TRICARE PAR Study Act

I 116TH CONGRESS 1ST SESSION H. R. 4994 To direct the Secretary of Defense to conduct a study on reimbursement rates for mental health care providers under the TRICARE program. IN THE HOUSE OF REPRESENTATIVES NOVEMBER 8, 2019 Ms. GABBARD introduced the following bill; which was referred to the Committee on Armed Services A BILL To direct the Secretary of Defense to conduct a study on reimbursement rates for mental health care providers under the TRICARE program. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘TRICARE Payment 4 And Reimbursement Study Act’’ or the ‘‘TRICARE PAR 5 Study Act’’. 6 VerDate Sep 11 2014 01:18 Nov 19, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H4994.IH H4994 dlhill on DSKBBY8HB2PROD with BILLS 2 •HR 4994 IH SEC. 2. STUDY ON REIMBURSEMENT RATES FOR MENTAL 1 HEALTH CARE PROVIDERS UNDER TRICARE 2 PRIME AND TRICARE SELECT IN THE EAST 3 AND WEST REGIONS OF THE TRICARE PRO- 4 GRAM. 5 (a) STUDY.—The Secretary of Defense shall conduct 6 a study assessing the impact of using established rates to 7 reimburse covered mental health care providers on the 8 availability of such providers. 9 (b) ELEMENTS.—The study under subsection (a) 10 shall include the following: 11 (1) An evaluation of— 12 (A) whether there are enough covered men- 13 tal health care providers to adequately serve the 14 beneficiaries under TRICARE Prime and the 15 beneficiaries under TRICARE Select of each lo- 16 cality in the East and West regions of the 17 TRICARE program, including in rural commu- 18 nities in such regions; and 19 (B) whether the requirements under sec- 20 tions 1079(h)(1) and 1097b of title 10, United 21 States Code, to use established rates to reim- 22 burse covered mental health care providers lim- 23 its the number of covered health care providers 24 serving each locality in the East and West re- 25 VerDate Sep 11 2014 01:18 Nov 19, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H4994.IH H4994 dlhill on DSKBBY8HB2PROD with BILLS 3 •HR 4994 IH gions of the TRICARE program, including in 1 rural communities in such regions. 2 (2) An assessment of the impact of using estab- 3 lished rates to reimburse covered mental health care 4 providers on— 5 (A) the ability of beneficiaries under 6 TRICARE Prime and beneficiaries under 7 TRICARE Select to access appropriate and 8 timely mental health care in accordance with 9 section 199.17 of title 32, Code of Federal Reg- 10 ulations; and 11 (B) the availability of services provided by 12 mental health care providers that are needed by 13 members of the Armed Forces to be medically 14 ready. 15 (3) Information about instances in which the 16 Secretary provided or applied exceptions to estab- 17 lished rates pursuant to section 1079(h)(2) of title 18 10, United States Code, to increase the number of 19 covered mental health care providers. 20 (4) A description of how the Secretary solicits 21 and collects feedback from covered mental health 22 care providers on established rates. 23 (5) A list of actions the Secretary has taken to 24 address such feedback. 25 VerDate Sep 11 2014 01:18 Nov 19, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H4994.IH H4994 dlhill on DSKBBY8HB2PROD with BILLS 4 •HR 4994 IH (6) Any legislative, regulatory, or policy rec- 1 ommendations that are necessary to improve the 2 overall medical readiness of the Armed Forces. 3 (c) REPORT.—Not later than one year after the date 4 of the enactment of this Act, the Secretary shall submit 5 to the Committee on Armed Services of the House of Rep- 6 resentatives and the Committee on Armed Services of the 7 Senate a report on the results of the study required under 8 subsection (a). 9 (d) BRIEFING.—Not later than 60 days after the date 10 on which the report required under subsection (c) is sub- 11 mitted to the Committee on Armed Services of the House 12 of Representatives and the Committee on Armed Services 13 of the Senate, the Secretary shall provide a briefing to 14 such committees on the results of the study required under 15 subsection (a). 16 (e) COMPTROLLER GENERAL REVIEW AND RE- 17 PORT.—Not later than 180 days after the date on which 18 the report under subsection (c) is submitted to the Com- 19 mittee on Armed Services of the House of Representatives 20 and the Committee on Armed Services of the Senate, the 21 Comptroller General of the United States shall— 22 (1) review the report required under subsection 23 (c); and 24 VerDate Sep 11 2014 01:18 Nov 19, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H4994.IH H4994 dlhill on DSKBBY8HB2PROD with BILLS 5 •HR 4994 IH (2) submit to the Committee on Armed Services 1 of the House of Representatives and the Committee 2 on Armed Services of the Senate an assessment of— 3 (A) whether the results of the study re- 4 quired under subsection (a) are supported by 5 the data and information examined in the study 6 required under subsection (a); and 7 (B) the feasibility of any recommendations 8 identified by the Secretary under subsection 9 (b)(6). 10 (f) DEFINITIONS.—In this section: 11 (1) The term ‘‘established rate’’ means the pay- 12 ment amount determined by the Secretary pursuant 13 to sections 1079(h)(1) and 1097b of title 10, United 14 States Code, and section 199.14 of title 32, Code of 15 Federal Regulations. 16 (2) The term ‘‘covered mental health care pro- 17 vider’’ means a mental health care provider under 18 TRICARE Prime and TRICARE Select in the East 19 and West regions of the TRICARE program. 20 (3) The term ‘‘mental health care provider’’ 21 means a psychiatrist, clinical psychologist, certified 22 psychiatric nurse specialist, certified clinical social 23 worker, certified marriage and family therapist, 24 TRICARE certified mental health counselor, pas- 25 VerDate Sep 11 2014 01:18 Nov 19, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H4994.IH H4994 dlhill on DSKBBY8HB2PROD with BILLS 6 •HR 4994 IH toral counselor under the supervision of a physician, 1 and supervised mental health counselor under the 2 supervision of a physician. 3 (4) The term locality means a geographic loca- 4 tion— 5 (A) designated as a Prime Service Area 6 under section 199.17(b)(1) of title 32, Code of 7 Federal Regulations; and 8 (B) in which the Secretary entered into a 9 contract under chapter 55 of title 10, United 10 States Code, with a contractor under the 11 TRICARE program to provide health care serv- 12 ices to beneficiaries by TRICARE-authorized ci- 13 vilian health care providers. 14 (5) The terms ‘‘TRICARE Prime’’ and 15 ‘‘TRICARE Select’’ have the meanings given those 16 terms in section 1072 of title 10, United States 17 Code. 18 Æ VerDate Sep 11 2014 01:18 Nov 19, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\H4994.IH H4994 dlhill on DSKBBY8HB2PROD with BILLS