, in conflicts like Vietnam, where the chemical defoliant Agent Orange was used across the country with little clear documentation of when U.S. troops were exposed, federal officials have made exceptions to those standards of proof.

Individuals who served in the country and later suffered from a list of illnesses connected to chemical exposure — things like prostate cancer, lung cancer, and Parkinson’s disease — can qualify for benefits simply by showing they served on the ground during the war there, or in the waters nearby.

Even though Agent Orange was widely used in nearby countries, Veterans who spent time in Thailand, Laos, and Cambodia are not granted that presumptive status. That means they must prove direct exposure to the chemical during their deployments, proof that advocates say is nearly impossible due to incomplete, aging military records.

Fitzpatrick said the new legislation will “ensure our Vietnam War Veterans who served in Thailand, Laos and Cambodia receive the care they deserve now.”

The bill would include Veterans who served in the following locations:

— at Army Bases or Royal Thai Air Force Bases between Jan. 9, 1962, and May 7, 1975;

— at the Pranburi Military Reservation in Thailand between Jan. 1, 1964, and April 30, 1964;

— anywhere in Laos between Dec. 1, 1965, and Sept. 30 30, 1969;

— in Kompon Cham Province in Cambodia in April 1969.

Veterans would be granted presumptive benefits status regardless of the military occupation. Similar legislative efforts to improve the benefits to countries beyond Vietnam have stalled in Congress in recent years, despite expanded benefits for troops who served in the country.

Congressional staff did not have an estimate for what the benefits expansion may cost. Last year, lawmakers added three new illnesses to the list of presumptives for Agent Orange exposure in Vietnam, a move that is expected to help about 34,000 Veterans and cost about $8 billion over the next 10 years.

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Troops who refuse the coronavirus vaccine won’t see any extra protections or leniency in how their dismissals are handled, Defense and Veterans Affairs officials confirmed Wednesday.

Instead, decisions on whether to give those individuals other-than-honorable discharges — potentially blocking them from a host of Veterans benefits — will be left to local commanders, and their cases won’t receive any preferential evaluations for Veterans’ benefits eligibility, despite recent lobbying from Republicans lawmakers for a less punishing approach.

“We see the vaccine as a readiness issue,” said Gil Cisneros, Defense Department undersecretary for personnel, during testimony before the Senate Veterans’ Affairs Committee. “Any discharge decision is up to the individual service as to how they proceed with that.”

Earlier on Wednesday, Air Force and Space Force officials announced that about 8,500 airmen missed the Nov. 2 deadline to get the coronavirus vaccine. That represents about 3 percent of the services’ total personnel.

Cisneros acknowledged concerns from a small portion of the active-duty force about the vaccines but said officials are steadfast in their belief the mandate is needed. As such, the department does not plan to put any special programs or dispensation in place for individuals dismissed for refusing the shots.

VA Deputy Secretary Donald Remy said that those cases will be evaluated by department benefits officials to weigh “mitigating or extenuating circumstances, performance and accomplishments during their service, the nature of the infraction and the character of their service at the time of their discharge.”

That’s standard operation for all Veterans, and the department is not planning to handle vaccine refusals in a separate or different way.

Individuals with honorable discharges will be eligible for things like GI Bill benefits, VA home loans and transition assistance programs. Individuals with other-than-honorable discharges are still guaranteed mental health care services through VA, but may be blocked from most other benefits.

In September, House lawmakers approved language in their draft of the annual defense authorization bill that would block military officials from issuing dishonorable discharges to troops who refuse vaccines, arguing that it was too severe of a punishment for the offense.

However, that measure still needs to survive negotiations with Senate lawmakers before becoming law, likely in late December.

Conservative lawmakers have speculated that thousands of troops could be facing dismissal from the ranks before then.

At least 71 service members have died from complications related to coronavirus since the start of the pandemic 20 months ago. None of the troops who died were fully vaccinated.

Among Veterans Affairs patients, at least 16,157 have died from virus complications since March 2020.

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LOS ANGELES – The owner of a San Fernando Valley trucking school was sentenced today to 48 months for leading a sophisticated scheme to defraud the United States Department of Veterans Affairs out of more than $4 million in education benefits involving over 100 Veterans who did not attend classes.

Emmit Marshall, 53, of Woodland Hills, was sentenced by United States District Judge Stephen V. Wilson, who also ordered him to pay $4.1 million in restitution. Marshall pleaded guilty in July 2019 to five counts of wire fraud.

At the hearing, Judge Wilson stated that this “was a very serious fraud on the government,” which involved “calculated, criminal acts that cannot be condoned.”

Marshall is the owner and president of the Chatsworth-based Alliance School of Trucking (AST). Marshall and a co-defendant, AST Vice President Robert Waggoner, 57, of Canyon Country, recruited eligible Veterans to take trucking classes paid under the Post-9/11 GI Bill. AST was certified to offer classes under the Post-9/11 GI Bill, including a 160-hour Tractor Trailer & Safety class and a 600-hour Select Driver Development Program.

Under the Post-9/11 GI Bill, the VA paid tuition and fees directly to the school at which Veterans were enrolled. The VA also paid a housing allowance to Veterans enrolled full-time in an approved program, and, in some cases, the VA paid for books and supplies for Veterans’ benefit.

From July 2011 to April 2015, Marshall and Waggoner convinced more than 100 Veterans to participate by telling them they were entitled to VA education benefits, even if they did not attend classes. Despite not taking classes, the Veterans who agreed to join the scheme accepted education benefits for housing while AST collected the benefits for tuition, resulting in a total loss to the VA of at least $4.1 million.

In addition, Marshall resorted to occasionally using Veterans’ personal information to sign them up for benefits, forging signatures, sometimes without the Veterans’ permission. Finally, in an attempt to obfuscate the overall scheme and the forgeries of student enrollment paperwork, Marshall directed the Veteran-students to lie to VA investigators and ordered the destruction of AST paperwork by co-schemers.

“[Marshall] profited most from this conduct, pocketing nearly $1 million himself, which he used for jewelry, a cruise, a trip to Hawaii, property taxes on his Woodland Hills residence, purchase of a Ford F-150 and purchase of semi-tractor trailers for a new business,” prosecutors wrote in their sentencing memorandum.

Waggoner pleaded guilty on February 24 to five counts of wire fraud. His sentencing hearing is scheduled for March 15, 2021, at which time he will face a statutory maximum sentence of 100 years in federal prison.

This matter was investigated by the U.S. Department of Veterans Affairs Office of Inspector General, the U.S. Department of Justice Office of the Inspector General, and the FBI.

This case was prosecuted by Assistant United States Attorney Kimberly D. Jaimez of the Major Frauds Section.

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Half of Veterans who have undergone psychological assessments have clinically high levels of suicidal ideation, according to research from the Texas Tech University Department of Psychological Sciences. Paul Ingram, an assistant professor in counseling psychology, is looking to improve the diagnosis and treatment of Veterans’ mental health. Since he began his research in 2012, Ingram’s findings have revealed that nearly 50% of Veterans have clinically high levels of suicidal ideation, which includes suicidal thoughts, consideration and planning.

“When you look across the board, clinical levels of suicidal ideation are astronomically high in Veterans,” Ingram said. “Forty-five to 50% endorse suicidal ideation. It doesn’t matter where we’re assessing them. It could be a primary care clinic, a post-traumatic stress disorder (PTSD) clinic, psychiatric rehabilitation, traumatic brain injury clinic – it’s everywhere. The rates of suicidal ideation are huge. That says we need to be getting good assessments so we can link Veterans with the services they need.”

Ingram’s research focuses on improving diagnoses so the needs of individuals can be met with accuracy and in a timely manner. His solution for improving diagnoses is improving mental health assessments for Veterans, using the Minnesota Multiphasic Personality Inventory (MMPI).

In 2019, he published a number of articles documenting the findings of his research over the past eight years, including a seven-year sample that explains how to expand and improve the mental health of Veterans and explores different health settings in Veteran Affairs (VA).

Background and passion for psychology

Ingram came to Texas Tech in 2017 after finishing his doctoral internship at the Eastern Kansas Veteran Affair Medical Center. Ingram said he was attracted to Texas Tech because of the research opportunities and the possibilities associated with an expanding community VA clinic.

“I’ve always been interested and passionate about psychology,” Ingram said. “A big part of psychology and mental health is the diagnosis because it tells us how things are causing problems in everyday life. To me, the idea that we can come up with good ways to figure out what’s going on with people so we can figure out what they need, is big. My goal is to bring resources to those needs.”

Most Veterans have significant mental health needs, Ingram said, and the best way to meet those needs is with diagnoses and mental health assessments, which can pinpoint the correct treatment for any given individual based on those different diagnostic needs.

The MMPI

To conduct his research, Ingram uses the MMPI, a personality inventory used to measure psychopathology. Psychopathology, the study of mental health disorders, is used to achieve a mental health diagnosis, including substance use, suicide, depression, antisocial behaviors, thoughts related to paranoia, schizophrenia and average experiences. Ingram described the MMPI as a “comprehensive battery” of an individual’s psychopathology which assesses all these areas of need.

Ingram began using the MMPI after its last revision in 2008, but has been working specifically conducting assessments and improving diagnoses for Veterans and active-duty personnel since 2012. He is working on the newest version of the MMPI, slated to be released later this year.

“This new instrument came out, and it was a serendipitous way for me to dip my toe into research,” Ingram said. “I had run into problems finding good assessments before. It was really intended as a side project, and I fell in love with the idea that if I’m asking a question well, and I have a good way to measure it, I get a better answer.”

The MMPI is an assessment in the form of true/false questions. Ingram said it’s not that different from sitting down and conducting an interview, except the assessment gives psychologists a standard way questions are asked and answered, so scales can be created to represent the information. The quantitative data gives psychologists comparative ways to think about diagnoses.

“Veterans are one of the most severely impacted groups for many diagnoses,” Ingram said. “Improving our diagnostic process for them has great potential to improve their treatment. There’s a lot of room for improvement because there’s a lot they’re dealing with. The more problems someone has and the more diagnoses they hold, the more difficult it is to figure out what they need.

“That’s where the MMPI comes in. It’s kind of like taking your car to the shop: it’s like undergoing a comprehensive checkup to see what the problem is so it can get taken care of. It’s looking at behavior patterns, thought patterns and emotional patterns that may be making their lives harder. Anything you would traditionally think of as a mental health problem is measured on the MMPI.”

Although Ingram has been working with the MMPI since 2012, he’s begun publishing extensively on the MMPI only in the past four years because of how long it takes to build databases for clinical populations. In his research, Ingram looks for mechanistic ways to diagnose people by creating instruments that can reliably predict problems and outcomes.

“One of the things I’ve been able to do in my research is point to where we need to be concerned,” Ingram said. “Fifty percent of Veterans endorsing suicidal ideation is insane. That’s one in two Veterans at risk. And with those kinds of odds, our assessments need to be as good as they can be. Instruments like the MMPI are traditionally better predictors of outcomes than clinical interviews where we just ask the client. When we use mental health assessments, we get better outcomes. My goal is in line with the historic precedent of continuing to improve those assessments.”

Challenges in Veteran mental health care

One of the greatest challenges involved with providing mental health care for Veterans is the stigma surrounding mental health. Ingram said that while there’s a culture of asking for help within the VA, there’s a prescriptive element to it that can be damaging. Telling someone they need help with their PTSD without a thorough diagnosis and a culture of engaging in therapy implies they have PTSD and encourages them to hold on to all the problems that come along with it.

“It becomes part of who they are,” Ingram said.

Sometimes getting Veterans into a doctor’s office is only the first step, as many aren’t willing to verbalize their struggles.

“It’s not as simple as asking questions, because people don’t always want to verbalize what’s going on,” Ingram said. “It’s hard for people to talk about suicidal ideations because they’re concerned that people will think less of them or that they’ll be locked up. With substance use, people are worried about getting into legal trouble. A lot of it comes down to stigma. So they suffer alone.”

Hopes for the future

Much of Ingram’s work is with the creator of the MMPI and he hopes their efforts will contribute to refinements and improvements moving forward. He currently conducting several studies on the next version of the instrument, which will be released in the later part of this year.

In addition to contributing to revisions to the MMPI, Ingram hopes to help physicians and mental health care providers adapt their practices to better address Veterans’ needs.

“Identifying the correct diagnoses means having the ability to offer the most impactful treatments and being able to predict who will drop out and who will be successful,” Ingram said. “It also means being aware of who may need additional support while getting those therapies. I’m working with several treatment clinics around the country to do this.”

To learn more about Ingram’s research, visit his lab website.

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FREDERICK, Md. — A member of the Tuskegee Airmen celebrated his 100th birthday by taking a flight.

Retired Army Air Forces Col. Charles McGee flew a private jet Friday between Frederick, Maryland, and Dover Air Force Base in Delaware, news outlets reported.

The Tuskegee Airmen is the nickname of the first African American unit to fly combat airplanes in World War II. The Air Force recently honored the famed group of airmen with the naming of its new trainer jet.

McGee is one of the Air Force's most celebrated pilots. He flew 409 fighter combat missions over three wars.

McGee, who turned 100 on Saturday, attributes positive thinking to his longevity.

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DETROIT - Two defendants have been charged via criminal complaint for their roles in separate frauds related to Covid-19 Vaccination Record Cards, announced Acting United States Attorney Saima S. Mohsin.

Joining in the announcement were Gavin McClaren, Acting Special Agent in Charge, VA-OIG, Central Field Office, Special Agent in Charge Lamont Pugh III of the U.S. Department of Health & Human Services, Office of Inspector General (HHS-OIG) – Chicago Region and Vance R. Callender, Special Agent in Charge of Homeland Security Investigations (HSI) field offices in Michigan and Ohio.

The first complaint charges Bethann Kierczak, 37, of Southgate with theft of government property and theft or embezzlement related to a healthcare benefit program. Kierczak, a registered nurse, was arrested this morning and will be appearing in federal court this afternoon on the charges.

According to the complaint, Kierczak is responsible for stealing or embezzling authentic Covid-19 Vaccination Record Cards from the VA hospital—along with vaccine lot numbers necessary to make the cards appear legitimate—and then reselling those cards and information to individuals within the metro Detroit community. The complaint alleges that Kierczak’s theft of Covid-19 Vaccination Record Cards began at least as early as May of this year and continued until the present. It is further alleged that Kierczak sold the cards for $150-$200 each and communicated with buyers primarily via Facebook Messenger.

The second complaint charges Rapheal Jarrell Smiley, 32, of Detroit with fraud involving department or agency seals, identity document fraud, and trafficking in counterfeit goods. Smiley was arrested earlier today and will also be making his initial appearance in federal court as well.

According to the complaint, Smiley is responsible for conducting an ongoing scheme to import and sell or otherwise distribute fraudulent Covid-19 Vaccination Record Cards. It is alleged that Smiley ordered the cards from two shippers in China, both of which have been previously identified by law enforcement as importers of fraudulent Covid-19 Vaccination Record Cards. Further, the complaint alleges that Smiley advertised the cards for sale via his Facebook and Instagram accounts.

“These arrests reflect our deep commitment to protecting the health of our community and preventing this dangerous fraud from affecting our most vulnerable citizens,” said Acting US Attorney Mohsin. “Regardless of whether an individual choses to get vaccinated, we urge everyone to avoid turning to schemes like these to evade vaccination requirements. Importing these cards is a crime. Selling these cards is a crime. We will continue to investigate these crimes and prosecute them accordingly.”

“VA’s COVID-19 safety protocols, including ensuring accurate vaccination records, exist to keep both Veterans and VA’s healthcare workers safe during this global pandemic,” said Gavin McClaren, Acting Special Agent in Charge, VA-OIG, Central Field Office. “These charges symbolize VA OIG’s commitment to protecting the integrity of VA’s healthcare delivery system, and diligently investigating any potential criminal activity that could threaten the safety of its patients and employees.”

“The theft of government property is a serious crime, particularly when it involves documents that are used in recording patient health information,” said Special Agent in Charge Lamont Pugh III of the U.S. Department of Health & Human Services, Office of Inspector General (HHS-OIG) - Chicago Region. "Stealing and selling COVID-19 vaccination cards is an inexcusable act and will not be tolerated. HHS is committed to working with our law enforcement partners to protect the health and safety of the public during this pandemic.”

“At a time when Americans eagerly want to return to a normal way of life, these counterfeit vaccine cards undermine our confidence in COVID-19 vaccines,” said Vance R. Callender, Special Agent in Charge of Homeland Security Investigations (HSI) field offices in Michigan and Ohio. “HSI dedicates significant resources to investigate a wide variety of pandemic-related fraud schemes. This arrest and seizure demonstrates HSI’s ongoing commitment to support the integrity of our public healthcare system by preventing the illegal importation and sale of counterfeit vaccine cards.”

A complaint is only a charge and is not evidence of guilt. Trial cannot be held on felony charges in a complaint. When the investigations are completed, determinations will be made whether to seek felony indictments.

The cases are both being prosecuted by Assistant United States Attorney Ryan A. Particka. The Kierczak investigation is being conducted by the U.S. Department of Veterans Affairs-Office of Inspector General (VA-OIG), VA Police Detroit and the Medicare Fraud Strike Force (MFSF) partners, a partnership among the Criminal Division, U.S. Attorney’s Offices, the FBI and U.S. Health and Human Services-Office of Inspector General (HHS-OIG). The Smiley investigation is being conducted by agents from Homeland Security Investigations, the principal investigative arm of the Department of Homeland Security.

On May 17, 2021, the Attorney General established the COVID-19 Fraud Enforcement Task Force to marshal the resources of the Department of Justice in partnership with agencies across government to enhance efforts to combat and prevent pandemic-related fraud. The Task Force bolsters efforts to investigate and prosecute the most culpable domestic and international criminal actors and assists agencies tasked with administering relief programs to prevent fraud by, among other methods, augmenting and incorporating existing coordination mechanisms, identifying resources and techniques to uncover fraudulent actors and their schemes, and sharing and harnessing information and insights gained from prior enforcement efforts. For more information on the Department’s response to the pandemic, please visit https://www.justice.gov/coronavirus.

Anyone with information about allegations of attempted fraud involving COVID-19 can report it by calling the Department of Justice’s National Center for Disaster Fraud (NCDF) Hotline at 866-720-5721 or via the NCDF Web Complaint Form at: https://www.justice.gov/disaster-fraud/ncdf-disaster-complaint-form.

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Damian Williams, the United States Attorney for the Southern District of New York, and Scott J. Lampert, Special Agent in Charge of the U.S. Department of Health and Human Services Office of Inspector General (“HHS-OIG”) New York Regional Office announced today the arrest of ZACHARY S. SEID and ANTHONY CRACCHIOLO on charges of conspiracy, health care fraud, wire fraud, and unlawfully receiving kickbacks in connection with Medicare. As alleged in an Indictment unsealed today in Manhattan federal court, SEID and CRACCHIOLO, ran companies dedicated to illegally buying and selling prescriptions for durable medical equipment (“DME”) such as leg, arm, and back braces, and then using those prescriptions to file fraudulent Medicare claims for more than $11 million, as well as selling such prescriptions to other DME supply companies, so that those companies in turn could also file fraudulent Medicare claims. The case has been assigned to U.S. District Judge John P. Cronan. SEID and CRACCHIOLO, who were arrested this morning in Florida, will be presented tomorrow before magistrate judges in the Southern District of Florida.

U.S. Attorney Damian Williams said: “Medicare is an invaluable taxpayer-funded program dedicated to providing affordable health care to beneficiaries over 65 or with disabilities, not to enriching those who would defraud the program by buying and selling false prescriptions.”

HHS-OIG Special Agent in Charge Scott J. Lampert said: “These allegations describe a greed-fueled scheme that undermined our health care system and the people it serves. Such scams threaten patient health, waste taxpayer funds, and drive up healthcare costs for all of us. Working closely with our law enforcement partners, we will continue to aggressively root out health care fraud and bring criminals to justice.”

As alleged in the Indictment:[1]

From at least July 2019 through at least October 2020, SEID and CRACCHIOLO engaged in a scheme to defraud Medicare in at least three ways. First, SEID and CRACCHIOLO illegally paid kickbacks of more than $565,000 to purchase fraudulent DME prescriptions, including prescriptions “signed” by doctors who never in fact signed or authorized those prescriptions and were unaware that their names and identities were being so used. These DME prescriptions were for such equipment as braces for ankles, knees, elbows, wrists, and backs. Second, SEID and CRACCHIOLO unlawfully received more than $425,000 in kickbacks, reselling some of these prescriptions to DME suppliers, so that those suppliers in turn could fraudulently bill Medicare for the DME. Finally, in about May and June 2020, SEID and CRACCHIOLO acquired five of their own fraudulent DME supply companies, and used the bogus prescriptions to file more than $11 million in fraudulent Medicare claims, seeking payment to the DME suppliers that SEID and CRACCHIOLO controlled.

Together, SEID and CRACCHIOLO sold to multiple DME supply companies, and established control over at least five DME supply companies of their own, which they used to submit their fraudulent Medicare claims. Those companies were: 1 Medical Supplies Corp., Ameri Med Supplies Corp., One Medical Health Supplies Corp., Sun Med Equip Corp., and Sunrise Med Service Group Corp. In addition, Seid owned a company called Seid Services, Inc., while Cracchiolo owned a company called Dataco.

*     *     *

SEID, 35, of Boynton Beach, Florida, and CRACCHIOLO, 42, of Parkland, Florida, are each charged in four counts with conspiracy to commit health care fraud and wire fraud, health care fraud, wire fraud, and receiving kickbacks in violation of the Anti-Kickback Statute. The conspiracy and wire fraud counts each carry a maximum potential prison sentence of 20 years; the health care fraud count carries a maximum potential prison sentence of 10 years; and the count charging violation of the Anti-Kickback statute carries a maximum potential prison sentence of five years. The maximum potential penalties are prescribed by Congress and are provided here for informational purposes only, as any sentencing of the defendant will be determined by the judge.

Mr. Williams praised the investigative work of HHS-OIG.

This case is being handled by the Office’s Complex Frauds and Cybercrime Unit. Assistant United States Attorney David Raymond Lewis is in charge of the prosecution.

The allegations contained in the Indictment are merely accusations, and the defendants are presumed innocent unless and until proven guilty.

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NEWARK, N.J. – Two Florida men have been indicted for their roles in durable medical equipment and compound medication schemes involving kickbacks and fraud, Acting U.S. Attorney Rachael A. Honig announced.

Thomas Farese, 79, of Delray Beach, Florida, and Domenic J. Gatto Jr., 47, of Palm Beach Gardens, Florida, are charged in an 11-count indictment with conspiracy to commit wire fraud, conspiracy to commit health care fraud, health care fraud, conspiracy to transact in criminal proceeds, transacting in criminal proceeds, and conspiracy to violate the federal Anti-Kickback Statute.

According to documents filed in the case and statements made in court:

Farese and Gatto played key roles in a scheme to defraud health care benefit programs by offering, paying, soliciting, and receiving kickbacks and bribes in exchange for doctors’ orders for durable medical equipment (DME) without regard to medical necessity, namely orthotic braces. Farese, Gatto, and their conspirators had financial interests in multiple DME companies that paid kickbacks to suppliers of DME orders, in exchange for DME orders. The suppliers, in turn, used telemedicine companies to obtain DME orders without regard to medical necessity. The DME companies owned by Farese and Gatto subsequently fraudulently billed Medicare, TRICARE, CHAMPVA, and other health care benefit programs for the DME orders. The defendants concealed their ownership of the DME companies by using straw owners who were falsely reported to Medicare as the owners of the companies. Gatto also brokered a kickback relationship whereby he received an illegal kickback each time specific DME suppliers provided DME orders to the DME companies controlled by him and his conspirators. Gatto and his conspirators then laundered the proceeds of the scheme through several layers of bank accounts under their control.

Gatto and his conspirators entered into a related kickback scheme involving prescriptions for compounded medications. They agreed that suppliers of compounded medications would receive kickbacks in exchange for submitting the orders to the pharmacies with whom Gatto and his conspirators had relationships. Gatto also agreed with others that he would receive kickbacks from those pharmacies for the compounded medication orders submitted by those suppliers. The compounding pharmacies then billed Medicare for the compounded medication orders.

The defendants caused losses to Medicare, TRICARE, and CHAMPVA of approximately $25 million.

The charge of conspiracy to commit wire fraud is punishable by a maximum potential penalty of 20 years in prison. The charges of conspiracy to commit health care fraud, health care fraud, conspiracy to transact in criminal proceeds, and transacting in criminal proceeds are each punishable by a maximum potential penalty of 10 years in prison per count. The charge of conspiracy to violate the federal Anti-Kickback Statute is punishable by a maximum potential penalty of five years in prison. he maximum fine for each count is $250,000, or twice the gross profit or loss caused by the offense, whichever is greatest.

