A bill by Sen. Tim Kaine (D-VA) and Sen. Tom Cotton (R-AR) would allow more flexibility for military families who use TRICARE when shopping for drugs.
The bill would allow local pharmacies to fill prescriptions for non-generic drugs, which is not allowed under the current rules for the military health insurance, Kaine said.
“Many community pharmacies have left the TRICARE network because they were losing money on TRICARE transactions,” he said.
Under the current rules, patients can have their prescription for generic medication filled by an outside pharmacist, but prescriptions for brand name can only be filled by a military pharmacist.
“It's a way of making both the beneficiaries have more providers who are able to serve them, but it also reduces disincentives for the providers to participate in the TRICARE program," Kaine said.
Over 9 million servicemembers, retirees and their families use TRICARE. Patients complain that too few providers accept military health insurance. Providers have complained that the reimbursement rate for TRICARE services is too low, especially after payment delays lasted most of last year. Kaine's RX Access Act would require TRICARE to reimburse pharmacies for the full cost of the drug.
“We want to make it more convenient and treat military TRICARE beneficiaries like the general public, allowing them to get non-generic medications when they need them at community pharmacies,” Kaine said.
The bill does not address rising drug costs. Prices for prescription drugs rose from $1 to $9 for most TRICARE patients at the beginning of the year. The legislation is expected to be folded into the next Defense bill.
