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Military Surgeons General Testify Concerning the Defense Health Program
There is a video that is about 90 minutes long that you can watch, or you can read this summary article from Military Times:
Service surgeons general voice concern about military health care reforms
DSG Turnover and New Navy Medicine Logos
There has been turnover in the office of the Deputy Surgeon General (DSG) as RADM Moulton has retired and RADM Shaffer has taken over as DSG.
In addition, Navy Medicine has unveiled new logos.
Finance Friday Articles
Here are my favorites this week:
Four Rules I Followed To Get Wealthy
Should I Try To Time The Market?
What to Do (With Your Portfolio) about a Likely Pandemic
Here are the rest of the articles:
3 mistakes to avoid during a market downturn
Asset Allocation (Part 1): What’s In My Security Bucket?
Asset Allocation (Part 2): What’s In My Risk/Growth Bucket?
Coronavirus Pandemic Won’t Have Long-Term Effects on the Stock Market
Freaked Out by the Stock Market? Take a Deep Breath
Lessons in Fear and Wealth from the Coronavirus
Not Breaking a Sweat from the Coronavirus
Questions Every Investor Needs To Ask Themselves Right Now
Should Capitalists Really Be Afraid Of A Bernie Sanders Presidency?
Survive a Market Crash! How We Thrived After 2 Financial Meltdowns
The 60 Day Qualified Dividend Rule
Top 5 Tax Loss Harvesting Tips
What Happens to Stocks After a Big Down Month?
Throwback Thursday Classic Guest Post: Read Your Orders – Executing a Close Proximity Move
By Dr. G. Adam Jakubek*
I am in the process of a PCS from NH Jacksonville to Kings Bay, and noticed that my Basic Allowance for Housing (BAH) would drop significantly based on the change in duty station zip codes. The BAH rates vary depending on your duty station zip code, not your address, so you could see a dip in a few hundred dollars if your duty station changes but elect to keep your home in your prior, higher BAH rate zip code.
I’ve had colleagues PCS to close proximity duty stations and elect to not move their family and miss out on keeping their BAH at their old duty station. Some examples I’ve seen where people see a drop in BAH are PCS moves from San Diego to Camp Pendleton, or the Bethesda/National Capital Area to places like Annapolis or Baltimore where rates drop by $200-300/month.
The current order writing system authorizes funding for a household goods shipment by default if your new duty station is farther than 30 miles away from your prior duty station, but you might prefer to make the commute if it means staying in your home, keeping your kids in the same schools, etc.
My current orders have the following statement attached:
‐ MEMBERS WHO RECEIVE PCS ORDERS WHEN THEIR OLD AND NEW PERMANENT DUTY STATIONS ARE WITHIN CLOSE PROXIMITY TO EACH OTHER (BASED ON A REASONABLE COMMUTE DETERMINED BY THE GAINING CO) MAY BE ELIGIBLE TO RECEIVE A CLOSE PROXIMITY WAIVER AND RECEIVE BAH BASED ON THEIR OLD PDS LOCATION. SEE NAVADMIN 101/10 FOR WAIVER ELIGIBILITY REQUIREMENTS AND PROCEDURES. GO TO: HTTP://WWW.PUBLIC.NAVY.MIL/BUPERS‐NPC/ REFERENCE/MESSAGES/PAGES/DEFAULT.ASPX.
If you follow the instructions in the NAVADMIN, it is a relatively simple process, but the key is completing the request through your gaining command BEFORE you execute your orders. Your gaining command needs to endorse your request stating that your commute is ‘reasonable’ and you forfeit your household goods shipment, making it a no‐cost PCS move for the government.
Once you receive the signed endorsement letter from your gaining command, you forward that letter directly to your detailer. You’ll get an order modification that drops your household goods shipment funding and states that you’re authorized BAH at your prior duty station rate. Again, make sure you follow up with your detailer prior to checking out of your old command if you haven’t seen your order modification come through in NSIPS. Once you check into your new command PSD or Human Resources department with your modified orders, you’ll be locked into that BAH rate and cannot retroactively request funding for a household goods shipment if you decide to move later on in your tour.
