TRICARE: Enrollment of the Department of Defense's TRICARE Beneficiaries in Medicare Part B Page: 3 of 22
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encountered during the law's implementation, and (2) the extent to which TRICARE
beneficiaries were served.
To describe the steps that TMA, DMDC, CMS, and SSA took in response to
Section 625 of MMA, including their efforts to correct problems encountered, we
reviewed the TMA, DMDC, and CMS agreements to share enrollment and eligibility
data. We also interviewed CMS and SSA officials, as well as DOD representatives
from TMA and DMDC. We focused our work on those organizations' efforts to
identify, enroll, waive, and repay premium surcharges to eligible TRICARE
To describe the extent to which TRICARE beneficiaries were served, we obtained
data from the involved agencies on the number of TRICARE beneficiaries who were
enrolled in Part B or whose premium surcharges were repaid. We assessed the
reliability of the DOD, CMS, and SSA data by corroborating them with available
documentation from TMA, DMDC, CMS, and SSA. While we previously reported on
weaknesses in DEERS, we determined that those weaknesses were not germane for
the purposes of this report.5 We reviewed the Part B enrollment and premium
surcharge data for consistency and discussed the discrepancies with CMS and SSA
officials and determined that these data were reliable for purposes of this report. In
addition, we examined the notices and other correspondence that the organizations
sent to TRICARE beneficiaries to determine when and how they were given the
opportunity to enroll in Medicare Part B. We also determined whether the notices
included information on their right to appeal the amount of the premium surcharges
that were repaid, if they disagreed with SSA's calculation. Our scope was limited to
the actions taken by TMA, DMDC, CMS, and SSA to implement Section 625 of MMA."
We performed our work from July 2005 through May 2006 in accordance with
generally accepted government auditing standards.
RESULTS IN BRIEF
All four organizations-TMA, DMDC, CMS, and SSA-collaborated to implement
Section 625 of MMA. The organizations took a series of steps, including reaching
agreement to share necessary data. To identify the targeted TRICARE beneficiaries,
the organizations worked together, from May through July of 2004, to perform a data
match-a process during which they compared and matched Social Security numbers
and dates of birth of TRICARE beneficiaries in their respective databases. DMDC
mailed information to TRICARE beneficiaries in September 2004, alerting them that
they would receive important information from SSA concerning their Medicare Part B
enrollment. Also in September 2004, after the data match was finalized, SSA sent
5See GAO, Defense Health Care: TRICARE Claims Processing Has Improved but Inefficiencies
Remain, GAO-04-69 (Washington, D.C.: Oct. 15, 2003), and Defense Health Care: Most Reservists Have
Civilian Health Coverage but More Assistance Is Needed When TRICARE Is Used, GAO-02-829
(Washington, D.C.: Sept. 6, 2002).
'The Railroad Retirement Board (RRB) also enrolls Medicare beneficiaries and collects Part B
premiums on behalf of CMS. Less than 0.2 percent of the TRICARE beneficiaries targeted by Section
625 of MMA were RRB annuitants; as a result, we did not include this agency in the scope of our
GAO-06-489R TRICARE and Medicare Part B
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United States. Government Accountability Office. TRICARE: Enrollment of the Department of Defense's TRICARE Beneficiaries in Medicare Part B, text, June 30, 2006; Washington D.C.. (digital.library.unt.edu/ark:/67531/metadc301514/m1/3/: accessed October 21, 2018), University of North Texas Libraries, Digital Library, digital.library.unt.edu; crediting UNT Libraries Government Documents Department.