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Defense Health Care: DOD Lacks Assurance That Selected Reserve Members Are Informed about TRICARE Reserve Select

GAO-11-551 Published: Jun 03, 2011. Publicly Released: Jun 03, 2011.
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Highlights

TRICARE Reserve Select (TRS) provides certain members of the Selected Reserve--reservists considered essential to wartime missions--with the ability to purchase health care coverage under the Department of Defense's (DOD) TRICARE program after their active duty coverage expires. TRS is similar to TRICARE Standard, a fee-forservice option, and TRICARE Extra, a preferred provider option. The National Defense Authorization Act for Fiscal Year 2008 directed GAO to review TRS education and access to care for TRS beneficiaries. This report examines (1) how DOD ensures that members of the Selected Reserve are informed about TRS and (2) how DOD monitors and evaluates access to civilian providers for TRS beneficiaries. GAO reviewed and analyzed documents and evaluated an analysis of claims conducted by DOD. GAO also interviewed officials with the TRICARE Management Activity (TMA), the DOD entity responsible for managing TRICARE; the regional TRICARE contractors; the Office of Reserve Affairs; and the seven reserve components.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Defense The Secretary of Defense should direct the Assistant Secretary of Defense for Reserve Affairs to develop a policy that requires each reserve component to designate a centralized point of contact for TRS education, who will be accountable for ensuring that the reserve components are providing information about TRS to their Selected Reserve members annually. In establishing responsibilities for the centralized points of contact, DOD should explicitly task them with coordinating with their respective TRICARE Regional Offices to ensure that contractors are provided information on the number and location of reserve component units in their regions.
Closed – Implemented
DOD concurred with this recommendation. In July 2012, DOD's Under Secretary of Defense for Personnel and Readiness-the entity that the Assistant Secretary of Defense for Reserve Affairs reports to-signed an instruction that requires the reserve components to designate a centralized point of contact to manage, account for, and direct the application of the TRS program for the reserve component. In addition, each reserve component shall develop a comprehensive communications plan, and at least annually, educate its members about the TRS qualification requirements, exclusions, benefits and costs, and the reserve component member's responsibility for enrollment. This plan is to be coordinated with the TRICARE Management Activity-the DOD entity that supervises the TRICARE Regional Offices.

Full Report

Topics

Access to health careArmed forces reservesBeneficiariesClaimsConsumer educationHealth care planningHealth care programsInformation accessInformation disclosureManaged health careMilitary reserve personnelMonitoringInformation sharing