Here are some useful templates to help you with this process:
Close Proximity Approval Letter
Close Proximity Request Letter
*The views expressed in this blog are those of the author(s) and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense or the United States Government.
Updated Special Pays Frequently Asked Questions – 4 MAR Edition
As you can imagine, we’ve been getting a lot of questions in the Corps Chief’s Office about the FY20 pay plan. We’ve compiled a list of the questions so far and answers. Here they are with new ones noted in bold right at the top:
Q – Will BUMED be treating Active Duty Service Obligation (ADSO) associated with Career Intermission Program (CIP) as other AD obligations associated with non-medical training? Some physicians use the CIP for medical training (e.g. fellowship).
A – Per paragraph 3.a.(2)(a) page 4 of the Pay Guidance, an officer under obligation for CIP is not eligible to enter an RB. The reason for CIP (medical or non-medical) does not make any difference.
Q – I thought I paid back my HPSP obligation during residency, so how do I still have obligated service?
A – Any time spent in Navy-funded training does not count toward repayment of obligation from your commissioning program (ROTC, HPSP, USUHS, USNA). Internship is neutral, which means that you neither incur any obligated service for it nor does it count as payback. Time spent as a GMO, UMO, or Flight Surgeon does count towards repayment of your commissioning program obligation.
Q – Is there any guidance on dual board certified MDs? For example, I am dual boarded in Family Medicine and Preventive Medicine. The Family Medicine bonus is affected, but Preventive Medicine is not. Is there any action required or impact expected?
A –If you are getting a Preventive Med RB, no action is required (unless it is time to sign a new RB). If you are getting an FM RB, then your RB will continue to pay at the current rate until the expiration of your contract. If it is time to sign a new RB, then you need to look at the different RB bonus rates to determine which specialty RB you want to receive. One caveat – please remember that you must be actively privileged and practicing in the specialty for which you are receiving the RB.
Q – For newly board certified physicians, what is the difference between a board certification pay (BCP) request and a retroactive BCP request? For example, you passed your board on 1 Jan 2020, but were waiting to put the request in for BCP until the FY20 NAVADMIN was released and you lack the letter from your board confirming that you have passed the boards (which will come later in the spring). Must you wait to request BCP until the physical letter arrives, or is there other proof of board certification (e.g. screen shot, web print out) that one can provide as substantiating documentation?
A – A retroactive BCP request is simply a request for BCP that begins at a date that has already passed. In order to receive BCP, you must provide proof of your board certification date, which is not necessarily the day you took your board exam. You can do this one of two ways: (1) provide a copy of the official notification from your ABMS board that you are board certified as of whatever date, or (2) ask your local credentials office to verify your board certification status for you and then submit the primary source verification (PSV) as proof of board certification through your local special pays coordinator.
Q – If an AD member in a specialty for which pays were reduced (OB/GYN, Peds, etc.) wanted to transfer GI Bill benefits to a child, which incurs a new service obligation, would that member would no longer be eligible to take a retention bonus for the four year obligation associated with the GI Bill transfer?
A – Obligation associated with non-medical training (e.g. GI Bill, War College) does not disqualify you from accepting an RB. To put it another way, you can transfer your GI Bill to your child and still have your RB.
Q – If you are eligible for your continuation pay (8-12 years’ time in service) and you accept it, does that mean you can’t get a retention bonus if you are in those specialties that are not eligible for RB with any active duty service obligation?
A – No. Continuation pay is unrelated to RB eligibility. You can have continuation pay and your RB at the same time.
Q – Can I just resign/retire and/or ask for a waiver if I have an existing obligation, time in grade requirements, or time left on my current RB?
A – You are entitled to submit a request to resign or retire and/or submit a waiver request for any remaining service obligation, time in grade, etc. in order to facilitate resignation/retirement. Requests are routed through PERS. If granted (and that is a big if), however, the Navy may elect to recoup any extra special or incentive pays you have already received (e.g. the difference in the 4 year and 2 year RB amounts). Please see this page on waivers or this page on resignations for more information.