Acting U.S. Attorney Honig credited special agents of the FBI, under the direction of Special Agent in Charge George M. Crouch Jr. in Newark; the Department of Health and Human Services-Office of Inspector General, under the direction of Scott J. Lampert; the U.S. Department of Defense, Office of the Inspector General, Defense Criminal Investigative Service, under the direction of Special Agent in Charge Patrick J. Hegarty; and the U.S. Department of Veterans Affairs Office of Inspector General, under the direction of Special Agent in Charge Christopher F. Algieri, with the ongoing investigations.

The government is represented by Assistant U.S. Attorneys Sean M. Sherman of the Opioid Abuse Prevention & Enforcement Unit in Newark, Ryan L. O’Neill of the Health Care Fraud Unit in Newark, Senior Trial Counsel Barbara Ward of the Asset Recovery & Money Laundering Unit in Newark, and Trial Attorney Darren Halverson of the Health Care Fraud Unit of the Criminal Division’s Fraud Section.

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Miami, Florida – Two South Florida residents have pleaded guilty to running a mental health care fraud scheme that over-billed Medicaid for hundreds of thousands of dollars.

During the change of plea hearing in federal court in Fort Lauderdale, Florida, Lorena Osella, 44, of Ft. Lauderdale, Florida, pleaded guilty to one count of conspiracy to commit health care fraud, and Juan Luis Matos, 59, of Miami, Florida, pleaded guilty to one count of conspiracy to defraud the United States and to pay health care kickbacks. U.S. District Judge William P. Dimitrouleas, who sits in Ft. Lauderdale, Florida, will sentence both defendants on January 10, 2022.

As part of their guilty pleas, Osella and Matos admitted that they paid kickbacks of $400 in cash per month to Medicaid beneficiaries in exchange for the beneficiaries receiving psychosocial rehabilitation (PSR) services at Lighthouse Community Center LLC, in Doral, Florida. In addition, Osella admitted that she fraudulently billed Medicaid for at least $350,206 in psychosocial rehabilitation (PSR) services that were not provided as claimed. Psychosocial rehabilitation (PSR) services are a type of mental health group counseling designed to help people with depression, anxiety, and other mental disorders cope with their conditions and improve their ability to conduct daily life activities. Medicaid allowed these services to be administered via telemedicine beginning in April 2020 because of the COVID-19 pandemic. Osella and Matos also admitted to illegally receiving Florida unemployment benefits during the time they committed the health care fraud.

HHS-OIG investigated the case. Assistant United States Attorney Timothy Abraham is prosecuting the case. AUSA Emily Stone is handling asset forfeiture.

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Two men were sentenced in federal court Wednesday for helping orchestrate a scheme where physicians received kickback payments in exchange for writing and referring expensive compounded drug prescriptions to OK Compounding, announced U.S. Attorney Clint Johnson.

Johnathon Yates Boyd III, 50, of Katy, Texas, was sentenced to 12 months of probation and ordered to pay $391,475.41 in restitution. Bryan Fred Woodson, 61, of Beach City, Texas, was sentenced to 12 months of probation and ordered to pay $553,232.45 in restitution.

Boyd III and Woodson each pleaded guilty to conspiracy to pay kickbacks.

It is illegal to pay or receive “kickbacks” in conjunction with federal health care insurance. Prohibitions against kickbacks are crucial to ensure that financial motives do not undermine the medical judgment of physicians and other health care providers.

Boyd III and Woodson admitted to conspiring together with Christopher Parks, 60, of Jenks, and Dr. Gary Lee, 61, of Tulsa, to enrich themselves through the scheme at the expense of the federal government.

According to court documents, Boyd III and Woodson, formed R&A Marketing Group LLC around 2012. R&A Marketing introduced its recruited physicians to OK Compounding, a pharmacy controlled and operated by Parks and Lee, for the purpose of entering into a referral relationship with the pharmacy. The conspirators provided illegal kickbacks and bribes to the physicians, and in return, the physicians wrote expensive patient prescriptions for compounded drugs and referred those prescriptions to OK Compounding. The pharmacies then submitted large claims for payment of the costly prescriptions to various federal health care programs.

Physicians were allegedly provided pre-printed prescription pads that listed compounded formula choices. They would then check a box with their preferred selection then fax it directly to OK Compounding, rather than writing a prescription tailored to the patient who could then take it to a pharmacy of their choice.

Payments to physicians were disguised through various sham business arrangements. For example, physicians would enter into agreements with a pharmacy to serve as “medical directors” or “consulting physicians.” However, physicians did not provide any services to OK Compounding nor any other pharmacies controlled by Parks and/or Lee.

In exchange for recruiting physicians to enter into contracts as “medical directors” or “consulting physicians”, R&A Marketing was paid a commission based on the reimbursed prescriptions.

Compounding prescriptions is a practice in which a pharmacist or physician combines, mixes or alters ingredients of a drug or multiple drugs to create a medication that is tailored to the specific needs of a patient. These medications are prescribed when standard Food and Drug Administration (FDA) approved drugs are unsuitable for the patient. They are also more expensive and reimbursed at a far higher rate by federal and private insurance companies. Compounded drugs are not to be mixed or marketed in bulk.

OK Compounding is no longer in operation. Charges are currently pending against Parks and Lee. They are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

Veteran’s Affairs- Office of Inspector General, Defense Criminal Investigative Service, Department of Labor- Office of Inspector General (OIG), IRS- Criminal Investigation, U.S. Postal Service- OIG, FBI and the Department of Health and Human Services-OIG conducted the investigation. Assistant U.S. Attorneys Melody Noble Nelson and Richard M. Cella prosecuted the case.

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Two doctors who helped a local hospice agency scam Medicare were sentenced today to a combined 23 years in prison for healthcare fraud, announced U.S. Attorney for the Northern District of Texas Chad E. Meacham.

In May, a federal jury found Novus Health Services Medical Directors Dr. Mark E. Gibbs and Dr. Laila Hirjee, along with Novus RN Tammie Little, guilty of conspiracy to commit healthcare fraud and other charges. Today, Chief U.S. District Judge Barbara M.G. Lynn sentenced Dr. Gibbs to 13 years in federal prison and ordered him to pay $27,978,903 in restitution; she sentenced Dr. Hirjee to 10 years in federal prison and ordered her to pay $16,253,281 in restitution. The judge also sentenced Ms. Little to 33 months in federal prison.

According to evidence presented at trial, the defendants helped Novus CEO Bradley Harris defraud Medicare by, among other things, illegally admitting patients who were not appropriate for hospice and submitting materially false claims for hospice services.

Mr. Harris, who pleaded guilty prior to trial, testified against his former employees.

He told the jury that instead of relying on the expertise of licensed medical professions, he and Novus nurses determined which patients would be admitted to or discharged from hospice care, as well as which drugs and dosages they would receive.

They relied upon Novus doctors, including Dr. Gibbs and Dr. Hirjee, to certify that they had examined these patients face-to-face, when no such examinations had occurred, Mr. Harris testified.

Witnesses also testified that Dr. Hirjee and Dr. Gibbs engaged in the prescription of Schedule II controlled substances, such as morphine, hydromorphone, and fentanyl, by pre-signing blank C2 prescriptions and giving those to Brad Harris and others at Novus to let them prescribe controlled substances without any physician oversight.

As Director of Operations Melanie Murphey testified on day five of trial, “I was the doctor.”

Mr. Harris and the nurses used pre-signed prescription pads, prepared by Dr. Gibbs, Dr. Hirjee, and other Novus doctors, to dispense medications like morphine to patients. When Medicare suspended payment to Novus over concerns about billing, Mr. Harris, Dr. Gibbs, and others moved patients and employees to a new hospice company and continued to bill Medicare for hospice services.

In total, Medicare and Medicaid paid the Novus entities approximately $40 million dollars for hospice services before the companies were shut down.

“These doctors allowed Bradley Harris – an accountant with no medical expertise – to dispense controlled substances like candy, with little to no medical oversight,” said U.S. Attorney Chad Meacham. “They claimed to have had hands-on experience with hospice patients, when in fact, they’d entrusted life-or-death medical decisions to untrained businesspeople. We are satisfied to know they will spend the next decade behind bars.”

“The defendants violated their Hippocratic Oath as doctors and instead focused on lining their pockets at the expense of patient safety. This case highlights the importance of thoroughly investigating any complaint of healthcare fraud,” said FBI Dallas Special Agent in Charge Matthew DeSarno. “We encourage the public to help us identify, investigate, and prosecute this crime. If you suspect health care fraud, report it to the FBI at tips.fbi.gov, 1-800-CALL-FBI, or contact your health insurance provider.”

Several of their codefendants – Novus CEO Brad Harris, his wife, Novus Vice President of Patient Services Amy Harris, Novus Director of Operations Melanie Murphy, Novus Medical Director Charles Leach, Novus Medical Director Reziuddin Siddique (deceased), Novus Vice President of Marketing Samuel Anderson, Novus Director of Marketing Slade Brown, Novus RN Jessica Love, Novus triage RN Patricia Armstrong, Novus LVN Taryn Stewart, and Ali Rizvi, the owner of a separate physician home visit company – pleaded guilty to various offenses prior to trial. Love was sentenced 102 months, Stuart was sentenced to 96 months, Armstrong was sentenced to 84 months, Dr. Leach was sentenced to 57 months, and Anderson was sentenced to 33 months. The remaining defendants are facing statutory maximums of between two and 14 years in federal prison.

The Federal Bureau of Investigation’s Dallas Field Office, the U.S. Department of Health & Human Services Office of Inspector General (HHS-OIG), and the Texas Attorney General’s Medicaid Fraud Control Unit conducted the investigation. Assistant U.S. Attorneys Donna Strittmatter Max and Marty Basu are prosecuting the case with Assistant U.S. Attorneys Stephen Gilstrap, Gail Hayworth, and Brian McKay.

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PHILADELPHIA – Acting United States Attorney Jennifer Arbittier Williams announced that two related, integrative chiropractic practices and their chiropractor owners have agreed to make payments totaling $805,978 to resolve liability under the False Claims Act for the alleged improper billing of P-Stim electro-acupuncture devices, in these cases branded ‘ANSiStim.’

The settling parties are: (1) Discover Optimal Healthcare of Brookhaven, PA, with its owner, Jason Weigner, and his affiliate Weigner Healthcare Management Group, LLC (collectively, “Weigner”); and (2) Yucha Medical Pain Management & Chiropractic Rehabilitation, LLC of Pottstown, PA, and its owners, Randolph E. Yucha and Rodney Gabel (collectively, “Yucha”).

Chiropractors are generally limited in what services they can bill to federal healthcare programs (more information here). However, integrative chiropractic practices such as Weigner and Yucha may in certain circumstances bill additional services to federal healthcare programs through affiliated medical providers, in this case a medical doctor contractor. From approximately September 2016 to February 2017, Weigner and Yucha separately billed Medicare, and Weigner also billed the Federal Employees Health Benefit Program, for the implantation of neuro-stimulators – a surgical procedure which usually requires an operating room and which is reimbursed by federal healthcare programs – when in fact the only procedures performed had been the non-surgical application of ANSiStim by a non-surgeon contractor physician. ANSiStim is another brand name for the P-Stim device, which is also branded as NeuroStim, Stivax, E-Pulse, and NSS-2 Bridge. ANSiStim devices are applied with an adhesive and insertion of a limited number of needles; their application does not involve surgery or anesthesia, nor does it take place in an operating room. Federal healthcare programs do not reimburse for devices such as ANSiStim, whether they are characterized as an electro-acupuncture device or as an implantable neuro-stimulator. Weigner promoted this scheme to Yucha and received a portion of Yucha’s profits.

For the fraudulently billed P-Stim services here, Weigner previously repaid $306,342 to Medicare and will pay an additional $356,150. Likewise, Yucha had repaid $94,089 to Medicare and will pay an additional $49,397.      

“As we have said before, the application of P-Stim devices is not surgery and should not be billed using the surgical codes improperly pushed by marketers,” said Acting U.S. Attorney Williams. “If a marketer pushes a healthcare scheme like P-Stim that sounds too good to be true, it likely is – and you shouldn’t agree to it.”

These are the fourth and fifth P-Stim provider settlements announced in this District as part of an ongoing investigation. Other jurisdictions including the Southern District of Texas, the Southern District of Georgia, and the Middle District of Tennessee have also taken action to hold providers accountable.

Acting U.S. Attorney Williams continued: “Our continued enforcement through this series of cases has already recovered millions and is a lesson to anyone who might consider a similar fraudulent billing scheme – especially those that prey on vulnerable Medicare beneficiaries looking for legitimate pain management solutions. You will be held accountable by our Office and our partners at the Centers for Medicare & Medicaid Services’ Center for Program Integrity, the Department of Health and Human Services Office of Inspector General, other federal healthcare programs, state partners, and sister U.S. Attorney’s Offices around the country. And if you have already been involved in such a scheme, it is better to come forward and self-disclose than have us find you, as we will.”

“Every time DOJ stops a provider who is committing fraud, it protects patients and improves the sustainability of the Medicare program,” said Chiquita Brooks-LaSure, Administrator for the Centers for Medicare and Medicaid Services (CMS). “Actions like this to combat fraud, waste and abuse in our federal programs would not be possible without the successful partnership of CMS, the Department of Justice and Department of Health and Human Services Office of Inspector General.”

“Accurately billing for services provided to Medicare beneficiaries is required of all health care providers,” said Maureen R. Dixon, Special Agent in Charge for the U.S. Department of Health and Human Services, Office of the Inspector General. “HHS-OIG, CMS’s Center for Program Integrity, and the U.S. Attorney’s Office will continue to evaluate and pursue inaccurate billings of P-Stim and similar devices.”

The settled civil claims are allegations only. There has been no determination of civil liability. This case was investigated by the U.S. Department of Health and Human Services Office of the Inspector General. It was handled by Assistant U.S. Attorney Matthew E. K. Howatt, Civil Chief Gregory B. David, and Auditor Dawn Wiggins.

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SAN ANTONIO – This week, two San Antonio residents were sentenced for their roles in health care fraud schemes. Yesterday, Nancy Almaguer, 42, was sentenced to 18 months in prison and today, Christopher Felix Montoya, 47, was sentenced to two 18-month prison sentences to run consecutively.

According to court documents, Montoya was a licensed physician’s assistant and owner of TPC Family Care and Medical Clinics in San Antonio and Laredo. Almaguer was the Chief Operating Officer for the clinics. Beginning in September 2018 through June 2019, Montoya and Almaguer agreed to refer lab testing requests to specific laboratories. The labs billed insurance programs, including Medicare and TRICARE, and paid Almaguer and Montoya a percentage of their receipts in return for the referrals. The kickback schemes resulted in over $500,000 in billings to public and private insurance companies.

In July and September of 2021, Montoya and Almaguer, respectively, pleaded guilty to one count of conspiracy to defraud the U.S. and to pay and receive health care kickbacks.

In a separate case, in July 2021, Montoya pleaded guilty to one count of conspiracy to receive health care kickbacks. In this case, Montoya admitted that for five months beginning in February 2015 he received kickbacks to write prescriptions for compounded medication from a California-based pharmacy that had high TRICARE reimbursements. Based on the evidence, TRICARE was billed $8,832,268.73 for prescriptions Montoya wrote to which TRICARE paid out $6,690,598.77.

In addition to the prison sentence, Almaguer was ordered to forfeit $137,792.10 in criminal proceeds and pay $52,603.62 in restitution. Montoya was ordered to pay a total of $849,865.93 in restitution.

“Kickback regulations exist to protect patient choice and ensure that only medically necessary procedures are performed,” said U.S. Attorney Ashley C. Hoff. “Our office continues to help protect federal insurance programs from fraud. We hope that these sentences communicate that these regulations should be taken seriously.”

“Health care fraud significantly harms the U.S. economy by costing this country billions of dollars a year,” said FBI Special Agent in Charge Christopher Combs. “Those losses result in rising medical costs for all Americans. The FBI is committed to investigating those involved in this crime through investigative partnerships with other federal agencies.”

The FBI; Texas Attorney General’s Office Medicaid Fraud Control Unit; U.S. Department of Health and Human Services—Office of Inspector General; the U.S. Office of Professional Management—Office of Inspector General; and the Defense Criminal Investigation Service investigated this case.

Assistant U.S. Attorneys Justin Chung and William R. Harris prosecuted this case on behalf of the government and Assistant U.S. Attorney Antonio Franco handled the forfeiture aspects.

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MADISON, WIS. – Timothy M. O’Shea, Acting United States Attorney for the Western District of Wisconsin, announced that Fredericka DeCoteau, 63, Cloquet, Minnesota, and Edith Schmuck, 77, Rice Lake, Wisconsin, were sentenced today in federal court in Madison, Wisconsin for theft of federal program funds.

U.S. District Judge William M. Conley sentenced DeCoteau to 2 years in prison, and Schmuck to 1 year and 1 day in prison. Judge Conley also ordered the defendants to jointly pay restitution of $777,283. Both defendants were ordered to report to the Bureau of Prisons on December 29, 2021 to begin their sentences.

DeCoteau and Schmuck pleaded guilty to one count of theft of federal funds on July 15 and June 24, 2021, respectively. They worked at Ain Dah Ing (ADI) which has operated as a non-profit halfway house in Spooner, Wisconsin since 1971. DeCoteau worked as the Executive Director at ADI from 2002 to 2017. Schmuck worked as the bookkeeper from 1990 to 2017. They were fired after the thefts were discovered.

ADI offered mental health and alcohol and substance abuse services to Native Americans from Michigan, Minnesota, and Wisconsin tribes. ADI's services included a 90-day program at its 15-bed Community-Based Residential Facility in Spooner, Wisconsin. ADI's funding came from a federal commercial contract with the U.S. Department of Health and Human Services, Public Health Service, Indian Health Services Division.

Both DeCoteau and Schmuck pleaded guilty to embezzling a total of $777,283 from ADI by paying themselves unauthorized bonuses via payroll checks that were signed using a rubber signature stamp of the ADI Treasurer. The embezzlement lasted from 2007 to 2017.      

At today's sentencing, Judge Conley noted that DeCoteau and Schmuck stole over 67% of the total funds intended for programming at ADI, and that they gambled away most of this money at local Indian casinos. Judge Conley explained that the defendants violated the trust of the ADI Board of Directors and took advantage of vulnerable people with addictions. In imposing sentence, Judge Conley made clear to both defendants that the gravity of the offense, coupled with the long-term nature of the embezzlement, mandated that they serve prison time despite their claims of being addicted to gambling.

The charges against DeCoteau and Schmuck were the result of an investigation conducted by the U.S. Department of Health and Human Services, Office of Inspector General, and the Spooner Police Department. Assistant U.S. Attorney Daniel Graber handled the prosecution.

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Tampa, Florida – U.S. District Judge Virginia M. Hernandez Covington has sentenced Michael Nolan (48, Tampa) and Richard Epstein (29, Aurora, CO) for their roles in a conspiracy to defraud federal health benefit programs, Medicare and the Civilian Health and Medical Program of the Department of Veterans Affairs (“CHAMPVA”).

Nolan was sentenced to six years and six months in federal prison, followed by three years of supervised release. Epstein was sentenced to five years and three months in federal prison, followed by three years of supervised release. As part of their sentences, the court also entered a money judgment against each defendant in the amount of $2.1 million and $3 million, respectively, which were proceeds of the conspiracy. Noland and Epstein were also ordered to pay restitution, jointly and severally with each other and other conspirators, in the amount of $29,020,304.

Nolan and Epstein each had pleaded guilty on July 31, 2020.

According to court documents, from around October 2016 through around April 2019, Epstein and Nolan ran a telemarketing company in Tampa called REMN Management LLC that targeted the elderly to generate thousands of medically unnecessary physicians’ orders for durable medical equipment (“DME”) and cancer genetic testing (“CGx”). Epstein and Nolan also created and operated Comprehensive Telcare, LLC, a “telemedicine” company through which they illegally bribed physicians to sign the orders regardless of medical necessity. Epstein and Nolan then illegally sold the signed physicians’ orders to client-conspirators for use as support for false and fraudulent claims submitted to Medicare and CHAMPVA. The conspiracy resulted in the submission of at least $134 million in fraudulent claims to the federal health benefit programs, resulting in approximately $29 million in payments.

The investigation and prosecution of the case were a joint effort between the Middle District of Florida and the Department of Justice - Criminal Division, Fraud Section, Health Care Fraud Unit, as part of nationwide actions known as Operation Brace Yourself and Operation Double Helix. The operations targeted ongoing schemes, such as the conspiracy described above, in which DME companies, laboratories, and marketers were paying illegal bribes through “telemedicine” operators to secure signed physicians’ orders for DME and CGx, which were then used as support for fraudulent, illegal claims submitted to Medicare and other federal health benefit programs.

“These significant sentences and restitution of over $29,000,000 to our nation’s critical healthcare system – Medicare – are a result of law enforcement’s unified efforts to hold the perpetrators of one of the largest healthcare fraud schemes in history accountable for their crimes,” said Special Agent in Charge Omar Pérez Aybar of U.S. Department of Health and Human Services Office of Inspector General.

“We are all victims of these corrupt individuals because they cheated the taxpayer funded Medicare system,” said FBI Tampa Division Special Agent in Charge Michael McPherson. “Health care fraud investigations are given high priority within the FBI’s Criminal Investigative Division. Because this abuse impacts us all, protection of these federal health benefit programs is a shared responsibility which can be accomplished with the support of an engaged community willing to bring health care fraud to the attention of law enforcement.”

“Today’s sentence properly holds these defendants accountable for their fraudulent actions and reflects the magnitude of the crime committed against CHAMPVA and Medicare,” said Special Agent in Charge David Spilker of the Department of Veterans Affairs Office of Inspector General’s Southeast Field Office. “The VA OIG’s continued oversight of VA’s multiple healthcare programs, including CHAMPVA, is one of the agency’s highest priorities. We thank our outstanding law enforcement partners for their efforts in this joint investigation.”

"The significant prison terms and financial penalties will hopefully bring some closure to those victimized by Nolan and Epstein,” said IRS Criminal Investigation Special Agent in Charge Brian Payne. “They preyed on the elderly and military Veterans to subject them to unnecessary medical testing and to use unnecessary medical equipment for their own financial gain. We will continue to investigate these con artists and hold them accountable.”

This case was investigated by U.S. Department of Health and Human Services – Office of Inspector General, the Federal Bureau of Investigation, the Department of Veterans Affairs – Office of Inspector General, and the Internal Revenue Service –Criminal Investigation, Tampa Field Office. The criminal case is being prosecuted by Assistant United States Attorneys Tiffany E. Fields, Jay G. Trezevant, James A. Muench, and Department of Justice Trial Attorney Gary A. Winters.

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CHICAGO — Two suburban Chicago physicians have been indicted on federal criminal charges for allegedly prescribing opioids to individuals who lacked a legitimate medical need for the drugs.

STANLEY DAVID DEMOREST managed Demorest Consultants LLC, a medical practice in Melrose Park, Ill. NICHOLAS RECCHIA was employed there as a physician. From 2015 to 2020, Demorest and Recchia agreed to dispense hydrocodone, oxycodone, fentanyl, and other controlled substances to various individuals who visited Demorest Consultants but received no meaningful physical examination or medical tests, and whom Demorest and Recchia knew had no legitimate medical need for the drugs, according to an indictment returned Monday in U.S. District Court in Chicago. Demorest, who in 2015 voluntarily surrendered his DEA Registration Number and lost his ability to lawfully prescribe controlled substances, used Recchia’s name and DEA Registration Number to issue prescriptions for controlled substances to patients, the charges allege.

Demorest and Recchia also caused pharmacies to submit numerous claims to Medicare and Medicaid seeking payment for the improper prescriptions, the indictment states.

The indictment charges Demorest, 65, of Bloomingdale, Ill., and Recchia, 62, of River Grove, Ill., with conspiracy to dispense controlled substances outside the usual course of professional practice and without a legitimate medical purpose. The pair also face individual counts of health care fraud and unlawful dispensing of controlled substances. Arraignments in federal court in Chicago have not yet been scheduled.

The indictment was announced by John R. Lausch, Jr., United States Attorney for the Northern District of Illinois; Robert J. Bell, Special Agent-in-Charge of the Chicago Division of the DEA; Emmerson Buie, Jr., Special Agent-in-Charge of the Chicago Field Office of the FBI; Lamont Pugh III, Special Agent-in-Charge of the Chicago Division of the U.S. Department of Health and Human Services, Office of Inspector General; and Irene Lindow, Special Agent-in-Charge of the Chicago Division of the U.S. Department of Labor, Office of Inspector General. The government is represented by Assistant U.S. Attorneys Kaitlin G. Klamann and Valerie R. Raedy.

