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Letter to Secretary Hagel - 'Immediate Action' on TRICARE Contract Problems


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Congressman Doug Lamborn (CO-05) today sent a letter to Secretary of Defense Chuck Hagel asking for "immediate action to ensure the proper medical care" for service members and their families affected by the recent change in the TRICARE West contract. Up to 2.9 million beneficiaries may be affected. Yesterday Congressman Lamborn met with about 30 healthcare providers, some who say they will be forced to lay off employees, because they are not getting patient referrals or reimbursement for services.

Congressman Lamborn sent a similar letter to the CEO of the new contract, United Healthcare, late last week and spoke by phone to the CEO of the company's military and veterans division, Lori McDougal, to demand action.

The text of letter follows below:

May 2, 2013

Honorable Chuck Hagel

Secretary of Defense

The Pentagon

Washington, DC

Dear Secretary Hagel,

I am deeply concerned by a growing problem that TRICARE recipients in my district are facing since United Healthcare took over management of TRICARE West Region on April 1, 2013. Specifically, healthcare providers and recipients have told me that patient referrals are either not occurring or are severely backlogged. The result is that active and retired service members and their families are not receiving the critical medical care they need. This problem is widespread and includes critical health specialties where a month-long delay in receiving care could have a significant negative health impact.

Delays also mean that many of these medical providers are facing unexpected and dramatic reductions in their workload and are now faced with the prospect of laying off employees. In fact, I am aware of medical providers who may begin reducing their workforce within days. My understanding is there may be hundreds of thousands of pending referrals, delaying vital care for thousands of TRICARE recipients across the West Region. My staff has heard from one large provider that the delays in reimbursement are costing them tens of thousands of dollars per day.

While I understand that United Healthcare is working to resolve the problem, to date they have not been able to provide me with a clear process or timeline to resolving the problem. These service members and their families should not be stuck in limbo, waiting for important healthcare services, due to the mistakes of a contractor. Likewise, these healthcare professionals should not have to face job losses due to the mistakes of a contractor. Therefore, I ask that you immediately establish a temporary system to allow TRICARE recipients in the West Region to receive medical care. Also, I ask that you ensure timely payments to medical providers so that the professionals caring for our service members do not face job losses or undue financial strain.

United Healthcare has now had over a month to fix this problem, but has been unable to do so. TRICARE recipients and healthcare providers simply cannot afford to wait any longer. The situation is truly dire and I ask that you take immediate action to ensure the proper medical care of our service members and their families.


Doug Lamborn

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