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(1) ONGOING REVIEW.—The Comptroller General
shall, on an ongoing basis, review—
(A) the processes, procedures, and analysis
used by the Department of Defense to determine
the adequacy of the number of health care and
mental health care providers—
(i) that currently accept TRICARE
Standard or TRICARE Extra beneficiaries
as patients under TRICARE Standard in
each TRICARE area as of the date of com-
pletion of the review; and
(ii) that would accept TRICARE
Standard or TRICARE Extra beneficiaries
as new patients under TRICARE Standard
or TRICARE Extra, as applicable, within
a reasonable time after the date of comple-
tion of the review; and
(B) the actions taken by the Department of
Defense to ensure ready access of TRICARE
Standard beneficiaries to health care and mental
health care under TRICARE Standard in each
TRICARE area, including any pending or re-
solved requests for waiver of payment limits in
order to improve access to health care or mental
health care in a specific geographic area.
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(2) REPORTS.—The Comptroller General shall
submit to the Committees on Armed Services of the
Senate and the House of Representatives on a bi-an-
nual basis a report on the results of the review under
paragraph (1). Each report shall include the fol-
lowing:
(A) An analysis of the adequacy of the sur-
veys under subsection (a).
(B) An identification of any impediments
to achieving adequacy of availability of health
care and mental health care under TRICARE
Standard or TRICARE Extra.
(C) An assessment of the adequacy of De-
partment of Defense education programs to in-
form health care and mental health care pro-
viders 
about 
TRICARE 
Standard 
and
TRICARE Extra.
(D) An assessment of the adequacy of De-
partment of Defense initiatives to encourage
health care and mental health care providers to
accept patients under TRICARE Standard and
TRICARE Extra.
(E) An assessment of the adequacy of infor-
mation available to TRICARE Standard bene-
ficiaries to facilitate access by such beneficiaries
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to health care and mental health care under
TRICARE Standard and TRICARE Extra.
(F) An assessment of any need for adjust-
ment of health care and mental health care pro-
vider payment rates to attract participation in
TRICARE Standard by appropriate numbers of
health care and mental health care providers.
(d) EFFECTIVE DATE.—This section shall take effect
on October 1, 2007.
(e) REPEAL
OF SUPERSEDED REQUIREMENTS
AND
AUTHORITY.—Section 723 of the National Defense Author-
ization Act for Fiscal Year 2004 (10 U.S.C. 1073 note) is
repealed, effective as of October 1, 2007.
(f) DEFINITIONS.—In this section:
(1) The term ‘‘TRICARE Extra’’ means the op-
tion of the TRICARE program under which
TRICARE Standard beneficiaries may obtain dis-
counts on cost-sharing as a result of using TRICARE
network providers.
(2) The term ‘‘TRICARE Prime’’ means the
managed care option of the TRICARE program.
(3) The term ‘‘TRICARE Prime service area’’
means a geographic are designated by the Department
of Defense in which managed care support contractors
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develop a managed care network under TRICARE
Prime.
(4) The term ‘‘TRICARE Standard’’ means the
option of the TRICARE program that is also known
as the Civilian Health and Medical Program of the
Uniformed Services, as defined in section 1072(4) of
title 10, United States Code.
(5) The term ‘‘United States’’ means the United
States (as defined in section 101(a) of title 10, United
States Code), its possessions (as defined in such sec-
tion), and the Commonwealth of Puerto Rico.
SEC. 703. REPORT ON PATIENT SATISFACTION SURVEYS.
(a) REPORT REQUIRED.—Not later than March 1,
2008, the Secretary of Defense shall submit to the congres-
sional defense committees a report on the ongoing patient
satisfaction surveys taking place in Department of Defense
inpatient and outpatient settings at military treatment fa-
cilities.
(b) CONTENT.—The report required under subsection
(a) shall include the following:
(1) The types of survey questions asked.
(2) How frequently the surveying is conducted.
(3) How often the results are analyzed and re-
ported back to the treatment facilities.
