Vet Choice program: Veterans can now receive acupuncture from "out-in-town" Acupuncturists as a covered VA benefit

related posts:  Affordable Care Act (Obamacare) and Acupuncture, Essential Health Benefits and Acupuncture, Worker's compensation and Acupuncture coverage

So, I have been hearing from veterans and East Asian Medicine (acupuncture) practitioner colleagues that a new program, Vet Choice, started covering acupuncture services by EAMP (licensed acupuncturist) practitioners in late 2015.  I have heard for years from vets who want to receive acupuncture for their health and well-being from helping improve or maintain their activities of daily living, their chronic pain, their sleep, or their stress/anxiety/PTSD.  Getting access to acupuncture has been challenging for them.  The VA has been slow to hire EAMPs and in general, the VA has had a reputation of long wait lists and access to care challenges.

There has been, in the news, pressure over the last few years from Congress for the VA to overhaul its system and provide more access to care for veterans and, particularly, access to integrative medicine therapies as a non-drug, non-surgery option.  I believe the Vet Choice program is part of this.

This is what I understand about the VetChoice program so far:

• it covers acupuncture services for those vets who need it
• it covers acupuncture as practiced by EAMPs/acupuncturists with current, unrestricted licenses
• The EAMP does not have to work in a VA facility for VetChoice to cover care a veteran has received.

Caveats
You must "dot your i's and cross your t's" on this.
This is what I have learned from veterans and EAMPs who have been successful receiving coverage/payment for services from this program.

1. The veteran must get pre-authorization for service.  This can be calling their VetChoice provide and strongly requesting it or having the paperwork approval from their PCM.
2. The EAMP/acupuncturist must get all the VetChoice paperwork forms filled out and completed.  Reimbursement claims have a 30 day window.  That means, as a provider, you must get your insurance paperwork to the VetChoice office in less than 30 days from the date you did the treatment.  [Yes, that is much shorter than the average insurance company.]  Claims must be authorized.  Diagnosis must be the authorized diagnosis only.  Physical medicine services (all the common acupuncture procedure codes fall under this category of codes) must use modifier GP.  You may request additional visits.

Positives I have heard

1. From practitioners:  it is a fair reimbursement rate.
2. From veterans:  they can get in to see their provider in a timely manner, they are getting the treatments they need in the frequency they need, and they are receiving benefit/ their conditions are improving
3. Reports from both veteran and practitioner that the process for requesting more or different  treatment authorization from VetChoice is streamlined (compared to many civilian insurance companies and compared to the process these veterans have, over the years, become accustomed)

If you think you qualify, here is the information I have been given to share.  As always, double-check your facts with your local primary care provider and your local insurance provider:
in the Pacific Northwest Region, the VetChoice program is through TriWest.

From one of my colleagues:  “the Vet has care for acupuncture under TriWest.  They can request to be referred by their primary MD.  If the MD refuses to refer, the Vet can contact TriWest directly indicating they wish to have acupuncture for back pain, etc, and TriWest will generally directly authorize.  Go first to the primary care provider, however.”

Pacific Northwest Region Vet Choice Program contact information from the website:

To enroll contact TriWest provider services or email choiceprovider@triwest.com

Customer service 855 722-2838

MidWest and East regions program contact information

Healthnet Federal Services:  https://www.hnfs.com/content/hnfs/home/va/home/pccc/FrequentlyAskedQuestions/general-information.html  and http://www.battlefieldacupuncture.net/vaacupuncture/

Patient-centered Community Care regions are 1, 2, and 4.  See the map.  Generally, VetChoice program is available in East Coast and upper MidWest. 

VetChoice program covering other Integrative Medicine therapies, such as massage and chiropractic
I do not know.  This is the link to more information about the Vet Choice program, its history, and its intention.  Maybe you will find an answer there.  If so, please share in the comments section.
VA blog post on the topic, October 1st, 2015
Veterans Choice program website

25th Anniversary of the Americans with Disabilities Act, 2015, and connection to EFMP resources

Good to review this equal access/equal opportunity law, whether you review it for yourself, your

spouse, your EFMP child, or your friend.

July 26th, 2015 is the 25th anniversary of the Americans with Disabilities Act.  You can find more about this on the ADA's anniversary page.

ADA 25th anniversary page: 

The ADA legacy tour is traveling to U.S cities with an exhibit to show how the ADA has affected the lives of Americans.

For tour dates and locations or to host the exhibit, check out the official Legacy Tour webpage

Other resources
The Exceptional Advocate, the Military OneSource newsletter for EFMP families
Military OneSource fact sheets: "Americans With Disabilities Act" and "Equal Opportunity for Individuals With Disabilities"
Military Special Needs Network (MSNN)
The MSNN blog

References
Americans with Disabilities Act
ADA 25th anniversary page
ADA legacy tour page and official tour info page
Military OneSource
Exceptional Family Member Program (EFMP)

Public Service Work and U.S. Federal Student Loan Forgiveness

Is public service work your passion?  Do you want to work in emergency response or education or law or medicine but your student loans are huge and you have no idea how to do the work you love and find a way to pay down your federal student loans?  [Or pay for lunch?]

