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Begich Cites Concerns About Tricare, Calls for Improvement

Cites Concerns about Preparedness of Contractor and Resulting Impacts on Military Members, Retirees and their Families

In response to complaints about referrals, enrollment, customer service and delayed reimbursement to medical providers, U.S. Sen. Mark Begich yesterday requested that the Government Accountability Office (GAO) undertake a review of United Healthcare’s (UHC) management of Tricare, the program that provides health care benefits to service members, retirees and their families.

Tricare Region West serves 2.9 million beneficiaries in the 21 states including Alaska. UHC assumed administration responsibilities for Tricare in Region West through a Department of Defense (DoD) contract on April 1, 2013. 

“Those who are serving in the military or have retired from service should not have to endure delays or glitches in health care,” said Sen. Begich.  “Unfortunately, my office has received several complaints from frustrated Tricare beneficiaries about poor customer service and delayed referral processing. I have also heard from providers about reimbursement delays.   I intend to do whatever is necessary to get to the bottom of these issues and resolve them.  This issue matters to every military member, retiree and their families in Alaska—it’s a priority for me.”

In a letter sent yesterday to the GAO, Sen. Begich noted that service members, retirees, family members, providers, government officials, and stakeholder groups have all expressed dissatisfaction with the performance and transparency of the transition process to UHC.   In his letter Sen. Begich, a member of the Senate Veterans Affairs Committee, expressed support for Senator Patty Murray’s (D-WA) request that the GAO review how UHC has managed the transition.

Sen. Begich writes, “Although I appreciate the steps UHC has taken to address these problems to date, a GAO review will help shed light on whether UHC would have experienced so many issues with better preparation and management of the contract transition.”

Specific items the GAO report will address include:
 

  • Whether UHC was fully prepared for the transition;
  • Whether UHC undertook a robust and effective outreach and communications effort to providers, beneficiaries, and stakeholder groups to prepare them for the transition;
  • The quality of UHC’s performance in the transition of Tricare Region West as compared to prior transitions of that region or similar regional health networks.

The results of the GAO assessment will help to inform the decision whether to exercise the option to extend the contract in the future. 

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