Important Advisory for TRICARE Members

NHF and HFA were notified recently that community members received notification in late October of changes to their specialty pharmacy benefits covered under TRICARE, the healthcare program of the United States Department of Defense (DOD) Military Health System.   The letter advised certain members that effective November 4, 2009, they could no longer receive their clotting factor from their current provider.  The letter listed three alternative providers:  Crescent Healthcare, Medex BioCare and Hemophilia of the Sunshine State (which is now CuraScript, Express Scripts' in house specialty pharmacy).  It appears that TRICARE members who receive drugs from specialty pharmacies that are no longer a part of the network, are the only members affected by the changes.  However, the limited timeline combined with unclear guidance have created confusion among some patients and providers, several of whom have since contacted NHF, HFA and several chapters and associations.

NHF and HFA have been working together to assess the impact of these changes on patients and get further clarification as to which providers are no longer in Express Scripts' network.   We have since learned from Express Scripts that several providers, in addition to the ones mentioned above, remain in their network (including at least 12 infusion specialty providers and various 340B providers affiliated with hemophilia treatment centers).

Express Scripts, with support from the DOD, is currently preparing a revised letter outlining the full network of pharmacy providers and better clarification of the changes taking place.  Copies will also be shared with NHF and HFA for distribution to the community.  We hope to have additional information to distribute early next week.

We realize there are many unanswered questions.   We ask for your patience as additional information is gathered.  If you have any questions, please feel free to contact any member of the NHF or HFA advocacy and public policy teams.

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