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106TH CONGRESS
1ST SESSION
H. R. 1547
To amend title 10, United States Code, to make certain improvements with
respect to the TRICARE program.
IN THE HOUSE OF REPRESENTATIVES
APRIL 22, 1999
Mr. THORNBERRY introduced the following bill; which was referred to the
Committee on Armed Services
A BILL
To amend title 10, United States Code, to make certain
improvements with respect to the TRICARE program.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION. 1. IMPROVEMENT OF TRICARE PROGRAM.
(a) IMPROVEMENT OF TRICARE PROGRAM.—Chap-
ter 55 of title 10, United States Code, is amended by in-
serting after section 1097a the following new section:
‘‘§ 1097b. TRICARE: comparability of benefits with
benefits under Federal Employees Health
Benefits program; other requirements
and authorities
‘‘(a) COMPARABILITY OF BENEFITS.—The Secretary
of Defense shall, to the maximum extent practicable, en-
sure that the health care coverage available through the
TRICARE program is substantially similar to the health
care coverage available under similar health benefits plans
offered under the Federal Employees Health Benefits pro-
gram established under chapter 89 of title 5.
‘‘(b) PORTABILITY OF BENEFITS.—The Secretary of
Defense shall provide that any covered beneficiary enrolled
in the TRICARE program may receive benefits under that
program at facilities that provide benefits under that pro-
gram throughout the various regions of that program.
‘‘(c) PATIENT MANAGEMENT.—(1) The Secretary of
Defense shall, to the maximum extent practicable, mini-
mize the authorization or certification requirements im-
posed upon covered beneficiaries under the TRICARE
program as a condition of access to benefits under that
program.
‘‘(2) The Secretary of Defense shall implement, with
respect the first two contracts awarded after the date of
the enactment of this section to provide managed care sup-
port under the TRICARE program, redesigned procedures
for payment and processing of claims under such program.
Such procedures shall incorporate best industry practices
for processing claims for health care services in a sim-
plified and expedited manner and shall include electronic
claims processing.
‘‘(d) AUTHORITY FOR CERTAIN THIRD-PARTY COL-
LECTIONS.—(1) A medical treatment facility of the uni-
formed services under the TRICARE program may collect
from a third-party payer the reasonable charges for health
care services described in paragraph (2) that are incurred
by the facility on behalf of a covered beneficiary under
that program to the extent that the beneficiary would be
eligible to receive reimbursement or indemnification from
the third-party payer if the beneficiary were to incur such
charges on the beneficiary’s own behalf.
‘‘(2) The reasonable charges described in this para-
graph are reasonable charges for services or care covered
by the medicare program under title XVIII of the Social
Security Act.
‘‘(3) The collection of charges, and the utilization of
amounts collected, under this subsection shall be subject
to the provisions of section 1095 of this title. The term
‘reasonable costs’, as used in that section shall be deemed
for purposes of the application of that section to this sub-
section to refer to the reasonable charges described in
paragraph (2).
‘‘(e) CONSULTATION.—The Secretary of Defense
shall carry out any actions under this section after con-
sultation with the other administering Secretaries.’’.
(b) CLERICAL AMENDMENT.—The table of sections
at the beginning of chapter 55 of such title is amended
by inserting after the item relating to section 1097a the
following new item:
‘‘1097b. TRICARE: comparability of benefits with benefits under Federal Em-
ployees Health Benefits program; other requirements and au-
thorities.’’.
(c) REPORT ON IMPLEMENTATION.—(1) Not later
than 6 months after the date of the enactment of this Act,
the Secretary of Defense, in consultation with the other
administering Secretaries, shall submit to Congress a re-
port assessing the effects of the implementation of the re-
quirements and authorities set forth in section 1097b of
title 10, United States Code (as added by subsection (a)).
(2) The report shall include the following:
(A) An assessment of the cost of the implemen-
tation of such requirements and authorities.
(B) An assessment whether or not the imple-
mentation of any such requirements and authorities
will result in the utilization by the TRICARE pro-
gram of the best industry practices with respect to
the matters covered by such requirements and au-
thorities.
(3) In this subsection, the term ‘‘administering Secre-
taries’’ has the meaning given that term in section
1072(3) of title 10, United States Code.
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