Mrs. B is the widow of a decorated Vietnam Veteran who simply needed to have prescriptions for medication filled. After twice getting those medications at Ft. Jackson’s Moncrief Army Community Hospital (MCAH) pharmacy, she received a large bill for them. But it was the aftermath, the attempt to resolve what is clearly a wrong that is even more distressing. Senator Lindsey Graham’s representative treated Mrs. B disrespectfully as did Moncrief.
[Mrs. B is a private citizen and constituent. Her real name is not used to protect her identity. The names of others, however, are true. These are public servants whose job is to assist and enable the citizenry. Therefore, their identities are not required protection.]
Mr. B served in the Navy ROTC in college and then four years as an active duty Marine, including a tour in Vietnam. He subsequently served a dozen years in the reserves. He continued his support of the Corps by serving as President, Board member, and fundraiser for his college ROTC Alumni Association, and was named Admiral of the Year by the University NROTC.
Mr. B had been granted 100% military disability because he suffered a number of ailments that were attributed to his exposure to Agent Orange in Vietnam. He passed away from brain cancer. He was 68. Interestingly, the widow of another Vietnam Veteran who died of the same form of brain cancer as Mr. B was awarded VA benefits because of the connection to Agent Orange.
Because of Mr. B’s service and status, Mrs. B has privileges at military facilities. Excluded, per her ID card, are medical facilities. This is because Mr. B did not retire from the Marine Corps with twenty or more years. Understandable. However, when Mrs. B wanted to get prescriptions filled, she decided to take them to the the Moncrief Army Hospital pharmacy at Ft. Jackson, South Carolina to see if they might accommodate. She wasn’t looking for special treatment or subversion of the rules. Mrs. B simply wanted – as do we all – to try to save money on her medical expenses.
On her first visit to the Moncrief pharmacy, personnel there took her ID card and filled her prescriptions! There was no mention of ineligibilty or cost. The three drugs she obtained are common ones. Six months later, she returned for a refill of the previous three and one additional. Again, nothing extraordinary.
It was at this second visit to the Moncrief pharmacy that Mrs. B was issued a Department of Defense 2569 Verification Card. On it, the individual who gave it to her printed Mrs. B’s name and wrote “EXP: INDEF.” Clearly, this indicates “Indefinite expiration” of privileges. At her first visit and per an individual at the MCAH pharmacy, Mrs. B filled out a form to obtain a DD 2569 card. It was presented to her at her second visit . To her, and any reasonable person, this gave her pharmacy privileges.
What is DD 2569?
DD 2569 is The Third Party Collection program was legislated by Congress in 1986. It obligates Department of Defense Military Treatment Facilities to bill private health insurance carriers such as Blue Cross/Blue Shield, Mail Handlers, Aetna, etc., for the cost of medical care furnished to retirees and family members covered by their own health insurance policies. This includes all medical benefits and ancillary services such as pharmacy items. [emphasis added]
You will NOT be billed for the difference!
Whatever your insurance company pays is considered “payment in full.” We will never bill you for any co-pays, deductibles, or care that your insurance does not cover. [emphasis per original]
Imagine Mrs. B’s shock when, three months after her last visit to the pharmacy, when she was issued the DD 2569, she received a bill for over $1419.84.
Certain the bill was an error, Mrs. B went to the hospital billing office where she was instructed to meet with a Mr. Marvin L. Ragin, DAC Medical Service Accounts Office (MSAO). Mr. Ragin was not in, so she was referred to Ms. Willie Warren.
Ms. Warren advised Mrs. B that, according to her military ID card, she was not authorized to receive medications from the pharmacy. Ms. Warren noted the back of the card that stipulates “Direct: No – Civilian: No.” Explaining that she had no idea what that meant, Mrs. B pointed out that it was the pharmacy that issued her the validation card and, upon checking her Military ID, should have advised her that she was not eligible for medications.
Having received only a bill for $1419.84 without specification, Mrs. B asked Ms. Warren for a copy of the itemized bill.
She was told she could not have one!
Stunned, Mrs. B convinced Ms. Warren to allow her to hand copy (right) the prescriptions and costs from an itemized list. To this date, Mrs. B has yet to receive an official itemized bill from MCAH.
Military health care facilities must comply with Health Insurance Portability and Accountability Act (HIPAA) regulations. Per those regulations, and from MCAH’s own website is this:
Right to Inspect and Copy. As allowed by law, you may inspect and request a copy of your medical or billing records (including an electronic copy, if we maintain the records electronically). You have the right to have the information sent directly to a party you designate, such as your physician. In limited situations, we may deny your request or part of it, but if we do, we will tell you why in writing and explain your right to review, if any.
