TREA: The ENLISTED ASSN

FROM WASHINGTON

NEWS FOR THE ENLISTED

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1) Pentagon Asks Congress to Allow Them to Reprogram TRICARE Money -- Congress (and We) Ask Why?

Recently the Department of Defense requested that Congress allow them to “reprogram” $708 billion from the Defense Health Program and TRICARE. It is not unusual for government agencies and departments to reprogram money in the last quarter of a fiscal year. However in this case we have been hearing all term that TRICARE costs were bleeding DoD dry. And that that is why retirees need to pay new and increased enrollment fees and co-pays. But clearly the program was over funded this year (last year they reprogrammed about $500 million in TRICARE and DHP funds.)

DoD also said that they would use the funds for “higher priorities.” When the HASC received this request the Personnel Subcommittee’s Chair (Rep. Joe Wilson R-SC) and Ranking Member (Rep. Susan Davis D-CA) and 22 House members from both sides of the aisle wrote a letter asking both about the continuing requests for TRICARE co-pay increases and why the money could not be used for underfinanced TBI and PTSD programs. We are very pleased about the letter and thought you should get a chance to see it. In August when speaking to your Senators and Representatives you can bring it up. When we see Secretary Panetta’s response we will send it on.

2) QUESTION: Which Proposed TRICARE Rx Co-Pay Plan Do You Prefer? WARNING: YOU WON’T LIKE EITHER OF THEM

We have already gone over the presently pending NDAA’s TRICARE provisions in past Updates but here is a recap. The full House of Representatives has passed its version, HR4310. The Senate’s version, S3254, was passed by the Senate Armed Services Committee and is now waiting to be brought to the floor for consideration by the full Senate. TREA, the Enlisted Association, is very pleased with many aspects of both proposed versions of the bill and how they differ from the Administration’s proposals.

Specifically, both versions of the bill do not include most of the Administration’s proposed fee hikes and new enrollment fees.

• Retirees will not have a yearly enrollment fee for TRICARE for Life (TFL)
• Retirees under the age of 65 will not have a yearly enrollment fee for TRICARE Standard and Extra
• Retirees under the age of 65 enrolled in TRICARE Prime will only see a 3.6% COLA increase in their enrollment fee in FY2013. Not the double and triple increases proposed by DOD
• There is no increase in the catastrophic cap

All of this is extremely good. But we cannot let up until these provisions are signed into law.

However, there are different proposals in the 2 bills concerning the Pharmacy benefit. Both will increase the TRICARE Pharmacy co-pays and that is what we wish to hear from you.

The Senate version is completely silent on the Administration’s proposal to double the present co-pays this year and then triple them later. Since under present law the Secretary of Defense has the power to make the pharmacy co-pays this means the SASC had effectively agreed to those co-pays.

To be fair if the SASC barred the higher co-pays for TFL beneficiaries they would have to cut “mandatory funding” in other retirement or survivor programs.

We believe the House version is better. Their pharmacy provisions include a much smaller co-pay increase in FY2013; having future co-pay increases be no higher than the COLA increase received by the military retiree; and taking future control of the co-pays out of the hands of the Pentagon and into the hands of Congress.

They pay for this change in “mandatory funding” by creating a 5 year pilot pharmacy program that would require all TFL pharmacy beneficiaries to use the Home delivery for maintenance drugs for at least one year. (After a year they can switch back and there would be hardship waivers available.) Also initial prescriptions and one time prescriptions (example antibiotics) would not be included. And we have been assured that TFL beneficiaries could continue to refill their maintenance drugs at the MTFs.

Below is a chart comparing the 2 sets of pending co-pays.

DoD/Senate vs. House-Passed Rx Copays

Retail Meds

Mail-Order Meds

*Assumes 3% annual COLAs

** Non-formulary medications wouldn’t be available in retail pharmacies under DoD/Senate plan

Please notice that another important provision in the House plan is that it keeps retail pharmacy access to non-formulary (3rd tier drugs.) DoD’s provisions that would take effect in the Senate version.

Obviously, we are against any co-pay increases. But if we are stuck with these two proposals please tell us if you prefer the House version with much lower co-pays and 3rd tier drugs remaining available in the retail pharmacies? Or is the mandatory mail order/home delivery requirement for a year worse and you then prefer the DoD/Senate proposal?

When answering could you please tell us your age, pay grade, whether you use retail pharmacy or mail order, and how many prescriptions you and your spouse normally fill in a month. This is so we can speak to how much these proposals will cost a normal retiree. Not just the cost if you only took 1 drug.

Also have you ever used or are using the TRICARE Mail Order/Home delivery program now? And if you have what do you think of it?

Thank you we need to hear what you think as soon as possible.

3) UnitedHealthcare New West Region TRICARE Contractor

The TRICARE West Region’s contract has, after 3 years, has finally been awarded to UnitedHealth Care. They are scheduled to take over the civilian healthcare management contract on April 1, 2013. Until then TriWest will continue to serve the 21 state region. We will keep you informed of any transition news.

