Management’s Discussion and Analysis
18
TRICARE Retail Pharmacy Refunds Program
Program To Date (CY 2008-
3rd Quarter, CY 2018 Total DHP Non-DoD MERHCF
SDP -
Billed $7,767,316,589 $3,533,064,654 $119,650,058 4,114,601,877
Collected (7,468,113,084) (3,403,791,255) (114,168,670) (3,950,153,159)
Net 299,203,505 129,273,399 5,481,388 164,448,718
ADP -
Billed 4,745,537,027 2,151,949,586 73,985,370 2,519,602,071
Collected (4,543,283,635) (2,063,943,291) (70,563,736) (2,408,776,608)
Net 202,253,392 88,006,295 3,421,634 110,825,463
UDC
1
(349,828) (151,345) (6,076) (192,407)
Total -
Billed $12,512,853,616 $5,685,014,240 $193,635,428 $6,634,203,948
Collected (12,011,396,719) (5,467,734,546) (184,732,406) (6,358,929,767)
UDC (349,828) (151,345) (6,076) (192,407)
Net
$501,107,069 $217,128,349 $8,896,946 $275,081,774
Aging -
Current $418,112,159 $180,888,729 $7,262,643 $229,960,787
61 Days to 2 Years
2
15,592,652 6,445,418 632,190 8,515,044
Over 2 Years 67,402,257 29,794,201 1,002,112 36,605,944
Total
3
$501,107,068 $217,128,348 $8,896,945 $275,081,775
1. UDC applied to CY18.
2. Pharmacy debt not delinquent until 70 days. 70-day A/R aging bucket not available; 61-day aging used instead.
3. 3QCY2018 Estimate added to Billings to reconcile with A/R: $117,137,000 MERHCF; $95,841,000 DHP & Non-DoD.
TRICARE has a waiver dated September 23, 1996, 10 USC 1079a, Champus: Treatment of Refunds and Other
Amounts Collected that states:
“All refunds and other amounts collected in the administration of the Civilian Health and Medical Program of the
Uniformed Services shall be credited to the appropriation available for that program for the fiscal year in which the
refund or amount is collected.”
Thus TRICARE records all Collections/Refunds into the current year and decreases budgetary disbursements for the
current year. The refunds collected are not treated as offsetting collections.
The DHA in FY 2018 continued to aggressively collect pharmacy refunds for both the Standard and Additional
Discount Programs. Through the concerted efforts of CRM, POD, HCDA, and OGC, DHA collected 98.9% of the
delinquent debt from 1st Quarter Calendar Year (CY) 2008 through 2nd Quarter CY 2017. All unpaid debts for these
quarters have been referred to the OGC’s Claims Collections Section and/or to the Department of the Treasury for
further collection activity.
The percent collected for 3rd Quarter CY 2017 through 1st Quarter CY 2018 is 97.8% with payments due for 2nd
Quarter CY 2018 in November 2018.