TRICARE NEWS
(AND HEALTH RELATED NEWS/INFORMATION)

TRICARE information is intended for active duty and retired TRICARE beneficiaries of all the military services, reserves, guards, and their families.

1.  To contact TRICARE Help Desks, call the following toll-free numbers:
 
    o General TRICARE information/assistance: 1-877-874-2273
 
    o TRICARE Pharmacy: 1-877-363-6337
 
    o TRICARE For Life: 1-888-363-5433
 
2.  To obtain assistance via E-mail, contact mailto:QUESTIONS@tma.osd.mil
or mailto:TRICARE_Help@amedd.army.mil

Posted:  15 FEB 02
TRICARE Toll-Free Numbers and Web Sites

1.  National Toll Free Numbers
==============================

Senior Pharmacy Program 1.877.DOD.MEDS (1.877.363.6337)
 http://www.tricare.osd.mil/pharmacy/
 
TRICARE For Life 1.888.DOD.LIFE (1.888.363.5433)
 http://www.tricare.osd.mil/tfl/
 http://www.troa.org
 
TRICARE Prime Remote (TPR) (active duty and family members)
 1.888.DOD.CARE (1.888.363.2273)
 http://www.tricare.osd.mil/remote/
 
TRICARE Retiree Dental Plan - Deltal Dental  1.888.838.8737
 http://www.tricare.osd.mil/tricare/beneficiary/supprog.html
 http://www.ddpdelta.org/
 
TRICARE Dental Program (TDP) - United Concordia 1.800.866.8499
 http://www.tricare.osd.mil/tricare/beneficiary/supprog.html
 http://www.ucci.com/tdp/tdp.html
 
National Mail Order Pharmacy - Merck Medco 1.800.903.4680
 http://www.tricare.osd.mil/pharmacy/
 http://www.merck-medco.com
 
Defense Enrollment Eligibility Reporting Systems (DEERS) 1.800.538.9552
 http://www.tricare.osd.mil/DEERSAddress/
 
Active Duty Claims (MMSO) 1.800.876.1131
 http://navymedicine.med.navy.mil/mmso/
 
TRICARE Claims Information
http://www.tricare.osd.mil/claims/default.htm
 
2.  Regional Toll Free Numbers
==============================
 
Northeast (1)  1.888.999.5195
 http://www.tricare.osd.mil/regionalinfo/list.cfm?RegionID=1
 http://www.sierramilitary.com/
 
Mid-Atlantic (2)  1.800.931.9501
 http://www.tricare.osd.mil/regionalinfo/list.cfm?RegionID=2
 http://www.humana-military.com/Region2/home.htm
 
Southeast (3)  1.800.444.5445
 http://www.tricare.osd.mil/regionalinfo/list.cfm?RegionID=3
 http://www.humana-military.com/home.htm
 
Gulfsouth (4)  1.800.444.5445
 http://www.tricare.osd.mil/regionalinfo/list.cfm?RegionID=4
 http://www.humana-military.com/home.htm
 
Heartland (5)  1.800.941.4501
 http://www.tricare.osd.mil/regionalinfo/list.cfm?RegionID=5
 http://hmd.humana-military.com/region5/main.asp
 
Southwest (6)  1.800.406.2832
 http://www.tricare.osd.mil/regionalinfo/list.cfm?RegionID=6
 http://www.hnfs.net/bene/bw1_0_bene_welcome.asp
 
Central (7/8)  1.888.874.9378
 http://www.tricare.osd.mil/regionalinfo/list.cfm?RegionID=8
 http://www.triwest.com/
 
Southern California (9)  1.800.242.6788
 http://www.tricare.osd.mil/regionalinfo/list.cfm?RegionID=9
 http://www.hnfs.net/bene/bw1_0_bene_welcome.asp
 
Golden Gate (10)  1.800.242.6788
 http://www.tricare.osd.mil/regionalinfo/list.cfm?RegionID=10
 http://www.hnfs.net/bene/bw1_0_bene_welcome.asp
 
Northwest (11)  1.800.404.2042
 http://www.tricare.osd.mil/regionalinfo/list.cfm?RegionID=11
 http://www.hnfs.net/bene/bw1_0_bene_welcome.asp
 
TRICARE Pacific
 Alaska and Hawaii   1.800.242.6788   
 http://www.tricare.osd.mil/regionalinfo/list.cfm?RegionID=12
 http://www.hnfs.net/bene/bw1_0_bene_welcome.asp

 WESTPAC   1.888.777.8343
 http://www.tricare.osd.mil/regionalinfo/list.cfm?RegionID=15
 http://www.healthnetfederalservices.com/bene/bw1_0_bene_welcome.asp
        
Latin America & Canada  1.888.777.8343
 http://www.tricare.osd.mil/regionalinfo/list.cfm?RegionID=16

Puerto Rico & Virgin Islands  1.888.777.8343
 http://www.tricare.osd.mil/regionalinfo/list.cfm?RegionID=17
 http://rooseyroads.med.navy.mil/

Europe  1.888.777.8343
 http://www.tricare.osd.mil/regionalinfo/list.cfm?RegionID=13
 http://www.europe.tricare.osd.mil

3.  NOTE:  If you do not know which TRICARE region you're in, a map is available online at http://www.tricare.osd.mil/regionalinfo/

-----------------
SOURCE:  TRICARE Web Site at http://www.tricare.osd.mil/main/tollfree.htm

Posted:  15 FEB 02
Toll Free Numbers for Contacting the VA

Toll Free Numbers for Contacting the VA
=======================================
1.  VA Benefits: 1-800-827-1000
For information about:
    Education
    Home Loan
    Disability
    Medical Care
    Burial
    Life Insurance
    Sexual Trauma

2.  Life Insurance: 1-800-669-8477

3.  Education (GI Bill): 1-888-442-4551

4.  Health Care Benefits: 1-877-222-8387

5.  Income Verification and Means Testing: 1-800-929-8387

6.  Mammography Helpline: 1-888-492-7844

7.  Gulf War/Agent Orange Helpline: 1-800-749-8387

8.  Status of Headstones and Markers: 1-800-697-6947

9.  Telecommunications Device for the Deaf (TDD): 1-800-829-4833

10.  For health care services, contact your nearest VA medical facility.  To locate the nearest VA medical facility, go online to
http://www.va.gov/sta/guide/division.asp?divisionId=1

11.  CHAMPVA:

     by E-mail.. hac.inq@med.va.gov
     by phone... 1-800-733-8387 
     by FAX..... 1-303-331-7804 
     by mail.... VA Health Administration Center 
                 CHAMPVA
                 PO Box 65023 
                 Denver CO 80206-9023

-----------------
SOURCE:  Veterans Administration web site, http://www.va.gov and http://www.va.gov/vbs/health/

Posted: 15 FEB 02
PTSD -- Women Veterans

The October 2001 Agent Orange Review just arrived in the mail, February 5th.
"VA Studying Women Veterans Who Have PTSD"
"PTSD Common Among Women Veterans"
"Volunteers Sought for Study"
are articles on pages 4 & 5.


VA Studying Women Veterans Who Have PTSD

Many women are traumatized while serving in the military. A recent study of female veterans estimated that 60% had experiences at least one traumatic event during military service. The prevalence of serious trauma appears especially high among veterans who have served since Vietnam, who now constitute the majority of female veterans. Most often, military trauma in women involves sexual assault or rape, but other sources are physical assault, accidents, disasters, and even war-zone exposure, including medical assignments that involve exposure to seriously injured personnel.

Women also experience trauma before and after entering military service. In fact, the prevalence of sexual assault during childhood and adolescence appears to be higher in military women than in the general U.S. population.

Traumatic exposure can have profound effects on a person's well being and functioning, and may lead to the development of Post-Traumatic Stress Disorder. PTSD occurs not only in combat veterans but also in other survivors of traumatic events such as natural disasters and interpersonal or sexual violence. Among civilian adults in the U.S., the lifetime prevalence of PTSD is 5% of men and 10% in women.

A new research project, sponsored by the Department of Veterans Affairs (VA) Cooperative Studies Program, and the Department of Defense, is designed to address the needs of female veterans and active duty personnel who have PTSD. The new VA study, identified as VA Cooperative Study #494; A Randomized Clinical Trial of Cognitive-Behavioral Therapy for Women, also will test the helpfulness of exposure therapy for female veterans and active duty personnel with PTSD.

PTSD Common Among Women Veterans

PTSD is a prevalent condition among women who have military service experience. A recent population sample of active duty Navy and Marine Corps personnel found that among women, 17.4% had PTSD at some time and 8.3% had current PTSD. The VA National Vietnam Veterans Readjustment Study estimated that 26% of women who served in Vietnam had PTSD at some point since their service, and 8.5% has PTSD at the time fo their assessment in the 1980s. Current PTSD prevalence in women who served in the Gulf War is 8-10%. Prevalence is substantially higher among women who seek VA treatment for stress-related problems: one study found that 50% of those women had current PTSD.

PTSD is associated with a range of comorbid (occurring at the same time) conditions and functional difficulties, including other anxiety disorders, depression, substance abuse, psychological impairment, poor physical health, and greater service utilization. Thus, PTSD has far-reaching effects on many aspects of the military and veterans women?s lives.

A variety of drugs and phychotherapies are used for treating PTSD. Among phychotherapies, cognitive-behavioral therapy appears to be the most promising approach. One useful cognitive-behavioral technique is ?exposure,? in which a patient is guided through a vivid remembering of a traumatic even repeatedly until the patient's emotional response decreases through habituation.

Volunteers Sought for Study

The Study will enroll 384 women, who will be randomly assigned to receive either exposure therapy or therapy that focuses on current life problems. Both treatment will last 10 weeks, and the women will be followed for 6 months after the end of treatment to evaluate how PTSD and other symptoms respond to treatment.

The study represents a collaboration between the VA and the Department of Defense. Co-Chairs of the project are Paula P. Schnurr, Ph.D., and Matthew J. Freidman, M.D., Ph.D., from the VA?s National Center for PTSD and LTC Charles C. Engel, M.D., from Walter Reed Army Medical Center. The VA National Center for PTSD is located at the Veterans Affairs Medical Center in White River Junction, VT, where Dr. Freidman is the Executive Director and Dr. Schnurr is the Deputy Director. The biostatistician is Ken James, Ph.D., and the study is coordinated by the VACSPCC at Palo Alto, CA.

Women will be enrolled at 11 VA sites around the country: Albuquerque, Atlanta, Baltimore, Bay Pines/Tampa, Boston, Cincinnati, Cleveland, Dallas Denver, New Orleans, and Portland. There also will be a Department of Defense site in Washington, DC. Women who are interested in participating in the trial may contact the project at : csp494@nmbus.dartmouth.edu for referral to participating medical centers.

The above article was prepared and submitted by Dr. Schnurr, identified above, especially for the "Review."


Posted:  15 FEB 02
Force Health Protection and DOD Population Health and Health Promotion Conferencees

PUBLIC AFFAIRS OFFICE
U.S. ARMY CENTER FOR HEALTH PROMOTION AND PREVENTIVE MEDICINE
ABERDEEN PROVING GROUND, MARYLAND 21010-5403

For more information, call 410-436-2088/800-222-9698/FAX 410-436-4784 (or contact Ms. Jane Gervasoni at Jane.Gervasoni@APG.AMEDD.ARMY.MIL )
 
PR 05-02
12 February 2002

ADAPTING TO A CHANGING GLOBAL ENVIRONMENT
Joint Conferences to be Held in Baltimore

BY:  Evelyn B. Riley
        
The Fifth Annual Force Health Protection Conference and the Second Annual DOD Population Health and Health Promotion Conference will be held jointly 9 - 16 August 2002, at the Baltimore Convention Center, at the Inner Harbor in MD.  The theme for the joint conferences is "Adapting to a Changing Global Environment".  The U.S. Army Center for Health Promotion and Preventive Medicine, Aberdeen Proving Ground, MD will host both conferences.

The conferences will provide the multidisciplinary military and civilian force  health protection community with the opportunity to increase knowledge and awareness of current issues, attend short courses for professional development, mentor, network, and earn CEUs or CMEs.  The first three days, 9 - 11 August, will be skills training workshops designed primarily for, but not limited to, the DOD Conference attendees.  The core conference, beginning on 12 August, will include both plenary and breakout sessions designed to provide an exchange of information that has a wide application within the DOD community in the areas of homeland security, environmental health, population health, complimentary and alternative medicine, behavioral health, veterinary medicine, medical research and development, injury prevention, nutrition, and spiritual health.  In addition, service-specific breakout sessions will be offered. Topics and lessons learned relating to the events of 11 September 2001 will be presented.  The DOD
Conference and the three tracks that make up the FHP Conference are described below:

The Second Annual DOD Population Health and Health Promotion Conference - designed to unite the population health and health promotion specialties in an integrated environment that will provide scientific and technical training necessary for the diverse specialties; allow participants to address relevant and significant force health protection issues; and provide mentoring and networking opportunities.  It will begin with three days of pre-conference Skills Training Workshops focused primarily on humanitarian assistance, risk communication, behavioral health - post deployment issues, tobacco cessation, dental health promotion, and HIV/STD.

Life Sciences Track - the technical aspects of prevention/detection of environmental, occupational, and disease threats to the health and performance
of DOD personnel.  This track will include research and development in support of the soldier, toxicology, and veterinary services.

Clinical Sciences Track - the science and delivery of preventive medicine services.  Clinical and general preventive services to include immunization,
occupational medicine services, hearing conservation, vision conservation, and behavioral health and associated services.

Environmental Sciences Track - topics related to identifying, assessing and providing recommendations for protecting soldier health.  This includes
environmental health topics such as industrial hygiene, food and water sanitation, medical surveillance, entomological services, health physics,
environmental noise, field sanitation, and disease prevention.

Participants are invited to prepare and display technical posters that will be judged for content and aesthetics by a panel of subject matter experts.  The winners will be announced on the final day of the conference.  USACHPPM will judge all posters, selecting the ten best submissions for partial central funding of travel and per diem. 

Technical presentations are also being solicited for the conference.  Both military and civilian vendors are encouraged to exhibit during the conference. 
Information on the call for papers and the exhibitor prospectus will be found on the FHP website at:  http://chppm-www.apgea.army.mil/fhp
        
The website will be available for registration in March.  POC:  LTC Roxanne E. Baumgartner, Director, (DSN) 584-7387/(Commercial) 410-436-7387 or Ms. Jane Gervasoni, (DSN) 584-5091/(Commercial) 410-436-5091.

===============
SOURCE:  U.S. Army Center for Health Promotion and Preventive Medicine (USACHPPM), Ms. Jane Gervasoni, Jane.Gervasoni@APG.AMEDD.ARMY.MIL , (DSN) 584-5091/(Commercial) 410-436-5091.

Posted:  15 FEB 02
DoD, TRICARE Play Big Roles in Homeland Security Planning

By Gerry J. Gilmore
American Forces Press Service

WASHINGTON, Feb. 12, 2002 -- TRICARE personnel and assets are playing a big part in DoD's preparedness plans in support of other federal, state and local emergency medical response teams in dealing with possible terrorist acts committed on American soil, a senior DoD official said here
today.

Ellen P. Embrey, DoD's new deputy assistant secretary of defense for force health protection and readiness, outlined the president's homeland security goals and plans and steps participants of the annual TRICARE conference here can take to support them. She advises the assistant secretary of
defense for health affairs on all DoD medical readiness and deployment medicine policies and activities, and national medical disaster support.

"As the direct provider of beneficiary care and a respected military health professional in your local community, you will be asked to participate in local, city, county or statewide disaster and terrorism emergency management contingency planning and exercise activities," she said.

Former Pennsylvania Gov. Tom Ridge, director of the Office of Homeland Security, coordinates and implements national homeland security strategy, Embrey noted.

In his fiscal 2003 budget request, she said, President Bush called for $38 billion to support homeland security efforts contained in four key objectives: support first responders first; defend against bio-terrorism; secure America's borders; and use 21st century technology to secure the homeland.

Embrey told conference attendees the first two objectives are relevant to them and DoD. First responders -- local police, firefighters and civilian and military emergency medical professionals -- "have the greatest potential to save lives and limit casualties after a terrorist attack," she explained.

On the second objective, current homeland security plans recognize that bio-terrorism defense will require the nation to invest significantly in its healthcare system, "of which you are a critical part," Embrey told attendees.

Almost $2 billion is being proposed to bolster state and local public healthcare systems, Embrey said, to manage both contagious and noncontagious diseases, to expand healthcare surge capacities, to upgrade public health laboratory capabilities, and to provide training for medical personnel.

Funds are also provided, she added, to support mutual regional medical aid agreements and communications networks linking acute care assets, including military, with local communities' public health organizations.

Embrey said the military stands ready to assist. Its emergency response capabilities include the Army's Chemical/Biological Rapid Response Team, Technical Escort Units, the Marine Corps' Chemical/Biological Ready Response Force, and the National Guard's Weapons of Mass Destruction
Civil Support teams.

The president and Congress, she said, have also taken steps to create national supplies of smallpox vaccine and an antibiotics stockpile to treat potential anthrax victims.

"Our success or our failure as a nation to respond to bio-terrorism will depend in large measure on the quality and effectiveness of our diagnostic tests, vaccines and therapeutic drugs," Embrey noted.

She said military commanders depend on TRICARE healthcare professionals' plans and preparations for possible bio-terrorism attacks -- and "don't underestimate their need to rely on you," she told conferees.

"The chemical and biological agent awareness training, personal protective equipment stocks, medical supplies needed to support chemical/biological wartime support operations are (what) your installation commander wants you to have ready in case of a potential attack," she added.  Embrey said TRICARE personnel also could be called to help in local relief efforts.

Related Site of Interest:
TRICARE Web Site at http://www.tricare.osd/mil

Posted:  8 FEB 02

TRICARE For Life, a new health benefit extended by the Department of Defense (DoD) to approximately 1.5 million beneficiaries aged 65 and over, provides pharmacy benefits and TRICARE coverage secondary to Medicare. More than 3.1 million health care claims have been paid since the program started in October 2001. Payment for some health care claims, however, was initially denied by TRICARE for individuals recorded as being ineligible for TRICARE in the Defense Enrollment Eligibility Records System (DEERS). In many cases, these denials were based on persons who have "expired eligibility" in DEERS, meaning that their eligibility has not been re-verified in the last four years as required by DoD policy.

DoD announced today that TRICARE claims will be paid for a limited time for TRICARE For Life (TFL) beneficiaries with "expired eligibility" in DEERS. Claims filed beginning October 1, 2001 but denied due to "expired eligibility" will be automatically reprocessed. Neither beneficiaries nor providers will be required to resubmit the denied claims.

Beneficiaries are required, however, to ensure their eligibility is updated in DEERS by August 1, 2002.

"We want to ensure that our beneficiaries, some of whom are re-entering the Military Health System, and using TRICARE for the first time, have the best possible experience and receive their rightful benefits. We will do everything we can to overcome initial difficulties that may arise," explained Dr. William Winkenwerder, Assistant Secretary of Defense for Health Affairs. "We understand that some of our elderly beneficiaries who have not used military benefits in many years may not have kept their military eligibility files updated or they may be unable to make contact with the military." 

"We are working with DoD leaders who manage the DEERS system and with The Military Coalition and the National Military and Veterans Alliance to redouble our outreach to these beneficiaries," said Winkenwerder.

After August 1, 2002, claims received for beneficiaries with expired eligibility will be denied until the eligibility information is updated.

Mr. Charles Abell, Assistant Secretary of Defense for Force Management Policy is working with the Personnel community on the Department's outreach effort. "We will help our beneficiaries understand how to update their eligibility information," said Abell. "And we are exploring how we can make this process easier for those unable to travel." 

To learn how to update or re-verify eligibility for those persons 65 and older, beneficiaries who have received an Explanation of Benefits (EOB) stating that they need to get a new military ID card should call 1-800-361-2620.

For more information on TRICARE for Life, interested persons can visit the TRICARE Web site at www.tricare.osd.mil, or call the TRICARE Information Center, toll-free, at 1-877-363-5433 (1-877-DOD-LIFE).

---------
SOURCE:  TRICARE News Release, http://www.tricare.osd.mil

Posted:  8 FEB 02
New Deployment Health Care Guideline Announced

NEWS RELEASE from the United States Department of Defense
 

No. 059-02

(703)695-0192(media)
IMMEDIATE RELEASE
February 7, 2002
(703)697-5737(public/industry)

NEW DEPLOYMENT HEALTH CARE GUIDELINE ANNOUNCED
Assistant Secretary of Defense for Health Affairs Dr. William Winkenwerder announced today the implementation of a new clinical guideline for use by military and Veterans Affairs physicians in caring for the unique needs of military personnel and their families.  Informed by a decade of lessons learned from the Gulf War, military and Veterans Affairs (VA) physicians are now better prepared to provide care for military personnel returning from Afghanistan and other deployments.  The cornerstone of this new health initiative is the Clinical Practice Guideline on Post-Deployment Health Evaluation and Management: http://www.pdhealth.mil/PDHEM/frameset.htm developed jointly by the Department of Defense and the Department of
Veterans Affairs.  Service members and their families will begin to experience the benefits of this guideline starting in early March.

"Keeping our active duty members healthy is an important aspect of force health protection.  This guideline assists physicians and patients by focusing on specific health concerns that may be deployment related," offered Winkenwerder.

The development of the guideline represents a two-year multidisciplinary effort involving experts from the VA, Army, Navy, Air Force,  and DoD.  Specialty experts included clergy, social workers, nurses, toxicologists, epidemiologists, risk communications specialists, psychiatrists, and family
practitioners.  Health care providers at Fort Bragg, N.C., Camp LeJeune, N.C., and McGuire Air Force Base, N.J., were part of a guideline demonstration project.

"This guideline, which provides a structure to assess and manage post-deployment health, is primarily about improving the medical care for post-deployment concerns among all our patients, whether an active duty servicemember, a spouse, a child, a veteran or reservist," explained Army Lt. Col. Charles Engel, a collaborator in the development of the guideline.  Engel directs the Deployment Health Clinical Center, a DoD center based at
Walter Reed Army Medical Center, Washington, D.C.  Since the Gulf War, "opportunities for change and improvement have emerged as a result of lessons learned through the implementation of the DoD's Comprehensive Clinical Evaluation Program and the VA's Gulf War Registry, research studies, and feedback from veterans," said Engel, a practicing psychiatrist and a Gulf War veteran.

        "The guideline," said Mark Brown, Ph.D., director of the VA's Environmental Agents Service, "was developed in response to the health care needs of Gulf War veterans with difficult to diagnose yet sometimes debilitating deployment-related symptoms."  Brown added, "In the long-run the Clinical Practice Guideline will give VA primary care providers the tools needed to diagnose and treat veterans returning from
combat and peace-keeping missions abroad."

The guideline also applies to individuals who were not deployed, but who link their concerns to a military deployment, for example, family members of recently deployed active duty personnel.  The guideline also will offer physicians support in monitoring the long-term health of patients with deployment health issues and provide patients with the education they need to take an active role in their health care delivery.

"In the new approach we will disseminate up-to-date information to all clinicians about all deployments and essentially make them more knowledgeable about deployment health issues," said Engel whose Deployment Health Clinical Center will be responsible for monitoring the improvement of post-deployment care in primary care settings and insuring improvements in the quality of data gathered.  The major route for disseminating this information is the Center's new Web site, PDHealth.mil, located at http://www.PDHealth.mil .  The guideline, as well as
the proceedings of a satellite broadcast about the guideline, may be found on this Web site.

[Web version: http://www.defenselink.mil/news/Feb2002/b02072002_bt059-02.html

Posted:  8 FEB 02
Tricare Basic and Advance Student Course (TBASCO) - 2002

For information/assistance concerning the below listed course, please contact Mr Theodore Moore, Course Administrator, at Theodore.Moore@tma.osd.mil or (DSN) 926-3744 or (303) 676-3744.
--------------------

Training conducted by Military Liaison Division

The TRICARE Basic and Advance Student Course (TBASCO) is sponsored by the Military Liaison Division (MLD). The course is open to anyone who wishes to attend. The audience typically includes representation from all services, including Active, Reserve, and Guard personnel, as well as retirees, Health Benefits Advisors/ Beneficiary Counseling and Assistance Coordinators, other hospital personnel, contractors affiliated with the federal government, and beneficiaries. There is no cost for the course, in terms of registration, etc.

The course will being held at the Double Tree Hotel, located at 32nd Street and Quebec, Denver, Colorado (about 6 miles East of downtown Denver). Hotel telephone # is (303) 321-3333.

Registration for the course is done online through the TRICARE web site: www.tricare.osd.mil. Click on "Training" on the pull-down menu, and then
select TRICARE Basic & Advanced Student Course (TBASCO).

Following is a list of training dates. Any necessary changes to training dates will be posted on the web site:

February 26-28,2002 ..... Basic Course only

April 2-4, 2002 ......... Basic Course only

May 14-17, 2002 ......... Basic and Advance Course

August 13-15,2002 ....... Basic Course only

September 24-26, 2002 ... Basic Course only

November 5-7,2002 ....... Basic Course only

December 10-13, 2002 .... Basic and Advance Course

For additional information contact Theodore.Moore@tma.osd.mil  Course Administrator, at (DSN) 926-3744 or (303) 676-3744.

Posted:  8 FEB 02
Clark: TRICARE Delivers on Promise of Quality Healthcare

By Gerry J. Gilmore
American Forces Press Service

WASHINGTON, Feb. 4, 2002 ­- Young service members expect military leaders to issue equipment and orders, and to pay attention to their quality-of-life concerns, the chief of naval operations said here today.

Adm. Vernon Clark, keynote speaker at the annual TRICARE conference being held Feb. 4-7 in a downtown hotel, said today's troops want fair pay, good housing -- and quality medical care. That last item, he told hundreds of military and civilian healthcare professionals, is a "covenant," a
promise, made between leaders and the rank-and-file.

In that respect, TRICARE, the military's healthcare system, has made "truly, truly remarkable" gains in the past few years, Clark noted. TRICARE health providers are "seeing to it that this institution keeps its promise," he said.

"I want you to know that I appreciate what you're doing," he told his audience.

The quality healthcare and customer service provided by TRICARE is "one of the best-kept secrets out in the (healthcare) industry," the admiral noted.

Clark acknowledged the system once had negative issues, such as patient access, that have since been fixed. The admiral noted that the master chief petty officer of the Navy recently reported to him: "We're not hearing much (bad) about TRICARE these days."

Now is not the time to rest upon laurels, Clark noted, adding that TRICARE needs to be made "as effective and efficient as we can."

Related Site of Interest:
TRICARE Web site at http://www.tricare.osd.mil/

Posted:  1 FEB 02
Exercise is Good -- As Long As You Go About It Intelligently

Special to the American Forces Press Service

WASHINGTON, Jan. 31, 2002 -- Innovations in equipment for the home and office have made quick work of chores. More and more of our waking hours are spent sitting, in front of a computer, in our cars commuting to and from work, and shuttling our families to and fro. While our brains may get a workout, unfortunately our bodies are not.

"Our bodies truly prefer to be in a balanced state, a balance between activity and rest, calorie intake and calorie expenditure, stress and relaxation," said Karen Friedman, a physical therapist with the Deployment Health Clinical Center at Walter Reed Army Medical Center in Washington. "When a person experiences too little exercise, many complications can occur."

Complications can include loss of flexibility, muscle mass strength, bone density, endurance and weight gain; activity intolerance; stored stress; poor sleep, cardiac concerns, elevated blood pressure, and more. On the other hand, she said, a well-planned and consistent exercise program can
positively impact on all of these concerns.

When we talk about exercise as part of a healthy lifestyle, Friedman said, we are speaking of making significant long- term changes in daily habits. A healthy lifestyle is not a hobby that you do whenever you feel like it. It involves making a commitment to look better, feel better and, in
turn, perform our jobs and life roles more effectively.

For most of us, exercise does not happen unplanned.  Implementing and maintaining a lifelong exercise program involves commitment and strategy. Two key strategies in adopting an exercise routine are to make it realistic and enjoyable.

"Exercise is beneficial for everyone. Our military personnel are in a culture that encourages physical fitness as part of daily routine and readiness requirements, Friedman said. "Civilians may also be in a climate that fosters a healthy way of life, but too often members of both groups find themselves with too little time and too much to do and no time to exercise."

A balanced exercise program, she continued, contains stretching for flexibility, cardiovascular activity to increase endurance, strengthening exercises to increase muscle mass and bone density, and variety to avoid repetitive stress injuries and boredom. Try to exercise 30 to 40 minutes at least three times a week, she recommended.

She discussed a sample program for five exercise sessions a week. Try three sessions of cardiovascular exercise followed by stretching, she said, and two days of strength training with either machines or free weights followed by stretching.

Good choices among cardiovascular activities, she suggested, include walking or running on a treadmill or track; bicycling on a regular or stationary bike; swimming or water walking; and using cross-training, stair climbing and rowing machines.

Friedman shared some thoughts for beginners and veterans alike:

Set a comfortable level for the first few exercise sessions. Too many people mistakenly start so ambitiously ("no pain, no gain") that they become sore and discouraged. Then they quit. If you haven't exercised for a while, a 15-minute neighborhood walk is a good start.

Begin your exercise session with a warm-up and end with a cool-down. Follow up your exercise with stretching to help ward off soreness and to increase your flexibility.

Slow, gentle stretching exercises are more effective than fast or abrupt movements. Stretching should not cause pain. Never bounce when you stretch.
Dress appropriately. Wear loose, comfortable clothing in light layers that you can remove as you warm up.

Wear the right shoes. Knee, hip and back problems can occur if the shoes don't support your feet properly or they're worn out. Also, orthopedic problems in your legs or feet may require medical treatment or special shoe fittings called orthotics.

Some people shy from weight training because they don't want to "bulk up." Friedman said the key to gaining strength but not large muscle masses is to do more repetitions (two or three sets of 10 "reps") using light  weights.

Exercise when you're most geared up for it. For instance, don't do mornings if you're the kind of person who needs a coffee transfusion to open your eyes. Try not to exercise after dinner, because raising your metabolism when your body is trying to wind down for sleep invites insomnia.

Find out what motivates you to stick with your program. One person might need company and encouragement while another prefers being alone to decompress and ponder.

Get a medical check-up before starting an exercise program, and especially if you've had a recent or current health problem.

Learn proper technique. Exercises done improperly won't give you the results you want, but they will put you at risk for injury.

"Exercise is good for everyone as long as you go about it intelligently," she said. "If you are already fit, think about adding variety to your workout. If you have not been exercising but want to start, be patient, be realistic in setting goals.

"Whatever you do, select activities you enjoy," Friedman insisted. "You will not stick with a program you hate."

(From the Office of the Assistant Secretary of Defense for Health Affairs.)

Posted:  1 FEB 02
Post-Deployment Health a DoD Priority

By Sgt. 1st Class Kathleen T. Rhem, USA
American Forces Press Service

WASHINGTON, Jan. 30, 2002 -- DoD officials believe caring for service members after a deployment should be a national priority. They've taken the lessons learned since the Gulf War and devised a set of guidelines for healthcare professionals to care for service members with deployment-
related health concerns.

Beginning March 1, healthcare providers will ask service members who seek medical care if their visit is related to concerns stemming from a deployment.

"We're not necessarily asking patients to make a diagnostic call and tell us whether their disease or ailment is caused by that deployment," said Army Lt. Col. (Dr.) Charles Engel, "but is that part of the concern that's driving their care that day?"

Engel is the director of DoD's Deployment Health Clinical Center at Walter Reed Army Medical Center here. He also serves as the DoD consultant for the new clinical practice guidelines.

If the service member answers, "yes," the new guidelines require the provider to take certain steps, including a specific evaluation and arrange follow-up visits. Engel said patients receiving routine check-ups or wellness visits would not be asked the deployment question.

After the 1990-1991 Gulf War, DoD realized veterans were suffering from unexplained health problems, typified by fatigue, diffuse pain, and sleep and memory problems, Engel explained.

He said DoD officials have come to realize deployment-related health conditions may not show up during or immediately after a deployment.

"A certain proportion of people return (from deployments with) valid and real physical symptoms, and unfortunately diagnostic testing doesn't give us the exact answer as to what their disease is or ailment is," Engel said. "And what we have found after the Gulf War is that even 10 years
later, the best science doesn't give us a discreet answer as to what exposure on the battlefield may be responsible for this."

However, he said, DoD medical professionals are trying to do a better job of acknowledging patients' concerns than has been done in the past. That's where the Clinical Practice Guideline for Post-Deployment Health Evaluation and Management comes in.

"Part of what the guideline does is essentially teach doctors how to meet and greet service members returning from a hazardous workplace with valid physical concerns and address those concerns in an expeditious way -- the sort of way that they're entitled to after having served their
country and made important sacrifices," Engel said.

He said this helps patients trust their healthcare providers, which helps clinicians provide better care.

"A big part of the guideline is informing providers as to what sorts of tests that they should run, but I'd say an even bigger part of the guideline is helping clinicians to recognize that there are strategies they can use to embrace the returning veterans' health concerns," Engel said.

The guidelines don't contain a strict definition of "deployment." Engel explained there are countless situations in which military service members might
experience hazardous exposures -- be they psychological, industrial or environmental.

"This is an evaluation for people who've been to what essentially amounts to a hazardous workplace -- a deployment of some sort -- in service to their country," he said. Engel said the team developing the guidelines didn't want to use a strict definition of deployment, because that
might exclude people from being treated properly under the guidelines.

"It becomes a way that many veterans feel like they're being cut out of care rather than brought into it," Engel said. "If the person relates their health concern to a deployment, however improbable the healthcare provider might think that is, they are cared for under this guideline."

For more information on post-deployment healthcare, visit http://www.pdhealth.mil/

Posted:  2 FEB 02
CHAMPVA OnLine News Registration

As of Monday, January 28, the Department of Veterans Affairs Health Administration Center (HAC) web site at http://www.va.gov/hac will have a link that will allow CHAMPVA beneficiaries and other interested personnel to automatically subscribe to the HAC mailing list.

The HAC mailing list is used to distributes updates to CHAMPVA policies and  programs.  It is also used to send out beneficiary and provider newsletters.

If you (or someone you know) are interested in getting on the HAC mailing list, please visit http://www.va.gov/hac on or after 28 January to do so.

Please report web page and/or mailing list problems, questions, comments, etc., to Glenn.Johnson@med.va.gov

--------------
SOURCE: Public Affairs Officer/EEO Manager, Public Affairs Officer/EEO Manager
Department of Veterans Affairs

Posted:  1 FEB 02
TRICARE Fiscal Year Catastrophic Cap Reduced for Retirees, Their Family Members and Survivors

TRICARE Fiscal Year Catastrophic Cap Reduced For Retirees, Their Family Members
And Survivors 

January 25, 2002
No. 02-02

The TRICARE fiscal year "catastrophic cap" has been reduced from $7,500 to $3,000 for uniformed services retirees, their family members and survivors. The cap is the maximum amount of out-of-pocket costs these beneficiaries are required to pay for medical care during a fiscal year (Oct. 1 through Sept. 30).

For active duty family members, the catastrophic cap remains $1,000 per fiscal year.