Q – The Special Pays instruction states in paragraph 2.a.(1) “Is serving in the Medical specialty for which the IP is being paid” and in 2.a.(3) “Member must continue to be credentialed, privileged, and practicing at a facility designated by the Surgeon General as an authorized medical facility, in the Medical specialty for which the IP is being paid”. For RB, it states under paragraph 3.a. “To be eligible for the AD RB, a Physician.meets the same eligibility requirements as for the active duty IP” and in 3.a.(5) is “practicing at a facility designated by the Navy as an authorized facility, in the Medical Specialty for which the RB is being paid, and maintain those for the length of the agreement”. According to Table 2, there is a clear distinction made between General Internal Medicine (IM) and the CAT IV Subspecialties. If I execute an IP/RB for a CAT IV Subspecialty, would I only practice in my Subspecialty and not be required to practice General IM?
A – No. The Navy requires you to maintain General IM privileges regardless of subspecialty, so you must continue to do that. That said, you can only be paid an RB based on one specialty, even if you have privileges in multiple specialties. Since IM subspecialties are paid at a higher rate than General IM, you are better served collecting your IP/RB based on your CAT IV subspecialty.
Q – If I am on a 4-year retention bonus but that option no longer exists for my specialty, can they take it away?
A – No, per the guidance on the BUMED Special Pays website, “If a member is under an existing agreement, the officer will continue to be paid the rate in that agreement until it expires.”
Q – If you are in OB/GYN, Ophthalmology, Otolaryngology, Urology, Pathology, Family Medicine, General Internal Medicine, Pediatrics, Nuclear Medicine, or Radiology, it appears you can no longer take a Retention Bonus (RB) if you have any obligated service when previously it was only your initial obligation that had to be repaid before you could take an RB. Is that correct?
A – Yes, that is correct. Paragraph 3.a.(6) on page 5 of the Medical Corps Special Pays guidance states that physicians in these specialties “are not eligible to enter an RB while under an Active Duty Service Obligation (ADSO) for medical education, training, or Special Pays RB.” You cannot have any obligated service if you wish to sign up for an RB in these specialties during FY20.
Q – For the specialties that saw loss of the 4 year RB and/or reductions in IP/RB amounts, will time-in-grade (TIG) or service obligation (MSR) waivers be offered?
A – At present, no. However, a draft NAVADMIN that addresses TIG and MSR waivers that is with PERS; it was placed on hold due to Congressional language which prohibits the military divestitures until a Report to Congress is submitted. No timeline for a decision is available.
Q – The DFAS medical special pay website has different values/contracts available for FY-2020. Are the major changes announced yesterday specific to the Navy and the Army/Air Force special pays for 2020 are reflected on this website?
A – The rates posted on the DFAS website are the maximum allowable payment rates set by DOD. Physician pay plans are service-specific, and the services are allowed to pay “up to” those amounts. The pay rates in the documents we sent yesterday (27 FEB) and that are available on the BUMED Special Pays Website are the relevant rates for the Navy in FY20.
Q – If I have a valid RB, is there anything I need to do?
A – No. There is no longer a need to submit an annual request. Your IP and RB will continue to pay at the current rate through the expiration of your contract.
Q – Why is Family Medicine one of the specialties affected by the reductions when it’s not currently overmanned?
A – The special pays plan was based on manning levels that incorporated some of the planned divestitures. Yes, I know this seems to run counter to the NAVADMIN argument above.
Q – Does terminate and renegotiate extend the time owed?
A – Yes. If you terminate and renegotiate, your obligation resets to day 0 on the effective date of the contract. For example, if you currently have three years left on a 4 year contract (obligated until 2023) and you terminate and renegotiate for a 6 year RB, you would then be obligated through 2026.
Q – Are the RB and GME reductions temporary, or will they continue until some specialties are eliminated from Navy Medicine?