The charges were brought by the U.S. Attorney’s Office’s Opioid Task Force, which was formed in November 2019 for the purpose of combatting the growing number of unlawful distributions of controlled substances fueling the nation’s opioid crisis.

The public is reminded that an indictment is not evidence of guilt. The defendants are presumed innocent and entitled to a fair trial at which the government has the burden of proving guilt beyond a reasonable doubt.

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BOSTON – A Colorado woman and a Houston woman were sentenced today in federal court in Boston for their roles in a multi-million-dollar Medicare fraud scheme.

Jessica Jones, 32, of Lakewood Colo., and Elizabeth Putulin, 31, of Houston, Texas were each sentenced by U.S. District Court Senior Judge George A. O’Toole, Jr. to three years of supervised release, the first year to be served in home detention. Judge O’Toole, Jr. also ordered Jones to pay restitution in the amount of $8.6 million and ordered Putulin to pay restitution in the amount of $20.7 million. Jones and Putulin are also barred from engaging in an occupation business in the health care industry. On Jan. 20, 2021, Jones and Putulin each pleaded guilty to one count of conspiracy to commit health care fraud.

Jones and Putulin conspired with Juan Camilo Perez Buitrago to submit more than $107.6 million in false and fraudulent claims for durable medical equipment (DME) such as arm, back, knee and shoulder braces. Jones and Putulin helped Perez manufacture and submit false and fraudulent Medicare claims by establishing shell companies in more than a dozen different states, including Massachusetts. At Perez’s request, Jones and Putulin purchased Medicare patient data from foreign and domestic call centers that targeted elderly patients and instructed call centers to contact the Medicare beneficiaries with an offer of ankle, arm, back, knee and/or shoulder braces “at little to no cost.” Perez then submitted Medicare claims for those patients without obtaining a prescriber’s order to ensure that the braces were medically necessary. Jones and Putulin further facilitated the fraud by answering frequent phone calls from Medicare patients who received DME that they did not request, want or need. Additionally, Jones and Putulin responded to insurance companies’ requests for prescriber’s orders and medical records, which they were unable to provide.

United States Attorney Rachael S. Rollins; Johnnie Sharp Jr., Special Agent in Charge of the Federal Bureau of Investigation, Birmingham Field Division; Phillip M. Coyne, Special Agent in Charge of the Department of Health and Human Services, Office of the Inspector General, Boston Division; and Ketty Larco Ward, Inspector in Charge of the U.S. Postal Inspection Service made the announcement today. Assistant U.S. Attorney Elysa Q. Wan of Rollins’ Health Care Fraud Unit prosecuted the case.

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A survey of staff at Mann-Grandstaff VA Medical Center shows plummeting morale tied directly to the Cerner Millennium electronic health record platform.

One year after the Veteran Affairs Department launched the first instance of its new electronic health record system at Mann-Grandstaff VA Medical Clinic, two-thirds of employees surveyed said they’re considering leaving their jobs because of the new system.

That was one bullet point in a damning survey of 833 employees at the medical center in Spokane, Washington, conducted by the VA National Center for Organization Development. The survey results, obtained by Nextgov, show staff are not acclimating to the new EHR system despite several pushes from VA leadership to increase training and claims of improved workflows.

VA deployed the first instance of the Cerner Millennium platform at Mann-Grandstaff in October 2020—the first go-live for a program that started in 2018 with the goal of matching the Defense Department’s MHS GENESIS program, which includes Cerner’s commercial EHR platform, as well.

Amid an ongoing pandemic, wildfires and a freak snowstorm and ensuing power outage, VA officials reported a “flawless” cutover to the Cerner system last October. But while the technical transition went smoothly enough, the users have had a harder time of it.

The survey—conducted voluntarily and anonymously in August and September of this year—shows low job satisfaction, high burnout and mounting frustrations, all attributed directly to the new EHR platform.

Despite these survey results, VA officials said Tuesday the agency plans to move forward with the next scheduled deployment in Columbus, Ohio, in early 2022.

During a hearing held by the House Veterans Affairs Subcommittee on Technology Modernization, VA Deputy Secretary Donald Remy noted the February 2022 deployment will be a soft launch rather than a full go-live. But the department plans to move forward nonetheless, he said.

Rep. Cathy McMorris Rodgers, R-Wash., who represents Spokane and was invited to join Tuesday’s hearing, said VA’s plans to continue deployments makes it seem as though agency leadership has decided to move on from Mann-Grandstaff without resolving key issues.

“This has been an extremely difficult time,” McMorris Rodgers noted, citing the ongoing pandemic as likely the biggest stressor for those in the medical field. “In addition to that, they have been putting in extra time to roll out a new electronic health record.”

McMorris Rodgers said Mann-Grandstaff employees have worked 61,000 hours of overtime—equivalent to seven years of work hours.

“The staff are tired, they’re frustrated and, to date, the electronic health record is making their jobs harder, not easier,” she said.

While subcommittee ranking member Matt Rosendale, R-Mont., and others acknowledged that past issues were not Remy’s fault—he was just recently confirmed to the deputy secretary position in July—the problems have persisted for over a year now.

“We’re talking about after a year of extra support, all the extra workarounds, everybody trying to do their best to implement this,” Rosendale said, asking Remy whether he believes this has risen to an emergency situation.

“I think it’s something we absolutely have to tend to immediately,” Remy said, noting he plans to visit Mann-Grandstaff in the coming weeks to see the issues for himself.

For Rosendale, that isn’t nearly soon enough.

“If I had those kinds of problems taking place in my business, I would be there tomorrow morning,” Rosendale told Remy. “We’re talking about major problems. There are flights to Spokane daily.”

Remy said he is taking the survey results to heart and offered a three-point plan going forward.

“First, we’re learning from the implementation mistakes of the past. Second, that the Cerner system works, and I believe we’ve properly positioned it for success,” he said, later noting the commercial platform is used widely around the world. “Third, we’re bringing together all relevant stakeholders to ensure an effective EHRM deployment.”

“I appreciate our employees on the ground at Mann-Grandstaff. I take their concerns very seriously,” Remy said. “We’ve taken steps to work with them to address the concerns that they’re articulating.”

The program has also been plagued by ballooning expenses. While the original contract was pegged around $10 billion, it soon became clear the project would cost at least $16 billion to implement.

However, two separate investigations by the VA inspector general showed the program office neglected to include key infrastructure costs in the estimates, adding up to $5.1 billion to the total price, if not more.

“It seems the Veterans administration is trying to basically close off—or ignore—the problems at Mann-Grandstaff,” Rosendale said, echoing the sentiments of McMorris Rodgers. “That is very problematic. It’s like, ‘We’re trying to ignore all of these problems and we’re going to do it better next time, we promise you. So, just continue to give us this money so we can proceed down the line.’ … I’m not buying into that.”

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GRAND RAPIDS – U.S. Attorney Andrew B. Birge announced a series of criminal and civil enforcement actions taken as part of a joint-agency healthcare fraud operation in the Western District of Michigan investigating medical practitioners who signed off on illegitimate orders for medical braces and cancer genetic testing promoted by telemarketers. The ongoing investigation—dubbed Operation “Happy Clickers” to reflect many of the practitioners’ habits of approving these orders with little to no review—resolves alleged fraud losses to date to the Medicare Program of over $7.3 million.

These actions follow nationwide takedowns of so-called marketers and owners of durable medical equipment (“DME”) supply companies and cancer genetic testing laboratories who conducted large-scale fraud schemes designed to defraud the Medicare Program (see press releases for takedowns on April 9, 2019, September 27, 2019, and September 30, 2020). The marketers called Medicare beneficiaries, often through overseas call centers, soliciting them for medically unnecessary braces and cancer genetic testing for screening purposes. The marketers, typically working through locum tenens companies, paid medical practitioners to purportedly review and sign these orders under the guise of telemedicine and then sold those signed orders to the owners of the DME supply companies and laboratories in violation of the federal anti-kickback statute.

The resolutions U.S. Attorney Birge announced involved four of the Michigan practitioners who approved and signed these orders on behalf of the marketers:

Richard Laksonen, N.P., a nurse practitioner from Ishpeming, MI, pleaded guilty on August 6, 2021, to one count of making a false statement relating to health care matters. As part of his guilty plea, Mr. Laksonen admitted that he signed orders for medical braces and cancer genetic testing, attesting that he had performed the assessments and verifying that the orders were reasonably and medically necessary, when, in fact, he typically executed the orders without reviewing the records. For example, Mr. Laksonen admitted that, in a one-week period, he signed approximately 335 separate single-patient files, many containing multiple types of braces, spending on average 18 seconds from the time he opened the record to the time he executed it. Mr. Laksonen continued to approve these orders, even after an investigator for a health insurer warned him that the patient referrals were the result of aggressive telemarketing. The investigation further established that many of these braces and tests were not medically necessary. As part of his plea agreement, Mr. Laksonen admitted that Medicare paid over $5.7 million for the orders he approved and signed. The Court will sentence Mr. Laksonen on November 15, 2021.

Hugh G. Deery II, M.D., of Petoskey, MI, Colleen Browne, D.O., formerly of Portland, MI, and Mosab Deen, D.O., of Royal Oak, MI, resolved civil liability for alleged violations of the False Claims Act by entering into civil settlements with the United States. These physicians approved orders for medically unnecessary braces and cancer genetic testing despite many red flags that these items and services were illegitimate. For example, there were often discrepancies between the brace orders and “examination” notes that the physicians signed and the recorded phone calls between the overseas call centers and the Medicare beneficiaries. Additionally, the marketer often suggested the physicians sign multiple brace orders for each beneficiary, and the physicians were pressured not to deny claims.

Medicare beneficiaries targeted by this fraud scheme complained of being “bombarded” by overseas telemarketing calls offering “free” braces. If the doctors took the time to listen to these recorded phone calls, they would have known that the calls were run by telemarketers and not medical professionals. The orders the physicians signed resulted in hundreds of thousands of dollars paid by Medicare for medically unnecessary braces, which beneficiaries often did not want or use.

To resolve their individual liability, Dr. Deery has agreed to pay $301,140, Dr. Browne has agreed to pay $42,000, and Dr. Deen has agreed to pay $28,545. Dr. Browne’s settlement agreement also resolved allegations that she ordered medically unnecessary cancer genetic testing for Medicare beneficiaries for cancer screening purposes. Generally, Medicare does not cover genetic testing solely for the purpose of screening for cancer.

“Given that their approval and signatures are necessary for Medicare to pay for these braces and testing, medical practitioners are the professional backstop against these fraud schemes,” said U.S Attorney Birge. “And when medical practitioners ignore their professional responsibilities, facilitating these fraud schemes in our district, they will be held accountable.”

“The ordering of medically unnecessary services resulting from purported telemedicine visits to Medicare is blatant fraud,” said Lamont Pugh III, Special Agent in Charge, U.S. Department of Health & Human Services, Office of Inspector General – Chicago Region. “The OIG will continue to work with our law enforcement partners and federal prosecutors to identify and hold accountable those individuals who choose to execute healthcare fraud schemes, and the practitioners who legitimize these schemes, and waste vital taxpayer dollars.”

“As medical professionals, these defendants had an obligation to conduct a good faith review of the devices and medical tests being ordered on behalf of Medicare patients,” said Timothy Waters, Special Agent in Charge of the FBI’s Detroit Field Office. “Their failure to do so contributes to the billions of dollars of fraud losses Medicare suffers annually. Collaborative efforts like this one, demonstrate the FBI and our partners resolve to hold accountable those seeking to defraud the Medicare system.”

Operation “Happy Clickers” is an ongoing initiative by HHS-OIG, the FBI, and the U.S. Attorney’s Office for the Western District of Michigan. Assistant U.S. Attorney Raymond E. Beckering III is overseeing and prosecuting the criminal investigation, and Assistant U.S. Attorney Andrew J. Hull is representing the United States in the parallel civil investigations.

Individuals, including medical professionals, who are aware of past or ongoing conduct involving solicitation and fraudulent approval of medical braces and cancer genetic testing through purported telemedicine services can call the U.S. Attorney’s Office Healthcare Fraud Investigator at 616-808-7572 or submit an online complaint to the HHS-OIG Hotline: https://oig.hhs.gov/fraud/report-fraud/

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Fox Chase-area Pharmacy was the Top Retail Purchaser of Oxycodone in Pennsylvania

PHILADELPHIA – United States Attorney Jennifer Arbittier Williams announced that the United States filed a civil lawsuit against Philadelphia-based pharmacy Spivack, Inc., which previously operated under the name Verree Pharmacy, and its former owner, pharmacist Mitchell Spivack, alleging that they engaged in a years-long practice of illegally dispensing opioids and other controlled substances, and systematic health care fraud. The lawsuit alleges that Verree and Spivack illegally dispensed unparalleled quantities of opioids and other controlled substances into the Philadelphia community. The complaint seeks civil penalties and civil damages, which could total in the millions of dollars, as well as injunctive relief.

The culmination of a multi-year federal-state investigation, the complaint alleges that Verree Pharmacy, its pharmacist and then-owner Mitchell Spivack and other employees of Verree, had a responsibility to dispense opioids and other controlled substances only when appropriate. Instead, the United States alleges that the pharmacy and Spivack dispensed the drugs, even when faced with numerous red flags suggestive of diversion—such as opioids in extreme doses, dangerous combinations of opioids and other “cocktail” drugs preferred by those struggling with addiction, excessive cash payments for the drugs, blatantly forged prescriptions, and other signs that the pills were being diverted for illegal purposes. The complaint alleges that Verree—which was the top retail pharmacy purchasing oxycodone in Pennsylvania—has been a nationwide and regional outlier in its deviant purchasing, dispensing, and billing of controlled substances. To avoid scrutiny from the drug distributors that sold them the pills, Verree through Spivack, allegedly made false statements to maintain the façade of legitimacy and keep the pharmacy stocked with these pills critical to its profits. Behind that façade, the complaint alleges that Spivack drew millions of dollars from the pharmacy while the public suffered the consequences, including one patient who overdosed and died next to Verree Pharmacy bottles dispensed by Spivack.

The United States’ complaint alleges that Verree and Spivack were also engaging in an expansive health care fraud scheme involving fraudulent billings for drugs not actually dispensed. The alleged cornerstone of the scheme was a code used by the pharmacy employees in their internal computer system: “BBDF” or “Bill But Don’t Fill.” Verree, Spivack and their co-conspirators allegedly used BBDF as a means to cover their losses on other drugs and further line their pockets with illicit profits by falsely claiming to insurers, including Medicare, that they had dispensed a drug to a patient, when in fact they had not. According to the complaint, this sophisticated fraud—which one of the employees admitted to investigators—resulted in significant losses to Medicare and other federal programs.

The lawsuit seeks to impose civil penalties and damages on Verree and Spivack under the Controlled Substances and False Claims Acts. If Verree and Spivack are found liable, they could face civil penalties up to $68,426 for each unlawful prescription dispensed, civil penalties up to $23,607 for each false claim they submitted to federal health care programs, and treble damages for the alleged health care fraud against federal programs. The court may also award injunctive relief to prevent Verree and Spivack from committing additional controlled substance violations.

“Pharmacies and pharmacists engage in the deepest violation of the community’s trust when they exploit their access to opioids and other controlled substances and illegally dispense the drugs for their own financial gain,” said U.S. Attorney Williams. “It is even more disturbing when pharmacies take advantage of their position of trust by fraudulently billing Medicare and other federal health care programs for bogus prescription drugs. My Office will use every resource it has to pursue and hold these individuals accountable. I am grateful for the support and investigative teamwork that the DEA, HHS-OIG, and the Pennsylvania Attorney General’s Office provided in this important matter.”

“In a city that has been so adversely and disproportionately affected by the opioid epidemic, Verree Pharmacy was the top retail pharmacy purchasing oxycodone in the entire state of Pennsylvania,” said Thomas Hodnett, Special Agent in Charge of the Drug Enforcement Administration’s (DEA) Philadelphia Field Division. “Spivack and the other employees at Verree routinely demonstrated total disregard for their professional and ethical obligations and improperly dispensed powerful painkillers when numerous warning signs were present.”

“The Medicare and Medicaid Programs provide vital prescription drug services to their beneficiaries, said Maureen R. Dixon, Special Agent in Charge of the Philadelphia Regional Office for the Department of Health and Human Services, Office of Inspector General. “Pharmacies are required to only bill for prescriptions and products they actually provide to their patients. HHS-OIG will continue to work with the U.S. Attorney’s Office, the Pennsylvania Attorney General’s Office, and the DEA to investigate allegations of fraudulent insurance billings.”

“We know that nearly 80% of those who use heroin first started with misusing a prescription opioid,” said Attorney General Josh Shapiro. “Pharmacies and medical professionals have a responsibility under the law to dispense these drugs only when appropriate. These allegations of illegal dispensing and fraud are disturbing -- they hurt families and communities all over the Commonwealth and steal needed resources from taxpayers. Our office is committed to continuing to work with our federal partners, and I am thankful for the women and men who collaborated on this case.”

If the public has any information regarding Verree Pharmacy or any other health care fraud allegation, individuals should contact the HHS-OIG hotline at 800-HHS-TIPS.

The case is being investigated by the Philadelphia Field Division of the Drug Enforcement Administration, HHS-OIG, and the Pennsylvania Office of the Attorney General, with additional assistance from the Office of Personnel Management Office of Inspector General, the Defense Health Agency, and the Defense Criminal Investigative Service. The civil investigation and litigation are being handled by Assistant United States Attorney Anthony D. Scicchitano and auditors Dawn Wiggins and George Niedzwicki.

The complaint contains allegations only that the United States must prove if the case proceeds to trial.

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Acting United States Attorney Richard B. Myrus announced today that the United States has reached a settlement that resolves civil claims against Zaheer Shah, M.D. Park Square Urgent Care, Inc., and several affiliated entities, related to the defendants’ alleged submission of false claims to Medicare and Medicaid for urine drug screening tests they were ill-equipped to perform.

The agreement, under which the defendants will pay a total of $650,000, resolves a civil case filed by the government in federal court in the District of Rhode Island: United States of America v. Park Square Urgent Care, Inc., et al. No. 20-cv-00110-WES-LDA. The settlement is based on an analysis of the defendants’ ability to pay based on an extensive review of their current financial condition.

The government’s case alleged that these medical providers, acting under the direction of Dr. Shah, submitted tens of thousands of false claims to Medicare and Medicaid, seeking reimbursement for urine drug tests that they did not, and could not, perform, because their testing laboratories lacked the equipment or capability to carry out the tests. Despite the fact that these labs could only perform simpler tests, which carry a lower reimbursement rate, the labs were alleged to have knowingly billed Medicare and Medicaid for more complex, and expensive, drug screening tests.

In announcing the settlement, Acting United States Attorney Myrus thanks Attorney General Peter F. Neronha for the support and cooperation of the Attorney General’s Medicaid Fraud Control and Patient Abuse Unit in this investigation.

The government’s case was litigated by Assistant United States Attorney Bethany N. Wong, and was investigated by the U.S. Department of Health and Human Services, Office of Inspector General.

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UC San Diego Health, the academic health system of the University of California, San Diego, has paid $2.98 million to resolve allegations that it violated the False Claims Act by ordering medically unnecessary genetic testing reimbursed by Medicare.

The settlement resolves allegations that, from December 2015 to October 2019, UC San Diego Health ordered and submitted referrals for medically unnecessary genetic testing performed by CQuentia Arkansas Labs, CQuentia NGS and Total Diagnostic II (collectively “the CQuentia labs”). The government alleged that this conduct led to the submission of false claims for payment to Medicare for these tests.

“Hospitals are the gatekeepers for medical care and are expected to ensure that all services performed at their direction, including genetic tests, are medically appropriate,” said Acting Assistant Attorney General Brian M. Boynton for the Justice Department’s Civil Division. “The department will continue to pursue those who undermine the integrity of federal health care programs and waste taxpayer dollars.”

“Ordering unnecessary genetic tests creates a drain on vital government-funded health care programs like Medicare,” said U.S. Attorney Randy Grossman for the Southern District of California. “This settlement is another example of this office’s commitment to work with our law enforcement partners to hold medical providers accountable when their conduct leads to taxpayers bearing the cost of improper billing practices.”

“This resolution demonstrates the FBI’s commitment to pursuing those who abuse our health care system,” said Special Agent in Charge Suzanne Turner of the FBI San Diego Field Office. “False claims diminish trust in our health care while generating enormous unnecessary costs, and the FBI is proud to work alongside our federal partners to disrupt such schemes.”

The resolution obtained in this matter was the result of a coordinated effort between the Civil Division’s Commercial Litigation Branch, Fraud Section and the U.S. Attorney’s Office for the Southern District of California, with assistance from the U.S. Department of Health & Human Services Office of Inspector General and the FBI.

The government’s pursuit of this matter illustrates its emphasis on combating health care fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse and mismanagement can be reported to the Department of Health and Human Services, at 800‑HHS‑TIPS (800-447-8477).

This matter was handled by Trial Attorney Nicholas C. Perros of the Civil Division’s Commercial Litigation Branch, Fraud Section, and Assistant U.S. Attorneys Joseph Price and Joseph Purcell of the U.S. Attorney’s Office for the Southern District of California.

The claims resolved by the settlement are allegations only, and there has been no determination of liability.

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How Do I Know if My VA Claim Was Approved?

The rating decision is the most significant portion of the VA disability benefits claims process. Once the United States Department of Veterans Affairs receives a claim from a disabled veteran, the VA claims process can be lengthy. However, this news can be pivotal, especially if the decision includes a favorable disability rating and effective date.

Receiving a rating decision also means that your case is moving along in the very slow VA system, and even if the decision is not favorable, at least that means you are able to move forward with your case and determine the next steps that you will take. Today we are going to talk about the structure of the rating decision so you are able to get all the information from it that you need in order to decide what to do next.

Receiving a Rating Decision: What Is the Process?

To understand the VA rating decision, it’s important to also understand the veteran’s disability claims process. There are several steps that occur before the rating decision arrives at your door.

1. Receipt of Claim: Once the VA receives your claim, they will send you a letter in the mail within two weeks to confirm that they received it. If you submitted your claim through eBenefits, you will receive this notification electronically within one hour.
2. Initial Review: A Veteran Service Representative (VSR) will review your claim.
3. Evidence Gathering: The VSR may require additional evidence to prepare your claim for a decision. In this case, they would send you a letter requesting medical evidence, including medical records from all health care providers. The VA will then review your claim.
4. Preparation for Decision: Once the VA has all the evidence they need for your decision, a Ratings Veteran Service Representative (RVSR) will review all the documents in your initial claim. This evidence includes your initial application, results of your compensation and pension exam,
5. Pending Decision Approval: There is one final review after the RVSR’s review. The RVSR will send your claim to a superior, and the VA will make the decision.
6. Decision Notification: The VA will send a decision packet to your home in the mail.

At this point, you would either receive the veterans benefits as outlines in the decision packet. If you disagree with the VA disability rating, you would start the appeals process. You have the option to file an appeal on your own or work with a Veteran’s Service Officer (VSO).

Keep in mind that you can check the status of your claim on va.gov.

What Does the VA Include in a Rating Decision?

The VA rating decision will include several sections. Each section will explain how they assessed your VA disability claim. The sections include:

1. Introduction: The introduction of the rating decision will include some details about your military service. It will include the dates of services, military branch, type of claim you files, and other details about the nature of your claim.
2. Decision: This section includes the actual claim decision. Here, the VA will state whether they approved your claim, the effective date that your disability compensation will begin, and the specific percent rating.
3. Evidence: The VA will also list any evidence that they considered when assessing your claim. This evidence may include medical evidence, service treatment records, buddy statements, and more. Check this section carefully to make sure that the VA considered all of the evidence you submitted.
4. Reasons for Decision: Here, the VA will break down exactly why they approved or denied your claim. They will reference specific evidence that they used in their decision, as well as the percent rating for the disabilities in question.
5. References: This section will include all necessary citations for the rating decision. These citations may include information from the Code of Federal Regulations, details on a veteran’s right to appeal, and specifics about other regulations that are relevant to the VA claims process.

The rating decision should also include a cover letter (we refer to this document as the Notice of Action, or NOA). The NOA is important because the date of the NOA is the date that will be used to determine whether a Notice of Disagreement (VA Form 9) is timely. The NOA also includes a breakdown of the decision made on each issue and boilerplate language from the VA about the appeal process. Veterans have 60 days after receiving the NOA to files an NOD.

The rating decision is also accompanied by the rating sheet, which shows a history of all the claims ever made by the veteran.

Have Questions About Your VA Rating Decision?

If you were denied service connection or received a lower disability rating than you expected, the team at Hill & Ponton can provide legal advice and representation. Our veteran’s disability attorneys are committed to helping former service members and their family members obtain the VA benefits they deserve. Contact us today for a free case evaluation.

