New Tricare benefits delayed due to continued contract protest

by Tommy Grant

New Tricare contracts designed to improve care for the 9.6 million Tricare beneficiaries will be delayed from a planned start date of August 2024.

The actual start date remains up in the air, as a protest involving the West Region’s $65.1 billion contract continues in the United States Court of Federal Claims. A 12-month transition period is needed before the policies begin. Defense officials, however, halted work on the contracts pending the decision of the court.

Defense Health Agency officials have said there will be no disruption to patient care, but the ongoing dispute could delay some of the improvements beneficiaries were expecting. The new contracts, for example, would allow patients to transfer specialty care referrals to a new doctor when they move, even if their new duty station is not in their current Tricare region.

New contracts for the Tricare East and West regions have a potential combined value of $136 billion over nine years. Once the dispute is settled, an additional 1.5 million Tricare beneficiaries will be transferred to the West Region from six states in the East Region.

In court filings, West Health Net Federal Services contends that errors in the Defense Health Agency’s evaluation of proposals resulted in “the illogical conclusion that TriWest — an entity that has not performed a Tricare [Managed Care Support] contract in nearly a decade and that has no existing Tricare network — had equally relevant and more favorable past performance than the successfully performing West Region incumbent who has received glowing performance assessments for years.”

In August, the Government Accountability Office denied a second protest by West Health Net Federal Services and affirmed defense health officials’ selection of the Phoenix-based TriWest Healthcare Alliance Corp. as the new managed care support contractor for the Tricare West Region.

In a court document filed in November, the government responded that the Defense Health Agency “had rationally evaluated TriWest’s proposal to use its existing accredited federal network to help populate” its network.

Karen has covered military families, quality of life and consumer issues for Military Times for more than 30 years, and is co-author of a chapter on media coverage of military families in the book “A Battle Plan for Supporting Military Families.” She previously worked for newspapers in Guam, Norfolk, Jacksonville, Fla., and Athens, Ga.

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