What This Bill Does · Plain English
GovGreed Synthesis · AI extraction
This bill modifies the TRICARE military health insurance program to require the Secretary of Defense to pay the lowest authorized reimbursement rate when multiple rates are available for a service. It also mandates that reimbursement rates be specific to the type of facility where care is delivered (e.g., inpatient hospital, physician's office) rather than the provider's headquarters location, and requires claims to include a geographically specific national provider identifier code.
Action Timeline
2025-01-31
Referred to the House Committee on Armed Services.
2025-01-31
Introduced in House
2025-01-31
Introduced in House
Frequently Asked Questions
Did HR.873 pass?
HR.873 is still alive. Current stage: COMMITTEE. Pass likelihood: 99%.
What does HR.873 do?
This bill modifies the TRICARE military health insurance program to require the Secretary of Defense to pay the lowest authorized reimbursement rate when multiple rates are available for a service. It also mandates that reimbursement rates be specific to the type of facility where care is delivered (e.g., inpatient hospital, physician's office) rather than the provider's headquarters location, and requires claims to include a geographically specific national provider identifier code.
Who sponsored HR.873?
HR.873 was sponsored by Richard McCormick (R-Georgia).
Full Bill Text
119 HR 873 IH: 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. U.S. House of Representatives 2025-01-31 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain. I 119th CONGRESS 1st Session H. R. 873 IN THE HOUSE OF REPRESENTATIVES January 31, 2025 Mr. McCormick introduced the following bill; which was referred to the Committee on Armed Services A BILL 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. 1. TRICARE reimbursement rates (a) Rates Section 1097b(a) of title 10, United States Code, is amended— (1) in paragraph (1), by inserting and paragraph (3)(A) after Subject to paragraph (2) ; and (2) in paragraph (3), by striking In establishing and inserting the following: (A) (i) Except as provided by paragraph (1), if the Secretary may determine among more than one reimbursement rate to pay a health care provider for care or services provided under the TRICARE program, the Secretary shall pay the lowest rate authorized for such care or services. (ii) The Secretary shall establish reimbursement rates for care or services paid to health care providers under the TRICARE program that are specific with respect to the following locations at which the care or services were provided (regardless of the location of the headquarters of the health care provider): (I) An inpatient hospital. (II) An on-campus hospital outpatient department. (III) An off-campus hospital outpatient department. (IV) An ambulatory surgical center. (V) The office of a physician. (iii) The Secretary shall ensure that a claim for reimbursement includes a unique, geographically specific national provider identifier code that identifies the location of the provider as described in clause (ii). (B) In establishing . (b) Effective date The amendments made by subsection (a) shall take effect on January 1, 2026.
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