The catastrophic cap reduction is retroactive to Oct. 1, 2000. Retirees, their family members and survivors who have paid more than $3,000 out-of-pocket for TRICARE-covered services are eligible for reimbursement. The managed care support contractors (MCSC's) will search their files and identify beneficiaries due refunds.

Beneficiaries who have saved their receipts and choose to initiate a request for reimbursement, may do so by contacting their regional claims processor for guidance on where to submit their receipts and claims.

It is not necessary for beneficiaries to resubmit claims already paid by TRICARE to qualify for reimbursement of the amount paid over the catastrophic cap.

For retirees, their family members and survivors enrolled in TRICARE Prime, there is an enrollment year cap. The enrollment year cap begins on the
anniversary date of enrollment in TRICARE Prime, and applies to all enrollees.  Catastrophic caps, both fiscal year and enrollment year combined, will not exceed $3,000 in a given 12-month period for retirees, their family members and survivors, and $1,000 for family members of active duty members.  Once the catastrophic cap and enrollment year cap (combined) are met by TRICARE Prime enrollees, TRICARE will pay up to the TRICARE allowable amount for all covered services (excluding point-of-service charges which do not count toward the catastrophic cap).

For beneficiaries who are not enrolled in TRICARE Prime, TRICARE will pay up to the TRICARE allowable amount for all covered services for the remainder of the fiscal year after the fiscal year cap is met.

Retirees, family members, and survivors remain responsible for the cost of all services and treatments received which are not TRICARE covered benefits.

Some beneficiaries mistakenly believe that the $3,000 catastrophic cap is the ceiling on the amount that TRICARE will cover for a family during any given year, however the opposite is true. The cap will protect retirees, their family members and survivors from paying more than $3,000 out-of pocket for medical care.

For additional information on catastrophic cap reduction, beneficiaries are encouraged to contact the nearest TRICARE service center or military treatment facility beneficiary counseling and assistance coordinators for assistance. TRICARE benefit information is also available on the Military Health System/TRICARE Web site at http://www.tricare.osd.mil , or by calling 1-888-DoD-LIFE (1-888-363-5433).

--End --

NOTES FROM POSTMASTER: 

1.  For location of the TRICARE Service Center that supports your area, please go online to http://www.tricare.osd.mil/tricareservicecenters/default.cfm

2.  For telephone number, E-mail address, etc., of the TRICARE Beneficiary Counseling and Assistance Coordinator (BCAC) assigned to your area, please go to http://www.tricare.osd.mil/tricare/beneficiary/BCACDirectory.htm

Posted:  1 FEB 02
New Parenting Booklet Puts Decades of Research Into Easy-to-Read Guide

"Adventures in Parenting: How Responding, Preventing, Monitoring, Mentoring, and Modeling Can Help You Be a Successful Parent" highlights many of the toughest challenges that parents face in rearing happy and healthy children and suggests ways to become a more effective, more consistent, and more attentive parent.

This new booklet offers strategies on parenting practices that are based on scientific research that can be used by parents and guardians of children of any age.  It also includes stories of how some parents have incorporated these strategies into their own day-to-day parenting activities, as well as insights from parenting experts.

"Adventures in Parenting" is available free-of-charge by calling the National Institute of Child Health and Human Development (NICHD) Information Resource Center at 1-800-370-2943.  It also is available online at http://www.nichd.nih.gov/publications/pubs/parenting/index.cfm

NOTE:  If you have problems getting the booklet from the above web site, please contact NICHDClearinghouse@mail.nih.gov

--------------------
SOURCE:  healthfinder® web page at http://www.healthfinder.gov/

healthfinder® is a free Web guide to reliable health information, developed by the U.S. Department of Health and Human Services.  Each month, we choose a few exciting new resources and announce them through the healthfinder-l listserv.

The Web address for healthfinder® is www.healthfinder.gov.  If you are new to the site, please take a minute to visit our page for first time users at
http://www.healthfinder.gov/help/firstvisit.htm.

Please review selection guidelines at http://www.healthfinder.gov/aboutus/selection.htm if you have any questions about the type of resources that healthfinder® will consider for an announcement.  Please note: As a U.S. government Web site, healthfinder® does not accept advertising or endorse any commercial products or services.

Posted:  1 FEB 02
Scams Target Veterans for Identity Theft

NOTE:  Below listed message isn't exactly health related.  It's being provided  for the information of the many retired and soon-to-be retired members on this mailing list -- Postmaster
------
by Staff Sgt. Marcia Triggs

        WASHINGTON (Army News Service, Jan. 22, 2002) - An e-mail circulating about a retiree who had his identity stolen after filing separation papers at a county courthouse is no urban legend, according to Transition Center officials.

        Soldiers separating from the military are now being advised to ignore  the old recommendation to file their Department of Defense Form 214 (Military Discharge) with their local county courthouse. Instead, transition counselors  are advising soldiers to safeguard their personal information to guard against credit fraud, said Deborah Snider, Transition Center personnel analyst at the  U.S. Total Army Personnel Command.

        Between 600,000 to 700,000 cases of identity theft were reported by the Federal Trade Commission in 2000. Identity theft is the fastest growing crime today, according to the FTC, and many victims don't find out that their personal information has been stolen until they are trying to buy a house or get a loan.

        "I don't think anyone ever thought about this happening, which is the reason there are no provisions to 'unfile' records," Snider said. "This is a
serious problem, and soldiers are a prime target because everything is tied to the soldiers' Social Security number."

        The victims of identity theft suffer tremendously because the burden of  proof is on them, Snider said. It's hard to believe that a person's life could
be destroyed by this, she said, but it happens.

        A Navy retiree learned that someone had stolen his personal information and established credit in his name when he received a phone call from a clerk at American Express saying that someone was trying to cash a $9,000 check in his name made out to a Muslim or Arabic-sounding name.

        The clerk was suspicious and called the retiree because the address she had on file for him did not match the address on the check. After the retiree's case was investigated, he found out that a lawyer stole his identity. The  lawyer also had a laptop with several thousand military names, Social Security numbers and other information on it. The common link between the veterans on  the list was that they had filed their DD 214s with their county courthouse.

         "Someone stole my identity, now I feel I am no longer me," said a  victim of identity theft. "I reside in the pocket of a felon who can see that
she is allowed to steal me without penalty. She carries me casually, and each  time she pulls me out a small piece of me falls away."

        To help guard against identity theft the Transition Center is no longer placing Social Security numbers on discharge and retirement certificates,
Snider said. Anything that might be hung for display will not have a soldier's  Social Security number on it.

        When soldiers separate from active duty, Snider said the most vital  document they receive is the DD 214. It contains their Social Security number and birth date. In the past, soldiers were advised to file the form with their  local courthouse to ensure that they would always be able to get a certified copy. They need a certified copy to receive any Veterans Administration  benefits.

        Once the DD 214 is filed at a local county courthouse, however, it becomes a public record. Some courthouses have put this information online, and even more plan to do so in the future, Snider said.

        "Our recommendation is to safeguard the form as you would any vital papers such as a will, marriage license or insurance papers," Snider said. "A safe deposit box would be a good investment."

        Forty-six states now have identity theft laws, up from just three in 1996, according to the Federal Trade Commission. And many state lawmakers are considering toughening laws already on the books.

        Under a new Montana law that took affect in October, the maximum  penalty for identity theft involving more than $1,000 in gains is a $10,000
fine and 10 years in jail. In Missouri, identity theft is punishable by up to six months in jail for the first offense; up to one year in jail for the second
offense; and one to five years imprisonment for the third or subsequent offense.

 Link to original news item:
  http://www.dtic.mil/armylink/news/Jan2002/a20020122dd214.html

Posted:  1 FEB 02
'Silent Disease' Plagues Millions

by Richard Zowie
12th Flying Training Wing Public Affairs

01/16/01 - RANDOLPH AIR FORCE BASE, Texas (AFPN) -- It is a painless, chronic disease that currently plagues about 3 million Americans. Half of those with this disease, which has no known cure, do not even know they have it.

This disease, glaucoma, is also known as the "silent disease" since it slowly deprives a person of sight without any noticeable signs.

Glaucoma is the second leading cause of blindness in the United States and the leading cause of preventable blindness, Glaucoma Research Foundation officials said. About 120,000 Americans are blind because of glaucoma.

Blacks suffer glaucoma six to eight times more frequently than Caucasians. Glaucoma is also the leading cause of blindness among blacks, including
baseball star, Kirby Puckett, officials said.

Glaucoma is a group of diseases that limit or eliminate vision by causing damage to the optic nerve. This nerve carries images from the eye to the brain.
The most common form of glaucoma is primary open angle glaucoma.

With this disorder, the eye's drainage canals become clogged and cannot properly drain. As a result, the intraocular pressure within the eye rises. A
person suffering from this form of glaucoma will eventually lose their eyesight if the problem is not diagnosed or detected.

Glaucoma does not initially affect a person's color or fine vision, said Lt. Col. (Dr.) Greg Young, Randolph Clinic's optometry flight commander.

People with 20/20 or even 20/15 vision could still have glaucoma, he said. "We highly recommend that at-risk people have glaucoma exams more often than others," Young said. "At-risk people include African-Americans, people over 40  and those with a family history of glaucoma. If we target those who are high-risk, we can detect and treat it earlier. These are the people we want to screen for glaucoma every year."

If a medical screening detects glaucoma, patients are given eye drops or referred for more specialized treatment.

Eye drops are used for patients with mild cases of glaucoma, Young said. The drops work to decrease a person's intraocular pressure low enough to prevent damage to the eye.

"Usually, through an assortment or a combination of the drops, you can get the required effect," he said.

Young encourages people in at-risk groups to have eye exams every year. For people not in risk groups, he recommends an eye exam every two to three years.

"Bottom line, it's important that detection and prevention come before intervention and treatment," he said.

There are some things people can do to keep pressures low and damage to a minimum, Young said. Studies have shown that long distance runners have lowered their pressures significantly. Also, keeping the optic nerve nourished with a healthy blood supply can be accomplished through regular exercise along with eating a well-balanced diet or taking multivitamins.

For more information on glaucoma, people should call or visit their optometry clinic. (Courtesy of Air Education and Training Command News Service)

--------------------
SOURCE:  USAF web site at http://www.af.mil/news/Jan2002/n20020116_0070.shtml

Posted:  1 FEB 02
Advance Medical Directives

It is the right of every person to have an "advance medical directive." The following guidance is provided to help military beneficiaries decide if the
choice of an advanced medical directive is in their best interest.

An advanced medical directive is a written document that sets forth a person's desires concerning what medical care he will receive should he become incapable of making healthcare decisions on his own, or that gives another person the legal authority to make healthcare decisions on behalf of a person who has become mentally incapacitated.

Living wills and durable healthcare powers of attorney are both advanced medical directives. The advanced medical directive is often simply referred to as an advance directive.

A living will is a written document that sets forth a person's desires concerning the medical care that he will receive should he become terminally
ill or when his death is imminent.

A living will may specify which medical treatments should be provided, as well as which medical treatments should not.
 

A durable healthcare power of attorney is a written document which gives  another person (known as the agent, proxy or surrogate) legal authority to make healthcare decisions. This document is valid for any period of mental  incapacitation.


All competent adult patients have the moral and legal right to participate in their medical treatment decisions and to refuse medical treatment even in life-saving or life-sustaining situations. This includes the right to prepare advanced medical directives concerning their medical care.

In general, active-duty patients have the same rights as non-active-duty patients. However, active-duty soldiers may not refuse certain life-saving
medical or surgical procedures. When an active-duty soldier refuses such treatment, the matter is referred to the office of the staff judge advocate for
resolution. Guidance concerning this is covered in Army Regulation 600-20.  (and applicable regulations for the other military services)

An advanced medical directive is voluntary in nature. Patients are not required to have one to be admitted or treated. Patients' care will not be compromised if they do not have advanced medical directives.

Patients having advanced medical directives must inform their primary care managers accordingly. They must also provide copies of their advanced medical directives to their physicians or the outpatient records room as soon as possible.

Patients who desire to make cadaver donations must coordinate with the medical institutions of their choice. Advance arrangements must be made between the donor and the medical institution that will be receiving the body.

An advanced medical directive may be revoked or changed at any time. Patients may verbally inform their primary care managers or providers if they wish to change it.

To formally change an advanced medical directive, patients must contact their legal assistance office.

If a patient does not currently have an advanced medical directive and would like to get one, the legal assistance office is available to provide legal
advice and assist individuals in preparing one.

Discuss the information in your advanced medical directive with individual physicians and family members. Since local laws vary from state to state, it is suggested that patients verify that an advanced medical directive prepared in one state continues to be valid when a move to another state has taken place.

(Reprinted from the Fort Leonard Wood, Mo., Guidon)

============
SOURCE:  Army Medicine web site at
http://www.armymedicine.army.mil/armymed/default2.htm

Posted:  1 FEB 02
Vaccine Ban for Pregnant Servicewomen Strengthened

NEWS RELEASE from the United States Department of Defense

No.026-02
(703)695-0192(media)
IMMEDIATE RELEASE
January 16, 2002
(703)697-5737(public/industry)

VACCINE BAN FOR PREGNANT SERVICEWOMEN STRENGTHENED
Assistant Secretary of Defense for Health Affairs William Winkenwerder issued policy guidance today that reiterates and strengthens long-standing DoD policy to avoid immunization of servicewomen of childbearing age during pregnancy.

This action was taken because of issues raised about preliminary data from a non-peer reviewed Naval Health Research Center Study
of women who received the anthrax vaccine.

"Although these study results are preliminary and there are significant concerns about the database that require further investigation before any conclusions can be made, we are taking these steps to reaffirm our existing policies," stated Winkenwerder.

The preliminary data, which has not been scientifically peer reviewed and will require further validation, identified a possible relationship between maternal anthrax vaccination in the first trimester and higher odds of birth defects.  Because the data supporting the study showed that a number of women might have received the anthrax vaccine beyond the first trimester, study data is now being re-validated.  The peer-review publication process usually takes several months. The final report will be available then.

At the Department's request, the Centers for Disease Control and Prevention will issue a report next week in its Morbidity and
Mortality Report: http://www.cdc.gov/mmwr/ that provides further details of the study. Winkenwerder's memo is on the Web at
http://www.defenselink.mil/news/Jan2002/d20020116inoc.pdf

[Web version: http://www.defenselink.mil/news/Jan2002/b01162002_bt026-02.html]

-- News Releases: http://www.defenselink.mil/news/releases.html
-- DoD News: http://www.defenselink.mil/news/dodnews.html
-- Subscribe/Unsubscribe: http://www.defenselink.mil/news/dodnews.html#e-mail --

Today in DoD: http://www.defenselink.mil/today

Posted:  1 FEB 02
Keeping Those Healthy Resolutions

Whether you've made a 2002 resolution to cut calories, quit smoking, or eat better, healthfinder® can help you stay on track.

Keeping resolutions is in the news these days, so you might take a look at this recent story for some tips:
 
Top 10 Diet Blunders at
http://www.healthfinder.gov/news/newsstory.asp?docID=abcnews_2002_01_14_eng-
abcnews_health_eng-abcnews_health_060150_4389445422917884933

And don't forget the current Dietary Guidelines for Americans from USDA and HHS at
http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=373

If you haven't set some health goals for the coming year, why not visit www.healthfinder.gov today and write your own prescription for health with
the help of the Surgeon General?

Surgeon General's Prescription for Health at
http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6413

Also on the healthfinder® home page, you'll find our today's online checkup feature.  Every day, we highlight an interactive health checkup or quiz
(today it's an Interactive Menu Planner) and you can also search our collection of tools by topic.  These include cancer, cholesterol, smoking,
and many more. http://www.healthfinder.gov/scripts/Topics.asp?context=6&keyword=122&section=5

For more detailed recommendations for preventive health care, try one of these three Put Prevention Into Practice handbooks:

Child Health Guide
http://www.healthfinder.gov/Scripts/RecordPass.asp?RecordType=0&RecordID=30

Personal Health Guide
http://www.healthfinder.gov/Scripts/RecordPass.asp?RecordType=0&RecordID=26

Staying Healthy at 50+
http://www.healthfinder.gov/Scripts/RecordPass.asp?RecordType=0&RecordID=5969

You'll find much more prevention and wellness information in the healthfinder® health library, too, at http://www.healthfinder.gov/library/.

healthfinder® is a free Web guide to reliable health information, developed by the U.S. Department of Health and Human Services.  Each month, we choose a few exciting new resources.

The Web address for healthfinder® is www.healthfinder.gov .  If you are new to the site, please take a minute to visit our page for first time users at
http://www.healthfinder.gov/

-----------------
SOURCE:  healthfinder® at http://www.healthfinder.gov

Posted:  14 Jan 02
CDC:  Health Related Hoaxes and Rumors

1.  Consumer Alert: Buying antibiotics online:  Consumers who are visiting Web sites and/or receiving e-mail claiming to sell Ciprofloxacin (Cipro) and other antibiotics should consult "Offers to Treat Biological Threats: What You Need  to Know," produced by the Federal Trade Commission in conjunction with the Centers for Disease Control and Prevention (CDC) and the Food and Drug  Administration (FDA). These fraudsters often follow the headlines, tailoring their offers to prey on consumers' fears and vulnerabilities. The Consumer Alert is available online at http://www.ftc.gov/opa/2001/11/alert.htm

2.  Emails about Anthrax from CDC:  There are several emails being circulated with the false subject line: "Important information about anthrax from CDC."  CDC has not conducted a mass email campaign to consumers, therefore, these emails do not originate from CDC.

3.  False Report: Underarm Antiperspirants or Deodorants Cause Breast Cancer http://cis.nci.nih.gov/fact/3_66.htm

4.  False Report: Texas Child Dies of Heroin Overdose After Being Stuck by Used Needle Found in Play Area http://www.cdc.gov/hiv/pubs/faq/hoax3.htm

5.  False Report: HIV Can Be Transmitted by Contact with Unused Feminine (Sanitary) Pads http://www.cdc.gov/hiv/pubs/faq/hoax2.htm

6.  Tampons and Asbestos, Dioxin http://www.fda.gov/cdrh/ocd/tamponsabs.html

7.  False Report: HIV Can Be Spread Through the Air http://www.cdc.gov/hiv/pubs/faq/hoax1.htm

8.  False Email Report: Hantavirus Spread by Contact With Soda Cans or Grocery Packages
http://www.cdc.gov/ncidod/hoaxes/hanta-hoax.htm

9.  False Email Report: Klingerman Virus http://www.cdc.gov/ncidod/klingerman_hoax.htm

10.  False Internet Report: Bananas http://www.cdc.gov/ncidod/banana.htm

11.  Needle Stick Hoaxes http://www.cdc.gov/hiv/pubs/faq/faq5a.htm

----------------
SOURCE:  Centers for Disease Control and Prevention (CDC) web site at
http://www.cdc.gov and http://www.cdc.gov/hoax_rumors.htm

Posted:  21 Dec 01
DoD, VA Study Finds Lou Gehrig's Disease in Gulf War Vets

By Rudi Williams
American Forces Press Service

WASHINGTON, Dec. 21, 2001 ­ A large epidemiological study conducted by the departments of Defense and Veterans Affairs found preliminary evidence that Persian Gulf War veterans are nearly twice as likely as their non-deployed counterparts to develop Lou Gehrig's disease.

The disease, amyotrophic (am-ee-o-trow-phic) lateral sclerosis, or ALS, is often called Lou Gehrig's disease
because the baseball star died from it. It's a fatal neurological disease that destroys the nerve cells that control muscle movement. Scientists don't know what causes ALS, and there is no cure for it.

DoD provided the lion's share of the money for the $1.3 million jointly funded study, which began in March 2000.
The investigation involved nearly 700,000 service members who served in Southwest Asia during operations Desert
Shield and Desert Storm during the period Aug. 2, 1990 and July 31, 1991. More than 1.8 million service members who did not deploy to the Persian Gulf were also interviewed.

"We found 40 cases of Lou Gehrig's disease among veterans who served in the Gulf area -- almost twice as many
compared to those who didn't serve in the gulf," said VA Secretary Anthony J. Principi. About half of the 40 veterans have died.

"These findings are of great concern and warrant further study," Principi noted at a Washington press conference
earlier this month. "I intend to make certain that VA's medical resources and research capabilities are fully focused on this issue."

He emphasized that VA will compensate Desert Shield and Desert Storm veterans with ALS. "And we'll do so quickly," he said. "We'll immediately contact those who were identified by the study and will help them to file new
claims or prosecute existing claims -- and we'll pay benefits retroactively to the date their claims are filed," Principi said.

VA is moving so fast because veterans who have contracted the disease can't wait for the peer review process to be
completed, the secretary said.

"They need help now, and we'll offer it to them," he said.

Lou Gehrig's is a degenerative disease of the nervous system affecting the brain cells that carry impulses from the brain and spinal cord to the muscles. The disorder results in muscular weakness and the progressive wasting of muscles. The problem usually starts in the hands and arms and then spreads to other parts of the body. Patients eventually have difficulty speaking, swallowing and breathing.

Early symptoms include slight muscle weakness, clumsy hand movements and difficulty performing tasks that require
delicate movements of the fingers or hands. Veterans afflicted with the disease can also experience weakness of
the lips and impairment of the tongue, mouth or voice box. Other symptoms include uncontrollable twitching of muscles,
stiffness in the legs, and coughing.

Death usually follows diagnosis within three to five years. VA health officials said even with the increased diagnosis
among Gulf War veterans, the disease is extremely rare, affecting only about one in 25,000 people. Among Gulf War
veterans, it's one in 17,500. There's no evidence about higher rates of ALS among other groups of veterans. However, researchers plan to explore the possibility in later studies, officials said.

VA is providing free medical care and disability compensation for veterans who have the disease. Officials urge veterans or family members who believe they qualify to contact their nearest VA medical center, regional office or benefits office.

[NOTE:  To locate the nearest VA facility, go online to  http://www.va.gov/sta/guide/division.asp?divisionId=1 ]

Survivors of veterans who died from the disease are eligible for dependency and indemnity compensation,
enrollment in VA's healthcare program for survivors, educational assistance and vocational assistance, among
other benefits, officials said.

Related Site of Interest:
Office of the Special Assistant for Gulf War Illnesses "GulfLINK" web site at http://www.gulflink.osd.mil/

E-Mail:  special-assistant@gwillness.osd.mil
Phone:  (800) 497-6261
Mail:  5113 Leesburg Pike Suite 901
       Falls Church, Virginia 22041

Posted:  21 Dec 01
Gulf War Vets - Where To Get Help

Active duty military personnel with questions or concerns about their service in the Persian Gulf region: contact your commanding officer or call the Department of Defense (DoD) Gulf War Veterans Hotline (1-800-497-6261).

Gulf War veterans with concerns about their health:contact the nearest VA medical center. The telephone number can be found in the local telephone directory under Department of Veterans Affairs in the "U.S. Government" listings. A Persian Gulf Registry examination will be offered. Treatment will be provided to eligible veterans.

Gulf War veterans in need of marital/family counseling, contact the nearest VA medical center or VA vet center. For additional information, call the VA Gulf War Information Helpline at 1-800-PGW-VETS (1-800-749-8387).

Gulf War veterans seeking disability compensation for illnesses incurred in or aggravated by military service: contact a Veterans Benefits Counselor at the nearest VA regional office of health care facility or call the VA Gulf War
Information Helpline at 1-800-PGW-VETS (1-800-749-8387).

Gulf War veterans interested in learning about the wide range of benefit programs administered by the VA: contact a Veterans Benefits Counselor at the nearest VA regional office or health care facility or call the VA Gulf War
Information Helpline at 1-800-PGW-VETS (1-800-749-8387).

Individuals with first-hand information about "incidents" that occurred in the theater of operations during the Gulf War and that may be related to health problems experienced by individuals who served in the War: call the DoD
"Incidents" Hotline at 1-800-472-6719.

Veterans and military service organizations:

National veterans and military service organizations provide assistance and  representation for millions of veterans, servicemembers and their families through world-wide networks.

Office of the Special Assistant for Gulf War Illnesses (OSAGWI) personnel meet regularly with representatives of these organizations. The meetings give OSAGWI an opportunity to provide an update of OSAGWI activities and other actions in DoD for discussion with their membership. In turn, OSAGWI receives feedback and  requests for information on topics of interest to their members. A recap of the meetings along with briefing slides and related information materials are available on the DeploymentLINK web site http://www.deploymentlink.osd.mil

OSAGWI also participates in activities hosted by the veterans and military service offices. An activity calendar is available on the DeploymentLINK web site at
http://www.deploymentlink.osd.mil/current_issues/vso_mso/current_month.shtml

If you have suggestions for OSAGWI participation or support, please contact send E-mail to
special-assistant@gwillness.osd.mil , call toll-free 800-497-6261 or write to:

5113 Leesburg Pike Suite 901
Falls Church, Virginia 22041

Note: Veterans service organizations are also available to assist Gulf War veterans. A listing follows:

Air Force Association
1501 Lee Highway, Arlington, VA 22209-1198

American GI Forum
206 San Pedro, Suite 210, San Antonio, TX 78205

American Legion
1608 K Street, NW, Washington, DC 20006

American Legion Auxiliary
c/o Harper and Company, 11961 Tech Road, Silver Spring, MD, 20904

AMVETS
4647 Forbes Boulevard, Lanham, MD 20706

Association of the U.S. Army
2110 Washington Blvd., Arlington, VA 22204

Disabled American Veterans
807 Maine Street, SW, Washington, DC 20024

Enlisted Association of the National Guard
1219 Prince Street, Alexandria, VA 22314

Fleet Reserve Association
125 N. West Street, Alexandria, VA 22314-2754

Jewish War Veterans
1811 R Street, NW, Washington, DC 20009

Marine Corps League
8626 Lee Highway, #201
Merrifield, VA 22031

Marine Corps Reserve Officers Association
110 N. Royal Street, Suite 406, Alexandria, VA 22314

National Association of the Uniformed Services
5535 Hempstead Way, Springfield, VA 22151

National Guard Association of the US
1 Massachusetts Ave., NW, Washington, DC 20001

National Military Family Association
6000 Stevenson Ave., #304, Alexandria, VA 22304

Naval Enlisted Reserve Association
6703 Farragut Ave, Falls Church, VA 22042-2189

Naval Reserve Association
1619 King Street, Alexandria, VA 22314-2793

Navy League
2300 Wilson Blvd., Arlington, VA 22201

Non-Commissioned Officers Association
225 N. Washington Street, Alexandria, VA 22314

Reserve Officers Association
1 Constitution Ave., NE, Washington, DC 20002

Retired Officers Association
201 N. Washington Street, Alexandria, VA 22314

Veterans of Foreign Wars
200 Maryland Avenue, NE, Washington, DC 20002

Veterans of Foreign Wars Auxiliary
406 W 34th Street, Kansas City, MO 64111

Vietnam Veterans of America
1224 M Street, NW, Washington, DC 20005

============
SOURCE:  GulfLink Web Page at http://

Posted:  21 Dec 01
TRICARE Dental Plan Premium Rate Change

NOTE:  TRICARE Retiree Dental Program (TRDP) information is available online at
http://www.ddpdelta.org/
******
Harrisburg, PA (Dec 13) - TRICARE Dental Program (TDP) members will notice a  slight increase in their monthly premiums beginning January 2002. The new rates are effective on February 1, 2002; however, since premiums are collected one month in advance, TDP members will notice the change with their January 2002 billing statement, payroll allotment or deduction.

Effective February 1st, TDP premiums will increase by about 3.5 percent or a  little less than the annual increase in the dental services component of the Consumer Price Index.

The new monthly premium rate for active duty family members and members of the Selected Reserve, Individual Ready Reserve (Special Mobilization Category) and family members of reservists who are on active duty for more than 30
consecutive days is $7.90 for a single enrollment and $19.74 for a family enrollment. Members of the Individual Ready Reserve (Other than Special Mobilization Category) and their family members and the family members of the Selected Reserve will pay a new monthly rate of $19.75 for a single enrollment and $49.36 for a family enrollment. (See chart below for monthly premium rates applicable to each type of enrollee).

"Since the government will continue to pay 60 percent of the total monthly premium for most categories of TDP enrollees, the actual increase for the majority of TDP members will be fairly small - 27 cents a month for a single
enrollment and 66 cents a month for a family enrollment," said Tom Harbold, Senior Vice President for the TDP at United Concordia Companies, Inc.

While the TDP premium increases are due primarily to increases in the cost of dental services, part of the increase is the result of enhancing the general anesthesia benefit. Effective February 1, 2002, the requirement that general anesthesia be performed by a provider other than the surgeon, assistant surgeon or treating doctor is eliminated.

United Concordia Companies, Inc. administered the TRICARE Family Member Dental Plan (TFMDP) from February 1996 through January 2001. In February 2001, the TRICARE Selected Reserve Dental Program (TSRDP) and the TFMDP were combined to create the TRICARE Dental Program (TDP). United Concordia was selected by the
Department of Defense to administer the TDP. Headquartered in Harrisburg, Pa., United Concordia is the fifth largest dental insurer in the country with more than six million members worldwide. In 2000, the company processed more than
9.3 million claims and paid more than $781 million in dental benefits.

TDP Monthly Premiums
(February 2002 ­ January 2003)

Shared Premium                                     Single       Family
--------------------------------                   ------       -------
Active Duty Family Members                          $7.90       $19.74
Selected Reserve
IRR ­ Special Mobilization Category

Full Premium
----------------------------------------------  
IRR ­ Other than Special Mobilization Category     $19.75       $49.36
SELRES & IRR Family Members
 
=======
SOURCE: 
United Concordia web site at http://www.ucci.com/tdp/tdp.html
Telephone Inquiries:  1-888-622-2256

Posted:  21 Dec 01
Cold, Altitude Threaten Troops' Health in Afghanistan

By Sgt. 1st Class Kathleen T. Rhem, USA
American Forces Press Service

WASHINGTON, Dec. 14, 2001 -- Cold and altitude are currently the most serious environmental threats to troops
serving in Afghanistan. In a few months, they'll need to worry more about malaria.

Many different issues can impact service members' health while serving in Central Asia, but the most serious varies
depending on the area and the season, said Army Dr. (Lt. Col.) Bruno Petruccelli. He's the epidemiology program
manager with the Army Center for Health Promotion and Preventive Medicine, Aberdeen Proving Ground, Md.

"The most likely environmental or physical threats (now) would be the high altitude and the cold," Petruccelli said.
"In the summer months, the heat can get pretty horrendous as well."

Tactics can make a difference in preventing health problems, such as those from cold and altitude. But, Petruccelli said, military medical professionals don't recommend changes in tactics. They give information, and it's up to commanders to weigh the risks against the importance of the mission, he explained.

"When it is possible, altitude illness is best prevented by ascending slowly," he said. Ascending slowly and spending
at least one night at altitude will prevent most cases of "mountain sickness" and "make the mission go a little bit
more smoothly," he said.

But physical symptoms to altitude changes can occur as low as 5,000 feet in particularly susceptible individuals, he
said. And for some missions, slow ascent just isn't an option. "Sometimes we fly right into a high altitude,"
Petruccelli said.

Physical signs of altitude sickness include headache, dizziness, nausea and fatigue. "All things that in their mildest form may not interfere with normal functioning," Petruccelli said. "But they may predict a more serious event later on."

"A more serious event" might even include life-threatening cerebral edema, or fluid accumulating in the brain, he said. The condition's rare, he said, but physicians in the area need to be aware of possibilities.

The threat of altitude sickness declines after the first 24 to 48 hours. "After a while, our breathing adjusts and our
blood cells adjust and we do fine," Petruccelli said. "But it may take a few days to get there."

Cold is easier for individuals to protect themselves against. The military has excellent cold-weather gear that
can be mixed and layered depending upon weather conditions, Petruccelli said. He recommended troops use it properly.

He said it's possible to overdress and become a heat casualty even in the winter.

In the summer, some parts of Central Asia experience extremely high temperatures. Petruccelli said the best way
to avoid heat injuries is to stay hydrated. He recommended sipping up to a quart or more of water over the course of
each hour. Gulping large amounts of water at once is not as helpful, he said, and can even be harmful.

As early as March, the threat of malaria goes up considerably. U.S. forces deployed to areas where malaria
is present take one of two types of prophylactic medication.

The anti-microbial drug mefloquine is taken once a week and must be started at least two weeks before going into the
region, Petruccelli said. "It takes that long for adequate blood levels to be achieved," he said.

It also has to be taken for at least four weeks after one leaves the area in order to keep killing the parasites that
emerge in the individual.

"Malaria can still emerge several weeks later. Parasites can stay in the body and start to multiply after you stop
taking the drug," he explained. "The drug is a suppressant; it's not really an agent that immediately eliminates any
parasite that gets into your body."

The other drug U.S. forces can take to prevent malaria is the antibiotic doxycyline. Petrucelli said this drug is
taken daily when in the region and can be started as late as a day or two before deploying and still reach adequate
levels in the blood.

The likelihood of contracting malaria depends mostly on the level of individual protection, he said. "Going into the
winter, the likelihood of malaria transmission is very low," he said. "However, there are some areas where
transmission remains possible throughout the year."

One form of malaria found in Afghanistan, falciparum, is particularly deadly to individuals with no immunity built
up. Immunity is gained by living for a long period in an area where malaria is present.

Americans have virtually no natural ability to fight malaria, but even those who have some aren't safe from contracting the disease. Their partial immunity would only help them survive a malarial bout, Petruccelli said.

In addition to taking preventive medication, it's important for service members to wear insect repellent, sleep under
mosquito nets when possible, and have their uniforms treated with permethrin, an insecticidal chemical.

Personal protective measures aside, being physically fit and eating nutritiously are the best ways to fight illness,
Petruccelli said. Fitness also makes it easier to acclimate to extremes of temperature and altitude.

"A person who is physically fit and well nourished has a much stronger immune system," he said. "Heat casualties are
particularly notorious for someone who is not physically fit." That's because people who have to acclimate to heat
and physical activity at the same time put much more stress on their bodies, he noted.

Local food and water should also be considered hazardous. Diarrheal illnesses, typhoid, hepatitis A and many other
infectious diseases can be transmitted via food and water, Petruccelli said. Military members are vaccinated against
typhoid and hepatitis A, but many other serious diseases can be contracted through infected food and water.

U.S. forces provide safe food and water sources for deployed service members, but the risk of food- and water-
borne illness can be greater for special operations forces. These troops often travel in small groups on their own
among local populations. Carrying large amounts of safe food and water is not usually possible.

Still, Petruccelli said, these troops can minimize their risks. He recommended service members with no options but
locally produced food should avoid poorly cooked meat, dairy products and raw produce.

He explained there's a difference between a health risk and a threat. "A risk is everything out there that could
possibly impact on someone's health," he said. A threat, on the other hand, is the likelihood of being affected by that
risk even after you've taken personal protective measures into account, he said.