A – First, there are NO PLANS TO ELIMINATE ANY SPECIALTY(IES). Special pays are reviewed yearly and are set based on current inventory compared to future requirements. In the black and white world of the Comptroller, overmanned communities do not merit or require retention incentives; the fact that we can continue to offer something was a concession on their part. However, although our office has strenuously advocated against this approach (as has much of BUMED) over the last 18 months, “voluntary” force shaping measures such as reduction of special and incentive pays are likely to persist until inventory matches requirements.
Happy 149th Medical Corps Birthday!
Happy birthday! Here is RDML Hancock’s message, and the other birthday messages are here:
Dear Medical Corps Colleagues,
It is my honor to represent you, the nearly 4,300 physicians on active duty and in the reserves on the occasion of our 149th birthday! Let us continue to reflect on our respected Corps and our noble profession that has served the Navy, Marine Corps, and Joint Commands around the globe for 149 years. As you carry on the proud tradition of Navy Medicine, realize that everything you do as medical professionals continues to ensure that the defenders of our nation, past and present along with their family members have received the best health care our country has to offer. We are an unparalleled medical force that stands ready to support any operational requirement that arises in the future whether it be on land or at sea.
The Medical Corps has a proud and time-honored tradition of providing the highest quality healthcare to our Sailors, Marines, and their families. We have stood the watch in diverse environments whether it be operational or at a military treatment facility; setting the standard for compassionate-care, unswerving service and exceptional leadership and professionalism. As our operational environment evolves we continue to advance the innovations of military medicine. Our Graduate Medical Education programs and your continued dedicated mentorship and guidance within our community have ensured the next generation is ready to carry the tradition of excellence and ensuring the readiness of our warfighters. As the Corps Chief, I am proud to serve with you- and for you!
My heartfelt gratitude to you all as we celebrate another year of exemplary service to our Corps, our Navy and Marine Corps comrades-in-arms and our Country. Happy Birthday!
Sincerely,
JAMES L. HANCOCK
Rear Admiral, Medical Corps
United States Navy
Updated Special Pays Frequently Asked Questions – 3 MAR Edition
As you can imagine, we’ve been getting a lot of questions in the Corps Chief’s Office about the FY20 pay plan. We’ve compiled a list of the questions so far and answers. Here they are with new ones noted in bold:
Q – For newly board certified physicians, what is the difference between a board certification pay (BCP) request and a retroactive BCP request? For example, you passed your board on 1 Jan 2020, but were waiting to put the request in for BCP until the FY20 NAVADMIN was released and you lack the letter from your board confirming that you have passed the boards (which will come later in the spring). Must you wait to request BCP until the physical letter arrives, or is there other proof of board certification (e.g. screen shot, web print out) that one can provide as substantiating documentation?
A – A retroactive BCP request is simply a request for BCP that begins at a date that has already passed. In order to receive BCP, you must provide proof of your board certification date, which is not necessarily the day you took your board exam. You can do this one of two ways: (1) provide a copy of the official notification from your ABMS board that you are board certified as of whatever date, or (2) ask your local credentials office to verify your board certification status for you and then submit the primary source verification (PSV) as proof of board certification through your local special pays coordinator.
Q – If an AD member in a specialty for which pays were reduced (OB/GYN, Peds, etc.) wanted to transfer GI Bill benefits to a child, which incurs a new service obligation, would that member would no longer be eligible to take a retention bonus for the four year obligation associated with the GI Bill transfer?
A – Obligation associated with non-medical training (e.g. GI Bill, War College) does not disqualify you from accepting an RB. To put it another way, you can transfer your GI Bill to your child and still have your RB.
Q – If you are eligible for your continuation pay (8-12 years’ time in service) and you accept it, does that mean you can’t get a retention bonus if you are in those specialties that are not eligible for RB with any active duty service obligation?
A – No. Continuation pay is unrelated to RB eligibility. You can have continuation pay and your RB at the same time.
Q – Can I just resign/retire and/or ask for a waiver if I have an existing obligation, time in grade requirements, or time left on my current RB?
