To better serve beneficiaries worldwide, the Department of Defense (DoD) is consolidating the TRICARE regions in the continental United States this year from 12 regions to three—West, North and South.

The new regional contractors are TriWest Healthcare Alliance (West), Health Net Federal Services, Inc. (North) and Humana Military Healthcare Services, Inc. (South).

This move is intended to simplify the administration of the TRICARE program and improve beneficiaries’ access to health care. It is also intended to make TRICARE more accountable to beneficiaries and providers alike, in particular by streamlining the various processes and steps that providers take to serve beneficiaries in a simpler and more efficient manner.

In addition to consolidating regions, the DoD “carved out” various other contracts (e.g., retail pharmacy, TRICARE For Life) for services that were previously administered separately by the regional health care contractors. Now these services are centralized under national contracts. Known as “the next generation of contracts,” regional consolidation and carve-out programs are designed to improve health care portability for beneficiaries and simplify administrative processes for TRICARE and providers.

South Region Rollout Schedule
Each of the new TRICARE regions will be phased in according to a rollout schedule. In the south, former Regions 3, 4 and 6 become the TRICARE South Region.

Practices in the following states and locations become part of the South Region under TRICARE’s new consolidation plan, as of the following dates:

• Former Regions 3 and 4: Alabama, Florida, Georgia, Louisiana (New Orleans area), Mississippi, South Carolina and Tennessee— as of Aug. 1, 2004
• Former Region 6: Arkansas, Louisiana (all but New Orleans), Oklahoma and Texas (excluding the extreme western El Paso area)—as of Nov. 1, 2004

What's New?
As a South Region provider, you will continue to deliver the same quality care you always have. There are minimal changes to the delivery of the TRICARE benefit.

You will discover as you work with Humana Military that most of what’s new is administrative in nature.

Former Region 6 (Southwest) providers will experience a few more changes as they switch from working with Health Net, their outgoing contractor, to Humana Military. All providers should review the new TRICARE Provider Handbook for new and revised policies, including prior authorization and referral requirements, claims processing procedures, etc.

You can expect changes to be smoother, particularly if your practice uses the resources Humana Military developed to support this transition (see Article 3).