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