Post your personal experiences!

Some have started to post their personal experiences as comments to other blog entries. Let’s try to put them all together in one place so everyone can see what TRICARE Management Activity (TMA) is really doing to us. Don’t be shy or ashamed. We are all in this together and are suffering at the hand of TMA. We need to go public and in some detail explain how we have been discriminated against and the suffering and lack of care that result from their actions against military retirees, their families and survivors. If we get enough, maybe someone that can do something will see them and take some action.

TMA and ISOS Caught with Their Pants Down Once Again!

Other health insurance (OHI) is very common among TRICARE beneficiaries and has been for 20 years. Its existence and how to handle the process is something that even the most junior of TRICARE Management Activity (TMA) employees should know about and those employees that write the specifications for contractors and programs such as the Demonstration should be well aware of OHI if they are in the least bit competent.

Be Very Careful with Your Signature and the Demonstration

The TRICARE Management Activity (TMA) likes to blame TRICARE beneficiaries in the Philippines for all their past and current failures with fraud. They like to tell Congress that 77% of all beneficiaries in the Philippines are on “prepayment review” with the implication that the vast majority of us are suspected of defrauding TMA and the taxpayer; we have TMA letters to Senators stating this. This claim becomes problematic and fall apart when one considers that almost 77% of retirees recently indicated in our survey that they don’t even file claims due to the extreme difficulty in complying with the numerous technical requirements. Even if we assume our survey was off and only 25% don’t file claims the assertion that 77% are on “prepayment review” is still obviously an exaggeration by TMA intended to dissuade Congress from listening to any of the “defrauding” retirees in the Philippines as that would mean that every beneficiary that files claims is suspected of fraud. Put another way, out of 11,000 beneficiaries in the Philippines, TMA implies 8,470 retirees, widows, wives and children are suspected of defrauding them.

Military Retirees are Extremely Happy with Their TRICARE Benefit in the Philippines

At least that is what the TRICARE Management Activity (TMA) claims.

TMA tends to live in a world isolated from beneficiaries and hiding behind their contractors who feed them touchy-feely and feel good fairy tales. We need to break through that isolation and touchy-feely relationship that TMA has with their contractor. See our latest Newsletter that addresses what we need to do. Be sure to spread the word to your neighbors and friends as well. See Military Retirees are Extremely Happy with Their TRICARE Benefit in the Philippines.

The TRICARE Management Activity Contract Staff Have Significant Problems

Well, well, well. This may go a very long way in explaining why beneficiaries in the Philippines have to suffer with a contractor that can’t and hasn’t for years met significant portions of their contract in the Philippines and most recently with the Demonstration. In essence we have a contractor without the proper controls or monitoring.

Baypointe Accepting Patients Again

We have two individuals that confirmed Baypointe is now accepting patients again; a third individual did not respond to our inquiry requesting confirmation that originally reported the closure.

Given the many issues with the Demonstration design and implementation, we expect that facilities and physicians will drop out as Baypointe did and is likely to do again.

After Action Report, ISOS Demonstration Teleconference

The April teleconference was conducted on 25 April 2013. Initially there were 12 local participants but this time only 4 called in and one of them called in late to the call. Our feeling is that people do not feel ISOS and TMA are being open and receptive but more dictatorial and arbitrary in what can be discussed and then avoiding clear and straight forward answers in favor of innuendos, vague non-committal responses or avoiding the question or issue all together by responding with an irrelevant comment. As we have said in the past, TMA are the masters at spin where you can ask why the sky is blue and they will respond with a discussion about cloud formations; it seems their contractor has been taking lessons.

Of note was my question that dealt with the filing of claims in cases where beneficiaries paid 100% of the cost of the care. This was the second time around for this question and while we didn’t let them avoid the questions as they did the first time around they still refused to provide clear and straight forward answers, relying instead on more innuendos and “it’s not your business” comments. See ISOS Demonstration Teleconference 25 April 2013 for the complete after action report.

International SOS is Once Again Dumbfounded Over Local Health Care Industry Practices

Between International SOS’s (ISOS) lack of real feet on the ground and their local hires that are poorly trained in TRICARE and know even less of the local industry, they were once again dumbfounded when we brought to their attention that Demonstration providers were throwing TRICARE beneficiaries out on their ear if they discovered they had Philhealth, telling them they were not eligible to use the Demonstration and had to pay cash and submit their own claims; we know of at least two instances of this discrimination fostered on beneficiaries because of ISOS’s  lack of forethought and lack of qualified people working on the experiment.

More Providers Leaving the Scene; Baypointe & Thirteen Physicians

On 15 April 2013 ISOS announced, via their Approved Provider list, that 30 providers were no longer approved providers and was a significant loss amounting to almost 25% of the list.

Last Friday, 04/19/13, we got word that Baypointe Medical Center and associated doctors had also dropped out and that was confirmed by yet another source on Monday. That reduces the available hospitals in Olongapo to one facility that is known by most as the “Place you go to die” and is dirty and not an adequate facility for any TRICARE beneficiary to use, see http://www.youtube.com/watch?v=BOQAVfgf7yQ. This also eliminates Endocrinology, Hematology, Obstetrics & Gynecology and Ophthalmology as available specialties in Olongapo and will require that ISOS immediately add them to the Approved Specialty Waivers list. It also reduces the total available doctors in the area by 45%.