Military Insurance Binding Vets

May 29, 2008
Virginian-Pilot

Across America, soldiers, veterans and their families are running into red tape and roadblocks when they try to use their military insurance to get treatment for ailments such as post traumatic stress disorder.

Since 2003, about 40,000 troops have been diagnosed with PTSD. The number of cases rose by roughly 50 percent in 2007, according to Pentagon statistics released Tuesday.

The deployment of hundreds of doctors and therapists to Iraq and Afghanistan and the shortage of military health care providers has forced patients at U.S. installations to wait for months for appointments - and longer if they need to see a specialist, according to advocacy groups for members of the military and their families.

Meanwhile, civilian doctors and psychiatrists say they’re often faced with tough decisions about whether to turn away patients on Tricare, the Defense Department program that insures 9.2 million current and former service members and their dependents, because its reimbursement rates are low and its claims process is cumbersome.

Others volunteer their time and services rather than navigate Tricare’s red tape for what might ultimately prove to be a small reimbursement for services.

“We do have a lot of doctors who are seeing Tricare patients almost on a pro bono basis because they care and for the love of their country, b ut it’s easier to do that if it’s a dozen patients than if there are 100 patients,” said Steve Strobridge, the director of government relations at Military Officers Association of America.

Tricare’s reimbursement rates are linked to Medicare levels. Health care providers who treat patients on both programs will take a 10 percent pay cut July 1 and a second 5 percent, pay cut Jan. 1 .

“We want to do our patriotic part and take care of our military population,” said Dr. Mitchell Miller of Virginia Beach, who sees patients from a number of the area’s military installations. “I’ve already frozen my Medicare population, and I’m about to freeze my Tricare population. It doesn’t sit well with me to have to turn away people who have served our country, but it’s an economic reality. It’s an American tragedy, really.”

There are currently 742,944 Tricare beneficiaries in Virginia, a large proportion of whom are in Hampton Roads, said Austin Camacho, a Tricare spokesman. That includes active-duty and retired military as well as their families.

“Very few” of the primary care physicians in Sentara Medical Group, Hampton Roads’ largest physicians group, accept Tricare because of its low reimbursement rate, said Kim Van Sickel, a Sentara spokeswoman.

Sentara Medical Group includes more than 360 physicians, although not all of those are primary care physicians, Van Sickel said.

While physicians such as Miller will continue to see current patients on Tricare, many others are refusing to accept new patients.

The Department of Defense long has been aware of both the physician shortage and patient and provider complaints about Tricare.

During a recent American Psychiatric Association annual meeting in Washington, Col. Elspeth C. Ritchie, a psychiatry consultant to the Army’s surgeon general, pleaded with mental health care providers to consider joining the military or at least accepting Tricare.

Last year, a Pentagon mental health task force found that a Tricare office near Fort Campbell, Ky., the home of the Army’s 101st Airborne Division, often gets complaints from patients who have a hard time finding therapists who accept Tricare.

This story was compiled from reports by McClatchy News Service and staff writer Nancy Young.

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Many of the 742,944 Virginia beneficiaries of the military insurance Tricare live in Hampton Roads, but very few primary care physicians in the region accept it because of its low reimbursement rate, health officials say. cut in rates

Tricare’s reimbursement rates are linked to Medicare levels. Health care providers who treat patients on both programs will take a 10 percent pay cut on July 1 and a second, 5 percent pay cut on Jan. 1 .

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