TRICARE

TRICARE is the Department of Defense’ managed health care program for active duty military, active duty service families, retirees and their families, and other beneficiaries. A Pharmacy Benefit Program is in place, enabling beneficiaries to purchase prescription drugs from various types of facilities. The TRICARE Management Authority (TMA) is responsible for administering the Program.

At this time, the TRICARE Pharmacy Benefit Program is essentially a voluntary program. At one point, the Department of Veterans Affairs issued a Dear Manufacturer Letter, which purported to establish that manufacturers had to offer drugs at VA prices to TRICARE entities or facilities. However, in September of 2006 the United States Court of Appeals for the Federal Circuit ruled that the VA had failed to comply with the statutory requirements of the Administrative Procedure Act, and thus, the Letter and anything therein was invalid.

This ruling does not prevent the VA, or another agency with authority to do so, from reissuing the requirements found in that Letter through the proper rule-making channels in the future. In other words, it might-and probably will-come to pass that manufacturers will be required to offer VA pricing to entities through the TRICARE Pharmacy Benefit Program. Your organization must continue to monitor this Program and any related Federal Agencies.

CIS can assist you in keeping abreast of the latest government program developments and requirements and assist you in meeting those requirements as they are introduced.