Sec. 728. Improvement of health outcomes and control of costs of health care under TRICARE program through programs to involve covered beneficiaries
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/bill/114/s/2943/pap/section-728·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Not later than January 1, 2018, the Secretary of Defense shall implement the programs established under subsections
(b)and (c)— to increase the involvement of covered beneficiaries in making health care decisions; and to encourage covered beneficiaries to share more responsibility for the improvement of their health outcomes. The Secretary shall establish a program to incentivize covered beneficiaries to participate in medical intervention programs established by the Secretary, such as comprehensive disease management programs, by lowering fees for enrollment in the TRICARE program by a certain percentage or by lowering copayment and cost share amounts for health care services during a particular year for covered beneficiaries with chronic diseases or conditions described in paragraph
(2)who met participation milestones in the previous year in such medical intervention programs, as determined by the Secretary. Chronic diseases or conditions described in this paragraph include diabetes, chronic obstructive pulmonary disease, asthma, congestive heart failure, hypertension, history of stroke, coronary artery disease, mood disorders, obesity, and such other diseases or conditions as the Secretary determines appropriate. The Secretary shall establish a program to incentivize lifestyle interventions, such as smoking cessation and weight reduction, by lowering fees for enrollment in the TRICARE program by a certain percentage or by lowering copayment and cost share amounts for health care services during a particular year for covered beneficiaries who met participation milestones in the previous year with respect to such lifestyle interventions, such as quitting smoking or achieving a lower body mass index by a certain percentage, as determined by the Secretary. The Secretary may establish a program to charge and collect a fee from a covered beneficiary, other than a member of the Armed Forces on active duty, for failure to notify a military treatment facility within 24 hours of a scheduled appointment with a health care provider at such facility that the covered beneficiary will not attend the appointment. Any amounts collected under paragraph
(1)from a covered beneficiary for failure to notify a military treatment facility that the covered beneficiary will not attend an appointment at such facility shall be made available to such facility to improve access to health care, improve health outcomes, and enhance the experience of care for covered beneficiaries at such facility. Not later than January 1, 2020, the Secretary shall submit to the Committees on Armed Services of the Senate and the House of Representatives a report on the implementation of the programs established under subsections (b), (c), and (d). The report required under paragraph
(1)shall include the following: A detailed description of the programs implemented under subsections (b), (c), and (d). An assessment of the impact of the programs implemented under subsection
(b)and
(c)on— improving health outcomes for covered beneficiaries; and lowering per capita health care costs for the Department of Defense. An assessment of any reduction in numbers and types of appointments missed by covered beneficiaries at military treatment facilities resulting from charging fees under subsection
(d)for failure to timely notify such facility of the inability to attend a scheduled appointment. Not later than January 1, 2017, the Secretary shall prescribe an interim final rule to carry out this section. In this section, the terms covered beneficiary and TRICARE program have the meaning given those terms in section 1072 of title 10, United States Code.