Posted on 11/07/2012 4:47:14 PM PST by usnavy_cop_retired
Starting 1 January, 2013 US Military retirees and their families living in the Philippines will be ordered, (mandated), to use only doctors and hospitals that the Tricare Management Activity, (TMA), and their contractor, International SOS, (ISOS), have contracted with to provide medical care to retirees and their families in the Philippines.
This is the roll out of the TMA Demonstration Project in the Philippines. The rules state that all retirees must use only the medical providers, (doctors and hospitals), that ISOS was able to beg to agree to be a contracted network provider. If the retiree uses a doctor or hospital that is not a "network" provider, the retiree can not be reimbursed for their medical care. Thus the retiree will lose his earned Tricare benefits that he placed his life in jeopardy to earn.
ISOS contracted with 4 hospitals in four network areas that are expected to treat retirees and their families, (estimated to be around 4,000-5,000 in the network areas). Only one of these hospitals comes close to having the cleanliness standards required under the Tricare regulations. The other 3 hospitals are substandard at best. ISOS was unable to convince the quality hospitals in the network areas to join their network, and as is the norm for Government contractors, they lowered the standards of the product they are required to provide in order to get hospitals signed up for the network that retirees will be mandated to use.
This YouTube video, http://youtu.be/BOQAVfgf7yQ produced by members of the US_Military_Retirees_In_The_Philippines Yahoo Group was taken inside of one of these hospitals. The hospital is filthy and is known for it's high incidences of hospital acquired infections. In order to use the public area restrooms, (that are depicted in the video), the visitor and/or patient must pay the restroom attendant $.75. Would you use these restrooms? And what does the cleanliness of these restroom say about the cleanliness standards of the hospital management?
This is what ISOS and TMA consider a "quality" provider. There are several higher quality hospitals in the general area of the mandated network hospital, but they would not agree to be a Tricare network hospital because of Tricare's reputation in the Philippines for low payments and non-payment of claims and the myriad of complicated paperwork in order to get a claim paid.
Retirees should not be treated like second class citizens. Retirees earned the promised quality health care under the Tricare system.
Is this what retirees in the US and other overseas countries can expect from their Government? If you think that this is a travesty, please make your voice heard by sending an email to Tricare and by sharing this YouTube video with your friends and your elected representatives.
The link to the video is http://youtu.be/BOQAVfgf7yQ
The link to the video is http://youtu.be/BOQAVfgf7yQ
Bump for later
BTTT
what are the hospitals? Some of the hospitals in Manila are as good as any in the US.
But I am not military retiree: I have my own insurance...
Yea. I was interviewed by Travis Tritten on that article and provided him a lot of background information for the article.
As to your other question, I would rather not name the hospital in public, but it is not one in Manila. I am very familiar with almost all of the good hospitals in Manila. St. luke’s has the only Pet Scan. Philippine Heart Center is top of the line. Asian Medical is also top quality.
The problem is that ISOS had over a year to try to recruit hospitals and doctors for the network but couldn’t get anyone to bite. Most of the hospitals and quality doctors have been burned by Tricare in the past 10 years or more and will have nothing to do with them.
Our information is that The Medical City, in Manila, was so badly underpaid or had so many claims denied, even though they were legitimate claims, that they lost around $1,000,000 as a result of playing ball with Tricare.
St. Luke’s refused to file claims directly to Tricare because of the loss of substantial payments. We approached them a few years ago to attempt to get them to try again and were told that until Tricare pays all of the back claims, either denied or underpaid, they would have nothing to do with Tricare.
So basically, ISOS had to beg the sub-standard hospitals to join the network and had to do the same with the doctors.
sorry about the problem...they are also cutting tricare in the states.
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