UCAOA Initiates Dialogue with Defense Health Agency
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The Department of Defense has until the end of June 2016 to implement a pilot program that allows TRICARE beneficiaries to access care at urgent care centers without pre-authorization. The three-year pilot program was included in the Fiscal Year 2016 Defense Authorization Act signed by the president in November.

This month, UCAOA leaders spoke with representatives of the Defense Health Agency who will be responsible for implementing the pilot.  UCAOA provided background on the scope of urgent care centers and their role in the health care community, including connecting patients with primary care providers and reducing the dependence on emergency departments for evening and weekend care. UCAOA highlighted for the Agency the recently released 2015 Massachusetts Cost Trends Report, which concluded that greater access to after hours care options is strongly associated with lower emergency department use.

While the law directs the Department to carry out the pilot program, it does not specify the scope of the pilot, leaving that level of detail to the Defense Health Agency’s discretion. The law also requires incorporation of the Department’s nurse advice line to direct covered beneficiaries seeking access to care to the source of the most appropriate level of health care required to treat the medical conditions of the beneficiaries, including urgent care under the pilot program.

Implementation of the pilot will not be subject to public comment; however, UCAOA is hopeful the Agency will look to it as a resource as it pieces together details of the pilot.  UCAOA will report more information about the pilot as it becomes available. 

For more information and background on TRICARE, see UCAOA 2015 advocacy initiatives.

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