FLORIDA – Two Florida congressmen wrote a letter to the Defense Health Agency asking why there are reimbursement failures for local community care for active military members and their families.
U.S. congressmen Aaron Bean (FL-04) and John Rutherford (FL-05) wrote the letter to Dr. David J. Smith, the acting director of the DHA. They said the delays to TRICARE East beneficiaries are impacting veterans in Northeast Florida, military families, and medical providers.
The letter reads in part:
We have heard from countless concerned constituents that the new T-5 contract has had a severe impact on our military families and community medical providers. Providers across the nation have reported millions of dollars in unpaid or unprocessed claims. TRICARE beneficiaries are experiencing unfathomable delays. This crisis has put smaller practices at risk of shutting down, jeopardizing access to care for thousands of military families across the country…Additionally, we are hearing from providers who serve TRICARE beneficiaries that they are already notifying patients that their services will be greatly reduced or discontinued. For one clinic, TRICARE patients comprise roughly 30% of their total patient population and they are owed around $100,000 for unpaid services. With providers not being reimbursed, small businesses with a heart for serving military and veteran families are at risk of shuttering.
U.S. Congressman Aaron Bean (FL-04) and U.S. Congressman John Rutherford (FL-05)
Among the questions the congressmen asked are: when the delays are going to be resolved, how many beneficiaries are expected to lose coverage, what’s being done to proactively reach out to them, and what’s being done to ensure the delays don’t happen again.
Bean talked about the first time he got calls about TRICARE not making payments.
“It’s something happening not only to our office but communicating with Congressman Rutherford, so people are worried about not just getting their own healthcare needs met but their family members too,” Bean said.
MAPS Integrated Wellness in Fernandina Beach helps active duty military, their families, and veterans. Office manager Beth Matricia talked about the challenges they’re facing.
“So it’s actually TRICARE East as a whole, both active duty and retired so it’s all of the above,” Matricia said.
She added that the problem started Jan. 1, 2025, when new TRICARE contracts started. She said they weren’t warned and payments just stopped coming.
A military patient goes to a medical company for a service like medicine or therapy. The vendor gets paid for the service, but the problem is that TRICARE has not been paying its vendors.
“[TRICARE] owes us about at least $100,000,” Matricia said.
This impact hits home for people who need help.
“Your kiddo has ADHD and they can’t get their medication, now they’re going to start failing out of school, they’re suicidal, they can’t get their antidepressants, it’s a big deal,” Matricia said.
She reached out to Congress and they’re starting to get payments, but TRICARE still owes them money.
In the meantime, Bean said this is putting local businesses at risk and needs to be fixed.
“These vendors which are small businesses, when they don’t get paid when 30%, 40% of their business is from the Department of Defense it’s hard to stay in business,” Bean said.
We want to hear from you. How have you been affected by the delayed reimbursements? Let us know below.
Click here to read the full letter.
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