Coalition Lobbies Senate on Copays and Retirement. More than two dozen members of The Military Coalition visited offices of Senate Armed Services Committee members this week to oppose big TRICARE pharmacy hikes and ill-advised military retirement changes. Here’s the feedback.
Your Pharmacy Questions Answered. 97% of you support the House-passed defense bill provision that would protect against big copay hikes by establishing a limited requirement for mail-order refills. But how would that requirement be implemented for real people? Get the answers here.
Coalition Lobbies Senate on Copays and Retirement
More than a dozen teams of Military Coalition representatives visited offices of Senate Armed Services Committee members this week, seeking senators’ support to change the Senate’s FY2013 Defense Authorization Bill in two key ways:
- Avoid tripling TRICARE beneficiaries’ pharmacy copays by adopting the House alternative plan to achieve equivalent savings through requiring a temporary test of refilling TFL maintenance medications through either the mail-order or military pharmacy system.
- Amend a provision to establish a military retirement reform commission by dropping rules that would require Congress to vote “yes or no” on any commission recommendations, without any changes and with only limited debate.
These issues were identified as the top defense bill priorities for the 34-association Coalition, which MOAA co-chairs.
With the legislators out of town, even the most sympathetic staffers couldn’t commit specifically how their bosses would vote on these issues.
One expressed doubt that the Senate would approve such tight restrictions on considering military retirement recommendations. We reminded him the Armed Services Committee his boss sits on already voted to uphold them.
And not all were sympathetic. One senator’s staff member said unequivocally that his boss was on the side of the “big box pharmacies” and would oppose any mail-order plan (which means sticking military beneficiaries with far higher copays).
Many others said they had been visited by drug store lobbyists arguing against the House proposal. Just one such group already has made more than $170,000 in campaign donations.
This is an important fight. Tell your legislators to protect the military families who have sacrificed so much to protect America.
Your Pharmacy Questions Answered
Your survey responses showed 97% of you support the House-passed provision that would limit TRICARE Pharmacy copay increases, but require TFL-eligible beneficiaries to try the mail-order pharmacy (or use military pharmacies) for maintenance medication refills for one year. (The alternative is accepting the far larger current and future copay increases the Senate would allow. See details of the House vs. Senate/DoD copay schedules.)
Previously we answered your initial questions on the mandatory mail-order pharmacy concept.
After speaking with TRICARE and Express Scripts, Inc. (ESI, the TRICARE pharmacy contractor) officials, we can answer some more specific questions about how such a system would be implemented:
Q: A mail-order refill requirement for maintenance meds is a pretty big change from what TFL beneficiaries are used to. How would they all get the word?
A: TRICARE, ESI, and military and veterans organizations would all help publicize the requirement. Beneficiaries would be mailed individual notices, and there would be media blitzes in all forums about the requirement. In addition, ESI would send written and electronic guidance to all participating retail pharmacists about the requirement. Beneficiaries now using retail drug stores would get multiple notices, both at home, in the media, and at their retail points of service. Those who are taking certain kinds of high-priority medications would get personal phone calls from ESI to walk through setting up a mail-order account over the phone.
Q: If an 85 year old retiree somehow didn’t get the word on the mail-order refill requirement and went to the retail drug store for a refill needed that day, would he/she be turned away?
A: No. In that case, the pharmacist will have been advised to provide an interim 30-day refill along with information on how to establish a mail-order refill account. If there’s a problem setting up the account in that time, the pharmacist could provide a second interim refill. In cases where interim refills have been provided but no mail-order account has been set up, ESI officials would make phone calls to help the beneficiary set up the account by phone.
Q: Is it complicated/does it take a lot of time to set up a mail-order account?
A: No. It can be done with one phone call, typically in 10 minutes or less.
Q: Is the mail-order program as safe as face-to-face interaction with a pharmacist?
A: Automated mail-order is actually safer. It’s 99.99% accurate compared to 98.30% for retail. Registered pharmacists check every prescription and are available 24/7 to answer questions.
Q: Beneficiaries in nursing homes usually have special wrapping requirements for their medications that mail-order services don’t provide. How would they be treated?
A: DoD will have the ability to waive the mail-order refill requirement either for certain medications or for classes of people. In our discussions with ESI and TRICARE officials, they agreed that nursing home patients would be exempted from the requirement.