Pay & Benefits Watch Pay & Benefits WatchPay & Benefits Watch
Key developments in the world of federal employee benefits: health, pay, and much more.

TRICARE Fertility Care

ARCHIVES
Shutterstock.com

The rising cost of providing health care to active-duty and retired military personnel continues to be a third-rail political issue. During the past 12 years, the cost of military health care to the government has more than doubled, but Congress does not have the appetite for raising TRICARE fees. At least one provision in the Senate’s fiscal 2013 Defense authorization bill would increase the Pentagon’s health care tab slightly.

Some service members would receive additional coverage for infertility treatments under an amendment offered to the legislation by Sen. Claire McCaskill, D-Mo. The measure would provide fertility preservation services, such as in-vitro fertilization and other types of assisted reproductive technology, to military personnel who have difficulty conceiving children because medical treatment for an illness has caused sterility.

TRICARE currently covers tests for both men and women to identify illnesses or injuries to the reproductive system that could be the cause of infertility, but the insurance does not cover “noncoital” reproductive technologies “except under special circumstances for some severely wounded warriors,” said Austin Camacho, chief of the Pentagon’s benefit information and outreach branch TRICARE management activity.

The Congressional Budget Office estimated that about 1,200 active-duty members would take advantage of the benefit and the additional coverage would increase TRICARE costs by $145 million from 2013 through 2017. Considering the Defense Department’s more than $500 billion annual budget, that’s a drop in the bucket. Still, CBO estimates the services would cost about $15,000 per user, or between $15 million and $35 million annually over the next four years (the costs would increase after the first year).

It’s another cost at a time when many lawmakers, including McCaskill, oppose raising TRICARE enrollment fees, which have stayed relatively flat since the mid-1990s. Active-duty members and their families do not pay such fees, but retired enrollees in TRICARE Prime and their dependents do.

Claiming Lanes

Federal retirement applications aren’t the only claims swimming in a backlog. The Veterans Affairs Department, also struggling to expedite disability claims, plans to launch a new processing model at 16 regional offices this summer.

The idea is to separate claims into three “lanes” once they’re submitted: express, special operations and core. Express claims involve one or two medical conditions and have all the supporting documentation to process them quickly; special ops involve special circumstances, such as financial hardship, homelessness, or serious injury and illness; and core refers to claims with more than two medical conditions or those that need additional evidence to make compensation decisions.

“The segmented-lanes approach helps increase speed and accuracy because the claims specialists become familiar with processing claims of similar complexity,” VA said in a statement.

The department processed 1 million claims during each of the past two fiscal years, but more than 1 million claims were submitted in 2011 and 2010. VA wants to reduce the backlog this year by 100,000 claims in part through the new processing model it is launching. VA’s goal is to process all claims within 125 days with 98 percent accuracy in 2015. The department provides compensation benefits to 3.4 million veterans.

“We have received an unprecedented growth in claims -- nearly 48 percent more than three years ago,” said Allison Hickey, undersecretary of benefits at VA’s Veterans Benefits Administration, testifying Wednesday on Capitol Hill.

Kellie Lunney covers federal pay and benefits issues, the budget process and financial management. After starting her career in journalism at Government Executive in 2000, she returned in 2008 after four years at sister publication National Journal writing profiles of influential Washingtonians. In 2006, she received a fellowship at the Ohio State University through the Kiplinger Public Affairs in Journalism program, where she worked on a project that looked at rebuilding affordable housing in Mississippi after Hurricane Katrina. She has appeared on C-SPAN’s Washington Journal, NPR and Feature Story News, where she participated in a weekly radio roundtable on the 2008 presidential campaign. In the late 1990s, she worked at the Housing and Urban Development Department as a career employee. She is a graduate of Colgate University.

FROM OUR SPONSORS
JOIN THE DISCUSSION
Close [ x ] More from GovExec
 
 

Thank you for subscribing to newsletters from GovExec.com.
We think these reports might interest you:

  • Sponsored by Brocade

    Best of 2016 Federal Forum eBook

    Earlier this summer, Federal and tech industry leaders convened to talk security, machine learning, network modernization, DevOps, and much more at the 2016 Federal Forum. This eBook includes a useful summary highlighting the best content shared at the 2016 Federal Forum to help agencies modernize their network infrastructure.

    Download
  • Sponsored by CDW-G

    GBC Flash Poll Series: Merger & Acquisitions

    Download this GBC Flash Poll to learn more about federal perspectives on the impact of industry consolidation.

    Download
  • Sponsored by One Identity

    One Nation Under Guard: Securing User Identities Across State and Local Government

    In 2016, the government can expect even more sophisticated threats on the horizon, making it all the more imperative that agencies enforce proper identity and access management (IAM) practices. In order to better measure the current state of IAM at the state and local level, Government Business Council (GBC) conducted an in-depth research study of state and local employees.

    Download
  • Sponsored by Aquilent

    The Next Federal Evolution of Cloud

    This GBC report explains the evolution of cloud computing in federal government, and provides an outlook for the future of the cloud in government IT.

    Download
  • Sponsored by Aquilent

    A DevOps Roadmap for the Federal Government

    This GBC Report discusses how DevOps is steadily gaining traction among some of government's leading IT developers and agencies.

    Download
  • Sponsored by LTC Partners, administrators of the Federal Long Term Care Insurance Program

    Approaching the Brink of Federal Retirement

    Approximately 10,000 baby boomers are reaching retirement age per day, and a growing number of federal employees are preparing themselves for the next chapter of their lives. Learn how to tackle the challenges that today's workforce faces in laying the groundwork for a smooth and secure retirement.

    Download
  • Sponsored by Hewlett Packard Enterprise

    Cyber Defense 101: Arming the Next Generation of Government Employees

    Read this issue brief to learn about the sector's most potent challenges in the new cyber landscape and how government organizations are building a robust, threat-aware infrastructure

    Download
  • Sponsored by Aquilent

    GBC Issue Brief: Cultivating Digital Services in the Federal Landscape

    Read this GBC issue brief to learn more about the current state of digital services in the government, and how key players are pushing enhancements towards a user-centric approach.

    Download
  • Sponsored by CDW-G

    Joint Enterprise Licensing Agreements

    Read this eBook to learn how defense agencies can achieve savings and efficiencies with an Enterprise Software Agreement.

    Download
  • Sponsored by Cloudera

    Government Forum Content Library

    Get all the essential resources needed for effective technology strategies in the federal landscape.

    Download

When you download a report, your information may be shared with the underwriters of that document.