Taxpayers Footing Bill for Military Cosmetic Surgery?

WASHINGTON (March 11) -- Despite a ban imposed five years ago, some American service members are receiving breast augmentations, tummy tucks and other elective cosmetic surgery at taxpayer expense, a Pentagon audit suggests.

Completed early this year but little noticed until a report this week in the military-oriented newspaper Stars and Stripes, the study found shoddy accounting practices and record-keeping at 13 military hospitals in the U.S. and overseas.

A fact sheet summarizing the findings said the hospitals couldn't produce billing and payment records for nearly 75 percent of their cosmetic surgeries, even though troops are supposed to pay for the procedures in advance.

Citing a federal law protecting the confidentiality of "medical quality assurance records," the Defense Department declined to release the full report, including the number of surgeries performed and the hospitals surveyed.

The summary said 16 percent of the surgeries investigators determined were cosmetic were recorded in hospital records under other codes, effectively shifting the costs to the government.

Service members and their families get free care at military hospitals and clinics for injuries and illnesses but are required to pay for cosmetic procedures. Some surgeries considered cosmetic for civilians are deemed medically necessary in the military, Stars and Stripes said, citing one Army doctor who routinely performs breast reduction surgery on soldiers so they can comfortably wear body armor.

Troops wounded in Iraq and Afghanistan typically return to the U.S. through the military's flagship hospitals near Washington -- Walter Reed Army Medical Center and the National Naval Medical Center -- so surgeons there have plenty of cases to keep their skills sharpened.

But military doctors elsewhere struggle to keep their skills and certifications current, the report summary indicated. Officials interviewed for the study told investigators that since the Pentagon decided in 2005 to require troops to pay for cosmetic procedures, the number of those surgeries has declined and the military has had increasing difficulty retaining plastic surgeons and other physicians including ear, nose and throat specialists, dermatologists and oral surgeons.