The following email was sent to upper management at the Tricare Management Activity and the Military Health System at DOD as well as Stars and Stripes and various service organizations. The pictures mentioned come from the video of one of the hospitals we have to use that was addressed in an earlier post. Camacho is the Chief of public affairs for the Tricare Management Activity and should know better.
Ms. Forestell and Company,
Your people’s lies in the latest S&S article have gone over the top this time. We typically see many of them but this time your people outdid themselves. See Stars and Stripes article, Changes to Tricare come under fire in Philippines.
“The agency said Friday it has fully explained the system and denied troubles are looming. It decided in 2011 to try a closed network after struggling for years to reduce fraud and complaints from about 8,000 military beneficiaries in the Philippines who say red tape during claims processing has often blocked them from receiving full reimbursements for covered expenses.”
Fully explained = Sending a letter announcing a program with no details is not fully explaining. Presenting a PPT with little substance to 36 people in almost secret meetings where the general population was barred, and where presenters could not answer questions about the program except to say there was no consideration given to the quality of care provided by providers in the program, is not fully explaining. But we got the message, any local quack will do. Anyone with any common sense would know this is a joke and a number of attendees did after action reports and posted them on the internet implying just that. The presenters also told us it was our responsibility to spread the word to the other 10,964 beneficiaries and got out of town before their lies became known but would not allow recording of the briefing. Why was that? So that TMA could then deny the misinformation given out. Lies like the number of hospitals in Manila, claiming 4 when there is one and that there is 24/7 local support when it is M-F 9-6 and manned by people that don’t know the answers to even simple questions like what a specialty designation means on the very list of providers that they publish.
denied troubles are looming = Admitting time and again during the almost secret meetings that neither the contractor or TMA had thought of the issues brought up doesn’t seem to mesh with this statement. Then saying they would go back and provide answers which are still pending after more then two weeks looks like lots of trouble to those of us that are stuck in the middle of this mess including disease infested hospitals.
struggling for years to reduce fraud = Reducing access to care to where in 2010 the per capita payment by TMA for care in the Philippines was $545. Given that it should be more than $4,000, based on published TMA data, this claim either means TMA hasn’t a clue about what they are talking about or intend to eliminate Tricare in total in the Philippines by further reducing the per capita cost to almost nothing. The only thing TMA has struggled to do is defraud beneficiaries. Many of us know what has really been going on including fraud that was reported but pushed under the table to protect those involved; that doesn’t look like struggling very hard to us.
8,000 military beneficiaries in the Philippines = TMA can’t make up its mind which lie to tell. Before you claimed 10,000 in an article in S&S while at the same time you claimed 11,000 in the Federal Register notice and now it is 8,000? Are we to assume you figured you killed off 3,000 of us since the notice or is this just in anticipation of the results of seeing the low quality providers in the experiment?
red tape during claims processing has often blocked them from receiving full reimbursements for covered expenses = Deliberately implemented policies that were designed to increase the difficulty of filing claims and then denying they cause problems is what really happened. The red tape applies to both beneficiaries and providers and will be the demise of this experiment but is probably due to total ignorance on the part of TMA and the contractor as they have no understanding of the health care industry overseas and in particular in the Philippines. This was also clearly shown by comments from the contractor during and after the presentations when they discussed their understanding of how Philippine providers routinely complete claims. It showed a total disconnect from reality which we have seen for years.
“There are six hospitals and 71 doctors included in the first phase of the pilot project, according to the approved provider list published by Tricare.”
Another lie! The list offers 4, I repeat 4, hospitals and two of them are of questionable quality. In one area there is not one hospital on the list and in two areas, Olongapo and Manila, the better hospitals are excluded. How would you like to use a hospital with a bathroom maintained like the one in the attached pictures? That is what you are forcing on us and when there are much better hospitals in the same area. Not one, I repeat not one of the internationally accredited hospitals in the demo areas are included. We are now relegated to the ones with lower quality standards. The count of doctors, including quacks due to no quality standards, is 73 not 71 by the way. Some are of questionable quality but as you already told us TMA and the contractor are not concerned with the quality of the limited providers we are forced to use. Maybe that is why you are already claiming the population dropped from 11,000 to 8,000?
“In a written response to Stars and Stripes, Tricare denied veterans will be forced into long commutes or that it has not done enough to educate beneficiaries.
“Travel times have been considered in the recruitment of providers,” Tricare spokesman Austin Camacho wrote. “Beneficiaries may choose to drive to see approved providers but because it is locality based, four- to five-hour drive times are not required.””
Once again another lie! We were told by you and it was confirmed by the contractor that there were no travel considerations in the development of the experiment. We were even told by the TMA representative at the meetings that TMA had not responded to his requests for a policy on travel times. If TMA is unable to provide travel standards after months how could the contractor consider them? That makes absolutely no sense and TMA and those affected know it and the contractor admitted it.
