The American Legion Says TRICARE Must Cover TBI Therapy

WASHINGTON, Jan. 4, 2010 /PRNewswire-USNewswire/ -- While TRICARE continues its practice of not reimbursing policy holders suffering from traumatic brain injury (TBI) for the cost of cognitive rehabilitation therapy (CRT), The American Legion is calling upon the military's health-insurance provider to reverse its stand.

National Public Radio reported last month that TRICARE refuses to cover CRT for servicemembers, despite pressure from Congress and medical experts to do so.

"Research indicates that CRT helps those who have suffered brain damage," said Jimmie Foster, national commander of The American Legion. "So it is incomprehensible that TRICARE is refusing to cover such treatment for our wounded warriors. Our troops have certainly earned their health-care benefits through their sacrifices and they deserve the best treatment available."

The American Legion formed an ad hoc committee in October to study current and emerging TBI and post traumatic stress (PTS) treatment modalities. As part of its investigation, the Legion committee reviewed an April 2010 report from a conference hosted by the Defense Centers of Excellence.  It stated that CRT "is a well-accepted and common component of comprehensive rehabilitation for persons with moderate and severe TBI."

Committee member Dr. Jeanne Stellman, professor emerita and special lecturer at Columbia University's Mailman School of Public Health and an expert on veterans health issues, said that TRICARE's refusal to cover CRT "flies in the face of virtually every expert group in the world, including its own consensus panel -- made up of military experts. One must question whether the decision was based on valid science, or was made for budgetary reasons."

Dr. Stellman said that TRICARE based its decision essentially on a study "that used really stringent criteria, so that only 1,088 patients out of the tens of thousands with TBI [were] included in the analysis." Such studies, Stellman said, produce "uncertainty about outcomes and therefore an excuse not to pay."

Echoing his testimony before Congress last September, Commander Foster said "the cost of freedom doesn't end when the battles are over. What happens to our young veterans and their families is also a real cost of war -- those who must live with the wounds of battle for many decades.

"Too often, we consider only our warfighting costs. It is time for our government to start calculating the cost of long-term care for our wounded troops -- before we go to war," Foster concluded.

SOURCE The American Legion