Senator Jim Webb Announces DoD to Delay New TRICARE Reimbursement Payment System

Contact: Jessica Smith, (202) 228-5185
Tuesday, February 10, 2009

30 Day Comment Period Meant to Avoid Disrupting Military Patient Care

Following repeated requests by Senator Jim Webb (D-VA), the Department of Defense (DoD) has announced a 30 day extension for public comment before new TRICARE rules governing reimbursement payments for hospital outpatient services are implemented May 1, 2009. The Office of the Secretary of Defense announced it has reopened the public comment period to March 9, 2009.

In letters sent November 21, 2008, and February 3, 2009, to Secretary Gates, Senator Webb warned that potential reimbursement problems associated with DoD’s plan could result in civilian hospitals disrupting services to active duty personnel, their families, and retirees.

“Virginia is home to a significant proportion of the nation’s military health care recipients,” said Senator Webb. “I welcome Secretary Gates’ decision to postpone any action that could jeopardize services to our military men and women who rely on the TRICARE health care system.

Webb continued: “During the public comment period, I am hopeful that participating civilian hospitals and health-care organizations will make their views known so they may be considered prior to the new publication date for DoD’s final rule May 1. Such action will help ensure that any changes made to the program are reasonably implemented to minimize possible disruptions in care.”

Virginia has the nation’s third largest TRICARE population in the country, with more than 750,000 military families enrolled in the program. Senator Webb encouraged Secretary Gates to consider an alternative transition plan for any changes to the way TRICARE pay network hospitals for outpatient care to the military.

“Cutting TRICARE hospital outpatient payments abruptly by 25 percent is unreasonable and without precedent,” he wrote.

In 2002, Congress required DoD to move to Medicare rates “to the extent practicable.” The Pentagon’s proposed plan, outlined in the Federal Register April 1, 2008, would adopt Medicare’s current fee schedule for reimbursements to hospitals. In contrast to past actions to bring TRICARE payments in line with Medicare, the new DoD rule for reimbursement does not provide for a broad, multiyear transition period that is necessary for hospitals offering TRICARE services to adjust to a lower payment schedule.

To view Senator Webb’s joint letter with a number of his Senate colleagues to Secretary Gates on November 21, 2008, please visit: http://webb.senate.gov/newsroom/record.cfm?id=305445

To view a copy of Senator Webb’s letter to Secretary Gates on February 3, 2009, please visit: http://webb.senate.gov/pdf/Webb-GatesTRICAREltr3Feb2009.pdf