For more information on medical risks and staying healthy in Afghanistan go to chppm-www.apgea.army.mil/deployment/stayinghealthy.asp

NOTE:  This is a plain text version of a web page.  If your e-mail program did not properly format this information, you may view the story at http://www.defenselink.mil/news/Dec2001/n12142001_200112142.html
Any photos, graphics or other imagery included in the article may also be viewed at this web page.
####

Posted:  21 Dec 01
A Pound Here, A Pound There, and Talk Turns Weighty

Special to the American Forces Press Service

WASHINGTON, D.C., Dec. 13, 2001 -- The average American will gain about a pound on holiday goodies this year.
That's not much, but medical studies unfortunately show the years disappear, but the pounds don't.

DoD wants service members and their families -- especially children -- retirees and civilian employees to enjoy
lifelong health and fitness, said Air Force Col. (Dr.) Daniel L. Cohen, chief medical officer and deputy operations director in the Office of the Assistant Secretary of Defense for Health Affairs.

Cohen said the military medical system today stresses a "condition management approach" to obesity. That means
working with beneficiaries to prevent the problem rather than have to treat it. The approach marks a change in traditional thinking, one that requires a close partnership with beneficiaries.

It's for their good, but also the military medical system's, he noted. There's a healthier population of beneficiaries -- and also lower healthcare costs, he said.

All the services have body weight and conditioning standards. The Body Mass Index ratio developed by the National Institutes of Health in 1998 is one indicator. Its is the ratio of weight in kilograms to height in meters squared. A BMI of less than 25 is considered normal, 25 to 29.9 is overweight, and over 30 is obese.

About a thousand of service members are discharged each year because of their weight. That's sad, Cohen said, but
the active force's problem is minor compared to family members, who mirror the general public. Using the BMI, he
said, studies suggest 60 percent of Americans are overweight or obese.

About 15 percent to 20 percent of children are overweight or obese, he said. About 40 percent weigh over 80 percent
of their ideal body weight.

The services' elite forces are most effective at weight control, probably because of their culture, which stresses
physical prowess, agility and team coordination, Cohen observed.

"My anecdotal experience is that you do not commonly see overweight and obesity in our elite forces, though I
haven't really studied that scientifically," he said.

Whether or not his hunch is correct, he noted, one thing is certain for everyone: It's easier to prevent overweight and
obesity than to treat them. They're illnesses, he said, but many overweight individuals don't see themselves as sick or
needing treatment.

"They do not recognize the steep and very slippery slope on which they sit," Cohen said. Obesity is linked to higher
rates of chronic illness and worse physical quality of life than lifelong smoking, problem drinking and poverty
combined, in the United States, he contended. Overweight and obesity are clearly associated with type-2 diabetes,
gall bladder disease, hypertension, coronary artery disease, depression and elevated cholesterol and triglyceride levels in the blood.

Considering that an overweight 25 year old might gain 10 to 20 pounds per decade, he continued, it's not surprising
nearly 30 percent of Americans at any given time are trying to lose weight. The cost is up to $50 billion per year, and
most of it's wasted because it's spent on foods, nutritional programs, supplements and remedies of dubious value, he said.

"Losing weight and keeping it off is not easy, ever!" Cohen warned. The hardly secret truth about weight control is
that it means adopting a lifestyle that combines prudent dieting and a sustained exercise program. It's the only way
to prevent and to effectively treat overweight or obesity without resorting to medications, he said.

"Sustained exercise means 30 minutes of exercise, preferably vigorous, three or four times per week, and more often if one is inclined," Cohen explained. "The benefits of frequent exercise are well documented. Even walking is helpful as long as it is sustained. One should feel at least a little tired at the end of it, in my opinion."

A caution regarding children: Severely limiting children's caloric intake can adversely affect growth and development,
especially during adolescence, when their needs increase, he said. The best ticket, he noted, is a balanced diet that's neither excessive in calories nor excessively restrictive coupled with age-appropriate exercise. Children attempting to lose weight should do so only under the care of physicians or nurse health managers, he added.

Embarking on this life change, one can hope to lose 1 or 2 pounds per month. Losing 12 to 20 pounds in a year is a
real success story, he said.

A pound of fat contains about 3,500 calories. Vigorous exercise for 30 minutes may burn up to 350 calories, so
even with daily exercise at this rate it would take 10 to 12 days to burn a pound of fat  -- assuming you're eating
only a normal complement of calories. An average adult requires 2,000 to 2,500 calories daily, so the goal should
be to not exceed about 2,000, ever, Cohen said.

For more information on weight control problems and treatments, visit the Surgeon General's Overweight and
Obesity Web site at www.surgeongeneral.gov/topics/obesity/

Also of possible interest, the National Institutes of Health has a discussion on drugs and weight loss at
www.hhs.gov/news/press/1996pres/961217.html and a forum summary on childhood obesity and diabetes at and
www.hhs.gov/aspe/pic/9/pic6859.txt

(Adapted from materials from the Office of the Assistant Secretary of Defense for Health Affairs.)
####
_______________________________________________________
NOTE:  This is a plain text version of a web page.  If your e-mail program did not properly format this information, you may view the story at http://www.defenselink.mil/news/Dec2001/n12132001_200112131.html
Any photos, graphics or other imagery included in the article may also be viewed at this web page.

Posted:  6 Dec 01
TRICARE Mid-Atlantic (Region 2) Designates Reserve Liaison Officer

TRICARE Mid-Atlantic Designates Reserve Liaison Officer

(Norfolk, Va.) - The TRICARE Mid-Atlantic Region now has a reserve liaison  officer (RLO) in its Norfolk office to help activated guardsmen and reservists and their family members understand and use TRICARE, the military health care benefit.

When reservists are called to active duty, they must quickly prepare their families to manage all aspects of the household while they are activated.  Part of that preparation is becoming knowledgeable about TRICARE.

"When reservists are mobilized, they may wonder how their families will access TRICARE," said Rear Admiral Clinton E. Adams, TRICARE Mid-Atlantic Lead Agent. "We've designated our new RLO to answer their questions by phone and e-mail, as well as to physically go to reserve units to explain the military health care benefit."

Families of activated reservists and National Guard members become eligible for health care benefits under TRICARE Standard or TRICARE Extra on the first day of the military sponsor's active duty, if his or her orders are for more than
30 consecutive days of active duty.  When the orders for active duty are for more than 179 days, family members may enroll in TRICARE Prime or TRICARE Prime Remote.  To use this option, they must complete enrollment forms and use military medical facilities and TRICARE Prime network providers. Family members who live in North Carolina and Virginia (excluding Northern Virginia) are in the TRICARE Mid-Atlantic Region, regardless of where the service member's mobilization station is located.

Captain David W. Munter, TRICARE Mid-Atlantic Executive Director, said, "Our goal is to help the families transition into TRICARE.  We don't want reservists on active duty to be distracted worrying about health care for their families."

Currently, the RLO is Lt Col Dominic Ubamadu, an activated reservist who is a veteran of the TRICARE program.  He has several years of TRICARE operations experience, which includes a recent Active Duty tour as department head of
Communications and Customer Service at TRICARE Mid-Atlantic.

"I've worn many hats: first as an Army Reservist, then as active Army, followed by active Air Force.  I'm now an Air Force Reservist privileged to work in the TRICARE office.  I'm eager to help our activated service members and their
families understand TRICARE," said Lt Col Ubamadu.  "Many of them have never used the benefit, or it's been a while since they were covered by TRICARE.  We hope to ease some of their health care anxiety while the reservist is away."

Captain Munter encourages reserve and guard units within the region to contact the TRICARE Mid-Atlantic office to schedule meetings or briefings for their service members or family members once they receive their mobilization warning
orders.

The RLO may be contacted at 757-314-6080 or via e-mail at reserve.liaison@mh.tma.med.navy.mil

Activated reservists and National Guard members should check with their reserve centers or unit commanding officers to make sure that all information about themselves and family members is current and accurate in the DEERS (Defense
Enrollment Eligibility Reporting System) database.  Incorrect information can result in enrollment and appointment disruptions, delayed claims processing, problems with pharmacies and the National Mail Order Pharmacy (NMOP) benefit, and other difficulties.  For information about DEERS enrollment, they may contact DEERS toll free from 6 am to 5 pm, Pacific time, at 1-800-538-9552.

For specific information on TRICARE for reservists, log on to the TRICARE Mid-Atlantic Web site at http://www.tma.med.navy.mil and click on "Reservists."

###
SOURCE:  TRICARE Mid-Atlantic Press Release
POC:  Deborah Kallgren at (757) 314-6471

Posted:  15 Nov 01
Smoking Costs DoD Plenty

By Sgt. 1st Class Kathleen T. Rhem, USA
American Forces Press Service

WASHINGTON, Nov. 14, 2001 -- DoD officials can't be sure exactly how much smoking costs the department each year, but they know it's a bundle.

A 1998 DoD study estimated smoking costs the department $584 million per year in medical care and $346 million in
lost productivity, Air Force Lt. Col. Wayne Talcott said.

Talcott is a psychologist assigned to the Air Force Medical Operations Agency in San Antonio, Texas. He is also a
former head of DoD's Tobacco Use Reduction Committee.

His numbers are only estimates, he said, because it's impossible to quantify what illnesses are caused by smoking
and which are naturally occurring.

Lynn Pahland, director of Health Promotion and Preventive Services Policy with the Office of the Assistant Secretary
of Defense for Health Affairs, believes the estimates are conservative.

She said there needs to be a cultural shift against smoking throughout DoD. Officials shouldn't rely on the medical
community to wipe out smoking single-handedly, she said.

"We are trying to instill a culture change where we point out and endorse that we want a healthy culture," she said.
"We want to put a system in place throughout the Department of Defense -- not just in the healthcare system -- that
healthy lifestyle choices are what we want from everyone."

"Smoking is the single most preventable cause of death in the United States," Talcott said.

Part of this departmentwide push is making tobacco products less accessible at commissaries and exchanges. Talcott said cigarettes used to be much less expensive at these stores than off base. DoD has since succeeded in having the prices of tobacco products raised at commissaries and exchanges to make smoking less attractive.

But Congress has said tobacco is a legal product, so the commissaries and exchanges won't stop selling these items
any time soon, Pahland added. At the same time, though, store managers are dedicating less shelf space to tobacco
and giving more prominent display to smoking cessation aids, such as nicotine patches and gum, she said.

Smoking cessation aids are also available through many military heath clinics and hospitals, but not all. Pahland
said smoking cessation aid isn't a TRICARE benefit per se, but many hospitals and clinics offer cessation classes and
products to improve beneficiaries' health and cut down on healthcare costs.

Doctors in military medical treatment facilities can also prescribe medications to help patients quit, Talcott noted.
A combination of medication and behavior modification therapy is the best approach to kicking the habit, he said.

"The bottom line is we want our armed forces to be as healthy as possible," Pahland said. "It is a scientific
fact that tobacco use interferes with health and readiness from both a short-term and long-term perspective. We want
to give people the tools to help them make healthy choices."

She noted DoD is concerned about the health of the entire military family, not just service members. "If family
members are healthier, that's going to give peace of mind to our armed forces," she said.

The Great American Smokeout Day is Nov. 15. For more information on quitting tobacco for good, visit the
Smokeout Web sites supported by TRICARE at http://www.tricare.osd.mil/smokeout  and the American American Cancer Society at www2.cancer.org/eprise/main/docroot/SPC/SPC_0

Additional information and materials about tobacco and smoking cessation  programs are available from the American Cancer Society, www.cancer.org or call them at 1-800-227-2345. Or visit the Centers for Disease Control Web site
www.cdc.gov/tobacco or call them at 1-770-488-5476.

##########
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Posted:  15 Nov 01
TRICARE Management Activity Receives Joint Meritorious Unit Award

TRICARE Management Activity Honored with DoD's Joint Meritorious Unit Award             
November 9, 2001
No. 01-29

TRICARE Management Activity (TMA), the agency which oversees the delivery of  health care to active duty and retired members of the uniformed services, and their family members and survivors, has been honored with the highest joint unit award established by the Department of Defense (DoD).

Secretary of Defense Donald Rumsfeld recognized TMA with the Joint Meritorious  Unit Award for distinguishing itself through "exceptionally meritorious service" from Feb. 10, 1998, to Feb. 28, 2001.

The Joint Meritorious Unit Award is given to joint activities of the armed  services for achievement in pursuit of joint military missions of great significance.

The award citation praised the TMA staff for compiling "a record of  achievements unsurpassed in the provision of health care," ranging from "the design, creation, and implementation of previously non-existent medical  benefits for active duty service members and their families" to "development of cost-effective methods for 'Keeping the Promise' to retired beneficiaries."

"As the Military Health System faced greater challenges each day," said the  citation, "the TRICARE Management Activity staff met those tests with unceasing dedication, devotion, and focus on mission accomplishment and brought great  credit to TMA, Health Affairs, and DoD." Presented Oct. 1, 2001, by Under Secretary of Defense for Personnel and Readiness Dr. David S.C. Chu during a kick-off ceremony for TRICARE for Life at  TMA headquarters in Falls Church, Va., the honor was awarded for TMA's first three years in operation. During that period, great progress was made in developing, expanding, and improving the TRICARE program.

TRICARE serves 8.4 million eligible beneficiaries - active duty and retired members of the uniformed services (Army, Air Force, Navy, Marine Corps, Coast Guard, Public Health Service, and National Oceanic and Atmospheric
Administration), and their family members and survivors.

With a current annual budget of $17.6 billion, TRICARE processed 33.7 million  health care claims last year - with 44 million expected this year.

TRICARE health care services are delivered by 160,000 military and civilian  personnel at 76 military hospitals and medical centers and 460 ambulatory care clinics. Beneficiaries are also served by 161,000 providers, 2,000 facilities,
and 28,000 pharmacies that make up the TRICARE contract network.

Each year, 600,000 TRICARE beneficiaries are admitted to military hospitals for  inpatient treatment, and eligible service members and family members make 50.3 million visits to clinics for outpatient care and have 55 million prescriptions filled. TRICARE records 98,000 births each year.

SOURCE:  TRICARE News Release at http://www.tricare.osd.mil

POSTED:  15 Nov 01
Frequently Asked Questions About Diabetes

It is very important for people who think they might have diabetes to visit a  personal health care practitioner. The following simplified questions and answers can’t take the place of a personal consultation.

1.  What is diabetes?
Most of the food we eat is turned into glucose, or sugar, for our bodies to use  for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have
diabetes, your body either doesn't make enough insulin or can't use its own insulin as well as it should. This causes sugars to build up in your blood.

Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. Diabetes is the seventh leading cause of death in the United States.

2.  What are the symptoms of diabetes?
People who think they might have diabetes must visit a physician for diagnosis. They might have SOME or NONE of the following symptoms:

    Frequent urination
    Excessive thirst
    Unexplained weight loss
    Extreme hunger
    Sudden vision changes
    Tingling or numbness in hands or feet
    Feeling very tired much of the time
    Very dry skin
    Sores that are slow to heal
    More infections than usual.
    Nausea, vomiting, or stomach pains may accompany some of these symptoms in the abrupt onset of insulin-dependent diabetes, now called type 1 diabetes.

3.  What are the types and risk factors of diabetes?
The following types of diabetes and some of their risk factors are quoted from the National Diabetes Fact Sheet: National estimates and general information on diabetes in the United States (Centers for Disease Control and Prevention.  Atlanta, GA: US Department of Health and Human Services, 1997):

Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes. Risk factors are less well defined for type 1
diabetes than for type 2 diabetes, but autoimmune, genetic, and environmental factors are involved in the development of this type of diabetes.

Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus  (NIDDM) or adult-onset diabetes. Type 2 diabetes may account for about 90% to 95% of all diagnosed cases of diabetes. Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians,
and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes.

Gestational diabetes develops in 2% to 5% of all pregnancies but usually  disappears when a pregnancy is over. Gestational diabetes occurs more frequently in African Americans, Hispanic/Latino Americans, American Indians,
and people with a family history of diabetes than in other groups. Obesity is  also associated with higher risk. Women who have had gestational diabetes are at increased risk for later developing type 2 diabetes. In some studies, nearly
40% of women with a history of gestational diabetes developed diabetes in the future.

Other specific types of diabetes result from specific genetic syndromes,  surgery, drugs, malnutrition, infections, and other illnesses. Such types of diabetes may account for 1% to 2% of all diagnosed cases of diabetes.

4.  What is the treatment for diabetes?
Management strategies should be planned along with a qualified health care team.

The following information on treatments for diabetes is from the National  Diabetes Fact Sheet: National estimates and general information on diabetes in the United States (Centers for Disease Control and Prevention. Atlanta, GA: US
Department of Health and Human Services, 1997):

Diabetes knowledge, treatment, and prevention strategies advance daily.  Treatment is aimed at keeping blood glucose near normal levels at all times. Training in self-management is integral to the treatment of diabetes. Treatment
must be individualized and must address medical, psychosocial, and lifestyle issues.

Treatment of type 1 diabetes: Lack of insulin production by the pancreas makes type 1 diabetes particularly difficult to control. Treatment requires a strict regimen that typically includes a carefully calculated diet, planned physical
activity, home blood glucose testing several times a day, and multiple daily insulin injections.

Treatment of type 2 diabetes: Treatment typically includes diet control, exercise, home blood glucose testing, and in some cases, oral medication and/or insulin. Approximately 40% of people with type 2 diabetes require insulin injections.

5.  What causes type 1 diabetes?
The causes of type 1 diabetes appear to be much different than those for type 2 diabetes, though the exact mechanisms for development of both diseases are unknown. The appearance of type 1 diabetes is suspected to follow exposure to
an "environmental trigger," such as an unidentified virus, stimulating an immune attack against the beta cells of the pancreas (that produce insulin) in some genetically predisposed people.

6.  Can diabetes be prevented?
A number of studies have shown that regular physical activity can significantly reduce the risk of developing type 2 diabetes. It also appears to be associated with obesity. Researchers are making progress in identifying the exact genetics and "triggers" that predispose some individuals to develop type 1 diabetes, but prevention, as well as a cure, remains elusive.

7.  Is there a cure for diabetes?
In response to the growing health burden of diabetes mellitus (diabetes), the diabetes community has three choices: prevent diabetes; cure diabetes; and take better care of people with diabetes to prevent devastating complications. All
three approaches are actively being pursued by the US Department of Health and Human Services.

Both the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) are involved in prevention activities. The NIH is involved in research to cure both type 1 and type 2 diabetes, especially type 1. CDC focuses most of its programs on being sure that the proven science is put into daily practice for people with diabetes. The basic idea is that if all the important research and science are not made meaningful in the daily lives  of people with diabetes, then the research is, in essence, wasted.

Several approaches to "cure" diabetes are being pursued:

Pancreas transplantation
Islet cell transplantation (islet cells produce insulin)
Artificial pancreas development
Genetic manipulation (fat or muscle cells that don’t normally make insulin have  a human insulin gene inserted — then these "pseudo" islet cells are transplanted into people with type 1 diabetes).
Each of these approaches still has a lot of challenges, such as preventing  immune rejection; finding an adequate number of insulin cells; keeping cells alive; and others. But progress is being made in all areas.

8.  What are some other sources for information on diabetes?
The following organizations may help in your search for more information on diabetes:

o Federal Government Organizations

    Department of Veterans Affairs
    Internet http://www.va.gov/health/diabetes/

    Health Resources and Services Administration
    Internet http://www.hrsa.dhhs.gov/

    Indian Health Service
    Diabetes Program
    5300 Homestead Road NE, Albuquerque, NM 87110
    505/248-4182
    Internet http://www.ihs.gov/IHSMAIN.html

    National Diabetes Education Program
    Internet http://www.cdc.gov/diabetes/projects/ndeps.htm

    The NDEP is a new nationwide initiative of the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). It is an inclusive, partnership-based program involving many diverse public and private
sector partner organizations. The goal of the program is to reduce the morbidity and mortality of diabetes and its complications.

CDC contact: Faye L. Wong, MPH, RD, Associate Director for Diabetes Education, 770-488-5037 (phone); 770-488-5966 (fax); flw2@cdc.gov  (e-mail).

NIH contact: Joanne Gallivan, MS, RD, Director, Diabetes Outreach Program, 301-496-6110 (phone); 301-496-7422 (fax); gallivanj@hq.niddk.nih.gov  (e-mail).

    National Institute of Diabetes and Digestive and Kidney Diseases
    1 Information Way, Bethesda, MD 20892-3560
    800/GET LEVEL (800/438-5383) or 301/654-3327
    Internet http://www.niddk.nih.gov

    National Eye Institute (NEI)
    Bldg. 31, Room 6A32
    31 Center Drive, MSC 2510
    Bethesda, MD 20892-2510
    301/496-5248 or 800/869-2020 (to order materials)
    301/402-1065 (fax)
    Internet http://www.nei.nih.gov

    Educating People with Diabetes Kit
    (Sponsored by the National Eye Institute)
    2020 Vision Place, Bethesda, MD 20892
    Internet http://www.nei.nih.gov/nehep/diabkit.htm

    Office of Minority Health Resource Center
    US Department of Health and Human Services
    P.O. Box 37337, Washington, DC 20013-7337
    800/444-MHRC (444-6472)
    Internet http://www.omhrc.gov/

o Non-Federal Government Organizations

Links to non-Federal organizations are provided solely as a service to our  users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred.
The CDC is not responsible for the content of the individual organization Web pages found at these links.

American Association of Diabetes Educators
100 West Monroe, 4th Floor, Chicago, IL 60603-1901
800/338-3633 for names of diabetes educators
312/424-2426 to order publications
Internet http://www.aadenet.org

American Diabetes Association
1660 Duke Street, Alexandria VA 22314
800/232-3472 or 703/549-1500
800/ADA-ORDER to order publications toll free
ADA's D.I.A.L. Program (Diabetes Information and Action Line)
800/342-2383 or 800/DIABETES for diabetes information
Internet http://www.diabetes.org

American Dietetic Association
National Center for Nutrition and Dietetics
216 West Jackson Boulevard, Suite 800, Chicago, IL 60606-6995
800-366-1655 Consumer Nutrition Hotline (Spanish speaker available)
800-745-0775
Internet http://www.eatright.org/

American Heart Association National Center
7272 Greenville Avenue, Dallas, TX 75231
214/373-6300
Internet http://www.americanheart.org/

American Optometric Association
1505 Prince Street, Alexandria, VA 22314
800/262-3947 or 703/739-9200
Internet http://www.aoanet.org/

International Diabetic Athletes Association
1647-B West Bethany Home Road, Phoenix, AZ 85015
800/898-IDAA or 602/433-2113
602/433-9331 (fax)
idaa@getnet.com (e-mail)
Internet http://www.diabetesnet.com/idaa.html

Juvenile Diabetes Foundation International
The Diabetes Research Foundation
120 Wall Street, 19th Floor, New York, NY 10005-4001
800/JDF-CURE or 800/223-1138
212/785-9595 (fax)
Internet http://www.jdf.org

Medical Eye Care for the Nation's Disadvantaged Senior Citizens
The Foundation of the American Academy of Ophthalmology
P.O. Box 429098, San Francisco, CA 94142-9098
800/222-EYES (222-3937)

National Diabetes Information Clearinghouse
1 Information Way, Bethesda MD 20892-3560
301/654-3327 (phone); 301/907-8906 (fax)
ndic@aerie.com (e-mail)
Internet http://www.niddk.nih.gov/health/diabetes/ndic.htm

============
SOURCE:  Centers for Disease Control and Prevention web site at
http://www.cdc.gov/health/diabetes.htm

Posted:  15 Nov 01
TRICARE Retiree Dental Program

The TRICARE Retiree Dental Program (TRDP)--the only dental benefits program  authorized by the government for Uniformed Services retirees--will soon be moving into its fourth year.  The TRDP, which is administered by Delta Dental Plan of California in partnership with the U.S. Department of Defense, offers affordable dental benefits to retirees of the uniformed services and their family members throughout the 50 United States, the District of Columbia,
Canada and the U.S. territories of Puerto Rico, Guam, the U.S. Virgin Islands,  American Samoa and the Commonwealth of the Northern Mariana Islands. 

Over 600,000 people are currently enrolled in the TRDP, which allows subscribers to obtain covered services from any licensed dentist within the service area and to further limit their out-of-pocket costs when using any one of about 25,000 DeltaSelect USA Network dentists. 

In October 2000, the TRDP added coverage for cast crowns, bridges, full and partial dentures, orthodontia and dental accidents to its basic package of preventive and restorative services.  These changes make the TRDP one of the
most complete and competitively priced dental plans available outside of a traditional, employer-sponsored program. 

Those interested in more information about the TRDP, including eligibility and enrollment, may visit the TRDP web site at http://www.ddpdelta.org or call toll-free 1 (888) 838-8737.
---------
SOURCE:  TRDP News Article
***************************************
Additional Delta Dental contact information -

1.  Delta Dental Contact Info for Retirees:
By Phone:
Enrollment - 1 (888) 838-8737
Customer Service - 1 (888) 336-3260

By Mail:
Delta Dental Plan of California
Federal Services
P.O. Box 537008
Sacramento, CA 95853-7008

By E-mail:
Enrollment - ddpenroll@delta.org
Customer service - ddpservice@delta.org
Billing - ddpbilling@delta.org

2.  Delta Dental Contact Info for Dentists:

By Phone:
Participation - 1 (888) 838-8737
Customer Service - 1 (888) 336-3260  

By Mail:
Delta Dental Plan of California
Federal Services
P.O. Box 537007
Sacramento, CA 95853-7007

By E-mail:
Participation - ddpdentist@delta.org 
Customer service - ddpservice@delta.org 

Posted:  15 Nov 01
Glitch Forces Some to File Own TRICARE for Life Claims

By Sgt. 1st Class Kathleen T. Rhem, USA
American Forces Press Service

WASHINGTON, Nov. 9, 2001 -- A paperwork error caused the names of some 195,000 TRICARE For Life beneficiaries to not be provided to Medicare claims processors to allow for automatic claims processing.

Steve Lillie, TRICARE's director of over-65 benefits, said the names of roughly 13 percent of eligible TRICARE for
Life beneficiaries didn't get "matched up" with their files in the Medicare rolls. He said they're still eligible for
benefits, but they may have to take one extra step for the time being: They may have to file TRICARE claims themselves if they received care after Oct. 1 and the provider sends a bill for what remains after Medicare has paid its share.

Ideally, the TRICARE and Medicare databases would be synched so claims for anything not covered by Medicare are
automatically forwarded to TRICARE. The bill-paying process would be invisible to beneficiaries.

Lillie said the databases don't match because of the mistake, so Medicare isn't forwarding some claims to
TRICARE. Healthcare providers might send affected beneficiaries bills from unpaid amounts.

TRICARE expects to send affected beneficiaries letters by mid-month explaining the problem and telling them how best
to handle it. Lillie recommended beneficiaries who receive bills contact their healthcare providers' billing office
and explain the problem.

The billing office can then submit the claim directly to TRICARE. Alternatively, the beneficiary can file the claim
with TRICARE.  The beneficiary still won't have to pay for things covered by TRICARE, Lillie said.

Two specific groups were affected by this problem. The smaller group includes about 10,600 survivors of people who
died on active duty.

The rest are people who updated their Medicare status in the Defense Eligibility Enrollment Reporting System
themselves. Lillie explained that DEERS is the way DoD keeps track of who is eligible for what benefits. DEERS and
Medicare exchanged data in July so that all the people eligible for TRICARE for Life would be listed as such in
the Medicare databases.

"People who had updated their information ... with the best of intentions accidentally got left out of the submission
to Medicare," Lillie said. Apparently these names weren't sent to Medicare to cross-check for eligibility because
DEERS had already verified their Medicare enrollment status, he said.

The problem will be resolved by Dec. 1. All claims submitted to Medicare after Dec. 1 -- even for care
received before Dec. 1 -- will automatically be forwarded to TRICARE, he said. On the other hand, healthcare claims
won't go to TRICARE automatically if providers submit them from Oct. 1 up until the problem is corrected, he added.

TRICARE officials noticed the problem in mid-October during a routine overview of the program and immediately took
steps to correct it. Defense Department officials are also discussing the matter with officials from the American
Medical Association to determine if there's a way to make healthcare providers aware of the temporary situation.

"The key emphasis is it's a temporary glitch. The claim will be paid," Lillie said. "It's not what we wanted to
happen, but we anticipated a few problems with start up.  This happens to have affected more people than we would
have liked. But it will be fixed pretty quickly."

There are several avenues available to individuals seeking more information or experiencing problems with TRICARE for Life, Lillie explained. They can call TRICARE's main helpline at 1-888-DOD-LIFE (363-5433), visit any regional
beneficiary assistance office, or visit the TRICARE web site at  http://www.tricare.osd.mil

Posted:  8 Nov 01
Smallpox Information

Listed below are frequently asked questions and answers that are posted on the Centers for Disease Control and Prevention (CDC) web site.  More smallpox related information is available at
http://www.bt.cdc.gov/Agent/Smallpox/Smallpox.asp
-----------------------
1.  What should I know about Smallpox?

ANSWER:  Vaccination is not recommended, and the vaccine is not available to  health providers or the public. In the absence of a confirmed case of smallpox anywhere in the world, there is no need to be vaccinated against smallpox.
There also can be severe side effects to the smallpox vaccine, which is another  reason we do not recommend vaccination. In the event of an outbreak, the CDC has clear guidelines to swiftly provide vaccine to people exposed to this disease. The vaccine is securely stored for use in the case of an outbreak. In  addition, Secretary of Health and Human Services Tommy Thompson recently announced plans to accelerate production of a new smallpox vaccine.
 
2.  Are we expecting a smallpox attack?

ANSWER:  We are not expecting a smallpox attack, but the recent events that  include the use of biological agents as weapons have heightened our awareness of the possibility of such an attack.
 
3.  Is there an immediate smallpox threat?

ANSWER:  At this time we have no information that suggests an imminent smallpox threat.
 
4.  If I am concerned about a smallpox attack, can I go to my doctor and request the smallpox vaccine?

ANSWER:  The last naturally acquired case of smallpox occurred in 1977. The last cases of smallpox, from laboratory exposure, occurred in 1978. In the United States, routine vaccination against smallpox ended in 1972. Since the vaccine is no longer recommended, the vaccine is not available. The CDC maintains an emergency supply of vaccine that can be released if necessary, since post-exposure vaccination is effective.
 
5.  Are there plans to manufacture more vaccine in case of a bioterrorism attack using smallpox?

ANSWER:  Yes. In 2000, CDC awarded a contract to a vaccine manufacturer to produce additional doses of smallpox vaccine.
 
6.  If someone comes in contact with smallpox, how long does it take to show symptoms?

ANSWER:  The incubation period is about 12 days (range: 7 to 17 days) following exposure. Initial symptoms include high fever, fatigue, and head and back aches. A characteristic rash, most prominent on the face, arms, and legs, follows in 2-3 days. The rash starts with flat red lesions that evolve at the same rate. Lesions become pus-filled after a few days and then begin to crust early in the second week. Scabs develop and then separate and fall off after about 3-4 weeks.
 
7.  Is smallpox fatal?

ANSWER:  The majority of patients with smallpox recover, but death may occur in up to 30% of cases.
 
8.  How is smallpox spread?

ANSWER:  In the majority of cases, smallpox is spread from one person to another by infected saliva droplets that expose a susceptible person having face-to-face contact with the ill person. People with smallpox are most infectious during the first week of illness, because that is when the largest amount of virus is present in saliva. However, some risk of transmission lasts until all scabs have fallen off.

Contaminated clothing or bed linen could also spread the virus. Special precautions need to be taken to ensure that all bedding and clothing of patients are cleaned appropriately with bleach and hot water. Disinfectants such as bleach and quaternary ammonia can be used for cleaning contaminated surfaces.
 
9.  If someone is exposed to smallpox, is it too late to get a vaccination?

ANSWER:  If the vaccine is given within 4 days after exposure to smallpox, it can lessen the severity of illness or even prevent it.
 
10.  If people got the vaccination in the past when it was used routinely, will they be immune?

ANSWER:  Not necessarily. Routine vaccination against smallpox ended in 1972. The level of immunity, if any, among persons who were vaccinated before 1972 is uncertain; therefore, these persons are assumed to be susceptible. For those who were vaccinated, it is not known how long immunity lasts. Most estimates suggest immunity from the vaccination lasts 3 to 5 years. This means that nearly the entire U.S. population has partial immunity at best. Immunity can be boosted effectively with a single revaccination. Prior infection with the disease grants lifelong immunity.
 
11.  How many people have not had the vaccination?

ANSWER:  Approximately half of the U.S. population has never been vaccinated.
 
12.  Is it possible for people to get smallpox from the vaccination?

ANSWER:  No, smallpox vaccine does not contain smallpox virus but another live virus called vaccinia virus. Since this virus is related to smallpox virus, vaccination with vaccina provides immunity against infection from
smallpox virus.
 
13.  How safe is the smallpox vaccine?

ANSWER:  Smallpox vaccine is considered very safe. However, some people with pre-existing conditions such as eczema or immune system disorders have a higher risk for having complications from the vaccine. Adverse reaction
s have been known to occur that range from mild rashes to rare fatal encephalitis and disseminated vaccina. Smallpox vaccine should not be administered to persons with a history or presence of eczema or other skin conditions, pregnant women, or persons with immunodeficiency diseases and among those with suppressed immune systems as occurs with leukemia, lymphoma, generalized malignancy, or solid organ transplantation.
 
14.  Is there any treatment for smallpox?

ANSWER:  There is no proven treatment for smallpox, but research to evaluate new antiviral agents is ongoing. Patients with smallpox can benefit from supportive therapy (e.g., intravenous fluids, medicine to control fever or pain) and antibiotics for any secondary bacterial infections that may occur.
 
15.  Is there a test to indicate if smallpox is in the environment like there is for anthrax?

ANSWER:  Various agencies are currently validating tests designed to test for the smallpox virus in the environment.
 
16.  If smallpox is discovered or released in a building, or if a person develops symptoms in a building, how can that area be decontaminated?

ANSWER:  The smallpox virus is fragile and in the event of an aerosol release of smallpox, all viruses will be inactivated or dissipated within 1-2 days. Buildings exposed to the initial aerosol release of the virus do not need to be decontaminated. By the time the first cases are identified, typically 2 weeks after the release, the virus in the building will be gone. Infected patients, however, will be capable of spreading the virus and possibly contaminating surfaces while they are sick. Therefore, standard hospital grade disinfectants such as quaternary ammonias are effective in killing the virus on surfaces should be used for disinfecting hospitalized patients’ rooms or other contaminated surfaces. Although less desirable because it can damage equipment and furniture, hypochlorite (bleach) is an acceptable alternative. In the hospital setting, patients’ linens should be autoclaved or washed in hot water with bleach added. Infectious waste should be placed in biohazard bags and autoclaved before incineration.
 
17.  What should people do if they suspect a patient has smallpox or suspect that smallpox has been released in their area?

ANSWER:  Report suspected cases of smallpox or suspected intentional release of  smallpox to your local health department. The local health department is responsible for notifying the state health department, the FBI, and local law
enforcement. The state health department will notify the CDC.
 
18.  How can we stop the spread of smallpox after someone comes down with it?

ANSWER:  Symptomatic patients with suspected or confirmed smallpox are capable  of spreading the virus. Patients should be placed in medical isolation so that they will not continue to spread the virus. In addition, people who have come into close contact with smallpox patients should be vaccinated immediately and  closely watched for symptoms of smallpox. Vaccine and isolation are the strategies for stopping the spread of smallpox.

