Staff News & Announcements
New: Transitional Care for Service-Related Conditions
The Transitional Care for Service-Related Conditions (TCSRC) Program began on 1 November and it
extends TRICARE coverage to former active duty, Guard, and Reserve members for certain
service-related conditions beyond their regular 180-day TAMP coverage period.
Learn more about TCSRC.
TRICARE Pharmacy Program Update
As the Department of Defense implements the new combined TRICARE Pharmacy Services contract,
there are some things you may need to be aware of.
- The number of network SPECIALTY pharmacies decreases from 220 to 130. Approximately
2,200 beneficiaries will be impacted by this decrease; however, access to specialty
medications hasn't changed. Affected beneficiaries were notified of the change by mail.
Beneficiaries may contact ESI for assistance in finding a new network specialty pharmacy or
for assistance in transferring their prescriptions to the mail order pharmacy.
- The combined contract improves oversight of the pharmacy benefit, including strict
enforcement of prohibitions against cost sharing prescriptions written by sanctioned or
suspended providers. The TRICARE Operations Manual Chapter 13, Section 6, outlines how
sanctioned and suspended providers are treated. Section 6 outlines the authority given
to the Department of Health and Human Services (DHHS) to impose exclusion from all
Federal health care programs, including TRICARE. Failure to comply with DHHS exclusion
is a violation of Federal law and may subject ESI and the Government to penalties/fines.
Prescriptions from a sanctioned provider won't be cost shared after 4 November.
Affected beneficiaries were notified of this situation by mail.
- The Over-The-Counter (OTC) Medication Demonstration Project will continue for another
year but copays under the program will change from zero to the generic copay. After
4 November beneficiaries starting therapy on one of these select OTCs will need a
prescription from their provider. Due to contractual limitations ESI can't send letters
to beneficiaries with active refills for OTCs covered under this program until 4 November.
New TRICARE Pharmacy Services Contract Awarded