June 07, 2023
Health Net Federal Services (HNFS), the current contractor for the TRICARE West region, has filed a second protest over the federal government’s decision to award the new TRICARE West region managed care support contract to TriWest Health Alliance. This move may further delay the transition, currently planned for August 2024.
The U.S. Defense Health Agency (DHA) initially awarded the new contract in December 2022, but HNFS filed an initial protest with the Government Accountability Office (GAO). Although that protest was dismissed in April after DHA reconsidered and then reaffirmed the award of the TRICARE West region managed care support contract to TriWest Health Alliance, HNFS filed a second protest. GAO has until August 9 to render a decision on the subsequent protest. TriWest was originally expected to take over the West region beginning in January 2024, but that was delayed until August 2024 following the earlier protest.
Under the new contract, TriWest will be the contractor that facilitates beneficiary health care in the civilian sector and provides administrative support services to Tricare beneficiaries throughout the 25-state western region, which includes California. (Six states will be shifting from the east region to the west region beginning in 2024 to balance to the TRICARE population each regional contractor manages.)
The California Medical Association will be closely monitoring the transition, and will provide more information as it becomes available. Physicians can also sign up for email alerts from TRICARE to receive information about the upcoming changes.