-------------
SOURCE:  Centers for Disease Control and Prevention web site at
http://www.cdc.gov

Posted:  8 Nov 01
TRICARE Dental Program Provides Smile Insurance

TRICARE Dental Program Provides Smile Insurance 
November 5, 2001
No. 01-28
 
As with medical prevention, dental prevention should begin at an early age.  Having a regularly scheduled dental examination is essential for maintaining overall good health. The TRICARE Dental Program (TDP) serves active duty family members, members of the Selected Reserve and the Individual Ready Reserve, and  their family members.

The TDP provides a comprehensive benefit package at low monthly premiums. It covers preventive care at 100 percent to encourage family members and Reservists to seek dental care early to avoid more costly or serious dental diseases in the future. Approximately 1.5 million beneficiaries are enrolled but only about 54 percent have actually used the TDP benefit and scheduled an appointment for a routine dental check-up.

Recent studies show that periodontal "gum disease" is the most common cause of  tooth loss for adults and children. In early stages, it's called gingivitis and is both preventable and reversible. "Approximately 75 percent of American
children and adults have some form of gum disease or gingivitis and don't even  know it because it is usually painless in its early stages," said Navy Capt. Lawrence McKinley, senior dental consultant, TRICARE Management Activity.

"And while daily brushing and flossing are important, it's not enough.  Periodontal disease starts below the gum-line where toothbrushes and floss cannot reach. By having regularly scheduled dental exams routinely every six months, your dentist or dental hygienist can check for signs and symptoms of diseases, and remove plaque which can build up over time and harm teeth and gums," McKinley said.

If left untreated, gingivitis can lead to diseases which affect gum tissue,  bone and other supporting tissues of the teeth. Early detection and intervention by a dentist or dental hygienist can reduce the risk of developing  gum disease and prevent permanent damage to teeth and gums. For infants, the biggest oral health problem is baby-bottle tooth decay. This problem occurs mostly in infants who routinely fall asleep with bottles in their mouths filled  with sugary liquids such as milk, formula, juice, or anything other than plain water. Wiping baby's gums after feeding with a clean gauze pad or infant wash cloth, can help remove food particles and reduce plaque build up on erupting  infant teeth.

The TRICARE Dental Program provides "smile insurance" to enrollees because it  offers 100 percent coverage for diagnostic and preventive services, such as examinations, cleanings, x-rays, fluoride treatments and emergency services.
The program also provides some coverage for fillings, braces, athletic mouthpieces, root canals, crowns and bridges.

Overall good dental health starts at an early age by establishing good oral  hygiene routines and by visiting your dentist regularly. Enrolling in and using the TRICARE Dental Program provides the insurance for a lifetime of healthy  smiles. For general information on the program, active duty family members, Reservists and their family members may contact United Concordia (UCCI), the dental program administrator at 1-888-622-2256, or visit the UCCI Web site at
http://www.ucci.com . Family members and Reservists may also contact their local health benefits adviser, beneficiary counseling and assistance coordinator or dental treatment facility for information on how to enroll.

=============
SOURCE:  TRICARE News Release at http://www.tricare.osd.mil
***********************************

NOTE:  Information about the TRICARE Retiree Dental Program (TRDP) is available
online at http://www.ddpdelta.org/

Posted:  8 Nov 01
Gulf War - New Defects Study Contradicts Past Research

November 5, 2001 - WASHINGTON (DeploymentLINK) -- The seventh study on reproductive health of Gulf War veterans, released October 12, still leaves researchers unclear on any significant differences in birth defects between
Gulf War veterans and non-Gulf War veterans and signifies the need for further  study.

"Pregnancy Outcomes among U.S. Gulf War veterans: A population-based survey of  30,000 veterans," is the seventh published study on Gulf-War veterans' reproductive health and the second to find a statistical difference between
Gulf veterans and a comparison group of veterans who did not deploy to the  Gulf. The report was published in the October issue of the Annals of Epidemiology, and found that both men and women deployed to the Gulf reported
significant excesses of birth defects among their live born infants and that  male Gulf veterans reported a significantly higher rate of miscarriage.

The study is sponsored by the Department of Veterans Affairs and the project is  called the National Health Survey of Persian Gulf Veterans. Veterans were contacted for this study by mail and telephone. Gulf War veterans had a 75
percent response rate and 65 percent of non-deployed veterans responded.  Pediatricians analyzed the data, and the self-reported birth defects were reviewed by two pediatric epidemiologists and then classified into one of 12
descriptive groups of a hierarchical system.

"The strength of this study is that it is a population-based study with  randomly selected groups of Gulf veterans and non-Gulf veterans," said U.S. Army Col. Frank O'Donnell, M.D., the deputy director for medical readiness in
the Deployment Health Support Directorate. "However, the main weaknesses are  that the results come from a self-reported survey and that the veterans' reports of birth defects were not validated through medical records."

O'Donnell said an important next step would be to go back and look at the  children's medical records to find out if their parents' reports were accurate. Until such a record review is done, the findings of the study must be regarded
as preliminary. Nevertheless, it is clear that the results warrant further investigation.

Most previous research has not shown an excess rate of birth defects among the offspring of Gulf War veterans.

Scientists from the Centers of Disease Control and Prevention and the  Mississippi state health department studied the health problems and birth defects among children born to Gulf War veterans in Mississippi. This study was  prompted by media stories about birth defects among children of Mississippi National Guardsmen, including one parent's report that 12 out of 15 babies were affected. The findings, published in 1996, revealed only five children with  birth defects among the 54 born following the Gulf War whose medical records were reviewed. This was a small study, so the authors could conclude only that the frequency of birth defects was not greater than would be expected in the
general population.

In a large study done by the Navy Health Research Center, researchers studied  the frequency of birth defects among offspring of military personnel deployed to the Gulf (33,998 births) compared with military personnel who were not
deployed (41,463 births). The birth defect rates were identical at  approximately seven and-a-half percent.

A significant limitation to these studies was the fact that births occurring  only in military hospitals were recorded.

In another study by the NHRC designed to overcome the above limitation,  researchers collaborated with the Hawaii Department of Health, which requires physicians to report all birth defects detected during a child's first year of
life. All births occurring in Hawaii and all birth defects reported to the  state registry were matched against lists of all personnel in the military during the Gulf War. The frequency of birth defects in children born to Gulf War veterans and military parents who did not deploy was similar. Rates of birth defects among Gulf veterans' children were similar before and after the Gulf War.

In 1997, in the only other survey to find a higher rate of birth defects in  Gulf War veterans, Canada surveyed all Canadian Gulf War veterans and a sample of non-Gulf veterans. Completed questionnaires were returned by 73 percent of Gulf veterans and 60 percent of the comparison group. Like the U.S. VA National  Health Survey, veterans were asked about their own health as well as the outcomes of any pregnancies. The two groups reported similar frequencies of stillbirths and miscarriages. The Gulf veterans' group reported a frequency of  birth defects more than twice as high as the frequency among the comparison group. This difference was true even for babies conceived before the Gulf war. As in the recent VA study, the Canadian survey was self-reported and did not  attempt to validate reported birth defects by reviewing the children's medical records.

A study of male Danish soldiers compared 661 veterans of service in the Gulf  region between 1990-97 to 215 men who had not deployed to the Gulf. There were no differences between the two groups with respect to reproductive hormone levels, fertility, miscarriages, and birth defects among their offspring.

"While the new report from the VA accurately reflects the data collected, the  apparent increased risk of birth defects among Gulf War veterans is remarkably high," said O'Donnell. "It's hard to believe that a doubled risk would have
been missed in the larger studies, particularly those which verified birth  defects from medical records. Nevertheless, these new findings prompt the need for further study. Fortunately, there are at least three more studies nearing
completion."
\
Phase III of the VA National Health Survey, in progress now, entails clinical  examinations of 1,000 of the self-reported Gulf War veterans and their family members and 1,000 of the self-reported non-deployed veterans and their family
members. Because this phase of the study includes actual examinations of the  children in both groups, the frequency of birth defects and other medical problems among the children can be reliably compared between the groups.

The NHRC is expanding the Hawaii study to examine birth defect rates in  Arkansas, Arizona, California, Georgia, Hawaii and Iowa. Like Hawaii, these states require the reporting of all birth defects. Over two million births
occurred in these areas during the study period. The results of this study are still pending.

Lastly, research supported by the Medical Research Council of the United Kingdom has attempted to assess the reproductive health of all 52,000 British Gulf War veterans and compare it to a similarly large group of military
personnel who did not deploy to the Gulf. Through use of a survey  questionnaire, the study will examine such factors as infertility, miscarriage, low birth weight, birth defects, and childhood illnesses. Data collection is  complete and analysis is underway.

=============================
SOURCE:  DeployMent Link Web Site at http://deploymentlink.osd.mil/

Posted:  8 Nov 01
DoD Works to Better Educate Healthcare Workers on Vaccines

By Sgt. 1st Class Kathleen T. Rhem, USA
American Forces Press Service

WASHINGTON, Nov. 5, 2001 -- Military allergy and immunization specialists have worked hard to educate
healthcare providers on vaccine safety. But in light of rising bioterrorism concerns, they've ratcheted up their
efforts.

Army Dr. (Col.) Renata Engler is the medical director of the Vaccine Healthcare Center Network, which recently
opened its first center here at Walter Reed Army Medical Center. She explained that vaccines are tools to protect
DoD's members, but they also need to be afforded the same care, respect and safety precautions given other
prescription medicines.

DoD and the Centers for Disease Control and Prevention in Atlanta became partners this summer to provide a network of clearinghouses for information on vaccine safety and procedures throughout DoD.

The new initiative was in response to "the growing challenges that have arisen in the context of immunization
healthcare," Engler said, particularly concerning the public controversies surrounding immunization safety in
general as well as the DoD Anthrax Vaccine Immunization Program specifically.

"Knowledgeable resources had to be developed to support the providers and the small outlying immunization clinics who are dealing with the challenges and to support special, complex patient issues that local medical facilities might
not be resourced to handle," she said.

Engler said her work has come into a whole new light in the aftermath of Sept. 11 -- the contamination of the mail with
anthrax has made the threat of bioterrorism clear to Americans.

She said her organization has been involved in developing plans for possible new or changing vaccination programs for
service members.
 
Any possible use of smallpox vaccine is of particular concern, since America's stockpiles of vaccine for this
deadly, disfiguring disease are old and were made with outdated technology, experts have said. Engler and her
staff are consulting with various agencies to work up contingency plans in case experts decide there's a need to
vaccinate Department of Defense as well as emergency response personnel against smallpox, she said.

"There are some concerns about adverse events related to that vaccine," Engler said. "We've gotten busier faster
than we wanted to in response to new bioterrorism threats that are arising." But this is why the organization was
created in the first place.

"The Vaccine Healthcare Center is really a resource to address the need for outreach education in this rapidly
changing world of immunization challenges," Engler said "We need to do everything we can to give the right shot to
the right person at the right time in the right way."

She said service members 20 years ago received "a handful" of vaccines, but now routinely take more than 50 shots
during their careers. And another 30 vaccines are at various stages of the developmental pipeline and may be
introduced into the immunization requirements over the next five years.

Adverse reactions and drug reactions occur in 1 percent to 2 percent of people with any drug, Engler said. That small
percentage, she noted, can mean big problems in a large enough population.

"That's 20,000 to 40,000 people in a population of 2 million," she said. "Improving our understanding of rare
adverse events would enhance vaccine safety surveillance and lead to higher quality immunization healthcare delivery
overall."

The Vaccine Healthcare Center Initiative began in September and is scheduled to expand to include several regional
centers in the future. Several more are set to open in regional DoD medical centers in the United States in 2002,
leading up to a total of 15 regional centers by 2006, Engler said.

"These vaccine healthcare centers would work as a network to share information, not just internally but with the Food
and Drug Administration, CDC, and the Vaccine Adverse Event Reporting System, too, as questions arise surrounding a vaccine," she said.

####

NOTE:  This is a plain text version of a web page.  If your e-mail program did not properly format this information, you may view the story at http://www.defenselink.mil/news/Nov2001/n11052001_200111053.html
Any photos, graphics or other imagery included in the article may also be viewed at this web page.

Visit the Defense Department's newest Web site for the latest news and information about America's
response to the Sept. 11, 2001, terrorist attacks and the war against terrorism: "Defend America"
at http://www.DefendAmerica.mil.

Posted:  8 Nov 01
Winkenwerder Sworn in as Health Affairs Assistant Secretary

NEWS RELEASE from the United States Department of Defense

No. 550-01
(703)695-0192(media)
IMMEDIATE RELEASE
October 30, 2001
(703)697-5737(public/industry)

WINKENWERDER SWORN IN AS HEALTH AFFAIRS ASSISTANT SECRETARY

Dr. William Winkenwerder Jr. took the oath of office yesterday as the new assistant secretary of Defense.

Winkenwerder was nominated for the position by President Bush on September 21, 2001, and confirmed by the Senate on October 16, 2001.

Winkenwerder has held a variety of senior-level positions in the healthcare  industry.  Most recently, he was vice chairman, Office of the Chief Executive, and executive vice president of Health Care Services for Blue Cross Blue Shield of Massachusetts, the largest health insurance plan in New England with more  than 2.4 million enrollees.  Before moving to Massachusetts, Winkenwerder served as associate vice president for Health Affairs and vice president of
Emory Healthcare at Emory University in Atlanta, Ga.  From 1992 to 1995, Winkenwerder held the position of vice president and chief medical officer for Southern Operations for Prudential Healthcare based in Atlanta.  Prior to this
position, he served as the associate medical director at the Southeast Permanente Medical Group of Kaiser Permanente in Atlanta.  From 1987 to 1988, Winkenwerder worked at the Health Care Financing Administration, now Centers
for Medicare and Medicaid Services, Department of Health and Human Services, in Washington, D.C.

Winkenwerder received his bachelor's degree of science from Davidson College,  Davidson, N.C., in 1976, his medical degree from the University of North Carolina School of Medicine, Chapel Hill, N.C., in 1981, and his master's of  business administration from The Wharton School, University of Pennsylvania,  Philadelphia, Pa., in 1986.

Winkenwerder has completed post graduate training and fellowships in internal  medicine,  epidemiology and health services research.  He also completed a fellowship at the Department of Health and Human Services where he helped
develop a catastrophic Medicare legislation proposal for the Reagan Administration.  Winkenwerder holds a number of board memberships, has written broadly on health policy issues, and is active in a variety of professional associations.

As the Assistant Secretary of Defense for Health Affairs, Winkenwerder serves  as the principal staff assistant and advisor to the secretary and deputy secretary of Defense and the under secretary of Defense for Personnel and
Readiness for all Department of Defense health policies, programs, and  activities.  He will have the responsibility to effectively execute the department's healthcare mission.  This mission is to provide, and to maintain  readiness to provide, healthcare services and support to members of the armed forces during military operations.  In addition, the department's healthcare mission provides healthcare services and support to members of the armed forces, their family members, and others entitled to DoD healthcare.

Posted:  8 Nov 01
DoD Announces New Ways to Express Support

NEWS RELEASE from the United States Department of Defense

No. 556-01
(703)697-5131(media)
IMMEDIATE RELEASE
October 30, 2001
(703)697-5737(public/industry)

DOD ANNOUNCES NEW WAYS TO EXPRESS SUPPORT

        The Department of Defense today announced new ways for Americans to show support for their servicemembers deployed overseas.  The initiatives, made necessary by a moratorium on mail addressed to "Any Servicemember," provide alternatives to traditional letter-writing campaigns.  DoD suggests that Americans support the troops by instead supporting the communities in which they live.

        One way to show support is by doing a good deed on behalf of servicemembers.  Visit a VA hospital or nursing home, or volunteer in the local community to help make up for servicemembers who normally would volunteer but are now deployed or otherwise too busy with their duties.  Many servicemembers volunteer to coach children's teams, feed the homeless, and aid their communities in a variety of other ways.  Interested Americans can show their support and honor their military by volunteering in their local communities.

        Although many towns do not have a military base nearby, military recruiters are stationed nearly everywhere.  Local governments and chambers of commerce are encouraged to reach out to these local members of the military, invite them to speak at community events, and encourage members of the community to learn more about America's military.

        Members of the community who know military families might want to offer their support by reaching out to those
families while their loved ones are deployed.

        A number of private organizations are developing Web-based methods for Americans to show support.  While
donations of food and gifts for delivery overseas can no longer be accepted, interested Americans might contribute instead to military relief societies.  For more information see
http://www.defenselink.mil/news/Sep2001/n09172001_200109173.html
.
        All of these initiatives are in response to the suspension of the "Any Servicemember" mail program for operations in Bosnia and Kosovo.  Military postal officials will not be implementing a similar program for Operation Enduring
Freedom.  Operation Dear Abby, a morale booster for servicemembers overseas for more than 17 years, will also be
suspended.  DoD officials are working on alternatives to that program as well.

       Servicemembers value and appreciate expressions of support from the American people, and these and other mail
programs are a significant boost to morale.  However, recent mail-related attacks have resulted in additional precautions and the safety of servicemembers is paramount.  The increased  manpower required to ensure safe mail handling coupled with the increased volume of mail that letter-writing campaigns generate could exceed capabilities, and therefore cannot be supported at this time.

        Normal mail delivery addressed by name to individual servicemembers will continue uninterrupted.

Posted:  8 Nov 01
Active Duty Uniformed Services Members to Get Permanent Chiropractic Care

Active Duty Uniformed Services Members to Get Permanent Chiropractic Care Benefit 
October 25, 2001
No. 01-27
 
The National Defense Authorization Act (NDAA) passed last year authorizes  chiropractic care for active duty service members, but not for family members of active duty personnel, effective Oct. 1, 2001.

Previously, chiropractic care services were provided to active duty personnel  and family members under the Chiropractic Health Care Demonstration Program (CHCDP), which ended on Sept. 30, 2001.

Chiropractic care is a health care discipline that focuses on the relationship  between the structure (primarily the spine) and the function (as coordinated by the nervous system) and how that relationship affects the preservation and  restoration of health. Chiropractic care emphasizes healing without the use of  drugs or surgery. However, chiropractic providers work in cooperation with other health care providers in the best interest of the patient.

Chiropractic care for active duty members is available only at sites authorized  by the Department of Defense which for the Army includes: Fort Benning, Martin Army Community Hospital, Columbus, Ga.; Fort Carson, Evans Army Community Hospital, Colorado Springs, Colo.; Fort Jackson, Moncrief Army Community  Hospital, Columbia, S.C.; Fort Sill, Reynolds Army Community Hospital, Lawton, Okla.; and Walter Reed Army Medical Center, Washington, D.C.

Chiropractic sites in the Navy include: Camp Lejeune, Naval Hospital, Camp  Lejeune, N.C.; Camp Pendleton, Naval Hospital, Camp Pendleton, Calif.; Jacksonville Naval Air Station, Naval Hospital, Jacksonville, Fla.; and  National Naval Medical Center, Bethesda, Md.

Air Force chiropractic sites include: Offutt Air Force Base (AFB), Ehrling  Bergquist Hospital, 55th Medical Group, Omaha, Neb.; Scott AFB, 375th Medical Group, Belleville, Ill.; Travis AFB, 60th Medical Group, Fairfield, Ca.; and
Wilford Hall Medical Center, San Antonio, Texas.

Active duty service members may be treated by a chiropractic provider for neuro- musculoskeletal conditions if referred by their primary care manager at one of the designated military treatment facilities. During the course of treatment,  the primary care manager will determine if specialty care (traditional or chiropractic care) is required. If chiropractic care is considered an option, the patient will undergo a screening process to rule out any medical conditions  that would prohibit chiropractic care. If appropriate, the primary care manager may refer the patient to a chiropractic provider for treatment.

These procedures must be followed to receive chiropractic care under the  Chiropractic Care Program. Chiropractic care received outside of the designated locations may not be covered under the Chiropractic Care Program. Updates on the new chiropractic benefit for active duty service members, including new  sites, will be available on the MHS/TRICARE Web site at http://www.tma.osd.mil/ndaa . Service members are also encouraged to contact or
visit their local health benefits adviser or beneficiary counseling and assistance coordinators with any questions they may have regarding the new chiropractic benefit.

-----------
SOURCE:  TRICARE Web Page at http://www.tricare.osd.mil
Refer questions to QUESTIONS@tma.osd.mil

Posted:  8 Nov 01
Mailing List Info, TROA Pamphlets, and Info for Folks in Las Vegas

1.  Mailing List Info: 

    a.  Many beneficiaries join this mailing list thinking it's a newsletter,  i.e., published on a weekly, monthly or quarterly basis.  This is not true.  Messages are sent to the mailing list randomly, depending on receipt or  availability of TRICARE and/or Military Health System information.  You may receive several messages in a single day or no messages for several days.

    b.  While we try to ensure mailing list messages are of interest to most of  our mailing list members, sometimes messages may pertain to a single TRICARE region.  Sorry for any inconvenience such messages may cause.

    c.  If you send a message to mailto:HEALTH-OFF@PASBA2.AMEDD.ARMY.MIL to  have your address removed from the mailing list, you should receive a confirmation message within hours to inform you that your address has been removed.  If you do not receive the confirmation message, contact mailto:PASBA@pasba2.amedd.army.mil to have your address removed manually.

2.  TROA Pamplets:  The following TRICARE For Life related pamphlets are  available from The Retired Officers Association (TROA) web site at http://www.troa.org/Booklets/

    a.  "TRICARE For Life:  The Road to Honoring Health Care Commitments" - Explains all the who, what, where, when, why, and how regarding TRICARE's role as a "huge step toward fulfilling the 'lifetime health care' promise."

    b.  "TRICARE For Life:  A Friendlier Option for Providers" -  This new "Handbook for Providers" clarifies how TRICARE will work with providers, including how it will help cut claims-processing red tape.

Adobe Acrobat Reader is required to view/print the above pamphlets.  If you  don't have this program, it's available free from http://www.adobe.com

NOTE:  This is not intended an endorsement of TROA or its activities.  The  above information is provided for the use of mailing list members, as desired.  Please do not contact me if you're unable to use the Adobe Acrobat Reader
software, access the TROA web site, or encounter any other difficulties when attempting to view/print the TROA pamphlets.

3.  Below listed information is provided for the benefit of beneficiaries residing in the Las Vegas/Nellis Air Force Base area.

############

TriWest Builds Las Vegas TRICARE Provider Network to 1,000+ Providers

PHOENIX (Oct. 22, 2001)-TriWest Healthcare Alliance is pleased to announce that a strong health care provider network is in place to serve the 65,000 TRICARE beneficiaries in the Las Vegas/Nellis Air Force Base area.

Sierra Health Services, as one of 14 TriWest shareholders, previously had been responsible for developing and managing the TRICARE network for TriWest in Nevada. When TriWest purchased Sierra's ownership interest in TriWest last year, TriWest assumed that responsibility for network development and management.

In all more than 95 percent of the providers who had been part of Sierra's network have been retained. The network currently consists of 174 primary care physicians and 857 specialists. TriWest also has added the following hospitals and outpatient surgery centers as network providers in the Las Vegas area:

    *  Desert Springs Hospital,
    *  Summerlin Hospital Medical Center,
    *  Valley Hospital Medical Center,
    *  Goldring Surgical Center and
    *  Plaza Surgery Center.

According to Dave McIntyre, TriWest's president and chief executive officer, "TriWest received a four-year contract extension in July. With this extension and with our robust provider network, TriWest will continue to provide our beneficiaries in the Las Vegas and Nellis Air Force Base vicinity with access to high-quality health care services and superior customer service."

"TriWest is committed to serving the health care needs of the area's military families and of those who have previously served in the defense of freedom," says Dr. Jerry Sanders, the company's vice president of medical affairs.  "Amid the current uncertainty, TriWest assures our beneficiaries that we will continue to support the military health system and that
families will have access to seamless delivery of health care services."

TRICARE is a regionally managed health care program for active duty and retired members of the uniformed services, their families and survivors. It brings together the health care resources of the Army, Navy and Air Force and supplements them with networks of civilian health care professionals to provide better access and high quality service while maintaining the capability to support military operations.

TriWest Healthcare Alliance is a Phoenix-based management service organization that is contracted with the Department of Defense for the managed care support and administration of the TRICARE program in the 16-state TRICARE Central Region. TriWest's goal is to provide the region's TRICARE beneficiaries with access to cost-effective, quality health care and superior customer service. More information about TriWest and TRICARE can be
found at http://www.triwest.com ###

--------------
SOURCE:  TriWest News Release
POC:  Mark Jecker at MJecker@TriWest.com
Corporate Communications Specialist
TriWest Healthcare Alliance
15451 North 28th Ave.
Phoenix, AZ  85053
602-564-2074

Posted:  8 Nov 01
TRICARE Basic and Advance Student Course

Training conducted by Military Liaison Directorate
Point of Contact:  Theodore.Moore@tma.osd.mil

The Tricare Basic and Advance Student Course (TBASCO) is sponsored by the Military Liaison Directorate (MLD). The course is open to anyone who wants to attend. The audience typically includes representation from all services,
including Active, Reserve, and Guard personnel, as well as retirees, Health Benefits Advisors/Beneficiary Counseling and Assistance Coordinators, other hospital personnel, contractors affiliated with the federal government, and beneficiaries. There is no cost for the course, in terms of registration, etc.

The course is currently being held at the Double Tree Hotel, located at 32nd Street and Quebec, Denver, Colorado (about 6 miles East of downtown Denver). Hotel telephone number is (303) 321-3333.

Registration for the course is done online through the TRICARE web site at http://www.tricare.osd.mil . Click on the pull-down menu and select "Training,"  then click on "TBASCO" (TRICARE Basic & Advanced Student Course).

The following is a list of training dates. Any necessary changes to training dates will be posted on the web site:

    November 14-16,2001 Basic Course only
    December 4-7,2001 Basic and Advance Course
    January 29-31, 2002 Basic Course only
    February 26-28,2002 Basic Course only
    April 2-4, 2002 Basic Course only
    May 14-17, 2002 Basic and Advance Course
    August 13-15,2002 Basic Course only
    September 24-26, 2002 Basic Course only
    November 5-7,2002 Basic Course only
    December 10-13, 2002 Basic and Advance Course

For additional information contact Theodore.Moore@tma.osd.mil , Course Administrator, at (DSN) 926-3744 or (303) 676-3744.

=========
SOURCE:  TRICARE Management Activity
POC:  Theodore.Moore@tma.osd.mil

Posted:  19 Oct 01
DoD to Re-look Anthrax Vaccine Issue, Rumsfeld Says

By Gerry J. Gilmore
American Forces Press Service
 
WASHINGTON, Oct. 18, 2001 -- DoD will look at ways to kick-start U.S. production of anthrax vaccine that, up to now, has been manufactured by just one company in Michigan, Defense Secretary Donald H. Rumsfeld said today.
 
Rumsfeld remarked to Pentagon reporters that DoD is going to try to save its anthrax vaccine program with
manufacturer Bioport. He noted that other efforts to produce anthrax vaccine for the U.S. military had "failed over a period of years."
 
DoD's business relationship with Bioport to acquire anthrax vaccine may or may not be savable, he added.
 
Bioport was DoD's sole contractor for anthrax vaccine. The company has had quality control problems and hasn't
produced any vaccine for some time. Its manufacturing operations currently lack Food and Drug Administration
approval.
 
Rumsfeld said he discussed the vaccine issue today with S.C. "Pete" Aldridge, defense undersecretary for
acquisition, technology and logistics, and David S.C. Chu, defense undersecretary for personnel and readiness. He said they or their representatives will meet with Department of Health and Human Services officials to discuss the vaccine situation.
 
Rumsfeld said DoD would try to fashion an arrangement that would give Bioport one more chance at supply an FDA-
approved anthrax vaccine. 

Officials said DoD has anthrax vaccine on hand to meet anticipated military needs.
####

Visit the Defense Department's newest Web site for the latest news and information about America's
response to the Sept. 11, 2001, terrorist attacks and the war against terrorism: "Defend America"
at http://www.DefendAmerica.mil.
====================================================
Virtual tour of the Pentagon
     http://www.defenselink.mil/pubs/pentagon/

Posted:  19 Oct 01
TRICARE Claims Information

NOTE:  Below listed telephone numbers are provided for the benefit of beneficiaries residing in the TRICARE regions indicated.  Although telephone numbers for Regions 6 and 11 are not included, customer service personnel at the numbers listed will reportedly respond to TRICARE For Life (TFL) claims and TFL pharmacy related questions from beneficiaries in all TRICARE regions. 
 
Regions 6 and 11 apparently do not have special telephone numbers for TFL claims.  However, here are customer service telephone numbers to call for all claims related assistance:

     Region 6: 1-800-406-2832, Option 2
     Region 11: 1-800-404-0110
 
If you're not sure of your TRICARE region, you can find out by going online to http://www.tricare.osd.mil/claims/default.htm or go to http://www.tricare.osd.mil and use the pull-down menu to select "Claims Information."
------------------
 
1.  These are the correct telephone numbers for TRICARE For Life (TFL) claims for all regions except 6 & 11 (all states except Oregon, Washington, Texas and Oklahoma):
 
Region 1: 1-888-999-6355 (Sierra) 8:00 a.m.-6:00 p.m. EST Mon.-Fri.
Regions 2/5: 1-866-TFL-PGBA (1-866-835-7422) 8:00 a.m.-7:00 p.m. EST Mon.-Fri.
Regions 3/4: 1-866-TFL-PGBA (1-866-835-7422) 8:00 a.m.-7:00 p.m. EST Mon.-Fri.
Regions 7/8: 1-866-TFL-PGBA (1-866-835-7422) 9:00 a.m.-10:00 p.m. EST Mon.-Fri.
Regions 9/10/12: 1-866-TFL-PGBA (1-866-835-7422) 11:00 a.m.-11:00 p.m. EST Mon.-Fri.
 
2.  For TRICARE Senior Pharmacy and all non-TFL TRICARE claims questions (for all regions except 6 and 11), these are the correct numbers:
 
Region 1: 1-800-578-1294 8:00 a.m.-6:00 p.m. EST Mon.-Fri.
Regions 2/5: 1-800-493-1613 (beneficiaries)
             1-800-613-7124 (providers)  8:00 a.m.-7:00 p.m. EST Mon.-Fri.
Regions 3/4: 1-800-403-3950 8:00 a.m.-7:00 p.m. EST Mon.-Fri.
Regions 7/8: 1-800-225-4816 9:00 a.m.-9:00 p.m. EST Mon.-Fri.
Regions 9/10/12: 1-800-930-2929 (beneficiaries)
                 1-800-977-1255 (providers) 11:00 a.m.-11:00 p.m. EST Mon.-Fri.
 
3.  As always, TRICARE customers are invited to visit http://www.myTRICARE.com by PGBA for complete information.
======================
SOURCE:  Palmetto Government Benefits Administrators (PGBA) news release
Point of Contact:
Lynda Scott
Director, E-Commerce
http://www.myTRICARE.com by PGBA
Phone:  843.650.6100  ext. 17486
Fax:    843.650.0552
Email:  lynda.scott@mytricare.com

Posted:  19 Oct 01
How to Handle Anthrax and Other Biological Agent Threats

CDC Health Advisory
October 12, 2001, 21:00 EDT (9:00 PM EDT)

How To Handle Anthrax And Other Biological Agent Threats
 
Many facilities in communities around the country have received anthrax threat letters.  Most were empty envelopes; some have contained powdery substances.  The purpose of these guidelines is to recommend procedures for handling such incidents.
 
A.  DO NOT PANIC
 
1.  Anthrax organisms can cause infection in the skin, gastrointestinal system, or the lungs.  To do, so the organism must be rubbed into abraded skin, swallowed, or inhaled as a fine, aerosolized mist.  Disease can be prevented after exposure to the anthrax spores by early treatment with the appropriate antibiotics.  Anthrax is not spread from one person to another person.
 
2.  For anthrax to be effective as a covert agent, it must be aerosolized into very small particles.  This is difficult to do, and requires a great deal of technical skill and special equipment.  If these small particles are inhaled, life-threatening lung infection can occur, but prompt recognition and treatment are effective.
 
B.  SUSPICIOUS UNOPENED LETTER OR PACKAGE MARKED WITH THREATENING MESSAGE SUCH AS “ANTHRAX”:
 
1.  Do not shake or empty the contents of any suspicious envelope or package.
 
2.  PLACE the envelope or package in a plastic bag or some other type of container to prevent leakage of contents.
 
3.  If you do not have any container, then COVER the envelope or package with anything (e.g., clothing, paper, trash can, etc.) and do not remove this cover.
 
4.  Then LEAVE the room and CLOSE the door, or section off the area to prevent others from entering (i.e., keep others away).
 
5.  WASH your hands with soap and water to prevent spreading any powder to your face.
 
6.  What to do next…
 
    a.  If you are at HOME, then report the incident to local police.
 
    b.  If you are at WORK, then report the incident to local police, and notify your building security official or an available supervisor.
 
7.   LIST all people who were in the room or area when this suspicious letter or package was recognized. Give this list to both the local public health authorities and law enforcement officials for follow-up investigations and
advice. 
 
C.  ENVELOPE WITH POWDER AND POWDER SPILLS OUT ONTO SURFACE: 

1.  DO NOT try to CLEAN UP the powder.  COVER the spilled contents immediately with anything (e.g., clothing, paper, trash can, etc.) and do not remove this cover!
 
2.  Then LEAVE the room and CLOSE the door, or section off the area to prevent others from entering (i.e., keep others away).
 
3.  WASH your hands with soap and water to prevent spreading any powder to your face.
 
4.  What to do next…
 
    a.  If you are at HOME, then report the incident to local police.
 
    b.  If you are at WORK, then report the incident to local police, and notify your building security official or an available supervisor.
 
5.  REMOVE heavily contaminated clothing as soon as possible and place in a plastic bag, or some other container that can be sealed.  This clothing bag should be given to the emergency responders for proper handling.
 
6.  SHOWER with soap and water as soon as possible.  Do Not Use Bleach Or Other Disinfectant On Your Skin.
 
7.  If possible, list all people who were in the room or area, especially those who had actual contact with the powder. Give this list to both the local public health authorities so that proper instructions can be given for medical follow-up, and to law enforcement officials for further investigation.
 
D.  QUESTION OF ROOM CONTAMINATION BY AEROSOLIZATION:
 
For example: small device triggered, warning that air handling system is contaminated, or warning that a biological agent released in a public space.
 
1.  Turn off local fans or ventilation units in the area.
 
2.  LEAVE area immediately.
 
3.  CLOSE the door, or section off the area to prevent others from entering (i.e., keep others away).
 
4.  What to do next…
 
    a.  If you are at HOME, then dial “911” to report the incident to local police and the local FBI field office.
 
    b.  If you are at WORK, then dial “911” to report the incident to local police and the local FBI field office, and notify your building security official or an available supervisor.
 
5.   SHUT down air handling system in the building, if possible.
 
6.   If possible, list all people who were in the room or area. Give this list to both the local public health authorities so that proper instructions can be given for medical follow-up, and to law enforcement officials for further
investigation.
 