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BISMARCK - United States Attorney Nicholas W. Chase announced that U.S. District Court Judge Daniel M. Traynor sentenced Patrick Robert McKee, a/k/a William Patrick O’Hara, Age 77 from Flint, MI, to two years in federal prison for the charges of Social Security False Statements, False Statements, Health Care Fraud, and Aggravated Identity Theft. Judge Traynor also sentenced McKee to 3 years supervised release and a $400 Special Assessment.

Investigation determined that Patrick Robert McKee stole the identity of J.C. (Identity Protected) in 1997 and then converted J.C.’s identity to William Patrick O’Hara while retaining J.C.’s social security number. Since 1997, McKee fraudulently lived and worked under J.C.’s identity. He used J.C.’s identity to obtain healthcare benefits, home mortgages, credit cards and for numerous other fraudulent pretenses.

"It has become far too common for people to have their identification stolen and suffer financial disruption and damaged credit," said United States Attorney Nick Chase, and "it is appropriate that this defendant received the maximum penalty under the law for the crime of Aggravated Identity Theft."

"We will continue to pursue those who misuse the Social Security number of others for their own personal gain. For decades, by obtaining benefits and services as

someone else, McKee abused the identity of another person," said Christian Assaad, Special Agent in Charge of the Social Security Administration Office of the Inspector General, Denver Field Division. "I thank our law enforcement partners for working with in this investigation and the U.S. Attorney’s Office for their efforts in prosecuting this case and holding this individual accountable."

"Fraudsters who steal the identity of others to loot taxpayer-funded federal health care programs often do so at the immeasurable risk of undermining the integrity of these programs," said Special Agent in Charge Curt L. Muller of the Department of Health and Human Services Office of Inspector General. "In coordination with law enforcement partners, our oversight agency will continue to investigate those who participate in health care fraud schemes."

This case was investigated by the Social Security Administration – Office of Inspector General; Office of Inspector General, U.S. Department of Health and Human Services; United States Department of Agriculture; and ther United States Marshals Service, and the case is being prosecuted by the United States Attorney’s office, with Assistant United States Attorney Brandi Sasse Russell assigned to the case.

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The United States filed a complaint in the U.S. District Court for the Central District of California yesterday under the False Claims Act against Paksn Inc.; Prema Thekkek, one of its owners; and seven skilled nursing facilities (SNFs) owned by Thekkek and/or operated by Paksn. Those seven SNFs are Bay Point Healthcare Center, Gateway Care & Rehabilitation Center, Hayward Convalescent Hospital, Hilltop Care & Rehabilitation Center, Martinez Convalescent Hospital, Park Central Care & Rehabilitation Hospital, and Yuba Skilled Nursing Center.

The United States alleges that defendants entered into medical directorship agreements with certain physicians that purported to provide compensation for administrative services, but in reality, were vehicles for the payment of kickbacks to induce the physicians to refer patients to the seven SNFs. The Anti-Kickback Statute prohibits offering or paying anything of value to encourage the referral of items or services covered by federal health care programs.

Specifically, the United States alleges that defendants hired certain physicians who promised in advance to refer a large number of patients to the SNFs, paid physicians in proportion to the number of expected referrals, and terminated physicians who did not refer enough patients. On one occasion, a Paksn employee told Thekkek that two physicians were being hired because “they are promising at least 10 patients for $2000 per month.” On another, Thekkek complained that if Paksn’s employees did not pay medical directors promptly every month, “[t]hese doctors will not give us patients.” On a third occasion, a Paksn employee told Thekkek that because “lately there are no real referrals” from one of the medical directors, “i am planning to say goodbye to him.”

“Illegal financial arrangements with physicians can improperly influence the type and amount of health care that is provided to patients,” said Acting Assistant Attorney General Brian M. Boynton of the Justice Department’s Civil Division. “The department is committed to redressing the corrupting influence of kickbacks on the medical decision‑making of providers participating in federal health care programs.”

“The payment of kickbacks to physicians for referrals turns patients into commodities that can be traded,” said Acting U.S. Attorney Tracy L. Wilkison for the Central District of California. “Profits should not dictate medical decisions, which is why it is illegal to pay for referrals that can cloud physicians’ medical judgment.”

The lawsuit was initially filed in December 2015 by Trilochan Singh, who was previously employed as Paksn’s Vice President of Operations and Chief Operating Officer, under the whistleblower provisions of the False Claims Act. Those provisions authorize private parties to sue on behalf of the United States for false claims and share in any recovery. The Act permits the United States to intervene and take over the lawsuit, as it has done here in part. Those who violate the Act are subject to treble damages and applicable penalties. The case is captioned United States of America ex rel. Trilochan Singh v. Paksn, Inc. et al., No. 15‑cv-09064 (C.D. Cal.).

The United States’ intervention in this matter illustrates the government’s emphasis on combating health care fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse and mismanagement can be reported to the Department of Health and Human Services, at 800-HHS-TIPS (800-447-8477).

This matter is being handled by the Civil Division’s Commercial Litigation Branch (Fraud Section) and the U.S. Attorney’s Office for the Central District of California, with assistance from the U.S. Department of Health and Human Services Office of Inspector General.

The claims asserted against defendants are allegations only and there has been no determination of liability.

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Tampa, Florida – The United States has filed a civil lawsuit against Dr. Edward Lubin, a pain management doctor practicing in Tampa, alleging that he issued patients medically unnecessary prescriptions for Subsys, a fentanyl-based spray manufactured by Insys Therapeutics, Inc., and used to treat breakthrough cancer pain. Dr. Lubin allegedly participated in Insys’ sham speaker program, through which it paid doctors in exchange for them writing such unnecessary prescriptions for Subsys.

In its complaint, the government alleges Dr. Lubin violated the federal Anti-Kickback Statute and the False Claims Act by repeatedly accepting payments of up to $3,700 from Insys for attending sham speaking events and, in exchange for these payments, prescribed Subsys to patients for whom the drug was either not medically necessary or otherwise inappropriate. These prescriptions were submitted to and paid through the Medicare and TRICARE federal healthcare programs. As further alleged in the complaint, between 2014 and 2016, Dr. Lubin prescribed Subsys to 61 patients, only nine of whom actually had cancer. In total, the United States alleges Dr. Lubin received more than $159,000 in payments from Insys and, in return, wrote Subsys prescriptions for which Medicare paid more than $2.8 million in claims.

The United States previously prosecuted Insys under a criminal information filed in the District of Massachusetts, and Insys agreed to a global resolution of the government’s separate civil and criminal investigations. As part of the civil resolution, Insys agreed to pay $195 million to settle allegations it violated the False Claims Act and, as part of the criminal resolution, it entered into a deferred prosecution agreement with the government, its operating subsidiary pleaded guilty to five counts of mail fraud, and the company was subject to a $2 million fine and $28 million in forfeiture.

Additionally, the United States criminally prosecuted the founder and four former executives of Insys. A federal jury in Boston previously found those defendants guilty of, among other things, using Insys’ speaker program to bribe medical practitioners to prescribe Subsys.

The claims asserted against Dr. Lubin are allegations only, and there has been no determination of liability.

This case was investigated by the Department of Justice, the U.S. Department of Health and Human Services – Office of Inspector General, and Department of Defense Office of Inspector General – Defense Criminal Investigative Service. It is being prosecuted by Assistant United States Attorney Jeremy Bloor.

Tips and complaints from all sources about potential fraud, waste, abuse and mismanagement, can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477) and the Department of Defense Office of Inspector General at 1-800-424-9098.

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PITTSBURGH, PA – The United States has filed a complaint under the False Claims Act against the University of Pittsburgh Medical Center (UPMC), University of Pittsburgh Physicians, and James Luketich, M.D., in the U.S. District Court for the Western District of Pennsylvania, Acting U.S. Attorney Stephen R. Kaufman announced today. The United States’ complaint – which was based on a two-year investigation into allegations originally brought by a former UPMC physician under the False Claims Act’s whistleblower provisions – alleges that the defendants knowingly submitted hundreds of materially false claims for payment to Medicare, Medicaid, and other government health benefit programs over the past six years.

More specifically, the complaint alleges that Dr. Luketich – the longtime chair of UPMC’s Department of Cardiothoracic Surgery – regularly performs as many as three, complex surgical procedures at the same time, fails to participate in all of the “key and critical” portions of his surgeries, and forces his patients to endure hours of medically unnecessary anesthesia time, as he moves between operating rooms and attends to other patients or matters. According to the United States’ complaint, these practices violate the statutes and regulations governing the defendants, including those that prohibit “teaching physicians” (like Dr. Luketich) from performing and billing the United States for “concurrent surgeries.” As importantly, the United States’ complaint alleges that Dr. Luketich’s practices violate the standard of care and the patients’ trust, and heighten the risk of serious complications.

“The laws prohibiting ‘concurrent surgeries’ are in place for a reason: to protect patients and ensure they receive appropriate and focused medical care,” said Acting U.S. Attorney Kaufman. “Our office will take decisive action against any medical providers who violate those laws, and risk harm to Medicare and Medicaid beneficiaries.”

“When physicians and other healthcare providers put financial gain above patient well-being and honest billing of government healthcare programs, they violate the basic trust the public extends to medical professionals,” said Special Agent in Charge Maureen R. Dixon of the HHS-OIG Philadelphia Regional Office. “Our agency, working closely with our law enforcement partners, will continue to thoroughly investigate such healthcare fraud allegations to protect the health of patients and the integrity of taxpayer-supported programs serving them.”

“Doctors take an oath to uphold the highest levels of ethical standards and care,” said FBI Pittsburgh Special Agent in Charge Mike Nordwall. “The allegations set forth today violate those ethics, painting a picture of fraud and deception. The FBI will continue to investigate fraud in our health care system and hold those accountable to face the consequences of their actions.”

The False Claims Act is one of the most powerful tools in the United States’ continued efforts to combat healthcare fraud. The Act’s whistleblower (or “qui tam”) provisions authorize private parties to sue on behalf of the United States for false claims and share in any recovery, and permit the United States to intervene and take over the lawsuit, either in its entirety, or in part (as it did here). Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services, at 800 HHS TIPS (800-447-8477).

This matter was investigated by the U.S. Attorney’s Office for the Western District of Pennsylvania, the U.S. Department of Health and Human Services Office of Inspector General, and the Federal Bureau of Investigation, in conjunction with the Department of Defense Office of Inspector General, the Drug Enforcement Administration, Internal Revenue Service – Criminal Investigation, Department of Veterans Affairs Office of Inspector General, and the Pennsylvania’s Office of the Attorney General.

The case is captioned United States of America ex rel. Jonathan D’Cunha, M.D. v. James Luketich. et al., No. 19-cv-495 (W.D. Pa.). The claims asserted against defendants are allegations only and there has been no determination of liability.

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The United States has intervened and filed a complaint in the U.S. District Court for the Western District of New York under the False Claims Act against Independent Health Association, Independent Health Corporation (Independent Health), DxID LLC (DxID) and Betsy Gaffney, former CEO of DxID. The government alleges that Independent Health, DxID and Gaffney violated the False Claims Act by submitting or causing the submission of inaccurate information about the health status of beneficiaries enrolled in Medicare Advantage Plans in order to increase Independent Health’s reimbursement. Independent Health is headquartered in Buffalo, New York. DxID was headquartered in Buffalo until it ceased operations in August.

“The Medicare Advantage Program relies on accurate information about the health status of enrollees to ensure that they receive appropriate treatment and that participating health plans receive proper compensation for the services they actually provide,” said Deputy Assistant Attorney General Michael D. Granston of the Justice Department’s Civil Division. “The department will continue to hold accountable health plans or providers that report unsupported diagnoses to inflate risk adjustment payments.”

“The defendants are alleged to have submitted unsupported diagnosis codes to inflate reimbursements, which enabled them to receive payments from Medicare that were greater than they were entitled,” said U.S. Attorney James P. Kennedy Jr. for the Western District of New York. “Defrauding taxpayer funded health care programs such as Medicare hurts not only taxpayers but our nation’s entire healthcare system.”

Under Medicare Advantage, also known as Medicare Part C, Medicare beneficiaries have the option to enroll in managed healthcare insurance plans called Medicare Advantage Plans (MA Plans) that are owned and operated by private Medicare Advantage Organizations (MAOs). MA Plans are paid a fixed amount per enrollee to provide benefits covered by traditional Medicare to beneficiaries who enroll in their MA Plan. The Centers for Medicare and Medicaid Services (CMS), which oversees the Medicare program, make upward payment adjustments to MA Plans based on demographic information and the health status of each plan beneficiary. The adjustments are made using what are commonly referred to as “risk scores.” In general, a beneficiary with more severe diagnoses will have a higher risk score, and CMS will make a larger risk-adjusted payment to the MA Plan for that beneficiary.

Independent Health offers two MA Plans in New York State. Its wholly-owned subsidiary, DxID, provided retrospective chart review and addenda services to Independent Health and other MA Plans.

The United States alleges that DxID coded conditions that were not documented in the patient’s medical record during a visit or encounter. The government further alleges that DxID also asked health care providers to sign addenda forms up to a year after a visit or an encounter and subsequently used the addenda as substantiation for adding risk-adjusting diagnoses that were not documented during the patient encounter, in violation of Medicare requirements. DxID operated on a contingency fee of up to 20% of the additional recovery that the MA Plans received based on diagnoses captured by DxID.

The complaint alleges that these unsupported diagnoses inflated the risk scores of beneficiaries, resulting in inflated payments to Independent Health and other MA Plans. The lawsuit further alleges that once Independent Health became aware of these unsupported diagnosis codes, it failed to take corrective action to identify and delete the unsupported codes.

The lawsuit was filed under the qui tam, or whistleblower, provisions of the False Claims Act, which permit private parties to sue on behalf of the government for false claims and to receive a share of any recovery. The False Claims Act also permits the government to intervene in such lawsuits. Although the United States initially advised the court that it was not intervening in this case, the court subsequently granted the United States’ motion to intervene for good cause. The whistleblower, Teresa Ross, is a former employee of Group Health Cooperative (GHC). GHC was an MAO that offered MA Plans in Washington State. From 2011 to 2012, GHC used DxID’s chart review services. In November 2020, GHC entered into a settlement with the United States and Ross to resolve the claims against it arising out of this matter.

The United States’ intervention in this matter illustrates the government’s emphasis on combating health care fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse and mismanagement, can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).

This matter is being handled by the Civil Division’s Commercial Litigation Branch (Fraud Section) and the U.S. Attorney’s Office for the Western District of New York, with assistance from the U.S. Department of Health and Human Services Office of Inspector General.

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WILMINGTON, Del. – U.S. Attorney David C. Weiss announced today that the United States has filed a complaint in partial intervention against Connections Community Support Programs, Inc. (“Connections”) in the United States District Court for the District of Delaware. The United States alleges that Connections violated the False Claims Act by knowingly submitting claims for payment to Medicare and Medicaid that falsely represented the identity and professional qualification of individuals providing mental health services.

Connections provides mental health treatment services at facilities located throughout Delaware. Medicare regulations and policies only allow providers to bill for mental health services rendered by individuals holding specific professional qualifications. Delaware Medicaid regulations and policies similarly condition whether mental health services can be reimbursed, and at which fee rate, on the professional qualification of the rendering provider.

The United States alleges that from at least January 2015 through October 2019, Connections submitted over 4,000 claims to Medicare in which it falsely certified that an individual holding an eligible qualification provided mental health services to Medicare beneficiaries when, in reality, a different Connections staff member who did not hold an eligible qualification provided the mental health service. With respect to Medicaid, the United States alleges that Connections submitted over 250,000 false claims that resulted in either full or partial overpayments due to Connections falsely certifying to the licensure or education level of the rendering provider. As a result of the false claims Connections submitted to Medicare and Medicaid, the United States alleges that Connections was paid more than $4,500,000 for mental health services for which it was not entitled to reimbursement.

“Federal healthcare regulations and policies that govern mental health services exist to ensure that Medicare and Medicaid beneficiaries are treated by qualified professionals,” said U.S. Attorney Weiss. “We expect all providers to submit claims that are true, accurate, and complete, and entrust that they will do so. Connections violated that trust, and in the process, defrauded Medicare and Medicaid out of more than $4.5 million dollars. My office is committed to pursuing all providers who submit false claims to federal healthcare programs to obtain money to which they are not entitled.”

The original complaint was filed in 2019 under the qui tam or whistleblower provisions of the False Claims Act, which allow private parties to file suit on behalf of the United States for false claims and receive a share of any recovery. The act permits the United States to intervene in whole or in part in such actions, as the government has done here. Those who violate the Act are subject to treble damages and applicable penalties.

The matter is being investigated by the U.S. Department of Health and Human Services Office of Inspector General and the Delaware Medicaid Fraud Control Unit. The investigation and litigation are being handled by Assistant U.S. Attorneys Laura D. Hatcher and Jesse S. Wenger.

The claims asserted by the United States are allegations only and there has been no determination of liability.

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On Thursday, the U.S. District Court for the District of South Carolina entered default judgments for the United States totaling $136,025,077 against Oaktree Medical Centre P.C. (Oaktree), FirstChoice Healthcare P.C. (FirstChoice), Labsource LLC (Labsource), Pain Management Associates of the Carolinas LLC (PMA of the Carolinas) and Pain Management Associates of North Carolina P.C. (PMA of North Carolina). This is the second time the court has entered a default judgment in this matter. On July 20, 2020, the court entered a default judgment in the amount of $4,269,084.78 against ProLab LLC (ProLab) and ProCare Counseling Center LLC (ProCare). The court entered these judgments after these defendants failed to defend against the United States’ allegations.

In its complaint, filed on May 31, 2019, the United States alleged that Oaktree, FirstChoice, Labsource, PMA of the Carolinas and PMA of North Carolina — all of which were owned or operated by chiropractor Daniel McCollum — provided illegal financial incentives to providers to induce their referrals of urine drug tests in violation of the Stark Law and the Anti-Kickback Statute. The United States also alleged that ProCare, a substance abuse counseling clinic, and ProLab, a urine drug testing laboratory partially owned by McCollum, billed federal health care programs for unnecessary urine drug tests. McCollum answered the United States’ complaint and remains a party to the ongoing litigation.

Congress passed the Stark Law and the Anti-Kickback Statute to prevent financial incentives from improperly influencing medical decision-making, which can lead to excessive and unnecessary tests and services. Among other things, the Stark Law prohibits billing Medicare for laboratory testing services referred by a physician who has a financial relationship with the laboratory. The Anti‑Kickback Statute prohibits offering or paying anything of value to induce the referral of items or services covered by federal health care programs, including laboratory testing services.

“Improper financial relationships between health care providers and laboratories can lead to overutilization and increase the cost of health care services paid for by the taxpayers,” said Acting Assistant Attorney General Brian M. Boynton of the Justice Department’s Civil Division. “We will continue to ensure that health care decisions are based on the needs of patients rather than the financial interests of providers.”

“Patients should not have to question whether their doctor recommended a test or procedure for personal gain,” said Acting U.S. Attorney M. Rhett DeHart for the District of South Carolina. “For years, these companies used improper financial incentives to generate health care provider referrals. This $140 million judgment is a cautionary tale of why health care fraud does not pay.”

The judgment includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by Donna Rauch, Muriel Calhoun, Brandy Knight, Karen Mathewson and Tracy Hawkins, former employees of pain management clinics owned or operated by McCollum. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery. The qui tam cases are captioned United States ex rel. Rauch, et al. v. Oaktree Medical Centre, P.C., et al., No. 6:15-cv-01589-DCC (D.S.C.); United States ex rel. Mathewson v. Dr. Daniel A. McCollum, et al., No. 6:17-CV-01190-DCC (D.S.C.); and United States ex rel. Hawkins v. Pain Management Associates of the Carolinas, LLC, et al., No. 8:18-cv-02952-DCC (D.S.C.).

The resolution obtained in this matter was the result of a coordinated effort between the Civil Division's Commercial Litigation Branch, Fraud Section, and the U.S. Attorney’s Office for the District of South Carolina, with assistance from the FBI, the Department of Health and Human Service’s Office of Inspector General, the South Carolina Attorney General’s Office, and the Defense Criminal Investigative Service.

The investigation and resolution of this matter illustrates the government’s emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse and mismanagement, can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).

The matter was handled by Fraud Section Attorneys Yolonda Campbell, Michael Kass, Christopher Terranova, and David Wiseman, along with Assistant U.S. Attorney Beth Warren of the District of South Carolina.

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The Justice Department announced today that the United States has filed a complaint under the False Claims Act (FCA) against NH Learning Solutions Corp (NHLS). The complaint, filed in the Eastern District of Michigan, alleges that NHLS violated the FCA by knowingly submitting false claims to the Department of Veterans Affairs (VA) for inflated tuition benefits under the Post-9/11 GI-Bill. Michigan-based NHLS provides technology education courses at approximately 15 locations in the Midwest and Northeast.

“The Post-9/11 GI Bill is an important part of our promise to support our nation’s Veterans,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “Today’s complaint demonstrates our commitment to hold accountable companies that improperly seek to profit from this promise and the women and men who have served our country.”

“The U.S. government provides Veterans with access to programs for higher education through the Post-9/11 GI Bill,” said U.S. Attorney Dawn N. Ison for the Eastern District of Michigan. “Our office is prepared to pursue those who flout the rules that safeguard the integrity of important Veterans’ programs.”

Under the Post-9/11 GI Bill, the VA pays tuition and fees directly to qualifying schools on behalf of enrolled students. The VA pays the actual net cost for tuition and fees charged by the school after it has applied any scholarships, waivers, grants or other assistance designed to defray the cost of tuition and fees. This requirement is commonly referred to as the “Last Payer Rule,” and ensures that the VA is the payer of last resort and receives the benefit of any tuition-based, financial support available to a student.

The government’s complaint alleges that NHLS knowingly submitted false claims for inflated tuition and fees in violation of the Last Payer Rule at five of its school locations in Illinois, Ohio and Michigan. More specifically, the complaint alleges that NHLS repeatedly reported tuition and fees to the VA on student invoices where it failed to deduct the tuition scholarships, grants or waivers it provided to certain Veterans, thereby causing the VA to overpay NHLS for educational assistance benefits under the Post-9/11 GI-Bill for these Veterans.

“Safeguarding Post-9/11 GI Bill education benefit funds is a top priority,” said Special Agent in Charge Gregory Billingsley of Department of Veterans Affairs Office of Inspector General (VA-OIG)’s Central Field Office. “The VA-OIG is committed to investigating allegations of fraud that would impact VA’s programs and services.”

The lawsuit is captioned United States v. NH Learning Solutions Corp., No. 22-cv-13045 (E.D. Mich.), and is being handled by the Civil Division’s Commercial Litigation Branch (Fraud Section) and the U.S. Attorney’s Office for the Eastern District of Michigan. The Department of VA-OIG provided substantial assistance in the investigation.

The United States is represented in this matter by Senior Trial Counsel Christopher Wilson of the Civil Division and Assistant U.S. Attorney John Spaccarotella for the Eastern District of Michigan.

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Hunter Holmes McGuire VAMedical Center is newest opening

A crowd of people gathered around Jonathan Nguyen as he spoke to a mannequin lying in a hospital bed. Stranger yet, this one talked back. As its eyes blinked and its chest cavity rose and fell from simulated breathing, it told Nguyen about its pain.

This interaction displayed the latest simulation center for improving Veteran care, unveiled Sept. 17 at the Hunter Holmes McGuire VA Medical Center in Richmond, Virginia. The opening coincided with Healthcare Simulation Week Sept. 16-20.

Simulation growing

Simulation is a rapidly growing program within VA, said Dr. Scott Wiltz, associate medical director for training at the SimLEARN National Simulation Center in Orlando, Florida. The program helps train healthcare professionals to improve service to Veterans.

“We want to make sure everyone is trained to a standard,” Wiltz said. “That’s the key to zero harm, high reliability healthcare, earning the trust of Veterans.”

As an example, Wiltz said a cardiac arrest victim is 50% more likely to survive at a VA medical center. He said a study showed the increased survival rate was due to standardized training, which is one of the main goals of simulation.

VA currently has a network of 12 advanced certified sites. Wiltz said these sites are doing the “biggest and best of simulation” for VA, including virtual reality training and video training. Instead of sitting behind a screen completing computer-based training, healthcare providers can learn skills through hands-on and live-action demonstrations.

The programs also greatly increase training opportunities, leading to better-trained staff to serve Veterans. A typical training program could train 10-12 people at a time. With virtual classes, multiple sites can join in, training up to 50 people at a time. The programs also recently opened up to DoD and Immigrations and Customs Enforcement (ICE) healthcare participants.

