TRICARE Enhancement Act of 2000

Summary

TRICARE Enhancement Act of 2000 - Prohibits the Secretary of Defense, in the case of a covered beneficiary entitled to medical and dental care under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) who is enrolled in TRICARE Standard (a DOD managed health care program), from requiring with respect to authorized health care (other than mental health services) under any new health care contract that the beneficiary obtain: (1) a nonavailability statement or preauthorization from a military medical facility in order to receive services from a civilian provider; or (2) a nonavailability statement for care in specialized treatment facilities outside the 200-mile radius of a military medical facility. Provides exceptions. (Sec. 3) Requires the Secretary to direct that: (1) the Composite Health Care System (CHS) be used in lieu of the Customer Satisfaction Survey to measure the performance of the Department of Defense in scheduling appointments in military medical facilities for covered beneficiaries under TRICARE Prime; (2) any necessary modifications be made to the CHS to standardize appropriate access throughout the military health care system; and (3) compliance with appointment timeliness standards under TRICARE Prime in military medical facilities be reported at the facility level, the service level, the system level, and by various beneficiary categories. Requires a report from the Secretary to Congress. (Sec. 4) Authorizes covered beneficiary access under CHAMPUS to certified mental health counselors. Requires the Secretary to recognize such counselors as qualified to: (1) prescribe levels and courses of treatment for substance abuse disorders; and (2) conduct mental health evaluations. (Sec. 5) Requires new contracts under TRICARE to require a covered beneficiary under TRICARE Prime who is referred to a provider or facility more than 100 miles away due to the unavailability of a local provider to be reimbursed by the referring provider or facility for appropriate mileage costs or air travel. (Sec. 6) Requires that when TRICARE Standard is a secondary payer for health care provided to a covered beneficiary, it shall reimburse a provider the difference between the amounts paid by the primary insurance provider and the total charge for health care provided to the beneficiary, with a maximum limit. (Sec. 7) Directs the Secretary to extend the appeals process for the resolution of claims for participating dental care providers under TRICARE to non-network providers who provide dental care under CHAMPUS. Outlines procedures for disenrollment from the TRICARE dental program for military retirees and their dependents. (Sec. 8) Requires a report from: (1) the Secretary to Congress on the use of authority to provide reimbursement to health care providers at rates higher than otherwise authorized, but not exceeding 115 percent of CHAMPUS maximum allowable charges; and (2) the Comptroller General to Congress on whether the use of a mandatory floor of 70 percent of the usual and customary rates for reimbursement to health care providers under the TRICARE program, rather than a ceiling of 115 percent of CHAMPUS maximum allowable charges, would assist in providing a more robust health care network.

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Documents

3 official files

• Introduced in House (text)

  Introduced in House · EN · 10 May 2000

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• Introduced in House (PDF)

  Introduced in House · EN · 10 May 2000

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• Introduced in House

  summary · EN · 10 May 2000

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