E.  HOW TO IDENTIFY SUSPICIOUS PACKAGES AND LETTERS
 
1.  Some characteristics of suspicious packages and letters include the following…
 
    a.  Excessive postage
    b.  Handwritten or poorly typed addresses
    c.  Incorrect titles
    d.  Title, but no name
    e.  Misspellings of common words
    f.  Oily stains, discolorations or odor
    g.  No return address
    h.  Excessive weight
    i.  Lopsided or uneven envelope
    j.  Protruding wires or aluminum foil
    k.  Excessive security material such as masking tape, string, etc.
    l.  Visual distractions
    m.  Ticking sound
    n.  Marked with restrictive endorsements, such as “Personal” or “Confidential”
    o.  Shows a city or state in the postmark that does not match the return address
 
For more information on anthrax and other such agents, please visit the Centers for Disease Control (CDC) and Prevention web site at http://www.cdc.gov/ and http://www.bt.cdc.gov/
===========
SOURCE:  Centers for Disease Control and Prevention web site at  http://www.cdc.gov/

Posted:  19 Oct 01
Guidance for Emergency Care at Base/Post Facilities Under Enhanced Security

TRICARE Provides Guidance for Emergency Care at Base Facilities under Enhanced Security 
October 12, 2001
No. 01-26

In times of enhanced security at military installations it may be difficult for TRICARE beneficiaries to access uniformed services hospitals and clinics. The TRICARE Management Activity developed the following guidance for beneficiaries
seeking emergency, urgent and routine care at uniformed services facilities that are under these conditions.
 
In case of medical emergency, TRICARE beneficiaries should seek immediate treatment at the nearest hospital. This is true whether or not they are enrolled in TRICARE Prime. TRICARE defines an emergency as a medical, maternity
or psychiatric condition that would lead a "prudent layperson" (someone with average knowledge of health and medicine) to believe that a serious medical condition exists. An emergency condition is one in which the absence of medical attention would result in a threat to life, limb, or sight and requires immediate medical treatment. Further, it may be a condition marked by severe pain that requires immediate relief to alleviate suffering.
 
While the definition of an emergency may sound complicated, it really means that beneficiaries who believe they are experiencing a serious medical condition that requires immediate treatment should go to the nearest emergency
room. TRICARE will assist in paying for the cost of their care. This is true for beneficiaries who use TRICARE Standard or Extra or who are enrolled in Prime.
 
TRICARE beneficiaries who become ill but don't require emergency care as described above need urgent care. Those enrolled in TRICARE Prime who have a primary care provider who works out of a uniformed services facility that is
inaccessible due to increased security are encouraged to call their provider for assistance. Providers or staff members at military treatment facilities can inform beneficiaries of their best options for necessary care. In many circumstances, this may include taking care of oneself under the advice of a provider or a change in timing of the needed visit as appropriate. Beneficiaries also may contact their regional Health Care Information Line for information on self-care.
 
During times of increased security, routine appointments should be rescheduled if access to a military treatment facility is restricted. As with urgent care, beneficiaries should call ahead to their providers' offices for guidance.
================
SOURCE:  TRICARE News Release at http://www.tricare.osd.mil

Posted:  12 Oct 01
Anthrax - Frequently Asked Questions

1. What is anthrax?
 
Anthrax is an acute infectious disease caused by the spore-forming bacterium Bacillus anthracis. Anthrax most commonly occurs in wild and domestic lower vertebrates (cattle, sheep, goats, camels, antelopes, and other herbivores), but it can also occur in humans when they are exposed to infected animals or tissue from infected animals.
 
2. Why has anthrax become a current issue?
 
Because anthrax is considered to be a potential agent for use in biological warfare, the Department of Defense (DoD) has begun mandatory vaccination of all active duty military personnel who might be involved in conflict.
 
3. How common is anthrax and who can get it?
 
Anthrax is most common in agricultural regions where it occurs in animals. These include South and Central America, Southern and Eastern Europe, Asia, Africa, the Caribbean, and the Middle East. When anthrax affects humans, it is
usually due to an occupational exposure to infected animals or their products. Workers who are exposed to dead animals and animal products from other countries where anthrax is more common may become infected with B. anthracis (industrial anthrax). Anthrax in wild livestock has occurred in the United States.
 
4. How is anthrax transmitted?
 
Anthrax infection can occur in three forms: cutaneous (skin), inhalation, and gastrointestinal. B. anthracis spores can live in the soil for many years, and humans can become infected with anthrax by handling products from infected
animals or by inhaling anthrax spores from contaminated animal products.  Anthrax can also be spread by eating undercooked meat from infected animals. It is rare to find infected animals in the United States.
 
5. What are the symptoms of anthrax?
 
Symptoms of disease vary depending on how the disease was contracted, but symptoms usually occur within 7 days.
 
- Cutaneous: Most (about 95%) anthrax infections occur when the bacterium enters a cut or abrasion on the skin, such as when handling contaminated wool, hides, leather or hair products (especially goat hair) of infected animals.  Skin infection begins as a raised itchy bump that resembles an insect bite but within 1-2 days develops into a vesicle and then a painless ulcer, usually 1-3 cm in diameter, with a characteristic black necrotic (dying) area in the center. Lymph glands in the adjacent area may swell. About 20% of untreated cases of cutaneous anthrax will result in death. Deaths are rare with appropriate antimicrobial therapy.
 
- Inhalation: Initial symptoms may resemble a common cold. After several days, the symptoms may progress to severe breathing problems and shock. Inhalation anthrax is usually fatal.
 
- Intestinal: The intestinal disease form of anthrax may follow the consumption of contaminated meat and is characterized by an acute inflammation of the intestinal tract. Initial signs of nausea, loss of appetite, vomiting, fever
are followed by abdominal pain, vomiting of blood, and severe diarrhea. Intestinal anthrax results in death in 25% to 60% of cases.
 
6. Where is anthrax usually found?
 
Anthrax can be found globally. It is more common in developing countries or countries without veterinary public health programs. Certain regions of the world (South and Central America, Southern and Eastern Europe, Asia, Africa, the Caribbean, and the Middle East) report more anthrax in animals than others. 
 
7. Can anthrax be spread from person-to-person?
 
Direct person-to-person spread of anthrax is extremely unlikely to occur.  Communicability is not a concern in managing or visiting with patients with inhalational anthrax.
 
8. Is there a way to prevent infection?
 
In countries where anthrax is common and vaccination levels of animal herds are low, humans should avoid contact with livestock and animal products and avoid eating meat that has not been properly slaughtered and cooked. Also, an anthrax vaccine has been licensed for use in humans. The vaccine is reported to be 93% effective in protecting against anthrax.
 
9. What is the anthrax vaccine?
 
The anthrax vaccine is manufactured and distributed by BioPort, Corporation, Lansing, Michigan. The vaccine is a cell-free filtrate vaccine, which means it contains no dead or live bacteria in the preparation. The final product
contains no more than 2.4 mg of aluminum hydroxide as adjuvant. Anthrax vaccines intended for animals should not be used in humans.
 
10. Who should get vaccinated against anthrax?
 
The Advisory Committee on Immunization Practices has recommend anthrax vaccination for the following groups:
 
- Persons who work directly with the organism in the laboratory
- Persons who work with imported animal hides or furs in areas where standards are insufficient to prevent exposure to anthrax spores.
- Persons who handle potentially infected animal products in high-incidence areas. (Incidence is low in the United States, but veterinarians who travel to work in other countries where incidence is higher should consider being
vaccinated.)
- Military personnel deployed to areas with high risk for exposure to the organism (as when it is used as a biological warfare weapon).
- The anthrax Vaccine Immunization Program in the U.S. Army Surgeon General's Office can be reached at 1-877-GETVACC (1-877-438-8222).
http://www.anthrax.osd.mil
 
- Pregnant women should be vaccinated only if absolutely necessary.
 
11. What is the protocol for anthrax vaccination?
 
The immunization consists of three subcutaneous injections given 2 weeks apart followed by three additional subcutaneous injections given at 6, 12, and 18 months. Annual booster injections of the vaccine are recommended thereafter.
 
12. Are there adverse reactions to the anthrax vaccine?
 
Mild local reactions occur in 30% of recipients and consist of slight tenderness and redness at the injection site. Severe local reactions are infrequent and consist of extensive swelling of the forearm in addition to the local reaction. Systemic reactions occur in fewer than 0.2% of recipients.
 
13. How is anthrax diagnosed?
 
Anthrax is diagnosed by isolating B. anthracis from the blood, skin lesions, or respiratory secretions or by measuring specific antibodies in the blood of persons with suspected cases.
 
14. Is there a treatment for anthrax?
 
Doctors can prescribe effective antibiotics. To be effective, treatment should be initiated early. If left untreated, the disease can be fatal.
 
15. Where can I get more information about the recent Department of Defense decision to require men and women in the Armed Services to be vaccinated against anthrax?
 
The Department of Defense recommends that servicemen and women contact their chain of command on questions about the vaccine and its distribution. The anthrax Vaccine Immunization Program in the U.S. Army Surgeon General's Office can be reached at 1-877-GETVACC (1-877-438-8222). http://www.anthrax.osd.mil
 
===============
SOURCE:  Center for Disease Control and Prevention (CDC) web site at
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/anthrax_g.htm

Posted:  12 Oct 01
More Anthrax Info

The recent anthrax-related death and ongoing investigation have many asking about anthrax ­ what is it and what do I need to do to protect myself and my family?
 
Information from the Centers for Disease Control and Prevention says that anthrax is an acute infectious disease caused by the spore-forming bacterium Bacillus anthracis. Anthrax most commonly occurs in hoofed mammals and can also infect humans.
 
Symptoms of disease vary depending on how the disease was contracted, but usually occur within seven days after exposure. The serious forms of human anthrax are inhalation anthrax, cutaneous (skin) anthrax, and intestinal
anthrax. 
 
Initial symptoms of inhalation anthrax infection may resemble a common cold. After several days, the symptoms may progress to severe breathing problems and shock. Inhalation anthrax is often fatal.
 
In its most common form, anthrax is a skin disease that causes skin ulcers at the site where the bacterium enters the skin. Up to 20 percent of these cases are fatal if left untreated.
 
The intestinal form of anthrax may follow the consumption of contaminated food and is characterized by an acute inflammation of the intestinal tract. Initial signs of nausea, loss of appetite, vomiting, and fever are followed by
abdominal pain, vomiting of blood, and severe diarrhea.
 
Direct person-to-person spread of anthrax is extremely unlikely, if it occurs at all. Therefore, there is no need to immunize or treat contacts of persons ill with anthrax, such as household contacts, friends, or coworkers, unless
they were also exposed to the same source of infection.
 
In persons exposed to anthrax, infection can be prevented by antibiotic treatment. Early treatment of anthrax is essential ­ delay lessens chances for survival. Anthrax usually is susceptible to penicillin, doxycycline, and
fluoroquinolones.
 
An anthrax vaccine also can prevent infection. Vaccination against anthrax is not recommended for the general public to prevent disease and is not available. 
 
We continue to hear stories of the public buying gas masks and hoarding medicine in anticipation of a possible bioterrorist or chemical attack. Officials at the CDC do not recommend either. Local and state health departments are primed to investigate possible cases of anthrax and will inform the public about the actions individuals need to take.
 
To learn more about anthrax, visit the CDC's web site at
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/anthrax_g.htm or the DoD web site at
http://www.anthrax.osd.mil/ or call 1-800-438-8222.
 
============
SOURCE:  DeploymentLink web site at http://deploymentlink.osd.mil/

Posted:  12 Oct 01
Drug, Alcohol Treatment Available to DoD Beneficiaries

By Sgt. 1st Class Kathleen T. Rhem, USA
American Forces Press Service

WASHINGTON, Oct. 11, 2001 -- DoD aggressively treats drug and alcohol abuse in family members and retirees as well as active duty service members.
 
"Addiction is an illness. It's a medical condition that requires identification and treatment and rehabilitation,"
said Roger Hartman, a health policy analyst with the Office of the Secretary of Defense for Health Affairs.
 
Military and family members identified as substance abusers will receive counseling and treatment, Hartman said. He
noted that active duty members who use illegal drugs will typically be separated from their service.
 
"There was a time years ago that we would counsel and rehabilitate and try to return drug abusers to duty," he
said. "But in this day and age of high technology and sophisticated systems, we can't afford any lapse in
performance or behavior on the job."
 
Whether drug abusers step forward and ask for help or wait to be caught by urinalysis testing can make a difference on their future employment prospects. Members who self-refer themselves for treatment could be administratively
separated from the military as opposed to punitively separated, Hartman said.
 
"With alcohol, the military is a bit more tolerant because it's a legal beverage if you're over the age of 21,"
Hartman said. "We encourage early identification of those who do have a drinking problem, referral into an
appropriate level of counseling and treatment, and then return to duty and participation in an after-care program."
 
The same counseling and treatment services are available to family members and retirees. Hartman said DoD has been a leader in the field of substance abuse treatment for 30 years and uses the standards established by the American
Society of Addiction Medicine. "We have quality programs characterized by stringent certification requirements for
our counseling staff and accreditation requirements for the facilities themselves," he said.
 
Hartman said he believes the nature of substance abuse is similar, whether the substance be drugs or alcohol. "The
substance becomes something that begins to control and take over the life of the individual," he said. "Everyone's use
of drugs or alcohol starts out experimentally. I don't think anybody ever sets out to become an alcoholic or a
drug addict, but for some that path ultimately leads to addiction."
 
There are many avenues individuals seeking help for substance abuse can take. They can seek help through the
military medical system, base community or family counseling centers, chaplains or their chains of command,
Hartman explained.
 
Ultimately, Hartman said, substance abuse is a readiness issue. "Substance abuse treatment is part of the overall
effort to get our people as healthy, as fit and as ready as they can to do their job as a military member," he said.
####
 
NOTE:  This is a plain text version of a web page.  If your e-mail program did not properly format this information, you may view the story at http://www.defenselink.mil/news/Oct2001/n10112001_200110114.html
Any photos, graphics or other imagery included in the article may also be viewed at this web page.
 
Visit the American Forces Information Service’s newest Web site for the latest news and information about
America’s response to the Sept. 11, 2001, terrorist attacks and the war against terrorism: “Defend America”
at http://www.DefendAmerica.mil

Posted:  7 Oct 01
Providers Begin Seeing TRICARE For Life Patients Today (1 Oct 01)

Providers Begin Seeing TRICARE For Life Patients On October 1
 
As TRICARE For Life begins today, Oct. 1, about 1.5 million uniformed services retirees, their family members and survivors, age 65 and older, will receive expanded medical coverage through the Department of Defense (DoD) health care program. TRICARE For Life will be second payer to Medicare for services and supplies that are benefits under both programs, and the provider does not have to file a TRICARE claim.
 
Combined with the TRICARE Senior Pharmacy Program that was implemented last April, TRICARE For Life will cover most medical costs not covered by Medicare.  There are some health care services that are benefits under either Medicare or TRICARE, but not both. For example, Medicare covers some chiropractic services, whereas TRICARE does not. Conversely, TRICARE covers retail pharmacy prescriptions and Medicare does not. In these circumstances, the beneficiary will remain responsible for the applicable Medicare or TRICARE cost share and
deductible. For those TRICARE For Life users who have other health insurance, such as an employer-sponsored health plan, TRICARE will pay after the other health insurance and Medicare.
 
"The DoD worked with Medicare to integrate our payment systems, so that the TRICARE payment is done so seamlessly that the individual is hardly aware of it," said J. Jarrett Clinton, M.D., the DoD's Acting Assistant Secretary of Defense for Health Affairs. Most Medicare-eligible beneficiaries of the uniformed services will no longer need an individual Medigap policy, he added.
 
No TRICARE For Life beneficiary card is necessary for them to receive care, and no enrollment is required. However, to be eligible for the expanded TRICARE coverage, uniformed services retirees, eligible family members and survivors, age 65 and over, need to be registered in the Defense Enrollment Eligibility Reporting System (DEERS). They also must have Medicare Part A, and be enrolled in Part B.
 
Anyone with questions about TRICARE For Life should call TRICARE's toll-free number, 1-888-DOD-LIFE (1-888-363-5433).
 
Details about the TRICARE For Life program recently were mailed regionally by TRICARE managed care support contractors to eligible beneficiaries, using addresses from DEERS.
 
Many age 65 and over beneficiaries already are taking advantage of the TRICARE Senior Pharmacy Program, which started April 1. Eligible uniformed services retirees, their family members and survivors receive comprehensive prescription drug coverage with minimal co-payments through its National Mail Order Pharmacy Program, or through TRICARE network and non-network retail pharmacies. Co-payment amounts may be higher if beneficiaries choose non-network pharmacies.  They may also continue using military treatment facility pharmacies, which require no co-payments.
 
To learn more about the TRICARE Senior Pharmacy Program, call 1-877-DOD-MEDS (1-877-363-6337) toll-free.
 
Additional information and updates about TRICARE For Life are posted on the TRICARE Web site at http://www.tricare.osd.mil/ndaa
 
-end-
 
SOURCE:  TRICARE News Release, http://www.tricare.osd.mil

Posted:  7 Oct 01
DoD Moves to Restrict Civilian Blood Collections on Bases

By Sgt. 1st Class Kathleen T. Rhem, USA American Forces Press Service
 
WASHINGTON, Sept. 28, 2001 -- DoD officials have approved a policy to restrict blood drives by civilian agencies on military bases should the services need extra blood in coming months.
 
"The support required for an operation such as this may require us to … conserve our donor resource in case we need
them for specific support missions for the military," said Army Col. Michael Fitzpatrick, director of DoD's Armed
Services Blood Program Office.
 
Some bases may need to reduce blood drives by civilian agencies such as the Red Cross if they plan to increase
military blood drives. Other bases may need to suspend civilian blood drives because deployments have reduced the
available donor population, Fitzpatrick said.

A similar policy was enacted during Operations Desert Shield and Desert Storm for the same reasons, he said.
 
No bases have actually begun restricting access to civilian agencies wanting to conduct blood drives, but several are
considering it. Fitzpatrick said the largest post considering the move is the Army's Fort Jackson, S.C. Its 54,000 trainees per year, located an hour from Dwight D. Eisenhower Regional Medical Center at Fort Gordon, Ga.,
make an ideal donor pool. 

"We plan to collect more blood from trainees and recruits at Fort Jackson than we have in the past," he said.
 
Fitzpatrick seemed confident the move to restrict access to military installations wouldn't negatively affect civilian
blood-collection agencies. "The civilian supply should remain stable," he said. "If needed, we believe that both
DoD personnel and civilians would respond like they did the week of the attacks on the World Trade Center and the
Pentagon. The population has always responded in a situation like that if the call goes out for blood donors."
 
This is only intended to be a temporary move. "We'll monitor the blood supply and the restrictions. When it
appears that we can loosen the restrictions, we'll do that," Fitzpatrick said.
 
DoD maintains a blood supply separate from that maintained by civilian organizations. There are several reasons.
 
"In order to make sure the Department of Defense isn't impacted by a possible blood shortage, we've always
maintained our own blood collection system," Fitzpatrick said. "We also want to make sure we don't cause a shortage
in the civilian system. Since we run our own medical support system, we've always felt that it's important to
make that a complete system."
 
Related story:
 
DoD Delays New Blood Donor Deferral Rules at
http://www.defenselink.mil/news/Sep2001/n09142001_200109149.html
_______________________________________________________
NOTE:  This is a plain text version of a web page.  If your e-mail program did not properly format this information, you may view the story at  http://www.defenselink.mil/news/Sep2001/n09282001_200109283.html

Posted:  7 Oct 01
Anthrax Vaccines Not Harmful to Women's Reproductive System, Study Shows

by Harry Noyes
 
FORT SAM HOUSTON, Texas (Army News Service, Sept. 28, 2001) -- A study conducted by an Army preventive-medicine officer has calmed concerns that anthrax vaccinations might damage the reproductive success of military women.
 
Maj. Andrew R. Wiesen tracked the health of 4,092 active-duty service women. Out of that number, 513 women became pregnant during the course of the 15-month study, including 384 women who had been vaccinated against anthrax.
 
Compared to unvaccinated women, the vaccinated soldiers were just as likely to get pregnant and just as likely to give birth to healthy babies, Wiesen studies indicated. Birth problems and defects were no more frequent for the vaccinated
moms than for others.
 
The study was conducted at Fort Stewart, Ga. All of the women in the study were stationed at Fort Stewart or nearby Hunter Army Airfield.
 
"Pregnancy is an outcome that is almost never studied with vaccination, given the inherent difficulties in studies of that nature," Wiesen said. "We were just very fortunate to have a set of databases that allowed us to get the information we needed when we needed it."
 
Wiesen was chief of preventive medicine at Fort Stewart's Winn Army Community Hospital during the study, which ended in March 2000. He has since transferred to Madigan Army Medical Center, Fort Lewis, Wash., as chief of epidemiology.
 
Wiesen initiated and conducted the study on his own, but his protocol was reviewed and approved by the Institutional Review Board of the department of clinical investigation at Southeast Regional Medical Command. He was assisted
by Capt. Christopher Littell, a pediatrician who served as a subject matter expert on adverse birth outcomes.
 
Wiesen reported on the preliminary study results to a committee of the Institute of Medicine in July. He acknowledged that a larger study might reveal more, but that this one strongly indicates that there are no reproductive health problems associated with vaccination of military women.
 
"It is impossible to prove a negative, i.e., it cannot be proven that anthrax vaccine does not cause any harm," Wiesen explained. "The major benefit of negative studies such as this one -- studies that do not show a relationship between the exposure of interest and an outcome -- is that it increases our confidence that there is not a relationship.
 
"These types of studies are always subject to criticism that they should have been bigger, or a small effect could have been overlooked, etc. However, the likelihood of that occurring in this case is very small."
 
Wiesen's report on the research is being peer-reviewed for use in a major medical journal and should be published before the end of the year. 

(Editor's note: Harry Noyes is a member of the public affairs team for the Army's Medical Command at Fort Sam Houston, Texas.)
 
 Link to original news item:    http://www.dtic.mil/armylink/news/Sep2001/a20010928thraxpreg.html

Posted:  7 Oct 01
Frozen Blood Set Aside Overseas for Emergencies & DoD Asks Troop Donors to Pace Blood Donations

Frozen Blood Set Aside Overseas for Emergencies By Sgt. 1st Class Kathleen T. Rhem, USA
American Forces Press Service
 
WASHINGTON, Sept. 28, 2001 -- DoD stockpiles frozen blood around the world in case of military emergencies.
 
"We use computer models to project casualties in different scenarios, and we also add some extra for redundancy," said Col. Michael Fitzpatrick, director of the Armed Services Blood Program Office.
 
He said about 38,000 pints is stored in Korea and Japan. The services also keep about 6,000 pints in Italy for use
in the European theater and on Navy ships that might receive casualties in a conflict. The hospital ships USNS
Comfort and USNS Mercy also carry frozen blood, Fitzpatrick said.
 
The stockpiles are based on how long it would take to get fresh blood supplies to an area in a major emergency. For
instance, the Korea stockpile is larger because it would take longer to get fresh blood supplies there than to Europe.
 
New technology and equipment may make the system of stored frozen blood more flexible and responsive to global crises. "The Air Force, Navy and Army are working together right now to freeze additional blood at the Armed Services Whole Blood Processing Laboratory in McGuire Air Force Base, N.J.," Fitzpatrick noted.
 
################
 
DoD Asks Troop Donors to Pace Their Blood Donations By Sgt. 1st Class Kathleen T. Rhem, USA American Forces Press Service
 
WASHINGTON, Sept. 28, 2001 -- Troops wishing to give blood shouldn't be surprised if the donor center asks them to come back in a week or two.
 
"That just means we're trying to make sure there's a steady supply of blood available if we need it," said Col. Michael
Fitzpatrick, director of the Armed Services Blood Program Office. Fresh blood products can be used for 42 days after collection, but individuals can only donate blood every 56 days.
 
So, he said, an installation that holds a massive blood drive on one day could be in trouble if it needs large
amounts of blood six to eight weeks later. Service blood program officers and installations try to prevent such
problems by pacing collections. 
 
"Right now, there's no need for a lot of additional blood," Fitzpatrick said.

Posted:  7 Oct 01
Conversion Between FEHB and TRICARE

Federal Employees Health Benefits Program (FEHB) - Conversion Between FEHB and TRICARE or Medicare/Medicaid and Certain State Sponsored Health Plans
--------------------------
The Office of Personnel Management has issued an interim rule (see notes below) to allow TRICARE-eligible FEHB Program annuitants and former spouses to suspend their FEHB enrollments, and then return to the FEHB Program during the Open Season, or return to FEHB coverage immediately if they involuntarily lose TRICARE coverage. The intent of this rule is to allow TRICARE-eligible beneficiaries to avoid the expense of continuing to pay FEHB Program premiums while they are using TRICARE coverage, without endangering their ability to return to the FEHB Program in the future.
 
Effective October 1, 2001, the National Defense Authorization Act for 2001 will reinstate TRICARE coverage for Medicare-eligible uniformed services retirees, their survivors and eligible dependents. TRICARE coverage will be advantageous to many Medicare-eligible military system beneficiaries who now are covered under the FEHB Program as Federal civilian retirees, family members, or former spouses.
 
Under previous FEHB regulations, an annuitant or former spouse who canceled his or her FEHB coverage to use TRICARE coverage would not be allowed to return to FEHB coverage. Therefore, OPM has issued these interim regulations, with a request for comments, to allow these FEHB participants to suspend, rather than cancel, their FEHB coverage when they begin TRICARE coverage. Under this rule, they are allowed to return to FEHB coverage immediately if they involuntarily lose TRICARE coverage or, if not, during the next annual FEHB Open Season.
 
We also amended our regulations to clarify a similar situation involving FEHB- covered annuitants and former spouses. The regulations allow an individual who drops FEHB coverage when he or she enrolls in a Medicare-sponsored plan, or in Medicaid or a similar State-sponsored program of medical assistance for the needy, to return to FEHB coverage during the annual Open Season or immediately upon being involuntarily disenrolled from the non-FEHB coverage.
 
-----------------
POSTMASTER NOTES: 
 
1.  If you have FEHB related questions, please send them to fehb@opm.gov
 
2.  The above mentioned interim rule is available online in text and PDF format at the following web addresses:
 
Text Format:  http://www.opm.gov/insure/health/regulations/6649086.txt
 
PDF Format (Adobe Acrobat Reader required):  http://www.opm.gov/insure/health/regulations/6649086.pdf
---------

SOURCE:  Federal Employees Health Benefits Program web page at  http://www.opm.gov/insure/health/tricare.htm

Posted:  7 Oct 01
Eat Right, Feel Right in Stressful Times

by Sgt. Ed Passino
 
WASHINGTON (Army News Service, Sept. 27, 21) --First came denial, then the shock, as television sets played and replayed the gruesome terrorist acts Sept. 11.
 
For service members and military family members, it was more than just watching. It was a sudden attack on our lives and everything America stands for -- freedom, democracy, hot apple pie, red, white and blue, Ford pick ups, '57
Chevys, baseball, space exploration, Harley Davidsons, Converse sneakers, sunsets, and Budweiser beer.
 
As we sit here as a country, in the aftermath we face reality -- the daunting task of picking ourselves up and dusting ourselves off. We face the horror of the unknown -- what next?
 
We sit worried, jumpy, short-fused, impatient, scared, hungry, troubled, tearful, victimized, alone. We are stressed and depressed.
 
Stress brings with it the ugly face of reduced feelings of security, self-worth and accomplishment. It also brings health problems like heart disease, and weight issues related to unhealthy eating.
 
Some people gain weight, while others lose weight. Point blank, stress is not good for the body or soul.
 
But there are ways to battle stress. I am reminded of the serenity prayer, "God, grant me the courage to change things I can change, the serenity to accept the things I can't change, and the wisdom to know the difference."
 
For some, stress comes at us with increased workloads, longer travel times, and shorter periods of self and family time.
 
Yet the rut of stacking too much on our work plates must not affect what is placed on our breakfast, lunch and dinner plates. That, to an extent, we control.
 
Studies show stress resistance can be enhanced by regular exercise and a diet rich in a variety of vegetables, fruit and whole grains. Our bodies are apt to fight stress better when we take the time to prepare and fuel it with well-
balanced meals.
 
For the average person this means 5 to 6 percent of your daily intake of calories should come from carbohydrates, no more than 25 percent from fat and 15 percent from protein.
 
Carbs are the energy source for our bodies, without enough of them we don't function like we should. If at all possible, these carbs should be primarily from vegetables, then fruits and lastly unrefined whole grains.
 
These higher-complex carbohydrates (which are burned more slowly by the body) release glucose (sugar) into the bloodstream at a more efficient pace. 

Examples of these include broccoli, grapefruit, brown rice, apples, baked beans, oatmeal, multi-grain and whole-wheat breads. Some indicators of not getting enough carbs are sudden, continuous headaches, the inability to concentrate, longer recovery time from strenuous physical activities, dizzy spells and a sudden lack of energy.
 
Fats should represent mo more than 25 percent of total calorie intake. The key to this is having the fats come from monounsaturated oils such as olive oil. 

Another good fat to consume are omega-3 fatty acids. These are present in most types of fish, nuts and flax seeds.
 
Many recent diet books and magazines claim protein should have a more predominant role in a person's diet than carbs. This concept is based on the benefits protein and amino acids provide muscles. But for the average person
having 15 to 2 percent of your diet consist of protein is a good start.
 
Good sources of protein include lean meat such as grilled chicken, turkey breast, lean cuts of beef and fish. For vegetarians, protein alternatives include beans, soy products and supplement replacement meals like Slim Fast,
Ensure, or protein drinks.
 
Healthy eating guidelines regarding carbs, fat and protein consumption to fight stress include:
 
- Eating in moderation; eating too much at one sitting makes us sluggish and tired.
- Eating five to nine servings of fruit and vegetables per day, every day.
- Consuming enough fiber in your diet; fiber has been known to control fat consumption.
- Maintain a healthy weight for yourself.
- Limit snacks and treats. It's OK to have some every so often.
- Don't make large changes in your diet all once; work in changes over a period of time.
- Choose foods low in saturated fat and cholesterol.
- Limit your amount of alcohol consumption.
- The major conception with healthy eating is time it takes to prepare meals.
 
Unless you still live in the 16th century there are things called refrigerators, coolers, freezers and dozens of other gadgets to keep things hot, warm and cold. Not to mention, Tupperware, Glad, and others have invented
just as many container sizes to maintain freshness.
 
Eating healthy begins at the grocery store, not at the local burger or pizza joint. Avoid highly processed and junk foods.
 
In the end, as we sit here and battle the stress of today's tragic happenings, we can at least fuel our bodies with the right nutrients to help withstand the events to come.
 
Remember what you eat is important because it supplies your body with nutrients and fuel for muscle activity. The better prepared we are to eat more consistently and timely, the better success we'll have in the long run.
 
Although healthy eating and exercise cannot bring back our fellow Americans, it can provide us benefits that will last us throughout our own personal lifetimes.
 
(Editor's note: Sgt. Edward Passino, a staff writer for the Fort Belvoir Eagle, interviewed personnel at the DeWitt Army Community Hospital's nutrition care section for this article.)
 
Link to original news item:
http://www.dtic.mil/armylink/news/Sep2001/a20010927eat.html

Posted:  7 Oct 01
TRICARE For Life Info

1.  Following documents were mailed to eligible 65 and older beneficiaries by Managed Care Support Contractors during July-August, 2001.  If you did not receive the documents, they are available online at the web addresses listed
below: 
 
    o TRICARE For Life Beneficiary Letter        http://tricare.osd.mil/tfl/pdf/carratoletter.pdf
 
    o TRICARE For Life Brochure        http://tricare.osd.mil/tfl/pdf/brochure5_23.pdf
 
    o TRICARE For Life Beneficiary Information Card         http://tricare.osd.mil/tfl/tfl_bencard.html
 
    o TRICARE For Life Cost Matrix        http://tricare.osd.mil/tfl/matrix.html
    
NOTE:  To view/print the TRICARE For Life Beneficiary Letter and Brochure, Adobe Acrobat Reader software is required.  The Adobe program is free and is available at http://www.abobe.com
 
For TRICARE For Life frequently asked questions and related information, go to  http://www.tricare.osd.mil/tfl
 
2.  If you're unable to access the above web sites, following information is printed on the TRICARE For Life Beneficiary Information Card:

    Beneficiary Information Card for TRICARE For Life
 
                     FRONT OF CARD

                     TRICARE for Life
 
 To Provider: File claims in the usual manner to Medicare.  
 To Patient: Services that are a benefit of both Medicare and  TRICARE - no deductible or cost share is required.
 Medicare only benefit: Medicare deductible and cost share required.   TRICARE only benefit: TRICARE deductible and cost share required
 
          For benefits questions call 1-888-DoD-LIFE

                     BACK OF CARD
 
               TRICARE Senior Pharmacy
 
 Military Treatment Facility: No Co-pay
 National Mail Order Pharmacy: $3 generic/$9 brand name/90 day supply
 TRICARE Network Pharmacy: $3 generic/$9 brand name/30 day supply
 TRICARE Non-Network Pharmacy: $9 or 20% of cost/30day supply.
  $150/person or $300/family annual deductible applies

         For pharmacy questions call 1-877-DoD-MEDS
 
SOURCE:  TRICARE Web Site at http://www.tricare.osd.mil/tfl

Posted:  22 Sep 01
Mobilized Reservists May Retain Employers' Family Healthcare

By Sgt. 1st Class Kathleen T. Rhem, USA
American Forces Press Service
 
WASHINGTON, Sept. 21, 2001 -- Federal law provides mobilized Guard and Reserve members the opportunity to keep their employer-sponsored healthcare coverage.
 
If the employee will be absent for more than 30 days, the employer may require the employee to pay the entire premium cost plus a 2 percent administrative fee.
 
The Uniformed Services Employment and Re-employment Rights Act of 1994 allows mobilized reservists to keep health insurance provided through their civilian employer for up to 18 months, said Air Force Col. Kathleen Woody, director of medical readiness and programs with the Office of the Assistant Secretary of Defense for Reserve Affairs.
 
"The employer could continue to provide coverage at no cost to the employee," she said. If the employer requires the
reservist employee to pay the whole tab, however, coverage could be cost prohibitive for many families, she
acknowledged.
 
For members who elect healthcare for their families under TRICARE programs, USERRA allows them to return to their civilian employer insurance plans with no waiting period or penalty for pre-existing conditions (other than service-
connected conditions, which are covered by the military)," Woody said.
 
"For example, if a reservist elects to get his family care under TRICARE while he's activated and his daughter
subsequently is diagnosed with diabetes, he can still go back to his employer healthcare plan under the same
conditions as before he was mobilized," Woody explained. "The family would be covered as if the reservist employee
had never left." 

Employees with questions about their rights under this act should contact their agency's human resources department or visit the National Committee for Employer Support of the Guard and Reserve Web site at http://www.esgr.org or call 1-800-336-4590.
_______________________________________________________
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Posted:  22 Sep 01
TRICARE Covers Most Activated Reservists' Families

By Sgt. 1st Class Kathleen T. Rhem, USA
American Forces Press Service

WASHINGTON, Sept. 21, 2001 -- Family members of Guard and Reserve members called to active duty for more than 30 days are eligible for TRICARE benefits the day their military sponsor mobilizes.
 
