Heller seeks answers on coming changes in military health care plans

By Karoun Demirjian

Wednesday, Dec. 5, 2012 | 2 a.m.

In a few months, the military’s health insurance program for servicemen and veterans, known as Tricare, is going to be under new management in the West, and the changeover may force some veterans in Northern Nevada and other rural areas to change their health insurance plans.

United HealthCare, which won the Defense Department’s Tricare contract from longstanding provider TriWest Healthcare Alliance this year, has been warning that when it takes over in April, some health care services may be cut, and some recipients may be forced to change their insurance plans.

According to a recent news report in the Army Times, veterans in Reno could experience some of the most dramatic changes.

But neither United HealthCare nor Tricare will confirm whether this is the case. And lawmakers, growing impatient, are demanding answers.

Last week, Sen. Dean Heller, R-Nev., proposed an amendment to the National Defense Authorization Act to force the Defense Department to produce more answers about where Tricare services will change once United HealthCare takes over the contract. The amendment passed by unanimous consent, and the Senate passed the bill Tuesday.

“Nevada veterans deserve answers from the Department of Defense on any health care changes, and those changes should be justified,” Heller said in a statement upon the amendment’s adoption.

“After everything our veterans have done for us, the least we can do is make sure they are afforded the very best treatment our country can provide.”

But Heller’s amendment does not actually have the teeth to force the Defense Department to give the advance warning he seeks.

The amendment requires the Defense Department to send a report to the House and Senate Armed Services committees within 120 days of the bill’s passage, outlining where Tricare services will be affected. Even if President Barack Obama signed the NDAA tomorrow, the 120-day window wouldn’t expire until April, which is when the changes to Tricare are supposed to take effect anyway.

Heller based his amendment on reports, like that in Army Times, that suggested United HealthCare planned to shrink the network of approved Tricare primary care providers, pushing hundreds of veterans off the no-deductible/no-copay military health care insurance option known as Tricare Prime. Tricare Prime is limited to veterans who live within 40 miles of the nearest primary care provider.

Those who find themselves outside of the service area would have to switch to Tricare Standard and Extra, an insurance program that does carry deductibles (up to $300) and co-payments for almost all medical visits and procedures.

According to the Army Times report, Tricare Prime would still be an option for veterans living within 100 miles of a military treatment facility, but only if they signed a service waiver.

Tricare has been warning program recipients since this summer that some individuals in rural areas might no longer be eligible for Tricare Prime once United HealthCare takes over the contract, but has not specified where in the country those changes would take place.

“Anything that has been in the newspaper so far is speculation and comment on possible options that were being considered,” said Austin Camacho, a spokesman for Tricare, when asked if Reno or any other part of Northern Nevada was on the list. Camacho added that he did not know when the Defense Department planned to make its final plans known.

“But I do know no firm decisions have been made about locations,” he said.

The expectation is that the changes being implemented will save money on military health care costs.

TriWest Healthcare Alliance lost the Western Tricare contract to United HealthCare this year after TriWest settled court charges that it had been quoting the government higher service rates than it was actually paying the health care providers. TriWest appealed to the Government Accountability Office, but ultimately lost.