December 5, 2022

On Nov. 14, 2022, Express Scripts (ESI) announced that they would reopen the contracting process to allow for more independent and community pharmacies to join the TRICARE retail network.

However, many home infusion pharmacies have been left out of this opportunity. For those who have received notices, the ESI press release stated that the effective date for these agreements would be Jan. 15, 2023, if the pharmacy executes and returns the exhibit within 15 days of the fax notice.  

Patient Requests and Impact 

ESI does not indicate how pharmacies should respond to patient requests for service until network access is restored (presumably January 15, 2023) and ESI did not indicate whether they have sent updated communications to TRICARE beneficiaries explaining the situation and offering to allow them to continue using their local providers during this transition period. 

NHIA Sends Urgent Requests to Defense Health Agency

On December 2, 2022, NHIA sent a follow-up letter to Defense Health Agency (DHA), including a copy to Express Scripts (ESI), sharing recent updates on efforts by ESI to narrow the TRICARE pharmacy network and urging the DOD to reinstate all home infusion providers to the ESI network to prevent disruptions in home infusion access for TRICARE beneficiaries.