Clearly, Ms. Warren blatantly violated this policy by denying Mrs. B a copy of her billing records. She was allowed to copy, but not allowed a copy. Mrs. B was not advised that there was a “limited situation” or why. Mrs. B was not provided a written notice of denial.
Obviously agitated with the pharmacy Ms. Warren told Mrs. B that her office could not make a decision on forgiving the bill. She rushed Mrs. B from her office, indicating that she was going to the pharmacy to confront the staff.
Later, Mrs. B received another letter signed “T.K. Baker for Marvin L. Rabin,” stating, once again, that she owed the money. At this point, she contacted Senator Lindsey Graham’s Columbia office for help. She met with Scott Gillette who wrote a letter to the Headquarters at Fort Jackson (he would not give her a copy) and asked for clarification and explanation. He told Mrs. B he made copies of her cards to further show she had been granted indefinite use of the pharmacy.
The response from the Fort was that Mrs. B should have known what the print on the back of the card meant. It also stated that her Defense Enrollment Eligibility Reporting System (DEERS) record “specifically states she does not have medical of pharmacy coverage.” This was the first Mrs. B had ever heard of a “DEERS Record.” In all her conversations and correspondence with the Army, this was never brought up.
The final paragraph of the letter gives the name of Lieutenant Colonel Jennifer J. Camp, Deputy Commander of Administration, to call for further questions.
Mrs. B contacted LTC Camp who said she understood her frustration, but that she was not at liberty to reverse decisions. When questioned about the 2569 card giving her apparent “indefinite use” of the pharmacy, Camp said that Senator Graham’s office had not provided her with that evidence.
Again, Mrs. B called Graham’s office and spoke with Gillette who was amazed LTC Camp said she did not receive the copies of the authorization cards he sent with the letter. He complained that in the fifteen years he has worked in the Senator’s office, he had never had so blatant an accusation that he did not properly send information.
Mrs. B requested he call her, but he angrily refused instructing her to get back in touch with LTC Camp. Gillette was reminded that the letter from the Fort was written to him, and it would be helpful if he followed up, but he refused, asking Mrs. B to put in writing all that has transpired with this issue. On more than one occasion when trying to contact or talk to Scott Gillette, he abruptly either cut her off or said he had no time to discuss the situation.
Camp had given Mrs. B the telephone number for Ms. Jo-El Onstad at the Army Medical Department in San Antonio, Texas.
She left a message on Ms. Onstad’s voicemail identifying herself and asking for a return call. After not hearing from her for a week, she called again. She answered, and upon hearing Mrs. B’s name, she abruptly cut her off and said she was not at liberty to speak with her. She said after receiving Mrs. B’s message the week before, she had called LTC Camp and told her office not to refer Mrs. B to her. She also indicated she was surprised the LTC’s office had not called her back to relay that message and let her know not to follow-up with another call.
During the course of the next two months, Mrs. B made repeated calls to Marvin Ragin. He was seldom in his office and, based on responses and times of her calls, it appeared he spent a good bit of time at lunch. She was able to contact him only once and was given only a vague and perfunctory response.
In a subsequent call, Mrs. B related to LTC Camp her frustration with not being able to meet or talk with Mr. Ragin whose office had generated these letters. She responded by saying, “Ronald Reagan? He’s dead.” Mrs. B reminded her the letters to her from Moncrief Army Community Hospital over the signature of Marvin L. Ragin.
In her pursuit of a resolution, Mrs. B has learned that there is at least one other person with the very same experience with Moncrief.
Mrs. B never asked for rights, privileges or accommodations for which she was not entitled, nor did she insist on or even request the DD 2569, much less for one with “indefinite” privileges. The $1419.84 charge from Monroe for her prescriptions would have been only $298.20 at her local pharmacy.
All Moncrief had to do was inform Mrs B that she was not eligible for free or discounted drugs. Instead, her prescriptions were twice filled – against regulations – and she was led to believe this was approved; until she got the astronomical bill.
In trying to resolve the issue, she was lied to, given a bureaucratic run-around, spoken to like she was an idiot (“Ronald Reagan is dead!”) and dismissed and disrespected by the office of a United States Senator. The Army has admitted to Mrs. B that they are at fault, despite the blunder(s) and the admission, she was told “there is nothing (they) can do.”
Who else has been victimized by Moncrief’s incompetence and intransigence? How many other constituents have been disregarded by Scott Gillette?
Is this how our government is supposed to work? Is this the way we now treat our veterans and their spouses?