GAO upholds award of TRICARE contract to TriWest Healthcare Alliance

August 16, 2023

The Government Accountability Office (GAO) has upheld the U.S. Defense Health Agency (DHA) decision to award the TRICARE West region managed care support contract to TriWest Healthcare Alliance, rejecting Health Net Federal Services' (HNFS) second protest over the decision.

DHA initially awarded the new contract in December 2022, but HNFS filed an initial protest with the 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.

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.)

HNFS has indicated it plans to mount a legal challenge over the decision in the U.S. Court of Federal Claims. It is unclear how the suit will affect contract timeline and implementation. TriWest was originally expected to take over the West region beginning in January 2024, but that was delayed until August 2024 following the earlier protests.

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.


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