Simulation is used in other industries as well, such as training pilots and aircrew on aircraft, and oil and gas employees on pipeline design and storage management.

Newest facility

At Richmond, trainers can program the mannequin for a variety of different scenarios, said Nguyen, who is a simulation operations specialist. The mannequin talks, breathes and even bleeds. Trainers can simulate cardiac arrest, code blues, gunshot wounds and a host of other situations.

Throughout the training room, microphones and cameras capture events as they unfold. Once a scenario is finished, trainers can replay and point out where trainees can improve. Many times, trainees will see areas where they can improve just by watching the replay.

The simulation components can also move outside the training room and into work areas, Nguyen said. The medical center recently trained on an operating room fire with smoke and fake fires, as well as moving patients up and down stairs if there’s an evacuation.

Patient safety and path forward

Since VA has a large population of residents, or doctors in training, simulation can help with patient safety significantly.

“We can teach people a lot of stuff before they go out,” said Dr. Michael Czekajlo, director of the Simulation Center. “If you’re a nursing student, a medical student or resident, you can be on your cardiology rotation and there were no heart attacks the week you were there. With simulation, we can make sure you saw that process.”

Czekajlo said having simulation allows a chance to perfect techniques. The technology has been used to help brain surgeons test new methods to ensuring standardized care, all without harming any patients.

The latest opening is an example of VA’s path forward on healthcare technology. Wiltz said there are pockets within VA doing very well with simulation training, which they are trying to expand. Additionally, VA is collaborating with the Defense Health Agency, sharing information and resources to improve care.

For more information about VA’s SimLEARN program, vist https://www.simlearn.va.gov/.

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U.S. Army Sgt. Hasan Akbar attacked the U.S. military in March 2003, killing Army Capt. Christopher Seifert and Air Force Maj. Gregory Stone and severely wounding 14 others

An Iraq War Veteran is pushing the military to honor the 16 casualties in U.S. Army Sgt. Hasan Akbar's 2003 ambush on the 101st Airborne Division with the Purple Heart.

Akbar, who is on death row in a military prison, cut the generators that lit Camp Pennsylvania in Kuwait and tossed grenades into several tents on March 23, 2003, three days after the War in Iraq began.

Army Capt. Christopher Seifert, 27, was fatally shot in the back and Air Force Maj. Gregory Stone, 40, died from 83 shrapnel wounds.

At least 14 others were severely wounded, and many couldn't return to the war.

Retired Army Command Sgt. Maj. Bart Womack and Rep. Don Bacon (R-Nebraska) have been the driving forces behind the effort.

Womack recalled the attack in vivid detail during an interview with Fox News Digital.

Womack said he continues to "live it every day" and has been pushing the military to award the Purple Heart to Seifert, Stone and the 14 others who were wounded.

The Purple Heart is one of the most recognized and respected U.S. military medals that is awarded to those who were wounded or killed as a result of enemy action.

Womack's efforts have been supported by Rep. Bacon, a retired Air Force Veteran, who wrote letters to the Army and Air Force.

But both branches of the military responded in separate Jan. 9 letters that said the 16 casualties weren't eligible for the honor because of a technicality.

"There was no evidence that the attack was inspired by a foreign terrorist organization or the Sgt. Akbar was in communication with any such entity," the Army wrote in its letter, which was shared with Fox News Digital.

"As a result of these findings, the Army cannot award the Purple Heart to service members who were killed or wounded during this tragic incident."

The Air Force's letter was nearly identical.

Both military branches left the door open, saying "If new evidence comes to light that demonstrates Sgt. Akbar was in communication with a foreign terrorist organization before the attack and was inspired or motivated by the organization, all due consideration will be made."

"It's bulls--t," Bacon said. "These Veterans were victims of an Islamic extremist who were killed and injured protecting America … I hope the Army and Air Force reconsider."

Womack penned a response letter to the military's Jan. 9 letters that she shared with Fox News Digital.

"The United States military, and America, has failed to recognize this attack as an act of terror, thereby making those killed and wounded ineligible for the Purple Heart Medal," Womack wrote.

Officials at the Pentagon didn't respond to Fox News Digital's request for comment.

PRECEDENT FOR CHANGE

The Purple Heart's eligibility criteria were slightly amended in February 2015 to accommodate Army Maj. Nidal Hassan's attack on Fort Hood in 2009, which claimed the lives of 13 people and wounded more than 30 others.

Congress expanded the eligibility by redefining what should be considered an attack by a "foreign terrorist organization" for purposes of determining eligibility for the Purple Heart.

"The legislation states that an event should now be considered an attack by a foreign terrorist organization if the perpetrator of the attack ‘was in communication with the foreign terrorist organization before the attack’ and ‘the attack was inspired or motivated by the foreign terrorist organization,'" the Department of Defense said in a press release.

In 2016, the victims and their families were honored with the Purple Heart.

But it took seven years and a bi-partisan effort among lawmakers to push for change and honor the victims.

Womack argued in his letter that service members have been awarded the Purple Heart under the precedence of Jihadi Ideology since the criteria was changed in 2015.

He used the example of the Airman who was stabbed in the face and neck while taking down a heavily armed gunman on a train to Paris on Aug. 21, 2015, as well as the service members who were killed and wounded in a shooting by a Saudi Military Officer at Naval Air Station Pensacola on Dec. 6, 2019.

"I require your advocacy and collaboration to have the March 23, 2003, attack recognized as a terrorist attack under the precedence of Jihadi Ideology," Womack wrote in his letter to the military.

"Also, to have the military revise their regulations to award the Purple Heart Medal for Jihadi Ideology, Jihadi Radicalized and American Jihadist inspired or motivated attacks."

Womack said, "These precedences were included in the inquiry filed by Congressman Bacon, and were completely ignored and not addressed by the military in their response."

The retired Army officer said he isn't backing down and will continue to fight for those killed and wounded on March 23, 2003.

"We're just getting started," Womack said.

Meanwhile, Akbar was found guilty of murder and premeditated murder and sentenced to death by lethal injection.

He is one of four former soldiers on death row at Fort Leavenworth in Kansas, according to the Death Penalty Information Center, a Washington, D.C.,-based organization that provides "analysis and information on issues concerning capital punishment."

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A U.S. Veteran’s search for his beloved dog came to an end earlier this month after he found an anonymous note in his mailbox saying the pup had been shot dead after being caught on someone's property without a leash.

Chad Stricker, of Pearl River County, Miss., spent days searching for his 10-month-old wolfdog named Nymeria when he found the typed note, along with her collar, in his mailbox. He shared a picture of the note and collar on Facebook in a now-viral post.

“I’m sorry to inform you that your dog was shot and killed Saturday night while digging through my garbage,” the note said. “It did not suffer and I did not take pleasure in killing it. There is a county leash law which you should abide by so that I do not have to kill any more of your pets.”

Stricker, whose social media page says he served in the Army, was heartbroken.

“I was sick to my stomach,” he told the Biloxi Sun Herald. “To think that someone killed her while we had been out looking for her, for digging in the garbage... An animal is not worth more than your trash or the time to make a phone call?”

Nymeria’s large yellow collar had an attached tag that showed her photo and description of her personality, along with Stricker’s address and phone number, the paper reported. Stricker described Nymeria as “one of the sweetest dogs anywhere around and very loving” in his post.

However, he told the paper that there was nothing he or police could do because Nymeria had been off her leash while on another person’s property.

The leash law in Pearl River County requires all animals to be fenced in or restrained on a leash, or otherwise be considered a public nuisance, according to the outlet.

Shooting a so-called “nuisance animal” isn’t uncommon, Elizabeth Treadaway, the shelter manager Pearl River County SPCA, told the paper.

“Unfortunately we see that a lot,” Treadaway said. “This dog lost its life over an invisible line it can’t see. As soon as an animal goes onto someone else’s property, that leash law goes into effect. But just because it’s law, doesn’t make it right what this person did.”

Stricker wrote a lengthy note of his own to the anonymous “coward” who claimed to have shot the dog.

“It’s sad to think I have a neighbor of your moral character living so close to me that would do this,” it read in part. “Do I hate you, no, I pity the person you are and those who have to tolerate you.”

Stricker said Nymeria’s body wasn’t returned to him. He asked to be told where the body was or for it to be left on his driveway so he could give his beloved dog a proper burial.

“I pray one day you come to realize what you have done and teach those in your household to be better,” he wrote.

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US Veterans, current service members and their families are being targeted online with malware and by foreign entities and influence campaigns, and the government isn't doing enough to stop it, a new report says.

The study by Vietnam Veterans of America, a non-profit that advocates for and serves the needs of all Veterans, documents a myriad number of ways Veterans are impersonated and targeted online -- particularly on Facebook. In at least one instance, they've been targeted by influence campaigns from foreign governments.

Russia's Internet Research Agency, for instance -- the "troll factory" with ties to the Russian government that creates content to push divisive messages on American social media -- purchased more than a hundred online ads targeting US service members and Veterans, the study found. It also specifically purchased ads focused on people who followed a number of legitimate organizations on Facebook, including Vietnam Veterans of America, Iraq and Afghanistan Veterans of America and Concerned Veterans for America.

But the sources of the efforts to target Veterans was not always clear. The report found numerous other Facebook pages and groups, often with moderators who were listed in countries like Russia (though not necessarily tied to the IRA) and "with concentrations in Eastern Europe and Vietnam", that follow very similar trends.

One Facebook page called Vietnam Veterans, which has been around since at least 2016, posted both photos of VVA's president to imply a relation with the group, and re-posted Russian IRA memes.

Another, the since-deleted "Vietnam Vets of America," mimicked the VVA logo, a legitimate organization with its own Facebook page, and frequently posted links to a now-defunct inflammatory news blog called vVets.eu.

Another page, We Are Veterans, which was created in 2017, mimics a legitimate page called We Honor Veterans, an extension of a group in Alexandria, Virginia, that provided companionship to Veterans in hospice care. All nine administrators for We Are Veterans are listed as coming from Vietnam. In addition to also posting both IRA-created and pro-Trump memes, the page has at times offered military-themed memorabilia for sale.

Given some of those targeted are active duty service members, the security concerns are heightened, the authors caution. They even include examples from the conflict in Ukraine highlighted how conventional warfare mixed with cyber-attacks can have deadly consequences.

"The unfortunate reality is that bad actors, exploiting Facebook's openness and reach, have used this American-bred company to spread disinformation, sow division and undermine our very own democracy," Sen. Mark Warner, the top Democrat on the Senate Intelligence Committee, told CNN. "And they've done this, in part, by zeroing in on service members and Veterans."

Facebook periodically announces it has proactively taken down what it describes as "coordinated inauthentic behavior" -- some of those fall into the category of influence campaigns, which usually benefit a particular country's government. But Facebook isn't aware of all its users' intentions, and tips from some past takedowns have originated with other tech companies or the FBI.

In total, VVA inspected more than 150 pages, with moderators originating from at least 32 different countries. For its part, Facebook has shut down at least a third of the pages that the VVA has flagged, citing inauthentic behavior.

Facebook declined to comment on the record about how it identifies where page administrators come from. In a statement, spokeswoman Jennifer Martinez said, "This report describes several instances of Veterans being targeted on social media. We take these issues seriously and will continue to work with the Veterans community to address their concerns."

In at least one known instance, according to the Washington Post, the US government has taken direct action to disrupt such actors: US Cyber Command reportedly blocked the IRA's internet access during the 2018 midterm election.

Unclear who should play defense

But it's less clear who's supposed to play defense. The study's author, VVA researcher Kris Goldsmith, told CNN he doesn't solely put the blame on the tech platforms they highlighted including Facebook, and wants the government to take a proactive role in protecting Veterans from influence operations and scams.

"The fact that it's on Facebook makes it look to members of Congress right now as if like it's all Facebook's fault," Goldsmith said. "In our view, Facebook's an American asset, one of the most important American companies to ever exist, one that can be a force for good to spread democracy around the world, and our adversaries have turned it against us."

The Departments of Defense and Veterans Affairs, for instance, should "coordinate federal efforts to protect servicemembers and Veterans from deceptive, foreign-generated online content," he wrote in the study, but the agencies have not responded to him.

In a statement to CNN, Pentagon spokeswoman Heather Babb said current personnel "must undergo annual cyber security training. As part of this training, personnel learn about the potential dangers of social media, phishing and other cyber threats, as well as measures they can take to protect themselves."

Veterans Affairs spokesman Randal Noller told CNN that "Veterans are the targets of many of the same types of fraud as the rest of society, including mail, telephone and online fraud."

"VA appreciates this group's views and will respond to them directly," Noller added.

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ALBANY, NEW YORK – Robert Seifert, age 63, of Utica, New York, plead guilty today to making telephonic threats to employees of the Albany Stratton Veterans Affairs Medical Center.

The announcement was made by Acting United States Attorney Antoinette T. Bacon and Christopher Algieri, Special Agent in Charge of the Northeast Field Office for the United States Department of Veterans Affairs Office of Inspector General.

Seifert, who has been convicted twice before of threatening VA employees, admitted that on January 14, 2021, he made three successive calls to employees at the Albany Stratton VA with no legitimate purpose other than to harass and threaten them, and left threatening voicemails in which he used demeaning and offensive language that caused each of the employees to fear for their own safety and property.

United States Magistrate Judge Daniel J. Stewart is scheduled to sentence Seifert on October 6, 2021, at which time Seifert faces a maximum term of imprisonment of 364 days and a maximum fine of up to $1,000 for each of the three counts, and a term of supervised release of up to 1 year. A defendant’s sentence is imposed by a judge based on the particular statute the defendant is charged with violating, the U.S. Sentencing Guidelines, and other factors.

This case was investigated by U.S. Department of Veterans Affairs Office of Inspector General, and the Veterans Affairs Police Service at the Albany Stratton VA Medical Center, and is being prosecuted by Assistant U.S. Attorney Alexander P. Wentworth-Ping.

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A whistleblower sparked an investigation that also uncovered hundreds of millions in wasted taxpayer dollars.

The Department of Veterans Affairs failed to pay non-VA doctors, leaving Veterans without care, in debt and sending them to collections agencies, according to a newly released report from the U.S. Office of Special Counsel.

A whistleblower sparked a 2018 Office of Special Counsel investigation which found that VA hospitals did fail to make payments to those private doctors on time, “which resulted in some of those providers terminating services for Veterans and referring Veterans to collection agencies,” investigators said.

In 2017 alone more than 2,500 Veterans contacted VA about credit and collection issues because of VA’s failure to pay their claims.

VA has known about Veterans being sent to collections or having care cut off because of the department’s flawed reimbursement system since at least 2014, when the whistleblower first reported, according to a letter sent to the president Thursday by Henry Kerner of the Special Counsel, who called it “gross mismanagement” in another letter to VA Secretary Robert Wilkie.

Both problems are further examples of department failures linked to outdated technology and information systems and a lack of accountability for spending or resolving Veteran claims. Many of those issues have come to a head as VA expands Veterans’ opportunities to seek care in their communities rather than in VA hospitals and clinics.

Part of the confusion often is the result of a complex VA reimbursement system -- VA both reimburses private doctors directly and sometimes uses a third-party system to pay providers.

“Despite widespread communication and education strategies (most involved) find it difficult to understand the complexities of healthcare billing and payment,” investigators said.

The investigation discovered about 51 percent of claims submitted to the central VA billing center were considered clean and accepted for payment.

The investigation focused on the mid-Atlantic region of VA healthcare facilities, where the whistleblower worked, beginning with VA medical facilities and staff in Durham and Asheville, N.C. and in Salem, Va. That region is working to reduce its claims backlog, investigators said, but the claims are coming in faster than its system and staff can keep up.

VA’s Office of the Medical Inspector made multiple recommendations to clean up the claims process to prevent Veterans from having their care cut off or from being sent to collections in the future, and VA said it expected to deploy a new claims management system by the end of this month and hire “additional support staff” by March 2020. VA also stood up a call center in 2015 to help Veterans with credit and collections issues from VA’s failure to pay claims.

Improper travel payments

The report also showed a “gross waste of funds,” including hundreds of millions of dollars spent on improper travel claims at VA, according to the report released publicly Thursday by the Special Counsel, the leading federal whistleblower-protection agency.

VA’s Fiscal Year 2017 financial report included $223.76 million in improper travel payments, Kerner’s letter and the report said.

VA sometimes pays Veterans who live far from VA facilities and have to travel for care. But that program uses accounting software to process claims that is antiquated, dating back nearly 30 years ago. That system isn’t planned for updates -- needed to reduce the number of improper payments -- until 2022. The Inspector General has reported that the system was outdated and did not comply with federal regulations every year since 2012 when reporting began, investigators said.

“I commend the whistleblower for coming forward to identify this gross waste of federal taxpayer dollars and the unwarranted hardships placed on Veterans as a result of the VA’s longstanding failure to properly pay provider claims,” Kerner said in his letter to the president, adding that he was “disappointed that it has taken multiple reports and hundreds of millions of dollars in wasted taxpayer funds for the VA to address the flaws in its accounting software.”

Kerner noted that VA’s report in response to the investigation “appears reasonable” and said he was “encouraged” by the department’s response and that “the agency is now taking steps to ensure these problems are addressed.”

VA spokeswoman Christina Mandreucci told Connecting Vets that the investigation "highlights allegations that date to the previous administration" and that the department is pleased with Kerner's recognition of their efforts to address the problems.

Since the allegations surfaced several years ago, Mandreucci said VA has:

• Implemented a departmentwide electronic claims management system;
• Launched a campaign to educate private providers on how to submit claims;
• Hired more contracted staff to process claims;
• Developed a departmentwide plan to reduce improper travel payments.

Last month, an Inspector General report revealed that VA kept thousands of Veterans' appeals claims in boxes, file cabinets, cubicles and mailrooms -- some for years -- rather than send them to offices that had staff to process them.

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The U.S. Department of Veterans Affairs (VA) announced today the Board of Veterans’ Appeals (Board) reached a historic milestone, issuing more than 100,000 decisions this fiscal year (FY) 2020.

The Board also completed over 15,000 hearings with 4,000 conducted as virtual tele-hearings.

FY 2019 previously marked the highest point for decisions at just above 95,000 decisions issued.

“The Board continues to demonstrate its effort to improve and modernize VA’s appeals process,” said VA Secretary Robert Wilkie. “VA reaching this milestone ensures Veterans will receive the benefits and services they have earned.”

The Board’s modernization efforts afford Veterans the option to select a virtual tele-hearing. This hearing platform allows Veterans the convenience of having their hearings wherever they are located rather than having to travel to a VA facility.

Learn more about transitioning to a virtual tele-hearing.

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As a military spouse, you’re qualified, educated and ready to serve. You have a unique perspective and understanding of what it means to care for our nation’s heroes. Here at VA, we value this experience.

We also know you bring so much more to the table.

That’s why we’ve partnered with the U.S. Department of Defense (DOD) Military Spouse Employment Partnership (MSEP) program. The career program connects military spouses with more than 390 affiliated employers who have committed to recruit, hire, promote and retain military spouses in jobs everywhere.

“VA is thrilled to help DOD and military installations engage military spouses in conversations about career opportunities caring for our nation’s Veterans,” said Tracey Therit, Chief Human Capital Officer at the Office of Human Resources and Administration/Operations, Security and Preparedness. “We are using every method — communications, job feeds, social networking and more — to provide information on the federal hiring process and links to real opportunities at VA.”

Finding opportunities to grow

There are over 600,000 active duty military spouses worldwide. Of those actively seeking employment, 30% are unemployed and 56% underemployed.

How are MSEP and VA making sure you get the chance to apply for a meaningful and rewarding career? Quite a bit, in fact.

On USAJobs, we tag VA jobs ideal for military spouses. We highlight key information — remote work opportunities, flexible work schedules, child care and health benefits — on our job announcements.

For positions covered under Title 5 hiring authority, we use noncompetitive procedures approved by the Office of Personnel Management. That means when you apply to become a VA accountant, police officer or human resource specialist and meet the minimum qualifications, you’re hired.

We also work with DoD to identify spouses with health care experience or training as a physician, nurse, social worker or occupational therapist. These VHA-administered positions do not require application through USAJobs.

Choose VA today

A career with VA is meaningful and mission-driven — and our total rewards benefits package consistently edges out those offered by the private sector. Keep an eye on this space for more on how military spouses can benefit from choosing a VA career.

• SEARCH for open positions using “military spouses” as a keyword.
• WATCH Tracey Therit discuss VA’s commitment to hiring military spouses.
• EXPLORE the benefits of a VA career.
• REACH a recruiter at This email address is being protected from spambots. You need JavaScript enabled to view it.">This email address is being protected from spambots. You need JavaScript enabled to view it..

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Department of Veterans Affairs officials announced Monday that it has added nine rare respiratory cancers to the list of illnesses considered to be related to exposure to burn pits and other particles in the air encountered overseas, a designation that will expedite affected Veterans' access to health care and benefits.

The move follows a White House announcement last November that it planned to establish presumption for the illnesses that have become more common among Veterans in the past 32 years, with advocates and health experts zeroing in on burn pits used to dispose of trash and industrial waste in Iraq and Afghanistan as a likely culprit.

The new additions are rare, affecting roughly six per every 100,000 Americans, and the expedited benefits are being offered to affected Veterans who served in the Persian Gulf since Aug. 2, 1990, as well as Afghanistan, Syria, Djibouti or Uzbekistan on or after Sept. 19, 2001.

VA Secretary Denis McDonough told reporters Monday that the move, published Tuesday in the Federal Register, will "keep President Biden's promise... in ensuring that Veterans who suffer from those conditions and their survivors will get the benefits and care they've earned."

"If you suffer from any of those conditions... you may be eligible for disability benefits without having to prove causality between your service and your condition," McDonough said.

The rare respiratory cancers that now are eligible for health care and expedited disability claims include:

• Squamous cell carcinoma of the larynx
• Squamous cell carcinoma of the trachea
• Adenocarcinoma of the trachea
• Salivary gland-type tumors of the trachea
• Adenosquamous carcinoma of the lung
• Large cell carcinoma of the lung
• Salivary gland-type tumors of the lung
• Sarcomatoid carcinoma of the lung
• Typical and atypical carcinoid of the lung

The illnesses join three already considered to be linked to burn pits and overseas duty if they develop within 10 years of deployment -- asthma, rhinitis and sinusitis.

The presumptive designation allows Veterans to apply for disability benefits without having to provide proof that their disease was caused by an exposure or injury when they served in the military.

VA officials said Monday that the change will affect roughly 100 Veterans who previously filed claims for these illnesses and were denied as well as an unknown number of Veterans who may file claims for these conditions in the future.

As of last month, the department had processed 16,500 claims related to the first three new presumptive conditions for a total of $36 million in benefits.

The Biden administration also has pledged to commit more research to understanding the connection between the burn pits used in Iraq and Afghanistan and elsewhere and is considering whether to designate another lung disease, known as constrictive bronchiolitis, as a presumptive condition.

The initiatives come as Congress weighs legislation that would expand the list of burn-pit related conditions to include additional cancers and respiratory illnesses and provide benefits to more than a million new Veterans who served overseas in certain locations since Aug. 2, 1990.

The House passed the Honoring Our Promise to Address Comprehensive Toxics Act in March in a 256-174 vote. The legislation would expand VA health care access to more post-9/11 Veterans and calls for improving the federal response to Veterans sickened as the result of drinking water contamination at Camp Lejeune, North Carolina, as well as helping Veterans who developed illnesses in cleanup operations across the globe.

The Senate has approved a $1 billion bill that would extend VA health care to more Veterans, creating a one-year enrollment period for VA medical care for post-9/11 combat Veterans who served since 1998 and never enrolled, and expanding the enrollment period from five years to 10.

While the White House has not identified by name which piece of legislation it supports, President Joe Biden released a statement Monday urging Congress "to pass bipartisan legislation to comprehensively address toxic exposures and further deliver the vital benefits our Veterans have earned."

"We can and must do more to address the harms that come from hazardous exposures, which have gone unaddressed for far too long," Biden said in the statement.

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About one in six Veterans use them

Proton pump inhibitors (PPIs) are among the most commonly prescribed medications in VA. Roughly one in six Veterans uses them to ease digestive disorders, such as heartburn or acid reflux. The drugs are effective and well-tolerated when consumed properly.

They are also overused. Studies show that as many as six in 10 PPI prescriptions lack a clear evidence-based indication. Long-term use of the drugs carries a risk of serious side effects, such as pneumonia and bone fractures.

Individual VA pharmacies have been working to lower PPI use for Veterans who do not truly need them. For example, at the Lexington VA Medical Center in Kentucky, pharmacist Kelly Davis says her team’s program has yielded good results.

“The whole facility has bought into it, including our primary care providers. The awareness of the program, coupled with the fact that physicians are seeing more evidence of the risks of long-term PPI therapy, has led providers to be very cautious when prescribing PPIs. As a whole, we’ve found that the program has decreased our unnecessary PPI use.”

