21 March, 2019 07:25

Military Times: Should veterans have to pay for VA’s benefits errors?
By: Leo Shane III  19 hours ago
A group of Senate lawmakers is again arguing that if veterans are overpaid on benefits because of accounting errors, they shouldn’t be punished for the federal government’s mistakes.
Legislation introduced Wednesday would require changes to how the Department of Veterans Affairshandles benefit corrections, including limiting the amount they can withhold from veterans’ future payouts to cover the debt.
“It’s wrong to put the debt from the VA’s accounting mistakes on the shoulders of men and women who have served their country,” Sen. Jon Tester, ranking member of the Senate Veterans’ Affairs Committee, said in a statement. “For some veterans, these benefits make the difference between paying monthly rent or missing payments.
“We’ve got to stop the VA from pulling the rug out from under veterans and their families.”
Under current law, VA officials can withhold 100 percent of a veteran’s monthly benefits to cover past overpayments, even if those mistakes are the fault of federal officials.
The new legislation would limit that withholding to no more than 25 percent of a monthly benefits check and put a five-year limit on the time where VA officials can recover overpayments. The measure would not wipe out all debts related to VA mistakes.
The senators said up to 200,000 overpayment notifications are sent out to veterans and their families each year.
Bill co-sponsor Sen. John Boozman, R-Ark., called the moves a common-sense step in providing better customer service to veterans.
“Supporting veterans and their families by eliminating the potential for hardships caused by the VA’s errors is important to honoring our commitment to their service and sacrifice,” he said in a statement.
Lawmakers proposed similar reforms last session but saw only parts of that legislation become law. Those changes included rewriting VA policy to allow veterans to update personal information in department systems, in an effort to cut down on potential mistakes in benefits payouts.
This measure goes further, requiring VA to update its computer systems to ease that process and mandating electronic notification of debt notices, including information on how to request hardship waivers.
The legislation, called the Veterans Debt Fairness Act, has not yet been scheduled for a committee hearing.

Military.com: VA to Offer New Ketamine-Based Nasal Spray for Depression

20 Mar 2019
Military.com | By Patricia Kime
The newest FDA-approved medication to treat severe depression, a nasal spray based on the anesthetic (and misused hallucinogenic party drug) ketamine, will soon be available to veterans treated within theDepartment of Veterans Affairs.
In a move that may help thousands of former service members with depression that has not improved with other treatments, VA officials announced Tuesday that the department’s doctors are now authorized to prescribe Spravato, the brand name for esketamine, a molecular variation of ketamine.
The decision to offer a drug hailed by many as a breakthrough in treatment for its speedy results — often relieving symptoms in hours and days, not weeks — shows the VA’s "commitment to seek new ways to provide the best health care available for our nation’s veterans," Secretary Robert Wilkie said in a release.
"We’re pleased to be able to expand options for Veterans with depression who have not responded to other treatments," Wilkie added.
The treatment will be available to veterans based on a physician’s assessment and only will be administered to patients who have tried at least two antidepressant medications and continue to have symptoms of major depressive disorder.
An estimated 16 million Americans have had at least one major episode of depression, and of those, 1 in 3 are considered treatment-resistant. In the veteran population of 20 million, the estimated diagnosis rate of depression is 14 percent — up to 2.8 million veterans. Between one-third and half of those veterans may be treatment-resistant.
The lack of effective medications for difficult-to-treat patients prompted the Food and Drug Administration to place esketamine on a fast track, expediting its review of the drug to ensure that it went to patent as soon as safely possible, according to administration officials.
"Controlled clinical trials that studied the safety and efficacy of this drug, along with careful review through the FDA’s drug approval process, including a robust discussion with our external advisory committees, were important in our decision to approve this treatment," said Dr. Tiffany Farchione, acting director of the FDA’s Center for Drug Evaluation and Research Division of Psychiatry Products, in a release.
As with any other medication, there are risks. Spravato carries a boxed warning for side effects that include misuse, the reason it is administered under a doctor’s supervision. The list of side effects includes sedation and blood pressure spikes and disassociation, such as feelings of physical paralysis and out-of-body experiences. It also can cause suicidal thoughts and behaviors.
Acknowledging the dangers, FDA made esketamine available only through a restricted distribution system.
A veteran prescribed Spravato would inhale the nasal spray at a medical facility while under supervision of a medical provider, and would be monitored for at least two hours after receiving the dose. A typical prescription includes twice-weekly doses the first month, followed by a single dose weekly or biweekly as needed. Spravato cannot be dispensed for home use.
Spravato is made by Janssen Pharmaceuticals, a subsidiary of Johnson & Johnson. It is the first major antidepressant medication to hit the market in 30 years.
Stripes: Suicide spurs VA Medical Center in Florida to review how it monitors patients

By ELIOT KLEINBERG | The (West Palm Beach, Fla.) Palm Beach Post | Published: March 20, 2019

RIVIERA BEACH (Tribune News Service) — Authorities at the VA Medical Center in Riviera Beach say they are changing the way they monitor patients after a 33-year-old man hanged himself in the center’s first in-house suicide in at least five years.

The man, whom The Palm Beach Post is not naming, died about 6:30 p.m. Thursday, the Palm Beach County Medical Examiner confirmed.

Citing privacy laws, the VA would not identify the man nor say which branch of service he’d served in, nor when, and would not provide any details about his death.

The suicide took place 15 days after a patient opened fire in the center’s emergency room, injuring two people. The medical center, at Military Trail and Blue Heron Boulevard, has not said what safeguards, if any, it would add as a result of that incident.

It also occurred as several VA centers across the nation have had to respond to patients who have taken their own lives. The Washington Post reported in January that 19 suicides occurred on VA campuses between October 2017 and November 2018; seven of those were in parking lots.

