CHAMPUS does not have a reliable way of pinpointing which of its beneficiaries under
age 65 are disabled or have ESRD. Some of the CHAMPUS advisors have incorrectly counseled
beneficiaries about their eligibility. As a result of these problems, some disabled
people have been continued on CHAMPUS erroneously.
In addition, some aged or ESRD beneficiaries, while properly identified, have been
given erroneous information by CHAMPUS advisors about the effect of Medicare on CHAMPUS
eligibility and have been erroneously continued on the CHAMPUS rolls.
When the erroneous entitlements are discovered, and if DoD records show that the cause
is Federal Government error, the individuals receive a letter from DoD's Defense Enrollment
Eligibility Reporting System (DEERS) admitting fault and referring the individuals
to SSA for enrollment in SMI under equitable relief.