Rep. Kiggans Hosts Roundtable to Get to the Bottom of TRICARE Reimbursement Issues

Read about the event from Wavy's Chris Horne here.

Virginia Beach, VA-Last week, Rep. Jen Kiggans (VA-02) hosted a roundtable with medical providers, including hospitals and medical clinics, and Humana, to discuss TRICARE reimbursement delays.

Rep. Kiggans said, "We heard from many local providers, including major hospital systems, allied health providers, and smaller providers like those in the mental health field who have been dealing with reimbursement delays and even credentialing challenges. It's clear there are many policy issues Humana needs to work through. The purpose of this roundtable was to get answers and solutions for our military families who rely on TRICARE-and I believe we have made major progress towards that."

During the event, many providers discussed the delays in receiving reimbursement for TRICARE, some claiming they experienced delays upwards of six months.

"The last thing our military families and servicemembers need when facing health issues is to be concerned about whether their bills will get paid. In fact, many faced delayed reimbursements and administrative breakdowns that created real hardships." Rep. Kiggans continued. "That's why I was so concerned when my team and I heard from countless providers, military families, and retirees about serious TRICARE disruptions. In all, my team has spent over 50 hours attempting to get answers about this problem and this roundtable is just the next step in an effort to correct the issues people are still facing."

In February, Rep. Kiggans sent a letter to Lt. Gen. Telita Crosland, the Director of the Defense Health Agency (DHA), inquiring about ongoing TRICARE East reimbursement failures and their effects on our military families and community medical providers.

"I've heard directly from military families and medical providers in Hampton Roads and across the country who are suffering the consequences of these payment failures," said Rep. Kiggans. "Small practices, many of which provide critical specialty care, cannot wait months to be reimbursed for services they've already provided. Every day these payments are delayed, we risk losing the very providers our servicemembers and their families rely on."

"We're grateful to Congresswoman Kiggans for convening this important discussion on TRICARE reimbursement. At Adler Therapy Group, our top priority is ensuring our patients receive the care they deserve, and we remain committed to that mission. We hope Humana addresses the issues causing these delays, so providers can focus on patient care, not administrative hurdles," said Adler Therapy Group Chief Executive Officer Phil Helman.

"We are grateful to Congresswoman Kiggans for her leadership in convening medical providers, stakeholders, and Humana Military to address persistent challenges within the TRICARE system," said Rick Dwyer, Executive Director of the Hampton Roads Military and Federal Facilities Alliance. "These systemic issues have resulted in substantial financial burdens for some providers-amounting to millions of dollars in unpaid claims-and have forced others to discontinue acceptance of TRICARE patients or close their practices entirely. The consequences are severe-unacceptably long wait times and diminished access to care for thousands of service members, their families, and veterans across Hampton Roads. This is not just a health care crisis; it's a matter of military readiness and retention. We deeply appreciate the Congresswoman's commitment to resolving these critical concerns."

In conclusion, Rep. Kiggans stated, "As a veteran myself and a nurse practitioner, this issue is personal for me. I believe that we owe it to military families and providers to make sure future transitions are seamless, so that care and payments are never put at risk again. Ultimately, this roundtable was about learning from what went wrong and building safeguards so it doesn't happen again."

Read the lawmakers' original letter here and DHA's April 22nd response here.

Background: In January 2025, DHA signed a contract with Humana as its representative for handling the billings and reimbursements for providers who take TRICARE. This contract transition triggered widespread delays in provider reimbursement. Since January, providers have been experiencing delays in reimbursement from TRICARE for their services to military members and their families.