Tricare Pharmacy Reductions Hurting You? This GOP Lawmaker Wants to Hear About It

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Pharmacy at Reynolds Army Health Clinic at Fort Sill, Oklahoma.
A patient picks up a prescription from the pharmacy at Reynolds Army Health Clinic at Fort Sill, Oklahoma, Sept 21, 2022. (U.S. Army photo by Monica Wood)

A Republican congressman is asking Tricare beneficiaries to contact him with details about how they will be affected by the recent departure of thousands of pharmacies from the network in an effort to reverse the changes.

Rep. Buddy Carter, R-Ga., posted a form on his website for Tricare patients, as well as pharmacists and health care providers, to give him their feedback after he had what he described as a dismissive phone call with a Defense Health Agency official about the nearly 15,000 independent and community pharmacies that left the network earlier this month.

"It was the worst call I've ever had with a government agency," Carter told Military.com in a phone interview. "They said that they had not heard from anybody -- any recipients or any pharmacies -- about it. So we're taking it to the streets, if you will. We're getting our stories together."

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As of Monday, 14,963 retail pharmacies that used to participate in Tricare's pharmacy network, which is administered by Express Scripts, are gone.

Some independent pharmacies knew they would be dropped from Tricare next year because they wouldn't accept the terms of Express Scripts' contract, which included lowered reimbursement rates. But many were blindsided by the Oct. 24 date, an advocacy group for independent pharmacies told Military.com last month.

The advocacy group, the National Community Pharmacists Association, also sent a letter to Defense Secretary Lloyd Austin earlier this month saying Express Scripts "has created confusion among many Tricare beneficiaries and pharmacies alike" and calling on him to "rectify these problems."

A couple dozen Tricare beneficiaries also reached out to Military.com after it reported on the changes in September to express their shock and disappointment that their local pharmacies were leaving the network.

Last month, Carter and Sen. Tom Cotton, R-Ark., organized a letter that was co-signed by 98 other lawmakers pressing the Defense Health Agency for answers on the changes and expressing concern the reductions will cause "patient access and safety" issues.

Carter has not received a formal written response to the letter, but the call was in response to the missive, his office said.

A Defense Health Agency spokesperson did not respond to Military.com's requests for comment Thursday on Carter's characterization of the call.

In an earlier statement, the agency insisted that the network "will continue to meet or exceed Tricare's standard for pharmacy access" despite thousands of stores leaving.

"Beneficiaries will continue to have many convenient, local in-network options for filling their medications, including those beneficiaries in rural locations," agency spokesperson Peter Graves said in a September statement.

The form on Carter's website has been up for a few days and already received more than 240 responses, his office said. He said he plans to take the responses back to the Defense Department to show that the issue matters to people.

Carter said it particularly affects his constituents because he represents a largely rural district.

"It's impacting everyone, everywhere, but particularly in the rural areas, it's having a tremendous impact," he said.

While Oct. 24 has come and gone, he said he's hopeful the reductions will be reversed.

"These patients -- the veterans, the retirees -- they depend on these people. They depend on their pharmacies, and now you're cutting them out," Carter said. "So it's going to put 400,000 members of Tricare, recipients of Tricare, in jeopardy here."

-- Rebecca Kheel can be reached at rebecca.kheel@military.com. Follow her on Twitter @reporterkheel.

Related: Nearly 15,000 Pharmacies Leaving Tricare in October

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