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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘TRICARE Payment 

5 And Reimbursement Study Act’’ or the ‘‘TRICARE PAR 

6 Study Act’’. 


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1 SEC. 2. STUDY ON REIMBURSEMENT RATES FOR MENTAL 

2 HEALTH CARE PROVIDERS UNDER TRICARE 

3 PRIME AND TRICARE SELECT IN THE EAST 

4 AND WEST REGIONS OF THE TRICARE PRO5 GRAM. 

6 (a) STUDY.—The Secretary of Defense shall conduct 

7 a study assessing the impact of using established rates to 

8 reimburse covered mental health care providers on the 

9 availability of such providers. 

10 (b) ELEMENTS.—The study under subsection (a) 

11 shall include the following: 

12 (1) An evaluation of— 

13 (A) whether there are enough covered men14 tal health care providers to adequately serve the 

15 beneficiaries under TRICARE Prime and the 

16 beneficiaries under TRICARE Select of each lo17 cality in the East and West regions of the 

18 TRICARE program, including in rural commu19 nities in such regions; and 

20 (B) whether the requirements under sec21 tions 1079(h)(1) and 1097b of title 10, United 

22 States Code, to use established rates to reim23 burse covered mental health care providers lim24 its the number of covered health care providers 

25 serving each locality in the East and West reVerDate Sep 11 2014 01:18 Nov 19, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H4994.IH H4994

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1 gions of the TRICARE program, including in 

2 rural communities in such regions. 

3 (2) An assessment of the impact of using estab4 lished rates to reimburse covered mental health care 

5 providers on— 

6 (A) the ability of beneficiaries under 

7 TRICARE Prime and beneficiaries under 

8 TRICARE Select to access appropriate and 

9 timely mental health care in accordance with 

10 section 199.17 of title 32, Code of Federal Reg11 ulations; and 

12 (B) the availability of services provided by 

13 mental health care providers that are needed by 

14 members of the Armed Forces to be medically 

15 ready. 

16 (3) Information about instances in which the 

17 Secretary provided or applied exceptions to estab18 lished rates pursuant to section 1079(h)(2) of title 

19 10, United States Code, to increase the number of 

20 covered mental health care providers. 

21 (4) A description of how the Secretary solicits 

22 and collects feedback from covered mental health 

23 care providers on established rates. 

24 (5) A list of actions the Secretary has taken to 

25 address such feedback. 


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1 (6) Any legislative, regulatory, or policy rec2 ommendations that are necessary to improve the 

3 overall medical readiness of the Armed Forces. 

4 (c) REPORT.—Not later than one year after the date 

5 of the enactment of this Act, the Secretary shall submit 

6 to the Committee on Armed Services of the House of Rep7 resentatives and the Committee on Armed Services of the 

8 Senate a report on the results of the study required under 

9 subsection (a). 

10 (d) BRIEFING.—Not later than 60 days after the date 

11 on which the report required under subsection (c) is sub12 mitted to the Committee on Armed Services of the House 

13 of Representatives and the Committee on Armed Services 

14 of the Senate, the Secretary shall provide a briefing to 

15 such committees on the results of the study required under 

16 subsection (a). 

17 (e) COMPTROLLER GENERAL REVIEW AND RE18 PORT.—Not later than 180 days after the date on which 

19 the report under subsection (c) is submitted to the Com20 mittee on Armed Services of the House of Representatives 

21 and the Committee on Armed Services of the Senate, the 

22 Comptroller General of the United States shall— 

23 (1) review the report required under subsection 

24 (c); and 


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1 (2) submit to the Committee on Armed Services 

2 of the House of Representatives and the Committee 

3 on Armed Services of the Senate an assessment of— 

4 (A) whether the results of the study re5 quired under subsection (a) are supported by 

6 the data and information examined in the study 

7 required under subsection (a); and 

8 (B) the feasibility of any recommendations 

9 identified by the Secretary under subsection 

10 (b)(6). 

11 (f) DEFINITIONS.—In this section: 

12 (1) The term ‘‘established rate’’ means the pay13 ment amount determined by the Secretary pursuant 

14 to sections 1079(h)(1) and 1097b of title 10, United 

15 States Code, and section 199.14 of title 32, Code of 

16 Federal Regulations. 

17 (2) The term ‘‘covered mental health care pro18 vider’’ means a mental health care provider under 

19 TRICARE Prime and TRICARE Select in the East 

20 and West regions of the TRICARE program. 

21 (3) The term ‘‘mental health care provider’’ 

22 means a psychiatrist, clinical psychologist, certified 

23 psychiatric nurse specialist, certified clinical social 

24 worker, certified marriage and family therapist, 

25 TRICARE certified mental health counselor, pasVerDate Sep 11 2014 01:18 Nov 19, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H4994.IH H4994

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1 toral counselor under the supervision of a physician, 

2 and supervised mental health counselor under the 

3 supervision of a physician. 

4 (4) The term locality means a geographic loca5 tion— 

6 (A) designated as a Prime Service Area 

7 under section 199.17(b)(1) of title 32, Code of 

8 Federal Regulations; and 

9 (B) in which the Secretary entered into a 

10 contract under chapter 55 of title 10, United 

11 States Code, with a contractor under the 

12 TRICARE program to provide health care serv13 ices to beneficiaries by TRICARE-authorized ci14 vilian health care providers. 

15 (5) The terms ‘‘TRICARE Prime’’ and 

16 ‘‘TRICARE Select’’ have the meanings given those 

17 terms in section 1072 of title 10, United States 

18 Code. 

Æ 


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