Senior enlisted leaders called on lawmakers to help address ongoing problems with health care access for troops and their families during a congressional hearing on military quality-of-life challenges this week.
Funding shortages in the Military Health System and Defense Health Agency continue to affect the care available to beneficiaries and provider recruitment, said Master Chief Petty Officer of the Navy James Honea during testimony before the House Appropriations Committee on Tuesday.
“I ask for your continued support for the Military Health System and finding innovative ways to ensure that DHA funding doesn’t compete with our warfighting priorities,” Honea told lawmakers.
When care isn’t available in the military treatment facilities, beneficiaries rely on civilian networks. However, limited resources have affected care delivery, provider recruitment and Tricare’s ability to compete in the civilian insurance market, Honea said, adding that Tricare’s reimbursement rates are tied to Medicare rates and are often too low for providers.
Honea also noted complications with the new Tricare contracts have delayed claims processing and damaged civilian medical providers’ trust in their timely payment.
Rep. John Rutherford, R-Fla., said the continued payment problem could result in some providers leaving the Tricare network. He cited one provider who is owed about $100,000 from Tricare.
“Our family members in Jacksonville deserve to have these outside providers available,” he said.
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Military families have reported extensive issues with health care access since the new Tricare contracts began in January, which have caused medical shortfalls for some families and some providers dropping Tricare patients because of the difficulties, Military Times previously reported.
West Region beneficiaries and health care providers have reported a number of problems with the contract transition from Health Net Federal Services to TriWest Healthcare Alliance. Meanwhile, Humana Military has remained the East Region contractor, but a number of providers have reported difficulty getting paid since Jan. 1.
“I’ve taken a number of complaints from those providers,” said Honea. “They’re not being reimbursed on time. Defense Health Agency has worked with me to have those bills paid as quickly as possible.”
Medical provider shortages in the military health care system isn’t unique, as it is affecting communities across the country. However, with little to limited control over their assignment locations and providers, service members and their families are dependent on the Military Health System and local care.
When that access to health care doesn’t happen, Honea said, “It’s going to have detrimental effects to our family readiness and possibly to our military readiness, especially if we end up having to spend military readiness dollars toward making that account whole.”
Health care access is a pressing issue across all of the service branches, leaders said Tuesday. For instance, some Marines are having to seek out mental health care from civilian providers because there aren’t enough mental health providers in military treatment facilities, Sergeant Major of the Marine Corps Carlos Ruiz told lawmakers. Because there are few providers and appointments available in the civilian community, they may have to wait 45 to 60 days to get the help they need, Ruiz said.
“I can’t solve that problem, so I’m looking for you to help us bring attention to it,” he said.
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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