US Federal 2025-2026 Regular Session

US Federal House Bill HB873

Introduced
1/31/25  

Caption

To amend title 10, United States Code, to modify the rate of pay for care or services provided under the TRICARE program based on the location at which such care or services were provided.

Impact

If enacted, HB873 will require the Secretary of Defense to establish specific reimbursement rates for various locations such as inpatient hospitals, outpatient departments, and ambulatory surgical centers. The Secretary is mandated to ensure that a claim for reimbursement contains a unique identifier to specify the location of healthcare service providers. This approach is anticipated to create a more equitable reimbursement system that reflects the operational costs associated with different healthcare environments across the country.

Summary

House Bill 873 seeks to amend Title 10 of the United States Code, specifically regarding the reimbursement rates for care or services provided under the TRICARE program. This legislation proposes that the rate of pay for healthcare services should vary based on the specific location where the services were rendered. By introducing this locality-based pricing model, the bill aims to ensure that reimbursements are aligned with the costs associated with providing healthcare in different geographical areas.

Contention

While the bill is set to provide location-specific reimbursement rates, it may also generate discussions regarding the potential inequities this system could introduce. Stakeholders may raise concerns about how varying rates could affect healthcare access and the financial stability of providers in lower-cost areas compared to those in higher-cost metropolitan regions. Additionally, there may be apprehensions about the administrative burdens that could result from differentiating reimbursement based on geographical data and the readiness of the TRICARE system to implement such changes by the effective date of January 1, 2026.

Congress_id

119-HR-873

Policy_area

Armed Forces and National Security

Introduced_date

2025-01-31

Companion Bills

No companion bills found.

Previously Filed As

US HB874

To amend title 38, United States Code, to modify the rate of pay for care or services provided under the Community Care Program of the Department of Veterans Affairs based on the location at which such care or services were provided, and for other purposes.

US HB8057

To amend title 38, United States Code, to modify the rate of pay for care or services provided under the Community Care Program of the Department of Veterans Affairs based on the location at which such care or services were provided, and for other purposes.

US HB7933

To amend title 10, United States Code, to expand the authority to provide a wig and treat traction alopecia under the TRICARE program, and for other purposes.

US HB5400

To amend title 10, United States Code, to require the Secretary of Defense to annually review the amount of financial assistance for child care and youth program services providers provided by the Secretary.

US SF2438

Availability of crisis services and criteria modification for community-based program locations

US SB654

A bill to amend title 38, United States Code, to establish an external provider scheduling program to assist the Department of Veterans Affairs in scheduling appointments for care and services under the Veterans Community Care Program, and for other purposes.

US S09464

Modifies the rates of payment related to adult day health care services.

US HB5593

To amend title 38, United States Code, to include eyeglass lens fittings in the category of medical services authorized to be furnished to veterans under the Veterans Community Care Program, and for other purposes.

US HB2310

Enacting the career advancement, resources, employment and supports for the disability workforce act, providing for career education programs for students and career enhancement programs for professionals, requiring performance-based contracting for disability services providers, facilitating choice in services by individuals with disabilities, mandating rate parity across all state waiver programs, providing for an online data portal system for waitlist management and services-related communications, requiring the secretary of labor to publish information regarding the disability service provider workforce and providing that direct support workers may be covered by the state health plan.

US SB760

Kids' Access to Primary Care Act of 2025This bill modifies payments for Medicaid primary care services. Specifically, the bill applies a Medicare payment rate floor to Medicaid primary care services that are provided after the date of enactment of the bill and extends the payment rate to additional types of practitioners (e.g., obstetricians).The Centers for Medicare & Medicaid Services must conduct a study on the number of children enrolled in Medicaid, the number of providers receiving payment for primary care services, and associated payment rates before and after the bill's implementation.

Similar Bills

No similar bills found.