pentagon-seeks-smooth-transition-tricare-contracts | MilitaryTimes

The Defense Health Agency has taken steps to ensure that Tricare beneficiaries will see little disruption in their health services when two contractors take over management of Tricare next year, DHA director Vice Adm. Raquel Bono said last week.

Tricare will consolidate its three regions into two next year, with the new East region managed by Humana Military and the West region overseen by Health Net Federal Services under contracts awarded July 22.

Bono said the Defense Department will test the new contractors’ systems before they “go live” to make sure they work as intended.

“One of the big lessons we’re going to put into play here is that we absolutely will not shift over until we are assured that the new vendors can perform all the tasks they need to,” Bono said during a telephone conference with reporters July 22.

The process was developed to avoid any repeat of problems that arose when UnitedHealthcare assumed management of the Tricare West region in 2013.

During the first several months of that contract, the company’s website and customer service systems failed and physicians and patients complained of long delays in receiving payments and specialty referrals.

Bono said the transition period for the new contracts will last between nine and 12 months. She did not give a concrete date for the changeover.

Defense officials said four companies submitted proposals for managing the two regions, although they declined to name them. The winners and the losers will receive briefings this week from the government on the details of the bidding process and the final decision.

UnitedHealth officials said they would participate in the debriefing process before deciding whether to file a protest.

In an email to employees, John Mateczun, United Healthcare Military & Veterans president and a retired Navy vice admiral, reminded them that the company won the Tricare West contract following an awards appeal.

“Initial award announcements can be overturned,” Mateczun assured employees. “We will participate in the debrief process … to better understand the basis of its awards as well as our potential protest options.”

The contracts are worth up to $57 billion over five years. The Tricare East region contract, which oversees services in 29 states, parts of three more and the District of Columbia, has an up-front value of $67.5 million with an estimate of $40.5 billion for the duration of the contract.

The Tricare West contract to manage 18 states and parts of three states, is valued at more than $49 million in the initial phase and up to $17.7 billion over the five-year contract period.

Bono said DHA consulted with the Government Accountability Office and other acquisition experts to draft the request for proposals and select the contractors.
She added that she hoped the agency’s due diligence would avoid a lengthy protest process.

“And so, as a result of the deliberations and evaluating all the factors that went into the selection process, not only was the highest level of integrity preserved, but we, we have a very good way of describing and defending why our selections were made,” she said.

Following the company debriefs, the firms have 10 days to file an official protest with the GAO or the Court of Federal Claims.

Bono reiterated that regardless of whether companies filed protests, Tricare would take steps to ensure that beneficiaries' care remains unaffected.

“For now, everything stays the same for beneficiaries and we will keep them updated on any kind of transition efforts that are going on and what our patients might need to do in the future,” Bono said.
Patricia Kime covers military health care and medicine for Military Times. She can be reached at [login to see]