Bill > HR873

This bill modifies the TRICARE program's reimbursement rates for healthcare providers by introducing more precise payment guidelines based on the specific location where medical services are provided. Under the proposed changes, the Secretary of Defense will be required to pay the lowest authorized rate when multiple reimbursement rates are possible. The bill mandates that reimbursement rates be established with geographic specificity for five types of medical service locations: inpatient hospitals, on-campus hospital outpatient departments, off-campus hospital outpatient departments, ambulatory surgical centers, and physicians' offices. Additionally, the bill requires that reimbursement claims include a unique, geographically specific national provider identifier code to help track the exact location of service provision. These changes are designed to create more standardized and potentially cost-effective payment practices within the TRICARE program, which provides healthcare services for military personnel, retirees, and their families. The amendments will take effect on January 1, 2026, giving healthcare providers and administrators time to prepare for the new reimbursement framework.

Military Affairs and Security

https://www.congress.gov/bill/119th-congress/house-bill/873/all-info