( nadequate oversight and insufficient re...)Bush Administration Allows Returning Soldiers to Disintegrate, Say Critics,Health

nadequate oversight and insufficient reimbursement," the Defense Department's mental health task force said last month after reviewing the military's psychological care system.

The Tricare office that serves Fort Campbell, Ky., on the Tennessee-Kentucky state line, and Fort Bragg, N.C. Army posts with heavy war deployments told task force members that it routinely fields complaints about the difficulty in locating mental health specialists who accept Tricare.

"Unfortunately, in some of our communities ... we are maxed out on the available providers," said Lois Krysa, the office's quality manager. "In other areas, the providers just are not willing to sign up to take Tricare assignment, and that is a problem."

Tricare's reimbursement rate is tied to Medicare's, which pays less than civilian employer insurance. The rate for mental health care services fell by 6.4 percent this year as part of an adjustment in reimbursements to certain specialties.

Since 2004, Tricare has sped up payments to encourage more doctors to participate, said Austin Camacho, a Tricare spokesman. In some locations, such as Idaho and Alaska, the Defense Department has also raised rates to attract physicians, he said. "We are working hard to overcome those challenges," Camacho said.

Jack Wagoner is a retired military officer and psychologist and psychiatrist in private practice who also works for a Tricare contractor. He told defense mental health board members last December that in general, Tricare pays "considerably lower" than private health insurance plans.

According to data from Tricare's Medical Benefits and Reimbursement System office, Tricare pays mental health providers as much or more than a corporate plan would pay a therapist for treating a patient although in some cases it is lower.

There are different coverage plans within Tricare, and the amount paid to providers varies by
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