President Bush authorized the Defense Department to mobilize up to 50,000 National Guard and Reserve members to
deal with the aftermath of the Sept. 11 terrorist attacks at the Pentagon and in New York City. DoD officials have
indicated they intend initially to call up about 35,000.
 
The type of TRICARE coverage reserve component family members receive depends on the length of the sponsors'
activation orders, Air Force Col. Kathleen Woody said. Woody, a full-time reservist, is director of medical readiness and programs in the Office of the Assistant Secretary of Defense for Reserve Affairs.
 
Woody said Guard and Reserve members who are activated receive the same individual healthcare as their active duty
counterparts. Coverage for their families, though, can take many different forms.
 
Guard and Reserve families are ineligible for DoD medical benefits if their military sponsors have orders that call
them to duty for 30 days or less.

If sponsors have orders to active duty for more than 30 days, their families are covered under the TRICARE Extra or
Standard programs from the day the member is activated, Woody said. While these family members would be eligible
for space-available care in any military medical treatment facility, Woody, who is a nurse, cautioned that available
space is limited and suggested using it only for an emergency.
 
"You want to have them in a program with some continuity with the providers," she said.
 
Eligible family members pay deductibles and cost-shares under both TRICARE Extra and Standard, Woody explained. Using a TRICARE Extra network provider can minimize those costs. Beneficiaries can get information on finding network providers in their area on the TRICARE Web site at www.tricare.osd.mil, or at their local TRICARE service center.
 
In addition, family members of reservists and guardsmen activated under orders for 179 days or more have the option
to enroll in TRICARE Prime, the military's version of a health maintenance organization. They will receive care in
a military medical treatment facility or be assigned to a network provider in their area with no cost-shares or deductibles.
 
"TRICARE Prime is the only one of the TRICARE options that requires pre-enrollment on the part of the family members," Woody said. Enrollment information can also be found on the TRICARE Web site or by contacting a local TRICARE benefits counselor. "Enrollment has to occur by the 20th of the month in order to be eligible for care on the 1st of the following month."
 
For instance, reserve component members who might be mobilized in coming weeks must have their enrollment forms
in to TRICARE by Oct. 20 in order for their families to start receiving care on Nov. 1 under the Prime option, she
explained. The family would be covered under TRICARE Standard or Extra until enrolled in Prime.
 
She said the most important thing for all reserve component members to do is make sure all the information in the
Defense Enrollment Eligibility Reporting System is accurate, Woody said. Since DEERS is the system used to determine eligibility for military health care, family members could be denied care if DEERS information is
incorrect or incomplete. 
 
Activated reservists are given a chance to review and make changes to their families' DEERS enrollments during the
mobilization process, Woody said. 

In cases where service members are activated for contingency operations, they and their family members are
eligible to retain their military medical benefits for up to 30 days after they're released from active duty, unless
sooner covered by an employer sponsored health care plan.
 
"This gives them a cushion to get civilian healthcare coverage in place," Woody said.
 
Dental care for both reservists and their family members fall under somewhat different rules. Since earlier this
year, reserve component members and their families have been eligible to enroll in the TRICARE Dental Program.

Woody explained that reserve members who had previously enrolled in the program are automatically removed when
mobilized because they receive dental care from military providers while on active duty.
 
Reserve members in the Dental Program pay monthly premiums of $19.08 for one family member or $47.69 for a family enrollment. If the reserve sponsor is called to active duty, the premiums fall to the active-duty rates of $7.63
per month for one family member or $19.08 for multiple family members, Woody said.
 
Families who had previously declined TRICARE dental coverage but who wish to enroll after their sponsors are
mobilized will be able to join at active-duty rates during the first 30 days. Enrollment forms and information are
available online at http://www.ucci.com/tdp/tdp.html
 
Woody noted that once the sponsor leaves active duty the rates revert to the higher premiums.
 
For more information on TRICARE benefits, visit the program's Web site at http://www.tricare.osd.mil
 
Information on the TRICARE Dental Program can be found at http://www.ucci.com/tdp/tdp.html
 
Reserve Affairs has set up a family readiness Web site at http://www.defenselink.mil/ra/html/family.htm
 
%%%%%%%%%%%
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Any photos, graphics or other imagery included in the article may also be viewed at this web page.

Posted:  22 Sep 01
TRICARE For Life Ready to Kick Off Oct 1

By Sgt. 1st Class Kathleen T. Rhem, USA
American Forces Press Service
 
ARLINGTON, Va., Sept. 20, 2001 -- "TRICARE for Life is green -- all signs are go" for the program to begin as
scheduled Oct. 1, Air Force Col. Frank Cumberland said. 

"It's going to happen. It's funded. Let's press on," said Cumberland, director of communications and customer service
at the TRICARE Management Agency here. 
 
The TRICARE for Life program extends TRICARE benefits to military retirees who are over age 65 and Medicare-
eligible. The fiscal 2001 National Defense Authorization Act directed DoD to extend the medical coverage to this
previously ineligible population.
 
For eligible retirees and their spouses who are over age 65 and enrolled in Medicare Part B, TRICARE will become a
second payer to Medicare starting Oct. 1. This will end their need to pay many out-of-pocket expenses, and most
will probably conclude they no longer need to buy "Medigap" supplemental insurance, TRICARE officials said.
 
The only requirements for beneficiaries are that they check their enrollment information in the Defense Eligibility
Enrollment Reporting System (DEERS) to ensure its accuracy and that they be enrolled in Medicare Part B.
 
All but about 70,000 of the 1.5 million retirees eligible for TRICARE for Life are enrolled in Medicare Part B, said
Steve Lillie, TRICARE's director of over-65 benefits. Those 70,000 can take care of business during Medicare's next
general enrollment period of January through March 2002, he said.
 
As individuals start to use the program, questions are bound to crop up. Lillie recommended beneficiaries take
full advantage of the newly expanded TRICARE for Life call center at toll-free 1-888-DOD-LIFE (1-888-363-5433). He also said beneficiaries can use this number to help educate healthcare providers who are unsure of the expanded benefit.
 
"There are people there who can explain the program to the provider," he said. The call center staff helped many
people iron out details when the TRICARE Senior Pharmacy Benefit began in April. "We'd have a three-way call with
the beneficiary, the pharmacist and the call-center representative, helping them through the process and acquainting them with the program," Lillie said.
 
Lillie wanted beneficiaries to know the program will begin on schedule even if Congress and the president don't pass a
fiscal 2002 Defense Appropriations Act by Oct. 1. 
 
"The program will start even under a continuing resolution because it is an expansion of an existing program to new
beneficiaries rather than a brand-new program that might be affected by the rules in a continuing resolution," he said.
 
Lillie also said he believes TRICARE for Life will continue to be fully funded in the future. "The bills that enacted
TRICARE for Life passed the House and Senate by overwhelming majorities, and there is no indication of any
diminished support for the principles embodied in it," he said.
 
Program officials said beneficiaries can get more information on TRICARE for Life and on checking their DEERS
enrollment status by visiting the TRICARE Web site at www.tricare.osd.mil or by calling 1-888-DOD-LIFE (1-888-
363-5433).
 

Answers to TRICARE For Life related questions may also be

obtained by E-mail by sending your messages to TRICARE_Help@amedd.army.mil

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Posted:  22 Sep 01
Sun Can Cost You More Than the Skin off Your Nose

American Forces Press Service
 
WASHINGTON, Sept. 10, 2001 -- Maybe you've had your last sunbath for the year, but don't drop your guard. Summer's just the highest-risk season for sun-damaged skin. Fact is, your face and hide are at risk when the sun's up.
 
While you bask in those compliments about your great tan, here are the usual health carps about tans: You injured the
largest organ of your body. You've sped the day you will be a leathery prune. You upped your chances of contracting
skin cancer.
 
You tan when your body begins to find ultraviolet-B radiation intolerable. The most potent UVB source is sunlight for most people. Your body's defense is to create UVB-absorbing melanin -- skin coloring. You get darker as the exposure continues. The defense is not perfect; that's why people burn.
 
Repeated tanning and burning damage skin cells and wear out the skin's natural immunity and repair systems over time.
As UVB compromises the skin's ability to protect and fix itself, damaged cells and tissues can wreak havoc. If you're unlucky, moles, rashes and other lesions erupt. If the only luck you have is bad, you're looking at lethal malignant melanoma -- skin cancer.
 
Then there's ultraviolet-A radiation. UVA plays no role in tanning and burning, but it penetrates the skin deeper than
UVB rays and also damages the skin's immunity and repair systems. The skin dries, loses flexibility and wrinkles in
time; the risk of cancer increases. 

On any given day of the year, the sun's most intense UVB radiation arrives at midday. While people usually know to
take precautions at high noon, they may not realize the sun's ultraviolet energy is almost all a constant,
imperceptible, day-long, year-round stream of deep-penetrating UVA radiation. Keep that in mind when you've
been out long enough to catch a tan. 

People of color may have a protective head start against UVB, but they too can darken and burn -- it may just take
longer. Further, skin color offers no protection against UVA.
 
Fortunately, protection is easy. Stay indoors. Stay out of the sun. When those aren't options, your best defenses are
the same as in summer: sunscreens and clothes. 

Sunscreen racks may be gone from stores. Sunscreen chemicals, however, are increasingly easier to find year-
round in commercial cosmetics, skin creams and lotions, and lip balms.
 
Sunscreen protection is expressed as a "sun protection factor." The SPF multiplies the time you can be exposed to
UVB safely. If your normal limit in the sun is 10 minutes, a UVB sunscreen rated at SPF 15 would help protect you for
2.5 hours. 
 
There's no standard way to express UVA protection, such as an SPF, so it's possible your sunscreen and cosmetics offer none. Read the ingredients list. Common screens such as padimate and homosalate only stop UVB. If your product contains an effective UVA sunscreen such as benzophenone and avobenzone, the maker probably trumpets that fact.
 
Three year-round sunscreen rules: Use it liberally. Use it often. Apply it to exposed skin at least 20 minutes before
going outside. According to some medical researchers, sunscreens fail because people skimp. After all, the stuff's expensive, and people get distracted and are rushed.
 
Follow the product instructions. While "apply generously" doesn't say how much is enough, it's a hint that the stingy little dab on your fingertip that you've been using is not enough to protect your whole face.
 
Wash your hands? Reapply sunscreen. Wash your face? Reapply. Sweat? Reapply. Wipe your brow? Reapply. SPF
protection time's up? Reapply. 

Sunscreens don't work until they set, generally in 20 to 30 minutes. If your normal sun limit is 10 minutes but you apply your SPF 3000 screen only after you're on that lift up the sunny ski slope, you may be overdosed on UVB before you reach the top.
 
All clothing can provide some protection against UVB rays and also some against UVA if layered or heavy. Yardsticks: One layer of T-shirt fabric provides minimal  protection against UVB and none against UVA. Tightly woven fabrics protect better than loose weaves against both UVB and UVA. Dry protects better than wet. The Centers for Disease Control estimate blue denim jeans have an SPF of 1700! The jury's still out on whether fabric color makes any protective difference.
 
It's smart to wear a hat and sunglasses in the sun outdoors, regardless of the season. Sunglasses should say they filter both UVA and UVB. If they don't say or they filter only UVB, consider them good only for fashion statements.
 
Don't use tanning booths and beds. UVB radiation isn't safe whether it's from Mr. Sun or bulbs. Look pasty
from October to June? Get over it. 
####

Posted:  22 Sep 01
DOD Announces Stricter Blood Donation Standards

NEWS RELEASE from the United States Department of Defense
 
No. 409-01
(703)695-0192(media)
IMMEDIATE RELEASE
September 7, 2001
(703)697-5737(public/industry)
DOD ANNOUNCES STRICTER BLOOD DONATION STANDARDS
 
Dr. J. Jarrett Clinton, acting assistant secretary of Defense for Health Affairs, announced today new blood donor criteria for the Department of Defense.  "To ensure the health and safety of servicemembers and their families, we are adopting additional precautionary measures against the very small theoretical risk of the human form of 'mad cow' disease, " said Clinton.
 
Effective Sept. 14, the DoD criteria will restrict from donating (1) anyone who has traveled or resided in the United Kingdom from 1980 through 1996 for a cumulative period of three months or more; (2) DoD-affiliated persons who have been stationed in Europe from 1980 through 1996 for a cumulative period of six months or more; (3) others who have traveled or resided in Europe from 1980 to present for a cumulative period of five years (applies to DoD personnel on or after Jan. 1, 1997); (4) anyone who has received a transfusion in the United Kingdom since 1980; and (5) anyone who has received bovine insulin produced in the United Kingdom since 1980.
 
DoD is following draft guidance from the Food and Drug Administration on restricting blood donors who may have been exposed to the agent that causes variant Creutzfeldt-Jakob Disease (vCJD).  The risk of vCJD transmission from
human blood/blood products is theoretical-no cases of the disease have been transmitted in this manner, and no scientific study has established such a link.
 
Clinton advised, "DoD currently has enough blood to meet operational requirements as well as the requirements of our military medical treatment facilities."  However, this precautionary restriction will disqualify an estimated 18 percent of active-duty personnel, not all of whom are donors.  DoD will maintain its blood supply by increasing recruitment efforts to replace the restricted donors from the remaining pool of those eligible.
 
To encourage increased blood donation through the Armed Services Blood Program, DoD plans an information campaign in its internal media directed to its donor population and beneficiaries.  The campaign targets blood collections at training bases to maximize collections from training commands and new recruits, who are unlikely to be affected by the new restrictions.

-END-
 
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Posted:  22 Sep 01
Health Care Update

NOTE:  Following information was obtained from an Air Force source, however, the info provided also applies to other services.
- Postmaster
-------------------
09/07/01 - RANDOLPH AIR FORCE BASE, Texas (AFPN) -- The Air Force remains committed to providing servicemembers and their families with quality health care, according to a message sent to the field Aug 29.
 
In a joint memo from the offices of the surgeon general, manpower and reserve affairs, and people, a TRICARE update gave beneficiaries the latest information concerning their health care, officials said.
 
In the first of a series of health care messages the Air Force will deliver over the next several months, officials addressed the new authority for TRICARE Prime remote for family members. The message also provided tips for
registering newborns in DEERS and enrolling them in TRICARE Prime, and the importance of briefing health care information during in- and out-processing briefings.
 
TRICARE Prime remote offers benefits very similar to TRICARE Prime for active-duty people who are stationed more than 50 miles or a one-hour drive from a military hospital or clinic, officials said.
 
In 2002, the TRICARE Prime remote benefit will be offered to family members. To participate, family members must enroll in the TRICARE Prime remote for active-duty family member program.
 
The benefits include lower out-of-pocket costs for most health care, enhanced access to preventive services and the ability to select a primary care manager when one is available in the area, officials said.
 
To get more information about the program, officials urged military members and their families to visit the TRICARE Management Activity Web site at www.TRICARE.osd.mil and to click on "TRICARE beneficiaries, understanding your TRICARE benefits." For specific questions or to inquire about eligibility status, people can speak with a TRICARE Management Activity representative by calling (800) DOD-CARE, or (800) 363-2273.
 
An additional concern for active-duty family members, especially those in remote locations, is how to register a newborn child in DEERS, officials said. A little-known fact is the sponsor-signed DEERS enrollment form, DD Form 1172, together with a certificate of a live birth signed by the attending physician, can be mailed to the nearest military personnel flight.

Initially, sponsors do not need to have a social security number or birth certificate to register a child into DEERS or for initial enrollment into TRICARE Prime, officials said. These can be submitted at a later date once the sponsor receives the official documents.
 
To limit out-of-pocket costs and problems with claims processing, a newborn should be enrolled in TRICARE Prime not more than 120 days after birth, officials said.
 
The office of the secretary of Defense directed all military services to incorporate TRICARE education and enrollment into their in- and out-processing programs to ensure all beneficiaries are aware of their health care options
 
The Air Force surgeon general also directed all military treatment facility commanders to ensure either knowledgeable medical staff or TRICARE staff educate beneficiaries about their TRICARE benefits.
 
It is very important that active-duty people and their spouses understand their TRICARE options and have an easily accessible point of contact to obtain additional TRICARE information if needed, officials said. (Courtesy of Air
Education and Training Command News Service)
######
 
SOURCE:  Air Force Link web site at http://www.af.mil/

Posted:  22 Sep 01
Let's Dispel Those TRICARE For Life (TFL) Myths

Following is an extract from The Retired Officers Association web site at www.troa.org and is provided for your information.
-Postmaster
-------------
 
On October 1, military Medicare-eligible beneficiaries will become eligible for TRICARE For Life, under which TRICARE will provide second-payer coverage to Medicare. Unfortunately, such major and expensive benefit changes are frequently accompanied by rumors and misinformation, often spread by well-intentioned but worried people. While one can never fully protect against Murphy's Law, everything we see indicates TFL will be implemented and funded
as planned on October 1. So it's time to put the kibosh on those exasperating TFL myths.
 
Myth # 1: "TFL is not a permanent program and Congress is looking at cutbacks because of its high cost."
 
Reality: TFL is set in permanent law, in the same way as Social Security, Medicare, and military retired pay. As such, annual action by Congress to re-authorize TFL is not required. Public Law 106-398 established a DoD Medicare-
Eligible Health Care Trust Fund, to be effective October 1, 2002. The Fund will be resourced with annual mandatory contributions from the Department of Defense and the U.S. Treasury. Congress certainly has the power to change any
program, including Social Security, Medicare, military retired pay, or TFL, but that would take another law change. There has been no discussion in Congress of any TFL cutback. Congress and the Defense Department are committed
to bringing TFL on line, on time, as promised. 

Myth #2: "TFL has not been funded for FY 2002 so the program can't begin on October 1, 2001."
 
Reality: It's technically true that Congress has not yet passed the FY 2002 Defense Appropriations Act, but this is merely a formality as far as TFL is concerned. First-year TFL funding of $3.9 billion was included in the President's Budget and in the FY2002 Budget Resolution, which set Congress's spending agenda. Therefore, funds are already earmarked for inclusion in the FY 2002 Defense Appropriations Bill when Congress takes it up next month. If this defense-spending bill is not passed by October 1st, Congress will approve a Continuing Resolution (CR) to sustain funding for previously authorized initiatives. TROA has confirmed with the House and Senate Appropriations Committees and the Defense Department's General Counsel that, since TFL authority is already on the law books, it will still be implemented and funded on Oct 1 under the terms of the CR, even if no Defense Appropriations Act has
been enacted by that date.
 
Myth #3: "My doctors will not accept me as a TFL patient because they don't participate in TRICARE."
 
Reality: Under TFL, all Medicare-approved providers are automatically "TRICARE-approved providers." If Medicare pays the doctor, TRICARE will too ­ automatically. There is no requirement for the doctor to formally participate in TRICARE. In the worst case, a skeptical doctor may ask you to pay the Medicare copayment up front until he can be sure TFL will pay on time. Next month's TROA magazine will be accompanied by two copies of TROA's new TRICARE For Life Handbook for Providers. TROA designed this 8-page handbook specifically to show doctors how TFL will work, and persuade them that they won't need to require such upfront copayments.
 
Myth #4: "Doctors who treat TFL patients will have to file a secondary TFL claim for the supplemental coverage that my Medigap insurance now pays." 
 
Reality: For the vast majority of cases, all the doctor has to do is file the claim with Medicare, with no extra paperwork for TFL. Most providers already bill Medicare. Medicare will process the primary claim and send the Medicare
payment directly to the provider. The paid Medicare claim will be automatically forwarded to TRICARE, which will generate a TRICARE copayment directly to the provider. You will get an Explanation of Benefits (EOB) statement from both Medicare and TRICARE showing that both programs have paid their share of the bill and that you owe nothing. (Note: This automatic payment system will be in place for beneficiaries age 65 and over as of Oct 1, but won't be available until sometime next year for disabled Medicare- eligibles under 65. In the interim, a separate paper claim to TRICARE will still be necessary for the under-65 Medicare-eligibles.)

Myth #5: "Before I can get any benefits under TFL, I must have a new Uniformed Services Identification Card that shows eligibility for health care."

Reality: A new ID card is not required. Eligibility for TFL is based on your having correct information in DEERS, the Defense Enrollment Eligibility Reporting System. Even if the back of the Military ID Card indicates, "No civilian medical care is authorized" (after a stated date), TFL benefits will be paid so long as your DEERS information is accurate. In addition, TRICARE contractors mailed out a letter in late July and early August to all uniformed services beneficiaries 65 and older with a wallet-size "Information Card" that can be shown to a provider. The card states the provider should "file claims (for reimbursement) in the usual manner to Medicare." It also shows that the patient has no copay or deductible for TRICARE and Medicare-covered benefits and provides contact numbers for TFL information.

Myth # 6: "Because I am enrolled in a Medicare HMO or have other health insurance (OHI) coverage, TFL will not benefit me."

Reality: We believe you won't need other health insurance under TFL, but if you decide to keep it anyway, you will not get all the benefits of your premium-free TFL coverage. That's because TFL will be third-payer after Medicare and your other insurance. TROA recommends that all TFL eligibles should review their situation to assess whether it still makes sense to pay premiums for coverage that TFL provides at no cost. But even if you retain a Medicare HMO, Medigap insurance or a former employer's plan after October 1, TFL may still be of some value. If you pay copays under your other plan, you can file a TRICARE claim and be reimbursed for those costs. Also, if your plan has limited coverage, you can file a TRICARE claim for the out-of-pocket expenses, but you must enclose proof that your other plan's benefits have been exhausted. In order to submit a claim, the receipt or explanation of benefits form from your other insurer must show the patient's name, date of care, and type of service. If you are in a Medicare HMO, you should indicate that the receipt is from a Medicare Plus Choice HMO and is for your cost-share. The receipt and a claim form may then be submitted to TRICARE for adjudication. For more information, call the DOD Customer Call Center at 888-DoD-LIFE (888-363-5433).
 
Myth #7: "For retirees who travel or live outside the United States (its possessions or territories), Medicare will not pay. Thus, TFL offers no benefits overseas."
 
Reality: While Medicare doesn't provide benefits outside the United States, TRICARE does. If you are a TFL beneficiary (enrolled in Medicare Part B) and become ill while traveling or residing outside the United States, TFL will be the first payer for TRICARE-covered benefits. In this case, you'll be responsible for paying the TRICARE copayments and deductibles, up to the catastrophic cap of $3,000 per family per year plus any excess charges. You
also will be responsible for paying any billed charges above what TRICARE allows. For more information, call DoD's TFL Call Center toll-free at 1-888-363-5433.
 
Myth # 8: "TRICARE For Life will pay for long-term nursing care services, so I won't need long-term care insurance."
 
Reality: TFL does not cover long-term custodial care. Medicare and TRICARE cover certain "medically-necessary" skilled nursing care either in a Skilled Nursing Facility (SNF) or at home. Such services are very different from long-
term care services. SNF care may be needed following a period of hospitalization for rehabilitation or for stabilization of a condition. Long-term care, also called "custodial or personal care", is for people who require permanent assistance in activities of daily living, such as eating, bathing, dressing and physical movement. Beneficiaries are solely responsible for paying for custodial services. Beneficiaries desiring such coverage may want to purchase long-term care insurance, but they will have to meet certain "medical underwriting conditions" as determined by an insurance carrier.

Check your TRICARE For Life Profile at http://capwiz.com/tfl/index.html
 
########
Copyright © 2001, The Retired Officers Association (TROA), all rights reserved. Part or all of this message may be retransmitted for information purposes, but may not be used for any commercial purpose or in any commercial product, posted on a Web site, or used in any non-TROA publication (other than that of a TROA affiliate, or a member of The Military Coalition) without the written permission of TROA. All retransmissions, postings, and publications of this message must include this notice.

Posted:  5 Sep 01
TRICARE For Life Will Begin on October 1

TRICARE For Life Will Begin Oct. 1 - Uniformed Services Beneficiaries, 65 and Over, Will Receive Expanded Coverage
August 30, 2001
No. 01-24
 
When TRICARE For Life begins Oct. 1, about 1.5 million uniformed services retirees, their family members and survivors who are age 65 years and older, will receive expanded medical coverage through the military's health care
program. 

The TRICARE For Life program will make TRICARE available as a secondary payer to Medicare, which means TRICARE will pay most of the costs not covered by Medicare for these beneficiaries, eliminating many co-payments and deductibles. Details about the TRICARE For Life program were mailed regionally by TRICARE managed care support contractors to this beneficiary population, using addresses from the Defense Enrollment Eligibility Reporting System (DEERS). Those persons who believe they may be eligible, but did not receive this mailing, can request it by calling toll-free 1-888-DOD-LIFE (1-888-363-5433).
 
No TRICARE For Life beneficiary card is necessary for eligible beneficiaries to receive reimbursement for covered services, and no enrollment is required.  However, to be eligible for the expanded TRICARE coverage, uniformed services retirees, eligible family members and survivors, age 65 and over, need to be registered in DEERS and have valid military identification (ID) cards. They also must have Medicare Part A, and be enrolled in Part B.
 
Beneficiaries eligible for TRICARE For Life who do not possess a valid ID card, will need to obtain one from their local military ID card issuing facility. Beneficiaries can go online to find the three closest personnel offices or ID card facilities at http://www.dmdc.osd.mil/rsl/. They also can call 1-888-DOD- LIFE (1-888-363-5433) for these locations, and for other information about TRICARE For Life. To check their DEERS information, they may call the Defense Manpower Data Center Support Office (DSO) on its toll-free number, 1-800-538- 9552.
 
Other ways TRICARE-eligible beneficiaries may update their DEERS addresses include:
 
o Making changes on the Web site:
http://www.tricare.osd.mil and use the 'browse by topic' (DEERS Address Change).
 
o Faxing the address change to DSO, Attn: COA, 1-831-655-8317;

o Mailing changes to the DSO, Attn: TFL, 400 Gigling Road, Seaside, CA 93955-6771; or,
 
o Calling the toll-free number for DSO at 1-800-538-9552.
 
Documentation is required, and may be faxed or mailed. Beneficiaries who need to update their DEERS information other than address changes, should contact or visit the nearest military ID card issuing facility.

To become enrolled in Medicare Part B, beneficiaries should apply to the local Social Security Administration (SSA) office. The front of their Medicare card will indicate Part B enrollment status. For details on enrollment in Part B,
beneficiaries may call the SSA toll-free number, 1-800-772-1213, or visit any Social Security office. They also can find information on the Medicare Web site, http://medicare.gov (or call 1-800-MEDICARE (1-800-633-4227) to speak to a Medicare Customer Representative).
 
TRICARE For Life users may continue obtaining care from their Medicare providers, or they may receive care as available in military treatment facilities. Some may have the opportunity to use TRICARE Plus, a local primary care enrollment program available at some military treatment facilities. TRICARE Plus has no enrollment fees or premiums.
 
Many age 65 and over beneficiaries already take advantage of the TRICARE Senior Pharmacy Program, which started April 1. Eligible uniformed services retirees, their family members and survivors receive comprehensive prescription drug coverage with minimal co-payments through the National Mail Order Pharmacy Program, or through TRICARE network and non-network retail pharmacies. Co- payment amounts may be higher if beneficiaries choose non-network pharmacies. They may also continue using military treatment facility pharmacies, which require no co-payments.
 
To learn more about the TRICARE Senior Pharmacy Program, call 1-877-DOD-MEDS (1-877-363-6337) toll-free.
 
Additional information and updates about TRICARE For Life are posted on the TRICARE Web site at http://www.tricare.osd.mil/tfl/
 
++++++++++++
SOURCE:  TRICARE News Release
http://www.tricare.osd.mil

Posted:  30 Aug 01:
Upgrade of Computer-based Records as DC Area Military Hospitals and Clinics

The computer system that military health care providers use to keep track of patients' medical information is getting an upgrade that will improve services for all military medical beneficiaries in the DC area. Until now, the computer system known as CHCS (Composite Health Care System), which is used to record information regarding visits and order prescriptions or tests, has been maintained separately by Army, Navy and Air Force medical facilities in this area. With a new consolidated system set to start functioning Sept. 4, information inputted into your patient record will be accessible whether you are at Malcolm Grow Medical Center, National Naval Medical Center, Walter Reed Army Medical Center, or any of their associated branch clinics in the National Capital area. This will mean more efficient and coordinated health care.

Some services may experience a minor interruption.

Planners for the upgrade have scheduled the switch from the current system to the upgraded CHCS during the upcoming Labor Day weekend, beginning on Friday, Aug. 31. In doing so, they will take advantage of the long holiday weekend to make the switch as transparent to customers as possible. While most people will not notice any change, health care providers will be taking steps to ensure that all activities over the weekend are tracked and recorded on the new system, which will be up and running before the end of the holiday.

Do you need to take any specific action?

All services will be open and available. However, if you happen to need to use the pharmacy, lab or radiology services on Aug. 31 and during the weekend, they may be running a bit slower than normal. Also, you will not be able to schedule a new appointment for a visit or service during that period. If you know you are going to need to refill a prescription, or you have an outstanding lab test or X-ray you need to have done, you are encouraged to get those items taken care of prior to Aug. 31 to avoid experiencing any delays in service. Prescriptions may be refilled 14 days before your current supply runs out instead of the usual 7 days.

=============
SOURCE:  TRICARE News Release
http://www.treicare.osd.mil

Posted:  30 Aug 01:
Public Access to TRICARE Web Site Has Been Restored

Access to the TRICARE web site from non-military domains has been restored.  

This means that http://www.tricare.osd.mil is back online for the world!
 
Please take steps to notify your communities/mail groups/friends and neighbors that the block has been lifted.
Thank you,
 
Milton Bell
Listserver Mgr

Posted:  30 Aug 01
TRICARE Senior Prime to End December 31, 2001

TRICARE Senior Prime to end December 31, 2001
August 23, 2001
No. 01-23
 
Over the last several years, TRICARE Senior Prime was one of several test programs utilized by Department of Defense to evaluate its ability to provide health care services to its over age 65 beneficiaries. With direction from the
Fiscal Year 2001 National Defense Authorization Act, the Department of Defense will implement TRICARE for Life to meet this need. Consequently, the TRICARE Senior Prime program will end December 31, 2001.
 
TRICARE Senior Prime enrollment applications received by August 31, 2001 will be accepted for an effective date of September 1, 2001. These enrollees may remain enrolled until December 31, 2001. Enrollees in TRICARE Prime who turn 65 and become entitled to both Medicare and TRICARE and are assigned to an MTF primary care provider, may have priority for TRICARE Plus if capacity exists. Enrollment applications for TRICARE Senior Prime received between September 1, 2001 and December 31, 2001 will be returned. Current enrollees may remain enrolled until December 31, 2001 and will receive a letter that describes their rights and health care options for 2002. Current TRICARE Senior Prime enrollees may continue to utilize the military health care system through the TRICARE for Life program.
 
Information on TRICARE for Life will be mailed in August to age 65 and over Military Health System beneficiaries who are registered in the Defense Enrollment Eligibility Reporting System (DEERS).
 
NOTE FROM POSTMASTER:  TRICARE For Life related information is available online
at http://tricare.osd.mil/tfl/
########
SOURCE:  TRICARE News Release
http://www.tricare.osd.mil

Posted:  30 Aug 01
Shelton Talks Change, Troops, Transformation

By Gerry Gilmore
American Forces Press Service
 
WASHINGTON, Aug. 27, 2001 -- Chairman of the Joint Chiefs of Staff Gen. Henry H. Shelton reflected on change and present and future challenges facing the military during an Aug. 22 interview with American Forces Information Service.
 
The 59-year-old Army Ranger and Special Forces-schooled paratrooper is slated to complete his four-year term as
chairman and to retire Sept. 30. 

Shelton, who received his commission in 1963 through the ROTC at North Carolina State University, said he was proud of his military service and that of U.S. service members performing duty worldwide. He also commented on recently enacted pay, housing and health initiatives that improve the lives of service members, and of efforts to transform the military for envisioned 21st century threats.

The chairman noted that things have "changed considerably" across the military since he pinned on his gold
lieutenant's bars.

"We had a draft at that time and a force that was predominately single," Shelton remarked, adding that the majority of service members in today's volunteer military force are married. 

The active components performed most of DoD's missions during the Cold War years, said Shelton, a Vietnam and Gulf War veteran. However, with the fall of the Berlin Wall in 1989 and the ensuing drawdown, the reserve components had to shoulder more of the load.

"Today, it is a Total Force and we rely very heavily on our great troops in the Guard, as well as those in the
reserves," Shelton said. 

Shelton noted that today's military is 40 percent smaller than it was after the Gulf War. He said today's U.S. Army
may be only the seventh or eighth in size in the world, but he "has watched it get better and better" throughout the
years. 

"I've seen the quality of our force continue to improve, to where today -- there is no question about it -- we have the
finest armed forces in the world," Shelton said, adding he also has seen the quality of commissioned and enlisted
leadership improve significantly.

The noncommissioned officer corps "sets the example for others throughout the world to emulate," he said. Commenting on today's officer corps, Shelton remarked, "I'm just glad I that don't have to compete against those young lieutenants and ensigns that I bump into as I travel around the world."

America's armed forces are the best in the world, but "we have significant challenges that we'll have to deal with in
the future," Shelton said. One of those challenges, he noted, is to guard against complacency.

When Shelton spoke to Veterans of Foreign Wars members in Milwaukee Aug. 21, he said, he reminded them of history, and "the need to make sure that we're never surprised again."

Shelton said U.S. troops weren't ready to fight in the battle at Kasserine Pass in North Africa during World War
II and in the Task Force Smith debacle during the Korean War. In both actions, ill-trained and badly equipped
American units were forced to retreat.

"We were not prepared to carry out the missions our armed forces were given, and we paid a price in blood for having
done that," he emphasized. 

Another challenge for America's military is change, Shelton said.

"We need to make sure that we can change and transform our armed forces today to be prepared to deal with the 21st century threats that we will face, which may look a little bit different" from those of the past, he said.
 
"Cyber warfare -- certainly, we have to be prepared to deal with that," Shelton continued. "We've talked about
(ballistic) missile defense and the need to protect American citizens against that, to include homeland security in a larger context."

Transformation isn't easy whether within DoD or in the corporate world, he acknowledged. "Institutional resistance
to change is always something you have to contend with," he observed.

Military transformation is a complex endeavor, where leaders must not only prepare for today's threats, but also
those foreseen in 15 to 20 years, he said. As the world becomes more automated and relies more on information
technology, the armed forces need to maintain information superiority and be able to "protect our own systems from
attack by an adversary," Shelton said. He also spoke of "sensor-to-shooter" technology "that will maybe even allow
an unmanned aerial vehicle to respond with some type of robotic device to a threat."
 
Yet, Shelton emphasized that threats abound today.

"We've some nations today that concern us, [such as] North Korea," he said. "We've 38,000 great Americans in South Korea that stand guard day in and day out protecting America's interests along the DMZ.
 
