Sec. 701. IMPROVEMENTS TO TRICARE DENTAL PROGRAM
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## SEC. 701 IMPROVEMENTS TO TRICARE DENTAL PROGRAM ###
(a)In General Section 1076a of title 10, United States Code, is amended— ####
(1)in subsection (b)— #####
(A)by striking “ The plans ” and inserting the following: > > #### “(1) In general > > The plans” > ; and #####
(B)by adding at the end the following new paragraph: > > #### “(2) Premium sharing plans > > Effective as of January 1, 2026, the regulations prescribed pursuant to paragraph
(1)shall include, with respect to premium sharing plans referred to in subsection (d)(1), the following elements: > > > ##### “(A) > > 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. > > > ##### “(B) > > Such plans shall include the following three enrollment options: > > > ###### “(i) > > Self. > > > ###### “(ii) > > Self plus one. > > > ###### “(iii) > > Family. > > > ##### “(C) > > 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 two and not more than four dental insurance carriers. > > > ##### “(D) > > To the extent practicable, each carrier described in subparagraph (C)— > > > ###### “(i) > > 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; > > > ###### “(ii) > > shall, in addition to offering a standard option plan, offer a non-standard option plan; > > > ###### “(iii) > > may offer a non-standard option plan managed as a dental health maintenance organization plan; > > > ###### “(iv) > > shall establish and operate dental provider networks that provide— > > > ###### “(I) > > accessible care with a prevention or wellness focus; > > > ###### “(II) > > continuity of care; > > > ###### “(III) > > coordinated care (including appropriate dental and medical referrals); > > > ###### “(IV) > > patient-centered care (including effective communications, individualized care, and shared decision-making); and > > > ###### “(V) > > high-quality, safe care; > > > ###### “(v) > > shall develop and implement adult and pediatric dental quality measures, including effective measurements for— > > > ###### “(I) > > access to care; > > > ###### “(II) > > continuity of care; > > > ###### “(III) > > cost; > > > ###### “(IV) > > adverse patient events; > > > ###### “(V) > > oral health outcomes; and > > > ###### “(VI) > > patient experience; and > > > ###### “(vi) > > may conduct in the provider networks established and operated by the carrier under clause (iv), to the extent practicable, pilot programs on the development of a model of care based on the model of care commonly referred to as patient-centered dental homes.” > ; ####
(2)in subsection (d)(1)— #####
(A)in subparagraph (B), by striking “The member’s” and inserting “During the period preceding January 1, 2026, the member’s”; #####
(B)in subparagraph (C), by striking “of each year,” and inserting “of each year during the period preceding January 1, 2026,”; #####
(C)in subparagraph (D), by striking “The Secretary of Defense” and inserting “During the period preceding January 1, 2026, the Secretary of Defense”; and #####
(D)by adding at the end the following new subparagraphs: > > ##### “(E) > > Beginning on January 1, 2026, the amount of the premium required under subparagraph (A)— > > > ###### “(i) > > for standard option plans, shall be established by the Secretary annually such that in the aggregate (taking into account the adjustments under subparagraph
(F)and subsection (e)(3), the Secretary’s share of each premium is 60 percent of the premium for each enrollment category (self, self plus one, and family, respectively) of each standard option plan; and > > > ###### “(ii) > > for non-standard option plans, 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. > > > ##### “(F) > > Beginning on January 1, 2026, 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.” > ; ####
(3)in subsection (e), by adding at the end the following new paragraph: > > #### “(3) > > Beginning on January 1, 2026, 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.” > ; ####
(4)in subsection (j), by striking “The Secretary of Defense may not reduce benefits provided under a plan established under this section until” and inserting “During the period preceding January 1, 2026, the Secretary of Defense may not reduce benefits provided under a plan established under this section, and on or after January 1, 2026, the Secretary may not reduce benefits provided under a standard option plan under this section, until”; and ####
(5)by adding at the end the following new subsection: > > ### “(l) Definitions > > In this section: > > > #### “(1) > > The term ‘non-standard option plan’ means a high option dental insurance plan that includes covered services in addition to, or provides greater coverage with respect to, services covered under a standard option plan. > > > #### “(2) > > The term ‘standard option plan’ means a dental insurance plan that provides for the coverage of preventive services, basic restorative services, and specialty dental care services at a level that is at least commensurate with the coverage of the same services provided under the premium sharing plans under this section during the period preceding January 1, 2026.” > . ###
(b)Rulemaking **[**[10 U.S.C. 1076a note](/us/usc/t10/s1076a)**]** Pursuant to the authority under section 1076a(b)(1) of title 10, United States Code, as amended by subsection (a), the Secretary of Defense shall— ####
(1)not later than January 1, 2026, prescribe an interim final rule to carry out the amendments made by subsection (a); and ####
(2)after prescribing the interim final rule under subparagraph
(A)and considering public comments with respect to such interim final rule, prescribe a final rule, effective on January 1, 2027, to carry out such amendments. ###
(c)Briefings Not later than January 1 of each of 2024, 2025, 2026, and 2027, the Secretary of Defense shall provide to the Committees on Armed Services of the House of Representatives and the Senate a briefing on the status of the implementation of the amendments made by subsection (a).
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Sec. 701
IMPROVEMENTS TO TRICARE DENTAL PROGRAM
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