II 

118TH CONGRESS 

2D SESSION S. 4891 

To amend title 10, United States Code, to direct the Secretary of Defense 

to limit copayments for outpatient visits for mental health or behavioral 

health under the TRICARE program, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JULY 31, 2024 

Mr. CASEY (for himself, Mr. BROWN, Mrs. GILLIBRAND, Ms. STABENOW, Mr. 

WELCH, and Ms. KLOBUCHAR) introduced the following bill; which was 

read twice and referred to the Committee on Armed Services 

A BILL 

To amend title 10, United States Code, to direct the Secretary of Defense to limit copayments for outpatient 

visits for mental health or behavioral health under the 

TRICARE program, and for other purposes. 

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 ‘‘Stop Copay Overpay 

5 Act’’. 


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1 SEC. 2. LIMITATION ON COPAYMENTS FOR OUTPATIENT 

2 VISITS FOR MENTAL OR BEHAVIORAL 

3 HEALTH UNDER TRICARE PROGRAM. 

4 (a) LIMITATION ON MENTAL OR BEHAVIORAL

5 HEALTH COPAYMENTS.— 

6 (1) LIMITATION.—Chapter 55 of title 10, 

7 United States Code, is amended by inserting after 

8 the item relating to section 1075a the following new 

9 section: 

10 ‘‘§ 1075b. TRICARE program: limitation on copay11 ments for certain mental or behavioral 

12 health visits 

13 ‘‘(a) LIMITATION ON COPAYMENTS.—Notwith14 standing any other provision of this chapter, the Secretary 

15 of Defense may not charge to a covered individual a copay16 ment in an amount greater than the amount described in 

17 subsection (b) for an outpatient visit for mental health or 

18 behavioral health under the TRICARE program, regard19 less of whether such outpatient visit is furnished by a spe20 cialty care provider. 

21 ‘‘(b) AMOUNT DESCRIBED.—The amount described 

22 in this subsection with respect to a covered individual is 

23 the amount of a copayment that would be charged to the 

24 covered individual under the TRICARE program for an 

25 outpatient visit for primary care services during the year 


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1 in which the covered individual is being charged pursuant 

2 to subsection (a). 

3 ‘‘(c) COVERED INDIVIDUAL DEFINED.—In this sec4 tion, the term ‘covered individual’ means an individual en5 rolled under the TRICARE program, regardless of the 

6 beneficiary category of the individual with respect to such 

7 program or the duty status of the individual.’’. 

8 (2) CLERICAL AMENDMENT.—The table of sec9 tions for such chapter is amended by inserting after 

10 the item relating to section 1075a the following new 

11 section: 

‘‘1075b. TRICARE program: limitation on copayments for certain mental or behavioral health visits.’’. 

12 (3) APPLICABILITY.—The amendments made 

13 by this subsection shall apply with respect to out14 patient visits for mental or behavioral health occur15 ring on or after the date of the enactment of this 

16 Act. 

17 (b) TEMPORARY LIMITATION ON OTHER SPECIALTY

18 CARE COPAYMENTS.— 

19 (1) TEMPORARY LIMITATION.—During the one20 year period beginning on the date of the enactment 

21 of this Act, the Secretary of Defense may not in22 crease the amount of a copayment charged to a cov23 ered individual for any service described in para24 graph (2) beyond the amount that the Secretary 


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1 would have charged to the covered individual for 

2 such service during fiscal year 2021. 

3 (2) SERVICES DESCRIBED.—A service described 

4 in this paragraph is a service— 

5 (A) that is furnished to a covered indi6 vidual by a specialty care provider under the 

7 TRICARE program; and 

8 (B) that is not covered under section 

9 1075b of title 10, United States Code, as added 

10 by subsection (a). 

11 (3) APPLICABILITY.—The limitation on copay12 ments specified in paragraph (1) shall apply with re13 spect to specialty care received on or after the date 

14 of the enactment of this Act. 

15 (c) REPORT ON EFFECTS OF LIMITATIONS.— 

16 (1) IN GENERAL.—Not later than one year 

17 after the date of the enactment of this Act, the Sec18 retary of Defense shall submit to the Committee on 

19 Armed Services of the Senate and the Committee on 

20 Armed Services of the House of Representatives a 

21 report on how the limitation under section 1075b of 

22 title 10, United States Code (as added by subsection 

23 (a)), has affected, or may affect, the health care sys24 tem of the Department of Defense. 


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1 (2) ELEMENTS.—The report required under 

2 paragraph (1) shall include— 

3 (A) any findings by the Secretary as to 

4 whether the limitation under section 1075b of 

5 title 10, United States Code (as added by sub6 section (a)), may result in an increase in copay7 ments charged for services described in sub8 section (b)(2) after the period specified in sub9 section (b)(1) concludes; and 

10 (B) recommendations by the Secretary on 

11 how to avoid such an increase, as applicable. 

12 (d) DEFINITIONS.—In this section: 

13 (1) COVERED INDIVIDUAL.—The term ‘‘covered 

14 individual’’ has the meaning given that term in sec15 tion 1075b of title 10, United States Code, as added 

16 by subsection (a). 

17 (2) TRICARE PROGRAM.—The term 

18 ‘‘TRICARE program’’ has the meaning given that 

19 term in section 1072 of such title. 

Æ 


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