ASAM Disclosure of Relevant Financial Relationships Content of Activity:

1. ASAM Disclosure of Relevant Financial Relationships Content of Activity: 2013 Medical Scientific Course Conference

2. By R. Jeffrey Goldsmith MD, FASAM, DLFAPA Trauma Recovery Center, Cincinnati VAMC Eligibility For VA Healthcare Benefits

3. Nation’s largest integrated health care system Over 1500 sites About 175 Hospitals For more information, visit: www.va.gov/health VA Healthcare

4. Best Care Anywhere • Despite demographic changes, VA enrolled 5.3 million veterans in 2010 compared to 3.3 million in 2000. • 2006 study of life expectancy among the elderly, VA men 40% fewer died than Medicare Advantage over next two years. • 2006 study of life expectancy among elderly, VA women 24% fewer died over next two years compared to Medicare Advantage. • NEJM 2003, 11 quality of care measures compared VA services to fee-for-service Medicare. VA superior in all 11 categories.

5. Best Care Anywhere Praise • JAMA 2005 (Leape and Berwick), “quickly emerged as a bright star in the constellation of safety practice” • BMJ 2007 (Woolhandler and Himmelstein), VA “has recently emerged as a widely recognized leader in quality improvement and information technology. At present, the Veterans Health Administration offers more equitable care, at higher quality, at comparable or lower cost than private-sector alternatives.

6. Best Care Anywhere Stigma • 2009 Tea Party Website • LOOK AT THE VETERANS HOSPITALS AND ALL THE PROBLEMS OUR VET HAVE EXPERIENCED. WE MUST KEEP THE FEDERAL GOVERNMENT OUT OF HEALTHCARE.

7. Served in active military, naval, or air service Discharged or released under conditions other than dishonorable Reservists and National Guard members Called to active duty (other than for training) By a Federal order Completed the full period for which they were called or ordered to active duty Eligibility

8. Enlisted after 9/7/80 or entered active duty after 10/16/81 Served 24 continuous months or the full period for which they were called to active duty May not apply to veterans discharged for hardship, early out or a disability incurred or aggravated in the line of duty Minimum Duty Requirements

9. For most veterans, enter VA health care system by applying for enrollment Can apply online using www.1010ez.med.va.gov/sec/vha/10104z/ In person using VA Form 1010EZ, submit in writing Call 1-877-222-VETS(8387) 8am to 8pm Eastern Time, Mon-Fri Any VA health care facility or VA regional benefits office Afforded privacy rights under federal law VA’s Notice of Privacy Practices Can find Notice of Privacy Practices online: www.va.gov/vhapublications/viewpublication.asp?pub_ID=1089 Enrollment

10. Group 1: SC disabilities rated 50% or more and/or Veterans determined unemployable due to SC conditions. Group 2: SC disabilities rated 30 or 40% Group 3: former POWs, Purple Heart Medal, Medal of Honor, discharged for a disability incurred or aggravated in the line of duty, SC 10% or 20%, awarded special eligibility under Title 38, U.S.C. 1151 Priority Groups 1-3

11. Group 4: increased compensation or pension based on need for regular Aid and Attendance or permanently housebound or catastrophically disabled. Group 5: Nonservice-connected veterans and noncompensable SC 0% whose annual income +/or net worth are not greater than VA thresholds. Veterans receiving VA Pension and Veterans eligible for Medicaid benefits. Priority Groups 4-5

12. Group 6: complicated special ratings Group 7: income below the geographically-adjusted income threshold and agree to pay copayments Group 8 includes those veterans above income threshold and agree to pay copayments, and other details. There are not eligible veterans Priority Groups 6-8 and others

13. Veterans with 0 Dependents: $30,978 Veterans with 1 Dependent: $37,175 Veterans with 2 Dependents: $39,304 Veterans with 3 Dependents: $41,433 Child Income exclusion, Medicare deductible, Income and/or Asset Threshold, Maximum Annual Rate of Pension Means Test 2013