{"id":71915,"date":"2023-01-12T00:27:45","date_gmt":"2023-01-12T00:27:45","guid":{"rendered":"https:\/\/one.sightlinemg.com\/navytimes\/uncategorized\/2023\/01\/12\/more-pharmacies-rejoin-tricare-network-are-there-enough\/"},"modified":"2026-08-08T15:05:08","modified_gmt":"2026-08-08T15:05:08","slug":"more-pharmacies-rejoin-tricare-network-are-there-enough","status":"publish","type":"post","link":"https:\/\/one.sightlinemg.com\/navytimes\/management\/pay-benefits\/2023\/01\/12\/more-pharmacies-rejoin-tricare-network-are-there-enough\/","title":{"rendered":"More pharmacies rejoin Tricare network. Are there enough?"},"content":{"rendered":"\n

Nearly a third of the independent pharmacies that were dropped from the Tricare retail pharmacy network<\/a> in October have opted to rejoin the network, according to officials from Express Scripts, which manages the prescription plan.<\/p>\n\n\n\n

\u201cWe are pleased that an additional 4,356 independent pharmacies accepted the contract terms we offered in December and will rejoin the Tricare network this month,\u201d said Justine Sessions, spokeswoman for Cigna\/Express Scripts. As of Jan. 15, there will be more than 42,000 pharmacies in the Tricare network, including nearly 12,000 independent pharmacies, she said.<\/p>\n\n\n\n

In October, 14,963 independent pharmacies \u2014 out of a total of 55,586 retail pharmacies in the network \u2014 dropped out of Tricare<\/a>, mostly because of what they perceived as low reimbursement rates. But a number of community drug stores never even received the proposed 2023 contract, which Express Scripts sent by fax earlier in 2022, according to the National Community Pharmacists Association.<\/p>\n\n\n\n

In addition to fewer independent retail pharmacies, all of the more than 2,200 Kroger pharmacies left the network Jan. 1. Kroger officials described the Express Scripts drug pricing model as \u201cunsustainable\u201d for Kroger and its customers.<\/p>\n\n\n\n

Reimbursement rates have been the key issue for the independent pharmacies, too, although earlier in 2022, more than 7,000 independent pharmacies accepted the proposed Tricare network rates for 2023.<\/p>\n\n\n\n

Although the number of pharmacies has gone from 55,586 to 42,000, \u201capproximately 98% of all Tricare beneficiaries have an in-network pharmacy within a 15-minute drive of their home,\u201d said Peter Graves, spokesman for the Defense Health Agency.<\/p>\n\n\n\n

Under the new Tricare pharmacy contract that began Jan. 1, Express Scripts must have at least one pharmacy within 15 minutes driving time of 90% of the beneficiaries.<\/p>\n\n\n\n

Graves said Express Scripts \u2018has consistently exceeded Tricare\u2019s access standards established in their government contracts with the [Defense Health Agency] over time. The access standard is measured across the entire network and the DHA remains confident in our ability to meet and exceed those standards.\u201d<\/p>\n\n\n\n

The contract allows Express Scripts \u201cto use its own discretion in contracting with pharmacies to establish a competitively priced network that meets contract access standards,\u201d he said, and any realized savings are passed directly to the government.<\/p>\n\n\n\t