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Fight continues for brain-injured soldiers Carlos R. Davalos | Sat, Feb 12 2011 12:00 PM

A bipartisan group of 74 lawmakers issued a letter  Feb.4 demanding that the Pentagon's health plan cover a treatment for brain-injured soldiers known as cognitive rehabilitation therapy.

Rep. Bill Pascrell , D-N.J., and Rep. Todd Platts , R-Pa., the leaders of the Congressional Brain Injury Task Force, cited an investigation by ProPublica and NPR revealing that Tricare, an insurance-style plan covering soldiers and many veterans, had relied on a controversial study to avoid paying for the intensive and often expensive treatment.

"We hope that you share our concern that service members returning from the battlefield cannot wait to receive treatment for their injuries," the letter states. "It is our hope that there exists some contingency plan to provide cognitive rehabilitation for service members who are returning home today."

Official Pentagon figures show that nearly 200,000 troops have suffered traumatic brain injuries since 2001, though our investigation  found evidence suggesting the true toll is far higher. Although the majority of soldiers recover from the most common form of head trauma, known as mild traumatic brain injury or concussion, some suffer lifelong mental difficulties, with trouble remembering words or following directions.

Pascrell and Platts first wrote a letter, also signed by scores of lawmakers, demanding that Tricare provide cognitive rehabilitation more than two years ago. In response, Tricare contracted a study  that found insufficient evidence to justify providing the treatment.

In confidential reviews obtained by ProPublica and NPR, however, leading brain specialists blasted the study for ignoring evidence that the therapy helped, calling the study "deeply flawed." Top Pentagon health officials have also expressed concern about the high cost of the treatment, our reporting found.

Tricare has said that it will cover many aspects of cognitive rehabilitation, which typically includes physical and speech therapy. But soldiers, families and civilian clinics told us they have had trouble convincing Tricare to pick up the tab.

Tricare’s stance stands in contrast to some major private insurance companies and some state Medicaid programs, which cover the treatment. Expert panels convened by the Pentagon and the Institutes of Medicine have also endorsed the therapy, which can cost more than $50,000 per soldier.

Tricare has since commissioned the Institutes of Medicine to carry out another review of cognitive rehabilitation. The review kicks off on Monday but is not expected to be complete until the end of this year.

Pascrell urged the Pentagon to react more quickly to Congressional concerns.

"Clearly, the Pentagon is overdue in responding to our nation's wounded warriors," Pascrell said in a statement. "It's time to act."

Sen. Claire McCaskill, D-Mo., who signed Friday’s letter, also has begun an investigation into the contract between Tricare and ECRI, a nonprofit firm that reviews medical treatments. ECRI has defended its study as scientifically sound and pledged to cooperate with the inquiry.

McCaskill chairs a Senate subcommittee on contracting oversight.

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