The Department of Defense has upheld its $65.1 billion decision to award the next generation contract to manage Tricare's West Region to TriWest, a ruling that will affect nearly five million patients in the DoD health system.
The company that currently has the contract for that segment of the Tricare system and lost out to TriWest, Health Net Federal Services, had filed a protest to stop the deal.
The Defense Health Agency announced Thursday that TriWest, which also manages the Department of Veterans Affairs Community Care Network in the western United States and Hawaii, will manage a 26-state region that provides care to patients using the Tricare health program.
DoD announced in December that TriWest and Humana Military were awarded the fifth-generation Tricare Managed Care Support contracts, known as T-5, worth up to $136 billion over a nine-year period. The deal is worth up to $70.9 billion for Humana and $65.1 billion for TriWest.
As a result of that decision, Health Net Federal Services had filed a protest, prompting the Defense Health Agency to withdraw its decision as it looked into "information potentially impacting one area of the evaluation," according to a DHA press release Thursday.
The agency examined the source selection record and dismissed the protest. In the release, DHA officials said they could not discuss the decision in more detail because the protest remains "under a protective order" at the Government Accountability Office.
Neither Health Net nor TriWest responded to a request for comment by publication.
The Tricare health program provides private health-care treatment, referrals, customer service, claims processing and other support services to roughly 9.6 million beneficiaries, including active-duty personnel, some members of the Reserve and National Guard, military retirees and family members.
Health Net still has an opportunity to protest. Generally, protests must be filed within 10 days after the contract award is announced or five days after the losing bidder requests and receives a debriefing from the federal government on the award.
According to DHA, Health Net also has an option to mount a legal challenge through the federal court system.
For now, DHA is proceeding with the contract turnover as planned.
"Assuming GAO denies or dismisses all protest allegations and there is no subsequent litigation, DHA may proceed with contract performance, including a one-year transition period from the current ... contract to the T-5 contract. Start of health care delivery would then begin in August 2024," officials said in a release.
The T-5 contracts contain a number of provisions that will affect beneficiaries. The decision shifts all beneficiaries currently in the West Region from HealthNet to TriWest.
And six states will shift from the East to the West Region, moving 1.5 million beneficiaries in
Arkansas, Illinois, Louisiana, Oklahoma, Texas and Wisconsin from Humana to TriWest.
-- Patricia Kime can be reached at Patricia.Kime@Military.com