April 03, 2017
Area(s) of Interest: Practice Management 

As previously reported, the Department of Defense awarded the $17.7 billion TRICARE West Region contract to Health Net Federal Services (HNFS). As the recipient of the contract, HNFS will provide managed care services to 2.9 million TRICARE beneficiaries in 19 western states, including California, beginning October 1, 2017. 

In preparation for the transition, Health Net has sent recruitment notices to physicians soliciting interest in participation in the new Health Net Federal Services (HNFS) West Region network.

Included in the recruitment packet is a “Join our Network” form. Physicians interested in joining the HNFS network should return the completed form to HNFS via email, fax or mail. According to Health Net, submission of the “Join our Network” form is only an expression of interest and does not obligate the physician to participate. HNFS will then mail the physician a contract offer approximately 72 hours after receipt of the completed form. Physicians will have the opportunity to review the contract terms before making a final decision.

Physicians should be aware that terms of the HNFS contract may vary from the prior United Healthcare Military and Veterans (UMVS) TRICARE contract. Providers are encouraged to closely review the proposed contract terms.

The California Medical Association (CMA) is in the process of reviewing the HNFS contract and will publish an update as soon as more information is available.

During the 2013 transition of TRICARE managed care services from TriWest to UMVS, a CMA survey found widespread reports of problems, including contracting issues and significant delays in processing of authorizations and referral requests, which delayed timely access to medical care. CMA has shared feedback with HNFS on the flawed transition to UMVS. HNFS advised that it has been a continuous TRICARE administrative contractor for 28 years, has an existing medical management system in place in the North Region that it will be utilizing and that it, along with the Department of Defense, is taking proactive steps to ensure the transition goes smoothly. CMA will work closely with HNFS on the transition and will be publishing a TRICARE transition guide to provide assistance to physician practices.

Physicians with questions regarding the TRICARE amendment may contact HNFS at HNFSProvRel@healthnet.com.