Change in Tricare hospital payments delayed
By Karen Jowers - Staff writer
Posted : Wednesday Feb 11, 2009 16:35:30 EST
Civilian hospitals that provide outpatient services to Tricare beneficiaries got a temporary, 11th-hour reprieve from the Pentagon’s proposed plan to have Tricare switch to using Medicare’s payment system for those services.
Critics said the change, which had been set to take effect Monday, has the potential to disrupt outpatient services in civilian hospitals for Tricare users.
In 2002, Congress required the Defense Department to use Medicare payment rates for the Tricare system “to the extent practicable.”
The Pentagon’s proposed plan, outlined in the April 1, 2008, Federal Register, would have Tricare adopt Medicare’s fee schedule for reimbursements to hospitals for outpatient services, which is about 25 percent less than Tricare’s current payment rates to hospitals.
Sen. Jim Webb, D-Va., one of the critics of the propsal, said the Pentagon plan “does not provide for a broad, multi-year transition period that is necessary for hospitals offering Tricare services to adjust to a lower payment schedule.”
In a statement Tuesday, Webb said he welcomes the decision by Defense Secretary Robert Gates “to postpone any action that could jeopardize services to our military men and women who rely on the Tricare health care system.”
In a notice published in the Feb. 6 Federal Register, defense officials said they have moved the effective date of the proposed change to May 1 in order to ensure that administrative claims processing procedures are fully in place to accommodate the new payment schedule.
Defense officials also noted that in the meantime, a Jan. 20 memorandum from the Obama administration asked agencies to consider delaying the effective dates of pending rules, and to invite additional public comments on the final rule.
The Pentagon has reopened the public comment period on the proposed change in the hospital fee schedule until March 9.
In a November letter to defense officials, 57 senators said the transition period for the outpatient payments should cover all services in all hospitals serving Tricare patients, to cushion hospitals from across-the-board reductions in payments from Tricare.
In a Jan. 28 letter to Gates, Sen. Ben Nelson, D-Neb., urged reopening the public comment period and consider revisions.
“This is an opportunity to reverse course on a rule that would cut nearly $500 million in payments to hospitals serving our nation’s servicemen and women and their families,” Don May, vice president for policy for the American Hospital Association, said in an advisory posted on the AHA Web site.
Thursday, February 12, 2009
Change in Tricare hospital payments delayed