Yep.  I hear ya.  Fortunately, Congress has heard you, too.  So, they have some ideas.  None of which are immediate fixes.  Of course there are the cool federal volunteer programs like AmeriCorps, Peace Corps, and VISTA.  But what if your life situation does not let you just up and leave for a year or so that these programs require.  Well, not much options.  Of course, talking with your federal loan servicer for different options and rates and even income-sensitive adjusted payments and deference and forbearance is always a first call.

However, this post is about something new that came together in 2007 and updated (with more concrete information) in 2012 called the Public Service Student Loan Forgiveness Act.

Source:  ClipArt

 

What is the Public Service Student Loan Forgiveness Act?

Well, it is complicated. I will piece together what I have learned so far and paste the links to the information I studied for this post. If you have more insights on this subject, PLEASE share in the comments box below.

"Federal Student Aid" is an office of the U.S. Department of Education.  On their website or studentaid.ed.gov, they say “if you work full-time in a public service job, you may qualify for Public Service Loan Forgiveness.” 

 What is the Public Service Loan Forgiveness Program (PSLF)?

According to studentaid.gov website, the program was created in 2007 by Congress.  Its goal is to encourage people with college degrees to “enter and continue to work full-time in public service jobs”.  If you have accrued large federal student loans in your quest to obtain your college and/or graduate degree(s), you “may qualify for forgiveness of the remaining balance due on eligible federal student loans”.  However, there are limits to being able to qualify for the loan forgiveness. 

• First, you must have already made 120 payments on these qualifying federal loans.
• Second, you must have made these 120 payments while employed by certain public service employers. 
• Third, these payments must be made as part of specific repayment plans.  (See the website for specific plans that qualify).  
• Fourth, only payments made after October 1^st, 2007, qualify to be counted as part of these 120 payments.
• Fifth, only loans received under the Federal Direct Loan program qualify for PSLF.  “FFEL and the Perkins Loan program are not eligible for PSLF.”

So, say you think your gigantic federal student loan qualifies under most or all of the above 5 specifications, do you know what kind of public service employment qualifies?

The website states: 
1.  “qualifying employment is any [job] with a federal, state, or local government agency, entity, or organization” or

2.  a 501(c)3 non-profit organization.

3.  “A private non-profit employer that is” does NOT have 501(c)3 status MAY “be a qualifying public service organization if it provides certain specified public services.”  Services such as:  emergency management, military service, public safety, law enforcement, school library, other school-based services, public interest law services, early childhood education, public service for individuals with disabilities and the elderly.

Employment through a non-profit that does NOT qualify:
1.  An organization that is a labor union or a partisan political organization does NOT qualify as a public service organization for the PSLF program.

2.  An organization that is non-profit and your employment involves “time spent participating in religious instruction, worship services, or any form of proselytizing” does NOT qualify as a public service organization for the PSLF program.

 What does PSLF consider full-time employment?

“At least an annual average of 30 hours per week”.  However, if you are “a teacher or other employee of a public service organization, under contract for at least eight out of 12 months, you meet the full-time standard if you work an average of at least 30 hours per week during the contractual period and receive credit by your employer for a full year’s worth of employment”.

Also, “if you are employed in more than one qualifying part-time job simultaneously, you may meet the full-time employment requirement if you work a combined average of at least 30 hours per week with your employers.”
 

Keeping Track of Your Eligible Employment and Loan Repayments

So, if you still think you may be eligible, start keeping track of your hours!  See the website for more information on eligibility and check out the PSLF online form.  PSLF created this form to help you keep track of your qualifying employment terms and qualifying payments.  The form “allows you to get your employer’s certification of employment while you are still employed at that organization or shortly after leaving.”  Keeping track of this information will make it easier for you to submit proper documentation for potential loan forgiveness by the PSLF if they deem you qualify for it.  The website lists steps to follow to apply for student loan forgiveness that includes an “employment certification for public service loan forgiveness”, submitting it to the correct authorities, and following it up with the proper office.
 
Remember, you do not become eligible for the PSLF until AFTER you make your 120^th qualifying payment.
 