A – You are entitled to submit a request to resign or retire and/or submit a waiver request for any remaining service obligation, time in grade, etc. in order to facilitate resignation/retirement. Requests are routed through PERS. If granted (and that is a big if), however, the Navy may elect to recoup any extra special or incentive pays you have already received (e.g. the difference in the 4 year and 2 year RB amounts). Please see this page on waivers or this page on resignations for more information.
Q – The Special Pays instruction states in paragraph 2.a.(1) “Is serving in the Medical specialty for which the IP is being paid” and in 2.a.(3) “Member must continue to be credentialed, privileged, and practicing at a facility designated by the Surgeon General as an authorized medical facility, in the Medical specialty for which the IP is being paid”. For RB, it states under paragraph 3.a. “To be eligible for the AD RB, a Physician.meets the same eligibility requirements as for the active duty IP” and in 3.a.(5) is “practicing at a facility designated by the Navy as an authorized facility, in the Medical Specialty for which the RB is being paid, and maintain those for the length of the agreement”. According to Table 2, there is a clear distinction made between General Internal Medicine (IM) and the CAT IV Subspecialties. If I execute an IP/RB for a CAT IV Subspecialty, would I only practice in my Subspecialty and not be required to practice General IM?
A – No. The Navy requires you to maintain General IM privileges regardless of subspecialty, so you must continue to do that. That said, you can only be paid an RB based on one specialty, even if you have privileges in multiple specialties. Since IM subspecialties are paid at a higher rate than General IM, you are better served collecting your IP/RB based on your CAT IV subspecialty.
Q – If I am on a 4-year retention bonus but that option no longer exists for my specialty, can they take it away?
A – No, per the guidance on the BUMED Special Pays website, “If a member is under an existing agreement, the officer will continue to be paid the rate in that agreement until it expires.”
Q – If you are in OB/GYN, Ophthalmology, Otolaryngology, Urology, Pathology, Family Medicine, General Internal Medicine, Pediatrics, Nuclear Medicine, or Radiology, it appears you can no longer take a Retention Bonus (RB) if you have any obligated service when previously it was only your initial obligation that had to be repaid before you could take an RB. Is that correct?
A – Yes, that is correct. Paragraph 3.a.(6) on page 5 of the Medical Corps Special Pays guidance states that physicians in these specialties “are not eligible to enter an RB while under an Active Duty Service Obligation (ADSO) for medical education, training, or Special Pays RB.” You cannot have any obligated service if you wish to sign up for an RB in these specialties during FY20.
Q – For the specialties that saw loss of the 4 year RB and/or reductions in IP/RB amounts, will time-in-grade (TIG) or service obligation (MSR) waivers be offered?
A – At present, no. However, a draft NAVADMIN that addresses TIG and MSR waivers that is with PERS; it was placed on hold due to Congressional language which prohibits the military divestitures until a Report to Congress is submitted. No timeline for a decision is available.
Q – The DFAS medical special pay website has different values/contracts available for FY-2020. Are the major changes announced yesterday specific to the Navy and the Army/Air Force special pays for 2020 are reflected on this website?
A – The rates posted on the DFAS website are the maximum allowable payment rates set by DOD. Physician pay plans are service-specific, and the services are allowed to pay “up to” those amounts. The pay rates in the documents we sent yesterday (27 FEB) and that are available on the BUMED Special Pays Website are the relevant rates for the Navy in FY20.
Q – If I have a valid RB, is there anything I need to do?
A – No. There is no longer a need to submit an annual request. Your IP and RB will continue to pay at the current rate through the expiration of your contract.
Q – Why is Family Medicine one of the specialties affected by the reductions when it’s not currently overmanned?
A – The special pays plan was based on manning levels that incorporated some of the planned divestitures. Yes, I know this seems to run counter to the NAVADMIN argument above.
Q – Does terminate and renegotiate extend the time owed?
A – Yes. If you terminate and renegotiate, your obligation resets to day 0 on the effective date of the contract. For example, if you currently have three years left on a 4 year contract (obligated until 2023) and you terminate and renegotiate for a 6 year RB, you would then be obligated through 2026.
