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Posts Tagged ‘Claire McCaskill’

Congress to Investigate Pentagon Decision to Deny Coverage for Brain Injured Troops

Posted by defensebaseactcomp on January 24, 2011

By T Christian Miller  ProPublica and Daniel Zwerdling NPR

WASHINGTON, D.C.–A key congressional oversight committee announced [1] today that it was opening an investigation into the basis of a decision by the Pentagon’s health plan to deny a type of medical treatment to troops with brain injuries.

Sen. Claire McCaskill, D-Mo., the chairman of the subcommittee on contracting oversight, said she wanted to examine a contract issued by Tricare, an insurance-style program used by soldiers and many veterans, to a private company to study cognitive rehabilitation therapy for traumatic brain injury. Such injuries are considered among the signature wounds of the wars in Afghanistan and Iraq.

The study, by Pennsylvania-based ECRI Institute, found insufficient or weak evidence to support the therapy. Often lengthy and expensive, cognitive rehabilitation programs are designed to rewire soldiers’ brains to conduct basic life tasks, such as reading books, remembering information and following instructions. ECRI’s findings ran counter to several other studies, including ones sponsored by the Pentagon and the National Institutes of Health, which concluded that cognitive rehabilitation was beneficial.

In a letter to Defense Secretary Robert Gates, McCaskill cited an investigation [2] by ProPublica and NPR in December, which found that top scientific experts had questioned the Tricare-funded study in confidential reviews, calling it “deeply flawed” and “unacceptable.”

“If true, these reports raise significant questions regarding the Department’s award and management of the contract with ECRI Institute, and may have profound implications for hundreds of thousands of injured service members and their families,” McCaskill wrote. “We owe it to our brave service members to find the truth.”

The ProPublica and NPR investigation also found that senior Pentagon officials have worried about the high price of the care, which can cost more than $50,000 per patient. Some studies estimate that as many as 400,000 troops have suffered traumatic brain injuries in the war zones, though only a small percentage of them would need a full-scale program of cognitive rehabilitation therapy.

McCaskill joins a growing chorus demanding that Tricare reconsider its decision to deny coverage for cognitive rehabilitation. In recent weeks, the American Legion, the nation’s largest veterans’ organization, called [3] on Tricare to provide treatment. Sen. Bob Casey, D-Penn., chairman of the Senate Foreign Relations subcommittee with oversight of the Middle East, sent a letter [4] to Gates asking for an explanation of Tricare’s stance.

McCaskill was also one of the senators who signed a letter [5] in 2008 asking Gates to direct Tricare to begin providing cognitive rehabilitation to troops. This November, the Pentagon sent a response [6] to Congress informing them of the Tricare study’s findings. George Peach Taylor Jr., then-acting assistant secretary of defense for health affairs, said the Pentagon would continue to study the treatment, with another report expected later this year.

In strongly worded response [7] on Jan. 19, McCaskill said that the senators who signed the original letter believed that enough evidence existed on the treatment’s benefits to justify covering the cost for brain-damaged soldiers.

She asked for Gates to provide her committee with a series of documents on the contract and critical scientific reviews by Feb. 18.

“While we agreed that further research on cognitive rehabilitation therapy was appropriate, we also called on the Defense Department to err on the side of providing this proven treatment to service members,” McCaskill wrote.

ProPublica and NPR have filed a similar request under the Freedom of Information Act, but Tricare has denied access to the documents, giving contradictory explanations [8] for why. ProPublica and NPR have appealed.

Tricare officials have said their decision to deny cognitive rehabilitation is based on regulations requiring scientific proof of the efficacy and quality of treatment. They have said that the study by ECRI highlighted a lack of rigorous evidence proving the therapy’s benefits.

Tricare officials also noted that the agency does cover some types of treatment considered part of cognitive rehabilitative therapy. For instance, Tricare will pay for speech and occupational therapy, which plays a role in cognitive rehabilitation. Tricare officials deny that cost played any role in their decision. In a statement [9], Tricare said the care of troops was their “utmost” concern.

Tricare did not immediately return requests for comment on McCaskill’s investigation.

ECRI defended its study. The non-profit institute, which has carried out numerous health reviews for Tricare, other agencies and hospital and medical groups, said they applied standard protocols in reviewing scientific literature about the efficacy of cognitive rehabilitation therapy. ECRI provided a document explaining its review here [10].

“The issue of how well cognitive rehabilitation therapy works for traumatic brain injury is important,” said Jeffrey C. Lerner, the president and CEO of ECRI Institute. “ECRI Institute is fully committed to providing information to the U.S. Senate on our report and methodology.”

Posted in Afghanistan, Civilian Contractors, Contractor Casualties and Missing, Delay, Deny, Injured Contractors, Iraq, PTSD and TBI, T Christian Miller, Veterans Affairs | Tagged: , , , , , , , | 2 Comments »

Contractors in Iraq to be Subject to American Laws

Posted by defensebaseactcomp on November 19, 2009

Under American law, the Defense Base Act, they’ll still be allowed to kill, maim, or allow their employees to be raped, just not anyone else.

Courthouse News Service

by Nick Wilson

WASHINGTON (CN) – Senators introduced legislation Wednesday that would bring foreign military contractors under the jurisdiction of American laws following an appeal from the parents of a soldier allegedly killed by a contractor in Iraq.
In introducing the legislation, Subcommittee on Contracting Oversight Chair Claire McCaskill from Missouri told the story of Lt. Col. Dominic Baragona who was allegedly killed when a contractor’s truck slammed into him in 2003. The man’s parents spent years appealing to the Defense Department, the Bush administration and the Army to seek accountability and information regarding their son’s death.
The family sued Kuwait & Gulf Link Transport Company (KGL), the contracting company, in 2006. McCaskill said the contracting firm did not show up before the court until after the family won a $4.9 million judgment. The contractor then argued that the government does not have jurisdiction over it and the court vacated the judgment.
“The need for Congress to act with this legislation has raised serious questions for me about the systematic failures that have allowed companies like KGL to escape accountability for their actions,” McCaskill said.
The subcommittee also released a report showing that federal agencies rarely dismiss abusive contractors.
The investigation revealed that over the last five years, the Defense Department Office of Inspector General reported 2,700 convictions, but the Defense Department only debarred 708 contractors.
The Department of Homeland Security did not debar any contractors in 2006, despite widespread reports of waste, fraud and abuse following Hurricane Katrina.
The “Lieutenant General Dominic ‘Rocky’ Baragona Justice for American Heroes Harmed by Contractors Act” would require foreign companies that enter into contracts with the United States to consent to personal jurisdiction in cases involving serious injury, death or rape.

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