Sec. 732. FUTURE AVAILABILITY OF TRICARE PRIME THROUGHOUT THE UNITED STATES
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## SEC. 732 FUTURE AVAILABILITY OF TRICARE PRIME THROUGHOUT THE UNITED STATES ###
(a)Report Required ####
(1)In general Not later than 90 days after the date of the enactment of this Act, the Secretary of Defense shall submit to the Committees on Armed Services of the Senate and the House of Representatives a report setting forth the policy of the Department of Defense on the future availability of TRICARE Prime under the TRICARE program for eligible beneficiaries in all TRICARE regions throughout the United States. ####
(2)Elements The report required by paragraph
(1)shall include the following: #####
(A)A description, by region, of the difference in availability of TRICARE Prime for eligible beneficiaries (other than eligible beneficiaries on active duty in the Armed Forces) under newly awarded TRICARE managed care contracts, including, in particular, an identification of the regions or areas in which TRICARE Prime will no longer be available for such beneficiaries under such contracts. #####
(B)An estimate of the increased costs to be incurred by an affected eligible beneficiary for health care under the TRICARE program. #####
(C)An estimate of the savings to be achieved by the Department as a result of the contracts described in subparagraph (A). #####
(D)A description of the plans of the Department to continue to assess the impact on access to health care for affected eligible beneficiaries. #####
(E)A description of the plan of the Department to provide assistance to affected eligible beneficiaries who are transitioning from TRICARE Prime to TRICARE Standard, including assistance with respect to identifying health care providers. #####
(F)Any other matter the Secretary considers appropriate. ###
(b)Additional Report ####
(1)Report required Not later than 180 days after the date of the enactment of the Carl Levin and Howard P. “Buck” McKeon National Defense Authorization Act for Fiscal Year 2015, the Secretary shall submit to the Committees on Armed Services of the Senate and the House of Representatives a report on the status of reducing the availability of TRICARE Prime in regions described in subsection (d)(1)(B). ####
(2)Matters included The report under paragraph
(1)shall include the following: #####
(A)A description of the implementation of the transition for affected eligible beneficiaries under the TRICARE program who no longer have access to TRICARE Prime under TRICARE managed care contracts as of the date of the report, including— ######
(i)the number of eligible beneficiaries who have transitioned from TRICARE Prime to the TRICARE Standard option of the TRICARE program since October 1, 2013; ######
(ii)the number of eligible beneficiaries who transferred their TRICARE Prime enrollment to a more distant available Prime service area to remain in TRICARE Prime, by State; ######
(iii)the number of eligible beneficiaries who were eligible to transfer to a more distant available Prime service area, but chose to use TRICARE Standard; ######
(iv)the number of eligible beneficiaries who elected to return to TRICARE Prime pursuant to subsection (c)(1); and ######
(v)the number of affected eligible beneficiaries who, as of the date of the report, changed residences to remain eligible for TRICARE Prime in a new region. #####
(B)An estimate of the increased annual costs per affected eligible beneficiary incurred by such beneficiary for health care under the TRICARE program. #####
(C)A description of the efforts of the Department to assess the impact on access to health care and beneficiary satisfaction for affected eligible beneficiaries. #####
(D)A description of the estimated cost savings realized by reducing the availability of TRICARE Prime in regions described in subsection (d)(1)(B). ###
(c)Access to TRICARE Prime ####
(1)One-time election Subject to paragraph (3), the Secretary shall ensure that each affected eligible beneficiary who is enrolled in TRICARE Prime as of September 30, 2013, may make a one-time election to continue such enrollment in TRICARE Prime, notwithstanding that a contract described in subsection (a)(2)(A) does not allow for such enrollment based on the location in which such beneficiary resides. The beneficiary may continue such enrollment in TRICARE Prime so long as the beneficiary resides in the same ZIP code as the ZIP code in which the beneficiary resided at the time of such election. ####
(2)Enrollment in TRICARE Standard If an affected eligible beneficiary makes the one-time election under paragraph (1), the beneficiary may thereafter elect to enroll in TRICARE Standard at any time in accordance with a contract described in subsection (a)(2)(A). ####
(3)Residence at time of election #####
(A)Except as provided by subparagraph (B), an affected eligible beneficiary may not make the one-time election under paragraph
(1)if, at the time of such election, the beneficiary does not reside— ######
(i)in a ZIP code that is in a region described in subsection (d)(1)(B); and ######
(ii)within 100 miles of a military medical treatment facility. #####
(B)Subparagraph (A)(ii) shall not apply with respect to an affected eligible beneficiary who— ######
(i)as of December 25, 2013, resides farther than 100 miles from a military medical treatment facility; and ######
(ii)is such an eligible beneficiary by reason of service in the Army, Navy, Air Force, or Marine Corps. ####
(4)Network In continuing enrollment in TRICARE Prime pursuant to paragraph (1), the Secretary may determine whether to maintain a TRICARE network of providers in an area that is between 40 and 100 miles of a military medical treatment facility. ###
(d)Definitions In this section: ####
(1)The term “affected eligible beneficiary” means an eligible beneficiary under the TRICARE Program (other than eligible beneficiaries on active duty in the Armed Forces) who, as of the date of the enactment of this Act— #####
(A)is enrolled in TRICARE Prime; and #####
(B)resides in a region of the United States in which TRICARE Prime enrollment will no longer be available for such beneficiary under a contract described in subsection (a)(2)(A) that does not allow for such enrollment because of the location in which such beneficiary resides. ####
(2)The term “TRICARE Prime” means the managed care option of the TRICARE program. ####
(3)The term “TRICARE program” has the meaning given that term in section 1072(7) of title 10, United States Code. ####
(4)The term “TRICARE Standard” means the fee-for-service option of the TRICARE Program.