Further since none of you have bothered to step foot in the Philippines your last comment only shows the total ignorance of Austin Camacho who has never tried to travel across Manila during the day or probably any other third world country for that matter. If he had he would not have made the comment he did as he would have known it would make him the laughing stock of every beneficiary in the Philippines and millions of Filipinos as well. Continuing to asses overseas situations based on U.S. experience will only result in continued failures of overseas programs. What he obviously doesn’t know is Manila has a population of 12 million that grows to 16 million during the day and there are no freeways transversing the city so all travel is on local access roads where traffic laws are not generally enforced and vehicles move at a few miles an hour. New York City has a population of 8 million. Since he won’t come to Manila maybe he can try crossing New York City, north to south, during the day to get to the one hospital allowed under his medical policy. By the way no cheating by using freeways, all travel must be on secondary roads. I bet it takes him many hours each way. How many still believe his story?
“Camacho said the agency sent a letter explaining the closed network to all beneficiaries in the Philippines who have filed a claim in the past two years and also conducted the briefings last month, which were held in areas that used to host large Navy and Air Force bases and still have some of the highest veteran populations. Tricare also has posted online information showing providers, area maps and step-by-step instructions on how to use the network.”
The letter was a joke, a real joke as it provided no details nor does the various web pages; not ready for prime time comes to mind for most of us.
Camacho also conveniently forgot to mention this massive briefing effort extended only to 36 beneficiaries out of 11,000. The comment that these deliberately limited attendance briefings “which were held in areas that used to host large Navy and Air Force bases and still have some of the highest veteran populations.” was a deliberate attempt to mislead the public by implying that the briefings were meant for and attended by large numbers of beneficiaries when in fact TMA deliberately limited attendance and did so because they feared the anger and wrath they knew they would find; if this program is so good why would you fear facing those that should be happy you have provided them with a “high quality” group of providers who will submit their claims? Adding spin to comments to try to imply what is not true is disingenuous and shows how far TMA will go to falsify the truth to cover their actions and it smacks of propaganda.
By the way Camacho also lied about area maps and step-by-step instructions, there is neither and you and he both know it. Further the provider search function on the web doesn’t work and even after pointing it out to the contractor almost two weeks ago, it still does not work. Sad commentary on a failing program that mandated a working search function 60 days prior to start.
“The agency will not create an advisory working group of retirees because it already considered veterans’ input when developing the network,”
Another lie that TMA likes to repeat again and again. TMA did not consider any input, never met with beneficiaries to discuss this idea and probably dumped the emails offering ideas and concerns sent after the secret was discovered in the Federal Registry and PPT presentations done in the states. We say this with confidence since all the presenters at the limited briefings acted with complete and total surprise when some of the same issues were raised about the processes. Not one RAO has any knowledge of any requests for input either. Not having any input or experience in the Philippines was extremely obvious and was also pointed out in this article and it was clear to everyone at the meetings, extremely clear.
“The agency unveiled details of its three-year pilot project during presentations to retirees in Manila, Subic Bay and Angeles City in late October, but the events did little to assuage concerns, said Mike Garcia, director of the Retired Activities Office Manila.
“The people they sent here to present the Tricare project didn’t know anything about the Philippines. They think it is just like the U.S.,” Garcia said. “I don’t think they will be able to put it [the closed network] in place by January because of all the questions and concerns.””
I was there as well and the look of total shock and disbelief when multiple problems with the current concepts were brought up made it very clear that these guys, staying in ultra-high priced hotels and isolated from reality, had no clue. Just as those that designed the experiment didn’t have a clue when they designed it while sitting in Washington.
Bottom line the overreaching concept is good but as with everything the devil is in the details and nobody at TMA or with the contractor management have a clue about the details and that was clear at the meetings. They only reinforced, what most believe already, that those involved in the Philippines don’t have any idea of how the health care industry works here and believe they are planning a program for the U.S.
Does it ever occur to those living in the TMA palace that if they were providing a good well thought out program with quality providers who were within easy driving distance and would process claims that beneficiaries would cry foul and claim there are problems when there are not? Would TMA be afraid to meet with beneficiaries and brief them instead of briefing 36 hand picked individuals so they can imply they educated thousands of beneficiaries. Anyone wonder how much TMA spent to fly three highly paid individuals to the Philippines, house them in five star hotels and rent three conference rooms in these hotels to brief 36 people across three cities over three days? How many denied claims for legitimate medical care could have been paid with the money spent on this?
Think about it! If this program is so much better than what was offered in the past where we had to pay up front and then fight to get reimbursed, why are so many objecting to this program? Might it be they are really worried that the quality of care they will receive will be severely degraded due to lack of concern by TMA for screening providers for quality of care as they do for Prime? Beneficiaries are also limited in choice with Prime but they have a choice to change back to Standard if they are concerned with quality which is no longer an option in the Philippines. We are the only group in the world that no longer can select Standard and pick our providers but are forced to use providers TMA admits were selected for us without any quality checks.