119-HR873

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.

Last action was on 1-31-2025

Bill is currently in: House
Path to Law
House Senate President

Current status is Referred to the House Committee on Armed Services.

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119th CONGRESS

1st Session

H. R. 873

1. TRICARE reimbursement rates

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.