National program underway

A national VA program called RaPPID is underway to do the same on a wide scale, and to teach best practices. The acronym stands for the National Randomized Proton Pump Inhibitor De-prescribing program.

The research team is led by Dr. Sameer Saini of the VA Ann Arbor Healthcare System in Michigan, Dr. Loren Laine of the VA Connecticut Healthcare System and Dr. Yu-Xiao Yang of the Corporal Michael J. Crescenz VA Medical Center in Philadelphia.

VA researchers are evaluating the program’s effectiveness. They are working with VA National Pharmacy Benefits Management Services, which is leading RaPPID. The researchers are trying to understand how effective RaPPID has been in improving the use of PPIs and ensuring no negative health consequences, such as peptic ulcer bleeding, have occurred with PPI de-prescribing.

The PPI stewardship team at the Lexington VA (pictured at the top of this blog) has included, from left, internist Dr. Sean Lockwood and pharmacists Kelly Davis and Rachel Hargreaves.

Learning opportunity

“We’re trying to understand the intended and unintended effects of PPIs and ensure that we maximize the learning opportunity for Veterans and the VA health system,” says Saini. “We hope this evaluation will provide not only valuable insight into the benefits and harms of a national effort to appropriately de-prescribe PPIs, but also broader lessons about how to effectively undertake other programs to de-implement low-value clinical practices in the future.”

PPIs account for more than 11 million 30-day prescriptions each year in VA. The drugs are inexpensive on a per-pill basis. However, their widespread use translates into $50 million in VA annually. Current research suggests patients could stop or reduce the use of the drugs in more than one-third of the cases.

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Native American Veteran was close to giving up

It is rare to meet a person who truly resembles not just a hero, but also a warrior in mind, body and spirit.

Carla Sabrina Rose Locklear is a proud Native American Air Force Veteran who served as a medic in Texas from 1997 to 2002.

“I had friends ask me why I would serve this government that had done damage to my people. I would respond with, ‘My ancestors have always protected this land… and we always will.’”

While in the military, Locklear was diagnosed with an extremely rare immunodeficiency disorder called hypogammaglobulinemia.

Her symptoms and ailments became worse and she had to be hospitalized more frequently. It was hard for her to accept that she needed a steady caregiver and support system.

Hard to reach out to ask for help

“Being a Veteran, you tend to just suck it up and push through stuff. It was hard for me to reach out to ask for help. I didn’t tell my family what was going on.”

Locklear was barely hanging on and already making end-of-life plans when word reached her aunt and uncle in Bluemont, Va. Her aunt, Air Force Veteran René White, formed a plan.

“I get my care from the Stephens City Community Based Outpatient Clinic. I wondered if the Martinsburg VA Medical Center would have the services Carla needed to get well.”

Aunt Rene found a hospital with “all the things I need”

“I couldn’t believe it. She found a VA hospital in West Virginia, 30 minutes from her home. They have all the things I need and they would help me,” said Locklear. “It blew my mind because here I was, picking out the colors of my coffin.”

Aunt René assumed the role of caregiver and advocated for her patient and loved one. Locklear felt hope and that things could go a different way.

Locklear left everything and moved to Virginia to find healing. She showed up to Aunt René’s house with nothing but her wheelchair and a backpack. Even though she didn’t arrive with any physical baggage, the emotional baggage was overwhelming. She is pictured above with her Aunt René and Uncle Chris.

Her vision: “To be on a healing mountain”

Together, they used a unique storyboard approach to prioritize what had to be decided immediately and what could wait. This process also led Locklear to find her personal vision statement: “To be on a healing journey, on a healing mountain and search for a cure.”

Once she spoke those words aloud, it changed the energy in her entire body and her new perspective became about healing and living.

“It really resonated because I was in this desert in Texas where nothing was growing or thriving in my life. I came to this mountain that was alive. It was alive with hope and it gave me hope.”

Locklear immediately started visiting the Martinsburg VAMC and Stephens City CBOC for treatment. Staff there adjusted her infusion cycle so she would get antibodies more frequently.

“The whole team was fantastic, from the moment we step off the elevator. The admin team even sings my name every time they see me walking down the hall. It just turns my whole energy around so I can accept the treatment and the healing.”

Locklear is a warrior in mind, body and spirit and the Martinsburg VAMC is proud to be a part of her tribe.

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Today, the U.S. Department of Veterans Affairs (VA), along with the Departments of Energy (DOE) and Health and Human Services (HHS) announced the formation of the COVID-19 Insights Partnership, an initiative to coordinate and share health data as well as research and expertise to aid in the fight against COVID-19.

The COVID-19 Insights Partnership creates a framework for VA and HHS to utilize DOE’s world-leading high-performance computing (HPC) and artificial intelligence resources to conduct COVID-19 research and analyze health data that would otherwise not be possible.

“Veterans served this country by putting on the uniform and protecting American interests overseas and now their health data will help in the fight against COVID-19 here at home,” said VA Secretary Robert Wilkie. “President Trump is marshalling all the resources he has available in the federal government to fight the virus and Veterans should be proud of the role they’re playing.”

“The Department of Energy is proud to be a member of the COVID-19 Insights Partnership,” said Secretary of Energy Dan Brouillette. “Our nation’s understanding of COVID-19 has already benefitted greatly from our world-leading high-performance computing and artificial intelligence resources and we look forward to continuing our coordination across federal departments and agencies in the fight against this virus.”

“This unprecedented data and computing partnership is the latest addition to President Trump’s whole-of-government effort against COVID-19,” said HHS Secretary Alex Azar. “The volume and quality of the data HHS has on COVID-19 has advanced by leaps and bounds in recent months. The Department of Energy’s world-class resources will help us derive new insights from the data we gather to help patients and protect our country.”

Research and analysis conducted by the COVID-19 Insights Partnership will focus on vaccine and therapeutic development and outcomes, virology and other critical scientific topics to understand COVID-19 better. HHS and VA will provide additional updates and information on research projects as it becomes available.

Summit, the United States’ fastest supercomputer, located at DOE’s Oak Ridge National Laboratory, is accelerating COVID-19 research by running large scale, complex analyses on a vast amount of health data. Summit’s unmatched capacity to analyze massive integrated datasets and divine insights will help researchers identify and advance potential treatments and enhance outcomes for COVID-19 patients with unprecedented speed.

The partnership expands upon recent efforts by the Trump Administration to leverage cutting-edge technologies in the fight against COVID-19, such as the COVID-19 High Performance Computing Consortium, which provides researchers worldwide with HPC resources and expertise from leading industry, Federal Government, and academia partners to accelerate the COVID-19 vaccine and therapeutic research.

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The U.S. Department of Veterans Affairs (VA) today announced a preliminary plan for distributing COVID-19 vaccinations it will implement once the Food and Drug Administration issues an emergency use authorization for a vaccine.

VA has worked in close coordination with the Centers for Disease Control and Prevention (CDC) and Operation Warp Speed to plan for COVID-19 vaccination of VA staff and Veterans.

VA will first provide vaccinations to front-line VA health care workers and Veterans residing in long-term care units in 37 of its medical centers across the country.

The centers, listed below, were chosen for their ability to vaccinate large numbers of people and store the vaccines at extremely cold temperatures.

Health care workers will be among the first to receive vaccinations because they are at high risk for contracting and spreading COVID-19 to other staff members and patients, and their health is critical to ensuring the continued care of Veterans.

Veterans in VA’s long-term care facilities will be the first patient group to be vaccinated. As vaccine supplies increase, additional Veterans will receive vaccinations based on factors such as age, existing health problems and other considerations that increase the risk of severe illness or death from COVID-19.

VA anticipates a limited vaccine supply immediately after FDA’s approval, but expects more supplies to be available in short order.

“VA is well prepared and positioned to begin COVID-19 vaccinations,” said VA Secretary Robert Wilkie. “Our ultimate goal is to offer it to all Veterans and employees who want to be vaccinated.”

The 37 VA sites chosen for initial distribution of the vaccine will closely monitor patients and staff for side effects and log this information in its vaccine monitoring and tracking system. This is the same system VA uses to monitor reactions to all vaccines, including those for the flu and shingles.

VA will report directly to the CDC data on all vaccine doses administered by VA. The department will also provide general, public updates on the number of people who receive the vaccination at these sites, similar to how VA posts COVID-19 testing figures.

The 37 VA sites are spread throughout the country and include:

• Birmingham (AL) VA Health Care System
• Phoenix (AZ) VA Health Care System
• Greater Los Angeles (CA) VA Health Care System
• Palo Alto (CA) VA Health Care System
• Eastern Colorado (CO) VA Health Care System
• Connecticut (West Haven Campus) VA Health Care System
• Washington DC VA Health Care System
• Orlando (FL) VA Health Care System
• Augusta (GA) VA Health Care System
• Edward J. Hines Jr. VA Hospital (IL)
• Lexington (KY) VA Health Care System
• Southeast Louisiana (New Orleans) VA Health Care System
• Maryland (Baltimore) VA Health Care System
• Bedford (MA) VA Health Care System
• Ann Arbor (MI) VA Health Care System
• Minneapolis (MN) VA Health Care System
• Harry S Truman Memorial Veterans Hospital (Columbia MO)
• Omaha (NE) VA Health Care System
• Southern Nevada (North Las Vegas) VA Health Care System
• Raymond G. Murphy (NM) VA Health Care System
• New York Harbor (Brooklyn) VA Health Care System
• Western New York (Buffalo) VA Health Care System
• Durham (NC) VA Health Care System
• Cleveland (OH) VA Health Care System
• Oklahoma City (OK) VA Health Care System
• Portland (OR) VA Health Care System
• Corporal Michael J. Crescenz VA Medical Center (Philadelphia PA)
• Pittsburgh (PA) VA Health Care System
• Caribbean (Puerto Rico) VA Health Care System
• Memphis (TN) VA Health Care System
• Dallas (TX) VA Medical Center
• Michael E. DeBakey VA Health Care System (Houston TX)
• Audie L. Murphy VA Hospital (San Antonio TX)
• Richmond (VA) VA Health Care System
• Puget Sound (WA) VA Health Care System
• Milwaukee (WI) VA Health Care System

Veterans seeking additional information should visit the VA COVID-19 vaccine webpage, contact their care team or visit their facility website.

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The Department of Veterans Affairs (VA) today announced a new clinical trial to study convalescent plasma for treating seriously ill COVID-19 patients as part of a larger effort to give Veterans faster access to potential COVID-19 treatments and test the treatments’ effectiveness.

The trial is the first of multiple studies in VA Coronavirus Research and Efficacy Studies (VA CURES), a master protocol that offers a standardized framework for studying potential treatments for COVID-19 without the need for a new study design and protocol each time.

“This trial will go a long way toward helping in the fight against COVID-19,” said VA Secretary Robert Wilkie. “VA CURES will provide valuable information that will benefit our Veterans who are battling COVID-19, as well as other patients and the medical community in general.”

The trial will enroll around 700 Veterans with COVID-19 who are hospitalized at VA medical centers. A study team will randomize the study volunteers to receive either convalescent plasma or a saline placebo, and track and assess recovery and effects of the treatment.

Convalescent plasma is donated by people who have recovered from COVID-19 and have antibodies against the virus in their blood. Antibodies are proteins the body makes to fight infections.

The U.S. Food and Drug Administration (FDA) previously authorized the use of convalescent plasma as an investigational treatment for COVID-19 through FDA’s expanded access program. The program, used widely throughout the nation, including at many VA sites, ended Aug. 28. FDA has since authorized the emergency use of the therapy based on the available scientific evidence to date. FDA stresses further evidence from rigorous trials — such as the new VA study — is “critically important” for establishing safety and efficacy.

Visit VA COVID-19 research for more information.

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Lawmakers are demanding reforms in how Veterans Affairs officials screen outside doctors for patient medical care after a recent Government Accountability Office review found the department’s referral list contains about 1,600 providers that are ineligible to treat Veterans, including 601 who are dead.

“While [the list] represents a small percentage of the Veterans Community Care Program’s roughly 1.2 million active providers, they represent potential threats to Veteran health and safety and risks for financial fraud,” a group of representatives wrote in a letter to VA health officials on Friday.

“We urge VA to review all ineligible providers identified by GAO and, as appropriate, deactivate them in the Community Care Network so Veterans are not referred to them for care.”

The request — signed by Reps. Chris Pappas, D-N.H.; Tracey Mann, R-Kansas; Julia Brownley, D-Calif.; and Jack Bergman, R-Mich. — comes amid increasing scrutiny of VA’s Community Care program, which allows Veterans to receive care from private-sector physicians but have the appointments paid for with taxpayer money.

The program has been a key part of VA health care for decades, but conservatives in recent years have pushed to expand it dramatically amid concerns of long wait times and specialist shortages at some VA medical centers.

But critics of that plan have said that department officials need to improve their oversight of Community Care providers first, to make sure they are meeting the same medical standards and expectations of VA physicians.

The latest GAO review appears to bolster that argument, noting that VA officials had failed to exclude a small but significant number of ineligible providers from the Community Care program.

Along with 601 deceased physicians, the list included 216 active providers who had a revoked medical license and 796 who have surrendered their medical licenses in response to an investigation.

One provider had a nursing license expire in 2016, was arrested for assault in 2018, and convicted of patient abuse in 2019. The individual was still added to the Community Care list later in 2019, a move that VA officials have now said was a clerical error.

“The vulnerabilities we identified … indicate that Veterans may potentially be at risk of receiving care from unqualified providers,” the GAO report states.

The researchers offered 10 recommendations for reforms, to include monthly checks of all outside provider credentials to look for any concerning activity and better fraud control safeguards for the current application system.

VA officials in response said that they will enact reforms in coming months, with improvements in the periodic checks of provider credentials to start next month.

The lawmakers — all members of the House Veterans’ Affairs Committee — requested a report from the department on that progress by the end of February.

The full report is available on the GAO web site.

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The U.S. Department of Veterans Affairs (VA) announced today it recently awarded $1.3 million in grants to 11 regional homelessness nonprofit organizations to bolster suicide prevention services for Veterans who are experiencing or at risk of homelessness.

VA’s combined public health approach to preventing suicide and addressing homelessness aims to improve the identification of Veterans in need within the community, increase Veteran and community awareness of suicide risk and protective factors, and increase Veterans’ connectedness to community and care resources.

“Our data shows Veterans are at particular risk for suicide within 30 days of an eviction or the onset of homelessness, especially when it is paired with other risk factors, such as financial instability and difficulty meeting basic needs,” said VA Secretary Robert Wilkie. “In response, VA is working hard during this challenging time to ensure Veterans who are experiencing or are at risk of homelessness have the support they need.”

The funds awarded will be managed and disbursed by VA’s Supportive Services for Veterans Families Program (SSVF) which offers an array of services to secure housing for Veterans facing homelessness. Additionally, SSVF will provide supportive services, including rapid rehousing and homelessness prevention support to Veterans identified as being at elevated risk of suicide — as well as Veterans facing extraordinary challenges during the COVID-19 pandemic due to increased unemployment and unstable finances.

Grantees operate in Arizona, California, Colorado, Florida, Indiana, Kentucky, Louisiana, Nevada, Tennessee and Texas. They were selected from a group of the highest-ranked applicants for the SSVF program in fiscal year 2020.

View the full list of the grantees and learn more how VA is working to protect Veterans during the COVID-19 pandemic.

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The U.S. Department of Veterans Affairs (VA) announced today it will award nearly $15 million to 119 national, regional and community programs, headquartered in 37 states, the District of Columbia and Puerto Rico.

Programs funded through these grants will offer adaptive sports and activities to more than 13,000 Veterans and members of the Armed Forces with disabilities.

Included are Paralympic sports, such as archery, cycling and skiing. Additional outdoor sporting activities are hunting, rock climbing and sky diving. Of the total, $1.5 million is being used to support organizations that offer equine-assisted therapy to support mental health.

“Adaptive sports empower Veterans to overcome daily challenges and live without limits,” said VA Secretary Robert Wilkie. “This is made possible by partnering with over 100 community organizations dedicated to providing adaptive sports and activities to encourage Veterans along their health and wellness journey.”

Grant recipients may use the funds for planning, developing, managing and implementing adaptive sports programs. VA will award the grants to national governing bodies, which prepare high-level athletes for Paralympic competition; Veterans Service Organizations; city and regional municipalities; and other community groups to provide a wide range of adaptive sports opportunities.

Information about the awardees and details of the program are available at VA Adaptive Sports Grants Program and @Sports4Vets on social media.

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The U.S. Department of Veterans Affairs (VA) announced today, the New Orleans and Bedford, Massachusetts VA Medical Centers are the first two department facilities to begin administration of COVID-19 vaccinations to frontline health care employees and Veterans residing in long-term care Community Living and Spinal Cord Injury and Disorder centers.

See here for a photo of the first VA patient to receive the vaccine.

Both facilities are part of the initial group of 37 VA medical centers across the country that began receiving and administering the Pfizer-BioNTech COVID-19 vaccine this week.

The sites were chosen for their ability to vaccinate large numbers of people and store the vaccines at extremely cold temperatures.

COVID-19 vaccine implementation will include an initial limited-supply phase followed by a general implementation phase, when large supplies of the vaccine become available.

“Ultimately, the department’s goal is to offer the vaccine to all Veterans receiving care at VA,” said VA Secretary Robert Wilkie. “As increased vaccine supply is obtained, VA plans to distribute these vaccines at additional facilities to provide the vaccine to more Veterans and employees.”

The U.S. Food and Drug Administration stated  in clinical trials the Pfizer-BioNTech COVID-19 vaccine was 95% effective in preventing COVID-19 disease. The vaccine is administered as a series of two doses, 21 days apart. The side effects appear similar to those of other vaccines and are short-lived.

VA will report directly to the CDC data on all vaccine doses administered by VA. The department will also provide general, public updates on the number of people who receive the vaccination at these sites, similar to how VA posts COVID-19 testing figures.

Veterans seeking additional information may sign up to get updated information through VA’s COVID-19 Vaccine Keep Me Informed tool, visit the VA Coronavirus Vaccine FAQs webpage, contact their care team or visit their facility website.

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What is Jet Fuel?

According to the Agency for Toxic Substances and Disease Registry (ATSDR), jet propulsion fuel-5 (JP-5) and jet propulsion fuel-8 (JP-8) are kerosene-based fuels used in military aircraft. “Jet A,” the type of fuel used in civilian aircraft, is sometimes used in military aircraft as well. All three types of jet fuel (i.e., JP-5, JP-8, and Jet A) colorless liquids that are flammable and smell like kerosene. Jet fuel is composed of hydrocarbons, which are compounds that only contain the elements carbon and hydrogen. Hydrocarbons are found naturally in the earth as crude oil.

Effect on Environment

Many things can happen when JP-5, JP-8, and Jet A enter the environment. Per ATSDR, some individual components of the fuels will evaporate into the air from open containers or when they are spilled into water or soil. Essentially, the chemicals may be broken down by reacting with sunlight or other chemicals in the air. However, certain chemicals in may slowly move from the soil to the groundwater and subsequently attach to particles in the water and sink to the bottom sediment.

In some cases, the jet fuel chemicals will be broken down by bacteria and other organisms in soil and water, thereby preventing attachment to water particles and bottom sediment. Nevertheless, some chemicals in JP-5, JP-8, and Jet A may stay in the soil for more than a decade, posing serious environmental and health risks.

Veterans Exposed to Jet Fuel

Sadly, many Veterans may have been exposed to jet fuel while serving on active duty. Exposure can occur in a number of ways, including the following:

• Working with such products
• Living very close to where the products are used or may have been spilled
• Breathing air in an area where an accident or leak has occurred
• Drinking water or touching soil contaminated with JP-5, JP-8, or Jet A
• Swimming in waters where spillage has occurred
• Working refueling military or civilian aircraft
• Transporting jet fuels (especially if protective clothing is not worn)
• Living near a hazardous waste site where these such products are disposed of

As such, Veterans with military occupational specialties related to working on aircraft were likely at risk of coming into contact with jet fuel; however, other Veterans may have come into contact as well due to its environmental presence. Please note that the list included above is non-exhaustive, meaning there are additional ways in which Veterans may have been exposed that are not noted herein.

There is limited research to show that jet fuel was sometimes mixed with Agent Orange and various pesticides during the Vietnam-era, as well.

Health Effects Associated with Jet Fuel Exposure

According to VA, possible health effects of jet fuel exposure depend on how Veterans were exposed (i.e., skin, oral, or breathing), length of time exposed, and personal factors (e.g., age, gender, genetic traits, diet). Unfortunately, little is known about the effects of JP-5, JP-8, and Jet A; however, results from several studies of military personnel suggest that exposure to jet fuel can affect the nervous system. Historically, observed effects include changes in reaction time and in other tests of neurological function.

Additional studies have been conducted with laboratory animals to explore the effects of exposure. Such studies found that exposure to high levels of jet fuel resulted in damage to the liver, decreased immune response, impaired performance on neurological tests, impaired hearing, and skin alterations. These findings are consistent with VA’s public health warnings regarding exposure. Specifically, VA’s reported health effects include:

• Irritation to unprotected skin
• Eye and upper respiratory irritation
• Fatigue
• Breathing difficulty
• Headaches
• Dizziness
• Sleep disturbances
• Hearing problems
• Lung and heart problems (if exposed to very high levels over a long period of time)

Hearing Problems

New VA research has shown that hearing problems are linked to jet fuel exposure. Dr. O’Neil Guthrie, a research scientist and clinical audiologist with the VA Loma Linda Healthcare System in California, states, “even at subtoxic levels, the exposure is affecting the brain and resulting in auditory processing dysfunctions.” Importantly, auditory processing dysfunctions are changes that occur inside the brain rather than the ear. This means that the issue does not involve typical deafness or inability to hear sound. Instead, the issue is that the brain cannot interpret the sound or decipher the message, making communication very difficult. There is currently no treatment for such auditory processing dysfunctions.

Cancer

So far, several studies have examined the potential connection between exposure to jet fuel and various types of cancer. However, the studies did not provide conclusive results due to significant limitations. As of now, the U.S. Department of Health and Human Services and the Environmental Protection Agency have not classified JP-5, JP-8, or Jet A fuels “as to their carcinogenicity” (i.e., tendency to produce cancer). On the other hand, the International Agency for Research on Cancer has classified these types as “Group 3 carcinogens” (i.e., not cancer-causing to humans).

VA Service Connection for Jet Fuel Exposure

Currently, there is no presumption of service connection related to jet fuel exposure. Therefore, Veterans must establish service connection for conditions related to jet fuel exposure on a direct basis. This means that Veterans will need to demonstrate the following:

• A current diagnosis of a qualifying medical condition;
• An in-service event (i.e., exposure); and
• A medical nexus linking the current, diagnosed condition to the in-service exposure

Here, the most important element of service connection will be the medical nexus. Veterans must obtain a positive medical nexus stating that their condition is “at least as likely as not” due to their in-service exposure to jet fuel. Veterans can submit additional evidence to support their claims, such as research, scientific studies, and medical literature pertaining to the effects of exposure described above.

Once service connection is established, VA will assign a disability rating based on the specific condition for which the Veteran is claiming benefits.

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Though there are no confirmed or even suspected cases of the novel coronavirus reported among U.S. Veterans so far, the Department of Veterans Affairs has activated an emergency team to prepare for a potential outbreak.

"We are testing our processes. We are making sure our supply chain is full," VA Secretary Robert Wilkie said at a hearing of the House Veterans Affairs Committee on Thursday.

"We don't need any extra money now," he said, but added the situation could change rapidly if the virus, known formally as COVID-19, begins to impact Veterans.

"If this develops into a pandemic, in which parts of the American health system break down, we're going to have a different conversation," said Dr. Richard Stone, head of the Veterans Health Administration.

As a precaution, the VA has activated its emergency management coordination cell (EMCC), the purpose of which is to coordinate national and local response efforts.<br> <br> But the department, which serves more than nine million Veterans annually, doesn't want anyone to panic.

"At this time, no Veterans receiving care at VA have been diagnosed with COVID-19," according to the VA's website.

At the hearing, Rep. Lauren Underwood, D-Illinois, pressed Wilkie and Stone on getting more funding to prepare for a potential virus outbreak. She also urged them to communicate more directly with Veterans on the threat.

"We are on the precipice of a significant public health crisis in our country," Underwood, a registered nurse and former senior adviser to the Department of Health and Human Services, said.

The Trump administration did not include any funding specifically for the VA in a $2.5 billion supplemental request sent to Congress on Monday to counter the spread of the coronavirus.

In a statement Monday, White House Office of Management and Budget spokeswoman Rachel Semmel said the $2.5 billion includes funding to "accelerate vaccine development, support preparedness and response activities, and to procure much needed equipment and supplies."

