The director of a military health care plan at the Pentagon promised immediate action to problems from the plan's administrator, United Health Care.
Jonathan Woodson, assistant secretary of defense for health affairs, also is director of the military plan TRICARE that is managed by UHC. He joined Congressman Doug Lamborn for a town hall meeting at Colorado Christian University.
The Department of Defense awarded a $20 billion contract to UHC in April. TRICARE serves active-duty military personnel, veterans and military dependents in 21 states including Colorado.
Since acquiring the contract, patients have complained that TRICARE hasn't accepted claims or reimbursed health care providers. Lamborn said there are as many as 170,000 eligible beneficiaries in his district alone.
Dr. Steven Topper, an orthopedic surgeon who treats many injured service men and women, said the situation has led providers to lay off staff because of the lack of reimbursement.
"I've only been reimbursed 5 percent," he said. "Fortunately, TRICARE is only a certain percentage of what we see. But I'm aware of other practices that have had to close their doors."
Aaron Wiseman, a disabled Air Force veteran, said TRICARE's problems caused his family to lose health care it needed but approved his claim for wrist surgery without question.
"That's no way to do business," he said. "I'd rather pay a higher premium and have more dependable care."
Lamborn said the problem was caused by TRICARE being unprepared for the transition when it acquired the contract.
"(TRICARE) needs a new process," said Lamborn. "I think Woodson will help them because in other areas of their business, they do a decent job. They just need to apply that here."
Woodson didn't speak to the media during his visit, but Lamborn said Woodson plans to meet Thursday with Mike Isle, UHC's chief executive officer, to discuss the situation.
"I believe we're making progress," said Lamborn.
Bruce Jarsurda, UHC's vice president of communications, released the following statement:
“UnitedHealthcare continues to make real, measurable progress in many aspects of its TRICARE West Region operations, working collaboratively and effectively with the Department of Defense, the TRICARE Management Activity, TRICARE West Region Office and the Military Treatment Facilities. UnitedHealthcare is committed to ensuring TRICARE beneficiaries continue to receive timely and necessary access to care and the prompt payment of claims received.”