Hyde-Smith, Colleagues Question Tricare Prescription Changes

Down below is a press release from Senator Cindy Hyde-Smith:

U.S. Senator Cindy Hyde-Smith (R-Miss.) nowadays joined U.S. Senator Tom Cotton in looking for responses from the Biden administration regarding TRICARE beneficiaries’ potential to sustain obtain to nearby pharmacies.

In all, 16 Senators signed a letter to Seileen Mullen, the Acting Assistant Secretary of Protection for Overall health Affairs, which raises concerns about Express Scripts decreasing reimbursements for prescriptions dispensed at in-network retail pharmacies for 2023, which could drive several retail pharmacies out of the TRICARE Pharmacy Method and disrupt service for beneficiaries who rely on unbiased local community pharmacies.

“Pharmacists continue to be just one of the most available wellbeing care vendors in the United States.  Over 90 p.c of People are living within just five miles of a local community pharmacy, and 76.5 {2c3a8711102f73ee058d83c6a8025dc7f37722aad075054eaafcf582b93871a0} of pharmacies in rural parts are impartial local community pharmacies.  As you know, in addition to dispensing prescription drugs and vaccines, neighborhood pharmacies give solutions that guide to much better wellbeing results, lower general administrative costs, and useful in-person consultations with a healthcare supplier,” the Senators wrote.

The Senators’ letter also concerns the early expiration of 2022 pharmacy contracts, which has triggered confusion and disruption for TRICARE beneficiaries who count on impartial local community pharmacies that will no for a longer period staying included in the 2023 TRICARE retail pharmacy community.

The Senators sought specifics on long term retail pharmacy participation in the plan and entry to in-person pharmacy expert services.

“Due to the patient obtain and basic safety problems expressed earlier mentioned, we seem forward to getting your response and operating with you to make certain TRICARE beneficiaries carry on to get the utmost care from trustworthy, nearby wellbeing care specialists,” the Senators concluded.

This inquiry is supported by the Mississippi Impartial Pharmacies Affiliation, Countrywide Neighborhood Pharmacies Affiliation, and the American Pharmacists Affiliation.

Other Senators signing the letter involved Roger Marshall, M.D. (R-Kan.), Charles Grassley (R-Iowa), Steve Daines (R-Mont.), John Boozman (R-Ark.), Marsha Blackburn (R-Tenn.), Shelley Moore Capito (R-W.Va.), John Thune (R-S.D.), Tommy Tuberville (R-Ala.), Jerry Moran (R-Kan.), Mike Rounds (R-S.D.), John Barrasso (R-Wyo.), Deb Fischer (R-Neb.), Mike Braun (R-Ind.), and Cynthia Lummis (R-Wyo.). 


Browse the textual content of the letter underneath.

Pricey Performing Assistant Secretary Mullen,

We produce to request info with regards to the Department of Defense Well being Agency’s (DHA) monitoring of TRICARE beneficiaries’ access to retail and community pharmacies.


It has been introduced to our interest that Categorical Scripts has lowered reimbursements for prescriptions dispensed at in-community retail pharmacies for 2023.  These reductions may well depart lots of retail pharmacies unable to take part in the TRICARE Pharmacy Software, therefore appreciably impacting 9.6 million TRICARE beneficiaries’ accessibility to nearby pharmacies.  Most not too long ago, Specific Scripts notified pharmacies and beneficiaries that recent 2022 pharmacy contracts will expire October 24, 2022, rather than the close of the 12 months.  This will only more cut down the pharmacy community for TRICARE clients and their households, and might pressure beneficiaries to adjust pharmacies at a time when several receive once-a-year vaccinations. 

Pharmacists proceed to be 1 of the most available health care suppliers in the United States.  Over 90 p.c of Us residents dwell within just five miles of a community pharmacy, and 76.5 p.c of pharmacies in rural places are unbiased group pharmacies.  As you know, in addition to dispensing medicines and vaccines, group pharmacies give expert services that guide to far better wellbeing results, lessen over-all administrative expenses, and beneficial in-individual consultations with a health care provider. 

To be certain TRICARE beneficiaries maintain access to neighborhood pharmacies, we respectfully request responses to the following concerns.


  1. How is DHA checking latest and potential retail pharmacy participation in the TRICARE Pharmacy program?
  2. If long term in-network pharmacy participation decreases, what steps will DHA choose to make certain suitable obtain to in-individual pharmacy services for TRICARE beneficiaries?
  3. Terminating the 2022 pharmacy contracts two months in advance of plan will most likely guide to a disruption of treatment for Tricare beneficiaries.  What explanations has Specific Scripts specified DHA for terminating the 2022 contracts early?  Please outline what oversight DHA has above Categorical Scripts, as effectively as what authority DHA has presented Express Scripts to make these agreement adjustments.

Thank you for your notice to this significant subject.  Due to the affected person obtain and basic safety considerations expressed earlier mentioned, we search forward to obtaining your response and performing with you to assure TRICARE beneficiaries continue on to acquire the utmost treatment from reliable, area overall health treatment industry experts.