Congress Investigating TRICARE Issues Amid Provider and Patient Disruptions

Congress is beginning to formally investigate ongoing issues with the TRICARE system that have affected health care providers and military families who rely on the program for coverage and care.

This latest move by Congress comes in response to repeated reports of delayed payments, ongoing operational and access issues, and patient care disruptions. The House Armed Services Committee has included language in a new report that could trigger deeper federal oversight.

As reported in a June article, APTA has been steadfast in its efforts to bring attention to some of these severe disruptions from TRICARE T-5, which began on Jan. 1 and is the fifth generation of TRICARE Managed Support Contracts. Since the start of 2025, when TriWest Healthcare Alliance took over as the Managed Care Support Contractor and the West region took on seven additional states, these disruptions have continued to wreak havoc on TRICARE beneficiaries and providers.

In July, APTA signed onto joint letters to both the U.S. Senate Committee on Armed Services and the U.S. House Armed Services Committee, citing the following critical issues:

• The crisis within the TRICARE system is jeopardizing the health and stability of veterans, service members, and their families.
• Critical data transfer failure, rooted in flawed software implementation and deployment of an inaccurate database on a live platform, has inflicted immeasurable damage upon providers and patients with no end point or solution.
• Beneficiaries and health care providers are grappling with unprecedented barriers to accessing care.

In its new report accompanying the 2026 National Defense Authorization Act, or NDAA, the House Armed Services Committee has included provisions requiring detailed reviews of TRICARE claim processing delays and the implementation of a study to investigate the Department of Defense's Military Health System's new TRICARE T-5 contract.

The provisions call on the Department of Defense to submit two comprehensive reports to Congress by March 31, 2026. These reports will examine:

• The root causes of TRICARE claim and payment delays, including contractor transitions, staffing shortages, and system inefficiencies
• The number of affected providers and beneficiaries, including disruptions in care, delayed authorizations, and access
• Performance metrics like average claim processing times and payment timelines broken out by region and contractor
• The reasons health providers left the TRICARE network
• The full scope and impact of the T-5 contract implementation in TRICARE East and West regions

You can read the full House NDAA report language here.

Calling APTA members who treat TRICARE beneficiaries: If you're still experiencing delays or challenges with TRICARE, we want to hear from you and assist you in your advocacy. Please contact APTA Advocacy for assistance.

Together, we are making your voice heard and helping ensure military families and providers receive the timely care and compensation they deserve.