One of the complaints from local health officials in California, where the first confirmed case of coronavirus in a patient not traceable to China was reported this week, has been the lack of kits for testing for COVID-19.

Thus far, there have been at least 62 confirmed cases of coronavirus in the U.S. -- the majority from recent evacuees from China and among the U.S. citizens who returned from aboard the Diamond Princess cruise ship off Japan.

More than 83,000 people in at least 56 countries have been infected, with more than 2,800 deaths. New infections in other countries are now outpacing those in China, according to the World Health Organization in Geneva.

On Friday, WHO also raised its risk assessment on the spread of the coronavirus to "very high," one step short of declaring a global pandemic.

This week, U.S. Forces Korea reported the first confirmed cases of coronavirus in the U.S. military: a 61-year-old dependent widow of a retired U.S. soldier and a 23-year-old active-duty soldier.

On Wall Street on Friday, the financial markets plunged again in what was on track to be the worst week for the markets since the 2008 recession. By mid-afternoon, the Dow Jones Industrial Average was down another 700 points.

On its website, the VA had this advice for Veterans: "If you have symptoms of fever, cough, and shortness of breath, please call your local VA medical center and select the option to speak to a nurse before visiting the facility. Tell them about your symptoms and any recent travel."

The VA's overall advice mirrors that of the Centers for Disease Control and Prevention and can be seen here and here.

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The U.S. Department of Veterans Affairs (VA) Secretary Robert Wilkie today broke ground on the first American Indian Veterans Memorial at a VA national cemetery.

This is VA’s first major monument honoring American Indian, Alaska Native and Pacific Islander Veterans.

“Today is California Native American Day and there is no better way to honor American Indian Veterans than with this groundbreaking ceremony,” said VA Secretary Robert Wilkie. “More Native Americans per capita serve our country than any other demographic. This memorial will honor their sacrifice and service in the United States military.”

The memorial at Riverside National Cemetery consists of a plaza and walkway centered on “The Gift,” a twice life-sized bronze statue representing an American Indian. Construction is expected to be completed in the next couple of years. The memorial is being paid for with funds raised by the Riverside National Cemetery Support Committee.

Riverside National Cemetery is the busiest cemetery managed by the VA’s National Cemetery Administration. It was established in 1976 through the transfer of 740 acres from March Air Force Base. The cemetery was dedicated and opened for burials November 11, 1978.

To learn more about the American Indian Veterans Memorial, contact Riverside National Cemetery Executive Director Peter Young at 951-653-8417, or visit www.facebook.com/NatCemRiverside.

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No more 3-mile bike rides to access Wi-Fi

Until a recent act of kindness, Veteran Charles Murray, 66, would lug his heavy, 12-year-old laptop three miles on his bike to Igo Library in San Antonio. He endured the weight of the eight-pound laptop in his backpack, pedaling in the Texas summer heat because he couldn’t afford bus fare.

Once he arrived at the library, which was closed due to the pandemic, he would sit on the outdoor patio and use its Wi-Fi to conduct his VA telehealth appointments. Murray did not have broadband to participate in video visits from his home.

“The video visits add a different dynamic than over-the-phone appointments,” Murray said. “It’s almost like you are right there with the person.”

As the days became colder, the library patio became a less appealing option. Thanks to VA, Murray found a way to connect with his VA care team by video from the comfort of his home. His home was also secured through a VA program since he previously experienced homelessness.

Digital Divide consult helps qualified Veterans get loaned equipment

Murray isn’t alone in not having reliable internet access. According to the Federal Communications Commission, 15% of Veteran households do not have a way to connect to the internet at home. That’s why VA Telehealth Services has developed the Digital Divide Consult and the connected device program. The programs help qualifying Veterans receive VA-loaned equipment.

Murray’s clinical psychologist, Dr. Amanda Wetegrove-Romine, ordered a Digital Divide Consult for Murray. The consult determined his eligibility for programs to help him get the internet service needed for VA telehealth. Heidi Morris, Murray’s homeless program social worker, then completed an assessment for a VA internet-connected device.

In collaboration with Apple – and facilitated by the Secretary’s Center for Strategic Partnerships – VA loaned Murray an iPad with cellular data service, as well as start-up instructions. Since then, Murray has connected with his care team through VA Video Connect from his home.

Patients more engaged using computer camera

Wetegrove-Romine said that providing Murray and other Veterans with these tools was a game changer. She added that Veterans are more engaged when they’re in front of a camera. And they reveal more through nonverbal cues – such as facial reactions to treatment recommendations – than they do over the phone.

“You need the internet right now, especially during the pandemic, to take part in health care, employment and education,” said Dr. Kevin Galpin, executive director of VA Telehealth Services. “It’s important that every Veteran has the ability to stay connected.”

VA social workers have seen an increase in Veteran engagement in VA programs due to increased access to VA-loaned devices and connectivity resources, said Jennifer Koget, a licensed clinical social worker and acting national director of VA’s national social work program office.

“Don’t know where I’d be without VA”

“Social workers can now reach Veterans who were lacking technology and connectivity resources and focus on resolving social determinants of health challenges, resulting in improved Veteran wellness,” Koget said.

“Veterans who have received VA-loaned connected devices have been thankful for and respectful of the technology,” said Wetegrove-Romine.

“They’re something to look forward to,” Murray said of his virtual visits, using his iPad. “They activate my mind to use brainpower. I don’t know where I’d be without the help of VA.”

Murray still enjoys biking through San Antonio on warmer days and researching on his iPad. He plans to learn how to check out e-books on wellness, spirituality and African American history from the library next.

For more on the Digital Divide Consult and related programs, check out this fact sheet.

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Memorializing a loved one is an important part of the transition that follows celebrations and honors of the life lived. However, many Americans may not know or fully understand VA’s burial and memorial benefits.

The VA Burial and Memorial Products Quick Start Guide (QSG) provides clear and concise information on VA burial benefits for Veterans, their families, caregivers and survivors.

DOWNLOAD

You can apply to find out in advance if you can be buried in a VA national cemetery. This is called a pre-need determination of eligibility—and it can help make the burial planning process easier for your family members in their time of need.

The VA Burial and Memorial Products guide covers:

How to apply for the burial benefits you’ve earned

Help planning for a burial or memorial service in a VA national cemetery

Assisting family members with ordering memorial items to honor the service of a Veteran

How to plan for a burial in advance or at time of need

How to obtain a Presidential Memorial Certificate

Links and phone numbers for additional information

Burial in a VA national cemetery is open to all members of the armed forces and Veterans who have met minimum active duty service requirements, as applicable, and were discharged under conditions other than dishonorable.

A Veteran’s spouse, widow or widower, minor children, and, under certain conditions, unmarried adult children with disabilities, may also be eligible for burial. Eligible spouses and children may be buried even if they predecease the Veteran.

VA provides the gravesite, grave liner, opening and closing of the grave, government headstone or marker, U.S. burial flag, Presidential Memorial Certificate, and perpetual care of the gravesite at no cost to the family.

*VA operates 151 national cemeteries and 34 soldiers’ lots and monument sites in 44 states and Puerto Rico. Nearly 5 million Americans, including Veterans of every war and conflict, are buried in VA’s national cemeteries. VA also provides funding to establish, expand, improve and maintain 117 Veterans cemeteries in 48 states and territories including tribal trust lands, Guam, and Saipan.

For Veterans not buried in a VA national cemetery, VA provides headstones, markers or medallions to commemorate their service.

Based on where you are in life, your VA benefits and services can support you in different ways. For end of life planning, view and download the VA Burial and Memorial Products Quick Start Guide. For all other VA benefits and services, download the VA Welcome Kit so you can turn to it throughout your life—like when it’s time to go to school, get a job, buy a house, get health care, retire, or make plans for your care as you age.

More information

Additional VA Quick Start Guides on VA Mental Health Services, community and urgent care, applying for a disability rating, education benefits, caregiver and survivor benefits are available for download here.

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After a yearlong delay, Veterans from World War II through Vietnam who need around-the-clock care from a loved one can apply for the Department of Veterans Affairs' family caregiver program, starting Oct. 1.

The VA announced Friday in the Federal Register that the program's expansion to include Veterans who served on or before May 7, 1975, will begin with several changes that affect all who are enrolled, including current Veterans and caregivers.

Under the new rules, Veterans with a single or combined service-connected disability rating of 70% or higher, who also meet certain criteria and served before the 1975 date, are eligible to apply in October.

The VA will determine whether the applicant fits into one of two categories: Level 1, those who need substantial caregiving but are more capable than the most disabled cohort; or Level 2, those who are not able to "self-sustain in the community," meaning they require continuous supervision and help with three or more daily activities.

According to the VA, the stipend amount for the Program of Comprehensive Assistance for Family Caregiving will be dependent on geography and level. A caregiver in Dallas, supporting a Level 2 Veteran, for example, would receive a monthly stipend of roughly $2,803.17. For someone caring for a Level 1 Veteran, it would be $1,751.98.

Those currently enrolled in the program and those with a pending application will be reassessed under the new eligibility criteria over the next year, according to the VA.

If a reassessment results in an increased stipend, the Veteran and their caregiver would receive the new amount, as well as a lump sum of retroactive pay back to Oct. 1, 2020. If the assessment determines the Veteran is eligible for a decreased amount, the VA will give them notice by Oct. 2, 2021, and the decrease would go into effect "no earlier than 60 days" after they receive the notice.

For Veterans who are currently enrolled but deemed during the reassessment to be ineligible under the new criteria, the VA will inform the Veteran at or around Oct. 1, 2021, and their benefits would continue for 90 days following discharge from the program.

As part of the assessment, the VA will examine the level of activity Veterans can do themselves each day, taking into account whether they can dress themselves, bathe, groom themselves, adjust a prosthetic or orthotic device on their own, go to the bathroom without assistance, feed themselves or need help moving around their homes.

The 2018 VA Mission Act required the department to expand its caregiver program to include combat Veterans from previous wars. The current program, which was established in 2011, serves combat-wounded Veterans of the post-9/11 era and has helped 38,000 former service members at a cost of roughly $900 million annually.

VA Secretary Robert Wilkie said Friday that the new regulation allows the most "vulnerable Veterans to stay home with loved ones for as long as possible."

"The expanded regulation addresses the complexity and expense of keeping Veterans at home with their families who provide personalized care," Wilkie said in a release.

Under the Mission Act, the program will undergo another expansion on Oct. 1, 2022, to include combat Veterans who served between 1975 and Sept. 11, 2001.

In addition to expanding eligibility beyond those who are combat wounded, the new regulations define new procedures for discharging former service members from the program, standardize operating procedures and provide new training for staff and caregivers. The changes also will give caregivers access to financial planning and legal services.

The program was the target of a VA Office of Inspector General investigation in 2018 that found problems with how the department managed the program, accepted applicants and monitored the health of those who were discharged from the program.

The IG found that the department also paid out $4.8 million to caregivers of Veterans who weren't eligible for the program.

Last year, four spouses and two fiancees of Veterans eligible for the program sued the VA for allegedly improperly revoking their benefits or denying them.

More information on the VA's caregiver program can be found on its website.

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The U.S. Department of Veterans Affairs’ (VA) announced today VA Chief Research and Development Officer, Rachel Ramoni, Ph.D., has been selected as the first recipient of the Above and Beyond Award from the Women in Science Forum of the Prostate Cancer Foundation (PCF).

Dr. Ramoni received the award for advancing biomedical research and clinical trials for Veterans with prostate cancer and contributing to the fight against COVID-19.

“This recognition shows the real-world impact of VA research,” said VA Secretary Robert Wilkie. “VA’s partnership with the Prostate Cancer Foundation is vital and significant to prevent, screen and promote research to speed the development of treatments and cures for prostate cancer as we serve the over 15,000 Veterans diagnosed with prostate cancer every year.”

To support better prostate cancer care for Veterans, the department established the VA Precision Oncology Program for Cancer of the Prostate (POPCaP) in partnership with the PCF. The program aims to deliver precision cancer care to all Veterans, including those who live in remote rural areas. There are currently 12 hubs in the POPCaP network distributed across the U.S.

Under Ramoni’s stewardship, the VA Office of Research and Development has implemented policies that have streamlined research efforts, especially for multi-site clinical trials. In some cases, this has reduced the start-up time for clinical trials from several months to a matter of weeks.

In addition to advancing precision oncology research, Ramoni promotes diversity within the VA research enterprise and has been instrumental in mentoring women researchers in VA.

Learn more about VA research and development.

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Understanding VA Disability Benefits For Parkinson’s Disease

If you are a former military service member living with Parkinson’s Disease, you may be eligible for disability compensation through the United States Department of Veterans Affairs. There are a few steps that you will need to complete to receive these disability benefits.

Specifically, Veterans need to prove service connection for their condition. You may also be eligible for benefits based on conditions that are secondary to Parkinson’s Disease. Based on these factors, the VA will calculate a disability rating to determine compensation.

It’s also important to note that Vietnam Veterans may be eligible for benefits for Parkinson’s Disease related to agent orange exposure. This guide will go over all of these factors, so you can start your disability claim and receive compensation for your medical conditions.

Service Connection For Parkinson’s Disease

Some former service members may be eligible for direct service connection, meaning something happened in military service that caused your Parkinson’s or the disease was first diagnosed or manifested during service. This service connection is not easy to prove and will almost always require an independent medical opinion to show that you were beginning to show signs of Parkinson’s during service or a particular chemical you were exposed to caused the condition.

There is research that is starting to show exposure to certain chemicals does cause Parkinson’s Disease, and some of those chemicals such as TCE and PCE have been found in the water of Camp Lejeune. There is also evidence that Agent Orange herbicide exposure causes Parkinson’s, which the VA has now conceded. Agent Orange has also been linked to respiratory cancer, multiple myeloma, prostate cancer, bladder cancer, lymphoma, soft tissue sarcoma, and chronic b-cell leukemias. This service connection is particularly prevalent for Vietnam War Veterans.

If you were exposed to Agent Orange and have Parkinson’s, you are able to take advantage of the VA’s rules for presumptive service connection. This is a relatively simple case if you served on the landmass or “brown water” of Vietnam, but for other Veterans, including Blue Water Veterans, claiming the presumption has been more difficult. With the expected changes coming to the VA law regarding Blue Water Veterans, many more Veterans should soon be able to take advantage of the presumption of service connection for Parkinson’s disease.

Disability Ratings For Parkinson’s Disease

Once you are awarded service connection for Parkinson’s, the fight may not be over. This is mostly because of the rating system the VA uses for Parkinson’s. The minimum rating you can be awarded by the VA for Parkinson’s disease is 30 percent, but if you fail to appeal that rating, you are potentially leaving thousands of dollars of benefits on the table.

The 30 percent rating is given to Veterans who have the diagnosis of Parkinson’s, and is basically acknowledging that they have the condition. What many Veterans do not realize is that once you are service connected for Parkinson’s Disease, you are entitled to service connection for all the other problems that the condition causes: talking, swallowing, walking, balance problems, using your hands, memory, concentration, depression, and many more. If you have Parkinson’s, you are entitled to a separate rating for any condition that it causes. As you may guess, this can be a long list, especially as the disease progresses.

If you are service connected for Parkinson’s, you also need to apply for a Total Disability Rating based on Individual Unemployability. Often Veterans are initially rated as 30 percent disabled by the VA for Parkinson’s, but are on Social Security for Parkinson’s. If you are unable to work because of Parkinson’s, it is important to file a claim for individual unemployability with the VA, not only so you receive benefits at the 100 percent rate, but so you can receive what is known as Special Monthly Compensation as well.

Special Monthly Compensation is compensation that is awarded above and beyond the 100 percent disability payments for conditions that are more serious and more debilitating than for which the 100 percent rate is able to compensate. For instance, you may be eligible for SMC is you are housebound or need aid and attendance. Or, you may be able to receive SMC for the loss of use of your hands, feet, or vision. Note that SMC is not a separate claim, and is instead part of the original appeal. When you appeal for a higher rating for Parkinson’s Disease, it is a good idea to also appeal for individual unemployability and any SMC to which you are entitled.

Disabilities Secondary to Parkinson’s Disease

While most people tend to think of Parkinson’s disorder as a neurological movement disorder, and it most certainly is, many people do not realize that other systems in the body can also be severely affected by Parkinson’s. Often, the same chemical exposure (for example Agent Orange,) can also cause other disorders, such as ischemic heart disease. However, often it is the Parkinson’s itself, or the medication used to treat it that is the causal factor in the development of a new disorder. Whether a Veteran’s Parkinson’s was caused by exposure to the TCDD in agent orange, pesticides, trichloroethylene, or its origins are unknown, Parkinson’s cause many secondary health effects and disabilities.

Cardiovascular Complications

Parkinson’s is known as a neurodegenerative disorder; that is, it causes neurons to degenerate or decay. The most famous area for PD degeneration is in an area of the brain called the substantia nigra, where Parkinson’s causes the death of neurons that generate dopamine, a neurotransmitter which is involved with movement. However, more recent studies have also shown that Parkinson’s also attacks nerves in the heart which produce another neurotransmitter, noradrenaline. This typically takes place in the left ventricle and can have many complications.

Noradrenaline is the primary messenger used by the sympathetic nervous system, the system of the body used to control things we don’t consciously think about: the beating of the heart, breathing, blood pressure, even how dilated our pupils are at any given time.

The most common cardiovascular problem related to Parkinson’s is orthostatic hypotension, which is a sudden drop in blood pressure when standing or sitting upright. Many Parkinson’s patients may need to get out of bed or out of a chair extremely slowly to avoid passing out. This can cause FURTHER secondary disabilities, including orthopedic or muscular trauma due to falls.

Medications such as Levodopa can be a lifesaver to Parkinson’s sufferers, however up to 10% of those medicated by PD medications such as Levodopa, Carbidopa, and Entacapone experience cardiovascular symptoms such as irregular heartbeat, hypertension, ischemic heart disease, and stroke. One study found that 2.4% of patients who were taking carbidopa/levodopa had cardiovascular ischemic events, compared to only 1.1% in patients taking a placebo.

A 2013 study found a nearly three-fold increase in the risk of stroke in patients with Parkinson’s. There is also a two-fold increase in the risk of heart failure and a 50% increase in the risk of dying from heart failure in Parkinson’s patients.

Orthopedic Problems

While Parkinson’s Disease is a neurological disorder, it can quite frequently cause orthopedic problems. Falls from Parkinson’s are frequent, both from the movement symptoms as well as the orthostatic hypotension noted above. As Parkinson’s frequently attacks the elderly, their bones may be brittle and easily break during a fall. To make matters worse, Parkinson’s sufferers have an increased risk of developing osteoarthritis and osteoporosis. This is believed to be due to a loss of bone mass resulting from the fact that PD sufferers tend to move around a lot less than non-sufferers.

In those sufferers who have had severe falls or needed spinal or other surgery, the tremors associated with Parkinson’s often severely affect recovery, or make total recovery nearly impossible. A cast is designed to reduce movement of a recovering limb; involuntary tremors are not helpful in this regard.

Psychiatric Problems

Both Parkinson’s itself, as well as the medications used to treat it, can have severe psychiatric effects that can often be extremely debilitating. Dementia is common, and PD sufferers often experience cognitive problems, attention problems, as well as depression, anxiety, and even psychosis.

As I mentioned above, the primary problem in Parkinson’s disease involves the creation of dopamine, and while dopamine is involved in movement, it also is involved in addictive behavior. Often, bizarre behavioral changes happen in patients who are being treated with Parkinson’s medication, such as sexual addiction, compulsive gambling, binge eating, and overuse of medications.

Other Problems

As I mentioned above, Parkinson’s affects the parts of our neurological system that works automatically, without effort. We do not will food along our digestive tract, or decide to start sweating more; it just happens. As such, many seemingly smaller problems can arise. Many Parkinson’s sufferers experience constipation, loss of bowel and/or bladder control, excessive sweating, vision problems, and even the loss of the sense of smell (anosmia.)

Sleep problems are extremely common in Parkinson’s patients. REM disorders, where patients actually act out their dreams, can be extremely dangerous and occur frequently in Parkinson’s. Other patients experience insomnia, others cannot stay awake. In fact, 13% of Parkinson’s patients who are on medication experience sudden sleep attacks.

50% to 80% of patients with Parkinson’s disease have abnormal glucose tolerance which may Parkinson’s medication may worsen. However, the link between diabetes and Parkinson’s is not yet fully understood. Diabetes may be secondary to Parkinson’s, particularly if the patient is obese, is experiencing binge eating due to medications, and is not moving as much as they used to. However, some research actually points to diabetes as being a possible culprit in the development of Parkinson’s, so this association may go either way.

Parkinson’s is an insidious and difficult disorder to experience, and we can see that it is much more than just some tremors. If you have service-connected Parkinson’s, you need to be fully aware of these secondary conditions in order to receive the medical care and compensation you deserve.

VA Claims for Parkinson’s Disease Related to Agent Orange Exposure

Some Veterans may develop Parkinson’s Disease due to Agent Orange exposure. If you are a Blue Water Veteran who is hoping to be awarded service connection for a condition caused by Agent Orange exposure due to the expected changes to VA law in regards to Blue Water Veterans, you need to be aware of the all the conditions that are on the VA’s list for presumptive service connection. Today, we are going to talk about Parkinson’s disease. This condition is one of the latest diseases to be added to the presumptive list and also has the potential to net you many benefits because of the residual conditions it causes.

As you can see, there is a potential for a lot of benefits for Veterans who suffer from Parkinson’s because it is a particularly devastating disease. For Blue Water Veterans who will finally be eligible for presumptive service connection under the expected changes to VA law, it is important to know what benefits are available to you so you do not leave any benefits that you are owed on the table. Especially for a condition like Parkinson’s, it is likely that you would be eligible for compensation above and beyond the 100 percent rate when you factor in SMC.

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Department of Veterans Affairs officials have cleared the way for five schools’ eligibility to enroll GI Bill students, after concluding the schools have adequately addressed “erroneous, deceptive or misleading” enrollment practices, officials said.

But a Veterans’ advocacy group says the VA’s decision amounts to an attempt to “ignore federal law in order to protect predatory colleges.”

“The only winners today are the schools that used their money and political influence to evade the law and harm Veterans,” said Carrie Wofford, President of Veterans Education Success, in a statement. “The GI Bill statute specifically requires VA to protect student Veterans, but the Trump Administration has chosen to defy that law.”

The schools are University of Phoenix, Colorado Technical University, American InterContinental University, Bellevue University and Temple University.

In March, VA officials sent the schools letters threatening to suspend their eligibility, based on findings by the Federal Trade Commission and state attorneys general about the schools’ practices. Officials cited a law that prohibits the use of deceptive or misleading advertising, sales or enrollment practices. Officials gave schools 60 days to take corrective action, and subsequently provided two 30-day extensions.

VA regional offices notified the five colleges of the decisions on July 2, stating the matters had been resolved to their satisfaction.

VA spokeswoman Christina Noel said that after careful review, VA had determined that the schools “had taken adequate corrective actions to avoid suspension of new GI Bill student enrollments.”

Among the actions she cited:

• Cooperation with VA compliance reviews
• Restitution to affected students
• Changes in marketing practice and personnel
• Changes in university leadership
• Renewed annual training for school employees
• Improved oversight of communications with students.

“VA will continue to act in the best interest of our nation’s service members, Veterans and taxpayers, and we look forward to working with these schools to ensure they fulfill the requirements for GI Bill enrollments,” Noel said.

However, the fact that the schools took action to resolve prior legal issues isn’t enough to justify allowing them to continue to accept GI Bill students, contends the Veterans Education Success nonprofit advocacy group. The group contends that by law, if VA becomes aware of deceptive recruiting practices of an institution, then the VA must not approve the enrollment of a GI Bill student at that institution.

Jeremy Butler, chief executive officer of the Veterans advocacy group Iraq and Afghanistan Veterans of America, agrees. “It was disappointing to see the VA so quickly reinstate these five schools,” Butler said. “I don’t think they were fully transparent in what they were requiring of the schools.”

The VA should ensure that the changes not only ensure the schools are not continuing with the same behavior in the future, but that they “really learn the real lesson about properly taking care of our military and Veteran students,” Butler said.

“This sends a signal to all schools that they can use deceptive practices to take advantage of GI Bill users to get their money in the door and to use that to further programs that may or may not be providing a real educational opportunity.”

Two separate 2019 FTC settlements involved three of the schools.

The University of Phoenix and its parents company, Apollo Education Group, reached a settlement with the FTC for $191 million to resolve charges they had used deceptive advertisements that falsely touted their relationships and job opportunities with companies such as AT&T, Yahoo!, Microsoft, Twitter, and the American Red Cross. According to the VA, the University of Phoenix has been the largest recipient of Post 911 GI Bill benefits since the program began.

