Defense Health Care: Continued Management Focus Key to Settling TRICARE Change Orders Quickly Page: 7 of 32
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DOD contracts with MCS contractors to administer its TRICARE program
on a regional basis. The MCS contractors' responsibilities include claims
processing, customer service, and developing and maintaining an adequate
network of civilian providers.
Since 1994, DOD has awarded seven MCS contracts covering the 11
TRICARE regions. These contracts were awarded for a base period and 5
option years.2 (See table 1.) Four of the MCS contracts have used all of the
option years and three of these have been extended for an additional 2
years. A fourth contract's extension is under way. TMA anticipates that all
of its MCS contracts will eventually be extended.
Table 1: MCS Contractors, Regions, and Date of Initial Award
Date of initial
MCS Contractor Region name and number award
Health Net Federal Servicesa Northwest/11 September
Health Net Federal Services Southwest/6 April 1995
Health Net Federal Services Golden Gate, Southern California, and August 1995
Pacific/9, 10, and 12
Humana Military Healthcare Southeast and Gulf South/3 and 4 November
TriWest Healthcare Alliance Central/(formerly 7 and 8) June 1996
Anthem Allianceb Mid-Atlantic and Heartland/2 and 5 September
Sierra Military Healthcare Northeast/1 September
aHealth Net Federal Services, formerly Foundation Health Federal Services, changed its name in
bln April 2001, DOD announced that Humana Military Healthcare Services acquired Anthem Alliance
and will assume responsibility for the Mid-Atlantic and Heartland Regions.
TMA, within DOD's Office of the Assistant Secretary of Defense (Health
Affairs), is responsible for administering the MCS contracts. TMA's
contracting officers have the ultimate responsibility for contract
administration, including the issuance of change orders. Contracting
GAO-01-513 TRICARE Change Order Management
2The base period, which varies by contract, consists of a transition period, ranging from 6-9
months, and the early months of health care delivery.
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United States. General Accounting Office. Defense Health Care: Continued Management Focus Key to Settling TRICARE Change Orders Quickly, report, April 10, 2001; Washington D.C.. (digital.library.unt.edu/ark:/67531/metadc293076/m1/7/: accessed November 21, 2018), University of North Texas Libraries, Digital Library, digital.library.unt.edu; crediting UNT Libraries Government Documents Department.