TRICARE Contractor Agrees CURES Provisions Apply to Rates

WASHINGTON, D.C. (February 22, 2017)—AAHomecare recently evaluated the language of the CURES Bill and how it pertains to the TRICARE network. As previously reported, AAHomecare received an attorney opinion that the language inside of the CURES Bill should relate to the TRICARE network as well.

AAHomecare sent this letter to the three regional TRICARE contractors and to the Department of Defense requesting they review the language in the CURES Bill and provide direction for implementation of this bill to the TRICARE network. AAHomecare contacted Health Net Federal Services, the contractor for TRICARE North region, and was informed that they believe after reviewing the information provided, that the CURES Bill impacts payments to the home medical equipment community. Health Net will need a directive issued by the Defense Health Agency to be able to reprocess these claims. They have scanned AAHomecare’s letter into their system so that everyone involved is aware of the concern. Health Net has also contacted Palmetto, the claims processing unit for TRICARE, to determine if the directive has been received. They have not received this directive from the DHA yet, but will continue to reach out to determine next steps when this occurs. AAHomecare will continue engagement efforts with the Defense Health Agency and Humana Military-TRICARE South and UHC Military-TRICARE West providers to push for the directive being issued. 

The TRICARE regions will also be changing as of October 1, 2017. Currently, there are three regional contractors. This is being consolidated to Health Net Federal Services as the TRICARE West Contractor and Humana Military as the TRICARE East Contractor. Health Net also stated that due to these contract changes later this year, they will not be renegotiating any current contracts at this time. They are working to transition the providers that are currently in network in these regions to the new contractors.  After this is completed, they will once again discuss contract renegotiations.

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