In the wake of controversy over its previous decision not to have the bulk of its hospitals belong to the health insurance network for U.S. military personnel, University of Pittsburgh Medical Center has announced that it is joining the Tricare Network.
UPMC said it is formalizing "the existing practice of treating military personnel and their families throughout its system" who are insured through the Tricare Network, which is administered in the north region of the country by Health Net Federal Services LLC.
Although UPMC treated military personnel and their families with Tricare Network insurance, some patients had complained that they faced higher copayments because UPMC had not been in the network.
Some Tricare members also said they were refused services at UPMC doctors' offices that were not in the Tricare Network, which is a Department of Defense insurance program for military personnel.
UPMC Mercy, Children's Hospital of UPMC of Pittsburgh and UPMC Horizon in Mercer Countyhave been part of Tricare and will continue their association with it.
Molly Tuttle, spokeswoman for Health Net, said UPMC doctors' offices and hospitals will be put online as network providers as they receive Tricare Network credentials. That process should be completed by mid-summer.
"In this process that began two months ago, UPMC has proven to be a diligent partner and anxious to join the network," she said. "We're excited they are joining the network of 2,600 current providers in the southwestern Pennsylvania area."
The West Penn Allegheny Health System has been a member of the Tricare Network.
In a news release yesterday, UPMC said media reports had "caused confusion within the military community regarding UPMC's historical and ongoing acceptance of those covered by Tricare."
"UPMC took the initiative to contractually formalize our relationship with Health Net and to reinforce our strong commitment to the military and their families," Joseph Chuba, of UPMC's Payor Contract Services, said in the release.
UPMC took the action after a Feb. 12 Post-Gazette report about Jean Rohal, of Bridgeville, the wife of an Army sergeant who raised the issue after she said she had to find a new doctor because her UPMC-affiliated physician would not accept Tricare insurance and recommended she seek treatment elsewhere.
She said it was shameful that most of UPMC facilities were not in the network, especially in a time of war and economic distress. Military families, she said, could not afford higher copayments for health care.
After lodging complaints with UPMC, she notified the Post-Gazette and U.S. Rep. Tim Murphy, R-Upper St. Clair, who held a meeting with UPMC officials to persuade them to join Tricare.
Any provider in the network accepts the reimbursement rates that Tricare pays and also the copayment amount it sets.
Other military personnel and their families with Tricare insurance responded to the news article with their own accounts of how UPMC's decision not to join the network had inconvenienced them.
They said they could not afford out-of-network copayments for health care, which forced them to travel longer distances to find doctors in the network.
One veteran said he moved to the Baltimore area because of UPMC's lack of participation in Tricare.
Mrs. Rohal said UPMC's decision to join the Tricare network is a wise one.
"I'm thrilled that they are going to take it," she said. "I just think it's a shame we had to do this to make it happen. But they are doing the right thing -- and a great thing for all military personnel in the area."
She also praised UPMC officials for providing her with regular updates about the progress in formalizing a contract with Health Net.
UPMC said anyone with Tricare insurance can call 412-647-0943 with questions about their insurance coverage or billing.