Page 13 - Mariner Winter 2023 Volume 65 Issue 3 Jan

28 November 2022

The Honorable Gil Cisneros The Honorable Seileen Mullen LTG Ronald Place, MC, USA
Under Secretary of Defense Acting Assistant Secretary of Director, Defense Health
(Personnel & Readiness) Defense for Health Affairs Agency

However, there is still time to reverse the course. Although Express Scripts has offered these pharmacies
The Honorable Jim Inhofe
The Honorable Jack Reed
The Honorable Adam Smith
the chance to rejoin the TRICARE network the unchanged contractual terms remain unaffordable –
Chair, Senate Committee on
Ranking Member, Senate
Chair, House Armed Services
hence why seemingly no local and independent pharmacies have chosen to opt back into the program
Armed Services Committee on Armed Committee
Services
Until these changes can be thoroughly evaluated, with full input from the stakeholders for these

beneficiaries, it is imperative the Department of Defense immediately reverse Express Scripts’

The Honorable Mike Rogers
unwarranted reduction in pharmacy coverage, transparently reevaluate the process by which the
Ranking Member, House Armed
Defense Health Agency approved such a change, and evaluate whether Express Scripts has properly
Services Committee
fulfilled its contractual obligations in administering TRICARE.

Dear Under Secretary Cisneros, Ms. Mullen, General Place, Chair Reed, Chair Smith, Senator Inhofe, and
Furthermore, the Department must reevaluate whether providing any pharmacy or pharmacy benefit
Representative Rogers:
manager with the sole-source contract for the TRICARE pharmacy program is the best way to ensure

conflicts of interest do not come at the expense of the beneficiary population the contractor is
The organizations listed below, all members of the National Military & Veterans Alliance, express their
required to care for through its pharmacy services.
deep-seated concern regarding the recent announcement that nearly 15,000 local and independent
And if the necessary corrective action(s) is not taken by the Department of Defense by December 2,
pharmacies have chosen to no longer participate in the TRICARE pharmacy program.
2022, then NMVA requests Congress to step-in and make the necessary changes required within the FY

We collectively call on the Department of Defense to immediately reverse the changes to the TRICARE
th
2023 National Defense Authorization Act, and then no later than the conclusion of the 117 Congress.
program which led to the mass exodus of these pharmacies; and if the Department of Defense is
unable or unwilling to do so, we call on Congress to adopt a legislative solution in the FY 2023
We stand ready to engage with the Department of Defense, Defense Health Agency, Congress, and
National Defense Authorization Act.
Express Scripts to resolve these significant issues immediately.

Under current practices, Express Scripts acts as a pharmacy benefit manager for the TRICARE program
Very Respectfully,
while serving as a mail-order and specialty pharmacy itself. Without question, this poses a conflict of

interest that must be reconciled to ensure TRICARE is compliant with federal procurement law and

provides for additional competition in the marketplace to drive down costs and expand options for

beneficiaries.
Kenneth Greenberg CAPT Bob Carey, USN (Ret)
For service members past and present and their family members, the sudden and wrongful network
National Executive Director
Chief Bottle Washer
reduction goes far beyond simply reducing access to care for TRICARE beneficiaries. For those
Jewish War Veterans of the USA
National Defense Committee
beneficiaries who need specialty medicines, the cut-rate standard shipping processes used by Express
Co-Chair, NMVA
Co-Chair, NMVA
Scripts threaten the medicinal integrity of the shipped medicines and place beneficiaries at risk of

receiving crucial medications late, damaged, or at reduced or eliminated effectiveness. Of greater
Signatory National Military & Veterans Alliance Members:
significance, it eliminates the crucial role local pharmacists play in protecting beneficiaries’ health,
Jewish War Veterans of the USA
National Defense Committee
The Catholic War Veterans and Auxiliary of the
Heroes Athletic Association
especially those requiring multiple medications where contraindications are always a concern.
Armed Forces Retirees Association United States of America
Overall, these pharmacy network changes will put service members and their families at risk in receiving
American Retirees Association
Naval Enlisted Reserve Association
the prescription drugs and treatment they need. NMVA’s longstanding conviction has been – and will
Japanese American Veterans Association
Veteran Warriors, Inc.
always be - to oppose any decisions made solely to ensure cost savings over the quality-of-care
American GI Forum
Wounded Paw Partnership
beneficiaries are receiving. In our estimation, such an approach to taking care of service members and
Korean War Veterans Association
AMVETS
Reserve Organization of America (ROA)
American Defenders of Bataan & Corregidor
their families will harm beneficiaries in the short term and readiness down range.
Memorial Society Burn Pits 360

National Military & Veterans Alliance
20 F St., NW, #703, Washington, DC 20001
www.NMVA.US, 202-779-1598
The Naval Enlisted Reserve Association 13