MILITARY HEALTH PLAN SERVICES

MILITARY HEALTH PLAN SERVICES

military servicewoman hugging family US Family Health Plan (USFHP) services military health plan

IDC has had the great honor of working with the servicemen and servicewomen of the United States military and their families since its inception in the early 2000s.

We specialize in working with health plans and providers that serve our military beneficiaries and their family members—both retirees and active duty.

IDC’s main clients have been TRICARE beneficiaries who are enrolled through the US Family Health Plan (USFHP) programs. IDC first began with USFHP at Pacific Medical Centers in 2001 and IDC’s president, Rance Hutchings, was nominated to represent USFHP on the Department of Defense Pharmacy and Therapeutics Committee from 2001-2003 when membership transitioned to the Beneficiary Advisory Panel in 2003. He then served as the USFHP representative on the BAP for a maximum term of eight years from 2003-2011. Since 2021, IDC has served USFHP clients from coast to coast.

Containing drug costs within the military takes experience, and IDC has successfully decreased overall drug spend while improving pharmacy quality of care and ensuring military readiness by taking care of the families of our brave men and women in uniform.

Services that IDC provides that are unique to our military clients include the following:

military servicewoman hugging family US Family Health Plan (USFHP) services military health plan

IDC has had the great honor of working with the servicemen and servicewomen of the United States military and their families since its inception in the early 2000s.

We specialize in working with health plans and providers that serve our military beneficiaries and their family members—both retirees and active duty.

IDC’s main clients have been TRICARE beneficiaries who are enrolled through the US Family Health Plan (USFHP) programs. IDC first began with USFHP at Pacific Medical Centers in 2001 and IDC’s president, Rance Hutchings, was nominated to represent USFHP on the Department of Defense Pharmacy and Therapeutics Committee from 2001-2003 when membership transitioned to the Beneficiary Advisory Panel in 2003. He then served as the USFHP representative on the BAP for a maximum term of eight years from 2003-2011. Since 2021, IDC has served USFHP clients from coast to coast.

Containing drug costs within the military takes experience, and IDC has successfully decreased overall drug spend while improving pharmacy quality of care and ensuring military readiness by taking care of the families of our brave men and women in uniform.

Services that IDC provides that are unique to our military clients include the following:

ICD Military Client Services

DHA/TRICARE Pharmacy Benefit Regulatory Controls and Compliance

  • Ensuring pharmacy benefit is compliant with the rules as outlined in the TOM, TPM, and USFHP Contract

UF Formulary Compliance

  • Including coordination with the DHA
  • Ensuring proper copayments
  • Ensuring proper prior authorization criteria/forms are being implemented
  • Ensuring proper quantity limits and age limits are being adhered to
  • Ensuring proper adjudication of claims by vendors at >63,000 network pharmacies

DHA/TRICARE Medical Benefit Regulatory Controls and Compliance for Injectables and Vaccines

  • Ensuring that drugs processing through the medical benefit or medical benefit drugs processing through the pharmacy benefit meet requirements of the TOM, TPM, and USFHP Contract

DLA/DoDAAC/DFAS Regulatory Controls and Compliance

  • Weekly FedMall Posting Oversight
  • Monthly DFAS Invoicing
  • Annual Auditing Oversight

DHA Pharmacy Audit Compliance and Oversight

  • Coordinating with contracted vendor for annual auditing

PBM/Pharmacy Vendor Oversight

  • Ensuring pharmacies dispense scripts compliant with DHA/TRICARE rules
  • Ensuring pharmacies purchasing under Prime Vendor are DLA/DoDAAC Compliant in regards to FFS Pricing
  • Ensuring PBM has benefit set up correctly to adjudicate claims compliant with DHA/TRICARE rules
  • Ensure PBM is receiving and updating eligibility files from USFHP as contracted

Assisting clients with other requirements

  • CQMP (quality projects)
  • URAC (quality projects)
  • HEDIS (interpretation of pharmacy related metrics)

ICD Military Client Services

DHA/TRICARE Pharmacy Benefit Regulatory Controls and Compliance

  • Ensuring pharmacy benefit is compliant with the rules as outlined in the TOM, TPM, and USFHP Contract

UF Formulary Compliance

  • Including coordination with the DHA
  • Ensuring proper copayments
  • Ensuring proper prior authorization criteria/forms are being implemented
  • Ensuring proper quantity limits and age limits are being adhered to
  • Ensuring proper adjudication of claims by vendors at >63,000 network pharmacies

DHA/TRICARE Medical Benefit Regulatory Controls and Compliance for Injectables and Vaccines

  • Ensuring that drugs processing through the medical benefit or medical benefit drugs processing through the pharmacy benefit meet requirements of the TOM, TPM, and USFHP Contract

DLA/DoDAAC/DFAS Regulatory Controls and Compliance

  • Weekly FedMall Posting Oversight
  • Monthly DFAS Invoicing
  • Annual Auditing Oversight

DHA Pharmacy Audit Compliance and Oversight

  • Coordinating with contracted vendor for annual auditing

PBM/Pharmacy Vendor Oversight

  • Ensuring pharmacies dispense scripts compliant with DHA/TRICARE rules
  • Ensuring pharmacies purchasing under Prime Vendor are DLA/DoDAAC Compliant in regards to FFS Pricing
  • Ensuring PBM has benefit set up correctly to adjudicate claims compliant with DHA/TRICARE rules
  • Ensure PBM is receiving and updating eligibility files from USFHP as contracted

Assisting clients with other requirements

  • CQMP (quality projects)
  • URAC (quality projects)
  • HEDIS (interpretation of pharmacy related metrics)

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