Sec. 701. Improvements to the TRICARE dental program
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Section 1076a of title 10, United States Code, is amended— in subsection (b)— by striking The plans and inserting the following: The plans ; and by adding at the end the following new paragraph: The regulations required by paragraph
(1)shall include, with respect to premium sharing plans referred to in subsection (d)(1), the following elements: A third party administrator shall manage the administrative features of such plans, including eligibility, enrollment, plan change and premium payment processes, submission of qualifying life events changes, and address changes. Such plans shall include the following three enrollment options: Self. Self plus one. Family. In the United States, to the extent practicable, individuals eligible to enroll in such a plan shall be offered options to enroll in plans of not fewer than four national dental insurance carriers. To the extent practicable, each carrier described in subparagraph (C)— shall manage dental care delivery matters, including claims adjudication (with required electronic submission of claims), coordination of benefits, covered services, enrollment verification, and provider networks; shall, in addition to offering a standard option plan consistent with the requirements of this section, offer a high option plan that provides more covered services; may offer an additional plan managed as a dental health maintenance organization plan; shall establish and operate dental provider networks that provide— accessible care with a prevention or wellness focus; continuity of care; coordinated care (including appropriate dental and medical referrals); patient-centered care (including effective communications, individualized care, and shared decision-making); and high-quality, safe care; shall develop and implement adult and pediatric dental quality measures, including effective measurements for— access to care; continuity of care; cost; adverse patient events; oral health outcomes; and patient experience; and shall conduct in their provider networks, to the extent practicable, pilot programs on the development of a model of care based on the model of care referred to as patient-centered dental homes. ; in subsection (d)(1)— in subparagraph (B), by striking the second sentence; by striking subparagraph
(C)and inserting the following new subparagraph (C): The amount of the premium required under subparagraph (A)— for standard option plans described in subsection (b)(2)(C)(ii), shall be established by the Secretary annually such that in the aggregate (taking into account the adjustments under subparagraph
(D)and subsection (e)(2)(C)), the Secretary’s share of each premium is 60 percent of the premium for each enrollment category (self, self plus one, and family) of each standard option plan; and for non-standard option plans described in clauses
(ii)and
(iii)of subsection (b)(2)(C), shall be equal to the amount determined under clause
(i)plus 100 percent of the additional premium amount applicable to such non-standard option plan. ; and by striking subparagraph
(D)and inserting the following new subparagraph (D): The Secretary of Defense shall reduce the monthly premium required to be paid under paragraph
(1)in the case of enlisted members in pay grade E–1, E–2, E–3, or E–4. ; in subsection (e), by adding at the end the following new paragraph: The Secretary of Defense shall reduce copayments required to be paid under paragraph
(1)in the case of enlisted members in pay grade E–1, E–2, E–3, or E–4. ; and in subsection (j), by striking plan established under this section and inserting standard option plan described in subsection (b)(2)(C)(ii). . The amendments made by subsection
(a)shall take effect on January 1, 2025. In order to implement the dental program improvements on the date specified in subsection (b), the Secretary of Defense shall, not later than January 1, 2024, issue an interim final regulation consistent with the provisions of section 1076a of title 10, United States Code, as amended by subsection (a), that will be in effect on the date specified in subsection (b). The regulation required by paragraph
(1)shall ensure that covered services under standard option plans described in subsection (b)(2)(C)(ii) of section 1076a of title 10, United States Code, as added by subsection (a), shall be no less than those services under the premium sharing plans under such section in effect as of the date of the enactment of this Act.