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Defense Health Care: Despite TRICARE Procurement Improvements, Problems Remain

HEHS-95-142 Published: Aug 03, 1995. Publicly Released: Aug 10, 1995.
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Highlights

Pursuant to a congressional request, GAO reviewed defense health care, focusing on: (1) procurement process problems identified by the bid protest experiences; (2) the Department of Defense's (DOD) actions to improve and help ensure the fairness of the procurement process; and (3) what problems and concerns remain and whether further actions are needed.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Defense The Secretary of Defense should direct the Assistant Secretary of Defense (Health Affairs) to weigh, in view of the potential effects of such large procurements on competition, alternative award approaches for the next procurement round.
Closed – Implemented
The Office of the Assistant Secretary of Defense (Health Affairs) has issued a request for information to solicit suggestions on alternate award approaches for the next round of procurements.
Department of Defense The Secretary of Defense should direct the Assistant Secretary of Defense (Health Affairs) to determine whether and, if so, how the next round's solicitation requirements could be simplified, incorporating the use of potentially better, more economical, best-practice managed care techniques while preserving the system's overall health care goals.
Closed – Implemented
The Office of the Assistant Secretary of Defense (Health Affairs) has issued a request for information to solicit suggestions on simplifying the next requests for proposals, using less prescriptive methods for utilization management and relying more on performance-based outcome measures.
Department of Defense The Secretary of Defense should direct the Assistant Secretary of Defense (Health Affairs) to adhere to the 8- to 9-month scheduled transition period and discontinue, whenever possible, reducing such periods to make up for delays incurred before contracts are awarded.
Closed – Implemented
Transition periods for Region 6 and Regions 3 & 4 were each 7 months. The transition period for the Region 7 & 8 contract was 6.5 months. The transition period for Regions 1, 2, and 5 is scheduled to be 7 months.
Department of Defense The Secretary of Defense should direct the Assistant Secretary of Defense (Health Affairs) to establish general qualification requirements for evaluator appointees.
Closed – Implemented
OCHAMPUS established general qualification requirements and used these requirements for selecting evaluators beginning in February 1996 for the procurements for Regions 1, 2, and 5.

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Topics

BeneficiariesContract award protestsContract negotiationsDefense procurementHealth care cost controlHealth care servicesHealth services administrationManaged health careMilitary personnelProcurement practicesService contractsMedicaid