Defense Health Care: Disability Programs Need Improvement and Face Challenges

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A letter report issued by the General Accounting Office with an abstract that begins "The military's health program--TRICARE--provides medical care to about 8.3 million active duty service members and retired beneficiaries and their dependents and survivors. The Department of Defense (DOD) also provides benefits for persons severely disabled by physical or mental problems through its Individual Case Management Program for Persons with Extraordinary Conditions (ICMP-PEC) and for less severely disabled active duty dependents through its Program for Persons with Disabilities (PFPWD). Recently, military families and advocacy groups have raised concerns about accessing ICMP-PEC benefits. Also, the DOD Authorization Act for ... continued below

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United States. General Accounting Office. October 12, 2001.

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Description

A letter report issued by the General Accounting Office with an abstract that begins "The military's health program--TRICARE--provides medical care to about 8.3 million active duty service members and retired beneficiaries and their dependents and survivors. The Department of Defense (DOD) also provides benefits for persons severely disabled by physical or mental problems through its Individual Case Management Program for Persons with Extraordinary Conditions (ICMP-PEC) and for less severely disabled active duty dependents through its Program for Persons with Disabilities (PFPWD). Recently, military families and advocacy groups have raised concerns about accessing ICMP-PEC benefits. Also, the DOD Authorization Act for 2001 entitled military retirees age 65 and older and their dependents and survivors to TRICARE benefits for life which may have caseload and cost effects on ICMP-PEC. As of June 2001, 38 ICMP-PEC participants were projected to receive $6 million in services in fiscal year 2001, Their annual per-case costs were projected to range from $13,000 to $382,000. ICMP-PEC now lacks a clear purpose, well-defined eligibility criteria and benefits, and an efficient application process. In contrast, PFPWD is an established program with well defined criteria and benefits that assist thousands of ADFMs with their special health care service and equipment needs. Also, before April 2001, PFPWD provided many services and equipment at modest cost to ADFMs with severe disabilities that were also available at higher copayments to less seriously disabled ADFMS under TRICARE Basics. Data are unavailable on how many PFPWD participants are affected by the program's $1,000 monthly benefit limit. A comparison of ICMP-PEC's home care benefit of up to 24 hours of skilled nursing care per day, seven days per week-and unlimited skilled nursing facility coverage with Medicare and selected Medicaid programs showed that ICMP-PEC's benefits are more generous."

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Government Accountability Office Reports

The U.S. Government Accountability Office (GAO) is an independent, nonpartisan agency that works for the U.S. Congress investigating how the federal government spends taxpayers' money. Its goal is to increase accountability and improve the performance of the federal government. The Government Accountability Office Reports Collection consists of over 13,000 documents on a variety of topics ranging from fiscal issues to international affairs.

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  • October 12, 2001

Added to The UNT Digital Library

  • June 11, 2014, 5:03 a.m.

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United States. General Accounting Office. Defense Health Care: Disability Programs Need Improvement and Face Challenges, report, October 12, 2001; Washington D.C.. (digital.library.unt.edu/ark:/67531/metadc294990/: accessed May 30, 2017), University of North Texas Libraries, Digital Library, digital.library.unt.edu; crediting UNT Libraries Government Documents Department.