Plain English
GovGreed Synthesis ·
TRICARE OBGYN Treatment and Access without Lags in Care Act or the TOTAL Care Act This bill requires the Department of Defense (DOD) to implement a five-year pilot program under which female beneficiaries enrolled in TRICARE Prime may receive obstetrical and gynecological care without a referral. (Generally, the TRICARE Prime program requires a beneficiary to obtain a referral for care through a designated primary care manager.) Under the pilot program, participating female beneficiaries may elect to designate an obstetrical or gynecological care provider under the TRICARE program (i.e., the various programs carried out by DOD, including TRICARE Prime) as an additional designated primary care manager.
Market Impact Map
Action Timeline
2025-02-27
Referred to the House Committee on Armed Services.
2025-02-27
Introduced in House
2025-02-27
Introduced in House
Full Bill Text
119 HR 1699 IH: TRICARE OBGYN Treatment and Access without Lags in Care Act U.S. House of Representatives 2025-02-27 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. 1699 IN THE HOUSE OF REPRESENTATIVES February 27, 2025 Mr. Horsford (for himself, Ms. Houlahan , Ms. Salazar , Ms. Strickland , Ms. Jacobs , Ms. Tokuda , Mr. Turner of Ohio , Mr. Johnson of Georgia , Ms. Goodlander , and Ms. McBride ) introduced the following bill; which was referred to the Committee on Armed Services A BILL To direct the Secretary of Defense to carry out a pilot program under which a TRICARE Prime beneficiary may access obstetrical and gynecological care without a referral, and for other purposes. 1. Short title This Act may be cited as the TRICARE OBGYN Treatment and Access without Lags in Care Act or the TOTAL Care Act . 2. Pilot program on access to obstetrical and gynecological care under TRICARE Prime program (a) Pilot program Beginning not later than 180 days after the date of the enactment of this Act, the Secretary of Defense shall carry out a pilot program under which— (1) the referral requirement in section 1095f(a)(1) of title 10, United States Code, does not apply with respect to obstetrical and gynecological care for covered participants, including the ordering of related obstetrical and gynecological items and services; and (2) covered participants may elect to designate an obstetrical or gynecological care provider under the TRICARE program as an additional designated primary care manager under such section. (b) Duration The Secretary shall carry out the pilot program for a period of five years. (c) Report Not later than four years after the date of the enactment of this Act, the Secretary shall submit to the congressional defense committees a report on the pilot program that includes the following: (1) An assessment of any increases or decreases to TRICARE Prime enrollment during the period in which the Secretary carries out the pilot program. (2) An assessment of any changes in the associated costs of providing obstetrical and gynecological care under TRICARE Prime. (3) Any other matters the Secretary determines appropriate. (d) Definitions In this section: (1) The term congressional defense committees has the meaning given that term in section 101(a)(16) of title 10, United States Code. (2) The term covered participant means a female beneficiary enrolled in TRICARE Prime who elects to participate in the pilot program. (3) The terms TRICARE Prime and TRICARE program have the meaning given those terms in section 1072 of title 10, United States Code.
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