Despite the continuing rollout of the military's Tricare managed-care program, the Senate is nearing approval of a measure that would delay the plan's implementation in parts of the East and Midwest.
The Senate's military spending bill for fiscal 1996 would bar the Department of Defense from soliciting any more bids from managed-care companies to enroll military dependents and retirees covered by the Civilian Health and Medical Program of the Uniformed Services, or CHAMPUS.
That proposed delay, part of the $10.2 billion defense health program appropriation, would postpone implementation of three regional contracts that were expected to begin operation in 1997. It would affect military healthcare in 20 states east of the Mississippi River, stretching from North Carolina to Maine to Wisconsin, plus the District of Columbia.
The Senate was expected to begin debating the appropriations bill late last week at the earliest.
The bill advocates a go-slow policy, saying that the department needs to evaluate the lessons of three contracts already awarded in the West and South, all of which have faced protest from losing bidders.
Most recently, the General Accounting Office decided that Foundation Health Federal Services, not QualMed, should have been the winner of the biggest plum: a $2.5 billion, five-year contract to cover 700,000 military beneficiaries in California and Hawaii (Aug. 7, p. 24).
Another Foundation contract, covering Oregon and Washington, is in operation and has withstood challenges from losing bidders. So if the Pentagon follows the GAO recommendation for the California and Hawaii pact and the award stands for a contract covering Arkansas, Louisiana, Oklahoma and parts of Texas, Foundation will have won all three of the five-year contracts. Together, they are worth nearly $5 billion and cover 1.5 million beneficiaries.
Representatives of beneficiary groups said the Senate is concerned that the Tricare contracts may actually cost the government more than the traditional indemnity-style CHAMPUS care.
The groups said they understand the Senate's concerns, but they bemoan the confusion the delay could cause among beneficiaries.
"It would delay a more uniform benefit across the country," said Frank Rohrbough, deputy director of government relations for the Retired Officers Association.
Senate legislation would delay Tricare contract awards covering the following states: