TriWest Fights Back!

March 27, 2012 | Terry Howell

TriWest announced their intent to file an official protest in response to last week’s news that the Department of Defense will be voiding their TRICARE Western Region  management contract and awarding it to UnitedHealth Group. (see TriWest Losses TRICARE West Contract)

TriWest issued a statement citing several reasons why they feel that awarding the contract to UnitedHealth Group was inappropriate. Here are some of the reasons cited in TriWest’s press release:

  • “…United’s extensive track record of problems with consumers, providers, beneficiaries and government enforcement agencies.”
  • TriWest’s price was significantly lower than UnitedHealth Group’s price.
  • Making the change will cause a disruption in services and will cost the “taxpayers hundreds of millions of dollars.
  • The government disregarded hundreds of millions of dollars in healthcare cost savings through discounts guaranteed by TriWest.
  • UnitedHealth Group has no experience providing military health care. TriWest has been providing excellence in military health care for 16 years.

The following is official press release announcing TriWest’s intent to protest the DoD’s decision.

Source: TriWest Healthcare Alliance

TriWest Healthcare Alliance announced today that it will protest the Department of Defense award of the TRICARE contract to provide access to health care for America’s military families in the 21-state TRICARE West Region, to UnitedHealth Group. TriWest has held the contract for 16 years. TriWest was initially awarded this most recent contract in July 2009 and underwent a lengthy protest process led by UnitedHealth Group, which led to a rebid of the T-3 contract in August 2011.

“On March 16, the U.S. Department of Defense made an inexplicable decision to award the TRICARE West Region contract to a subsidiary of UnitedHealth Group, a company with a long history of performance problems and legal issues, and with no history of providing health care to the military,” said David J. McIntyre, Jr., President and CEO of TriWest Healthcare Alliance. “Due to what we discovered in the government’s debriefing, TriWest will exercise its legal right to challenge this decision, with the goal of winning back the contract and continuing to provide military personnel, retirees and their families in 21 western states with the healthcare coverage they deserve and value.”

“As taxpayers, we welcome competition and believe that the government should purchase goods and services using a fair and lawful process. However, based on the debriefing, we believe that the government’s decision in awarding the TRICARE West Region contract is the result of a flawed and unfair process.  Among the key mistakes, we believe that:

  • The government failed to conduct a sufficient and reasonable evaluation of UnitedHealth Group’s proposal, the risks that it poses to military health care, and United’s extensive track record of problems with consumers, providers, beneficiaries and government enforcement agencies.
  • TriWest’s price was significantly lower than UnitedHealth Group’s price.
  • Due to significant disruption, it will cost the government and taxpayers hundreds of millions of dollars simply to change contractors.
  • The government disregarded hundreds of millions of dollars in healthcare cost savings through discounts guaranteed by TriWest.
  • UnitedHealth Group has no experience providing military health care. TriWest has been providing excellence in military health care for 16 years.
  • The government failed to adequately analyze the areas where transition risk might negatively impact beneficiaries and providers, and how to sufficiently avoid the negative past history of transitions from one TRICARE contractor to the next.”

“We owe it to those who put their lives on the line to protect our country to make sure their health care is the best it can be and is provided seamlessly to service members and their families. In today’s environment, it is unnecessarily disruptive to military families and the quality of their health care to be forced to change established relationships with trusted health care providers. Some will lose their doctors or have to pay more to keep them,” McIntyre added.

TriWest is honored and privileged to serve 2.9 million beneficiaries –  including active duty personnel, retirees and their families – and has more than 175,000 healthcare providers in its 21-state network. It employs 1,700 employees, many of whom are veterans, reservists and their family members. The current TRICARE contract continues through March 31, 2013.

# # # #

Stay tuned for further details.

 

About Terry Howell

Before becoming the Managing Editor for Military.com, Terry served 20 years in the U.S. Coast Guard as an Aviation Electrician’s Mate and aircrewman. In his final role in the Coast Guard, Terry served as a Career Development Advisor, where he provided career, finance, education, and benefits counseling to servicemembers and their families. Since retiring from the Coast Guard, Terry has authored the book, The Military Advantage, managed the content for TurboTap, the DoD's online transition program and VAforVets, the VA's transition assistance website. Terry earned both his Bachelor's and MBA at Corban University using Military Tuition Assistance and his GI Bill benefits to help cover the cost.

Comments

  1. G. Padilla says:

    My husband is military retired and Tri West is outstanding. He has had several surgeries and I came down with a rare cancer of the nose. They have paid all are bills. Tri West has been very good to us. Please we need Tri West.

