The leaders of the Senate Veterans Affairs Committee are calling on the Defense Department to conduct a comprehensive review of Tricare after several recent issues forced thousands of beneficiaries off of the health care system after the Army launched its new human resources software.
In a letter to Defense Secretary Lloyd Austin released Monday, committee Chairman Jon Tester, D-Mont., and ranking member Sen. Jerry Moran, R-Kan., pushed the department to actively help affected soldiers re-enroll and expressed concern that the Army snafu is the latest of an “alarming number” of Tricare issues in recent years.
“We urge you to take proactive measures to communicate with and re-enroll any recently dropped beneficiaries and for the department to undertake a comprehensive evaluation of Tricare to resolve the numerous challenges faced by Tricare beneficiaries,” they wrote in the letter.
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Last month, 25,000 Tricare beneficiaries were removed from coverage due to a glitch in the way the new Integrated Personnel and Pay System-Army, or IPPS-A, communicated with the existing Defense Enrollment Eligibility Reporting System.
The disruption lasted three days, but the Army said soldiers needed to check whether they and their families still had coverage if they needed immediate care.
“There is an automated process underway to resolve this, but we understand this may not be fast enough for those requiring care in the interim,” Army spokesperson Lt. Col. Joseph Payton told Military.com last month.
Last week, another technical glitch with the $600 million IPPS-A caused another 600 or so active-duty officers and warrant officers to be disenrolled from Tricare.
“It is unacceptable that the Army’s newly deployed Integrated Personnel and Pay System-Army (IPPS-A) is causing such drastic issues for soldiers and their families less than a week after the platform was integrated with the Defense Enrollment Eligibility Reporting System,” Tester and Moran wrote. “We urge the Department to conduct immediate, targeted outreach to affected individuals to provide them with the information they need to re-enroll and submit reimbursement claims for any care or prescriptions they received while disenrolled from Tricare.”
The senators also demanded answers on how many beneficiaries still need to be re-enrolled, how the automated re-enrollment process is working, and whether Tricare will have a special hotline to answer affected beneficiaries’ questions.
They also framed the Army episode as the latest in a series of missteps diminishing the quality of Tricare. Among the incidents they cited was thousands of independent pharmacies and grocery giant Kroger leaving the network because Express Scripts, which administers Tricare’s pharmacy benefits, offered what the senators described as “unfair” reimbursement rates. After congressional outcry last year, Express Scripts offered pharmacies the chance to rejoin, but advocacy groups said the terms of the contract were largely the same as the one they rejected and only a fraction of the pharmacies decided to rejoin.
The senators also pointed to cost-sharing increases this year they said have resulted in “exorbitantly higher yearly costs for beneficiaries.”
“Despite these increases in cost-sharing — which are intended to reflect rising health care costs — many Tricare providers are no longer accepting Tricare or have limited the number of Tricare patients they accept, citing low reimbursement rates, cumbersome billing processes, and complex conflicts between the Tricare system and other government-run health insurance plans,” the senators wrote.
“We ask that the department immediately begin a comprehensive analysis of Tricare to determine what steps need to be taken to restore this program to the best-in-class health care benefit our servicemembers and their families deserve.”
— Rebecca Kheel can be reached at firstname.lastname@example.org. Follow her on Twitter @reporterkheel.
Related: Soldiers Need to Check If Their Families Have Health Care After IT Snafu Kicked 25,000 Beneficiaries Off Tricare
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