Kenita Gordon, a spokeswoman at the Riviera Beach center, said Tuesday in an email that the center’s staff has stopped two on-campus suicide attempts in the past five years.

“Patient deaths deeply affect the entire West Palm Beach VA Medical Center staff — especially the health care team members involved with a veteran’s care. Whenever an unforeseen patient death occurs, we conduct an internal review of the case,” Gordon said in an email.

“As a result of this incident, West Palm Beach VAMC is reviewing its processes and has changed certain patient monitoring protocols,” Gordon said. She did not elaborate.
The man’s mother declined Tuesday to provide details or to comment.

Gordon said the VA is working with the Defense Department and other agencies “to deploy suicide prevention programming that supports all current and former service members — even those who do not come to VA for care.”

The agency said any veteran in distress can call the veterans crisis line anytime at 800-273-8255, Option 1.

“One life lost to suicide is one too many,” Gordon said.

AP: Trump says ISIS territory in Syria nearly eliminated
By:Deb Riechmann, The Associated Press  12 hours ago
WASHINGTON — President Donald Trump said Wednesday the last pocket of the Islamic State’s land in Syria will be liberated by U.S.-backed forces “by tonight.”
Trump has previously announced the defeat of the group, but sleeper cells of fighters have re-emerged. With no signs of fighting Wednesday, however, the long-running battle to retake the militants’ last outpost in eastern Syria appeared to have reached its conclusion.
"The caliphate is gone as of tonight," Trump said in a speech at a factory in Lima, Ohio, where military tanks are assembled.
The complete fall of Baghouz would mark the end of the Islamic State group’s self-declared caliphate, which at its height stretched across large parts of Syria and Iraq. Controlling territory gave it room to launch attacks around the world.
During his speech, Trump held up two maps of Syria — one covered in red representing territory held by the militant group when he was elected president in November 2016 and the other that had only a speck of red.
"When I took over, it was a mess. They were all over the place — all over Syria and Iraq," said Trump, who has said the U.S. will keep 400 troops in Syria indefinitely.
For the past four years, U.S.-led forces have waged a destructive campaign against the group. But even after Baghouz’s fall, ISIS maintains a scattered presence and sleeper cells that threaten a continuing insurgency.
The militants have been putting up a desperate fight, their notorious propaganda machine working even on the brink of collapse. The battle for Baghouz has dragged on for weeks and the encampment had proven a major battleground, with tents covering foxholes and underground tunnels.
The siege has also been slowed by the unexpectedly large number of civilians in Baghouz, most of them families of ISIS members. Over past weeks they have been flowing out, exhausted, hungry and often wounded. The sheer number who emerged — nearly 30,000 since early January, according to Kurdish officials — took the Syrian Democratic Forces by surprise.
Ciyager Amed, an official with the Kurdish-led SDF, said they were searching for any ISIS militants hiding in tunnels in a riverside pocket in the village of Baghouz. The SDF has not yet announced a victory over ISIS.
Associated Press journalists saw SDF soldiers loading women and children into trailer trucks on the hilltop over Baghouz — a sign that evacuations were still underway Wednesday. Black smoke was rising from the village.
On Tuesday, the SDF seized control of the encampment held by ISIS after hundreds of militants surrendered overnight, signaling the group’s collapse after months of stiff resistance.

Military Times: A government watchdog is investigating Trump’s defense secretary. Here’s why.
By:Tara Copp 15 hours ago
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The Department of Defense Inspector General announced Wednesday it had initiated an investigation into Acting Defense Secretary Patrick Shanahan over reports that he has disparaged competing defense companies to the potential benefit of his former firm, Boeing.
In a statement announcing the investigation, IG spokeswoman Dwrena Allen said the agency “decided to investigate complaints we recently received that Acting Secretary Patrick Shanahan allegedly took actions to promote his former employer, Boeing, and disparage its competitors, allegedly in violation of ethics rules."
Last week, Citizens for Responsibility and Ethics in Washington filed an ethics complaint asking the IG to investigate the claims against Shanahan, to include reports that the acting defense secretary touted Boeing’s line of aircraft over rival Lockheed Martin.
Previous news reports indicated that Shanahan has disparaged Lockheed Martin’s fighter, the F-35, and other Lockheed weapons systems in private Pentagon meetings. In January, Politico reported that Shanahan called the F-35 “f—ed up” and reportedly said Lockheed “doesn’t know how to run a program.”
“We have informed him that we have initiated this investigation,” Allen said.
Shanahan spokesman Army Col. Joseph Buccino Shanahan welcomed the review.
“Shanahan has at all times remained committed to upholding his ethics agreement filed with the DoD,” Buccino said. “This agreement ensures any matters pertaining to Boeing are handled by appropriate officials within the Pentagon to eliminate any perceived or actual conflict of interest issue with Boeing.”
In response to the investigation, Sen. Elizabeth Warren, D-Mass., said the reports of his Boeing comments concerned her. She added that even though Shanahan had officially recused himself from any decisions involving Boeing, he may not be able to truly be objective, given his long ties to the company.
“Your decades of work for Boeing might be influencing — either intentionally or unintentionally — your behavior toward the company and its competitors, and other employees at the Department that are responsible for contracting decisions that involve Boeing,” Warren wrote, asking Shanahan to follow up with her on any additional steps he planned to take to address the perceived bias.
Shanahan, 56, worked at Boeing for more than 30 years prior to being tapped by President Donald Trump to serve as deputy secretary of defense under former Defense Secretary Jim Mattis. When Mattis submitted his resignation in December, Shanahan was named by Trump as acting defense secretary.