January 31, 2025
Mr. McCormick introduced the following bill; which was referred to the Committee on Armed Services
To amend title 10, United States Code, to modify the rate of pay for care or services provided under the TRICARE program based on the location at which such care or services were provided.
Section 1. TRICARE reimbursement rates
(a) Rates
Section 1097b(a) of title 10, United States Code, is amended—
(1)
in paragraph (1), by inserting and paragraph (3)(A)
after Subject to paragraph (2)
; and
(2)
in paragraph (3), by striking In establishing
and inserting the following:
(A)
(i)
Except as provided by paragraph (1), if the Secretary may determine among more than one reimbursement rate to pay a health care provider for care or services provided under the TRICARE program, the Secretary shall pay the lowest rate authorized for such care or services.
(ii)
The Secretary shall establish reimbursement rates for care or services paid to health care providers under the TRICARE program that are specific with respect to the following locations at which the care or services were provided (regardless of the location of the headquarters of the health care provider):
(I)
An inpatient hospital.
(II)
An on-campus hospital outpatient department.
(III)
An off-campus hospital outpatient department.
(IV)
An ambulatory surgical center.
(V)
The office of a physician.
(iii)
The Secretary shall ensure that a claim for reimbursement includes a unique, geographically specific national provider identifier code that identifies the location of the provider as described in clause (ii).
(B)
In establishing
(b) Effective date
The amendments made by subsection (a) shall take effect on January 1, 2026.