A bill to amend title 10 United States Code to make certain improvements with respect to the TRICARE program

6 Pages·1999·0.22 MB·English

by  United States. Congress. House

106thcongress H.R.1547
1stSession
Toamendtitle10,UnitedStatesCode,tomakecertainimprovementswith
respecttotheTRICAREprogram.
IN THE HOUSE OF REPRESENTATR^S
April22,1999
Mr.Thornberryintroducedthefollowingbill;whichwasreferredtothe
CommitteeonArmedServices
A
BILL
Toamendtitle 10,UnitedStatesCode,tomakecertain
improvementswithrespecttotheTRICAREprogram.
1 BeitenactedhytheSenateandHouseofRepresenta-
2 tivesoftheUnitedStatesofAmericainCongressassembled,
3 SECTION.1.IMPROVEMENTOFTRICAREPROGRAM.
—
4 (a) ImprovementofTRICARE Program. Chap-
5 ter55 oftitle 10, United States Code, isamendedbyin-
6 sertingaftersection1097athefollowingnewsection:
1 "§1097b. TRICARE: comparability of benefits with
2 benefitsunderFederalEmployeesHealth
3 Benefits program; other requirements
4 andauthorities
—
5 "(a) COMPAEABILITYOFBENEFITS. The Secretarv^
6 ofDefense shall, tothe maximum extentpracticable, en-
7 sure that the health care coverage available through the
8 TRICARE programis substantiallysimilarto the health
9 carecoverageavailableundersunilarhealthbenefitsplans
10 offeredundertheFederalEmplo.yeesHealthBenefitspro-
11 gramestablishedunderchapter89oftitle5.
—
12 "(b) PortabilityofBenefits. TheSecretaryof
13 Defenseshallprovidethatanycoveredbeneficiaryenrolled
14 intheTRICAREprogrammayreceivebenefitsunderthat
15 programatfacilitiesthatpro\idebenefitsunderthatpro-
16 gramtlu-oughoutthevariousregionsofthatprogram.
—
17 "(c) Patient Management. (1) The Secretar>^of
18 Defense shall, to the maximum extent practicable, mini-
19 mize the authorization or certification requirements im-
20 posed upon covered beneficiaries under the TRICARE
21 program as a condition of access to benefits under that
22 program.
23 "(2) The SecretaryofDefenseshallimplement,mth
24 respectthe firsttwo contracts awarded afterthe date of
25 theenactmentofthissectiontoprovidemanagedcaresup-
26 portundertheTRICAREprogram,redesignedprocedures
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1 forpajTiientandprocessingofclaimsundersuchprogram.
2 Suchprocedures shah incorporate bestindustr^^practices
3 for processing claims for health care services in a sim-
4 plified and expedited maimer and shall include electronic
5 claimsprocessing.
6 "(d) AUTHORIIT FOR CERTAIN THIRD-PARTY CoL-
7 LECTIONS.—(1) A medical treatment facility ofthe uni-
8 formedservicesundertheTRICAREprogrammaycollect
9 fromatliird-party^payerthereasonablechargesforhealth
10 careservicesdescribedinparagraph(2)thatareincurred
11 by the facility on behalf of a covered beneficiary under
12 thatprogramtothe extentthatthebeneficiarywouldbe
13 eligibleto receivereimbursementorindemnificationfrom
14 thethird-partypayerifthebeneficiaiyweretoincursuch
15 chargesonthebeneficiary'so-v\tibehalf.
16 "(2) The reasonable charges described inthis para-
17 graphare reasonablechargesfoi"servicesorcarecovered
18 bythe medicareprogramundertitleX\T;II ofthe Social
19 SecurityAct.
20 "(3) The collectionofcharges, andtheutilizationof
21 amounts collected, underthis subsection shall be subject
22 to the provisions ofsection 1095 ofthis title. The term
23 'reasonablecosts',asusedinthatsectionshaUbedeemed
24 forpurposesoftheapphcationofthatsectiontothissub-
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1 section to refer to the reasonable charges described in
2 paragraph(2).
—
3 "(e) Consultation. The Secretary of Defense
4 shall carrv" out any actions under this section after con-
5 sulfationwiththeotheradministeringSecretaries.".
—
6 (b) Clerical Amendment. The table of sections
7 at the beginning ofchapter 55 ofsuch title is amended
8 byinserting afterthe item relatingto section 1097a the
9 followingnewitem:
"1097b.TRICARE:comparabilityofbenefitswithbenefitsunderFederalEm-
ployeesHealthBenefitsprogram;otherrequirementsandau-
thorities.".
—
10 (c) Report on Implementation. (1) Not later
11 than6montlisafterthedateoftheenactmentofthisAct,
12 the Secretarj^ ofDefense, in consultation with the other
13 administeringSecretaries, shaU submitto Congress are-
14 portassessingtheeffectsoftheimplementationofthere-
15 quireinents and authorities set forth in section 1097b of
16 title 10,UnitedStatesCode (asaddedbysubsection(a)).
17 (2)Thereportshallincludethefollowing:
18 (A)Anassessmentofthecostoftheimplemen-
19 tationofsuchrequirementsandauthorities.
20 (B) An assessment whether or not the imple-
21 mentation ofany such requirements and authorities
22 will result in the utihzation by the TRICARE pro-
23 gram ofthe best industrj^ practices with respect to
m
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1 the matters covered by such requirements and au-
2 thorities.
3 (3)Inthissubsection,theterm"administeringSecre-
• 4 taries" has the meaning given that term in section
5 1072(3)oftitle10,UnitedStatesCode.
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