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Code · BILL · 118th Congress · H.R. 8070 (Reported in House) — To authorize appropriations for fiscal year 2025 for military activities of the Department of Defense, for military c... · Sec. 706

Sec. 706. Reimbursements under the TRICARE program to cancer and children’s hospitals for outpatient care of beneficiaries

244 words·~1 min read·/bill/118/hr/8070/rh/section-706

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When evaluating an application under the TRICARE program by a cancer hospital or a children’s hospital for a general temporary military contingency payment adjustment to a reimbursement amount under the TRICARE outpatient prospective payment system, the Secretary of Defense shall consider the adequacy of the TRICARE network and the availability of specialized health care services for affected beneficiaries. Not later than 180 days after the date of the enactment of this Act, the Secretary of Defense shall provide to the Committees on Armed Services of the Senate and House of Representatives a report regarding applications, payments, and adjustments described in subsection (a).
The report shall include the following elements: A list of payment mechanisms available to the Secretary to make a reimbursement described in subsection (a). A list of the authorities for such payment mechanisms. A list of the payment adjustments the Secretary may make to a reimbursement amount described in subsection (a). The factors the Secretary considers when determining whether to make such a payment adjustment. Whether the Secretary measures the effects of a change to a reimbursement or payment adjustment when determining whether to continue such a payment adjustment.
Any identified differences in diagnoses or the complexity of care, for pediatric TRICARE outpatients at children's hospitals and at other hospitals. The extent to which differences in such payments reflect differences in the complexity of care for such patients. Recently identified trends in the use of children's hospital services by pediatric TRICARE patients.
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