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Ore. lawmaker wants answers on Tricare changes

Oct. 22, 2012 - 05:00PM   |   Last Updated: Oct. 22, 2012 - 05:00PM  |  
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An Oregon lawmaker has asked the Pentagon's top doctor to explain why military retirees and family members in his district will lose access to Tricare Prime starting next April.

After hearing last week that the Defense Department will stop offering Tricare Prime in Oregon and several other areas in the Tricare West region in 2013, Republican Rep. Greg Walden fired off a letter to Assistant Secretary of Defense for Health Affairs Dr Jonathan Woodson on Oct. 18 asking for confirmation and urging him to publicly announce the move.

"These changes could have a significant impact on the lives of Tricare beneficiaries in my district, the state of Oregon and in the Tricare West region and affected service members and veterans should be made aware right away," Walden wrote.

The Pentagon has made no formal announcement of the proposal, which includes eliminating the Prime option in Oregon as well as Iowa; Minnesota; Reno, Nev.; and Springfield, Mo.

An official said Oct. 18 the intention is to bolster health care support around core active-duty populations at military bases and facilities that have been left shorthanded "due to the deployment requirements of military medical providers."

"This will not affect active-duty military and their families," Pentagon spokeswoman Cynthia Smith said. "This change also will not impact areas where there is a military treatment facility."

The areas targeted to lose their Prime networks lie outside service areas covered under new Tricare regional contracts. Tricare will offer Prime only within "catchment areas," defined as a 40-mile radius around military treatment facilities and in areas affected by the 2005 base closure and realignment process.

Some provisions will allow Prime beneficiaries living within 100 miles of a service area to stay in the network or permit new enrollments if there is network capacity.

The plan to pull Prime back has been in the works since at least 2007, when it was written into a draft of the proposed Tricare contracts. With the last regional contract award having been settled in July, the Tricare Management Activity is quietly moving ahead with the initiative.

But a source told Military Times last week that Pentagon officials have discussed delaying a formal announcement until after the Nov. 6 election.

Walden said he has heard the same.

"I've been led to believe the Pentagon was holding back the announcement until after a certain date in November. I certainly hope that was not the case. This tremendously affects those who have relied on Tricare Prime in my district," Walden said.

Military beneficiaries who lose Tricare Prime won't be without health care; they qualify for Tricare Standard, traditional fee-for-service coverage that has no enrollment fees but carries greater out-of-pocket costs.

But Walden expressed concern that with the dissolution of the Prime networks in his district, physicians won't be eager to take Tricare Standard patients or assist them with claims.

"In a state like Oregon, which already has limited medical resources, this places an undue hardship on our veterans, especially when we have come to rely so heavily on the National Guard and reserves, who most often hail from rural areas," he said.

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