Career Education Corporation, the previous parent company of both American InterContinental University and Colorado Technical University, reached a $30 million settlement with the FTC and an additional settlement of nearly $500 million with 49 states on charges the CEC used deceptive lead generators to market its schools. The lead generators told potential students the schools were affiliated with or recommended by the military.

Here are the corrective actions the schools have taken, according to the VA letters:

University of Phoenix:

• The marketing campaign in question ended in 2014.

• The executive leadership team in place at the time of the FTC review period and the marketing personnel responsible for the advertising campaign have been replaced.

• Marketing activities are no longer outsourced, and the university uses a new review process that requires marketing be approved by multiple departments including the Ethics and Compliance Department, the Legal Department and at times, faculty experts.

• Annual training requirements now include compliance training focused on consumer protection requirements.

• Contacts with prospective students are recorded, analyzed and monitored for key words or phrases that would be potentially problematic; corrective actions with those prospective students are taken in those cases.

• In the wake of the FTC allegations and subsequent settlement, UoP conducted outreach to notify students and make them aware of the waiver of tuition debts for students during the period in question—$141 million and a specific $50 million settlement to be dispersed by FTC for any additional student relief claims (to include any Veterans).

• Since 2013, the VA has conducted more than 130 compliance reviews of UoP locations, to include specific marketing reviews in 2017 and 2019. UoP has fully complied with these audits. No findings of deceptive or misleading advertising or marketing were cited.

Perdoceo Education Corporation (owner of Colorado Tech and American InterContinental University):

• They’ve stopped the conduct regarding deceptive lead generators, and have taken the actions agreed to in settlements.

• The FTC, a federal court in Illinois, 49 state attorneys general and multiple state courts are conducting oversight and enforcement of the agreements.

• The company has committed a combined total of about $524 million to pay restitution to affected students, including Veterans.

• The company has bought new technology to evaluate lead generator content before buying and using the content.

Temple University

A lawsuit filed in federal court in Pennsylvania alleged that Temple’s Fox School of Business made false, deceptive and misleading statements to U.S. News and World Report regarding the ranking of its Online Masters of Business Administration program, from 2014 through 2017. University officials later discovered similar problems with several other masters programs in the school of business.

• VA found that Temple has provided substantial evidence to VA of its efforts to not only stop and correct the misreporting of data to ranking agencies, but to put in place university-wide protocols to prevent it in the future. The actions have been approved by the Pennsylvania attorney general, the U.S. District Court, and those in the lawsuit affected.

• Those in the lawsuit were paid a combined $5.5 million as part of the settlement, and there was another $2.8 million in non-monetary commitments.

Temple officials also:

• Determined who was responsible for the misreporting of data; and removed the personnel involved.

• Notified U.S. News and World Report, and other agencies and news outlets about the instances of misreported data.

• Instituted policy to address key aspects of the data reporting process, including supervision and oversight.

• Hired the first chief compliance officer, as part of explicit policy requiring mandatory reporting of suspected inaccurate data reporting.

• Provide training for employees about best practices in data collection, verification and reporting.

• Developed new process for rankings data.

• Periodically review compliance, with internal audits.

Bellevue University

A complaint filed by the Nebraska State Attorney General in federal court against Bellevue alleged that from May 2012 to March 2016, the school made false, deceptive, and misleading statements to prospective and then-current students regarding the accreditation status of its registered nurse (RN) to bachelor of science in nursing (BSN) program and the value of a BSN degree from an unaccredited nursing program. The complaint alleged that the RN to BSN program was not accredited before October 2017.

• Between February 2016 and April 2017, nine nursing students complained to the Nebraska Attorney General’s Office about Bellevue’s specialized accreditation. Bellevue responded to each complaint, and four of the nine were closed based on Bellevue’s response

• When Bellevue determined that it would not get the specialized accreditation in the anticipated time frame, it notified students and assisted any who wanted to transfer.

• The University offered scholarships to students who stopped attending prior to full accreditation; three students have accepted, and others have inquired.

• Bellevue has updated all marketing materials related to the RN to BSN program and began having students expressly acknowledge the programmatic accreditation status of Bellevue.

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The U.S. Department of Veterans Affairs (VA) announced today the Veterans Benefits Administration (VBA) and Office of Information and Technology (OIT) successfully completed all Information Technology (IT) updates to process education benefits for Veterans.

The updates were completed Oct. 31 in accordance with the Harry W. Colmery Veterans Educational Assistance Act of 2017, also referred to as the Forever GI Bill,  which included 31 GI Bill®-related provisions that expanded and enhanced opportunities for Veterans using the GI Bill® in pursuit of their educational and career goals.

“These IT changes improve our ability to deliver education benefits to GI Bill® students.” said VA Secretary Robert Wilkie. “As VA works to modernize processes, this milestone is an important step in our digital transformation journey — merging people, procedures and technology.”

Since 2018, VA has ensured Veterans realized the impact of these provisions — including restoration of entitlement, removal of the delimiting date to use the Post-9/11 GI Bill® and full benefits to eligible Purple Heart recipients — while implementing these changes within its IT systems.

The implementation of the Colmery Act has been a joint undertaking with VBA, OIT, MITRE Corporation and Accenture Federal Services. Working together as an integrated unit, the team delivered comprehensive software development, integration, testing, communications and training to meet immediate needs.

The “go-live” of Colmery Act IT updates ultimately changes the way VBA interfaces with Veterans.  The integrated solution allows VA to better serve Veterans in pursuit of their education and career goals through improved processing times, rapid response to legislation and fewer manual work arounds.

The team utilized an innovative Scaled Agile Framework (SAFe) to collaborate across multiple systems and VA offices, resulting in improved engagement, quality and efficiency. Despite transitioning to a virtual work environment in March, the team adapted quickly and continued to meet the mission leveraging the SAFe approach.

The following updates represent important benefits changes for GI Bill® students, as the Colmery Act expands opportunities under the Post-9/11 GI Bill®.

• Removed the expiration of benefits for those who served on or after Jan.1, 2013.
• Changed the way Post-9/11 GI Bill Monthly Housing Allowance is calculated.
• Expanded Yellow Ribbon Program eligibility to include Purple Heart recipients.
• Established the Edith Nourse Rogers STEM Scholarship and improved the attendance verification process for scholarship recipients.
• Proration of the entitlement charge for licensing, certifications, and national exams.

To communicate these important changes and provide updates throughout the implementation process, VA conducted extensive communication, outreach campaigns and gathered feedback. This included channels such as email, toolkits and focus groups, as well as grassroots efforts such as social media campaigns reaching more than 910,000 stakeholders, and a nine-state, 24-stop nationwide School Tour.

For more information on the bill visit VBA benefits.

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The U.S. Department of Veterans Affairs (VA) today dedicated a new 269-acre national cemetery in Corfu, New York, 20 miles east of Buffalo — to provide for the first time — a nearby VA burial option for an estimated 77,100 Veterans and their eligible family members.

VA Secretary Robert Wilkie along with Under Secretary for Memorial Affairs Randy Reeves, New York Lt. Governor Kathy Hochul, U.S. Senator Chuck Schumer and U.S. Representative Chris Jacobs unveiled the dedication plaque for Western New York National Cemetery.

“Our nation owes a debt to our Veterans who served and sacrificed so that we all could enjoy the blessings of liberty,” said Wilkie. “It is a tremendous honor for me, on behalf of VA, to provide the Veterans of the Buffalo area with access to burial and memorial benefits they have earned.”

Construction of the initial phase of the cemetery is ongoing, with first interments expected to occur before the end of this year.

With the addition of Western New York, the state currently has six open VA national cemeteries, including: Woodlawn in Elmira, Gerald B.H. Solomon Saratoga in Schuylerville, Calverton in Calverton, Bath in Bath and Long Island in Farmingdale, while Cypress Hills National Cemetery in Brooklyn is closed to new interments.

Due to the COVID-19 pandemic, the dedication ceremony was closed to the public and attendance was limited in accordance with federal, CDC, state and local guidelines and mandates. Photos and video of the dedication can be found on the National Cemetery Administration’s Facebook site.

For more information contact Western New York National Cemetery Director James Metcalfe II at 717-639-4644. Visit VA’s National Cemetery Administration or call 800-535-1117 for information on VA burial benefits or to apply for burial benefits in advance of need.

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President Trump signed the Vietnam War Veterans Recognition Act of 2017 on March 28, 2017, to recognize and thank our Vietnam Veterans and their families for their service and sacrifice during one of the longest wars in our country’s history. This Act designates every March 29 as National Vietnam War Veterans Day—a day for all Americans to come together to remember and honor the service and sacrifice of our Vietnam Veterans and their families.

We remember 9 million American men and women—more than 6 million living today—who served on active duty in the U.S. Armed Forces during our involvement in Vietnam from November 1, 1955, to May 7, 1975. Whether they were stationed in-country, in-theater, or elsewhere during those two decades, they answered the call to duty.

I am the son of a Vietnam Veteran and career Army officer. One of the most traumatic days of my life was being told that my father had been gravely wounded in the invasion of Cambodia in 1970. I was six. After three long years of recovery, he returned to the 82nd Airborne Division. So, my family and I experienced first-hand the enormous sacrifices this generation of Americans made in courageous service to our Nation.

This year, VA again joins more than 11,000 organizations across the country as a commemorative partner supporting the Department of Defense in this Vietnam War Commemoration. The commemoration program was launched in 2012 and continues to 2025. I invite all VA leaders to either host ceremonies or participate in community events from March 25 to March 29.

Additionally, help us reach those Vietnam Veterans who may be living in remote locations, those who are physically unable to attend commemorative events, and those in assisted living, geriatric, rehabilitative, or palliative care. It is our duty to show our deep gratitude to this generation of warriors and their families.

Please visit https://www.vietnamwar50th.com/ to learn how your organization or facility can be a commemorative partner and participate in this important tribute. Official commemorative partnership offers historical media and opportunity to request lapel pins and other recognition items to present to Vietnam Veterans.

Thank you all for your service to VA and your devotion America’s Veterans.

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WASHINGTON — The U.S. Department of Veterans Affairs (VA) announced today it completed transferring patient data into its new electronic health record (EHR) solution in preparation for the system’s launch in the Pacific Northwest later this month.

The Oct. 1 migration includes clinical and demographic data for approximately 88,000 Veterans and equips VA health care providers with a longitudinal view of patient information when using the Electronic Health Record Modernization (EHRM) solution at Mann-Grandstaff VA Medical Center (VAMC) in Spokane, Washington.

“Giving our VA clinicians quick, secure access to patient data means we are making progress to improve Veteran safety and health outcomes,” said VA Secretary Robert Wilkie. “Moving and organizing the data ensures Veteran information is readily available for clinicians at Mann-Grandstaff as part of this historic modernization program.”

When the new EHR launches, VA clinicians and administrative staff at the facility will be able to easily access, verify and update patient information directly within the EHR itself, rather than using multiple systems. This information includes patient medications, allergies, immunizations, past medical procedures and ongoing health concerns, as well as demographic details, such as address, phone and emails.

With this information more accessible, VA health care providers will be able to view patient medical histories that will support clinical decision-making and improve Veteran health results.   

VA’s transfer of active patient data into the new EHR is the latest of several EHRM milestones. In August, VA launched its new patient appointment system, the Centralized Scheduling Solution (CSS), at sites in the VA Central Ohio Healthcare System. In April, VA and the Department of Defense launched a joint health information exchange, which allows providers in both departments to quickly and securely access data for patients seen by a participating community partner or health system.

This latest achievement moves VA closer to its goal of enabling a lifetime of seamless care for service members and Veterans. Following the implementation at Mann-Grandstaff, the EHRM program will continue over the next several years, rolling out the new software until it is in place nationwide at all VA facilities by 2028.

Learn more about VA’s EHRM program.  

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Veterans Affairs officials acknowledged to lawmakers that the department’s debt collection practices remain “too clunky and too confusing” to ensure families aren’t left in financial jeopardy. And they promised additional reforms within the next year.

“We are too often fragmented, uncoordinated and highly variable in our processes,” said Jon Rychalski, chief financial officer for the Department of Veterans Affairs, told members of the House Veterans’ Affairs Committee on Thursday. “Frankly, we have a way to go before we can declare success.”

Last fiscal year, VA overpayments to Veterans totaled roughly $1.6 billion, on par with mistakes in previous years.

The cases include mistakes in disability payouts after beneficiary information is updated, payments that conflict with other federal benefits like drill pay, changes in college enrollment that lower GI Bill eligibility, and simple math errors by department employees.

Officials from Veterans Education Success said one in four recipients of GI Bill benefits face some time of overpayment-related debt.

The department sent out more than 600,000 debt collection notices to Veterans and their families in fiscal 2018 in an effort to recover the money. Members of the House Veterans’ Affairs Committee said too often they hear from Veterans who face significant financial hardship as a result of those actions, even when they incur the debt through no fault of their own.

“VA has a lot of work ahead to reduce the number of overpayments sent to Veterans,” said Rep. Chris Pappas, D-N.H. “Receiving these notices of balance due can prove particularly burdensome to Veterans living on fixed incomes.”

VA has changed policies in recent years that required withholding future checks until the debt was fully repaid, instead opting for automatic 12-month repayment plans to ease the burden.

But lawmakers and outside advocates said in many cases the debt — which often tops $2,500, according to committee statistics — is still too large to comfortably deduct from monthly payouts.

“The resultant debts owed by Veterans often cause severe financial hardships for Veterans and their families,” said Shane Liermann, deputy national legislative director for benefits at Disabled American Veterans.

“In many cases, the burden of repaying these debts can negatively impact a Veteran’s quality of life, put them at risk of homelessness and affect their access to VA health care.”

Lawmakers pressed VA on making hardship waivers for debt collection easier to obtain, and for broader use of VA’s authority to wipe out the debt completely.

Rychalski said officials have to balance their responsibility to taxpayers to recover overpayments with Veterans’ financial health, but said the department is reviewing how cases are handled to see if systemic changes are needed.

He said within the next year he expects VA to offer a new online portal where Veterans can monitor any outstanding debts, and new department policies to minimize the number of debt notices sent to Veterans from various sub-agencies within VA.

The department is also targeting a new online debt payment system within the next three years. Rychalski acknowledged that timeline is slower than many would like, but said the process will require coordinating a host of aging computer systems.

Lawmakers urged more speed on the solutions.

“The clock is running,” Pappas said. “Every day this isn’t enacted is a day where a Veteran is potentially put in dire financial straits.”

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The U.S. Department of Veterans Affairs’ (VA) disability claims backlog reached its lowest point ever, Nov 23 from its previous record low achieved May 2018.

Additionally, the percentage of the total inventory in backlog is less than 18%, surpassing the previous record from October 2016.

“I’m pleased with the Veterans Benefits Administration’s delivery on our commitment to improve customer service and provide benefits in a way that honors Veterans for their service,” said VA Secretary Robert Wilkie. “This is evidence, that VA’s unprecedented modernization efforts are yielding positive results.”

These milestones follow VA’s highest ever claims process output of 1.44 million claims completed at the end of fiscal year 2019, 4% more than its prior best-ever in 2015.

VA’s strategic target is to process disability claims within 125 days. Since Oct. 1, approximately 75% of those claims have been completed in that time frame.

Veterans who apply for disability benefits currently receive a response in an average of 107 days. This includes first-time claims from recently-discharged Veterans and older Veterans who file claims for additional benefits. Some claims take longer due to complex evidence requirements and medical examination scheduling necessary to decide the claim.

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The Department of Veterans Affairs surpassed 40,000 coronavirus cases on Monday, but the number of active cases within the health system continued to decline since hitting a peak in late July.

The total number of cases among the Veterans health system’s patients has grown by more than 10,000 in the last 19 days alone, as the virus outbreak has spiked in hot spots around America.

But Veterans Affairs officials have repeatedly emphasized in recent weeks that they are seeing progress in combating the fast-spreading illness, with hospitalization rates down and patients recovering from the virus rising.

The number of active cases among VA patients as of Monday evening was 5,574. That’s down about 10 percent from two weeks ago, when the number of active cases topped 6,200 patients.

The total is still up about 33 percent from July 1 and more than 300 percent from June 1, when the department recorded its lowest levels of active cases (about 1,400) since the first few weeks of the pandemic in March.

Thirteen VA medical center sites are currently dealing with 100 or more active coronavirus cases. They include four in Florida (Orlando, Gainesville, Miami and Tampa), three in Texas (Harlingen, San Antonio and Houston), and two in South Carolina (Columbia and Charleston).

At least 2,148 patients and 42 VA employees have died from complications related to the illness. That figure has grown at a slower rate than the active case count, but is still nearly double the total deaths recorded on June 1.

More than 5 percent of patients in VA care who contract the virus have eventually died from the illness, above the 3 percent death rate for cases among all Americans, according to the latest data released by the Centers for Disease Control and Prevention.

However, VA officials have said the mortality data for their patients “cannot be used to compare VA infection or mortality rates with the community because of differences in population risk, test availability, and follow-up.”

More than 32,500 patients in the department’s health system have recovered from the illness.

On Monday, during a White House press conference, President Donald Trump praised the department’s use of remote health care options since the start of the pandemic, allowing Veterans to continue to receive health care despite access restrictions at many sites.

“Now telehealth is a critical part of our path forward in the VA,” he said. “It is becoming a critical path, especially with our senior citizens. You don’t have to go to the doctor’s office, you don’t have to go to hospitals.”

Nationwide, about 4.6 million Americans have been infected with the coronavirus and about 155,000 have died from complications related to it.

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The VA Debt Management Center (DMC) is sending a letter this month to Veterans with benefit debts advising that due process notification letters will resume after January 1, 2021.

The November letter reads as follows:

Dear Veteran/Beneficiary,

We hope this letter finds you well. You are receiving this letter because you may have outstanding VA benefit debt(s), and we want you to be aware of actions VA will take after January 1, 2021, and your options.

To ease financial difficulties during the pandemic, the VA Debt Management Center (DMC) suspended issuing debt notification letters and suspended collection action on debts established after April 3, 2020, through January 1, 2021. DMC also offered suspensions or extended repayment plans for debts established prior to April 3, 2020.

WHAT WILL HAPPEN IN 2021

If your debt was established after April 3, 2020, DMC will issue your debt notification letter(s) starting in January 2021. If you have debt that was established prior to April 3, where collections have been suspended due to the COVID-19 pandemic, your suspension will end on January 1, 2021, and the DMC will resume withholding from your VA benefits to pay the debt effective with your February 1, 2021, benefit payment. If you do not receive VA benefits, your payment will be due to DMC by February 1, 2021.

WHAT YOU CAN DO NOW

If you expect difficulties making payments, you are not required to wait until after January 1, 2021, to request assistance. Please review the information found on our website: https://www.va.gov/debtman; or reach out to the DMC for help at https://iris.custhelp.va.gov/app/ask/ or call us at 1-800-827-0648.

We can work with you to determine your debt relief options, which may include:

• Establishing a repayment plan.
• Requesting a waiver.
• Disputing the debt.
• Submitting a compromise offer.
• Requesting a temporary hardship suspension.

WHOM TO CONTACT

• For questions about your VA benefit debt, including information on how to make voluntary repayment arrangements or request a waiver, a dispute, or a compromise offer, submit your online request at https://iris.custhelp.va.gov/app/ask/ or call 1-800-827-0648 from 6:30 a.m. to 6 p.m. CT Monday through Friday.
• If you have a question about your VA Benefits or the status of a claim, please call:
  • Education benefits – VA Education Contact Center at 1-888-442-4551.
  • Other VA benefits – VA Regional Office at 1-800-827-1000.
• For questions about your VA Health Care debt, call the Health Resource Center at 1-866-400-1238.
• If your debt was referred to the U.S. Department of the Treasury, the debt will remain under their jurisdiction. Treasury can be reached at:
  • Cross-Servicing Program at 1-888-826-3127.
  • Treasury Offset Program at 1-800-304-3107.

We are here to support you during this COVID-19 pandemic. Please follow national and local guidelines to stay healthy and safe.

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The U.S. Department of Veterans Affairs (VA) today announced the Veterans Benefits Administration (VBA) has improved procedures by incorporating an artificial intelligence (AI) solution to reduce the time it takes to process in-coming mail from 10 days to just one day.

The software reads the mail document contents and automatically routes it to VA employees working the next step of the claims process; which means faster processing of the information Veterans send to VBA in support of their claims.

“Moving past manual mail processes to automation puts the emphasis on Veterans,” said VA Secretary Robert Wilkie. “This new capability allows VA to process Veterans’ claims quickly and efficiently.”

On average VBA receives more than 550,000 pieces of mail per month related to benefits and services. The volume of mail comes from submissions by Veterans, surviving spouses, service agencies, attorneys and claims agents. This mail is often the starting point to initiate a claim or provide supportive documentation for potential benefits and services they may be eligible for; in addition to general inquires.

Visit VBA for more program information.

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Rollout of the Department of Veterans Affairs’ new electronic health records system will be delayed for an undisclosed period while VA ensures it will work within the department’s current IT framework and trains employees to use it.

A VA official confirmed the delay Tuesday after lawmakers issued a press release late Monday praising the move, saying the “worst thing VA could do is jump the gun” implementing the system, built by Missouri-based Cerner Corp.

VA Press Secretary Christina Mandreucci said the department “heard the call” of lawmakers, including House Veterans Affairs Committee ranking Republican Phil Roe of Tennessee and Rep. Jim Banks, R-Ind., ranking member of the House VA Subcommittee on Technology Modernization, who urged VA to proceed cautiously.

"VA leaders … are proceeding deliberately and thoughtfully to adhere to the project’s ten-year timeline, which calls for a rolling implementation schedule through 2027,” Mandreucci said in a statement. “After rigorous testing of our new [electronic health records system], the department will need more time to complete the system build and ensure clinicians and other users are properly trained on it.”

Initial deployment was set to begin in March at the Mann-Grandstaff VA Medical Center, Spokane, Wash., and in a briefing Monday on the fiscal 2021 proposed VA budget, senior department officials said the program was on schedule.

But same day, VA officials notified Congress that the initiative would be delayed.

Mandreucci said the system is 75 percent to 80 percent complete in regard to integration and training and a revised “go-live” schedule will be announced “in the coming weeks.”

The White House has requested $2.6 billion in new funding for the project in fiscal 2021, nearly half of that total for new equipment and infrastructure related to the records upgrades.

Roe and Banks applauded VA’s decision Monday, saying the department recognized that “more training and preparation is needed and [it is] taking the time to do get this right.”

”We hope that VA will be able to move forward with the complete Cerner system in Spokane to deliver the best possible Veteran experience, and we look forward to continuing the committee’s oversight of this project to achieve a fully interoperable health records system for the millions of men and women who have served,” they wrote in a statement.

Democrats on the committee, however, were less effusive, saying that VA had not been transparent about progress to date.

Rep. Susie Lee, a Democrat from Nevada, chairwoman of the House VA Subcommittee on Technology Modernization called for a hearing Tuesday to investigate the delay, saying Congress “needs to know we can take VA at its word.”

“As chair, I have repeatedly called for VA to be forthright about its progress, identify concerns, and notify Congress about any challenges,” Lee said in a statement. “Secretary Wilkie and I spoke this afternoon and he provided his reasoning behind the delay. While I respect the need to make this tough decision, I want to be sure that we have key action items and schedules to address these issues and roll out without harming our Veterans.”

House Veterans Affairs Committee Chairman Rep. Mark Takano a Democrat from California, said, however, that a short-term delay is “far better than rushing through.”

“VA should take the time it needs to get this $16 billion dollar implementation right, but it needs to be transparent with Congress,” Takano said in a statement.

VA chose the Pacific Northwest for initial rollout of its $16 billion system to match the Department of Defense’s electronic health records program, also built by Cerner and introduced in Washington state in 2017.

Last week, VA Secretary Robert Wilkie told reporters the department still planned to deploy the new system in March. The system is designed to be interoperable with the Department of Defense system as well as the VA’s other records systems.

“I sat down with the Secretary of Defense about a week ago to discuss where we are,” Wilkie told reporters. “This is a joint partnership with the Department of Defense. We are doing well, and Mission Act shows that this VA is capable of pulling off enormously complex programs. I expect us to do well with this venture, as we did with Mission.”

The Defense Department continues to expand its use of the platform, which it calls MHS Genesis. Last September, the system went live at four sites in the West, bringing the total number of military health facilities using it to seven.

Seven more DoD sites are expected to get the new system this June, including Nellis Air Force Base, Nevada, Fort Irwin, the Marine Corps Air Ground Combat Center, and Edwards, Beale, Los Angeles and Vandenberg Air Force bases in California.

The remaining DoD facilities are expected to switch over in the next three years.

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