| 1 | 1 | | I |
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| 2 | 2 | | 119THCONGRESS |
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| 3 | 3 | | 1 |
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| 4 | 4 | | STSESSION H. R. 873 |
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| 5 | 5 | | To amend title 10, United States Code, to modify the rate of pay for |
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| 6 | 6 | | care or services provided under the TRICARE program based on the |
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| 7 | 7 | | location at which such care or services were provided. |
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| 8 | 8 | | IN THE HOUSE OF REPRESENTATIVES |
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| 9 | 9 | | JANUARY31, 2025 |
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| 10 | 10 | | Mr. M |
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| 11 | 11 | | CCORMICKintroduced the following bill; which was referred to the |
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| 12 | 12 | | Committee on Armed Services |
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| 13 | 13 | | A BILL |
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| 14 | 14 | | To amend title 10, United States Code, to modify the rate |
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| 15 | 15 | | of pay for care or services provided under the TRICARE |
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| 16 | 16 | | program based on the location at which such care or |
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| 17 | 17 | | services were provided. |
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| 18 | 18 | | Be it enacted by the Senate and House of Representa-1 |
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| 19 | 19 | | tives of the United States of America in Congress assembled, 2 |
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| 20 | 20 | | SECTION 1. TRICARE REIMBURSEMENT RATES. 3 |
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| 21 | 21 | | (a) R |
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| 22 | 22 | | ATES.—Section 1097b(a) of title 10, United 4 |
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| 23 | 23 | | States Code, is amended— 5 |
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| 24 | 24 | | (1) in paragraph (1), by inserting ‘‘and para-6 |
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| 25 | 25 | | graph (3)(A)’’ after ‘‘Subject to paragraph (2)’’; and 7 |
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| 26 | 26 | | VerDate Sep 11 2014 22:57 Feb 27, 2025 Jkt 059200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H873.IH H873 |
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| 27 | 27 | | ssavage on LAPJG3WLY3PROD with BILLS 2 |
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| 28 | 28 | | •HR 873 IH |
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| 29 | 29 | | (2) in paragraph (3), by striking ‘‘In estab-1 |
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| 30 | 30 | | lishing’’ and inserting the following: 2 |
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| 31 | 31 | | ‘‘(A)(i) Except as provided by paragraph (1), if the 3 |
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| 32 | 32 | | Secretary may determine among more than one reimburse-4 |
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| 33 | 33 | | ment rate to pay a health care provider for care or services 5 |
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| 34 | 34 | | provided under the TRICARE program, the Secretary 6 |
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| 35 | 35 | | shall pay the lowest rate authorized for such care or serv-7 |
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| 36 | 36 | | ices. 8 |
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| 37 | 37 | | ‘‘(ii) The Secretary shall establish reimbursement 9 |
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| 38 | 38 | | rates for care or services paid to health care providers 10 |
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| 39 | 39 | | under the TRICARE program that are specific with re-11 |
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| 40 | 40 | | spect to the following locations at which the care or serv-12 |
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| 41 | 41 | | ices were provided (regardless of the location of the head-13 |
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| 42 | 42 | | quarters of the health care provider): 14 |
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| 43 | 43 | | ‘‘(I) An inpatient hospital. 15 |
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| 44 | 44 | | ‘‘(II) An on-campus hospital outpatient depart-16 |
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| 45 | 45 | | ment. 17 |
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| 46 | 46 | | ‘‘(III) An off-campus hospital outpatient de-18 |
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| 47 | 47 | | partment. 19 |
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| 48 | 48 | | ‘‘(IV) An ambulatory surgical center. 20 |
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| 49 | 49 | | ‘‘(V) The office of a physician. 21 |
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| 50 | 50 | | ‘‘(iii) The Secretary shall ensure that a claim for re-22 |
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| 51 | 51 | | imbursement includes a unique, geographically specific na-23 |
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| 52 | 52 | | tional provider identifier code that identifies the location 24 |
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| 53 | 53 | | of the provider as described in clause (ii). 25 |
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| 54 | 54 | | VerDate Sep 11 2014 22:57 Feb 27, 2025 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H873.IH H873 |
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| 55 | 55 | | ssavage on LAPJG3WLY3PROD with BILLS 3 |
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| 56 | 56 | | •HR 873 IH |
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| 57 | 57 | | ‘‘(B) In establishing’’. 1 |
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| 58 | 58 | | (b) E |
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| 59 | 59 | | FFECTIVEDATE.—The amendments made by 2 |
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| 60 | 60 | | subsection (a) shall take effect on January 1, 2026. 3 |
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| 61 | 61 | | Æ |
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| 62 | 62 | | VerDate Sep 11 2014 22:57 Feb 27, 2025 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6301 E:\BILLS\H873.IH H873 |
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| 63 | 63 | | ssavage on LAPJG3WLY3PROD with BILLS |
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