"Over in the Persian Gulf, we have roughly 22,000 of our troops that on any given day are subjected to potential
attack by individuals such as Saddam Hussein," Shelton noted. "Making sure that we're prepared to deal with that
at a low to moderate level of risk is very important."
 
DoD's military and civilian leaders, Shelton said, "will continue to make sure that our forces are trained and ready
today, even as we modernize the force, bringing in the latest in technology to ensure that we'll always have that
technological edge when we put our men and women in harm's way."
 
He said incorporating those new capabilities costs money, and sometimes "creates the friction" for resources among
the services, none of which want to be left out. 

"But, I think we've got a good game plan laid out," Shelton emphasized. "The Quadrennial Defense Review is helping in that regard. I'm confident that we'll be in great shape for the future."

Back to the present day, Shelton said he is "thankful to get feedback from our troops in the field, whether it is
the young airman, young Marine, soldier, sailor, and the NCOs and the officers, because they kind of frame the
issues for us here in Washington inside the Pentagon."

Feedback from service members has prompted senior leaders to re-evaluate personnel policies and deployment schedules, Shelton said.
 
"It started off pretty heavily with perstempo and operational tempo … the lack of predictability in their lives in terms of knowing what was coming next. I think we've made some great headway," Shelton said. "Are we there, yet? No, we're not, and part of the Quadrennial Defense Review's goal is to try to bring all that (perstempo and optempo) back into balance."

Listening to service members' issues has also resulted in better quality of life in the form of higher military pay,
improvements in military housing, health care and retirement, he added.
 
"It helped us achieve the largest pay raise in the last 18 years," Shelton said, adding that more will be done in the
military pay realm in the future. "We corrected the retirement system that had been changed back in 1986 that had made our retirement program more of a disincentive than an incentive for those that stayed for 20 years. We've been
able to reduce the out-of-pocket expenses for housing for those who have to live off the installation."
 
Myriad improvements in the TRICARE health care system have also been made in recent years, Shelton said, to include "better business practices such as access and the management of the program, the transferability from one
region to another … reducing the out-of-pocket expenses for our active force." He recalled a visit to Fort Leavenworth, Kan., where he posed the question, 'Have you had an experience with TRICARE?' to 1,000 people representing all the services.

"Almost every hand went up and I asked, 'How many of you had a positive experience?' I saw almost no hands go up and I asked a whole series of questions and I got very, very negative feedback. We found out that this was something
that we really needed to take on," he said. 

Shelton noted that access to the system was a problem that has been mostly fixed. "Once you gained access, you
couldn't ask for a finer group of people, doctors and nurses," he added.
 
He also spoke of times when he read letters from military retirees who expressed feelings of disenfranchisement over
military health care. Their concerns, he added, were acted upon, and thanks to Congress military retirees will have
access to the "TRICARE for Life" health care system.

"We made a commitment to them when we brought them in," Shelton said. "If you talk to any recruiter in the last 15
years, they'll tell you that was one of the selling points for a military career, so we said we've got to fix this."
 
Maintaining competitive military pay and benefits, to include retirement, helps to keep good people in uniform,
Shelton said. The quality of today's armed forces will "remain our No. 1 challenge," he added, as the armed
services and corporate America continue to compete for qualified young people.
 
"We must continue to appeal to young men and women, to bring them into the services by letting them know of the
opportunities that exist in today's environment, and what they are really signing up for," he said.
 
The men and women who join the armed services "become members of America's 'first team,'" Shelton said. "We're
the ones that America turns to when the chips are down. We provide for -- in part, at least -- for the great
prosperity that our nation has today."

Posted:  24 Aug 01
Patient Experiences, Survey Findings Reveal Secrets of USFHP Success {01}

Personal Approach, Customer Service Improvements Drive Satisfaction Increases In TRICARE Prime Option Health Plan
 
Washington, D.C. (Aug. 22, 2001) - After 56 years of marriage, five children, and more than 30 years in the Navy and Air Force, Lawrence and Lucille Mitchell figured they could face just about any challenge. But this summer, the senior Louisiana couple was confronted with their biggest challenge ever - they were diagnosed with cancer within one week of each other.
 
Lucille's mammogram revealed that she had "suspicious-looking" calcium deposits in her left breast, which were later determined to be malignant. After consulting with her general surgeon, Dr. Issam Harmoush, at Saint Mary's CHRISTUS Health in Port Arthur, Texas, Lucille had a mastectomy and began her recovery. Throughout the diagnosis, treatment and recovery process, Dr. Harmoush was a constant presence, providing Lucille with detailed information so she could make important health care decisions. As a military beneficiary, Lucille and Lawrence use the CHRISTUS Health system through their enrollment in the Uniformed Services Family Health Plan (USFHP). CHRISTUS Health is one of seven community-based, non-profit provider groups in the country that contract with DoD to administer USFHP.
 
"I don't know how I would have coped with Lawrence's cancer diagnosis had I not felt so comfortable with the care I received from Dr. Harmoush," said Mrs. Mitchell. "His personal approach, the excellent treatment programs and the high level of care that we receive are the reason we keep coming back to CHRISTUS and stay in USFHP."
 
A recent member satisfaction survey, conducted by Market Street Research, indicates that innovative programs and quality services like those received by the Mitchells are creating healthier and happier members in each of the USFHP programs. For the eighth-straight year, USFHP's members are significantly more satisfied than members of national HMOs with the major components of the plan, including overall satisfaction, satisfaction with care received and satisfaction with their primary care providers and specialists.
 
In the 2001 survey, 82 percent of USFHP members rated overall satisfaction with the plan as an 8 or higher on a 10-point scale; nearly 91 percent rated it a 6 or higher. This rating is significantly higher than the national average of overall satisfaction for HMOs, where 57 percent of members rated the plan as an 8 or higher on a 10-point scale. In addition, the proportion of members who are very satisfied has increased over the past year (82 percent in 2001 vs. 78.6 percent in 2000). Survey respondents specifically mentioned providers' listening skills, thoroughness of explanations, and length of time providers spend with them as positive plan attributes.
 
Survey respondents also were highly satisfied with customer services and with plan administration (reasonable claims turnaround, accurate claims processing, understanding written information and paperwork). Specifically, USFHP members mentioned accuracy of the information given out by representatives and friendliness of plan representatives in these areas. "Based on the survey and my personal conversations with the users, the USFHP provides a very high standard of health care," said the President of the National Association for Uniformed Services, Major General Richard D. Murray, (Retired). "That standard, in place now for 20 years, has delivered on the promise of lifetime health care to the families of active duty career military personnel and to a patient population not covered by most other TRICARE options - those 65 and older. With the advent of TRICARE for Life, that experience makes USFHP a very successful model for DoD to base its new, over-65 health care programs on."
 
Sixty-eight-year-old Evelyn Hickman offers a good example of that model of service. Evelyn is a member of the USFHP located at Johns Hopkins in Maryland. She credits her primary care physician at Monacacy Valley Health Center in Frederick, Md. - a Johns Hopkins health center - for saving her eyesight and possibly her life. In June 2000, Hickman visited Dr. Naaz Hussain after experiencing significant peripheral vision loss. After examining Hickman, Dr. Hussain immediately referred her to an ophthalmologist. The following day, Hickman was admitted to Johns Hopkins to remove a brain tumor that was impinging on the optic nerves and affecting performance of the pituitary gland.
 
"During appointments, Dr. Hussain spends a great deal of time with me, especially going over the results of my lab tests," said Hickman. "The treatment and personal attention I've received through USFHP enrollment has been tremendous; even a nurse from the health center offered to come to the house and check on me if needed during my recovery."
 
USFHP is a TRICARE option available to families of active duty military, retirees and their eligible family members, including those age 65 and over, through networks of community-based hospitals and physicians in seven areas
of the country.

USFHP enrollment is offered through:  
 
JOHNS HOPKINS COMMUNITY PHYSICIANS
Serving central Maryland and parts of Pennsylvania, Virginia and West Virginia
 
MARTIN'S POINT HEALTH CARE
Serving Maine and southern New Hampshire
 
BRIGHTON MARINE HEALTH CENTER
Serving eastern Massachusetts, including Cape Cod, and Rhode Island
 
SAINT VINCENT CATHOLIC MEDICAL CENTERS OF NEW YORK
Serving parts of New York, all of New Jersey and southern Connecticut
 
FAIRVIEW HOSPITAL/CLEVELAND CLINIC HEALTH SYSTEM
Serving northeast Ohio
 
CHRISTUS HEALTH
Serving southeast Texas and southwest Louisiana
 
PACMED CLINICS
Serving the Puget Sound area of Washington State
 
For more information, visit the USFHP web site at http://www.usfhp.org or call 1-888-25-USFHP (87347).
 
# # #
SOURCE:  USFHP Press Release
Jennifer Garfinkel
Director, Health Care
Dittus Communications
1150 17th Street, NW
Suite 701
Washington, DC  20036
Phone:  (202) 775-1401
Fax:  (202) 775-1404
Email:  Jennifer.Garfinkel@Dittus.com 

Posted:  17 Aug 01
Healthful Web Sites

Healthful Web Sites
(Courtesy U. S. Army Medical Command Public Affairs Office)
 
1. Gateways and Publications
 
Healthfinder.gov
http://www.healthfinder.gov/
This comprehensive site is the federal government`s gateway to consumer health and human services information
 
MEDLINE Plus
http://www.nlm.nih.gov/medlineplus/
With over 9 million biomedical journal article abstracts, Medline is highly regarded by medical professionals. Plus links for health topics, dictionaries, organizations, news, and more
 
The Surgeon General
http://www.surgeongeneral.gov/sgoffice.htm
Visit the virtual office of the Surgeon General of the United States
 
Reports of the Surgeon General
http://www.surgeongeneral.gov/library/reports.htm
Reports on smoking, suicide, nutrition, physical activity and health, and HIV/AIDS, to name a few
 
National Institutes of Health
http://www.nih.gov
Easy access to the National Institutes of Health’s (NIH) 25 institutions and research trials (an NIH site specifically devoted to cancer trials is cancertrials.nci.nih.gov)
 
Health Topics A to Z
http://www.cdc.gov/health/diseases.htm
Health Topics A to Z from the Centers for Disease Control and Prevention provides a listing of disease and health topics found on the agency’s Web site
 
Links to State and Local Health Departments
http://www.cdc.gov/other.htm
Click on your state or selected counties
 
Health Web Links
http://www.consumer.gov/health.htm
Health consumer information from the Federal government
 
Government and Consumer Publications on Health
http://www.pueblo.gsa.gov/health.htm
General health information from the Federal Consumer Information Center in Pueblo, Colorado
 
Healthcare Cost & Utilization Project
http://www.ahrq.gov/data/hcup/hcupnet.htm
Identify, track, analyze, and compare statistics on hospitals at the national, regional, and state level
 
ACCESS America for SENIORS
http://www.seniors.gov
A government wide initiative to deliver electronic services from government agencies and organizations to seniors. Some features include Benefits, Health, Consumer Protection, Services, Employment & Volunteer Activities, a Retirement Planner online, Taxes, Travel & Leisure, Education & Training, and Other Links.
 
2. Food and Nutrition
 
Food Information Gateway
http://www.consumer.gov/food.htm
Consumer information on food from the Federal government
 
Interactive Healthy Eating Index
http://www.usda.gov/cnpp
Provides a quick assessment of the quality of your diet, including nutrition information targeted to your specific score

FoodSafety.Gov
http://www.foodsafety.gov
Gateway to government food safety information
 
Nutrition Navigator
http://navigator.tufts.edu/
A rating guide to nutrition Web sites
 
Center for Food Safety & Applied Nutrition
http://vm.cfsan.fda.gov/list.html
Food and nutrition information from the U.S. Food and Drug Administration
 
Recommended Dietary Allowances
http://www.nal.usda.gov/fnic/dga/rda.html
From the National Academy of Sciences
 
Local Farmers Markets
http://www.ams.usda.gov/farmersmarkets/map.htm
Click on your state to find a local farmers market
 
Dietary Guidelines for Americans
http://www.health.gov/dietaryguidelines
Online access to the fifth edition of Nutrition & Your Health: Dietary Guidelines for Americans, a joint publication of the U.S. Departments of Health & Human Services and Agriculture
 
3. Specific Topics or Concerns
 
Healthfinder Hot Topics
http://www.healthfinder.gov/hottopics.htm
Healthfinder’s monthly top search topics and perennial favorites are highlighted here for quick and easy searches. Topics include AIDS, diabetes, allergies, depression, pregnancy and alternative medicine

Help with Substance Abuse or Mental Health Problems
http://www.samhsa.gov
This site has resources to help you with a mental health or substance abuse problem, including directories of service providers, referral hotlines, and mental health/consumer survival resources
 
Mental Health: A Report of the Surgeon General
http://www.surgeongeneral.gov/library/mentalhealth/index.html
A look at mental illness as a critical public health problem
 
Help with Stress and Anxiety
http://www.mentalhealth.org/
Review the publications or use the search function to find information on dealing with stress and anxiety and other issues
 
Asthma and Indoor Environments
http://www.epa.gov/iaq/asthma
Basic information about asthma and reducing common asthma triggers in your home
 
Diet, Health and Fitness
http://www.ftc.gov/bcp/menu-health.htm
Consumer education publications in English and Spanish on topics such as dieting, indoor tanning, vision correction procedures, and infertility services to name a few
 
My Medicines
http://www.pueblo.gsa.gov/cic_text/health/my-medicines/meds_eng.html
Advice for women on using medicines wisely
 
Travelers’ Health
http://www.cdc.gov/travel/
How to protect yourself from disease when traveling outside the U.S. and alerts about disease outbreaks
 
CancerNet
http://cancernet.nci.nih.gov/
Gateway to the most recent and accurate cancer information from the National Cancer Institute
 
Clinical Trials
http://www.clinicaltrials.gov
Provides patients, family members, and members of the public current information about clinical research studies
 
National Center for Complementary and Alternative Medicine (NCCAM)
http://nccam.nih.gov/
Sponsored by The National Institutes of Health, NCCAM conducts and supports basic and applied research and training and disseminates information on complementary and alternative medicine
 
Choosing and Using a Health Plan
http://www.ahcpr.gov/consumer/hlthpln1.htm
Booklet to help you make sense of your choices for getting health care insurance
 
Oral Health
http://www.nidcr.nih.gov/sgr/oralhealth.asp
First-ever Surgeon General`s Report on oral health
 
Oncology Tools
http://www.fda.gov/cder/cancer
A variety of information related to cancer and approved cancer drug therapies from the Food and Drug Administration
 
Organ Donation
http://www.organdonor.gov
Information on how to become an organ and tissue donor
 
For Your Heart
http://www.4woman.gov
Information for women about cardiovascular disease, including exercise, nutrition, smoking, diabetes, cholesterol, and high blood pressure
 
What About Men`s Health?
http://www.4woman.org/mens/index.cfm
Information geared to help women learn more about the leading health concerns of the men in their lives; also includes a quiz for men to test their knowledge of women's health
 
Diabetes Frequently Asked Questions
http://www.cdc.gov/diabetes/faqs.htm
Learn about diabetes, its symptoms, types, major risk factors, and more
 
Prostate Cancer Fact Sheet
http://cancernet.nci.nih.gov/Cancer_Types/Prostate_Cancer.shtml
Learn about prostate cancer, its symptoms, risk factors, and more
 
Screening Mammograms Fact Sheet
http://cancernet.nci.nih.gov/clinpdq/detection/Screening_Mammograms.html
Learn the difference between screening and diagnostic mammograms, the factors that place a woman at increased risk for breast cancer, and more
 
Tuberculosis (TB)
http://www.cdc.gov/nchstp/tb/faqs/qa.htm
Information on TB, how to get tested and treated, and more
 
Cosmetics
http://www.cfsan.fda.gov/~dms/cos-toc.html
Answers to questions about cosmetic safety, animal testing, allergic reactions, and more
 
HIV/AIDS
http://www.cdc.gov/hiv/pubs/faqs.htm
Frequently asked questions on HIV/AIDS from the Centers for Disease Control & Prevention
 
4. Health Sites for Kids
 
Girl Power
http://www.health.org/gpower/
This site seeks to reinforce and sustain positive values about health among girls ages 9-14
 
Kids' Home at the National Cancer Institute
http://cancernet.nci.nih.gov/occdocs/KidsHome.html
Site for young persons being treated for cancer, HIV, and other illnesses
 
Snack Smart for Healthy Teeth
http://www.hhs.gov/kids
Site for kids’ dental care
 
Food Safety at Home, School and When Eating Out
http://www.foodsafety.gov/~dms/cbook.html
Activity book for kids to color
 
Smoke-Free Kids
http://www.smokefree.gov
Encourages adolescent girls to participate in soccer to maintain physical fitness and resist pressures to smoke
 
-------------------------
##################
SOURCE:  US Army Warrant Officer Association (USAWOA) at
http://www.penfed.org/usawoa/HealthfulWebSites.htm

More Web Sites

1.  Consumer - http://www.consumer.gov
The first Internet site with one-stop access to federal consumer information including information on health and health care quality.
 
2.  Department of Health and Human Services - http://www.hhs.gov
This is the official site of the Department of Health and Human Services (HHS). The mission of HHS is to protect  health and give a special helping hand to those who need assistance. HHS provides support and protection to older
Americans, and to the Nation's infants and children. The Department also provides aid to people with disabilities, as well as assistance and new opportunity for those in need. 
 
3.  Department of Veterans Affairs - http://www.va.gov
The Department of Veteran Affairs site provided information on VA programs, veterans benefits, VA facilities worldwide, and VA medical automation software. This site services several major constituencies including the veteran and his/her dependents, Veterans Service Organizations, the military, the general public, and VA employees around the world. 

4.  Firstgov - http://www.firstgov.gov
The first-ever government website to provide the public with easy, one-stop access to all online U.S. Federal Government resources. 
 
5.  Healthfinder - http://www.healthfinder.gov
Healthfinder.gov helps consumers find reliable health information from many Federal agencies, States, professional associations, nonprofit organizations and universities. Healthfinder brings consumers to information that can help
them stay healthy, understand diagnosis, explore treatment options, find support, and generally become more informed about health and medical topics of interest to them. 
 
6.  Insure Kids Now - http://www.insurekidsnow.gov
Do your (children or) grandchildren need health insurance? The State Child Health Insurance Program (S-CHIP) is the largest single expansion of health insurance coverage for children in more than 30 years. Today, nearly 11 million
American children -- one in seven are uninsured. S-CHIP enables States to insure children from working families with incomes too high to qualify for Medicaid, but too little to afford private coverage. Help get your grandchildren the health coverage they need to grow up healthy and strong.  

7.  Social Security Administration - http://www.ssa.gov
The official site of the Social Security Administration. Some online services are also available on this website including, ordering a replacement Medicare card, changing your address or phone number, and applying for Social Security
Retirement Benefits.
 
8.  Tricare for Life - http://www.tricare.osd.mil/ndaa
TRICARE for Life (TFL) starts October 1, 2001. It provides expanded medical coverage for: Medicare-eligible retirees, including retired guard members and reservists; Medicare-eligible family members and widow/widowers; and certain former spouses if they were eligible for TRICARE before age 65. You must have Medicare Part B to be eligible for TFL.
 
If eligible, you get all Medicare-covered benefits under the Original Medicare Plan, plus all TFL-covered benefits. If you use a Medicare provider, Medicare will be the first payer for all Medicare-covered services, and TFL will be the
second payer. TFL will pay all Medicare copayments and deductibles and cover most of the costs of certain care not covered by Medicare.
 
For more information on TFL call 1-888-DOD-LIFE (1-888-363-5433) or, look at TRICARE on the Web. Call 1-800-538-9552 for other military retiree benefit questions.
 ======================
SOURCE:  MEDICARE web site at http://www.medicare.gov
Call 1-800-MEDICARE (1-800-633-4227) to speak to a Medicare Customer Representative

Posted:  17 Aug 01
[Health.mil] "C o d e R e d" Worm Affecting Access to the TRICARE Web Stie {01}

The TRICARE Management Activity (TMA) has been contacted by hundreds of beneficiaries about the TRICARE web site being down/inaccessible.  Here are two quick points regarding this problem: 
 
1.  The problem is a result of the "C o d e  R e d" (no spaces) worm that has been covered extensively in the national media.
 
2.   TMA and the DoD "computer community" are working to fix this problem as soon as possible.
 
The following information will provide more background/detail on the technical side of the problem, what we're doing to fix it, and what can be done in the mean time.
 
Due to the C o d e  R e d worm, the Joint Task Force-Computer Network Operations has ordered that the DoD gateways be blocked from the Internet on TCP port 80 (protocol http).  This is the port that the TRICARE web site
utilizes. 
 
This will primarily affect those trying to connect to the TRICARE web site through a commercial Internet Service Provider such as AOL or Earthlink.     Those with a .mil address utilizing a direct connection to the Pentagon network
should be able to access the site.    However, those with a .mil address using a commercial connection, will not be able to access the site.   
 
Users utilizing a browser with 128 bit encryption will be able to access the web site if they add an "s" to the http: of the address.  In other words, to access the TRICARE web site, users with a commercial connection can type
https://www.tricare.osd.mil
 
------- ********* --------
SEE POSTMASTER NOTES BELOW
------- ********* --------
 
This block was originally set on August 1, 2001 for all of the Defense Information Systems Agency (DISA) gateways.  On August 2, 2001 the block was partially lifted.  Again on August 7, 2001 the block was again imposed and is
currently in effect until further notice.   Users may be able to access other .mil sites as the block is not affecting all .mil sites globally.  The TRICARE Management Activity is actively seeking relief from the block because of the web site's importance to our 8.3 million beneficiaries.
 
The bottom line remains: TMA and the DOD computer experts are working hard to resolve this problem as soon as possible.
 
TRICARE Management Activity points of contact for this issue: Mr. Gary Thomas, TMA/IMTR, 703-681-8826; and Ms. Kristi Beck, TMA/CCS, 703-681-1770.
-------------

POSTMASTER NOTES:
 
1.  The https://www.tricare.osd.mil route may not work well for everybody.  Some mailing list members have reported that they could not view FAQs, etc., while using this address. 
 
2.  If you need to connect to the TRICARE web site to get a form, etc., please advise.  We may be able to get it and E-mail it to you.

Posted:  17 Aug 01
[Health.mil} Updaing DEERS {01}

It is important to update your Defense Enrollment Eligibility Reporting System (DEERS) data to show any changes of address, family status such as marriage, divorce, birth or adoption. (Remember: Each family member's eligibility is
independent and must be updated.)
 
Home addresses are important because DEERS uses them to send out information on health benefits. Also, health benefits could be denied if DEERS is not updated to reflect new information.
 
You may update your DEERS address in several ways:
 
o Visit the DEERS website at
https://www.dmdc.osd.mil/swg/owa/webguard.login?appl=9012&rule=02
 
o Visit a local personnel office that has a Uniformed Services I.D. card facility. (Call ahead for hours of operation and for instructions if your are updating a record for someone who is housebound.) To locate the nearest military ID card facility visit http://www.dmdc.osd.mil/rsl/ (at this site, you may search for an ID card facility by city, state, ZIP code or name)
 
o Call the Defense Manpower Data Center Support Office (DSO) Telephone Center at 800-538-9552. The best time to call the Telephone Center is between 0900 - 1500 (Pacific Time) Wednesday through Friday to avoid delays.
 
o Fax address changes to 831-655-8317.
 
o Mail the change information to the
 
  DSO
  ATTN: COA
  400 Gigling Road
  Seaside, CA, 93955-6771
 
o Visit a military treatment facility.
 
Other aspects of the DEERS record may be updated by sending appropriate documentation (such as marriage or death certificates) to DEERS by mail or fax, or by visiting the nearest military ID card facility.
 
For additional questions regarding your DEERS record, call the DSO Telephone
Center at 800-538-9552. The hours of operation are 0600 - 1530 (Pacific Time)
Monday - Friday (excluding federal holidays).
 
#############
SOURCE:  TRICARE web site at http://www.tricare.osd.mil/DEERSaddress/

Posted:  17 Aug 01
Getting TRICARE Info From the Web {01}

The TRICARE web site (http://www.tricare.osd.mil) may be not be available to non ".MIL" addressees due to security precautions taken to protect the site from the Code Red virus. 
 
If you're unable to access the TRICARE web site, suggest you try using the below listed contractor web site, as applicable. 

If you're unable to get desired information from the web sites, suggest you contact your local TRICARE office or health benefits adviser for assistance. 

Milton Bell
Listserver Mgr
+++++++++++++++++++
 
TRICARE Northeast
Service area: Maine, New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island, Delaware, Maryland, New Jersey, New York, Pennsylvania, District of Columbia, Northern Virginia and the NE corner of West Virginia.
Toll-free number: (888) 999-5195
http://140.139.13.36/region01/index.htm
Sierra Military Health Services, Inc. 1-888-999-5195
http://www.sierramilitary.com
------------------------

TRICARE Mid-Atlantic
Service area: North Carolina and most of Virginia
Toll-free number: (800) 931-9501
http://www.tma.med.navy.mil
Anthem Alliance for Health, Inc. 1-800-931-9501
http://www.humana-military.com/region2and5/home.htm
------------------------
 
TRICARE Southeast
Service area: So Carolina, Georgia & Florida (excluding panhandle)
Humana Military Healtcare Services
Toll-free (800)444-5445
http://www.humana-military.com
------------------------
 
TRICARE Gulf South
Service area: Florida panhandle, Alabama, Mississippi, Tennessee and eastern third of Louisiana
Humana Military Healtcare Services
Toll-free (800) 444-5445
http://www.humana-military.com
------------------------

TRICARE Heartland
Service area: Michigan, Wisconsin, Illinois, Indiana, Ohio, Kentucky and West Virginia (excluding the northeast corner)
Toll-free number: (800) 941-4501; http://dodr5www.wpafb.af.mil
Anthem Allicance for Health, Inc, 800-941-4501
http://www.humana-military.com/region2and5/home.htm
------------------------

TRICARE Southwest
Service area: Oklahoma, Arkansas, western two-thirds of Louisiana, Texas (excluding southwest corner)
Toll-free number: (800) 406-2832; http://www.tricaresw.af.mil
Foundation Health Federal Services, 800-406-2832
http://www.fhfs.com/shared/select_region.asp?action=ChangeRegion&ps=bb
------------------------

TRICARE Central
Service area: New Mexico, Arizona (excluding Yuma), Nevada, southwest corner of Texas (including El Paso), Colorado, Utah, Wyoming, Montana, Idaho (excluding northern Idaho), No Dakota, So Dakota, Nebraska, Kansas, Minnesota, Iowa and Missouri
Toll-free: (888) 874-9378; http://web01.region8.tricare.osd.mil
TriWest Healthcare Alliance, 888-874-9378
http://www.triwest.com
------------------------

TRICARE Northwest
Service area: Washington, Oregon and northern Idaho
Toll-free: (800) 404-0110; http://tricarenw.mamc.amedd.army.mil
Foundation Health Federal Services, 800-982-0032
http://www.fhfs.com/shared/select_region.asp?action=ChangeRegion&ps=bb
------------------------
 
TRICARE Golden Gate
Service area: Northern California
Foundation Health Federal Services, (800) 242-6788
http://www.fhfs.com/shared/select_region.asp?action=ChangeRegion&ps=bb
------------------------
 
TRICARE Southern California
Service area: Southern California and Yuma, Ariz.
Foundation Health Federal Services, Toll-free 800-242-6788
http://www.fhfs.com/shared/select_region.asp?action=ChangeRegion&ps=bb
------------------------
 
TRICARE Alaska
Service area: Alaska
Toll-free number: (888) 777-8343
http://www.fhfs.com/shared/select_region.asp?action=ChangeRegion&ps=bb
------------------------
 
TRICARE Hawaii
Service area: Hawaiian Islands
Toll-free number: (800) 242-6788
http://www.fhfs.com/shared/select_region.asp?action=ChangeRegion&ps=bb
------------------------
 
TRICARE Latin America
Service area: Panama, Central America and South America
Toll-free number: (888) 777-8343; for Puerto Rico and Virgin Islands (800) 444-5445
http://tricare15.army.mil/indexReg15.htm
------------------------
 
TRICARE Europe
Service area: Europe, Africa, Middle East, Azores and Iceland
Toll-free number: (888) 777-8343
http://webserver.europe.tricare.osd.mil
------------------------
 
TRICARE Pacific
Service area: Western Pacific
Toll-free number: (800) 777-8343
http://tricare-pac.tamc.amedd.army.mil

This is the home page for all TRICARE programs in the Western Pacific Ocean.
Click on on-line titles for information about specific areas.
Foundation Health Federal Services, 800-242-6788
http://www.fhfs.com
 
TRICARE Guam
1-800-834-9785
 
TRICARE Japan
005-3111-4621
--------------------------------------------------------------------------------
 
TRICARE DENTAL PLANS AND PROGRAMS
In addition to the above TRICARE medical resources, there are also TRICARE Family Member Dental Plan and TRICARE Retiree Dental Program as follows:
 
TRICARE Family Member Dental Plan (active duty) (administered by United Concordia, Camp Hill, PA) - http://www.ucci.com.
 
TRICARE Retiree Dental Program (administered by Delta Dental, Sacramento, CA) -
Toll Free 1-888-838-8737, Web site:
http://www.ddpdelta.org/retiree/retirees.html
--------------------------------------------------------------------------------
 
Pharmacy and National Mail Order Pharmacy Programs
 
Sponsored by DoD - http://www.dscp.dla.mil/medical/pharm/dod99n.htm
Administered by Merck-Medco Managed Care - http://www.merck-medco.com/
Within the U.S. 1-800-903-4680, and Outside the U.S. 1-614-421-8211
--------------------------------------------------------------------------------
 
Change Your DEERS Address Easily at https://www.tricare.osd.mil/DEERSAddress/
Don't forget the "s" in the http or you will not be able to get on the site.
 
Need help with TRICARE? - Have a TRICARE question? Send an E-mail to TRICARE_Help@amedd.army.mil  While the address may say 'Army', it is for all beneficiaries from all services. Get answers from a TRICARE expert. You can also send questions to questions@tma.osd.mil 
 
myTRICARE.com by PGBA -Access your TRICARE claims information on your time, at your place. The benefits of myTRICARE.com - It's safe, it's secure, it's simple, it's free. Register at http://www.myTRICARE.com (not available for all TRICARE regions).
#########
SOURCE;  US Army Warrant Officer Association OnLine at
http://www.penfed.org/usawoa/woa_link.htm

Posted:  11 Aug 01
"VA Announces New Benefit, "CHAMPVA for Life"

VA Announces New Benefit, "CHAMPVA For Life"
August 2, 2001
 
WASHINGTON -- Improvements to the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) will bring financial relief to older survivors and dependents of some disabled or deceased veterans who face medical expenses not paid by Medicare or other third-party payers.
 
Called "CHAMPVA for Life," the new benefit is designed for spouses or dependents who are 65 or older.  They must be family members of veterans who have a permanent and total service-connected disability, who died of a service-
connected condition or who were totally disabled from a service-connected condition at the time of death.  They also must have Medicare coverage.
 
"This improved benefit is part of VA’s continuing effort to make sure the families of disabled veterans have health care when the veterans can no longer provide it," said Secretary of Veterans Affairs Anthony J. Principi.  "I’m delighted we can provide prescription outpatient medication coverage, a benefit not offered by Medicare."
 
Beginning October 1, CHAMPVA will pay benefits for covered medical services to eligible beneficiaries who are 65 or older and enrolled in Medicare Parts A&B.  The "CHAMPVA for Life" benefit is payable after payment by Medicare or other third-party payers.  For services not covered by Medicare or other insurance, such as outpatient prescription medications, CHAMPVA will be the primary payer.
 
CHAMPVA beneficiaries who reached age 65 as of June 5, 2001, but were not enrolled in Medicare Part B on that date, will be eligible for this expanded benefit even though not enrolled in Medicare Part B.  There is no change in
CHAMPVA coverage for those beneficiaries 65 and older who do not qualify for Medicare. 
 
Information about the new benefit was recently mailed to all previous CHAMPVA beneficiaries and providers who have filed claims with CHAMPVA. 

People over age 65 who have never been eligible for CHAMPVA can request an application by writing to the VA Health Administration Center (HAC), P.O. Box 469028, Denver, CO 80246-9028.
 
Veterans and family members can also call toll-free, 1-888-289-2411, to obtain the latest recorded information, leave a change of address, or request information to be mailed to them.  This phone line is available 24 hours a day.
 Inquiries may also be e-mailed to hac.inq@med.va.gov
 
Updates about "CHAMPVA for Life" and other benefits information will be posted
to VA’s Health Administration Center Web site at http://www.va.gov/hac
 
#   #   #
 
SOURCE:  VA News Release
http://www.va.gov/opa/pressrel/pressarchinternet.cfm

Posted:  11 Aug 01
"TRICARE Prime Enrollment Cards Receive A New Look"

TRICARE Prime Enrollment Cards Receive a New Look
Aug. 3, 2001
No. 01-21
 
Beginning in summer 2001, certain TRICARE Prime enrollees will start receiving the next generation of the TRICARE Prime enrollment card. The new TRICARE Prime card has a standardized look around the globe and will be printed centrally by the Defense Manpower Data Center, the agency that maintains the Defense Enrollment Eligibility Reporting System (DEERS), where eligibility reporting currently is done. The redesigned card provides beneficiaries with essential health care contact information.
 
TRICARE Prime, TRICARE Senior Prime and TRICARE Prime Remote new enrollees, as well as those who move to a different TRICARE region, will begin receiving the redesigned card this summer. Replacement cards for these programs also will be in the new format.  Beneficiaries who enroll in the Uniformed Services Family Health Plan (USFHP) will continue to receive a separate beneficiary card provided through the Iowa Foundation for Medical Care.
        
The new Prime enrollment card is filled with essential contact information to help enrollees access health care. The contact information is based upon the beneficiary's type of Prime enrollment (TRICARE Prime, TRICARE Senior Prime or TRICARE Prime Remote) and location (CONUS or overseas). The detailed contact information includes: whom to contact after receiving emergency treatment and when to call; the phone number for retail pharmacy questions; the TRICARE claims telephone numbers; where to call to obtain authorization for non- emergency care; and a number for health care information. The card also has spaces for writing in the primary care manager name and phone number. The beneficiary's name, sponsor's social security number and status appear on all cards.
 
The new TRICARE Prime enrollment card does not replace any aspect of the current enrollment process that beneficiaries use to enroll in TRICARE Prime or when they move to another region. The only changes for beneficiaries are to the look and content of the Prime enrollment card.
 
Beneficiaries currently enrolled in TRICARE Prime and who have a Prime card do not need to obtain a new card. Their Prime cards are valid until they move or change status. Medicare-eligible beneficiaries age 65 and over who will begin using TRICARE For Life on Oct. 1 do not need a TRICARE enrollment card. For more information on the new Prime cards, beneficiaries may call 1-888-DoD-CARE (1-888-363-2273).
 