  2. Ben Frickosn says:

    All our Senators need to know about this unjustifiable move by DOD. We, the Veterans have had excellent service from TriWest and it's rated 85 of 100, where DOD picked United Health Care that is only a mere 25. Any fool can read the complaints on I.N. and see how poor United is. DOD does not look out for any Military or Veterans. There history proves it. Buy again from China.

  3. Maria Adams says:

    AHEM to both comments. I find it pretty irritating that congress always wants to stick their nose where it doesn't belong. Why change something that has worked well for so long?

  4. Galen Pearson says:

    TriWest is the best; it would be difficult to find a company that could offer the excellent service they do.

  5. TriWest’s price was significantly lower than UnitedHealth Group’s price.

    The difference in price is probably what United will use to pay off the ones who made this stupid decision.

  6. Michael Schoenhals says:

    As a physician providing care for patients in Arizona I have had many issues with UnitedHealth Groups business model. I most certainly do not want to deal with it from the consumer end of things now that I am retired military!

  7. Go for it and don't let them get away with it. triWest has been good to us as retirees. I wish those that decide this have to have the same coverage as the military and the veterans. Why do they always have to pick on the military? Please try as hard as you can to fight for us Tri West we need your coverage.

  8. Gary Van Maanen says:

    Please keep Tri-west just has it has been. they have been the best service and we do not need to make changes. Because I just know in the long run it wil cost US military retirees more money. Stop spending more money.

    PLEASE JUST KEEP IT AS IT IS Stop always makeing changes

  9. Bob (USN(ret)) says:

    Every DOD contractor when they lose a contract they challenge it and it goes into legal limbo costing the govt millions of dollars. This cost which in turn will result in money being pulled from benefits from dependents and retirees and making dependents and retirees to have to pay more to offset the increased costs!

  10. Bob Fritz says:

    This seems a really bad move. TriWest has taken care of us very well and gone way beyond its contract requirements when they saw a need (e.g., putting mental health professionals in many armories when RC units returned from deployment). And United Healthcare has a really poor track records with its civilian customers.

  11. Stephanie Clopeck says:

    I am in the military, and have two kids in the TRIWEST region. TRIWEST has ALWAYS been very responsive and helpful for EVERYTHING dealing with my kids. I am scared as **** of the thought of the switch, and see absolutely NO reason. If some Bureaucrat or politician wants to get his/her name in the press by changing something, change something that will not mess with our servicemembers lives and families well-beings!

  12. Hickelbilly says:

    The four types of health care are the same worldwide no matter what. 1. Poor who get well or die quickly. 2. Low Class who get well or die as soon as the insurance runs out. 3. Upper class who get well or die as soon as they are in deep debt. 4. Rich who sometimes gets well before the wealth is gone.

  13. K. Worthington says:

    It wasn't broken and didn't need fixin'. Of course the Govnt. should go out for bids or quotes occassionally just to be sure the pricing is correct but if United was HIGHER than Tri West…… oh wait…. key word is Government.

    Since my husband retired in 1991, we have had absolutely no problems with TriWest. Matter of fact on one bill from a doctor's office Blue Cross & Blue Shield wouldn't pay or authorized a major portion of the bill. I contacted the Dr. office and reminded them to bill TriWest. I was informed that since BC&BS wouldn't pay it then TriWest wouldn't pay it. Contacted TriWest and was told they would pay and gave me a number to have the Dr. office call them. It was paid.

  14. Triwest has done good for my family and I. i know it works, why change

  15. Never had a issue with TriWest – Is crony capitalism at work here?

  16. L. Grable says:

    We Need and want Tri West !!!!!!!!!!!!

  17. SFC Hawkins` says:

    As a retiree, TriWest has consistently provided me with outstanding coverage and customer service! Absolutely flawless! I am seriously concerned (scared to death) DOD has made the decision to exchange TriWest's quality military healthcare benefit with this allegedly shoddy, more expensive/albiet shoddy, badly performing Health Group bunch. SOMETHINGS FISHY!! PLEASE FIGHT HARD, TRIWEST!! WE NEED YOU!! PLEASE.

    • pointluck says:

      SFC Hawkins – You can help too, by writing your Senators and Congressman, and tell them your experiences, and outrage that the DoD has awarded the new contract to United, who has no experience in TRICARE; has a track record for poor customer service; along with millions of dollars of fraud claims. And most importantly, mention how TriWest's bid was over $200 million dollars LOWER than United's!! Tell them how unacceptable this is, especially in light of the current Administration's focus on cost cutting, and how they are raising TRICARE premiums for all Veterans.

      • SFC Hawkins` says:

        I have written to Senator Patty Murray (D:Washington) in great detail. I have also contacted my Primay Care Hospital (Swedish) and they are prepared to participate as well.