Now, since the program started in 2007 and it takes 10 years to make 120 qualifying payments (assuming you had all your ducks in a row for this in October 2007), the program does not actually kick in until October 2017.  What does that mean?  Well, the program is still in development.  I hope some of you find the program useful.  Meanwhile, I will be keeping track (a written record) of my qualifying employment hours, my federal loan repayment times and dates, and have any potential 501(c)3 employers to sign my “employment certification for Public Service Loan Forgiveness” form.  Then, I will see how close I am to 120 qualifying payments in the years 2017 or 2018 and determine where I stand on how much I have still to pay in federal loans versus how many more qualifying payments I need to make to be eligible for the PSLF.

 --Megan

Other useful information on the program:
“Loan Forgiveness for Public Service Employees Fact Sheet” –published March 2012

“Public Service Loan Forgiveness Program Questions and Answers (Q&A) for Borrowers”—last updated 5/12/2012.
 
The PSLF form for keeping track of your qualifying employment and qualifying repayment, also called the “Employment Certification for Public Service Loan Forgiveness”

The “Dear Borrower Letter” that the Federal Student Aid office published in January 2012

The “Instructions for Completing Employment Certification for Public Service Loan Forgiveness” form
 
See a much better description of student loan forgiveness for public service on the Student Loan Network webpage

Stafford Loan Forgiveness is a separate program from the PSLF program.  It seems more geared toward federal student loan forgiveness for those students who volunteer with AmeriCorps, Peace Corps, and the VISTA programs.  For more information on the Stafford Loan Forgiveness program, check out this link.

More articles you may find useful 
Federal Government using Student Loan Repayment incentives to recruit new hires

Federal Government using Student Loan Repayment incentives to recruit CAM providers,including acupuncturists

Would the new (2012 proposed, different than the 2007 Public Service) Student Loan Forgiveness Act Help You?

The 2012 Student Loan Forgiveness Act

For physicians only--Partial federal student loan forgiveness for public service

Part of receiving federal student loan forgiveness lies in having a recognized “occupational health code”.  For more information on this, see the August 2008 article in Acupuncture Today (vol. 9, issue 8), by Kory Ward-Cook, the leader of the NCCAOM (National Certification Commission on Acupuncture and Oriental Medicine), “NCCAOM Seeks Federal Recognition of the Profession”.

New Labor Regulations to Help Military Spouses care for their Injured Servicemembers

New Labor Regulations to Help Military Spouses care for their Injured Servicemembers

Legislation to watch--this new series of labor regulations should help spouses of injured servicemembers take more time off of work to take care of their family's needs.  This SpouseBuzz article links to some of the pros and cons of the future legislation.

Wounded Warriors--2010 legislation for Daily Living special compensation

(Found this article on www.woundedwarriorregiment.org, the website for the U.S. Marines wounded warrior regiment.  This is directly quoted.)

Special Compensation for Assistance with Activities of Daily Living

By Capt. Jill Wolf

---

Some service members who are catastrophically wounded, ill or injured are now eligible for compensation designed to offset the economic burden primary caregivers incur when assisting them.
When a service member sustains a catastrophic injury or illness, a family member or close friend often takes on the role of caregiver, providing non-medical support for daily activities. These caregivers sometimes discontinue employment to care for their loved one, leading to a loss or reduction of income.
Authorized by the Fiscal Year 2010 National Defense Authorization Act, Special Compensation for Assistance with Activities of Daily Living (SCAADL) is designed to mitigate this financial hardship. Monthly payment amounts are based upon the U.S. Department of Labor’s Bureau of Labor Statistics wage rate for home health aides and are adjusted by the geographic area of residence or recovery and a three-tier system based on the complexity of care.
MARADMIN 501/11 describes the criteria for receiving SCAADL. The basic qualifications are as follows:

• Have a catastrophic injury or illness incurred or aggravated in the line of duty (combat or non-combat related);
• Have been certified by a DoD or Veteran Affairs physician to be in a need of assistance from another person to perform the personal functions required in daily living; and
• Would, in the absence of this provision, require some form of residential institutional care (i.e. hospitalization or nursing home care).
• Are not currently in inpatient status in a medical facility

According to DoD Instruction 1431.12, catastrophic is defined as, “a permanent severely disabling injury, disorder or illness incurred or aggravated in the line of duty that the Secretary of the Military Department concerned determines compromises the ability of the afflicted person to carry out activities of daily living to such a degree that the person requires personal or mechanical assistance to leave home or bed, or constant supervision to avoid physical harm to self or others.”
The United States Marine Corps Wounded Warrior Regiment has identified potentially eligible Marines within their command to begin the application and payment process. Applications for SCAADL require DD Form 2948 which must be completed by a licensed DoD or VA physician. SCAADL claims will be certified by the WWR Pay and Entitlements section. Marine Corps Base Quantico finance office will compute the payment amount and make the SCAADL payment. Service members who believe they are eligible for this compensation should contact a member of their recovery team, including their primary care manager, recovery care coordinator or unit leadership.
For more information on SCAADL, reference MARADMIN 501/11 and the WWR fact sheet.