Last year, TRICARE’s new contractors — Humana for the eastern region of the United States, and Health Net Federal Services in the west — announced that in 2018 they would reduce mental health provider reimbursement rates by as much as 35 percent. TRICARE, the health care plan for military personnel and their families, is administered by the Defense Health Agency (DHA) and covers almost 9.4 million peopleopens in new window.
These dramatic cuts affect psychologists, service members and their families nationwide, but their impact may be more deeply felt in states with large military populationsopens in new window.
In response, the APA Practice Organization has mounted a persistent advocacy effort to get TRICARE to restore more appropriate reimbursement rates, clarify its communications with providers and ensure its beneficiaries have meaningful access to mental health care.
The latest tactic: Sending psychologists directly to Congress to raise their concerns.
During the Practice Leadership Conference (PLC) last month, delegates from all 50 state psychological associations went to Capitol Hill to advocate for psychologists and their patients. As part of this effort, psychologists from states with large military populations — including Texas, California, Virginia, North Carolina and others — also asked their members of Congress to put pressure on their colleagues to “exert appropriate, immediate oversight of the DHA’s TRICARE program,” according to briefing materials shared with PLC attendees.
Psychologists share their stories
Anna Lucca, PhD, has a private practice in Falls Church, Virginia. She went to Capitol Hill with colleagues from the Virginia Academy of Clinical Psychologistsopens in new window (VACP), that state’s psychological association.
In VACP’s meeting with a staffer from the office of Sen. Mark Warner,D-Va., Lucca described the slashed and delayed payments, bungled communications and skyrocketing client copays that she and her fellow TRICARE providers in Northern Virginia have observed since the new contract with Humana went into effect.
“It’s been a disaster. Providers can’t sustain practices that have been virtually cut in half,” said Lucca.
APA Past President Antonio E. Puente, PhD, of Wilmington, North Carolina, used similar arguments to appeal to a staffer in the office of Sen. Thom Tillis, R-N.C. That staffer met with members of the delegation from the North Carolina Psychological Association.
“I’m the only neuropsychologist in North Carolina east of Interstate 95 that takes TRICARE,” he explained, highlighting the great lengths to which military personnel and their families must go in order to access care as a result of the new contract with Humana.
Across Capitol Hill, delegates from the Florida Psychological Association met with staff in the office of Rep. Al Lawson, Jr., D-Fla., to express similar concerns.
“While psychologists are as committed to assisting service members as anyone, they’re finding it financially impossible to do so,” said Tallahassee-based psychologist Carolyn Stimel, PhD, ABPP, after the meeting.
Stimel, FPA’s executive director, noted that many Florida psychologists have opted to decline the new contracts — a report echoed by psychologists from states all over the country.
Results — and next steps
Fortunately, psychologists who raised these concerns were “incredibly effective” in garnering support for Congress to formally look into the issues with TRICARE’s new contractors, said Heather O’Beirne Kelly, PhD, APA’s director of military and veterans health policy.
“Partly due to this increased awareness and interest following PLC, DHA staff have agreed to a request from the Practice Organization for a formal meeting in April to address these TRICARE concerns,” she said.
The Practice Organization will continue to provide updates on this issue as they become available. For photos from the PLC Hill visits, check out our Flickropens in new window page.