Q – Are the RB and GME reductions temporary, or will they continue until some specialties are eliminated from Navy Medicine?
A – First, there are NO PLANS TO ELIMINATE ANY SPECIALTY(IES). Special pays are reviewed yearly and are set based on current inventory compared to future requirements. In the black and white world of the Comptroller, overmanned communities do not merit or require retention incentives; the fact that we can continue to offer something was a concession on their part. However, although our office has strenuously advocated against this approach (as has much of BUMED) over the last 18 months, “voluntary” force shaping measures such as reduction of special and incentive pays are likely to persist until inventory matches requirements.
Special Pays Frequently Asked Questions
As you can imagine, we’ve been getting a lot of questions in the Corps Chief’s Office about the FY20 pay plan. We’ve compiled a list of the questions so far and answers. Here they are…
Q – If I am on a 4-year retention bonus but that option no longer exists for my specialty, can they take it away?
A – No, per the guidance on the BUMED Special Pays website, “If a member is under an existing agreement, the officer will continue to be paid the rate in that agreement until it expires.”
Q – If you are in OB/GYN, Ophthalmology, Otolaryngology, Urology, Pathology, Family Medicine, General Internal Medicine, Pediatrics, Nuclear Medicine, or Radiology, it appears you can no longer take a Retention Bonus (RB) if you have any obligated service when previously it was only your initial obligation that had to be repaid before you could take an RB. Is that correct?
A – Yes, that is correct. Paragraph 3.a.(6) on page 5 of the Medical Corps Special Pays guidance states that physicians in these specialties “are not eligible to enter an RB while under an Active Duty Service Obligation (ADSO) for medical education, training, or Special Pays RB.” You cannot have any obligated service if you wish to sign up for an RB in these specialties during FY20.
Q – For the specialties that saw loss of the 4 year RB and/or reductions in IP/RB amounts, will time-in-grade (TIG) or service obligation (MSR) waivers be offered?
A – At present, no. However, a draft NAVADMIN that addresses TIG and MSR waivers that is with PERS; it was placed on hold due to Congressional language which prohibits the military divestitures until a Report to Congress is submitted. No timeline for a decision is available.
Q – The DFAS medical special pay website has different values/contracts available for FY-2020. Are the major changes announced yesterday specific to the Navy and the Army/Air Force special pays for 2020 are reflected on this website?
A – The rates posted on the DFAS website are the maximum allowable payment rates set by DOD. Physician pay plans are service-specific, and the services are allowed to pay “up to” those amounts. The pay rates in the documents we sent yesterday (27 FEB) and that are available on the BUMED Special Pays Website are the relevant rates for the Navy in FY20.
Q – If I have a valid RB, is there anything I need to do?
A – No. There is no longer a need to submit an annual request. Your IP and RB will continue to pay at the current rate through the expiration of your contract.
Q – Why is Family Medicine one of the specialties affected by the reductions when it’s not currently overmanned?
A – The special pays plan was based on manning levels that incorporated some of the planned divestitures. Yes, I know this seems to run counter to the NAVADMIN argument above.
Q – Does terminate and renegotiate extend the time owed?
A – Yes. If you terminate and renegotiate, your obligation resets to day 0 on the effective date of the contract. For example, if you currently have three years left on a 4 year contract (obligated until 2023) and you terminate and renegotiate for a 6 year RB, you would then be obligated through 2026.
Q – Are the RB and GME reductions temporary, or will they continue until some specialties are eliminated from Navy Medicine?
A – First, there are NO PLANS TO ELIMINATE ANY SPECIALTY(IES). Special pays are reviewed yearly and are set based on current inventory compared to future requirements. In the black and white world of the Comptroller, overmanned communities do not merit or require retention incentives; the fact that we can continue to offer something was a concession on their part. However, although our office has strenuously advocated against this approach (as has much of BUMED) over the last 18 months, “voluntary” force shaping measures such as reduction of special and incentive pays are likely to persist until inventory matches requirements.
DHA Director Discusses Vision for Future
Here’s a link to this article:
Joel Schofer's Career Planning Blog 