U.S. Senator Patty Murray (D-WA) and Representative Rick Larsen (D-WA 2nd District) wrote a joint letter last week to Secretary of Defense Robert Gates and Under Secretary of Defense for Personnel and Readiness David Chu in support of a proposed regulation that would increase TRICARE payments to Critical Access Hospitals to a level similar to that of Medicare. This rule, if approved, would significantly benefit Whidbey General Hospital, a Critical Access Hospital in Coupeville, Washington.
“This change will bring real relief to Whidbey General and to the many Critical Access Hospitals that provide medical care to a large portion of active military personnel, veterans, and their dependents,” Murray and Larsen wrote in their letter.
Whidbey General serves a large portion of military service members, veterans, and their families on Whidbey Island. With the October 2007 reduction of Naval Air Station Whidbey Island’s emergency care services, Whidbey General has been increasingly relied upon to provide the military community with the care they need.
Because TRICARE – the military's medical benefits program - has been reimbursing Whidbey General at a low rate, the possibility that Whidbey will stop serving TRICARE beneficiaries has become reality. Aligning TRICARE payments with Medicare rates will allow Whidbey General to continue to provide health care to the military population.
"Whidbey General values the relationship we have with the U.S. Navy and its personnel and dependent families," said Scott Rhine CEO of Whidbey General. "They are part of our community and we wish to serve them. We appreciate the support of local and national defense leaders in understanding the dilemma of smaller, rural hospitals. Their willingness to actually put in place the Critical Access Hospital reimbursement model for small hospitals providing care to TriCare patients will insure increased access to needed care in rural areas."
"We appreciate the leadership of Senator Murray, Rep. Larsen and other Members in supporting the effort of TRICARE officials to correct an inequity in the reimbursement of Critical Access Hospitals, which are so important in meeting the health care needs of military families across the country." said Dave McIntyre, CEO of TriWest – which provides TRICARE coverage for residents of Whidbey Island.
The regulation has been cleared by the Department of Defense and still needs to be reviewed by the Office of Management and Budget and subjected to a public comment period.
“I am committed to ensuring that Whidbey General can serve the needs of our veterans and service members," said Senator Murray. "I look forward to seeing this rule change through to implementation.”
“This proposed rule change will help Whidbey General keep their doors open to local veterans and military families,” said Congressman Larsen. “The community has been waiting a long time for this.”
The full text of the letter Murray and Larsen wrote follows:
January 31st 2008
The Honorable Robert M. Gates The Honorable David S. C. Chu
Secretary of Defense Under Secretary of Defense
1000 Defense Pentagon Personnel and Readiness
Washington, DC 20301-4000 4000 Defense Pentagon
Washington, DC 20301-1000
Dear Secretary Gates and Under Secretary Chu:
We are writing to address TRICARE reimbursement rates to hospitals serving rural areas. We have a strong interest in maintaining access to the highest quality health care for servicemembers and veterans, as well as for their dependents. This is especially true for those who need access to health care in rural areas.
As you know, Congress established the Medicare Critical Access Hospital program in order to ensure needed health services are available to Medicare beneficiaries in rural areas. Although TRICARE payment policies generally seek to follow Medicare formulas, this is not the case with respect to payments to critical access hospitals. TRICARE reimbursements to critical access hospitals have been historically lower than those of Medicare and Medicaid, and we are concerned about how this affects the ability of critical access hospitals to provide top quality health care to the military community.
A number of hospitals in our state are affected by these lower payments. We are specifically concerned for the continued ability of Whidbey General Hospital, a critical access hospital that serves the military community on Whidbey Island, to continue to provide TRICARE services. Whereas Medicare and Medicaid reimburse Whidbey General at approximately 56 percent and 55 percent of charges, respectively, payments from TRICARE average only 39 percent of charges. Whidbey Island is home to Naval Air Station Whidbey Island and is a popular location for military retirees. Since the October 2007 reduction of NAS Whidbey's emergency care services, Whidbey General has been relied on to provide care to an even larger segment of the military population. They have done this despite low TRICARE reimbursements that have a serious budgetary impact on Whidbey General and may lead to Whidbey General eliminating their TRICARE contract.
We understand that DoD is in the process of approving a regulation that would increase TRICARE reimbursements to critical access hospitals to a level similar to that of Medicare. This change will bring real relief to Whidbey General and to the many critical access hospitals that provide medical care to a large portion of active military personnel, veterans, and their dependents. This assistance is needed to help ensure that critical access hospitals continue to provide TRICARE services to the military community, and we commend your efforts. We look forward to the timely implementation of this regulation and the release of the draft rule as soon as possible. Should you need our assistance in this process, please feel free to contact us at any time.
Patty Murray Rick Larsen
United States Senator United States Congressman