(4) To whom survey feedback is made available.
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(5) How best practices are incorporated for qual-
ity improvement.
(6) An analysis of the impact and effect of inpa-
tient and outpatient surveys quality improvement
and a comparison of patient satisfaction survey pro-
grams with patient satisfaction survey programs used
by other public and private health care systems and
organizations.
(c) USE OF REPORT INFORMATION.—The Secretary
shall use information in the report as the basis for a plan
for improvements in patient satisfaction surveys at health
care at military treatment facilities in order to ensure the
provision of high quality healthcare and hospital services
in such facilities.
SEC. 704. REVIEW OF LICENSED MENTAL HEALTH COUN-
SELORS, SOCIAL WORKERS, AND MARRIAGE
AND 
FAMILY 
THERAPISTS 
UNDER 
THE
TRICARE PROGRAM.
(a) REVIEW REQUIRED.—The Secretary of Defense
shall enter into a contract with the Institute of Medicine
of the National Academy of Sciences, or another similarly
qualified independent academic medical organization, for
the purpose of—
(1) conducting an independent study of the com-
parability of credentials, preparation, and training of
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individuals practicing as licensed mental health coun-
selors, social workers, and marriage and family thera-
pists under the TRICARE program to provide mental
health services; and
(2) making recommendations for permitting such
professionals to practice independently under the
TRICARE program.
(b) ELEMENTS.—The study required by subsection (a)
shall provide for each of the health care professions referred
to in subsection (a)(1) the following:
(1) An assessment of the educational require-
ments and curriculums relevant to mental health
practice for members of such profession, including
types of degrees recognized, certification standards for
graduate programs for such profession, and recogni-
tion of undergraduate coursework for completion of
graduate degree requirements.
(2) An assessment of State licensing require-
ments for members of such profession, including for
each level of licensure if a State issues more than one
type of license for the profession. The assessment shall
examine requirements in the areas of education,
training, examination, continuing education, and
ethical standards, and shall include an evaluation of
the extent to which States, through their scope of
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practice, either implicitly or explicitly authorize
members of such profession to diagnose and treat
mental illnesses.
(3) An analysis of the requirements for clinical
experience in such profession to be recognized under
regulations for the TRICARE program, and rec-
ommendations, if any, for standardization or adjust-
ment of such requirements with those of the other pro-
fessions.
(4) An assessment of the extent to which practi-
tioners under such profession are authorized to prac-
tice independently under other Federal programs
(such as the Medicare program, the Department of
Veterans Affairs, the Indian Health Service, Head
Start, and the Federal Employee Health Benefits Pro-
gram), and a review the relationship, if any, between
recognition of such profession under the Medicare pro-
gram and independent practice authority for such
profession under the TRICARE program.
(5) An assessment of the extent to which practi-
tioners under such profession are authorized to prac-
tice independently under private insurance plans.
The assessment shall identify the States having laws
requiring private insurers to cover, or offer coverage
of, the services of members of such profession, and
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shall identify the conditions, if any, that are placed
on coverage of practitioners under such profession by
insurance plans and how frequently these types of
conditions are used by insurers.
(6) An historical review of the regulations issued
by the Department of Defense regarding which mem-
bers of such profession are recognized as providers
under the TRICARE program as independent practi-
tioners, and an examination of the recognition by the
Department of third party certification for members
of such profession.
(c) PROVIDERS STUDIED.—It the sense of Congress
that the study required by subsection (a) should focus only
on those practitioners of each health care profession referred
to in subsection (a)(1) who are permitted to practice under
regulations for the TRICARE program as specified in sec-
tion 119.6 of title 32, Code of Federal Regulations.
(d) CLINICAL CAPABILITIES STUDIES.—The study re-
quired by subsection (a) shall include a review of outcome
studies and of the literature regarding the comparative
quality and effectiveness of care provided by practitioners
within each of the health care professions referred to in sub-
section (a)(1), and provide an independent review of the
findings.