Sending Office: Honorable Tulsi Gabbard
Endorsed by: American Psychological Association (APA), The Veterans of Foreign Wars of the US (VFW), Military Officers Association of America (MOAA)
Current cosigners: Walter Jones, Madeleine Bordallo, Tom O’Halleran, Raúl Grijalva
DEADLINE: Friday, May 18, 2018
Please join me in sending a bipartisan letter to the Defense Health Agency (DHA) expressing concern for the proposed discounts to TRICARE reimbursement rates for mental health providers.
For 2018, DHA selected Humana and Health Net Federal Services (HNFS) as the two sole TRICARE contractors for mental health care. Humana and HNFS proposed devastating discounted rates for TRICARE mental health care providers. Mental health providers from
the East and West regions reported receiving new contracts that include a proposed 30% discount off of Civilian Health And Medical Program of the Uniformed Services (CHAMPUS) rates. With the limited options and resources that TRICARE beneficiaries currently
have, these discounts will further jeopardize the mental health of military members, veterans, and their families who rely on TRICARE for their basic needs.
We are deeply concerned about the impacts these discounted rates will have on network adequacy and access to mental health care for highly-stressed military and veteran families in our communities. It is crucial that DHA provide our military members and
families with the care that they have earned with their service and sacrifice for our country.
For more information, or to cosign this letter, please contact Patrick Koetzle at Patrick.Koetzle@mail.house.gov.
Member of Congress
VADM R.C. Bono, MC, USN
Director, Defense Health Agency
7700 Arlington Boulevard, Suite 5101
Falls Church, VA 22042-5101
Dear Admiral Bono:
We write out of concern about proposed discounts to TRICARE reimbursement rates by Humana and Health Net Federal Services (HNFS) for TRICARE mental health providers in our states. The discounts being proposed are substantial and may severely impact network
adequacy and access to mental health care for highly-stressed military and veteran families in our communities and we require further information from the Defense Health Agency (DHA) so that these problems can be rectified.
Mental health providers from the East and West regions region report receiving new contracts for joining the TRICARE provider network from Humana and HNFS that included a proposed 30 percent discount off of Civilian Health And Medical Program of the Uniformed
Services (CHAMPUS) reimbursement rates that are currently in effect. These proposed discounts to already low reimbursement rates (based on Medicare rates) have resulted in a number of experienced, long-time TRICARE mental health providers abandoning the program.
In both the short and long-term, these discounts could have a devastating effect on high-quality care for military members, veterans, and their families.
TRICARE beneficiaries already have limited options and resources. We fear such large discounts could further deteriorate the TRICARE provider networks, leaving our most needy families without the experienced care they deserve, especially in rural areas.
Requiring a beneficiary to change mental health professionals is disruptive, and sometimes untenable, particularly for those undergoing treatment for Post-Traumatic Stress Disorder who have developed a relationship with their specialist. DHA has a duty to
administer the TRICARE Health Plan, provide appropriate oversight of its contractors and to protect its beneficiaries, especially as new contractors are being utilized in both regions. Substantial numbers of our constituent mental health providers report significant
problems with Humana and HNFS online billing systems, and difficulty getting representatives to return requests for time-sensitive information, which DHA needs to address.
It is imperative that DHA provide a detailed explanation regarding how its managed care support contractors are communicating with mental health providers with regard to the status and changes under their 2018 provider network contracts, including whether
these discounts can be negotiated or otherwise modified.
At a time when our nation’s military is engaged in conflicts around the globe, it is imperative DHA provide our 9.4 million uniformed service members, retirees and their families with the care and service they deserve. We look forward to your prompt response
in this matter.
Member of Congress
e-Dear Colleague version 2.0