-end-
 
SOURCE:  TRICARE News Release
http://www.tricare.osd.mil

Posted:  30 Jul 01
TriWest Signs Four-Year Extension of Its Managed Care Support Contract for the TRICARE Central Region

************
NOTE:  TRICARE Central Region (formerly known as Regions 7 and 8) — includes Arizona, New Mexico, Colorado, Wyoming, Utah, Montana, Nevada, North and South Dakota, Kansas, Nebraska, Minnesota, Iowa, most of Idaho except for six counties in northern Idaho, that piece of southwestern Texas that includes El Paso, and Missouri — except for the St. Louis area, which is in Region 5.
************
 
PHOENIX, Ariz., July 23, 2001-The U.S. Department of Defense Military Health System has awarded TriWest Healthcare Alliance Corp. a four-year extension of its managed care support contract for the 16-state TRICARE Central Region. With this contract extension, TriWest, which has just begun the fifth and final year of its original contract, will continue to manage health care for over 1.5 million active duty and retired service members and their families through 2006.
 
David J. McIntyre, Jr., president and CEO of TriWest, says, "I am very pleased that TriWest was awarded this extension. It is an equitable arrangement for both the taxpayers and the corporation, and we are pleased to continue serving this most important and deserving population. TriWest has worked very hard to optimize customer service and access to health care for our TRICARE beneficiaries in the Central Region, and I believe that the DoD has recognized this hard work by extending our contract."
 
TriWest Healthcare Alliance, the largest defense contractor based in Arizona, was founded in 1995 on the strong belief that health care service should be community-based. It is unique among the managed care support contractors in that its shareholders include 11 Blue Cross Blue Shield plans and two university hospital systems. TriWest, with its community-based approach, creative solutions and unique relationships, is striving to be the model for TRICARE administration and customer service. TriWest's strong partnership with the Central Region Lead Agent Office and the 26 military treatment facilities (MTF) across the Central Region is one its most notable achievements.
 
"TriWest, the Central Region Lead Agency and the MTF Commanders have formed a unique partnership that has resulted in dramatic increases in the efficiency and effectiveness of health care delivery and customer service throughout the region," says COL Ted McNitt, Lead Agent, TRICARE Central Region. "Two of the region's medical groups and their local TRICARE Service Centers (TSC) were recently saluted as 'Heroes of TRICARE' by the TRICARE Management Activity. I am convinced that the partnering philosophy shared by TriWest and the Central Region was the catalyst for these achievements. I am pleased that TriWest will be continuing to provide excellent service to our military men and women for four more years."
 
"TRICARE is an exciting and important program and, now that it will include providing health care services to the Senior 65+ population, it will be even more so. I'm thrilled and proud that TriWest will be serving these deserving
men and women," says McIntyre.
 
TRICARE is a regionally managed health care program for active duty and retired members of the uniformed services, their families and survivors.  TRICARE brings together the health care resources of the Army, Navy and Air Force and supplements them with networks of civilian health care professionals to provide better access and high quality service while maintaining the capability to support military operations.
 
TriWest Healthcare Alliance is a Phoenix-based management service organization that is contracted with the Department of Defense for the managed care support and administration of the TRICARE program in the 16-state TRICARE Central Region. TriWest's goal is to provide the region's TRICARE beneficiaries with access to cost-effective, quality health care and superior customer service. More information about TriWest and TRICARE can be found at http://www.triwest.com
 
###
SOURCE:  TriWest news release
POC:  Mark Jecker, 602-564-2074, MJecker@TriWest.com 

Posted:  28 Jul 01
DOD Tightens Blood Donor Safety Criteria {01}

ArmyLINK News Story
by Harry Noyes
 
WASHIGNTON (Army News Service, July 27, 2001) -- To reduce further the risk of spreading "mad-cow disease" by way of blood transfusions, the Department of Defense is tightening its restrictions on blood donations by personnel who have lived in Europe for extended periods during the past two decades.
 
The stringent rules will cut the active-duty donor pool by 18 percent and civilian donors by about 5 percent.  However, DoD can continue collecting the 105,000 units of blood that it needs annually by stepping up recruitment of
donors to replace the 18 percent loss, according to officials in the Armed Services Blood Program Office.
 
This can only be done by increasing command support, hiring some additional blood-collection personnel, integrating DoD and service blood assets, and optimizing collection sites by putting them at large installations and training
bases, the program official added.
 
The new donor restrictions, which are called deferral criteria, will be implemented by mid September. They are in line with tightened U.S. Food and Drug Administration guidelines, said Lt. Cmdr. Rebecca Sparks, deputy director
of the Armed Services Blood Program Office.
 
Under the new rules,  DoD-affiliated personnel - whether active-duty military, civil-service employee or family member - will be barred from donating blood if he (she) meets any one of the following three criteria:
 
(1) If, at any time from 1980 through the end of 1996, he (she) traveled or resided in the United Kingdom for three months or more; or if, at any time from 1980 to the present, he (she) received a blood transfusion in the U.K.
 
(2) If, at any time from 1980 through the end of 1996, he (she) traveled or resided anywhere in Europe for six months or more.
 
(3) If, at any time from January 1, 1997, to present, he (she) traveled or resided anywhere in Europe for a five years or more.
 
The FDA criteria distinguish between Europe north of the Alps and south of it, applying the more stringent six-month rule only to the 1980-1990 period in northern Europe. Convinced that many DoD people might have trouble remembering temporary-duty and travel days in various countries, DoD opted to apply the six-month rule to the whole 1980-1996 period in all parts of Europe, Sparks explained.
 
Both the FDA and DoD rules are less stringent than guidelines announced by the American Red Cross, which bar all donations from any person who has been in Europe for more than six months from 1980 to present.
 
The estimated difference in risk reduction between the two sets of criteria is very small. The FDA calculates that the new FDA criteria cut the risk of "mad-cow disease" by 91 percent. The Red Cross approach would improve the risks
by 92 percent.
 
The actual risk is small, according to officials. In three countries that have suffered human cases, less than a hundred people have been infected out of 122 million.
 
Mad-cow disease is a popular term for a disease called Bovine Spongiform Encephalopathy in cows and variant Creutzfeldt-Jakob Disease in humans. It is a fatal, brain-wasting illness caused by run-amok proteins called prions.
 
The rare human cases apparently have all come from eating infected meat.
 
None of the European victims caught the disease from blood transfusions, says Army Col. Mike Fitzpatrick, ASBPO director. He said there is no evidence that humans can get the disease that way.
 
However, animal testing suggests that there is a theoretical possibility of transmission via blood.  Therefore, in view of the disease's devastating effects and the lack of any way to test blood for renegade prions, DoD and other health officials have opted to exercise extreme caution.

The only debate has been over how far to go in taking precautions - how to balance the remote risk of spreading mad-cow disease to a handful of unfortunate people against the much larger risk of a blood shortfall that could
jeopardize thousands of lives.
 
DoD veterinary officials say the risk of mad-cow disease for DoD personnel is even lower than the tiny risk that Europeans face. That's because the Americans in Europe get most of their meat from American sources through military supply channels.
 
(Editor's note: Harry Noyes is the assistant editor at the Fort Sam Houston, Texas, Mercury.)

 Link to original news item:
 http://www.dtic.mil/armylink/news/Jul2001/a20010727blooddonor.html
===================
SOURCE:  ArmyLINK News Story at http://www.dtic.mil/armylink/

Posted:  23 Jul 01
TRICARE Plus Enrollment Will Provide Access to Military Primary Care {01}

TRICARE Plus Enrollment Will Provide Access to Military Primary Care
July 23, 2001
No. 01-20
 
A new TRICARE enrollment option called TRICARE Plus will allow some Military Health System beneficiaries to enroll with a military primary care provider. Enrollees will be provided access to primary care on the same basis as
beneficiaries enrolled in TRICARE Prime.
 
The program is being finalized. Local timing and availability will vary, and opportunities may not exist at all military treatment facility locations. TRICARE Plus is open to persons eligible for care in military facilities and not enrolled in TRICARE Prime, or a commercial health maintenance organization (HMO). There is no annual enrollment fee.
 
Persons enrolled in TRICARE Plus will be identified in Defense Enrollment Eligibility Reporting System (DEERS), and will use the military treatment facility as their source of primary care.
 
The new program differs from TRICARE Prime and TRICARE Senior Prime in several ways:
 
TRICARE Plus is not a comprehensive health plan. TRICARE Plus is a primary care enrollment program ONLY, and has no effect on the enrollees' use or payment of civilian health care benefits. Thus, TRICARE Standard or TRICARE Extra or Medicare may pay for civilian health care services obtained by a TRICARE Plus enrollee.
 
TRICARE Plus does not lock beneficiaries in to "managed care." They may seek care from a civilian provider, but are discouraged from obtaining non-emergency primary care from sources outside the military treatment facility where they
are enrolled. In addition to providing access to primary care, this plan enables their physician to coordinate health care more effectively.

TRICARE Plus does not guarantee enrollees access to specialty providers at the military treatment facility where they are enrolled.
 
TRICARE Plus is not portable. TRICARE Plus beneficiaries cannot use their enrollment at another facility.
 
The availability of TRICARE Plus in a location, and the number of enrollees, will be based on the local military treatment facility commander's determination of enrollment capacity. Should the number of applicants exceed the capacity for TRICARE Plus enrollment, enrollees will be selected by a fair process. Beneficiaries with existing primary care relationships at participating military treatment facilities, including those enrolled in the TRICARE Senior Prime demonstration, will have the first opportunity to enroll as long as a facility has the resources to provide the necessary primary care.

Military treatment facilities will review continued enrollment in TRICARE Plus annually. If capacity is no longer available at the military treatment facility, beneficiaries may be disenrolled. This will not affect their TRICARE
or Medicare benefits.
 
For more information about TRICARE Plus, call 1-888-DOD-LIFE (1-888-363-5433),
or visit the TRICARE Web site at: www.tricare.osd.mil/Plus .
===================
SOURCE:  TRICARE news release at http://www.tricare.osd.mil

Posted:  17 Jul 01
TRICARE Holds First Beneficiary Awareness Forum on Fraud, Patients' Rights and Coverage (01)

TRICARE Holds First Beneficiary Awareness Forum on Fraud, Patients' Rights and
Coverage
July 16, 2001
No. 01-19
 
The TRICARE Management Activity (TMA) Program Integrity office, the central coordinating agency for investigating alleged cases of fraud and abuse against the Military Health System TRICARE program, its beneficiaries, and U.S.
taxpayers, is hosting its first Beneficiary Awareness Forum. The objective of the forum is to ensure that beneficiaries understand their rights and coverage, and can identify if they have been victims of fraud and abuse. The forum will
be held this August in San Diego, Calif.
 
Representatives from TMA's Beneficiary and Provider Services, Military Liaison directorate, and Program Integrity office, as well as personnel from United Concordia and Delta Dental will be on hand to discuss ways in which
beneficiaries can resolve problems and report suspected fraud against the TRICARE program. In addition to beneficiaries, local health benefits advisers, provider representatives, and TRICARE service center representatives also may attend.
 
Topics on the agenda include health care fraud, in general, and its potential effect on TRICARE For Life beneficiaries, in particular. Presenters also will unveil the new TRICARE fraud and abuse Web site and other services available to
assist beneficiaries in identifying suspected fraud against the TRICARE program. After the formal presentation, beneficiaries will have an opportunity to discuss in both group and one-on-one discussions any fraudulent practices to
which they may have been subjected. Although the focus of the forum is fraud and abuse, TRICARE beneficiaries are welcome to bring their claims and explanation of benefit (EOB) forms, and receive personal assistance on any
TRICARE-related issue.
 
All beneficiaries, particularly those in the San Diego area, are invited to attend one of these sessions. The Beneficiary Awareness Forum will be held at the Marine Corps Recruit Division (MCRD) Auditorium on the following dates:
 
    Aug. 28, 2001, 6 p.m. to 9 p.m.
 
    Aug. 30, 2001, 1 p.m. to 4 p.m.
 
    Aug. 30, 2001, 6 p.m. to 9 p.m.
 
For more information about the Beneficiary Awareness Forum, call 303-676-3438, ext. 3551, or visit http://www.tricare.osd.mil/downloads/Web_Advertisement.htm
 
Beneficiaries who wish to report health-care fraud may call 800-424-9098 or send e-mail to hotline@dodig.osd.mil 
=================
SOURCE:  TRICARE at http://www.tricare.osd.mil

Posted:  16 Jul 01
Customer Service is One of Our Best Stories (01)


By Thomas F. Carrato
Executive Director
TRICARE Management Activity
July 10, 2001
 
Great customer service happens right on the front lines of the Military Health System (MHS), and, judging from this month's "Salute to the Heroes of TRICARE," I think it's one of the best untold stories of TRICARE.
 
Our unique challenge is to keep everyone happy, from the halls of Congress to the patient examination room. Toward that end, we've worked very hard to eliminate confusion about TRICARE, to educate our providers and beneficiaries, and to simplify our processes. The real test of our success is in public perception of TRICARE, which to a great extent, is measured in patient satisfaction levels, and by the tone of TRICARE headlines in the public press.
 
Often, exceptional customer service occurs during one-on-one contact - between a beneficiary counseling and assistance coordinator (BCAC) and an active duty member, between a provider and a patient, or between a TRICARE managed care support contractor telephone operator and a military treatment facility (MTF) appointment clerk. Good customer service also results from collaborations between TRICARE's various entities. Each time
it results in someone having a positive experience with military health care, it's a victory for TRICARE.
 
We work hard at customer service, providing training and resources at all levels. Our customer and beneficiary services offices, the individual services, lead agents, and managed care support contractors all have created effective customer service training modules for beneficiaries and providers. We implemented the beneficiary counseling and assistance
coordinator and debt collection assistance officer (DCAO) programs to complement other customer service initiatives in place at military treatment facilities, lead agent's offices and TRICARE service centers, and to deal with specific issues that were affecting beneficiary satisfaction.
 
One of our most recent customer service victories is the implementation of toll-free telephone numbers to assist our beneficiaries with all types of questions. Deployed just before the launch April 1 of TRICARE Senior Pharmacy program, the 1-877-DoD-MEDS number contributed significantly to its successful beginning. Customer service representatives had 300,000 incoming calls and made 100,000 outgoing calls to assist beneficiaries with questions during the first 90 days of the program.

Good customer service is not something to be gleaned from textbooks; ultimately, it boils down to TRICARE attitude. Some individuals are blessed with a positive, can-do approach to problem-solving, and truly care about the people they encounter every day in our clinics, hospitals, and offices. They love what they are doing, and as Humana Military Health Services has so aptly coined the phrase, they put the "I CARE" in TRICARE. They are the ones that foster the wonderful anecdotal accounts from our beneficiaries about how well TRICARE works for them.
 
Personal experiences are an important gauge of customer service, but they can vary greatly, depending on many dynamics. To get a truer, more objective picture of our system-wide efforts, we collect information about customer service and other important factors from TRICARE users with a variety of surveys. These include our comprehensive Healthcare Survey of Department of Defense Beneficiaries which monitors the health and health care needs of the Military Health System populations, as well as their satisfaction with health care services in or outside the Military Health System. Our Customer Satisfaction Survey evaluates beneficiary satisfaction with outpatient experiences at military clinics; the Purchased Care Survey examines beneficiary satisfaction with outpatient experiences at civilian provider's offices, and the MHS Survey of Inpatient Care looks at inpatient satisfaction.
 
The MHS Survey of Inpatient Care, conducted at 22 MHS hospitals, produced valuable insight on the experience of patients at those hospitals. Done under the aegis of a nationally recognized health care research organization with substantial experience in measurement of patient perceptions of care, it provides external validation of our outstanding
success in the area of customer service.
 
Compared with civilian hospitals using this same survey, MHS inpatients reported high satisfaction with customer service related to their post-hospital discharge needs. In response to the survey's questions about "Continuity and Transition," which included explanations about medications and dangers to avoid at home after hospitalization, MHS beneficiaries reported nearly 30 percent fewer problems, when compared with civilian hospital averages. We think these findings reflect a pattern of concern about, and attention to, the needs of beneficiaries using the Military Health System. 

Ninety-two percent of respondents to the Customer Satisfaction Survey conducted between October and December 2000 said they were satisfied with "interpersonal relations" during their outpatient visits to their military health care facilities. This score was derived from questions about the friendliness and courtesy of clinic staff, attention given to the
beneficiary, and the personal interest shown for them and their medical problems.
 
The Purchased Care Survey, conducted between November 2000 and January 2001, asked questions similar to those in the Customer Satisfaction Survey. The survey findings are strikingly close to those reported by outpatients seen at military treatment facility clinics: over 90 percent of respondents were satisfied with "interpersonal relations" they
experienced during their outpatient visits to their non-military health care facilities.
 
The Healthcare Survey of Department of Defense Beneficiaries examines courtesy and customer service over a 12-month period, among many other health care needs and issues. Results from the first calendar quarter of 2001, indicated that nearly nine beneficiaries out of 10 had no problems related to the courtesy and helpfulness of military treatment facility office staffs in the previous 12 months they used TRICARE Prime. However, this survey indicated that we need to continue our efforts to assist beneficiaries with their understanding of informational materials, ability
to get help when needed from a TRICARE customer service representative, and problems with TRICARE paperwork.
 
The TMA and MHS surveys provide a rich source of information for customer service staffs at military treatment facilities and clinics to use in developing their customer service programs. For example, National Naval Medical Center in Bethesda, Md., uses them, along with letters from beneficiaries, to select customer service heroes who are featured on a "Hall of Customer Service Heroes" in their centrally located Customer Service Center.
 
But the best indicator of good customer service is the one measured by individuals in their personal encounters with every person in the Military Health System. All in all, I believe it ranks very high. 

SOURCE:  TRICARE web page at http://www.tricare.osd.mil

Posted:  16 Jul 01
Mustard Agent Exposure Remains "Indeterminate" (01)

NEWS RELEASE from the United States Department of Defense
 
No. 309-01
(703)695-0192(media)
IMMEDIATE RELEASE
July 12, 2001
(703)697-5737(public/industry)
MUSTARD AGENT EXPOSURE REMAINS "INDETERMINATE"
 
The Department of Defense released today the final version of its case narrative, "Reported Mustard Exposure Operation Desert Storm."  This final report concludes the investigation into the possibility that a soldier was exposed to mustard agent during the Gulf War.  Investigators from the Office of the Special Assistant for Gulf War Illnesses, Medical Readiness and Military deployments assessed this incident as "indeterminate."
 
This final report concurs with the interim narrative published in October last year.  Since then, no new evidence and no new leads were developed that contradict the assessment as stated in the second interim report.  However, minor editorial changes were made prior to publishing this final report.
 
The investigation examines the March 2, 1991, diagnosis of then-Pfc. David A. Fisher as having been exposed to liquid mustard chemical warfare agent.  Among the strongest evidence supporting the conclusion that he was exposed to a
chemical warfare agent were statements from well-trained medical personnel who diagnosed and treated the injury as an exposure to mustard agent.  However, the only surviving evidence that supports a mustard exposure was a videotape of a MM-1 operator's screen during an examination of a flak jacket.  While the videotape was evaluated in 1993 by an expert as a valid detection, further examination in 2000 revealed the sample was missing critical ions necessary for mustard presence.
 
In 1991, a physician and leading expert in the field of chemical warfare agent injuries concurred with the diagnosis of chemical warfare agent injury.  However, in 1995 and 1999 interviews, this doctor also stated that other causes
could explain Fisher's injury.  Because another cause could not be found, the nature of the injury remains open.  A urinalysis also failed to detect thiodiglycol, a mustard breakdown product.  This result was inconsistent with the diagnosis, but not unexpected considering the low-level of exposure. Additionally, the location of the bunker where Fisher was believed exposed was 100 miles from Iraq's nearest chemical warfare storage facility according to
the CIA and the United Nations Special Committee on Iraq.  The CIA and UNSCOM have reported no evidence that Iraq moved any chemical warfare agents south of Khamisiyah.
 
Due to the conflicting evidence, investigators are less certain and the assessment of this event remains as indeterminate.
 
This narrative, and all other publications of the Office of the Special Assistant for Gulf War Illnesses, Medical Readiness and Military Deployments, is posted on GulfLINK at http://www.gulflink.osd.mil/fisher_final

Posted:  16 Jul 01
Dietary Supplements:  Ask Your Doctor To Be Sure (01)



By Gerry J. Gilmore
American Forces Press Service

WASHINGTON, July 11, 2001 - People thinking about taking dietary supplements to pep up, bulk up or slim down ought to ask their doctor or other health provider first.

Dietary supplements can affect different people differently and may also interact adversely with prescription drugs,
said Army Col. Mike Heath, the pharmacy consultant with the Office of the Army Surgeon General.

"It is in your best interest to talk to your health care provider before you take a dietary supplement," Heath said,
"particularly if you know that you have a family history of heart disease, high blood pressure, diabetes, [or] asthma."

Dietary supplements, which include so-called energy boosters, over-the-counter diet pills and bodybuilding
drinks or mixes, can also pose risks for people not taking prescription drugs.

"Anytime you put a chemical in your body, your body metabolizes or digests it, and there can be potential side
effects," he noted, to include allergic reactions. 

Heath said energy-enhancing dietary supplements provide a caffeine-like boost, similar to how strong coffee affects
the central nervous system.

"It is a stimulant - it gives you a 'buzz' and affects the heart and cardio-vascular system in terms of raising your
blood pressure and increasing the heart rate," he explained.

Heath recommends that military members not take dietary supplements, such as products containing the chemical
compound ephedra, before engaging in strenuous physical activity.

"I'd caution them not to take these performance enhancing drugs or energy boosters and then go out and perform the PT test, particularly in hot weather," he said. "If you had some underlying problems, you could be setting yourself up
for potentially serious side affects."

People should also be aware that, with the exception of vitamins, the Food and Drug Administration doesn't regulate
dietary supplements the same way as it does prescription and other over-the-counter products, Heath said.

Under the Dietary Supplement Health and Education Act of 1994, the dietary supplement manufacturer is responsible
for ensuring that a dietary supplement is safe before it is marketed, according to the FDA website at http://vm.cfsan.fda.gov

The FDA is responsible for taking action against any unsafe dietary supplement product after it reaches the market,
according to the website. Generally, manufacturers do not need to register with FDA nor get FDA approval before
producing or selling dietary supplements.

"There is no [FDA] standardization of quality control in terms of what is in" dietary supplements, Heath noted,
adding that the potency of doses and other inert additives can vary from batch to batch.

The bottom line, Heath said, is that dietary supplements are "chemicals you are putting into your body."

"How do you know, unless you ask someone qualified, whether or not these products can interfere with other drugs, to
include any other over-the-counter products that you are taking?" he concluded.


Posted:  16 Jul 01
Change and Toll-Free Numbers (01)

1.  CORRECTION:  The correct dates for the Fourth Annual Force Health Protection Conference (mentioned in an earlier message) are 26-30 August 2001 at the Albuquerque Convention Center.  For additional conference information, schedules, registration, etc., visit http://chppm-www.apgea.army.mil/fhp/ .  Points of contact are LTC Wayne Smetana, wayne.smetna@apg.amedd.army.mil, (DSN)584-2641 or (COM)410-436-2641, and Ms. Jane Gervasoni, jane.gervasoni@apg.amedd.army.mil, (DSN)584-5091 or (COM)410-436-5091.

2.  CHANGE:  New dates for the November 2001 TRICARE Basic Student Course (TBASCO) are 14-16 November 2001.  POC is Mr Theodore Moore at theodore.moore@tma.osd.mil 
 
3.  TOLL-FREE NUMBERS:  Please remember, there are several new toll-free telephone numbers you can call for TRICARE assistance, information, guidance, etc.  The numbers are:
 
o General TRICARE information/assistance: 1-877-363-2273
 
o TRICARE Pharmacy: 1-877-363-6337
 
o TRICARE For Life: 1-888-363-5433
 
Other toll-free TRICARE telephone numbers, web site links, etc., are available online at http://www.tricare.osd.mil/tricare/phonenumbers.html

Posted:  29 Jun 01

TRICARE University is Open to The Public
June 28, 2001
No. 01-18
 
TRICARE University, an on-line version of the TRICARE Basic Student Course is now available to anyone who wants to improve their understanding of the TRICARE benefit. This includes individuals whose job it is to provide advice on the military health care program for those seeking in-depth knowledge of the benefit. TRICARE University introduces its students to the health care benefits available for uniformed services beneficiaries and family members. In addition, this course provides customer service guidance and an overview of TRICARE administration.
 
TRICARE University consists of 13 lessons, practice questions and non-graded examinations that are accessible at the end of each lesson. The questions reinforce lesson content and promote learning with immediate feedback and, if
necessary, guided review.

A "Course Objectives" button takes students through information related to objectives, prerequisites, and requirements. Those new to the TRICARE University's web-based learning environment can use the "Navigation Tutorial" section to learn how to navigate through the various features and functions available in the course.

At the end of this course, the student will be able to recall the basic benefits of TRICARE options, pharmacy and dental programs, to match available health benefit options with beneficiary eligibility status and category, calculate costs, and file claim forms. They will also be able to find a list of resources available on the Internet and from TRICARE Management Activity if they need further information.
 
TRICARE University can be found on the TRICARE Web site at http://199.211.83.208/public/homepage.html or by going to http://www.tricare.osd.mil , clicking on "Browse by Topic" to get the drop-down menu, and then selecting TRICARE University.

------------------
SOURCE:  TRICARE web page at http://www.tricare.osd.mil

Posted:  30 Jun 01

Personalized TRICARE for Life Information Available (01)

The Retired Officer Association (TROA) has started a new free service called the TFL Personal Profile, which provides specific TRICARE for Life (TFL) information tailored to the personal situation of a specific TFL beneficiary. The TROA and the Air Force Retiree News Service reports that the new service is available to all TFL beneficiaries whether or not they are TROA members. By completing a simple nine-item questionnaire, you can view a personal summary describing how TFL will work for you. You can print your TFL Personal Profile for handy reference and also have your spouse or friends complete the survey to see how TFL will apply to their circumstances. The questionnaire answers are confidential, and the questionnaire does not ask for a Social Security number or address.
 
The TFL Personal Profile is at http://www2.troa.org/TFLProfile
 
More health related information for retirees is available at
http://www.military.com/Resources/ResourceFileView?file=retirees_health.htm
--------------
SOURCE:  Military Report June 28, 2001 Issue
MilitaryReport.com at http://www.militaryreport.com

Posted:  1 Jul 01

Fisher House Opens in Germany (01)

By Alicia Gregory

LANDSTUHL, Germany (Army News Service, June 28, 2001) -- In a landmark partnership between Fisher House Foundation Inc., and the Army Corps of Engineers, the first Fisher House built outside of the United States was
dedicated here June 18.
 
Completion of the Landstuhl Fisher House took half the time expected.  The success was due to the teamwork of Fisher House Foundation officials and U.S. Army Engineers working on the project, according to Ray Flock, Chief U.S.
Army Engineer Group, Project Management Section.

"To pull this together, (U.S. Army Europe) had to find a site, the money to fund that site, and get the approval to build the house itself. It pulled together all the team members, the engineers, legal, and contracting," said Flock. "We faced complexities with status of forces agreements, so we turned to the people who could get it done, the Army Corps of Engineers," said Fisher."We could not have built this house without them."

 The houses are a refuge for what USAREUR Commanding Gen. Montgomery C. Meigs called "families in crisis."

"One of the difficult things for the chain-of-command is reaching out to the family when they have to deal with this sort of crisis.This facility will make that process more capable and efficient," said Meigs.

The 28 Fisher houses already in the United States and now Europe, serve as comfortable, temporary homes for the families of service members who are hospitalized. The houses are built near medical facilities, so that family members can stay near their loved ones undergoing medical care.

The charge is approximately $10 per night.

Located between the hospital and on-post housing, the Landstuhl Fisher House is a 5,600 square-foot home with eight rooms serving up to 16 family members.Two of the rooms on the lower floor are designed for handicapped access. Each room includes bath, common kitchen, dining room, living room and laundry facilities.


Prior to the Fisher House, families stayed in billeting at Landstuhl Regional Medical Center or a hotel on the German economy.
 
The plaque above every Fisher House reads, "Their gift is dedicated to our greatest national treasure...our military service men and women and their loved ones."

The Landstuhl facility marks the second house opening since the death of noted philanthropist Zachary Fisher who began building the houses with the support of his wife, Elizabeth.Zachary Fisher died, June 4, 1999.

 The Fisher Foundation's senior partner Anthony Fisher represented the family at the dedication.

"The very least we can to for the men and women in the Armed Services is to provide them with dignity and the comfort of a home, sometimes far away from their real home," he said.

(Alicia Gregory is the web manager for the United States Corps of Engineers, Europe District.)
 
 Link to original news item:
  http://www.dtic.mil/armylink/news/Jun2001/a20010628fisher0628.html

Posted:  2 Jul 01

Items covered below:
-- TRICARE toll-free telephone numbers
-- Chiropractic benefit for active duty
-- Separate beneficiary card not required for TRICARE For Life
-- DEERS update info

1.  TRICARE has new toll-free telephone numbers.  The numbers below are staffed by experts who can help beneficiaries find out about TRICARE, TRICARE For Life, the TRICARE Senior Pharmacy Program and TRICARE Prime Remote for active duty and their family members. Everything you want to know about TRICARE.  The new
telephone numbers greatly expand TRICARE's communications efforts.
    o TRICARE General Info and Senior Pharmacy Program 1-877-DoD-MEDS (1-877-363-6337)
    o TRICARE For Life program 1-888-DoD-LIFE (1-888-363-5433)
    o TRICARE Prime Remote for active duty and their family members program 1-888-DoD-CARE (1-888-363-2273)
    o Hearing or speech-impaired beneficiaries may call TTY/TDD 1-877-535-6778
 
Hours of operation (all times Eastern) are:
    Mon - Fri    0800-2300
          Sat    0900-2000
          Sun    1000-1730
     Holidays    Closed
 
2.  DoD is Working on a Chiropractic Benefit.  Under the 1995 National Defense Authorization Act (NDAA), Congress directed the Department of Defense (DoD) to conduct a Chiropractic Health Care Demonstration Program (CHCDP) at selected military treatment facilities (MTFs). DoD completed that demonstration in September 1999 and submitted a report with recommendations to Congress on March 3, 2000. Using civilian practitioners, chiropractic services are still offered at select facilities including: Ft. Benning, Ga.; Ft. Carson, Colo.; Ft. Jackson, S.C.; Ft. Sill, Okla.; Walter Reed Army Medical Center, Washington D.C.; Jacksonville Naval Base, Fla.; Camp LeJeune, N.C.; Camp Pendleton, Calif.; National Naval Medical Center, Bethesda, Md.; Scott Air Force Base (AFB), Ill.; Travis AFB, Calif.; Offutt AFB, Neb.; and Wilford Hall Medical Center, Texas. Effective October 1, 2001, chiropractic services provided within DoD will only be available to active duty personnel at the 13 sites listed above.
 
As for the future of chiropractic health care, Section 702 of the 2001 NDAA directed DoD to implement a chiropractic care program for active duty service members at designated MTFs. An implementation plan will be submitted to Congress in the summer of 2001.
 
3.  A separate beneficiary card is not required to receive health benefits under TRICARE For Life. Your Uniformed Services Identification (I.D.) card and your Medicare card are all you need for Medicare to pay first and TRICARE to
pay second on your claims starting Oct. 1, 2001. In summer 2001, potentially eligible beneficiaries will receive a TRICARE For Life package that will include an information card, letter, benefit comparison chart, brochure, a
survey form and return envelope for notifying TRICARE if you intend to cancel other health insurance. The information card is not needed to access care. The card is a handy (wallet-size) TRICARE For Life reference for you and your
doctor. 

4.  All TRICARE beneficiaries should have up-to-date information in the Defense Enrollment Eligibility Reporting System (DEERS).  Eligible beneficiaries must have the most accurate family and beneficiary data in DEERS.  Eligible
beneficiaries may update their addresses in DEERS by:

    o Visiting local personnel offices that have an ID card facility. 
 
      NOTE:  You can search online for the location of the nearest ID card issuing office at http://www.dmdc.osd.mil/rsl/ 
 
    o Calling the Defense Manpower Data Center Support Office (DSO) Telephone Center at 1-800-538-9552. The best time to call the Telephone Center is Wednesday - Friday, between 9 - 3 (Pacific Time) to avoid delays.
 
    o Faxing address changes to 1-831-655-8317
 
    o Mailing the change information to the DSO, Attn: COA, 400 Gigling Road, Seaside, CA 93955-6771
 
    o Visiting a military treatment facility
 
    o Emailing information to addrinfo@osd.pentagon.mi l and include the following information:
       Sponsor's Name and Social Security Number
       Name(s) of other family members affected by the address change
       Effective date of address information
       Telephone number (to include area code), if available
 
To change information other than address data, however, beneficiaries may only visit an ID card facility, mail or fax changes with appropriate documentation to the address/numbers provided above. To learn what documentation is required, call an ID card facility or the DSO toll-free number, 1-800-538-9552. The hours of operation for DSO are Monday-Friday (excluding Federal Holidays), 0600-1530 (Pacific Time).
-----------
SOURCE:  Compiled from information available on the TRICARE web page at http://www.tricare.osd.mil and RAPIDS Site Locator web site at http://www.dmdc.osd.mil/rsl/

Posted:  3 Jul 01

VA Toll-Free Spina Bifida Hot Line and CHAMPVA Number Change (01)

VA Sets Up Toll-Free Spina Bifida Hot Line
 
WASHINGTON, DC -- Vietnam veterans now have a new national toll-free hot line to answer their questions about health care benefits for their children who have spina bifida.
 
The number for the hot line, operated by the Department of Veterans Affairs (VA), is 1-888-820-1756. Callers can speak to a benefits adviser Monday through Friday, from 10 a.m. to 1:30 p.m., and from 2:30 p.m. to 4:30 p.m., Eastern time.
 
"This new helpline is part of a continuing effort by VA to reach out to veterans and their families," said Secretary of Veterans Affairs Anthony J. Principi, himself a Vietnam veteran.
 
An after-hours phone message will allow callers to leave their names and telephone numbers for a return call the next business day. The hot line is managed by VA's Health Administration Center in Denver.
 
Eligibility for VA's spina bifida benefits is limited to Vietnam veterans' children who have been diagnosed with spina bifida (except spina bifida occulta). The veteran-parent must have served in Vietnam during the Vietnam War. The Spina Bifida Healthcare Program covers most health services and supplies that are medically or psychologically necessary for the treatment of spina bifida and related medical conditions.

For general information on VA's spina bifida program, visit the VA Web site at http://www.va.gov/hac.

---------------------------------

Hours Change for CHAMPVA Toll-Free Number
 
WASHINGTON -- The telephone hours for CHAMPVA -- “Civilian Health and Medical Program of the Department of Veterans Affairs” -- have changed.

Callers can now speak to a benefits counselor from 9 a.m. to 1:30 p.m., and from 2:30 p.m. to 5 p.m., Eastern time.   The phone number is unchanged -- 1- 800-733-8387. 
 
CHAMPVA is a health benefits program in which VA shares with eligible beneficiaries the cost of certain health care services and supplies. 
 
VA’s Health Administration Center (HAC) in Denver manages CHAMPVA.
================
 
SOURCE:  Veterans Administration web page at http://www.va.gov


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