PL 108-181, Sec 711

Attachment 4

NDAA FY 2008 Section 711 Legislation

Public Law 110-181

110th Congress

SEC. 711. <<NOTE: 10 USC 1073 note. SURVEYS ON CONTINUED VIABILITY OF

TRICARE STANDARD AND TRICARE EXTRA.

(a) Requirement for Surveys.--

(1) In general.--The Secretary of Defense shall conduct

surveys of health care providers and beneficiaries who use

TRICARE in the United States to determine, utilizing a

reconciliation of the responses of providers and beneficiaries

to such surveys, each of the following:

(A) How many health care providers in TRICARE Prime

service areas selected under paragraph (3)(A) are

accepting new patients under each of TRICARE Standard

and TRICARE Extra.

(B) How many health care providers in geographic

areas in which TRICARE Prime is not offered are

accepting patients under each of TRICARE Standard and

TRICARE Extra.

(C) The availability of mental health care providers

in TRICARE Prime service areas selected under paragraph

(3)(C) and in geographic areas in which TRICARE Prime is

not offered.

(2) Benchmarks.--The Secretary shall establish for purposes

of the surveys required by paragraph (1) benchmarks for primary

care and specialty care providers, including mental health care

providers, to be utilized to determine the adequacy of the

availability of health care providers to beneficiaries eligible

for TRICARE.

(3) Scope of surveys.--The Secretary shall carry out the

surveys required by paragraph (1) as follows:

(A) In the case of the surveys required by

subparagraph (A) of that paragraph, in at least 20

TRICARE Prime service areas in the United States in each

of fiscal years 2008 through 2011.

(B) In the case of the surveys required by

subparagraph (B) of that paragraph, in 20 geographic

areas in which TRICARE Prime is not offered and in which

significant numbers of beneficiaries who are members of

the Selected Reserve reside.

(C) In the case of the surveys required by

subparagraph (C) of that paragraph, in at least 40

geographic areas.

(4) Priority for surveys.--In prioritizing the areas which

are to be surveyed under paragraph (1), the Secretary shall--

(A) consult with representatives of TRICARE

beneficiaries and health care and mental health care

providers to identify locations where TRICARE Standard

beneficiaries are experiencing significant levels of

access-to-care problems under TRICARE Standard or

TRICARE Extra;

(B) give a high priority to surveying health care

and mental health care providers in such areas; and

(C) give a high priority to surveying beneficiaries

and providers located in geographic areas with high

concentrations of members of the Selected Reserve.

(5) Information from providers.--The surveys required by

paragraph (1) shall include questions seeking to determine from

health care and mental health care providers the following:

(A) Whether the provider is aware of the TRICARE

program.

(B) What percentage of the provider's current

patient population uses any form of TRICARE.

(C) Whether the provider accepts patients for whom

payment is made under the medicare program for health

care and mental health care services.

(D) If the provider accepts patients referred to in

subparagraph (C), whether the provider would accept

additional such patients who are not in the provider's

current patient population.

(6) Information from beneficiaries.--The surveys required by

paragraph (1) shall include questions seeking information to

determine from TRICARE beneficiaries whether they have

difficulties in finding health care and mental health care

providers willing to provide services under TRICARE Standard or

TRICARE Extra.

(b) GAO Review.--

(1) Ongoing review.--The Comptroller General shall, on an

ongoing basis, review--

(A) the processes, procedures, and analysis used by

the Department of Defense to determine the adequacy of

the number of health care and mental health care

providers--

(i) that currently accept TRICARE Standard or

TRICARE Extra beneficiaries as patients under

TRICARE Standard in each TRICARE area as of the

date of completion of the review; and

(ii) that would accept TRICARE Standard or

TRICARE Extra beneficiaries as new patients under

TRICARE Standard or TRICARE Extra, as applicable,

within a reasonable time after the date of

completion of the review; and

(B) the actions taken by the Department of Defense

to ensure ready access of TRICARE Standard beneficiaries

to health care and mental health care under TRICARE

Standard in each TRICARE area, including any pending or

resolved requests for waiver of payment limits in order

to improve access to health care or mental health care

in a specific geographic area.

(2) Reports.--The Comptroller General shall submit to the

Committees on Armed Services of the Senate and the House of

Representatives on a bi-annual basis a report on the results of

the review under paragraph (1). Each report shall include the

following:

(A) An analysis of the adequacy of the surveys under

subsection (a).

(B) An identification of any impediments to

achieving adequacy of availability of health care and

mental health care under TRICARE Standard or TRICARE

Extra.

(C) An assessment of the adequacy of Department of

Defense education programs to inform health care and

mental health care providers about TRICARE Standard and

TRICARE Extra.

(D) An assessment of the adequacy of Department of

Defense initiatives to encourage health care and mental

health care providers to accept patients under TRICARE

Standard and TRICARE Extra.

(E) An assessment of the adequacy of information

available to TRICARE Standard beneficiaries to

facilitate access by such beneficiaries to health care

and mental health care under TRICARE Standard and

TRICARE Extra.

(F) An assessment of any need for adjustment of

health care and mental health care provider payment

rates to attract participation in TRICARE Standard by

appropriate numbers of health care and mental health

care providers.

(G) An assessment of the adequacy of Department of

Defense programs to inform members of the Selected

Reserve about the TRICARE Reserve Select program.

(H) An assessment of the ability of TRICARE Reserve

Select beneficiaries to receive care in their geographic

area.

(c) Effective Date.--This section shall take effect on October 1,

2007.

[[Page 122 STAT. 193]]

(d) Repeal of Superseded Requirements and Authority.--Section 723 of

the National Defense Authorization Act for Fiscal Year 2004 (10 U.S.C.

1073 note) is repealed, effective as of October 1, 2007.

(e) Definitions.--In this section:

(1) The term ``TRICARE Extra'' means the option of the

TRICARE program under which TRICARE Standard beneficiaries may

obtain discounts on cost-sharing as a result of using TRICARE

network providers.

(2) The term ``TRICARE Prime'' means the managed care option

of the TRICARE program.

(3) The term ``TRICARE Prime service area'' means a

geographic area designated by the Department of Defense in which

managed care support contractors develop a managed care network

under TRICARE Prime.

(4) The term ``TRICARE Standard'' means the option of the

TRICARE program that is also known as the Civilian Health and

Medical Program of the Uniformed Services, as defined in section

1072(4) of title 10, United States Code.

(5) The term ``TRICARE Reserve Select'' means the option of

the TRICARE program that allows members of the Selected Reserve

to enroll in TRICARE Standard, pursuant to section 1076d of

title 10, United States Code.

(6) The term ``member of the Selected Reserve'' means a

member of the Selected Reserve of the Ready Reserve of a reserve

component of the Armed Forces.

(7) The term ``United States'' means the United States (as

defined in section 101(a) of title 10, United States Code), its

possessions (as defined in such section), and the Commonwealth

of Puerto Rico.

OMB Submission: TRICARE Standard Survey-CP 4