Washington, D.C. – This week, Congresswoman Marilyn Strickland (WA-10) sent a letter to the Defense Health Agency expressing concerns about the transition of TRICARE West Region’s contract from Health Net Federal Services (HNFS) to TriWest Healthcare Alliance. After Strickland’s letter was sent, the Department announced that servicemembers would get a second payment update extension, now until February 28.
“TRICARE beneficiaries in the West Region are experiencing unending delays in reaching TriWest customer service, inoperable or overloaded websites unable to process payments, and an incomplete network of providers,” said Strickland, in the letter. “Ultimately, TriWest’s lack of preparedness, and the Defense Health Agency’s lack of contract oversight, are actively harming military readiness and the lives of our servicemembers, families, and retirees.”
Strickland added, “I am deeply concerned about press reports that the network of healthcare providers covered by TriWest is significantly smaller than what was offered under Health Net Federal Services. Despite a year preparing for this change, providers report communications failures with TriWest and a lack of information on how to apply under the new network.”
You can read the entire letter here or below.
Dr. David J. Smith
Acting Principal Deputy Assistant Secretary of Defense
Defense Health Agency
7700 Arlington Boulevard
Falls Church, VA 22042
Lt. Gen. Telita Crosland
Director
Defense Health Agency
7700 Arlington Boulevard
Falls Church, VA 22042
Dear Dr. David Smith and Lt. Gen. Telita Crosland,
I am writing to express deep concern about the transition of the TRICARE West Region’s contract from Health Net Federal Services (HNFS) to TriWest Healthcare Alliance. The men, women, and families who serve our country deserve the utmost care and support. The current state of the transition between TRICARE contractors is unacceptable.
According to widespread press reporting and significant feedback from dozens of my constituents, TRICARE beneficiaries in the West Region are experiencing unending delays in reaching TriWest customer service, inoperable or overloaded websites unable to process payments, and an incomplete network of providers. The combined effect of this mismanagement has led to canceled referrals, appointments, and even surgeries. Ultimately, TriWest’s lack of preparedness, and the Defense Health Agency’s lack of contract oversight, are actively harming military readiness and the lives of our servicemembers, families, and retirees.
We cannot allow servicemembers and their families to lose health coverage through no fault of their own. Currently, beneficiaries on TRICARE Prime and Select have until January 30, 2025, to update payment information or lose coverage retroactively to January 1, 2025. Despite the extensive difficulties documented by beneficiaries in contacting TriWest customer service and website problems, the current plan to disenroll beneficiaries who cannot establish a recurring payment is untenable. I strongly urge the Defense Health Agency (DHA) to extend the deadline to allow all eligible beneficiaries to establish recurring payments until a time when TriWest can adequately manage its customer contact inquiries.
Furthermore, I am deeply concerned about press reports that the network of healthcare providers covered by TriWest is significantly smaller than what was offered under Health Net Federal Services. Despite a year preparing for this change, providers report communications failures with TriWest and a lack of information on how to apply under the new network. To provide transparency for my constituents, I request a prompt response to the following queries:
- How many TRICARE beneficiaries are expected to lose coverage due to a lack of recurring payment information, and what steps are being taken by TriWest to proactively reach out to them?
- Does TriWest have a timeline in which it expects its websites to be fully functional and call centers sufficiently staffed to respond to customer contacts?
- How many/what percent of West Region beneficiaries have had a network Primary Care Manager change due to the TriWest transition?
- What is DHA and TriWest’s plan to ensure continuity of care for patients, particularly for those managing behavioral health, while a new provider network is built? What is TriWest’s timeline to complete provider credentialing?
- Is DHA considering any temporary policies, such as a specialty care referral waiver, to facilitate access to care during the transition?
- What are the metrics DHA uses to evaluate TriWest’s performance under their contract? Is DHA preparing any performance assessments to motivate early improvements in the execution of the contract? Will DHA assess the TriWest network versus the previous HNFS network?
Thank you for your prompt attention to this important matter. I urge you to rapidly work with TriWest Healthcare Alliance to implement timely solutions that ensure our servicemembers, families, and retirees are treated fairly.
Sincerely,
Marilyn Strickland
Member of Congress
Congresswoman Marilyn Strickland serves on the House Armed Services Committee and the House Transportation and Infrastructure Committee. She is Whip of the New Democrat Coalition, Secretary of the Congressional Black Caucus, the first African-American to represent Washington State and the Pacific Northwest, and one of the first Korean-American women elected to Congress.
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