TRICARE APOCALYPSE

Well, that’s the way we see it.

UPDATE 10/25/22

Below is the back story — TRICARE moved to shrink its network disproportionately removing the ability for beneficiaries to choose local independent pharmacies.

Clinton and La Conner cannot process rx claims.

Our Oak Harbor location still has a contract that is processing claims though.

So, we will continue servicing vaccines and medications for TRICARE.

We will deliver Rx’s for Clinton and La Conner for pickup from Oak Harbor (this may take an extra day or so to arrive at the remote store).

VACCINES: we will still administer vaccines for TRICARE beneficiaries at all three locations.

Many parties are still trying to rectify this atrocious move by DHA. Here is an update on all the action from National Community Pharmacy Association:

NCPA October 24, 2022

Kansas Gov. Laura Kelly (D) is the latest to raise concerns with the Department of Defense over the new Tricare pharmacy contract that excludes most independent pharmacies. In a letter to Seileen Mullen, Acting Assistant Secretary of Defense for Health Affairs, Kelly requested immediate action so that Tricare beneficiaries retain access to retail and community pharmacies. Kelly’s letter follows bipartisan efforts on Capitol Hill demanding answers from DOD and action to ensure beneficiary access, including letters from Sen. Jon Tester (D-Mont.) chairman of the Senate Veterans Affairs Committee and Sen. James Lankford (R-Okla.), a letter signed by 100 members of Congress that was led by Sen. Tom Cotton (R-Ark.) and Rep. Buddy Carter (R-Ga.) and a letter from House Armed Services Committee Member Mike Johnson (R-La.).

We will post updates here as they become available.

Original Post:

Many TRICARE beneficiaries have received letters like this.

Local Impact

How does this impact our region? A picture is worth a thousand words…

These are all the TRICARE addresses we proudly served since Jan ’21.

It is also an understatement as many of the vaccine only patients present Medicare cards, so those aren’t in this data set.

Why Did TRICARE Make These Changes?

Recently, the Department of Defense awarded a $4 billion contract to Express Scripts (to manage the prescription benefit) and at the same time reduced the size of the retail pharmacy network.

The Federal government has demanded a 33% reduction in its pharmacy network. Department of Defense leadership instructed Express Scripts to eliminate over 15,000 pharmacies from its current network.

Pharmacies directly contracted with Express Scripts were purposely not offered participation in this network for 2023. It is beyond unconscionable for the federal government to target community pharmacies in this severe restriction of provider access. This is a gross misuse of federal tax dollars paid by the very businesses being excluded.

This action will take pharmacy choice away from you, and from millions of other active and retired military and their families.

What are we doing

We are actively engaged with Senator Murray and Congressman Larsen’s office. They are working to gather information and see what can be done.

Senator Cantwell’s office has not replied (unfortunately).

UPDATE, here is a letter Congressman Larsen signed on to, waiting for Murray/Cantwell

What Can You Do?

  • Submit a complaint about your pharmacy of choice being excluded from the TRICARE network by calling 1-877-363-1303 or sending an email to DOD.customer.relations@express-scripts.com. Also mail a hardcopy of your complaint directly to:
    Defense Health Agency
    Pharmaceutical Operations Directorate
    7700 Arlington Boulevard, Suite 5101
    Falls Church, VA 22042-5101
  • Contact your U.S. senators and representative. Look up their contact information here:

https://bit.ly/fight4rx-legislators

  • Share your story on social media, tagging @MilitaryHealth, @TRICARE, and @ExpressScripts in your posts.
  • Submit a letter to the editor of your local newspaper.

Current Action

Please do not take any action on these notices at this time. As we are actively trying to achieve a resolution.

To be safe, if you are looking to get a COVID shot or any other vaccine, and only have TRICARE insurance, please come in before Oct 24 just in case there is a brief interruption.

We will have an update before the Oct 24 date. We have a backup plan in place to keep offering TRICARE beneficiaries the same access to generic medications here if there is an interruption.

Additional Thoughts

Our company has been serving those who serve for decades. In fact, this achievement was so noteworthy to our former owner, it was in his obituary:

“In 1986, Bill bought Island Drug in Oak Harbor, Wash. He added a number of innovative services, including a drive-up window, prescription delivery, nursing home consulting, compounding and homemade fudge. His was the first pharmacy on Whidbey Island to accept Champus Military Insurance, which was greatly appreciated by the families of the military personnel stationed at Naval Air Station Whidbey Island. https://whidbeyweekly.com/obituaries/william-richard-bulpin/

Express Scripts is contracted by DHA (Defense Health Agency). We are a sub-contractor of Express Scripts as they process electronic prescription claims, but they also compete against us by offering mail order services. But on a different playing field as the pricing to beneficiaries is vastly skewed in favor of mail. The playing field is set by the DHA contract.

Our message to DHA is two fold:

  1. Our role in the community is established after decades, and most recently in the vaccine rollout. Can you imagine if everyone but TRICARE beneficiaries were allowed to get vaccinated with us, the most accessible COVID vaccine site north of Seattle? This is a pic of just one week of vaccines provided during Spring 2021
  2. DHA should follow the message on the official @POTUS twitter account and NOT exploit community pharmacies. Rather, allow true competition and don’t force beneficiaries out of the local community and into certain national companies.

    TRICARE beneficiaries should hold the decision making authority on where they choose to access prescription benefits — on an even playing field.

Here is a video recap of the role we play locally.

“Thanks for Being Here” — Reflection & A Request

Being here may not be an option if the government separates us from our customers.

One thought on “TRICARE APOCALYPSE

  1. This is a national trend, vertically integrating big pharma and distribution to squeeze more profit out of the public. The public loses because your local pharmacy knows you and is a last line of defense against prescription errors and systemic failures that threaten your health!

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