Veterans Benefits Information

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Veterans Benefits Information

11-013

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Policy Memorandum to Establish 2012 Monthly Premium Rates for TRICARE Reserve Select and TRICARE Retired Reserve

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Audit of Compensation Program Claims Brokering\n\r\n\r (9/27/2011)

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This audit evaluated the effectiveness of VBA’s claims brokering. To help address VBA’s major challenge of processing the increased number of veterans’ compensation benefit claims, VBA has increased claims brokering from veterans service centers (VSCs) to resource centers or other VSCs to better align workload with staffing resources. We found VBA can improve the effectiveness of claims brokering by ensuring area offices consider additional factors affecting timeliness and accuracy. For nearly 171,000 brokered claims completed during FY 2009, we projected the average processing time of 201 days would have been 49 days less if VBA had avoided the claims processing delays identified in this report. Of nearly 117,000 claims VBA brokered for ratings, we projected area offices brokered about 54,000 (46.2 percent) to facilities with lower rating accuracy rates than original VSCs. In addition, staff at three of seven VAROs we visited brokered claims without area office approval. Increased effectiveness will reduce the risks of claims-processing inaccuracies. We recommended the VBA revise brokering policies and procedures to help improve claims-processing timeliness and accuracy, include brokered claims-processing timeliness and accuracy performance measurements in director performance plans, and evaluate VSC compliance with revised brokering policies and procedures.

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The Pentagon Budget and the Deficit

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Reforms of military pay, benefits and pensions must be phased in fairly, but they cannot be deferred any longer.

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Healthcare Inspection Quality of Care Provided at Corpus Christi Community Based Outpatient Clinic VA Texas Valley Coastal Bend Health Care System, Harlingen, Texas (9/27/2011)

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We evaluated the validity of allegations regarding quality of care at the Corpus Christi Community Based Outpatient Clinic (CBOC) in Corpus Christi, TX. We substantiated the allegation that a CBOC primary care provider did not diagnose a patient’s fractured ankle when the patient presented for evaluation. The facility had taken appropriate action prior to our review. We substantiated that a CBOC primary care provider prescribed antibiotics without first obtaining wound cultures. The primary care provider acknowledged that his usual practice to obtain a specimen for culture when drainage was present in a wound prior to starting antibiotics. We identified two factors that affected this patient’s care: Failure to implement the facility’s Skin Integrity Management Program Policy for managing the skin integrity of outpatients. Fee-basis records are not always available in the medical record. The facility identified opportunities for improvement prior to our review. We found their plan acceptable.nrWe recommended that the Medical Center Director ensure that the CBOC follow the Skin Integrity Management Program Policy. The Director concurred with our findings. We will follow up until the planned actions are completed.

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Wong presents plaque to Walcoff

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On Sept. 26, National Commander Fang Wong and Jacob Gadd, the Legion's deputy director for Healthcare, attended the retirement and award ceremony in honor of Michael Walcoff, deputy under secretary, Veterans Benefits Administration (VBA) for the Department of Veterans Affairs.

Walcoff served in increasing responsibilities in his 37 years of public service for VA, beginning in 1974 as a veterans claims examiner and later working as director of field offices, areas and associate deputy under secretary for Field Operations. As VBA's deputy under secretary, Walcoff directed VA's disability compensation, pension, education, home loan guaranty and other programs throughout the 57 VA regional offices.

Wong and Gadd presented Walcoff with a plaque to recognize his 37 years of public service and thank him for his work to benefit the nation's veterans on behalf of The American Legion.


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