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Sequester could mean longer wait at clinics

Mar. 5, 2013 - 04:32PM   |   Last Updated: Mar. 5, 2013 - 04:32PM  |  
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Service members, families and retirees who receive care at military hospitals and clinics are likely to feel the sting of sequestration if civilian workers roughly 41 percent of the nearly 140,000 Military Health System workforce are furloughed, Pentagon officials said Tuesday.

Addressing the impact of the budget cuts for the first time, Assistant Secretary of Defense for Health Affairs Dr. Jonathan Woodson said in a statement posted on the MHS website that the cuts will hamper research, delay maintenance and slow equipment purchases.

He added that if the department must furlough its civilian force, delivery of health care at military treatment facilities likely would be affected.

"Local hospital and clinic commanders will need to manage service availability while ensuring that the quality of care and safety of patients remain intact," Woodson wrote.

The Defense Department will have to furlough civilian employees one day a week without pay for about 22 weeks to meet the requirements of the 2011 Budget Control Act.

A bill currently circulating in the House to pay the government's bills for the rest of the year would give DoD more leeway to move money to personnel accounts, possibly providing relief from furloughs. The Senate is working on its own version.

Retirees and their family members are likely to be the most affected if military treatment facilities scale back on appointment availability.

By law, active-duty personnel have top priority at military hospitals, while family members are "entitled to care on a space available basis." But while retirees and their family members "may be given access to care," they have no right or entitlement to it at military treatment facilities.

The potential fallout comes as Tricare plans to trim 170,000 retirees and family members from Tricare Prime, the military's version of a health maintenance organization that relies on a network of physicians, including military health facilities, to provide care.

On Oct. 1, the geographic areas where Tricare Prime will be available will be scaled back to within 40 miles of a current military installation or a former base that has shut down, a change that will affect only retirees and their family members who live outside these zones.

Active-duty personnel and their family members have health care in these areas through the Tricare Prime Remote program.

Also, the Pentagon has tried, at least for the past two years, to dissuade retirees from using Tricare Prime by proposing to increase enrollment fees for the plan to levels significantly higher than those in Tricare Standard. Prime costs the government an estimated $600 per year per beneficiary more than Standard.

In his memo, Woodson said those who receive health care in the private sector, either as a Tricare Prime, Extra or Standard beneficiary, will not see any immediate impact from the cuts.

DoD officials previously had said private-sector care may be affected at the end of the fiscal year because Tricare may run out of money to reimburse claims.

"The Military Health System leadership … [is] closely monitoring the effects of sequestration on the health services provided to our 9.6 million beneficiaries," Woodson wrote.

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