    • 'Sgt Spoon says:

      Sergeant Hawkins, I share your feelings about TriWest. And yes Scarlet…something is very smelly, be it fish or the crooked loser-in-chief in the WH or his fiancier…G Soros.

      Thanks to all the folks we've spoken with, exchanged e-mails with or talked with on the phone. Life is frustrating when health issues crop up and TriWest has dealt most fairly with the care/concerns for both me and my wife. Still working to recover from an ultra rare carcinoma and TriWest made that nightmare's treatment possible.

      America's servicemen and women within your area of responsibility need, count and depend on you. I sincerely wish 'you' the utmost in overturning this aggregious ruling with the award of your contract to another. Damned ObummerScare!

  18. TriWest has done an outstanding job and as usuall it sounds like someone in the Defense department has a friend at United Health I would ask for an investigation of the award by the IG

  19. Delores Easthom says:

    The same thing happened to our family when tri-care changed and took Walgreen's pharamacy off their list of providers. I live 2 blocks away from Walgreens, have had 5 strokes, which left me with no perifial vision. I don't drive, so it is really a hardship. Our main contractor was in charge of the East Coast. I live in Florida, and this is a military town. Lots of dependents are harmed by this action. It was Express Scrips, I believe.

    • Express Scripts and Walgreens quit contracting with "each other" …. I have civilian health insurance that uses Express Scripts as their PBM and I cannot use Walgreens either. It has nothing to do with Tricare.

    • You can order your prescriptions thru the mail with Express Scripts and they will deliver them to your door every 90 days- and if you use generics they don't charge you. I would give them a call, it could benefit you.

  20. VegasSmitty says:

    My neighbor has United Healthcare and it seems to be a constant battle for them to get anything approved. Tricare works, why are the folks in D.C. trying to change, sounds like good old fashion bribery to me!

    • Janice1 says:

      Amen….. your neighbor is right. I have dealt with United Healthcare. Three years of denials, denials, denials before they would approve even basic needs. Leave us military alone!

  21. After reading all the comments, I keep seeing the same thing. Tri-West is the working the best for everyone and I so agree. My concern is about the $200 Million difference in the bid. Are we not trying to save money for the Government? I do not understand how they can award a contract to another company that is charging so much more for their bid. Oh wait, I forgot for a minute that I’m tolding aobut Government.

  22. Anj Himes says:

    Triwest has staff that actually care about our healthcare issues. They don't fight the docs when you need specialized care. If it weren't for Triwest I probably wouldn't have the level of care that I have had for my brain tumors and I woudn't be here today to say that they care and do an outstanding job!!!

    • Thank you for writing. TriWest is the best. United Health is a medical insurance company from hell.
      Praying for your health.

  23. That's how the Government works with contracts, Military members get used , abused and screwed for some cut rated contactor. TriWest been fair with me and my spouse. So the Government want to go cheap!

  24. Don Soltman says:

    As a civilian working in a coal mine in Wyoming, I had United Health Care. Is this the same group the government wants to give the TriWest contract to ? They were a really good company as far as I'm concerned. However, I have been quite happy with tri west except for their not covering some of my son's costs. I am a 61 year old retiree, with a 5 and 9 year old boys. If I did not have medicaid, I'd be in alot of financial trouble. The nine year old has autism and is a handful. I can't see a 200 million increase to a new company to handle things unless there is a proportionate increase in healthcare to us as beneficiaries in increased benefits with no increase in costs to us. Or at least a negligable increase in costs to us. Lets get a side by side comparison of benefits and premium costs . Here in Laramie, I'm using the same doctors with Tricare as I did with United Health Care.

  25. Karen House says:

    I have always been happy with the help I have gotten from TriWest. I wish you would rethink your decision to go with another company.

  26. You would think a congressman or senator would challenge the decision on this one. I have to agree Triwest has been the best. I would have liked to see the performance ratings and who was on the evaluation board in this decision making process. If I was Triwest I would protest as well.

  27. Keep TRI-West I am the widow of a retired Army Officer live here in Casper, WY. Have never had any trouble with Tri-West. I am diagnosed with a rare condition called Alpha-1 Antitrypsin Deficiency(a lung disease that culimates from not enough protein in the liver to protect the lungs hence emphysema.This is an inherited disease. I have a weekly infusion of Prolastin (protein) each week and this considerably costly and I have never had a problem with Tri-West paying for it. I shudder to think what might happen if United-Health Care takes over. I know Medicare won't pay for it!!!

  28. TheLostDutchman says:

    I would like to join the others in voicing my support for Tri-West. As a retiree living in Arizona and a cancer survivor, my medical needs have been many and varied. I have the highest regard for Tri-West.

