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Code · BILL · 117th Congress · S. 2792 (Reported in Senate) — To authorize appropriations for fiscal year 2022 for military activities of the Department of Defense, for military c... · Sec. 722

Sec. 722. Implementation of an integrated TRICARE program through effective market management

457 words·~2 min read·/bill/117/s/2792/rs/section-722·

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Not later than April 1, 2022, the Secretary of Defense, acting through the Director of the Defense Health Agency, shall implement integration of the direct care and purchased care components of the TRICARE program through effective management of geographic markets. The integration actions required by subsection
(a)shall include the following elements: Designation by the Director of the Defense Health Agency of a single market manager for each geographic market who shall— report to the Director, through the Assistant Director for Health Care Administration; be under the authority, direction, and control of the Director; and be responsible for the development and implementation of a market management plan for the geographic market. Determinations by the Director, with the assistance of the market manager for the geographic market concerned, that in carrying out section 1073d of title 10, United States Code, and section 703 of the National Defense Authorization Act for Fiscal Year 2017 ( Public Law 114–328 ; 10 U.S.C. 1073d note), the TRICARE preferred provider network in the geographic market has the capacity and capability to meet the needs of covered beneficiaries affected by the restructure or realignment of infrastructure or modification of services of the military medical treatment facility involved. Expeditious implementation of the requirements under section 725 of the National Defense Authorization Act for Fiscal Year 2017 ( Public Law 114–328 ; 10 U.S.C. 1074 note)— to ensure that health care services provided through military medical treatment facilities maintain the critical wartime medical readiness skills and core competencies of health care providers within the Armed Forces; to meet the health care needs of covered beneficiaries under the TRICARE program, subject to meeting the medical readiness requirements of the Armed Forces; and to maintain the level of care required by such section in facilities in foreign countries. With respect to TRICARE Prime— development of a streamlined and effective system of patient referrals for covered beneficiaries enrolled in TRICARE Prime, particularly with respect to referrals from a primary care provider in the TRICARE network to a specialty care provider at a military medical treatment facility for specialty care services available at the military medical treatment facility; and continued operation of enrollment of covered beneficiaries in TRICARE Prime in geographic areas where the Director determines that such enrollment is appropriate to support the effective operation of one or more military medical treatment facilities. In this section: The terms covered beneficiary , TRICARE Prime , and TRICARE program have the meanings given those terms in section 1072 of title 10, United States Code. The term geographic market , with respect to the TRICARE program, has the meaning given that term by the Director of the Defense Health Agency and shall include one or more inpatient military medical treatment facilities.
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Sec. 722
Implementation of an integrated TRICARE program through effective market management
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