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GAO-03-904R 1 (2003-06-13)

handle is hein.gao/gaobaamft0001 and id is 1 raw text is: im Accountability * Integrity * Reliability United States General Accounting Office Washington, DC 20548 June 13, 2003 The Honorable John Warner Chairman The Honorable Carl Levin Ranking Minority Member Committee on Armed Services United States Senate The Honorable Duncan Hunter Chairman The Honorable Ike Skelton Ranking Minority Member Committee on Armed Services House of Representatives Subject: DOD and VA Health Care: Access for Dual Eligible Beneficiaries The Department of Defense (DOD) reported that under its current policy, beneficiaries eligible for both TRICARE and the Department of Veterans Affairs' (VA) health care (dual eligible beneficiaries) are not allowed to utilize the services offered by both health care systems for treatment for the same episode of care.' For example, if a beneficiary experiences back pain and seeks treatment from VA, the beneficiary must then receive all care related to that back pain from VA. Should the beneficiary then decide to seek treatment for the back pain from TRICARE, any claims related to that care would be denied. According to DOD, this policy was established to ensure continuity of care for beneficiaries and to ensure that there was no duplication of care or of payments from TRICARE or VA. Under the policy, if beneficiaries are dissatisfied with the care provided by VA, they are unable to switch to TRICARE to receive services for the same episode of care. Section 708 of the Bob Stump National Defense Authorization Act for Fiscal Year 20032 directed the Secretary of Defense to establish a process for resolving issues related to patient safety and continuity of care for beneficiaries who are concurrently eligible for health care through DOD's TRICARE program and through VA. It also 'According to DOD, an episode of care is generally accepted to be all care related to a single injury or illness. 2Pub. L. No. 107-314, § 708, 116 Stat. 2458, 2585 (2002). GAO-03-904R DOD and VA Health Care for Dual Eligibles

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