[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 4891 Introduced in Senate (IS)]

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118th CONGRESS
  2d Session
                                S. 4891

   To amend title 10, United States Code, to direct the Secretary of 
Defense to limit copayments for outpatient visits for mental health or 
  behavioral health under the TRICARE program, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 31, 2024

 Mr. Casey (for himself, Mr. Brown, Mrs. Gillibrand, Ms. Stabenow, Mr. 
Welch, and Ms. Klobuchar) introduced the following bill; which was read 
         twice and referred to the Committee on Armed Services

_______________________________________________________________________

                                 A BILL


 
   To amend title 10, United States Code, to direct the Secretary of 
Defense to limit copayments for outpatient visits for mental health or 
  behavioral health under the TRICARE program, and for other purposes.

    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 ``Stop Copay Overpay Act''.

SEC. 2. LIMITATION ON COPAYMENTS FOR OUTPATIENT VISITS FOR MENTAL OR 
              BEHAVIORAL HEALTH UNDER TRICARE PROGRAM.

    (a) Limitation on Mental or Behavioral Health Copayments.--
            (1) Limitation.--Chapter 55 of title 10, United States 
        Code, is amended by inserting after the item relating to 
        section 1075a the following new section:
``Sec. 1075b. TRICARE program: limitation on copayments for certain 
              mental or behavioral health visits
    ``(a) Limitation on Copayments.--Notwithstanding any other 
provision of this chapter, the Secretary of Defense may not charge to a 
covered individual a copayment in an amount greater than the amount 
described in subsection (b) for an outpatient visit for mental health 
or behavioral health under the TRICARE program, regardless of whether 
such outpatient visit is furnished by a specialty care provider.
    ``(b) Amount Described.--The amount described in this subsection 
with respect to a covered individual is the amount of a copayment that 
would be charged to the covered individual under the TRICARE program 
for an outpatient visit for primary care services during the year in 
which the covered individual is being charged pursuant to subsection 
(a).
    ``(c) Covered Individual Defined.--In this section, the term 
`covered individual' means an individual enrolled under the TRICARE 
program, regardless of the beneficiary category of the individual with 
respect to such program or the duty status of the individual.''.
            (2) Clerical amendment.--The table of sections for such 
        chapter is amended by inserting after the item relating to 
        section 1075a the following new section:

``1075b. TRICARE program: limitation on copayments for certain mental 
                            or behavioral health visits.''.
            (3) Applicability.--The amendments made by this subsection 
        shall apply with respect to outpatient visits for mental or 
        behavioral health occurring on or after the date of the 
        enactment of this Act.
    (b) Temporary Limitation on Other Specialty Care Copayments.--
            (1) Temporary limitation.--During the one-year period 
        beginning on the date of the enactment of this Act, the 
        Secretary of Defense may not increase the amount of a copayment 
        charged to a covered individual for any service described in 
        paragraph (2) beyond the amount that the Secretary would have 
        charged to the covered individual for such service during 
        fiscal year 2021.
            (2) Services described.--A service described in this 
        paragraph is a service--
                    (A) that is furnished to a covered individual by a 
                specialty care provider under the TRICARE program; and
                    (B) that is not covered under section 1075b of 
                title 10, United States Code, as added by subsection 
                (a).
            (3) Applicability.--The limitation on copayments specified 
        in paragraph (1) shall apply with respect to specialty care 
        received on or after the date of the enactment of this Act.
    (c) Report on Effects of Limitations.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act, the Secretary of Defense shall 
        submit to the Committee on Armed Services of the Senate and the 
        Committee on Armed Services of the House of Representatives a 
        report on how the limitation under section 1075b of title 10, 
        United States Code (as added by subsection (a)), has affected, 
        or may affect, the health care system of the Department of 
        Defense.
            (2) Elements.--The report required under paragraph (1) 
        shall include--
                    (A) any findings by the Secretary as to whether the 
                limitation under section 1075b of title 10, United 
                States Code (as added by subsection (a)), may result in 
                an increase in copayments charged for services 
                described in subsection (b)(2) after the period 
                specified in subsection (b)(1) concludes; and
                    (B) recommendations by the Secretary on how to 
                avoid such an increase, as applicable.
    (d) Definitions.--In this section:
            (1) Covered individual.--The term ``covered individual'' 
        has the meaning given that term in section 1075b of title 10, 
        United States Code, as added by subsection (a).
            (2) TRICARE program.--The term ``TRICARE program'' has the 
        meaning given that term in section 1072 of such title.
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