For years, military families have reported barriers to getting mental health appointments in both military treatment facilities (MTFs) and the TRICARE network. As MOAA reported last year, an August 2020 DoD Inspector General report validated those claims and underscored the need to address mental health care access problems.
MOAA recognizes the shortage of mental health providers is a national problem and contributes to access challenges, so our recommendations focus on actionable goals to achieve incremental improvements, including:
Mental Health Appointment Schedulers: MOAA seeks a pilot program to test the effectiveness of mental health appointment schedulers in assisting beneficiaries with making mental health appointments. This “ask” is consistent with an IG report recommendation but expands the pilot to cover the direct care system as well as the TRICARE purchased care network.
The pilot would not only provide direct assistance to beneficiaries seeking mental health care but also could serve as a data collection tool to gain a better understanding of barriers to access. In response to the IG recommendation, the Defense Health Agency (DHA) stated plans to develop such a pilot. MOAA will seek legislation on key elements of the pilot and congressional reporting requirements.
Enhanced TRICARE Contract Requirements: MOAA will advocate for more robust mental health network adequacy and provider directory requirements in the next generation TRICARE contract (T-5) including:
- Ongoing mental health provider certification/credentialing to continuously build the pool of TRICARE-authorized mental health providers even if overall network adequacy requirements are met.
- Provider directory accuracy requirements specific to mental health care to eliminate duplicates, providers no longer practicing, and inaccurate provider categorization.
- A comprehensive list of institutional behavioral health providers across all regions, accessible to all beneficiaries. This list is critical for families who must seek inpatient care outside their geographic area due to limitations on local options.
Telehealth Licensure Flexibility: MOAA seeks a study on the impact of COVID-19 national emergency licensure waivers allowing providers to practice telehealth across state lines, and the feasibility of making such waivers permanent.
Reduced Mental Health Copays: MOAA wants a targeted fix to reduce mental health and other therapy copays that does not result in increases to other TRICARE Prime or Select copays, enrollment fees, or other out-of-pocket costs. TRICARE mental health copays more than doubled in 2018, and military families now pay more per visit than federal employees covered by Federal Employees Health Benefits plans. The combination of high copays plus the frequent visits required for mental health care treatment creates a barrier to access for some families. We cannot allow cost to prevent families from seeking care.
The mental health of servicemembers and military families is a readiness issue. MOAA is committed to improving access to mental health care for all military beneficiaries. Our efforts will include outreach to DHA, members of Congress, and professional staff on the House and Senate Armed Services Committees. Please stay tuned to advocacy updates at MOAA.org for developments.