    Many of us who rely on Tri-West have already done our time and paid our dues. We are getting older and have greater needs for stability in this everchanging economy that has left our lives in a state of flux. Making major changes in our medical care and our provider network will cause major upsets and needless psychological and emotional distress at a time in our lives when we are most ill prepared to deal with them. Stop screwing with our quality of life – our lives are filled with enough problems and worries! The General Services Administration needs much more oversight. Send your watchdogs and bean counters over there. Tri-West is working exactly as it should. PLEASE leave Tri-West alone! Leave US alone! We've been screwed with enough!

  29. Tom Hart says:

    As a cancer survivor and heart attack survivor I can attest to the excellent services provided by TriWest. After 22 years of active service I have used TriWest for all my health needs and have never encountered any problems with either treatment or medications. As the saying goes "if it ain't broke, don't fix it". UnitedHealth Care is comparable to most chinese products; cheap, and very poor quality;

  30. United Healthcare is TERRIBLE if you have ever dealt with them.

  31. Alicia poindexter says:

    I have had Tricare for over twenty years and never had a problem. My daughter has United Health and have had nothing but problems? Tricare is a blessing for Military Retirees?

    • Robert Craig III says:

      You must live near a military base and not out of the area. I have had nothing but problems with Tricare on the West coast.

  32. Ann Parish says:

    how can I become a member of Tri Care? My husband was in the Army for 2 years 1952-1954

  33. We lived in Monterey Ca. and had Tri West. The doctors they sent me to were horrible. One even fired me, saying I was too complicated. One never touched me till my 5th visit just handed out drugs they didn't even have a nurse the front desk womwn took my blood pressure. A pain docctor they sent me to injected sugar water into a scar to help my nerve pain. They sure don't really look at who they have as providers.

  34. Had United as a HMO from the School District I worked for after retiring, and the problems were many. The bigest was i had to go to there specalist instead of ones I had used for years.

  35. I have UHC coverage via a state employees health plan. I would change to an alternative, but the plan and the competing insurance companies fail to give you a valid coverage comparison document during the change period, and what they do have is subject to major change as soon as coverage begins. I suspect that the size of UHC allows it to do extensive lobbying.

  36. I have had TriCare for years and am quite happy. United health care will cost me significantly as I would have to absorb more than 25% of my medical costs of the original bill and my co-pay would also be much higher. It astounds me how the government would contract with a company United that would cost more and provide less adequate services than contine contracting with the company TriCare that has provided excellent services, fees, and doctors of our choice. TriCare needs to stay as our military and retired personnels medical insurance provider .

  37. I have had United Healthcare in the past. PLEASE dont change to them! Never an issue with Triwest! Great co-pays and never trouble getting things covered. Our veterens deserve to keep this great insurance.

  38. Bill-Eileen says:

    Transition went VERY poorly. When United Health took over they assigned me a new PCP…I was happy with the one I'd been using for 10 years BUT their paper work had been accepted yet. The new PCP had moved out of state three months before I was assigned her. Not just out of state, more than 1500 miles away. United Health has been told this four times over the last five months and they have yet to change.

    TriWest was great, no problems in the 25 years.

  39. Janice1 says:

    Did you contact your Congressman/woman? I am sorry you have had trouble with Tricare. It has been wonderful for us. Amen. If you think Tricare is awful just wait until the change to United Healthcare occurs. They are a health insurance company from hell. They specialize in denials and hired people programed to be ugly!
    Thanks to you and your family's service.
    I wish I knew how to help you.

  40. TriWest (the contractor) does not grant or cancel coverage. This must have been a TriCare (government) decision. I agree with the previous comment. Contact your congress.

  41. Have you tried faxing in an official appeal? You can do that and they usually will reinstate you.

  42. Jess mg,

    Please write a letter to TriWest customer relations asking for reinstatement. Explain your hardship to them. They are a very fair company. Don't call, write! Do so as soon as possible. You could even fax your letter to them.

  43. Call this number: 253-572-2888
    This is for Joan Lamb at TRO West.
    I was in a similar situation and she helped me get retroactively re-instated.
    It took me 3 months of bureaucracy and red tape to get that number.

  44. Contacting your Congress, will get you nowhere. And Martin is speaking the truth about TRICARE and government decision, to a point. If you take a few minutes to write a letter explaining your hardship, send it to TriWest customer relations, the reinstatement decision is ultimately made by governing officials of TRICARE. Please do so as soon as possible.

  45. Robert Craig III says:

    You have obviously ignored the rising cost of medicine and the increasing size of the formulatory list of medicines since the Health Care Initiative preparations have begun.