[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4994 Introduced in House (IH)]

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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 Representatives 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''.

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 PROGRAM.

    (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 mental health 
                care providers to adequately serve the beneficiaries 
                under TRICARE Prime and the beneficiaries under TRICARE 
                Select of each locality in the East and West regions of 
                the TRICARE program, including in rural communities in 
                such regions; and
                    (B) whether the requirements under sections 
                1079(h)(1) and 1097b of title 10, United States Code, 
                to use established rates to reimburse covered mental 
                health care providers limits the number of covered 
                health care providers serving each locality in the East 
                and West regions of the TRICARE program, including in 
                rural communities in such regions.
            (2) An assessment of the impact of using established 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 
                Regulations; 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 established 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.
            (6) Any legislative, regulatory, or policy recommendations 
        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 Representatives 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 submitted 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 Report.--Not later than 180 days 
after the date on which the report under subsection (c) is submitted to 
the Committee 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
            (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 required 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 payment 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 provider'' 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, pastoral 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 location--
                    (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 services to beneficiaries by TRICARE-
                authorized civilian 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.
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