4) Express Scripts Has New Improved Mobile App

For all of you living on or through your smart phone or mobile devise Express Scripts has good news for you. They have improved their mobile app to allow you to create an online account that (among other things) can send daily medication reminders and other information that can make it easy to keep up with any medicine regime. Below please find the Express Scripts press release. For you folks who do not live on their smart phones you can get the information through Express Scripts web site.

Express Rx Enhancements Offer Greater Convenience, Access For TRICARE® Beneficiaries

ST. LOUIS, JULY 24, 2012 -- Express Rx, the mobile app for TRICARE® beneficiaries to access pharmacy benefit information on smart phones and mobile devices, now offers even more convenient features.

TRICARE beneficiaries with smart phones can create an online account through the mobile app and set up daily medication alerts that remind them to stay adherent to their treatment regimen. The alerts can include pictures of the medication to assist beneficiaries who take multiple medications.

“The enhancements support our ongoing focus to provide beneficiaries convenient access to their pharmacy information and a demonstration of our alignment with the goals of the TRICARE program,” said Tracy Egler, senior director, of Express Scripts’ TRICARE Pharmacy Division.

Express Rx is available for download, free, at the Apple App Store or the Android Market. Other users, including those on Blackberry devices, can access the mobile-optimized website at http://m.esrx.com.

The Express Rx app and mobile-optimized website already allow beneficiaries to register for, and convert medications to TRICARE Pharmacy Home Delivery, order home delivery refills, check order status, and look up drug information. On GPS-enabled smart phones, the Express Rx app also can direct beneficiaries to the closest retail pharmacy in their network.

The Express Rx app supplements the 24-hour phone and e-mail communication channels beneficiaries currently have available to interact with pharmacists and patient care advocates.

Since 2003, Express Scripts (NASDAQ: ESRX) has managed pharmacy benefits for the 9.7 million TRICARE beneficiaries, making the use of prescription drugs safer and affordable for American military personnel, retirees and their families.

For more information, visit Express-Scripts.com/mobile/ .

About Express Scripts

Express Scripts manages more than a billion prescriptions each year for tens of millions of people. On behalf of our clients -- employers, health plans, unions and government health

5) Pentagon Rolls Out Their New And Improved Transition Assistance Program

This week DoD launched it newly redesigned Transition Assistance Program (TAP) now called Transition GPS for military members planning to enter civilian life. The TAP has not had a major overhaul in almost 20 years. The new program was developed not only by DoD but also through the work of the Departments of Veterans Affairs, Labor, Education, and Homeland Security, and the Office of Personnel and Management and the Small Business Administration.

The White House put out the following description of the new program.

• Pre-Separation Assessment and Individual Counseling: Through the new transition program, separating service members will have individual counseling to discuss their career goals and start their transition process. Subsequently, members will have a needs and goals assessment coupled with a counseling session about benefits, resources, and available assistance across a wide scope of military separation topics. Each service member will develop an Individual Transition Plan that documents his or her personal transition, as well as the deliverables he or she must attain to meet the new transition program’s Career Readiness Standards.

• 5-Day Core Curriculum: The five-day Transition GPS Core Curriculum will include a financial planning seminar, a workshop offered by the Department of Veterans Affairs on available veterans’ benefits and services, and a re-designed employment workshop offered by the Department of Labor. Transitioning service members will also undertake a Military Occupational Code Crosswalk to translate their military skills, training, and experience into civilian occupations, credentials, and employment. An Individual Transition Plan session will allow Members to seek guidance from subject matter experts, identify career goals, and develop a roadmap for their transition.

• Career-Specific Additional Curriculum: In addition to completing the Transition GPS Core Curriculum, transitioning service members will also have the option of participating in a series of two day tailored tracks within the Transition GPS curriculum: (1) an Education track, for those pursuing a higher education degree; (2) a Technical and Skills Training track, for those seeking job-ready skills and industry-recognized credentials in shorter-term training programs; and (3) an Entrepreneurship track, for those wanting to start a business.

• CAPSTONE Event: Before their separation from military service, service members will participate in a CAPSTONE event, which will verify that transitioning service members completed the Transition GPS curriculum and achieved Career Readiness Standards. Service members who require additional assistance will be referred to supplemental training opportunities. In addition, through the CAPSTONE event, all service members will be offered a ‘warm handover’ to appropriate government agencies and organizations that will be able to provide them continued benefits, services, and support as veterans.

• Military Life Cycle Transition Model: The new transition program will incorporate career readiness and transition preparation into the entire span of a service member’s career. In the past, transition and preparation for the civilian workforce occurred late in a service member’s time in the military – near the point of separation. Under this new program, these concepts will be incorporated earlier to ensure that the counseling, assessments, and access to resources to build skills or credentials occur at earlier stages of a service member’s

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Phone: 800-338-9337
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